1
|
Sun C, Zhang WS, Jiang CQ, Jin YL, Au Yeung SL, Woo J, Cheng KK, Lam TH, Xu L. Association of Cantonese dietary patterns with mortality risk in older Chinese: a 16-year follow-up of a Guangzhou Biobank cohort study. Food Funct 2024; 15:4538-4551. [PMID: 38578200 DOI: 10.1039/d3fo03766e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Background: Evidence about the associations between Cantonese dietary patterns and mortality is scarce. We examined the prospective association of the dietary pattern with all-cause, cancer and cardiovascular disease (CVD) mortality in older Chinese. Methods: We included 19 598 participants of a Guangzhou Biobank cohort study aged 50+ years, who were recruited from 2003 to 2006 and followed up until July, 2022. The diet was assessed by using a 300-item validated food frequency questionnaire. The food items were collapsed into 27 food groups. Factor analysis (FA) was used to identify dietary patterns. Multivariable Cox regression produced hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Results: During 305 410 person-years, 4966 deaths including 1971 CVD, 1565 cancer and 1436 other-causes occurred. Four dietary patterns were identified by FA. No association of the vegetable-based dietary pattern with all-cause, CVD and cancer mortality was found. Compared with the lowest quartile of the healthy Cantonese dietary pattern score, the highest quartile showed lower risks of all-cause (HR 0.86, 95% CI 0.80-0.94) and CVD mortality (HR 0.84, 95% CI 0.72-0.97). The highest quartile of the nut and fruit dietary pattern showed lower risks of all-cause (HR 0.92, 95% CI 0.85-0.99) and CVD mortality (HR 0.82, 95% CI 0.72-0.93), while the unhealthy western dietary pattern was associated with a higher risk of all-cause (HR 1.10, 95% CI 1.01-1.19) and cerebrovascular disease mortality (HR 1.28, 95% CI 1.03-1.58). Conclusion: We have first identified four dietary patterns based on the Cantonese cuisine and found that healthy Cantonese and nut and fruit dietary patterns were associated with lower risks of all-cause and CVD mortality, whereas the unhealthy western dietary pattern was associated with a higher risk of all-cause and cerebrovascular disease mortality.
Collapse
Affiliation(s)
- Ce Sun
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
- Great Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Wei Sen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
- Great Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Chao Qiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
- Great Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Ya Li Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - Shiu Lun Au Yeung
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Great Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Great Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
- Great Bay Area Public Health Research Collaboration, Guangzhou, China
| |
Collapse
|
2
|
Zheng J, Zhu T, Li F, Wu H, Jiang S, Shivappa N, Hébert JR, Li X, Li Y, Wang H. Diet Quality and Mortality among Chinese Adults: Findings from the China Health and Nutrition Survey. Nutrients 2023; 16:94. [PMID: 38201925 PMCID: PMC10780502 DOI: 10.3390/nu16010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The association between diet quality and all-cause mortality in Chinese population is unclear. We aimed to study the associations of three a priori diet quality indices-including the Diet Quality Index-International (DQI-I), Chinese Healthy Eating Index (CHEI), and energy-adjusted Dietary Inflammatory Index (E-DII)-and their included components with all-cause mortality. We used baseline data from the 2004, 2006, 2009, and 2011 waves of the China Health and Nutrition Survey (CHNS). We used a multivariable-adjusted Cox model to examine the associations between DQI-I, CHEI, and E-DII with all-cause mortality. During a mean of 7 years of follow-up, a total of 461 deaths occurred among 12,914 participants. For DQI-I, there were significant inverse associations with mortality for the variety score (HRQ4 vs. Q1 = 0.69, 95%CI = 0.52-0.92) and overall balance score (HR>0 vs. 0 = 0.81, 95%CI = 0.66-0.91). The adequacy score of CHEI was associated with 40% less risk of all-cause mortality (HRQ4 vs. Q1 = 0.60, 95%CI = 0.43-0.84). E-DII was not associated with mortality. An estimated 20.1%, 13.9%, and 31.3% of total mortality would be averted if the DQI-I variety score, DQI-I overall balance score, and CHEI adequacy score improved from the bottom to the top quartile, respectively. Improving diet quality, especially improving diet variety and adequacy, and having a more balanced diet may reduce all-cause mortality in Chinese adults.
Collapse
Affiliation(s)
- Jiali Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Tianren Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Fangyu Li
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Han Wu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China;
| | - Shuo Jiang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Xiaoguang Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| |
Collapse
|
3
|
Lim JJ, Lim YYE, Ng JY, Malipeddi P, Ng YT, Teo WY, Wong QYA, Matta SA, Sio YY, Wong YR, Teh KF, Rawanan Shah SM, Reginald K, Say YH, Liu MH, Chew FT. Burgers, Fast Foods, and Increased Associated Risk for Atopic Dermatitis: A Cross-Sectional Study of Dietary Habits among Young Chinese Adults in Singapore/Malaysia. Dermatology 2023; 240:77-84. [PMID: 37666213 DOI: 10.1159/000533942] [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: 05/26/2022] [Accepted: 08/29/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND We see increasing evidence that dietary and nutrients factors play a pivotal role in allergic diseases and recent global findings suggest that dietary habits influence the pathogenesis of atopic dermatitis (AD). Frequent consumption of fast food diets is associated with AD development. Despite the rising prevalence of AD in Asia, efforts in investigating the role of dietary habits and AD in adults are still lacking. METHODS We evaluated the association between the dietary intake of 16 food types and AD manifestations using our Singapore/Malaysia Cross-sectional Genetics Epidemiology Study (SMCGES) population. Dietary habits profiles of 11,494 young Chinese adults (1,550 AD cases/2,978 non-atopic controls/6,386 atopic controls) were assessed by an investigator-administered questionnaire. AD cases were further evaluated for their chronicity (550 chronic) and severity (628 moderate-to-severe). Additionally, we derived a novel food index, Quality of Diet based on Glycaemic Index Score (QDGIS), to examine the association between dietary intake of glycaemic index (GI) and various AD phenotypes. RESULTS The majority of AD subjects are distributed in the good (37.1%) and moderate (36.2%) QDGIS classes. From the multivariable analyses for age and gender, a moderate QDGIS class was significantly associated with a lower odds of AD (adjusted odds ratio (AOR): 0.844; 95% confidence interval (CI): 0.719-0.991; p < 0.05) and moderate-to-severe AD (AOR: 0.839; 95% CI: 0.714-0.985; p < 0.05). A good QDGIS class was only significantly associated with a lower odds of chronic AD (AOR: 0.769; 95% CI: 0.606-0.976; p < 0.05). Among high GI foods, frequent consumption of burgers/fast food was strongly associated with an increased risk of chronic and moderate-to-severe AD. Among low GI foods, increased intake frequencies of fruits, vegetables, and pulses decreased the odds of AD. Finally, we identified significant associations between frequent seafood, margarine, butter, and pasta consumption with an increased odds of AD despite them having little GI values. CONCLUSION While genetic components are well-established in their risks associated with increased AD prevalence, there is still a lack of a focus epidemiology study associating dietary influence with AD. Based on the first allergic epidemiology study conducted here in Singapore and Malaysia, it laid the groundwork to guide potential dietary interventions from changing personal dietary habits.
Collapse
Affiliation(s)
- Jun Jie Lim
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore,
| | - Yi Ying Eliza Lim
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Jun Yan Ng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Praneeth Malipeddi
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Yu Ting Ng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Wei Yi Teo
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Qi Yi Ambrose Wong
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Sri Anusha Matta
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Yang Yie Sio
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Yi Ru Wong
- Department of Biological Sciences, School of Medicine and Life Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Keng Foo Teh
- Department of Biological Sciences, School of Medicine and Life Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Smyrna Moti Rawanan Shah
- Department of Biological Sciences, School of Medicine and Life Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Kavita Reginald
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
- Department of Biological Sciences, School of Medicine and Life Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Yee-How Say
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
- Department of Biological Sciences, School of Medicine and Life Sciences, Sunway University, Petaling Jaya, Malaysia
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR), Kampar, Malaysia
| | - Mei Hui Liu
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| |
Collapse
|
4
|
Sun D, Liu C, Zhu Y, Yu C, Guo Y, Sun D, Pang Y, Pei P, Du H, Yang L, Chen Y, Meng X, Liu Y, Zhang J, Schmidt D, Avery D, Chen J, Chen Z, Lv J, Kan H, Li L. Long-Term Exposure to Fine Particulate Matter and Incidence of Esophageal Cancer: A Prospective Study of 0.5 Million Chinese Adults. Gastroenterology 2023; 165:61-70.e5. [PMID: 37059339 PMCID: PMC7615725 DOI: 10.1053/j.gastro.2023.03.233] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND & AIMS Evidence is sparse and inconclusive on the association between long-term fine (≤2.5 μm) particulate matter (PM2.5) exposure and esophageal cancer. We aimed to assess the association of PM2.5 with esophageal cancer risk and compared the esophageal cancer risk attributable to PM2.5 exposure and other established risk factors. METHODS This study included 510,125 participants without esophageal cancer at baseline from China Kadoorie Biobank. A high-resolution (1 × 1 km) satellite-based model was used to estimate PM2.5 exposure during the study period. Hazard ratios (HR) and 95% CIs of PM2.5 with esophageal cancer incidence were estimated using Cox proportional hazard model. Population attributable fractions for PM2.5 and other established risk factors were estimated. RESULTS There was a linear concentration-response relationship between long-term PM2.5 exposure and esophageal cancer. For each 10-μg/m3 increase in PM2.5, the HR was 1.16 (95% CI, 1.04-1.30) for esophageal cancer incidence. Compared with the first quarter of PM2.5 exposure, participants in the highest quarter had a 1.32-fold higher risk for esophageal cancer, with an HR of 1.32 (95% CI, 1.01-1.72). The population attributable risk because of annual average PM2.5 concentration ≥35 μg/m3 was 23.3% (95% CI, 6.6%-40.0%), higher than the risks attributable to lifestyle risk factors. CONCLUSIONS This large prospective cohort study of Chinese adults found that long-term exposure to PM2.5 was associated with an elevated risk of esophageal cancer. With stringent air pollution mitigation measures in China, a large reduction in the esophageal cancer disease burden can be expected.
Collapse
Affiliation(s)
- Dong Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Cong Liu
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education, National Health Commission Key Laboratory of Health Technology Assessment, Integrated Research on Disaster Risk, International Centers of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yunqing Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Yu Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Xia Meng
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education, National Health Commission Key Laboratory of Health Technology Assessment, Integrated Research on Disaster Risk, International Centers of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Dan Schmidt
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Daniel Avery
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
| | - Haidong Kan
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education, National Health Commission Key Laboratory of Health Technology Assessment, Integrated Research on Disaster Risk, International Centers of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
| |
Collapse
|
5
|
Pan L, Shi K, Lv J, Pang Y, Guo Y, Pei P, Du H, Millwood I, Yang L, Chen Y, Gao R, Yang X, Avery D, Chen J, Yu C, Chen Z, Li L. Association of dietary patterns, circulating lipid profile, and risk of obesity. Obesity (Silver Spring) 2023; 31:1445-1454. [PMID: 37037666 DOI: 10.1002/oby.23720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/08/2022] [Accepted: 01/01/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE The aim of this study was to simultaneously explore the associations of major dietary patterns (DP) with lipid profiles and the associations of these profiles with general and central obesity risks and to evaluate the extent to which the metabolites mediate such associations. METHODS Habitual food consumption of 4778 participants with an average age of 47.0 from the China Kadoorie Biobank was collected using a 12-item food frequency questionnaire. Plasma samples were analyzed via targeted nuclear magnetic resonance (NMR) spectroscopy to quantify 129 lipid-related metabolites. Anthropometric information was measured by trained staff. RESULTS Two DPs were derived by factor analysis. The newly affluent southern pattern was characterized by high intakes of rice, meat, poultry, and fish, whereas the balanced pattern was characterized by consuming meat, poultry, fish, fresh fruit, fresh vegetables, dairy, eggs, and soybean. The newly affluent southern pattern was positively associated with 45 metabolites, which were positively associated with risks of obesity at the same time. The global lipid profile potentially explained 30.9%, 34.7%, and 53.1% of the effects of this DP on general obesity, waist circumference-defined central obesity, and waist-hip ratio-defined central obesity, respectively. CONCLUSIONS The newly affluent southern pattern points to an altered lipid profile, which showed higher general and central obesity risks. These findings partly suggest the biological mechanism for the obesogenic effects of this DP.
Collapse
Affiliation(s)
- Lang Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Kexiang Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yu Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ruqin Gao
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xiaoming Yang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Daniel Avery
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| |
Collapse
|
6
|
Lee YQ, Whitton C, Neelakantan N, van Dam RM, Chong MFF. Dietary patterns and predicted 10-year cardiovascular disease risk in a multiethnic Asian population. Nutr Metab Cardiovasc Dis 2022; 32:2093-2104. [PMID: 35843801 DOI: 10.1016/j.numecd.2022.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS Studies examining associations between dietary patterns and Framingham risk score (FRS) and predicted 10-year cardiovascular diseases (CVD) risk in an Asian population are lacking. This study aimed to identify a posteriori dietary patterns across three major ethnic groups in Singapore and ascertain their associations with locally modified FRS and predicted 10-year CVD risk. METHODS AND RESULTS This cross-sectional study included 8594 Singapore residents (aged 21-75 years) from the Singapore Multi-Ethnic Cohort. Data on sociodemographic and lifestyle factors were collected via questionnaires. Food consumption was assessed using a validated Food Frequency Questionnaire. Dietary patterns were identified using principal component analysis and associations with CVD risk factors, FRS and predicted CVD risk (%) were analysed using multiple linear and logistic regression. Four dietary patterns emerged that explained 25.6% of variance. The 'processed food and sugar-sweetened beverages' pattern was significantly associated with higher FRS (β: 0.13; 95% CI: 0.04, 0.23), while the 'ethnic breads, legumes and nuts' (β: 0.13; 95% CI: 0.22, -0.04) and 'whole grains, fruit and dairy' (β: 0.17; 95% CI: 0.24, -0.10) patterns were significantly associated with lower FRS. The 'meat and vegetables' pattern was not significantly associated with FRS. Increased adherence to the 'whole grains, fruit and dairy' pattern was associated with lower odds of having predicted CVD risk of ≥10% (p-trend: 0.03). CONCLUSION Adherence to the 'ethnic breads, legumes and nuts' and 'whole grains, fruit and dairy' patterns was associated with a lower predicted CVD risk, and an inverse association for the 'processed food and sugar-sweetened beverages' pattern in an Asian population. These findings can inform the development of culturally sensitive dietary interventions to prevent CVD.
Collapse
Affiliation(s)
- Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore, 117549, Singapore.
| | - Clare Whitton
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, 6102, Australia
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore, 117549, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, 117549, Singapore; Department of Nutrition and Exercise Sciences and Epidemiology, Milken Institute School of Public Health, George Washington University, Washington DC, 20052, USA
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, 117549, Singapore; Singapore Institute for Clinical Sciences (SICS), Brenner Centre for Molecular Medicine, Agency for Science, Technology, and Research (A∗STAR), 117609, Singapore
| |
Collapse
|
7
|
Tan YWB, Lau JH, AshaRani PV, Roystonn K, Devi F, Lee YY, Whitton C, Wang P, Shafie S, Chang S, Jeyagurunathan A, Chua BY, Abdin E, Sum CF, Lee ES, Subramaniam M. Dietary patterns of persons with chronic conditions within a multi-ethnic population: results from the nationwide Knowledge, Attitudes and Practices survey on diabetes in Singapore. Arch Public Health 2022; 80:62. [PMID: 35189947 PMCID: PMC8862351 DOI: 10.1186/s13690-022-00817-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Chronic conditions are a leading cause of death and disability worldwide and respective data on dietary patterns remain scant. The present study aimed to investigate dietary patterns and identify sociodemographic factors associated with Dietary Approaches to Stop Hypertension (DASH) scores within a multi-ethnic population with various chronic conditions. Methods The present study utilised data from the 2019-2020 Knowledge, Attitudes, and Practices study on diabetes in Singapore – a nationwide survey conducted to track the knowledge, attitudes, and practices pertaining to diabetes. The study analysed data collected from a sample of 2,895 Singapore residents, with information from the sociodemographic section, DASH diet screener, and the modified version of the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 checklist of chronic physical conditions. Results Respondents with no chronic condition had a mean DASH score of 18.5 (±4.6), those with one chronic condition had a mean DASH score of 19.2 (±4.8), and those with two or more chronic conditions had a mean DASH score of 19.8 (±5.2). Overall, the older age groups [35– 49 years (B = 1.78, 95% CI: 1.23 – 2.33, p <0.001), 50–64 years (B = 2.86, 95% CI: 22.24 – 3.47, p <0.001) and 65 years and above (B = 3.45, 95% CI: 2.73 – 4.17, p <0.001)], Indians (B = 2.54, 95% CI: 2.09 – 2.98, p <0.001) reported better diet quality, while males (B = -1.50, 95% CI: -1.87 – -1.14, p <0.001) reported poorer diet quality versus females. Conclusion Overall, respondents with two or more chronic conditions reported better quality of diet while the sociodemographic factors of age, gender and ethnicity demonstrated a consistent pattern in correlating with diet quality, consistent with the extant literature. Results provide further insights for policymakers to refine ongoing efforts in relation to healthy dietary practices for Singapore.
Collapse
Affiliation(s)
- Yeow Wee Brian Tan
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore.
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - P V AshaRani
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Clare Whitton
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Western Australia, 6102, Bentley, Australia
| | - Peizhi Wang
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, Singapore, Singapore
| | - Eng Sing Lee
- National Healthcare Group Polyclinics, Fusionopolis Link. Nexus@One-North, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| |
Collapse
|
8
|
Qin C, Lv J, Yu C, Guo Y, Bian Z, Gao M, Du H, Yang L, Chen Y, Shen L, Zhou S, Chen J, Chen Z, Li L. Dietary patterns and cardiometabolic diseases in 0.5 million Chinese adults: a 10-year cohort study. Nutr J 2021; 20:74. [PMID: 34479555 PMCID: PMC8418004 DOI: 10.1186/s12937-021-00730-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The effect of the overall diet quality on cardiometabolic diseases has been well studied in the Western population. However, evidence is still in need regarding dietary patterns depicting unique Chinese dietary habits and their associations with cardiometabolic diseases. METHODS A prospective cohort recruited around 0.5 million Chinese residents aged 30-79 years from 10 diverse survey sites during 2004-08. Dietary patterns were obtained using factor analysis based on the habitual consumption of 12 food groups collected at baseline. Among 477,465 eligible participants free of prior heart disease, stroke and cancer, linkages to multiple registries and health insurance database recorded 137,715 cardiovascular diseases (CVD) and 17,412 diabetes cases (among 451,846 non-diabetic participants) until 31 December 2017. Adjusted hazard ratios (HRs) were estimated to compare the risks of cardiometabolic diseases across quintiles of dietary pattern scores using the Cox regression. RESULTS Two dietary patterns were derived: the traditional northern pattern, characterised by wheat, other staples, egg and dairy products; and the modern pattern, featured with fresh fruit, meat, poultry, fish, dairy products and soybean. Adherence to either dietary pattern was associated with lower risks of major cardiometabolic diseases in a dose-response relationship way. After multivariate adjustment, participants adhering to the traditional northern pattern the most had an 8% (95%CI: 5-11%) lower risk of CVD in comparison with those adhering the least. Corresponding risk reductions were 12% (11-32%) for haemorrhagic stroke (HS), 14% (8-19%) for ischaemic stroke (IS), and 15% (6-24%) for diabetes, respectively. When comparing extreme quintiles of the modern pattern, the adjusted HR of HS was 0.67 (95%CI: 0.59-0.77). Corresponding HRs were 0.89 (0.86-0.92) for CVD, 0.88 (0.77-0.99) for MCE, 0.85 (0.80-0.89) for IS, and 0.89 (0.81, 0.97) for diabetes. CONCLUSION Among Chinese adults, both traditional northern and modern dietary patterns were associated with lower risks of cardiovascular disease and diabetes beyond other risk factors.
Collapse
Affiliation(s)
- Chenxi Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Peking University Institute of Environmental Medicine, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Meng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Huaidong Du
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
| | - Ling Yang
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
| | - Yiping Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
| | - Leijia Shen
- The Second hospital of Tongxiang, Tongxiang, Zhejiang Province, China
| | - Songgen Zhou
- Wuzhen Town Health Centres, Tongxiang, Zhejiang Province, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.
| |
Collapse
|
9
|
English LK, Ard JD, Bailey RL, Bates M, Bazzano LA, Boushey CJ, Brown C, Butera G, Callahan EH, de Jesus J, Mattes RD, Mayer-Davis EJ, Novotny R, Obbagy JE, Rahavi EB, Sabate J, Snetselaar LG, Stoody EE, Van Horn LV, Venkatramanan S, Heymsfield SB. Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review. JAMA Netw Open 2021; 4:e2122277. [PMID: 34463743 PMCID: PMC8408672 DOI: 10.1001/jamanetworkopen.2021.22277] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022] Open
Abstract
Importance The 2020 Dietary Guidelines Advisory Committee conducted a systematic review of existing research on diet and health to inform the current Dietary Guidelines for Americans. The committee answered this public health question: what is the association between dietary patterns consumed and all-cause mortality (ACM)? Objective To ascertain the association between dietary patterns consumed and ACM. Evidence Review Guided by an analytical framework and predefined inclusion and exclusion criteria developed by the committee, the US Department of Agriculture's Nutrition Evidence Systematic Review (NESR) team searched PubMed, the Cochrane Central Register of Controlled Trials, and Embase and dual-screened the results to identify articles that were published between January 1, 2000, and October 4, 2019. These studies evaluated dietary patterns and ACM in participants aged 2 years and older. The NESR team extracted data from and assessed risk of bias in included studies. Committee members synthesized the evidence, developed conclusion statements, and graded the strength of the evidence supporting the conclusion statements. Findings A total of 1 randomized clinical trial and 152 observational studies were included in the review. Studies enrolled adults and older adults (aged 17-84 years at baseline) from 28 countries with high or very high Human Development Index; 53 studies originated from the US. Most studies were well designed, used rigorous methods, and had low or moderate risks of bias. Precision, directness, and generalizability were demonstrated across the body of evidence. Results across studies were highly consistent. Evidence suggested that dietary patterns in adults and older adults that involved higher consumption of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish, and lean meat or poultry (when meat was included) were associated with a decreased risk of ACM. These healthy patterns were also relatively low in red and processed meat, high-fat dairy, and refined carbohydrates or sweets. Some of these dietary patterns also included intake of alcoholic beverages in moderation. Results based on additional analyses with confounding factors generally confirmed the robustness of main findings. Conclusions and Relevance In this systematic review, consuming a nutrient-dense dietary pattern was associated with reduced risk of death from all causes.
Collapse
Affiliation(s)
- Laural K. English
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Jamy D. Ard
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Regan L. Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Marlana Bates
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Lydia A. Bazzano
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Carol J. Boushey
- Epidemiology Program, University of Hawai’i Cancer Center, Honolulu
| | | | - Gisela Butera
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Emily H. Callahan
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, US Department of Health and Human Services, Washington, DC
| | - Richard D. Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Elizabeth J. Mayer-Davis
- Departments of Nutrition and Medicine, The University of North Carolina at Chapel Hill, Chapel Hill
| | - Rachel Novotny
- Nutritional Sciences, Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai’i at Mānoa, Honolulu
| | - Julie E. Obbagy
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
| | | | - Joan Sabate
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California
| | | | | | - Linda V. Van Horn
- Nutrition Division, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sudha Venkatramanan
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge
| |
Collapse
|
10
|
Does diet map with mortality? Ecological association of dietary patterns with chronic disease mortality and its spatial dependence in Switzerland. Br J Nutr 2021; 127:1037-1049. [PMID: 33971997 PMCID: PMC8924527 DOI: 10.1017/s0007114521001525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We investigated the associations between dietary patterns and chronic disease mortality in Switzerland using an ecological design and explored their spatial dependence, i.e. the tendency of near locations to present more similar and distant locations to present more different values than randomly expected. Data of the National Nutrition Survey menuCH (n 2057) were used to compute hypothesis- (Alternate Healthy Eating Index (AHEI)) and data-driven dietary patterns. District-level standardised mortality ratios (SMR) were calculated using the Swiss Federal Statistical Office mortality data and linked to dietary data geographically. Quasipoisson regression models were fitted to investigate the associations between dietary patterns and chronic disease mortality; Moran’s I statistics were used to explore spatial dependence. Compared with the first, the fifth AHEI quintile (highest diet quality) was associated with district-level SMR of 0·95 (95 % CI 0·93, 0·97) for CVD, 0·91 (95 % CI 0·88, 0·95) for ischaemic heart disease (IHD), 0·97 (95 % CI 0·95, 0·99) for stroke, 0·99 (95 % CI 0·98, 1·00) for all-cancer, 0·98 (95 % CI 0·96, 0·99) for colorectal cancer and 0·93 (95 % CI 0·89, 0·96) for diabetes. The Swiss traditional and Western-like patterns were associated with significantly higher district-level SMR for CVD, IHD, stroke and diabetes (ranging from 1·02 to 1·08) compared with the Prudent pattern. Significant global and local spatial dependence was identified, with similar results across hypothesis- and data-driven dietary patterns. Our study suggests that dietary patterns partly contribute to the explanation of geographic disparities in chronic disease mortality in Switzerland. Further analyses including spatial components in regression models would allow identifying regions where nutritional interventions are particularly needed.
Collapse
|
11
|
Chuang SY, Chang HY, Fang HL, Lee SC, Hsu YY, Yeh WT, Liu WL, Pan WH. The Healthy Taiwanese Eating Approach is inversely associated with all-cause and cause-specific mortality: A prospective study on the Nutrition and Health Survey in Taiwan, 1993-1996. PLoS One 2021; 16:e0251189. [PMID: 33956833 PMCID: PMC8101962 DOI: 10.1371/journal.pone.0251189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Few longitudinal studies have investigated the association between foods/dietary pattern and mortality risk in the Asian population. We investigated the prospective association between foods/dietary pattern and risk of death among ethnic Chinese adults in Taiwan. Methods The study population included 2475 young and middle-aged adults (aged 18–65 years at baseline) who completed the questionnaires and physical examinations in the Nutrition and Health Survey in Taiwan from 1993 to 1996. A food frequency questionnaire was administered to assess food consumption habits in a face-to-face interview. With survey data linked to the Taiwanese Death Registry, Cox proportional hazard model was used to identify the foods associated with all-cause mortality(followed until 2012), which were then tallied to calculate a dietary pattern score called Taiwanese Eating Approach(TEA) score. The TEA scores were then associated with various kinds of mortality outcomes. In addition, data from 431 elders (aged≥65 yrs) with 288 death endpoints were used to conduct a sensitivity analysis. Results A total of 385(15.6%) participants died (111 cardiovascular related deaths and 122 cancer related deaths) during the 17.8-year follow-up period(41274 person-years). Twelve foods (9 inverse [vegetables/fish/milk/tea](+1) and 3 positive[fatty meats/fermented vegetables/sweet drinks](-1)) were significantly associated with all-cause mortality risk. All adults were grouped by their cumulative food score into three diet groups: poor diet(29.3% of all subjects), average diet(44.0%), and healthy diet(26.70%). The better the diet, the lower the total, cardiovascular, and other cause mortality outcomes (trend-p < .001). The hazard ratio for the healthy diet was 0.64 (95% confidence interval:0.47–0.87) for total mortality, and 0.52(0.28–0.95) for cardiovascular death, compared with the poor diet in the multivariable models. This phenomenon was also seen in older adults for all-cause, cancer, and other cause mortalities. Conclusion Consuming a healthy Taiwanese Eating Approach (TEA) diet is negatively associated with all-cause, cardiovascular, and other-cause mortalities in Taiwan.
Collapse
Affiliation(s)
- Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
- * E-mail: (SYC); (WHP)
| | - Hsing-Yi Chang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan, R.O.C
| | - Hsin-Ling Fang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
| | - Shu-Chen Lee
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, R.O.C
| | - Yueh-Ying Hsu
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
| | - Wen-Ting Yeh
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, R.O.C
| | - Wen-Ling Liu
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
| | - Wen-Harn Pan
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, R.O.C
- * E-mail: (SYC); (WHP)
| |
Collapse
|
12
|
Choy MJY, Brownlee I, Murphy AM. Data-Driven Dietary Patterns, Nutrient Intake and Body Weight Status in a Cross-Section of Singaporean Children Aged 6-12 Years. Nutrients 2021; 13:nu13041335. [PMID: 33920618 PMCID: PMC8074157 DOI: 10.3390/nu13041335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 12/19/2022] Open
Abstract
Pattern analysis of children’s diet may provide insights into chronic disease risk in adolescence and adulthood. This study aimed to assess dietary patterns of young Singaporean children using cluster analysis. An existing dataset included 15,820 items consumed by 561 participants (aged 6–12 years) over 2 days of dietary recall. Thirty-seven food groups were defined and expressed as a percentage contribution of total energy. Dietary patterns were identified using k-means cluster analysis. Three clusters were identified, “Western”, “Convenience” and “Local/hawker”, none of which were defined by more prudent dietary choices. The “Convenience” cluster group had the lowest total energy intake (mean 85.8 ± SD 25.3% of Average Requirement for Energy) compared to the other groups (95.4 ± 25.9% for “Western” and 93.4 ± 25.3% for “Local/hawker”, p < 0.001) but also had the lowest calcium intake (66.3 ± 34.7% of Recommended Dietary Allowance), similar to intake in the “Local/hawker” group (69.5 ± 38.9%) but less than the “Western” group (82.8 ± 36.1%, p < 0.001). These findings highlight the need for longitudinal analysis of dietary habit in younger Singaporeans in order to better define public health messaging targeted at reducing risk of major noncommunicable disease.
Collapse
Affiliation(s)
- Michelle Jie Ying Choy
- Devan Nair Building, Newcastle Research and Innovation Institute, Newcastle University, Singapore 600201, Singapore; (M.J.Y.C.); (A.M.M.)
| | - Iain Brownlee
- Devan Nair Building, Newcastle Research and Innovation Institute, Newcastle University, Singapore 600201, Singapore; (M.J.Y.C.); (A.M.M.)
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
- Correspondence: ; Tel.: +44-191-227-4187
| | - Aoife Marie Murphy
- Devan Nair Building, Newcastle Research and Innovation Institute, Newcastle University, Singapore 600201, Singapore; (M.J.Y.C.); (A.M.M.)
| |
Collapse
|
13
|
Ru Y, Wang N, Min Y, Wang X, McGurie V, Duan M, Xu X, Zhao X, Wu YH, Lu Y, Hsing AW, Zhu S. Characterization of dietary patterns and assessment of their relationships with metabolomic profiles: A community-based study. Clin Nutr 2020; 40:3531-3541. [PMID: 33349486 DOI: 10.1016/j.clnu.2020.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND & AIMS Determining dietary patterns in China is challenging due to lack of external validation and objective measurements. We aimed to characterize dietary patterns in a community-based population and to validate these patterns using external validation cohort and metabolomic profiles. DESIGN We studied 5145 participants, aged 18-80 years, from two districts of Hangzhou, China. We used one district as the discovery cohort (N = 2521) and the other as the external validation cohort (N = 2624). We identified dietary patterns using a k-means clustering. Associations between dietary patterns and metabolic conditions were analyzed using adjusted logistic models. We assessed relationships between metabolomic profile and dietary patterns in 214 participants with metabolomics data. RESULTS We identified three dietary patterns: the traditional (rice-based), the mixed (rich in dairy products, eggs, nuts, etc.), and the high-alcohol diets. Relative to the traditional diet, the mixed (ORadj = 1.7, CI 1.3-2.4) and the high-alcohol diets (ORadj = 1.9, CI 1.3-2.7) were associated with type 2 diabetes and hypertension, respectively. Similar results were confirmed in the external validation cohort. In addition, we also identified 18 and 22 metabolites that could distinguish the mixed (error rate = 12%; AUC = 96%) and traditional diets (error rate = 19%; AUC = 88%) from the high-alcohol diet. CONCLUSIONS Despite the complexity of Chinese diet, identifying dietary patterns helps distinguish groups of individuals with high risk of metabolic diseases, which can also be validated by external population and metabolomic profiles.
Collapse
Affiliation(s)
- Yuan Ru
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Ninglin Wang
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Yan Min
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, 94305, USA; Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, 94305, USA
| | - Xuemiao Wang
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Valerie McGurie
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Meng Duan
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Xiaochen Xu
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Xueyin Zhao
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Yi-Hsuan Wu
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Ying Lu
- Department of Biomedical Data Sciences, Stanford School of Medicine, Stanford University, Stanford, CA, 94305, USA; Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Ann W Hsing
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, 94305, USA; Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, 94305, USA; Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA, 94305, USA.
| | - Shankuan Zhu
- Chronic Disease Research Institute, The Children's Hospital, National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, China.
| |
Collapse
|
14
|
Xu Y, Zhu S, Zhou Y, Pramono A, Zhou Z. Changing Income-Related Inequality in Daily Nutrients Intake: A Longitudinal Analysis from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207627. [PMID: 33086763 PMCID: PMC7588920 DOI: 10.3390/ijerph17207627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022]
Abstract
Because of economic reform, dietary pattern in China changed rapidly during the past two decades. Meanwhile, the changes of income and nutrients intake had the same trend. This study aims to measure the income-related inequality in daily nutrients intake and its health-related income mobility over time. Data was sourced from four waves of China Health and Nutrition Survey. Concentration indexes and health-related income mobility indexes were employed to measure the income-related inequality of nutrients intake and its change over time. This study found that the daily protein intake, daily fat intake, daily energy intake, and proportion of energy from fat over 30% were more concentrated on the rich, whereas daily carbohydrates intake among the poor. The income-related inequalities were more severe than the cross-sectional perspective in the long run. The dynamic change of urbanisation indexes has resulted that over 30% of energy from fat was more concentrated among the rich and carbohydrates intake among the poor. The nutrition transition may bring about more severe disease economic burden to the poor in the future. This study recommends an approach to minimize gaps between rural and city areas by promoting rural revitalization to reduce the income-related inequality in daily nutrient intake.
Collapse
Affiliation(s)
- Yongjian Xu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China; (S.Z.); (Y.Z.); (Z.Z.)
- Correspondence:
| | - Siyu Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China; (S.Z.); (Y.Z.); (Z.Z.)
| | - Yiting Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China; (S.Z.); (Y.Z.); (Z.Z.)
| | - Andi Pramono
- Community and Aged Care Services, Hunter New England Health, Wallsend 2287, NSW, Australia;
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China; (S.Z.); (Y.Z.); (Z.Z.)
| |
Collapse
|
15
|
Balasubramanian GV, Chuah KA, Khor BH, Sualeheen A, Yeak ZW, Chinna K, Sundram K, Karupaiah T. Associations of Eating Mode Defined by Dietary Patterns with Cardiometabolic Risk Factors in the Malaysia Lipid Study Population. Nutrients 2020; 12:nu12072080. [PMID: 32674327 PMCID: PMC7400910 DOI: 10.3390/nu12072080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Cardiometabolic risk is scarcely explored related to dietary patterns (DPs) in Asian populations. Dietary data (n = 562) from the cross-sectional Malaysia Lipid Study were used to derive DPs through principal component analysis. Associations of DPs were examined with metabolic syndrome (MetS), atherogenic, inflammation and insulinemic status. Four DPs with distinctive eating modes were Home meal (HM), Chinese traditional (CT), Plant foods (PF) and Sugar-sweetened beverages (SSB). Within DP tertiles (T3 vs. T1), the significantly lowest risk was associated with CT for hsCRP (AOR = 0.44, 95% CI 0.28, 0.70, p < 0.001) levels. However, SSB was associated with the significantly highest risks for BMI (AOR = 2.01, 95% CI 1.28, 3.17, p = 0.003), waist circumference (AOR = 1.81, 95% CI 1.14, 2.87, p = 0.013), small LDL-C particles (AOR= 1.69, 95% CI 1.02, 2.79, p = 0.043), HOMA2-IR (AOR = 2.63, 95% CI 1.25, 5.57, p = 0.011), hsCRP (AOR = 2.21, 95% CI 1.40, 3.50, p = 0.001), and MetS (AOR = 2.78, 95% CI 1.49, 5.22, p = 0.001). Adherence behaviors to SSBs (T3) included consuming coffee/tea with condensed milk (29%) or plain with sugar (20.7%) and eating out (12 ± 8 times/week, p < 0.001). Overall, the SSB pattern with a highest frequency of eating out was detrimentally associated with cardiometabolic risks.
Collapse
Affiliation(s)
- Gaiyal Viliy Balasubramanian
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (G.V.B.); (A.S.)
| | - Khun-Aik Chuah
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (K.-A.C.); (Z.-W.Y.)
| | - Ban-Hock Khor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia;
| | - Ayesha Sualeheen
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (G.V.B.); (A.S.)
| | - Zu-Wei Yeak
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (K.-A.C.); (Z.-W.Y.)
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia;
| | - Kalyana Sundram
- Malaysian Palm Oil Council, Menara Axis, Petaling Jaya, Selangor 46100, Malaysia;
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor 47500, Malaysia
- Correspondence: ; Tel.: +60-192-731-400
| |
Collapse
|
16
|
Sualeheen A, Khor BH, Balasubramanian GV, Sahathevan S, Ali MSM, Narayanan SS, Chinna K, Daud ZAM, Khosla P, Gafor AHA, Karupaiah T, Cheak BB, Ahmad G, Goh BL, Lim SK, Visvanathan R, Yahya R, Bavanandan S, Morad Z. Habitual Dietary Patterns of Patients on Hemodialysis Indicate Nutritional Risk. J Ren Nutr 2020; 30:322-332. [DOI: 10.1053/j.jrn.2019.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 09/05/2019] [Accepted: 09/15/2019] [Indexed: 02/07/2023] Open
|
17
|
Sheng LT, Jiang YW, Pan XF, Feng L, Yuan JM, Pan A, Koh WP. Association Between Dietary Intakes of B Vitamins in Midlife and Cognitive Impairment in Late-Life: The Singapore Chinese Health Study. J Gerontol A Biol Sci Med Sci 2020; 75:1222-1227. [PMID: 31094422 PMCID: PMC7243584 DOI: 10.1093/gerona/glz125] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dietary intakes of B vitamins (eg, folate) are related to cognitive function according to epidemiological studies in western countries. But prospective studies in Asian populations are scarce. This study evaluated the relationships of dietary intakes of six B vitamins in midlife with cognitive impairment in old age in a Chinese population living in Singapore. METHODS This study included 16,948 participants from the Singapore Chinese Health Study, a population-based prospective cohort. Baseline dietary intakes of B vitamins were assessed using a validated 165-item food frequency questionnaire when the participants were aged 45-74 years (1993-1998). After an average follow-up of 20 years, cognitive function was examined using a Singapore-modified version of Mini-Mental State Examination scale in 2014-2016, and cognitive impairment was defined using education-specific cutoffs. Logistic regression models were applied to estimate the association between B vitamins and cognitive impairment. All the six B vitamins were mutually adjusted in the final model. RESULTS In the 2014-2016 interview, 2,443 participants were defined as cognitive impairment. Riboflavin and folate were significantly and independently associated with cognitive impairment in a dose-dependent manner: the odds ratio (95% confidence interval) comparing the highest with the lowest quartile was 0.82 (0.69, 0.97) for riboflavin and 0.83 (0.70, 0.98) for folate (both p-trend <.05). Dietary intakes of thiamine, niacin, vitamin B-6, and B-12 were not significantly associated with risk of cognitive impairment. CONCLUSIONS Higher dietary intakes of riboflavin and folate in midlife were associated with a lower risk of cognitive impairment in late-life in the Chinese population.
Collapse
Affiliation(s)
- Li-Ting Sheng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yi-Wen Jiang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| |
Collapse
|
18
|
Orlich MJ, Chiu THT, Dhillon PK, Key TJ, Fraser GE, Shridhar K, Agrawal S, Kinra S. Vegetarian Epidemiology: Review and Discussion of Findings from Geographically Diverse Cohorts. Adv Nutr 2019; 10:S284-S295. [PMID: 31728496 PMCID: PMC6855947 DOI: 10.1093/advances/nmy109] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/26/2018] [Accepted: 11/07/2018] [Indexed: 01/08/2023] Open
Abstract
Epidemiologic cohort studies enrolling a large percentage of vegetarians have been highly informative regarding the nutritional adequacy and possible health effects of vegetarian diets. The 2 largest such cohorts are the European Prospective Investigation into Cancer and Nutrition-Oxford (EPIC-Oxford) and the Adventist Health Study-2 (AHS-2). These cohorts are described and their findings discussed, including a discussion of where findings appear to diverge. Although such studies from North America and the United Kingdom have been important, the large majority of the world's vegetarians live in other regions, particularly in Asia. Findings from recent cohort studies of vegetarians in East and South Asia are reviewed, particularly the Tzu Chi Health Study and Indian Migration Study. Important considerations for the study of the health of vegetarians in Asia are discussed. Vegetarian diets vary substantially, as may associated health outcomes. Cohort studies remain an important tool to better characterize the health of vegetarian populations around the globe.
Collapse
Affiliation(s)
- Michael J Orlich
- Schools of Medicine and Public Health, Loma Linda University, Loma Linda, CA,Address correspondence to MJO (e-mail: )
| | - Tina H T Chiu
- Department of Nutrition Therapy, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan,College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Preet K Dhillon
- Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India, Gurugram, India
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Gary E Fraser
- Schools of Medicine and Public Health, Loma Linda University, Loma Linda, CA
| | - Krithiga Shridhar
- Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India, Gurugram, India
| | - Sutapa Agrawal
- Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India, Gurugram, India
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
19
|
Identification of Dietary Patterns Related to Metabolic Diseases and Their Association with Cardiovascular Disease: From the Korean Genome and Epidemiology Study. Nutrients 2019; 11:nu11102434. [PMID: 31614783 PMCID: PMC6835220 DOI: 10.3390/nu11102434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/02/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022] Open
Abstract
Using data from the community-based cohort of the Korean Genome and Epidemiology Study (KoGES), we evaluated the dietary patterns (DPs) related to metabolic diseases and their associations with the incidence of non-fatal cardiovascular disease (CVD). After excluding those with a history of CVD or cancer, we analyzed the data of 8352 subjects aged 40-69 years. Based on their daily intake of 26 food groups at baseline, the DPs of the subjects with metabolic diseases (n = 1679, 20.1%) were analyzed using principal component analysis. Due to regional differences in the effect of DPs on CVD, we performed analyses stratified by region. The association between DPs and the incidence of non-fatal CVD was evaluated by calculating the hazard ratio (HR) and 95% confidence interval (CI) using the Cox proportional hazards model. During the 12-year follow-up, the incidence of non-fatal CVD was 5.4 per 1000 person-years (n = 431). An animal-based DP made the greatest contribution to the total variance and was characterized by a high intake of pork, beef, chicken, fish, and shellfish. The effect of DP on CVD differed by region (industrial/rural regions, p < 0.05) and was dominant in industrial regions, irrespective of metabolic disease status. In industrial regions, subjects in the top quintile of DP had a 0.42-fold (95% CI = 0.24-0.74) lower risk of incident CVD than those in the bottom quintile, even after adjusting for various covariates. In addition, the risk of CVD was high in individuals with a history of metabolic disease in both regions (HR = 1.74, 95% CI = 1.24-2.43 in industrial regions; HR = 1.88, 95% CI = 1.42-2.48 in rural regions). DP and a history of metabolic diseases, but not their interaction, were independently associated with incident CVD. In our study, an animal-based DP related to metabolic disease was independently associated with incident CVD, and this effect was noticeable only in industrial regions.
Collapse
|
20
|
Nachvak SM, Moradi S, Anjom-Shoae J, Rahmani J, Nasiri M, Maleki V, Sadeghi O. Soy, Soy Isoflavones, and Protein Intake in Relation to Mortality from All Causes, Cancers, and Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. J Acad Nutr Diet 2019; 119:1483-1500.e17. [PMID: 31278047 DOI: 10.1016/j.jand.2019.04.011] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We conducted a systematic review and dose-response meta-analysis of prospective studies to summarize findings on the associations between intakes of soy, soy isoflavones, and soy protein and risk of mortality from all causes, cancers, and cardiovascular diseases. METHODS Online databases were systematically searched to identify relevant articles published earlier than May 2018. We applied restricted cubic splines using random-effects analysis to assess dose-response associations. Between-study heterogeneity was assessed by I2 value and Cochrane Q test. Potential publication bias was assessed by visual inspection of funnel plots and Begg regression test. RESULTS In total, 23 prospective studies with an overall sample size of 330,826 participants were included in the current systematic review and the meta-analysis. Soy/soy products consumption was inversely associated with deaths from cancers (pooled relative risk 0.88, 95% CI 0.79 to 0.99; P=0.03; I2=47.1%, 95% CI 0.0% to 75.4%) and cardiovascular diseases (pooled effect size: 0.85, 95% CI 0.72 to 0.99; P=0.04; I2=50.0%, 95% CI 0.0% to 77.6%). Such significant associations were also observed for all-cause mortality in some subgroups of the included studies, particularly those with higher quality. In addition, higher intake of soy was associated with decreased risk of mortality from gastric, colorectal, and lung cancers as well as ischemic cardiovascular diseases. Participants in the highest category of dietary soy isoflavones intake had a 10% lower risk of all-cause mortality compared with those in the lowest category. We also found that a 10-mg/day increase in intake of soy isoflavones was associated with 7% and 9% decreased risk of mortality from all cancers and also breast cancer respectively. Furthermore, a 12% reduction in breast cancer death was indicated for each 5-g/day increase in consumption of soy protein. However, intake of soy protein was not significantly associated with all-cause and cardiovascular diseases mortality. CONCLUSIONS Soy and its isoflavones may favorably influence risk of mortality. In addition, soy protein intake was associated with a decreased risk in the mortality of breast cancer. Our findings may support the current recommendations to increase intake of soy for greater longevity.
Collapse
|
21
|
Shibasaki K, Kin SK, Yamada S, Akishita M, Ogawa S. Sex-related differences in the association between frailty and dietary consumption in Japanese older people: a cross-sectional study. BMC Geriatr 2019; 19:211. [PMID: 31382881 PMCID: PMC6683375 DOI: 10.1186/s12877-019-1229-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/26/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Female sex is an important factor predisposing individuals to frailty. Appropriate nutrition is one of the most effective ways to prevent older adults from developing frailty; Sex-related differences have also been detected in the association between nutritional intervention and health-related outcomes. However, few studies have discussed these sex-related differences. The aim of the present study was to investigate the sex-related differences in the association between frailty and dietary consumption. METHODS We conducted a cross-sectional study which investigated community-dwelling older adults aged ≥65 years. We surveyed age, sex, body mass index, family arrangement (living alone, living with a partner or living with parent(s) and/or child (ren)), dietary consumption and frailty status. Dietary consumption was surveyed using a food frequency questionnaire that included 13 major food categories (fish, meat, eggs, dairy products, soybean products, vegetables, seaweeds, potatoes, fruits, fats or oils, snacks, salty foods and alcohol). Frailty was defined by the Kihon Checklist score. The Kihon Checklist is composed of 25 simple yes/no questions, and it has been validated as a metric for frailty. A higher score indicates a greater degree of frailty. Multinomial regression analysis was performed to clarify the association between frailty and dietary consumption for each sex. RESULTS We analyzed 905 older adults (420 (46.4%) were male). After adjusting for cofounders, a low frequency of meat consumption (less than twice/week) was associated with a high prevalence of frailty in men (odds ratio: 2.76 (95%CI: 1.12-6.77), p = 0.027). In contrast, in women, low frequencies of consumption of fish, meat, vegetables, potatoes and snacks were associated with a higher prevalence of frailty compared with those who consumed foods from those categories daily (odds ratios: fish 2.45 (1.02-5.89), p = 0.045; meat 4.05 (1.67-9.86), p = 0.002; vegetables 5.03 (2.13-11.92), p < 0.001; potatoes 3.84 (1.63-9.05), p = 0.002; snacks 2.16 (1.02-4.56), p = 0.043). CONCLUSIONS More food categories were associated with frailty in women than in men. Nutritional intervention to prevent frailty is presumably more effective for women than for men.
Collapse
Affiliation(s)
- Koji Shibasaki
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shin Kei Kin
- Department of Physical Therapy, Health Science University, 7178 Kodachi, Fujikawaguchiko-town, Yamanashi, Japan
| | - Shizuru Yamada
- Komagane-kogen Ladies Clinic, 759-195, Akaho, Komagane-city, Nagano, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| |
Collapse
|
22
|
Meat consumption in midlife and risk of cognitive impairment in old age: the Singapore Chinese Health Study. Eur J Nutr 2019; 59:1729-1738. [DOI: 10.1007/s00394-019-02031-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 06/15/2019] [Indexed: 12/23/2022]
|
23
|
Talaei M, Feng L, Yuan JM, Pan A, Koh WP. Dairy, soy, and calcium consumption and risk of cognitive impairment: the Singapore Chinese Health Study. Eur J Nutr 2019; 59:1541-1552. [PMID: 31161350 DOI: 10.1007/s00394-019-02010-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 05/23/2019] [Indexed: 02/01/2023]
Abstract
PURPOSE It is unclear if midlife consumption of dairy and soy food intake, and their components of calcium and isoflavones (in soy), is related to cognitive impairment in elderly. METHODS We used baseline data on lifestyle and habitual diet of 16,948 participants collected during their recruitment into the Singapore Chinese Health Study from 1993 to 1998, and data on their cognitive function, measured using a 30-item Singapore modified Mini-Mental State Examination, during follow-up interviews from 2014 to 2016. We used multivariable logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for developing cognitive impairment. RESULTS Higher dairy intake was associated with a lower risk of cognitive impairment in a dose-dependent manner (P for trend = 0.009). Compared to the lowest quartile of dairy intake, ORs (95% CIs) were 0.93 (0.81-1.07) for the second, 0.88 (0.76-1.01) for the third, and 0.82 (0.72-0.94) for the fourth quartiles of intake. Similar results were found for dairy calcium intake (P for trend = 0.008). However, there was no statistically significant association for intake of soy (OR comparing extreme quartiles 0.99, 95% CI 0.87-1.14, P for trend = 0.92), isoflavones (OR 1.01, 95% CI 0.88-1.15, P for trend = 0.90) or non-dairy calcium (OR 1.06, 95% CI 0.86-1.30, P for trend = 0.81) with risk of cognitive impairment. CONCLUSIONS Dairy intake at midlife could have a protective association against cognitive impairment that may not be attributed to its calcium content alone, while soy or isoflavone intake was not associated with the cognition of elderly in our study.
Collapse
Affiliation(s)
- Mohammad Talaei
- National University Health System (NUHS) Centre for Healthy Ageing, Singapore, Singapore.
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
24
|
Liu Z, Shi O, Cai N, Jiang Y, Zhang K, Zhu Z, Yuan H, Fang Q, Suo C, Franceschi S, Zhang T, Chen X. Disparities in Cancer Incidence among Chinese Population versus Migrants to Developed Regions: A Population-Based Comparative Study. Cancer Epidemiol Biomarkers Prev 2019; 28:890-899. [PMID: 30944147 DOI: 10.1158/1055-9965.epi-18-0827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/26/2018] [Accepted: 11/28/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The incidence of cancer was determined by genetic and environmental factors and varied across the world. The discrepancies in cancer profile among Chinese people living in different regions remained obscure. METHODS Chinese people living in urban Shanghai, Hong Kong, Taiwan, Macau, Singapore, and Los Angeles were included in this study. The cancer case data and population data were collected from either the Cancer Incidence in Five Continents Plus database or the regional cancer registry. A rate model was applied to examine the regional differences in cancer risk with Shanghai set as the reference. RESULTS From 1983 to 2013, the cancer profiles in most regions were changed. Significant differences in cancer incidence, by sex, period, and age, were detected across regions. The most pronounced disparities were found between Shanghai people and American Chinese in Los Angeles. For cancer site, the most significant differences were detected in prostate, gastrointestinal, gynecologic, oral cavity and pharynx, and brain and central nervous system (CNS) cancers. Specifically, Shanghai was significantly higher in stomach, liver, esophageal, pancreatic, and brain and CNS cancers, while lower in colon, prostate, breast, cervical, and oral cavity and pharynx cancers compared with the other five populations. CONCLUSIONS Cancer profile was distinct across Chinese populations, which shared a similar genetic background but lived in different regions. The disparities indicate that cancer development was majorly determined by environmental factors, and suggests that region-tailored cancer prevention strategies were warranted. IMPACT The cancer patterns in populations sharing the same genetic background were significantly influenced by different living conditions.
Collapse
Affiliation(s)
- Zhenqiu Liu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Oumin Shi
- Department of Neurology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Ning Cai
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Kexun Zhang
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Zhen Zhu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Huangbo Yuan
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Qiwen Fang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Chen Suo
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Silvia Franceschi
- Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Itlay
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. .,Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China. .,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Human Phenome Institute, Fudan University, Shanghai, China
| |
Collapse
|
25
|
Chan RSM, Yu BWM, Leung J, Lee JSW, Auyeung TW, Kwok T, Woo J. How Dietary Patterns are Related to Inflammaging and Mortality in Community-Dwelling Older Chinese Adults in Hong Kong - A Prospective Analysis. J Nutr Health Aging 2019; 23:181-194. [PMID: 30697629 DOI: 10.1007/s12603-018-1143-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Studies examining dietary patterns and inflammageing in relation to mortality are limited. OBJECTIVE We examined the influence of various dietary patterns on all-cause and cardiovascular disease (CVD) mortality, taking into account demographics, lifestyle factors, and serum inflammatory markers. METHODS We conducted multivariate Cox regression analyses using data from a cohort of community-dwelling older Chinese adults (1,406 men, 1,396 women) in Hong Kong. Baseline interviewer administered questionnaires covered dietary intake estimation and dietary pattern generation from the food frequency questionnaire, demographic and lifestyle factors, cognitive function and depressive symptoms. Serum high-sensitivity C-reactive protein (hsCRP) and 25-hydroxyvitamin D (25OHD) were measured. All-cause and CVD mortality data at 14-year follow up were retrieved from an official database. RESULTS In men, higher hsCRP level was associated with lower Diet Quality Index-International (DQI-I) score, Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND) score, Okinawan diet score, "vegetables-fruits" pattern score and "snacks-drinks-milk" pattern score. Higher serum 25OHD level was associated with higher Mediterranean Diet Score (MDS) but lower "snacks-drinks-milk" pattern score. None of the dietary pattern scores was associated with all-cause or CVD mortality after adjusting for all covariates. In women, hsCRP level and serum 25OHD level were not associated with any dietary patterns. Higher DQI-I score (HR=0.77 (95% CIs: 0.59, 0.99) highest vs. lowest tertile, p-trend=0.038) and Okinawan diet score (HR=0.78 (95% CIs: 0.61, 1.00) highest vs lowest tertile, p-trend=0.046) was associated with a lower risk of all-cause mortality, whereas higher MIND score (HR=0.63 (95% CI: 0.36, 1.09) highest vs. lowest tertile, p-trend=0.045) was associated with a reduced risk of CVD morality in the multivariate adjusted model. CONCLUSION Higher DQI-I score and Okinawan diet score were associated with a lower risk of all-cause mortality, and higher adherence to the MIND diet was related to a reduced risk of CVD mortality in community-dwelling Chinese older women.
Collapse
Affiliation(s)
- R S M Chan
- Dr Ruth Chan, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, N.T., Hong Kong, Tel: 852-3505-2190, Fax: 852-2637-9215,
| | | | | | | | | | | | | |
Collapse
|
26
|
Weight change in relation to mortality in middle-aged and elderly Chinese: the Singapore Chinese Health Study. Int J Obes (Lond) 2018; 43:1590-1600. [DOI: 10.1038/s41366-018-0259-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/29/2018] [Accepted: 10/08/2018] [Indexed: 11/09/2022]
|
27
|
Relative validity and reproducibility of dietary quality scores from a short diet screener in a multi-ethnic Asian population. Public Health Nutr 2018; 21:2735-2743. [DOI: 10.1017/s1368980018001830] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveShort screeners for assessing dietary quality are lacking in Asia. We recently developed a short thirty-seven-item diet screener (DS). The present study aimed to evaluate reproducibility and relative validity of the DS in assessing a priori dietary quality indices (DQI; i.e. the Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMed) and Dietary Approaches to Stop Hypertension (DASH) diet) and intakes of selected foods.DesignDS administration and biomarker measurement took place twice within a 4-month interval. A 163-item FFQ was administered one month after the second DS administration.SettingSingapore, a multi-ethnic urban Asian country.SubjectsSingapore residents (n 161) aged 18–79 years, of Chinese, Malay and Indian ethnicity.ResultsReproducibility coefficients for the two DS were 0·71 (DQI) and 0·65 (food groups). Correlations (ρ) between mean DS and FFQ DQI scores were 0·51 (AHEI-2010), 0·50 (aMed) and 0·61 (DASH; all P<0·05). Cohen’s weighted kappa indicated moderate agreement between the two measures (κw=0·48–0·58). DS DQI scores were associated with concentrations of β-cryptoxanthin (AHEI-2010, ρ=0·26; P<0·05), odd-chain SFA (aMed, ρ=0·24; DASH, ρ=0·25; both P<0·05), and enterolactone, total carotenoids, PUFA and α-linolenic acid (all scores, ρ=0·17–0·30; all P<0·05). Scores were not associated with isoflavone or long-chain n-3 PUFA concentrations.ConclusionsA short screener can be used to assess DQI with good reproducibility and relative validity compared with a longer FFQ in an Asian population.
Collapse
|
28
|
Acheampong T, Yuan JM, Koh WP, Jin A, Odegaard A. Occupational exposure to endocrine disrupting substances and the risk of breast Cancer: the Singapore Chinese health study. BMC Public Health 2018; 18:929. [PMID: 30055614 PMCID: PMC6064056 DOI: 10.1186/s12889-018-5862-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/18/2018] [Indexed: 11/28/2022] Open
Abstract
Background Evidence from basic research links exposure to endocrine disrupting chemicals (EDCs) with a higher risk for breast cancer. However, there is less evidence from observational epidemiological research and the results are equivocal. Therefore, we examined the association between occupational exposure to substances where exposure to EDCs is likely and the risk of breast cancer. Methods A prospective study consisting of a population-based cohort of 33,458 Singaporean Chinese women aged 45–74 years enrolled in the Singapore Chinese Health Study (SCHS) from 1993 to 98 and followed through 2014. Subjects’ self-reported occupational exposure and duration to industries, job titles, and substance types were garnered at baseline, and cases of incident breast cancer (N = 988) were determined by linkage with the Singapore Cancer Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for exposure to substances, job titles, and industries. Results There was no association between cumulative exposure to substances via occupation where EDC exposure is likely and risk of breast cancer. These results were consistent for hypothesized high (HR 0.94, 95% CI: 0.66–1.35), medium (HR 1.03 95% CI: 0.77–1.38) and low (HR 0.74, 95% CI 0.48–1.13) combined substance exposure groups when compared with those who were not exposed via occupation. Similar null associations were observed when examining job titles and industry categories. Conclusions There was no association between EDC related occupational exposures and breast cancer risk in working women of the Singaporean Chinese Health Study. Future studies that employ rigorous methods with regard to exposure assessment of EDCs are needed. Electronic supplementary material The online version of this article (10.1186/s12889-018-5862-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Teofilia Acheampong
- Department of Epidemiology, University of California Irvine, School of Medicine, 224 Irvine Hall, Irvine, CA, 92697, United States.
| | - Jian-Min Yuan
- University of Pittsburgh, University of Pittsburgh Medical Center (Shadyside) Cancer Pavilion, 5150 Centre Avenue, Pittsburgh, PA, 15232, United States
| | - Woon Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Aizhen Jin
- Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Andrew Odegaard
- Department of Epidemiology, University of California Irvine, School of Medicine, 224 Irvine Hall, Irvine, CA, 92697, United States
| |
Collapse
|
29
|
Shikany JM, Safford MM, Bryan J, Newby PK, Richman JS, Durant RW, Brown TM, Judd SE. Dietary Patterns and Mediterranean Diet Score and Hazard of Recurrent Coronary Heart Disease Events and All-Cause Mortality in the REGARDS Study. J Am Heart Assoc 2018; 7:e008078. [PMID: 30005552 PMCID: PMC6064845 DOI: 10.1161/jaha.117.008078] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/28/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previously, we reported on associations between dietary patterns and incident acute coronary heart disease (CHD) in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Here, we investigated the associations of dietary patterns and a dietary index with recurrent CHD events and all-cause mortality in REGARDS participants with existing CHD. METHODS AND RESULTS We included data from 3562 participants with existing CHD in REGARDS. We used Cox proportional hazards regression to examine the hazard of first recurrence of CHD events-definite or probable MI or acute CHD death-and all-cause mortality associated with quartiles of empirically derived dietary patterns (convenience, plant-based, sweets, Southern, and alcohol and salads) and the Mediterranean diet score. Over a median 7.1 years (interquartile range, 4.4, 8.9 years) follow-up, there were 581 recurrent CHD events and 1098 deaths. In multivariable-adjusted models, the Mediterranean diet score was inversely associated with the hazard of recurrent CHD events (hazard ratio for highest score versus lowest score, 0.78; 95% confidence interval, 0.62-0.98; PTrend=0.036). The Southern dietary pattern was adversely associated with the hazard of all-cause mortality (hazard ratio for Q4 versus Q1, 1.57; 95% confidence interval, 1.28-1.91; PTrend<0.001). The Mediterranean diet score was inversely associated with the hazard of all-cause mortality (hazard ratio for highest score versus lowest score, 0.80; 95% confidence interval, 0.67-0.95; PTrend=0.014). CONCLUSIONS The Southern dietary pattern was associated with a greater hazard of all-cause mortality in REGARDS participants. Greater adherence to the Mediterranean diet was associated with both a lower hazard of recurrent CHD events and all-cause mortality.
Collapse
Affiliation(s)
- James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Monika M Safford
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY
| | - Joanna Bryan
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY
| | - P K Newby
- Department of Nutrition, Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
| | - Joshua S Richman
- Division of Gastrointestinal Surgery, School of Medicine, University of Alabama at Birmingham, AL
| | - Raegan W Durant
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Todd M Brown
- Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham, AL
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, AL
| |
Collapse
|
30
|
Liu H, Hall JJ, Xu X, Mishra GD, Byles JE. Differences in food and nutrient intakes between Australian- and Asian-born women living in Australia: Results from the Australian Longitudinal Study on Women's Health. Nutr Diet 2018; 75:142-150. [PMID: 29282841 DOI: 10.1111/1747-0080.12397] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/11/2017] [Accepted: 11/02/2017] [Indexed: 12/01/2022]
Abstract
AIM To determine differences in food and nutrient intakes between Australian- and Asian-born women living in Australia. METHODS Data were obtained from the Australian Longitudinal Study on Women's Health, including 6461 women born in Australia or Asia who completed food frequency questionnaires in 2001 and 2013. Diet was assessed using the Dietary Questionnaire for Epidemiological Studies version 2. Longitudinal generalised estimating-equation modelling was performed to determine the effect of country of birth and survey year on fruit and vegetable intake. RESULTS Asian-born women ate more cereals, soybeans and fish but less vegetables, legumes, dairy, meat and meat products than Australian-born women both in 2001 and in 2013. Asian-born women ate less cereals, rice and noodles, meat and its products (P < 0.05) in 2013 than in 2001. The earlier people came to Australia, the less their rice and noodle intake per day. However, the reverse was demonstrated regarding vegetable intake. Asian-born women had a lower daily intake of fat, calcium, zinc, thiamin, riboflavin, folate and retinol compared with those born in Australia. CONCLUSIONS Asian-born women living in Australia show different food and nutrient intakes from Australian-born women, although their diets tend to deviate from typical Asian characteristics and approach a Western diet.
Collapse
Affiliation(s)
- Huaqing Liu
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - John J Hall
- School of Public Health & Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Xiaoyue Xu
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Gita D Mishra
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
| | - Julie E Byles
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
31
|
Whitton C, Rebello SA, Lee J, Tai ES, van Dam RM. A Healthy Asian A Posteriori Dietary Pattern Correlates with A Priori Dietary Patterns and Is Associated with Cardiovascular Disease Risk Factors in a Multiethnic Asian Population. J Nutr 2018; 148:616-623. [PMID: 29659965 DOI: 10.1093/jn/nxy016] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/18/2018] [Indexed: 11/14/2022] Open
Abstract
Background Healthful dietary patterns are associated with cardiovascular disease risk factors in Western populations. However, a consistent healthful dietary pattern across major Asian ethnic groups has yet to be identified. Objective We aimed to identify a posteriori dietary patterns for Chinese, Malay, and Indian ethnic groups in an urban Asian setting, compare these with a priori dietary patterns, and ascertain associations with cardiovascular disease risk factors including hypertension, obesity, and abnormal blood lipid concentrations. Methods We used cross-sectional data from 8433 Singapore residents (aged 21-94 y) from the Multi-Ethnic Cohort study of Chinese, Malay, and Indian ethnicity. Food consumption was assessed using a validated 169-item food-frequency questionnaire. With the use of 28 food groups, dietary patterns were derived by principal component analysis, and their association with cardiovascular disease risk factors was assessed using multiple linear regression. Associations between derived patterns and a priori patterns (aHEI-2010-Alternative Healthy Eating Index-2010, aMED-alternate Mediterranean Diet, and DASH-Dietary Approaches to Stop Hypertension) were assessed, and the magnitude of associations with risk factors compared. Results We identified a "healthy" dietary pattern, similar across ethnic groups, and characterized by high intakes of whole grains, fruit, dairy, vegetables, and unsaturated cooking oil and low intakes of Western fast foods, sugar-sweetened beverages, poultry, processed meat, and flavored rice. This "healthy" pattern was inversely associated with body mass index (BMI; in kg/m2) (-0.26 per 1 SD of the pattern score; 95% CI: -0.36, -0.16), waist circumference (-0.57 cm; 95% CI: -0.82, -0.32), total cholesterol (-0.070 mmol/L; 95% CI: -0.091, -0.048), LDL cholesterol (-0.054 mmol/L; 95% CI: -0.074, -0.035), and fasting triglycerides (-0.22 mmol/L; 95% CI: -0.04, -0.004) and directly associated with HDL cholesterol (0.013 mmol/L; 95% CI: 0.006, 0.021). Generally, "healthy" pattern associations were at least as strong as a priori pattern associations with cardiovascular disease risk factors. Conclusion A healthful dietary pattern that correlated well with a priori patterns and was associated with lower BMI, serum LDL cholesterol, total cholesterol, and fasting triglyceride concentrations was identified across 3 major Asian ethnic groups.
Collapse
Affiliation(s)
- Clare Whitton
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Jeannette Lee
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - E Shyong Tai
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,Division of Endocrinology, National University Hospital, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
32
|
Abstract
OBJECTIVE To identify predominant dietary patterns in four African populations and examine their association with obesity. DESIGN Cross-sectional study.Setting/SubjectsWe used data from the Africa/Harvard School of Public Health Partnership for Cohort Research and Training (PaCT) pilot study established to investigate the feasibility of a multi-country longitudinal study of non-communicable chronic disease in sub-Saharan Africa. We applied principal component analysis to dietary intake data collected from an FFQ developed for PaCT to ascertain dietary patterns in Tanzania, South Africa, and peri-urban and rural Uganda. The sample consisted of 444 women and 294 men. RESULTS We identified two dietary patterns: the Mixed Diet pattern characterized by high intakes of unprocessed foods such as vegetables and fresh fish, but also cold cuts and refined grains; and the Processed Diet pattern characterized by high intakes of salad dressing, cold cuts and sweets. Women in the highest tertile of the Processed Diet pattern score were 3·00 times more likely to be overweight (95 % CI 1·66, 5·45; prevalence=74 %) and 4·24 times more likely to be obese (95 % CI 2·23, 8·05; prevalence=44 %) than women in this pattern's lowest tertile (both P<0·0001; prevalence=47 and 14 %, respectively). We found similarly strong associations in men. There was no association between the Mixed Diet pattern and overweight or obesity. CONCLUSIONS We identified two major dietary patterns in several African populations, a Mixed Diet pattern and a Processed Diet pattern. The Processed Diet pattern was associated with obesity.
Collapse
|
33
|
Association between dietary zinc intake and mortality among Chinese adults: findings from 10-year follow-up in the Jiangsu Nutrition Study. Eur J Nutr 2017; 57:2839-2846. [DOI: 10.1007/s00394-017-1551-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/28/2017] [Indexed: 12/22/2022]
|
34
|
Marques-Vidal P, Gaspoz JM, Theler JM, Guessous I. Twenty-year trends in dietary patterns in French-speaking Switzerland: toward healthier eating. Am J Clin Nutr 2017; 106:217-224. [PMID: 28592598 DOI: 10.3945/ajcn.116.144998] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 05/05/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Dietary patterns provide a summary of dietary intake, but to our knowledge, few studies have assessed trends in dietary patterns in the population.Objective: The aim was to assess 20-y trends in dietary patterns in a representative sample of the Geneva, Switzerland, population with the consideration of age, sex, education, and generation.Design: Repeated, independent cross-sectional studies were conducted between 1993 and 2014. Dietary intake was assessed by using a validated food-frequency questionnaire. Dietary patterns were assessed by using principal components analyses.Results: Among 18,763 adults, 1 healthy ("fish and vegetables") and 2 unhealthy ("meat and chips" and "chocolate and sweets") patterns were identified. Scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and "chocolate and sweets" pattern scores decreased in both sexes and across all age groups. The stronger increase in the "fish and vegetables" pattern score among the less well-educated participants led to a narrowing of educational differences (mean ± SD scores in 1993: -0.56 ± 1.39 compared with -0.05 ± 1.58 in low- compared with highly educated groups, respectively; P < 0.001; scores in 2014: 0.28 ± 1.64 compared with 0.24 ± 1.83, respectively; P = 0.772). Generational analysis showed that older age groups tended to show smaller changes than younger age groups: the yearly score change in "chocolate and sweets" was -0.021 (95% CI: -0.027, -0.014; P < 0.001) for the 35- to 44-y cohort compared with -0.002 (95% CI: -0.009, 0.005; P = 0.546) for the 45- to 54-y cohort.Conclusions: Three dietary patterns were identified; scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and the "chocolate and sweets" pattern scores decreased. The stronger increases in the "fish and vegetables" pattern score among the less well-educated participants led to a smaller difference in dietary intake across the different educational levels.
Collapse
Affiliation(s)
- Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Jean-Michel Gaspoz
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and
| | - Jean-Marc Theler
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and
| | - Idris Guessous
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and .,Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
35
|
Nanri A, Mizoue T, Shimazu T, Ishihara J, Takachi R, Noda M, Iso H, Sasazuki S, Sawada N, Tsugane S. Dietary patterns and all-cause, cancer, and cardiovascular disease mortality in Japanese men and women: The Japan public health center-based prospective study. PLoS One 2017; 12:e0174848. [PMID: 28445513 PMCID: PMC5405917 DOI: 10.1371/journal.pone.0174848] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 03/16/2017] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE A meta-analysis showed an inverse association of a prudent/healthy dietary pattern with all-cause mortality and no association of a western/unhealthy dietary pattern. However, the association of distinctive dietary patterns of Japanese population with mortality remains unclear. We prospectively investigated the association between dietary patterns and all-cause, cancer, and cardiovascular disease mortality among Japanese adults. METHODS Participants were 36,737 men and 44,983 women aged 45-74 years who participated in the second survey of the Japan Public Health Center-based Prospective Study (1995-1998) and who had no history of serious disease. Dietary patterns were derived from principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Hazard ratios of death from the second survey to December 2012 were estimated using cox proportional hazard regression analysis. RESULTS A prudent dietary pattern, which was characterized by high intake of vegetables, fruit, soy products, potatoes, seaweed, mushrooms, and fish, was significantly associated with decreased risk of all-cause and cardiovascular disease mortality. The multivariable-adjusted hazard ratios (95% confidence intervals) of all-cause and cardiovascular disease mortality for the highest versus lowest quartile of the prudent dietary pattern score were 0.82 (0.77 to 0.86) and 0.72 (0.64 to 0.79), respectively (P for trend <0.001 in both). A Westernized dietary pattern, characterized by high intake of meat, processed meat, bread, and dairy products, was also inversely associated with risk of all-cause, cancer, and cardiovascular disease mortality. A traditional Japanese dietary pattern was not associated with these risks. CONCLUSIONS The prudent and Westernized dietary patterns were associated with a decreased risk of all-cause and cardiovascular disease mortality in Japanese adults.
Collapse
Affiliation(s)
- Akiko Nanri
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Taichi Shimazu
- Prevention Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Junko Ishihara
- Department of Nutrition Management, Sagami Women’s University, Kanagawa, Japan
| | - Ribeka Takachi
- Faculty of Human Life and Environment, Nara Women’s University, Nara, Japan
| | - Mitsuhiko Noda
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Hiroyasu Iso
- Department of Public Health, Division of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Shizuka Sasazuki
- Prevention Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | |
Collapse
|
36
|
FENG L, HU Z, WANG Q. Dietary Calcium and Serum 25OHD Protect Chinese Women from Type 2 Diabetes. J Nutr Sci Vitaminol (Tokyo) 2017; 63:222-227. [DOI: 10.3177/jnsv.63.222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Lijun FENG
- Department of Nutrition, Sir Run Run Shaw Hospital, Medicine School of Zhejiang University
| | - Zhefang HU
- Department of Nutrition, Sir Run Run Shaw Hospital, Medicine School of Zhejiang University
| | - Qingqing WANG
- Department of Endocrinology, Sir Run Run Shaw Hospital, Medicine School of Zhejiang University
| |
Collapse
|
37
|
Chen LW, Aris IM, Bernard JY, Tint MT, Chia A, Colega M, Gluckman PD, Shek LPC, Saw SM, Chong YS, Yap F, Godfrey KM, van Dam RM, Chong MFF, Lee YS. Associations of Maternal Dietary Patterns during Pregnancy with Offspring Adiposity from Birth Until 54 Months of Age. Nutrients 2016; 9:nu9010002. [PMID: 28025503 PMCID: PMC5295046 DOI: 10.3390/nu9010002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/13/2016] [Accepted: 12/16/2016] [Indexed: 02/07/2023] Open
Abstract
Most studies linking maternal diet with offspring adiposity have focused on single nutrients or foods, but a dietary pattern approach is more representative of the overall diet. We thus aimed to investigate the relations between maternal dietary patterns and offspring adiposity in a multi-ethnic Asian mother–offspring cohort in Singapore. We derived maternal dietary patterns using maternal dietary intake information at 26–28 weeks of gestation, of which associations with offspring body mass index (BMI), abdominal circumference (AC), subscapular skinfold (SS), and triceps skinfold (TS) were assessed using longitudinal data analysis (linear mixed effects (LME)) and multiple linear regression at ages 0, 3, 6, 9, 12, 15, 18, 24, 36, 48, and 54 months. Three dietary patterns were derived: (1) vegetables-fruit-and-white rice (VFR); (2) seafood-and-noodles (SfN); and (3) pasta-cheese-and-bread (PCB). In the LME model adjusting for potential confounders, each standard deviation (SD) increase in maternal VFR pattern score was associated with 0.09 mm lower offspring TS. Individual time-point analysis additionally revealed that higher VFR score was generally associated with lower postnatal offspring BMI z-score, TS, SS, and sum of skinfolds (SS + TS) at ages 18 months and older. Maternal adherence to a dietary pattern characterized by higher intakes of fruit and vegetables and lower intakes of fast food was associated with lower offspring adiposity.
Collapse
Affiliation(s)
- Ling-Wei Chen
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
| | - Mya-Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Airu Chia
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand.
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore.
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Fabian Yap
- Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore 229899, Singapore.
- Duke-NUS Graduate Medical School, Lee Kong Chian School of Medicine, Singapore 169857, Singapore.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore.
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore 117599, Singapore.
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore 119228, Singapore.
| |
Collapse
|
38
|
Mirmiran P, Bahadoran Z, Vakili AZ, Azizi F. Western dietary pattern increases risk of cardiovascular disease in Iranian adults: a prospective population-based study. Appl Physiol Nutr Metab 2016; 42:326-332. [PMID: 28177742 DOI: 10.1139/apnm-2016-0508] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Limited data are available regarding the association of major dietary patterns and risk of cardiovascular disease (CVD) in Middle Eastern countries. We aimed to evaluate the association of major dietary patterns, using factor analysis, with the risk of CVD. Participants without CVD (n = 2284) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 4.7 years. Dietary intake of participants was assessed at baseline (2006-2008); biochemical variables were evaluated at baseline and follow-up examination. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary pattern scores. Linear regression models were used to indicate association of dietary pattern scores with changes of CVD risk factors over the study period. Two major dietary patterns, Western and traditional, were identified. During a mean 4.7 ± 1.4 years of follow-up, 57 participants experienced CVD-related events. In the fully adjusted model, we observed an increased risk of CVD-related events in the highest compared to the lowest tertile category of Western dietary pattern score (HR = 2.07, 95% CI = 1.03-4.18, P for trend = 0.01). Traditional dietary pattern was not associated with incidence of CVD or CVD risk factors. A significant association was observed between the Western dietary pattern and changes in serum insulin (β = 5.88, 95% CI = 0.34-11.4). Our findings confirm that the Western dietary pattern, characterized by higher loads of processed meats, salty snacks, sweets, and soft drinks, is a dietary risk factor for CVD in the Iranian population.
Collapse
Affiliation(s)
- Parvin Mirmiran
- a Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- b Nutrition and Endocrine Research Center, Student Research Committee, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Zadeh Vakili
- c Cellular and Molecular Endocrine Research Center, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- d Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
39
|
Chen Z, Fu X, Kuang J, Chen J, Chen H, Pei J, Yang H. Single-dose acarbose decreased glucose-dependent insulinotropic peptide and glucagon levels in Chinese patients with newly diagnosed type 2 diabetes mellitus after a mixed meal. BMC Endocr Disord 2016; 16:55. [PMID: 27686734 PMCID: PMC5041397 DOI: 10.1186/s12902-016-0133-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 09/21/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Acarbose slows down the intestinal absorption of carbohydrates, but its effects on the secretion of incretins are still poorly known. This study aimed to examine the effects of single-dose acarbose on the secretion of incretins in patients with newly diagnosed type 2 diabetes mellitus (T2DM). METHODS In this pilot study, twenty-three patients diagnosed with T2DM were randomly assigned to the oral glucose tolerance test (OGTT) group (n = 11) and the mixed meal test (MMT) group (n = 12). Fourteen subjects with normal OGTT were included as controls. Plasma glucose, insulin, glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP) were measured at 0 (fasting), 15, 30, 60, 90, and 120 min after nutrient load. A week later, controls underwent MMT, the OGTT group underwent OGTT receiving 100 mg acarbose, and the MMT group underwent MMT receiving 100 mg acarbose. The same blood markers were measured again. RESULTS No significant difference was observed in the OGTT group before and after administering acarbose. In the MMT group, postprandial levels of glucose (P < 0.01), insulin (P < 0.01), glucagon at 15 min (P < 0.05), glucagon area under the curve (AUC) (P < 0.05), GIP levels at 30 min (P < 0.05), and GIP AUC (P < 0.05) were decreased after receiving acarbose with a mixed meal, but GLP-1 levels and GLP-1 AUC did not change. CONCLUSIONS Single-dose acarbose could reduce the secretion of GIP and glucagon after a mixed meal in patients with newly diagnosed T2DM. The influence of acarbose on incretin levels could be related to the types of carbohydrate being consumed. TRIAL REGISTRATION This study was registered with the Chinese Clinical Trial Registry (Registration Number: ChiCTR-TRC-14004260 , Date of Registration: 2014-01-19).
Collapse
Affiliation(s)
- Zhong Chen
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| | - Xiaoying Fu
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| | - Jian Kuang
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| | - Ju Chen
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| | - Hongmei Chen
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| | - Jianhao Pei
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| | - Huazhang Yang
- Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080 Guangdong China
| |
Collapse
|
40
|
The effect of under-reporting of energy intake on dietary patterns and on the associations between dietary patterns and self-reported chronic disease in women aged 50–69 years. Br J Nutr 2016; 116:547-58. [DOI: 10.1017/s000711451600218x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe aim of this cross-sectional study was to investigate whether under-reporting of energy intake affects derived dietary patterns and the association between dietary patterns and self-reported chronic disease. Diets of 6204 women aged 50–69 years participating in the Norwegian Breast Cancer Screening Program were assessed using a 253-item FFQ. We identified dietary patterns using principal component analysis. According to the revised Goldberg cut-off method, women with a ratio of reported energy intake:estimated BMR<1·10 were classified as low energy reporters (n 1133, 18 %). We examined the associations between dietary patterns and self-reported chronic diseases by log-binomial regression, and the results are presented as prevalence ratios (PR) and CI. ‘Prudent’, ‘Western’ and ‘Continental’ dietary patterns were identified among all reporters and plausible reporters. The PR expressing the associations between the ‘Western’ and ‘Prudent’ dietary pattern scores and self-reported chronic diseases were consistently highest among plausible reporters except for joint/muscle/skeletal disorders. The largest difference in PR among plausible v. all reporters was found for the association between the ‘Prudent’ pattern and diabetes (PR for highest v. lowest tertile: PRall reporters 2·16; 95 % CI 1·50, 3·13; Ptrend<0·001; PRplausible reporters 2·86; 95 % CI 1·81, 4·51; Ptrend<0·001). In conclusion, our results suggest that under-reporting can result in systematic error that can affect the association between dietary pattern and disease. In studies of dietary patterns, investigators ought to consider reporting effect estimates both for all individuals and for plausible reporters.
Collapse
|
41
|
Li P, Zhang M, Zhu Y, Liu W, Zhang Y, Gao Y, Huang G. Dietary patterns and changes in cardiovascular risk factors in apparently healthy Chinese women: a longitudinal study. J Clin Biochem Nutr 2016; 58:232-9. [PMID: 27257349 PMCID: PMC4865601 DOI: 10.3164/jcbn.15-78] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/03/2015] [Indexed: 12/15/2022] Open
Abstract
Little is known of the relationships between dietary patterns and cardiovascular risk factors in China. We therefore designed a 3-year longitudinal study to evaluate the impacts of dietary patterns on changes in these factors among Chinese women. A total of 1,028 subjects who received health examination in 2011 and 2014 were recruited. Three major dietary patterns (“vegetable pattern”, “meat pattern”, and “animal offal-dessert-and-alcohol pattern”) were derived by principal component analysis based on validated food frequency questionnaires. Cardiovascular risk factors were standardized to create within-cohort z-scores and the changes in them were calculated as the differences between 2011 and 2014. Relationships between dietary patterns and changes in cardiovascular risk factors were assessed using general linear model. After adjustment for potential confounders, changes in total cholesterol and fasting blood glucose decreased across the tertiles of vegetable pattern (p for trend = 0.01 and 0.04, respectively). While, changes in diastolic blood pressure, total cholesterol and low density lipoprotein cholesterol increased across the tertiles of animal offal-dessert-and-alcohol pattern (p for trend = 0.02, 0.01, and 0.02, respectively). The findings suggest that vegetable pattern was beneficially related to cardiovascular risk factors, whereas animal offal-dessert-and-alcohol pattern was detrimental related to these factors among apparently healthy Chinese women.
Collapse
Affiliation(s)
- Ping Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Meilin Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Yufeng Zhu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Weiqiao Liu
- Health Education and Guidance Center of Heping District, Tianjin 300040, China
| | - Yuwen Zhang
- Health Education and Guidance Center of Heping District, Tianjin 300040, China
| | - Yuxia Gao
- Department of Cardiology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| |
Collapse
|
42
|
Elderly Taiwanese who spend more on fruits and vegetables and less on animal-derived foods use less medical services and incur lower medical costs. Br J Nutr 2016; 115:823-33. [PMID: 26786998 DOI: 10.1017/s0007114515005140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A higher intake of fruits and vegetables (F&V) compared with animal-derived foods is associated with lower risks of all-cause-, cancer- and CVD-related mortalities. However, the association between consumption patterns and medical costs remains unclear. The effects of various food group costs on medical service utilisation and costs were investigated. The study cohort was recruited through the Elderly Nutrition and Health Survey in Taiwan between 1999 and 2000 and followed-up for 8 years until 2006. It comprised free-living elderly participants who provided a 24-h dietary recall. Daily energy-adjusted food group costs were estimated. Annual medical service utilisation and costs for 1445 participants aged 65-79 years were calculated from the National Health Insurance claim data. Generalised linear models were used to appraise the associations between the food group costs and medical service utilisation and costs. Older adults with the highest F&V cost tertile had significantly fewer hospital days (30%) and total medical costs (19%), whereas those in the highest animal-derived group had a higher number of hospital days (28%) and costs (83%) as well as total medical costs (38%). Participants in the high F&V and low animal-derived cost groups had the shortest annual hospitalisation stays (5·78 d) and lowest costs (NT$38,600) as well as the lowest total medical costs (NT$75,800), a mean annual saving of NT$45 200/person. Older adults who spend more on F&V and less on animal-derived foods have a reduced medical-care system burden. This provides opportunities for nutritionally related healthcare system investment strategies.
Collapse
|
43
|
Affiliation(s)
- Manja Koch
- aInstitute of Epidemiology, Christian-Albrechts University Kiel, Kiel bNutritional Epidemiology, Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | | | | |
Collapse
|
44
|
Schwenke DC. Designing dietary patterns to minimize overall disease burden. Curr Opin Lipidol 2015; 26:241-2. [PMID: 25950707 DOI: 10.1097/mol.0000000000000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Dawn C Schwenke
- aPhoenix VA Health Care System bCollege of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| |
Collapse
|
45
|
Abstract
BACKGROUND There is limited research examining beverage habits, one of the most habitual dietary behaviors, with mortality risk. OBJECTIVE This study examined the association between coffee, black and green tea, sugar-sweetened beverages (soft drinks and juice), and alcohol and all-cause and cause-specific mortality. METHODS A prospective data analysis was conducted with the use of the Singapore Chinese Health Study, including 52,584 Chinese men and women (aged 45-74 y) free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993-1998) and followed through 2011 with 10,029 deaths. Beverages were examined with all-cause and cause-specific (cancer, CVD, and respiratory disease) mortality risk with the use of Cox proportional hazards regression. RESULTS The associations between coffee, black tea, and alcohol intake and all-cause mortality were modified by smoking status. Among never-smokers there was an inverse dose-response association between higher amounts of coffee and black tea intake and all-cause, respiratory-related, and CVD mortality (black tea only). The fully adjusted HRs for all-cause mortality for coffee for <1/d, 1/d, and ≥2/d relative to no coffee intake were 0.89, 0.86, and 0.83, respectively (P-trend = 0.0003). For the same black tea categories the HRs were 0.95, 0.90, and 0.72, respectively (P-trend = 0.0005). Among ever-smokers there was no association between coffee or black tea and the outcomes. Relative to no alcohol, light to moderate intake was inversely associated with all-cause mortality (HR: 0.87; 95% CI: 0.79, 0.96) in never-smokers with a similar magnitude of association in ever-smokers. There was no association between heavy alcohol intake and all-cause mortality in never-smokers and a strong positive association in ever-smokers (HR: 1.56; 95% CI: 1.40, 1.74). Green tea and sugar-sweetened beverages were not associated with all-cause or cause-specific mortality. CONCLUSIONS Higher coffee and black tea intake was inversely associated with mortality in never-smokers, light to moderate alcohol intake was inversely associated with mortality regardless of smoking status, heavy alcohol intake was positively associated with mortality in ever-smokers, and there was no association between sugar-sweetened beverages and green tea and mortality.
Collapse
Affiliation(s)
- Andrew O Odegaard
- Department of Epidemiology, School of Medicine, University of California-Irvine, Irvine, CA;
| | - Woon-Puay Koh
- Duke–NUS Graduate Medical School Singapore, Singapore;,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, and Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; and
| | - Mark A Pereira
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
46
|
Fruit and vegetable intake and mortality from cardiovascular disease in Japan: a 24-year follow-up of the NIPPON DATA80 Study. Eur J Clin Nutr 2015; 69:482-8. [DOI: 10.1038/ejcn.2014.276] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 08/23/2014] [Accepted: 12/02/2014] [Indexed: 01/14/2023]
|
47
|
Siri-Tarino PW, Chiu S, Bergeron N, Krauss RM. Saturated Fats Versus Polyunsaturated Fats Versus Carbohydrates for Cardiovascular Disease Prevention and Treatment. Annu Rev Nutr 2015; 35:517-43. [PMID: 26185980 PMCID: PMC4744652 DOI: 10.1146/annurev-nutr-071714-034449] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effects of saturated fatty acids (SFAs) on cardiovascular disease (CVD) risk are modulated by the nutrients that replace them and their food matrices. Replacement of SFAs with polyunsaturated fatty acids has been associated with reduced CVD risk, although there is heterogeneity in both fatty acid categories. In contrast, replacement of SFAs with carbohydrates, particularly sugar, has been associated with no improvement or even a worsening of CVD risk, at least in part through effects on atherogenic dyslipidemia, a cluster of traits including small, dense low-density lipoprotein particles. The effects of dietary SFAs on insulin sensitivity, inflammation, vascular function, and thrombosis are less clear. There is growing evidence that SFAs in the context of dairy foods, particularly fermented dairy products, have neutral or inverse associations with CVD. Overall dietary patterns emphasizing vegetables, fish, nuts, and whole versus processed grains form the basis of heart-healthy eating and should supersede a focus on macronutrient composition.
Collapse
Affiliation(s)
- Patty W. Siri-Tarino
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
| | - Sally Chiu
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
| | - Nathalie Bergeron
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
- College of Pharmacy, Touro University California, Vallejo, California 94594
| | - Ronald M. Krauss
- Atherosclerosis Research Program, Children’s Hospital Oakland Research Institute, Oakland, California 94609
| |
Collapse
|