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  Subjects -> NUTRITION AND DIETETICS (Total: 201 journals)
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American Journal of Clinical Nutrition
Journal Prestige (SJR): 3.438
Citation Impact (citeScore): 6
Number of Followers: 172  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0002-9165 - ISSN (Online) 1938-3207
Published by Oxford University Press Homepage  [419 journals]
  • Infant and child formula shortages: now is the time to prevent recurrences

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      Pages: 289 - 292
      Abstract: ABSTRACTAn acute shortage of infant formulas in the United States occurred in early 2022, exacerbating a longer-standing, less severe shortage that has occurred over the last several years. The shortage has been particularly problematic for specialized formulas such as those needed for infants and children with food allergies, intestinal failure, kidney disease, and metabolic disorders. Although undoubtedly the magnitude of the current shortage will abate over time, it has affected many children and caused tremendous distress for thousands of families. We propose a series of interventions to be undertaken as soon as feasible to help ensure that the conditions that led to this problem do not recur and families regain confidence in the safety and supply reliability of formulas for infants and young children regardless of their medical needs.
      PubDate: Tue, 17 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac149
      Issue No: Vol. 116, No. 2 (2022)
       
  • Healthy eating for healthy aging: What and when to eat as an older adult

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      Pages: 293 - 294
      Abstract: National Institute of General Medical Sciences10.13039/100000057P20GM109036National Institutes of Health10.13039/100000002P20GM109036
      PubDate: Thu, 09 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac121
      Issue No: Vol. 116, No. 2 (2022)
       
  • The quest to advance assessment of dietary intake: metabolomic meat
           markers

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      Pages: 295 - 296
      Abstract: See corresponding article on page 511.
      PubDate: Wed, 22 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac143
      Issue No: Vol. 116, No. 2 (2022)
       
  • The need for nuance with dietary data

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      Pages: 297 - 298
      Abstract: See corresponding article on page 551.
      PubDate: Thu, 09 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac120
      Issue No: Vol. 116, No. 2 (2022)
       
  • Scanning the evidence: process and lessons learned from an evidence scan
           of riboflavin to inform decisions on updating the riboflavin dietary
           reference intakes

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      Pages: 299 - 302
      PubDate: Wed, 22 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac102
      Issue No: Vol. 116, No. 2 (2022)
       
  • Higher vitamin B6 status is associated with improved survival among
           patients with stage I–III colorectal cancer

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      Pages: 303 - 313
      Abstract: ABSTRACTBackgroundFolate-mediated 1-carbon metabolism requires several nutrients, including vitamin B6. Circulating biomarker concentrations indicating high vitamin B6 status are associated with a reduced risk of colorectal cancer (CRC). However, little is known about the effect of B6 status in relation to clinical outcomes in CRC patients.ObjectivesWe investigated survival outcomes in relation to vitamin B6 status in prospectively followed CRC patients.MethodsA total of 2031 patients with stage I–III CRC participated in 6 prospective patient cohorts in the international FOCUS (folate-dependent 1-carbon metabolism in colorectal cancer recurrence and survival) Consortium. Preoperative blood samples were used to measure vitamin B6 status by the direct marker pyridoxal 5′-phosphate (PLP), as well as the functional marker HK-ratio (HKr)[3′-hydroxykynurenine: (kynurenic acid + xanthurenic acid + 3′-hydroxy anthranilic acid + anthranilic acid)]. Using Cox proportional hazards regression, we examined associations of vitamin B6 status with overall survival (OS), disease-free survival (DFS), and risk of recurrence, adjusted for patient age, sex, circulating creatinine concentrations, tumor site, stage, and cohort.ResultsAfter a median follow-up of 3.2 y for OS, higher preoperative vitamin B6 status as assessed by PLP and the functional marker HKr was associated with 16–32% higher all-cause and disease-free survival, although there was no significant association with disease recurrence (doubling in PLP concentration: HROS, 0.68; 95% CI: 0.59, 0.79; HRDFS, 0.84; 95% CI: 0.75, 0.94; HRRecurrence, 0.96; 95% CI: 0.84, 1.09; HKr: HROS, 2.04; 95% CI: 1.67, 2.49; HRDFS, 1.56; 95% CI: 1.31, 1.85; HRRecurrence, 1.21; 95% CI: 0.96,1. 52). The association of PLP with improved OS was consistent across colorectal tumor site (right-sided colon: HROS, 0.75; 95% CI: 0.59, 0.96; left-sided colon: HROS, 0.71; 95% CI: 0.55, 0.92; rectosigmoid junction and rectum: HROS, 0.61; 95% CI: 0.47, 0.78).ConclusionHigher preoperative vitamin B6 status is associated with improved OS among stage I–III CRC patients.
      PubDate: Fri, 08 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac090
      Issue No: Vol. 116, No. 2 (2022)
       
  • Dairy foods, calcium intakes, and risk of incident prostate cancer in
           Adventist Health Study–2

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      Pages: 314 - 324
      Abstract: ABSTRACTBackgroundProstate cancer is the most common noncutaneous cancer in American males. Causal links between dairy, or dietary calcium, and this cancer are considered suggestive but limited.ObjectivesTo evaluate these associations in a large North American cohort, including many with no (or very low) dairy intake and much calcium from nondairy sources.MethodsA prospective cohort study of 28,737 Seventh-day Adventist men in the United States and Canada, of whom 6389 were of black ethnicity. Diet was measured by FFQ, and 275 male participants also provided repeated 24-h dietary recalls as a calibration substudy. Incident cancers were mainly found by matching with cancer registries. Analyses used multivariable proportional hazards regressions and regression calibration for some analyses.ResultsIn total, 1254 (190 advanced) incident prostate cancer cases were found during an average 7.8 y of follow-up. Men at the 90th percentile of dairy intake (430 g/d) compared with the 10th percentile (20.2 g/d) had higher prostate cancer risk (HR: 1.27; 95% CI: 1.12, 1.43). Similar findings, comparing the same g/d intakes, were demonstrated for advanced prostate cancers (HR: 1.38; 95% CI: 1.02, 1.88), for nonadvanced cases (HR: 1.27; 95% CI: 1.11, 1.45), in black participants (HR: 1.24; 95% CI: 0.98, 1.58), and when excluding vegan participants (HR: 1.22; 95% CI: 1.03, 1.43). Calibrated dairy (g/d) regressions (all participants and all prostate cancers), adjusting for dietary measurement error, found a HR of 1.75 (95% CI: 1.32, 2.32). Comparing 90th percentile intake to zero intakes (uncalibrated), the HR was 1.62 (95% CI: 1.26, 2.05). There was no evidence of an effect of higher (905 mg/d) compared with lower (349 mg/d) intakes of nondairy calcium (HR: 1.16; 95% CI: 0.94, 1.44).ConclusionsMen with higher intake of dairy foods, but not nondairy calcium, had a higher risk of prostate cancer compared with men having lower intakes. Associations were nonlinear, suggesting greatest increases in risk at relatively low doses.
      PubDate: Wed, 08 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac093
      Issue No: Vol. 116, No. 2 (2022)
       
  • Prospective study of breakfast frequency and timing and the risk of
           incident type 2 diabetes in community-dwelling older adults: the
           Cardiovascular Health Study

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      Pages: 325 - 334
      Abstract: ABSTRACTBackgroundNo evidence-based recommendations regarding optimal breakfast frequency and timing and type 2 diabetes mellitus (T2DM) exist for older adults because of limited studies.ObjectivesWe sought to prospectively assess relations between breakfast frequency and timing and T2DM risk among older adults and determine whether these depended on sex or cardiometabolic risk factors.MethodsWeekly breakfast frequency and usual daily breakfast time were assessed by questionnaire at baseline in 3747 older adults (aged ≥ 65 y) from the Cardiovascular Health Study (CHS) who were free of cancer and T2DM and followed for 17.6 y. Multivariable-adjusted hazard ratios (aHRs) with 95% CIs estimated from Cox proportional hazards models were used to quantify associations with T2DM.ResultsMost CHS participants (median age: 74 y; IQR: 71–78 y) consumed breakfast daily (85.5%), and 73% had their first daily eating occasion between 07:00 and 09:00, both of which were associated with higher socioeconomic status, factors that are indicative of a healthier lifestyle, and lower levels of cardiometabolic risk indicators at baseline. During follow-up, 547 T2DM cases were documented. No strong evidence was observed linking breakfast frequency and risk of T2DM. Compared with participants whose breakfast timing (first eating occasion of the day) was 07:00–09:00, those who broke fast after 09:00 had an aHR for T2DM of 0.71 (95% CI: 0.51, 0.99). This association was present in participants with impaired fasting glucose at baseline (aHR: 0.61; 95% CI: 0.39, 0.95) but not in those without (aHR: 0.83; 95% CI: 0.50, 1.38). No associations between eating frequency or timing and T2DM were observed within other prespecified subgroups.ConclusionsEating breakfast daily was not associated with either higher or lower risk of T2DM in this cohort of older adults, whereas a later (after 09:00) daily first eating occasion time was associated with lower T2DM risk in participants with impaired fasting glucose at baseline.This trial was registered at clinicaltrials.gov as NCT00005133.
      PubDate: Tue, 05 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac087
      Issue No: Vol. 116, No. 2 (2022)
       
  • The effects of SCFAs on glycemic control in humans: a systematic review
           and meta-analysis

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      Pages: 335 - 361
      Abstract: ABSTRACTBackgroundNoncommunicable disease development is related to impairments in glycemic and insulinemic responses, which can be modulated by fiber intake. Fiber's beneficial effects upon metabolic health can be partially attributed to the production of SCFAs via microbial fermentation of fiber in the gastrointestinal tract.ObjectivesWe aimed to determine the effects of SCFAs, acetate, propionate, and butyrate on glycemic control in humans.MethodsThe CENTRAL, Embase, PubMed, Scopus, and Web of Science databases were searched from inception to 7 December 2021. Papers were included if they reported a randomized controlled trial measuring glucose and/or insulin compared to a placebo in adults. Studies were categorized by the type of SCFA and intervention duration. Random-effects meta-analyses were performed for glucose and insulin for those subject categories with ≥3 studies, or a narrative review was performed.ResultsWe identified 43 eligible papers, with 46 studies within those records (n = 913), and 44 studies were included in the meta-analysis. Vinegar intake decreased the acute glucose response [standard mean difference (SMD), −0.53; 95% CI, −0.92 to −0.14; n = 67] in individuals with impaired glucose tolerance or type 2 diabetes and in healthy volunteers (SMD, −0.27; 95% CI, −0.54 to 0.00; n = 186). The meta-analyses for acute acetate, as well as acute and chronic propionate studies, showed no significant effect.ConclusionsVinegar decreased the glucose response acutely in healthy and metabolically unhealthy individuals. Acetate, propionate, butyrate, and mixed SCFAs had no effect on blood glucose and insulin in humans. Significant heterogeneity, risks of bias, and publication biases were identified in several study categories, including the acute vinegar glucose response. As evidence was very uncertain, caution is urged when interpreting these results. Further high-quality research is required to determine the effects of SCFAs on glycemic control.
      PubDate: Thu, 07 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac085
      Issue No: Vol. 116, No. 2 (2022)
       
  • Associations between dietary patterns and cardiovascular disease risk in
           Canadian adults: a comparison of partial least squares, reduced rank
           regression, and the simplified dietary pattern technique

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      Pages: 362 - 377
      Abstract: ABSTRACTBackgroundHybrid methodologies have gained continuing interest as unique data reduction techniques for establishing a direct link between dietary exposures and clinical outcomes.ObjectivesWe aimed to compare partial least squares (PLS) and reduced rank regression (RRR) in identifying a dietary pattern associated with a high cardiovascular disease (CVD) risk in Canadian adults, construct PLS- and RRR-based simplified dietary patterns, and assess associations between the 4 dietary pattern scores and CVD risk.MethodsData were collected from 24-h dietary recalls of adult respondents in the 2 cycles of the nationally representative Canadian Community Health Survey (CCHS)-Nutrition: CCHS 2004 linked to health administrative databases (n = 12,313) and CCHS 2015 (n = 14,020). Using 39 food groups, PLS and RRR were applied for identification of an energy-dense (ED), high-saturated-fat (HSF), and low-fiber-density (LFD) dietary pattern. Associations of the derived dietary pattern scores with lifestyle characteristics and CVD risk were examined using weighted multivariate regression and weighted multivariable-adjusted Cox proportional hazard models, respectively.ResultsPLS and RRR identified highly similar ED, HSF, and LFD dietary patterns with common high positive loadings for fast food, carbonated drinks, salty snacks, and solid fats, and high negative loadings for fruit, dark green vegetables, red and orange vegetables, other vegetables, whole grains, and legumes and soy (≥ 0.17 ). Food groups with the highest loadings were summed to form simplified pattern scores. Although the dietary patterns were not significantly associated with CVD risk, they were positively associated with 402-kcal/d higher energy intake (P-trends < 0.05) and higher obesity risk (PLS: OR: 2.09; 95% CI: 1.62, 2.70; RRR: OR: 1.76; 95% CI: 1.44, 2.17) (P-trends < 0.0001) in the fourth quartiles.ConclusionsPLS and RRR were shown to be equally effective for the derivation of a high-CVD-risk dietary pattern among Canadian adults. Further research is warranted on the role of major dietary components in cardiovascular health.
      PubDate: Mon, 02 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac117
      Issue No: Vol. 116, No. 2 (2022)
       
  • Dietary quality and risk of heart failure in men

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      Pages: 378 - 385
      Abstract: ABSTRACTBackgroundDue to the increasing disease burden, strategies to predict and prevent heart failure (HF) are urgently needed.ObjectiveWe aimed to investigate whether the Alternative Healthy Eating Index (AHEI) and the clinically abbreviated Prime Diet Quality Score (PDQS) are associated with the risk of overall HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF).MethodsOur study included 44,525 men from the Health Professionals Follow-up Study (HPFS) who were free from cardiovascular disease and cancer at baseline. The AHEI and PDQS were computed based on dietary data repeatedly measured using semiquantitative FFQs. HF, HFpEF, and HFrEF were adjudicated based on review of medical records through 2008. Associations of diet quality with incident HF were estimated with multivariate-adjusted Cox proportional hazards models.ResultsDuring 929,911 person-years of follow-up, 803 HF cases were documented, including 184 with HFpEF and 181 with HFrEF among those with ejection fraction (EF) data. Adjusting for potential confounders, we did not observe a significant association between the AHEI and overall HF (HR per SD: 0.96; 95% CI: 0.89, 1.04; P-trend = 0.57) or between the PDQS and overall HF (HR per SD: 0.98; 95% CI: 0.91, 1.06; P-trend = 0.82). Both dietary indices were not significantly associated with HFpEF. However, a higher AHEI was associated with lower risk of HFrEF upon comparison of the extreme quintiles (HR per SD: 0.81; 95% CI: 0.69, 0.96; P-trend = 0.02). Every SD increment in the PDQS was associated with 20% lower risk of HFrEF (HR per SD: 0.80; 95% CI: 0.68, 0.95; P-quadratic = 0.03).ConclusionsA healthy overall diet was associated with lower risk of HFrEF, and associations were similar with the AHEI and PDQS. We did not observe a significant association between dietary indices and either overall HF or HFpEF.
      PubDate: Tue, 03 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac119
      Issue No: Vol. 116, No. 2 (2022)
       
  • The association of genetic susceptibility to smoking with cardiovascular
           disease mortality and the benefits of adhering to a DASH diet: The
           Singapore Chinese Health Study

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      Pages: 386 - 393
      Abstract: ABSTRACTBackgroundUnderstanding the genetic predisposition to cardiovascular disease (CVD) may help to improve clinical intervention strategies. Lifestyle factors, such as diet, may differ among ethnic groups and may, in turn, modify individuals’ risks to diseases.ObjectivesWe examined the genetic predisposition to ever smoking in relation to CVD mortality and assessed whether such an association could be modified by dietary intake.MethodsA total of 23,760 Chinese adults from the Singapore Chinese Heath Study who were free of cancer and CVD at recruitment (1993–1998) were included in the study. A weighted genetic risk score (wGRS) was calculated to define the genetically determined regular smoking behavior (never or ever). Multivariable-adjusted Cox regression models were used to assess the association between the wGRS and CVD mortality. We also conducted a 1-sample Mendelian randomization analysis for ever smoking and CVD mortality.ResultsOver a mean of 22.6 years of follow-up, 2301 CVD deaths were identified. A genetic predisposition to ever smoking was significantly associated with CVD mortality; the multivariable-adjusted HR of CVD mortality was 1.07 (95% CI: 1.03–1.12), with a per-SD increment in the wGRS. However, the Mendelian randomization analysis did not support a causal relationship between ever smoking and CVD mortality (OR, 1.13; 95% CI: 0.87–1.45). Additionally, the Dietary Approaches to Stop Hypertension (DASH) score significantly modified the association between the smoking wGRS and CVD mortality; the association between a genetic predisposition to smoking and CVD mortality was only observed among individuals with a low DASH score (P-interaction = 0.004).ConclusionsA genetic predisposition to smoking was associated with CVD mortality in the Chinese population. In addition, we detected a significant interaction showing higher CVD mortality related to genetically determined smoking among those with lower DASH scores.
      PubDate: Thu, 12 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac128
      Issue No: Vol. 116, No. 2 (2022)
       
  • Sources of dietary gluten in the first 2 years of life and associations
           with celiac disease autoimmunity and celiac disease in Swedish genetically
           predisposed children: The Environmental Determinants of Diabetes in the
           Young (TEDDY) study

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      Pages: 394 - 403
      Abstract: ABSTRACTBackgroundHigh gluten intake is associated with increased risk of celiac disease (CD) in children at genetic risk.ObjectivesWe aimed to investigate if different dietary gluten sources up to age 2 y confer different risks of celiac disease autoimmunity (CDA) and CD in children at genetic risk.MethodsThree-day food records were collected at ages 6, 9, 12, 18, and 24 mo from 2088 Swedish genetically at-risk children participating in a 15-y follow-up cohort study on type 1 diabetes and CD. Screening for CD was performed with tissue transglutaminase autoantibodies (tTGA). The primary outcome was CDA, defined as persistent tTGA positivity. The secondary outcome was CD, defined as having a biopsy specimen showing Marsh score ≥ 2 or an averaged tTGA level ≥ 100 Units. Cox regression adjusted for total gluten intake estimated HRs with 95% CIs for daily intake of gluten sources.ResultsDuring follow-up, 487 (23.3%) children developed CDA and 242 (11.6%) developed CD. Daily intake of ≤158 g porridge at age 9 mo was associated with increased risk of CDA (HR: 1.53; 95% CI: 1.05, 2.23; P = 0.026) compared with no intake. A high daily bread intake (>18.3 g) at age 12 mo was associated with increased risk of both CDA (HR: 1.47; 95% CI: 1.05, 2.05; P = 0.023) and CD (HR: 1.79; 95% CI: 1.10, 2.91; P = 0.019) compared with no intake. At age 18 mo, milk cereal drink was associated with an increased risk of CD (HR: 1.16; 95% CI: 1.00, 1.33; P = 0.047) per 200-g/d increased intake. No association was found for other gluten sources up to age 24 mo and risk of CDA or CD.ConclusionsHigh daily intakes of bread at age 12 mo and of milk cereal drink during the second year of life are associated with increased risk of both CDA and CD in genetically at-risk children.
      PubDate: Fri, 08 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac086
      Issue No: Vol. 116, No. 2 (2022)
       
  • Breastfeeding duration modifies the association between maternal weight
           status and offspring dietary palmitate oxidation

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      Pages: 404 - 414
      Abstract: ABSTRACTBackgroundOffspring of obese rodents develop a metabolic phenotype that favors fat deposition. Data regarding the impact of maternal obesity programing of offspring fuel usage in humans is scarce.ObjectiveThe objective of this study was to explore the association between maternal weight status and dietary palmitate oxidation (DPO) in 2-y-old offspring, taking into consideration potential confounders and modifiers.MethodsWomen (n = 56) were enrolled by the first trimester of gestation. Maternal physical activity (PA; measured with accelerometers) at enrollment and gestational weight gain (GWG) were measured. Offspring sex, race, and breastfeeding (BF) duration were self-reported. Human milk (HM) composition was determined at 6 mo postpartum. At age 2 y, dietary quality [healthy eating index (HEI)] and parental feeding practices [Child Feeding Questionnaire (CFQ)] were assessed. DPO in 2-y-olds (2-yo-DPO) was measured using deuterated palmitic acid. Generalized linear regression analysis was used to model the associations of 2-yo-DPO with maternal weight status [normal weight (NW), BMI <25 (in kg/m2) compared with excessive weight (EW), BMI ≥25].ResultsDPO was higher in offspring of women with EW compared with NW (2.1 ± 1.2%/h compared with 1.4 ± 0.7%/h, P = 0.03). Maternal weight status interacted with BF duration in association with 2-yo-DPO (log ß: 0.05, P = 0.04). Specifically, 2-yo-DPO was higher in the EW compared with NW group if BF duration was ≥9 mo. HM insulin (log ß: 0.35, P = 0.002) and HM leptin (log ß: 0.81, P = 0.001) concentrations directly associated with 2-yo-DPO. PA (log ß: 0.06, P = 0.013), parental feeding restriction (log ß: 0.05, P < 0.0001), and male sex (log ß: 0.54, P < 0.001) were positively associated with 2-yo-DPO. HEI was negatively associated with 2-yo-DPO (log ß:−0.03, P < 0.0001).ConclusionsHigher 2-yo-DPO in offspring of women with EW compared with NW were driven by BF duration. Higher HM insulin and leptin concentrations in women with EW may explain these finding. More studies are needed to confirm these results. This trial was registered at clinicaltrials.gov as NCT03281850.
      PubDate: Mon, 11 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac097
      Issue No: Vol. 116, No. 2 (2022)
       
  • Affordability influences nutritional quality of seafood consumption among
           income and race/ethnicity groups in the United States

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      Pages: 415 - 425
      Abstract: ABSTRACTBackgroundThe 2020 US Dietary Guidelines for Americans recommend that the US population consume more seafood. Most analyses of seafood consumption ignore heterogeneity in consumption patterns by species, nutritional content, production methods, and price, which have implications for applying recommendations.ObjectivesWe assessed seafood intake among adults by socioeconomic and demographic groups, as well as the cost of seafood at retail to identify affordable and nutritious options.MethodsNHANES 2011–2018 dietary data (n = 17,559 total, n = 3285 eating seafood) were used to assess adult (≥20 y) intake of seafood in relation to income and race/ethnicity. Multivariable linear regression assessed the association between seafood consumption and income, adjusted for age, sex, and race/ethnicity, and the association between nutrients and seafood price, using Nielsen 2017–2019 retail sales data, adjusted for sales volume.ResultsLow-income groups consume slightly less seafood than high-income groups [low income: mean 120.2 (95% CI: 103.5, 137.2) g/wk; high income: 141.8 (119.1, 164.1) g/wk] but substantially less seafood that is high in long-chain n–3 (ω-3) PUFAs [lower income: 21.3 (17.3, 25.5) g/wk; higher income: 46.8 (35.4, 57.8) g/wk]. Intake rates, species, and production method choices varied by race/ethnicity groups and within race/ethnicity groups by income. Retail seafood as a whole costs more than other protein foods (e.g., meat, poultry, eggs, beans), and fresh seafood high in n–3 PUFAs costs more (P < 0.002) than fresh seafood low in n–3 PUFAs. Retail seafood is available in a wide range of price points and product forms, and some lower-cost fish and shellfish were high in n–3 PUFAs, calcium, iron, selenium, and vitamins B-12 and D.ConclusionsNew insights into the relation between seafood affordability and consumption patterns among income and ethnicity groups suggest that specific policies and interventions may be needed to enhance the consumption of seafood by different groups.
      PubDate: Mon, 13 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac099
      Issue No: Vol. 116, No. 2 (2022)
       
  • Estimates of child mortality reductions attributed to vitamin A
           supplementation in sub-Saharan Africa: scale up, scale back, or
           refocus'

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      Pages: 426 - 434
      Abstract: ABSTRACTBackgroundVitamin A supplementation (VAS) has been implemented in over 82 countries globally, primarily because of its beneficial effect in preventing child mortality. Secular reductions in child mortality and the implementation of alternative programs to promote vitamin A intake have led to questions on the need for national VAS programs.ObjectivesThis study aimed to estimate child mortality changes related to VAS using current, scale-back, and scale-up coverage scenarios.MethodsData related to demographic characteristics, fertility, intervention coverage, anthropometry, child mortality and cause-of-death structure were integrated into the Lives Saved Tool (LiST). We estimated the cause-specific (LiST model) and all-cause mortality reductions related to VAS based on evidence from recent meta-analyses.ResultsBetween 2008 and 2018, VAS coverage declined in most sub-Saharan African (SSA) countries. In 2019 alone, 12% and 24% reductions in all-cause mortality related to VAS were expected to avert from 105,332 to 234,704 child deaths, respectively, in SSA; whereas the cause-specific mortality model (LiST) estimated that 141,670 child deaths were averted in 2019. Estimates of VAS-related child mortality reductions were highly variable among countries. Our scaling-back scenario led to highly variable country-level results, with expected increases in mortality rates, from a low of 0.04/1000 live births to as high as 49.3/1000 live births, suggesting that some countries could start considering scaling back, while others need to scale up.ConclusionsExcess child mortality that would be preventable by VAS has declined, but is still significant in many SSA countries. While scale-up of VAS is needed for most of the countries, scaling back can also be considered in some countries. Policy decisions, however, should be guided by more recent data on food consumption, vitamin A statuses, child health, and vitamin A fortification coverage.
      PubDate: Tue, 05 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac082
      Issue No: Vol. 116, No. 2 (2022)
       
  • Metagenomic profile of the fecal microbiome of preterm infants consuming
           mother's own milk with bovine milk–based fortifier or infant formula: a
           cross-sectional study

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      Pages: 435 - 445
      Abstract: ABSTRACTBackgroundPreterm (PT) infants harbor a different gut microbiome than full-term infants. Multiple factors affect gut microbial colonization of PT infants, including low gestational age, high rates of Cesarean section, exposure to antibiotics, and diet. Human milk, whether it's mother's own milk (MOM) or donor human milk, is the preferred feeding mode for PT infants but needs to be fortified to achieve adequate nutrient content. Infant formulas are introduced at later stages if human milk is insufficient or unavailable. How these dietary exposures affect the gut microbiome of PT infants is poorly understood.ObjectivesThe goal of this study was to evaluate the metagenomic potential of the fecal microbiome of PT infants consuming MOM with bovine milk–based fortifier compared with PT formula alone.MethodsForty-two stool samples, from 27 infants consuming MOM or formula (21 samples in each group) were included. Twelve infants had repeated sampling (2–3 samples). Shotgun genomic DNA sequencing was performed and analyzed using MetaPhlAn and HUMAnN2. Multivariate regression analysis, adjusting by the repeated sampling, was used to identify the features that differed between PT infants consuming MOM compared with formula.ResultsThe primary function of the fecal microbiome of PT infants was characterized by a high abundance of biosynthesis pathways. A set of core features was identified; these belonged to pathways for amino acid metabolism and vitamin K-2 biosynthesis. Five pathways significantly differed between the MOM and formula group. Pathways for fatty acid and carbohydrate degradation were significantly higher in the MOM group. Taxonomically, members of the phylum Actinobacteria and the genus Bifidobacterium were higher in PT infants exposed to MOM.ConclusionsThis study provides insight into the influence of feeding MOM compared with infant formula on the structure and function of the fecal microbiome of PT infants.
      PubDate: Wed, 06 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac081
      Issue No: Vol. 116, No. 2 (2022)
       
  • Effectiveness of an integrated agriculture, nutrition-specific, and
           nutrition-sensitive program on child growth in Western Kenya: a
           cluster-randomized controlled trial

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      Pages: 446 - 459
      Abstract: ABSTRACTBackgroundStunting rates remain unacceptably high in many regions, including sub-Saharan Africa. Agricultural programs have led to increased yields and household incomes but showed limited success in improving nutritional status.ObjectivesWe assessed whether linear growth could be improved through a potentially scalable, integrated program adding nutrition-specific and nutrition-sensitive components to an existing agricultural program.MethodsIn this cluster-randomized controlled trial in rural Western Kenya, we randomized children aged 6–35 months from farming families to an agricultural intervention without (control group) or with a bundle of interventions (intervention group), including distribution of micronutrient powders (MNP), poultry to increase egg consumption, seeds of greens and onions, and soap and chlorine solution, as well as provision of monthly behavior change trainings. The primary outcome was the change in height-for-age z-score (HAZ) over 2 years of follow-up. We assessed safety through active morbidity and passive adverse event monitoring. We conducted an intention-to-treat analysis, followed by per-protocol and prespecified subgroup analyses.ResultsFrom March to April 2018, we enrolled 1927 children from 126 clusters (control, 942 children in 63 clusters; intervention, 985 children in 63 clusters). Data on HAZ were available for 1672 (86.6%) children after 2 years. Adherence was >80% for use of MNP, chlorine, and greens and receipt of soap, and ∼40% for egg and red onion consumption. The intention-to-treat analysis indicated a greater change in HAZ over 2 years in the intervention group (adjusted effect size, 0.11; 95% CI: 0.02–0.19). We found a slightly stronger effect in the per-protocol analysis (adjusted effect size, 0.15; 95% CI: 0.06–0.24). Dietary diversity and consumption of iron-rich foods were improved in the intervention group, and reported instances of fever, lower respiratory tract infections, and diarrheal episodes were lower in the intervention group.ConclusionsThis study found a modest improvement in linear growth, indicating the need for multiple, integrated interventions to achieve benefits. The trial was registered with clinicaltrials.gov as NCT03448484.
      PubDate: Thu, 14 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac098
      Issue No: Vol. 116, No. 2 (2022)
       
  • Gestational weight gain and dietary energy, iron, and choline intake
           predict severity of fetal alcohol growth restriction in a prospective
           birth cohort

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      Pages: 460 - 469
      Abstract: ABSTRACTBackgroundAnimal models have demonstrated that maternal nutrition can alter fetal vulnerability to prenatal alcohol exposure (PAE). Few human studies have examined the role of nutrition in fetal alcohol spectrum disorders (FASD).ObjectivesOur objectives were to examine whether fetal vulnerability to PAE-related growth restriction is modified by: 1) rate of gestational weight gain; or prenatal dietary intakes of 2) energy, 3) iron, or 4) choline.MethodsIn a prospective longitudinal birth cohort in Cape Town, South Africa, 118 heavy-drinking and 71 abstaining/light-drinking pregnant women were weighed and interviewed regarding demographics, alcohol, cigarette/other drug use, and diet at prenatal visits. Infant length, weight, and head circumference were measured at 2 wk and 12 mo postpartum.ResultsHeavy-drinking mothers reported a binge pattern of drinking [Mean = 129 mL (∼7.2 drinks)/occasion on 1.3 d/wk). Rate of gestational weight gain and average daily dietary energy, iron, and choline intakes were similar between heavy-drinking women and controls. In regression models adjusting for maternal age, socioeconomic status, cigarette use, and weeks gestation at delivery, PAE [ounces (30 mL) absolute alcohol per day] was related to smaller 2-wk length and head circumference and 12-mo length, weight, and head circumference z-scores (β = −0.43 to −0.67; all P values <0.05). In stratified analyses for each maternal nutritional measure (inadequate compared with adequate weight gain; tertiles for dietary energy, iron, and choline intakes), PAE-related growth restriction was more severe in women with poorer nutrition, with effect modification seen by weight gain, energy, iron, and/or choline for several anthropometric outcomes.ConclusionsGestational weight gain and dietary intakes of energy, choline, and iron appeared to modify fetal vulnerability to PAE-related growth restriction. These findings suggest a need for screening programs for pregnant women at higher risk of having a child with FASD to identify alcohol-using women who could benefit from nutritional interventions.
      PubDate: Tue, 19 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac101
      Issue No: Vol. 116, No. 2 (2022)
       
  • Early pregnancy vitamin D status is associated with blood pressure in
           children: an Odense Child Cohort study

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      Pages: 470 - 481
      Abstract: ABSTRACTBackgroundBlood pressure in childhood tracks into later life. Vitamin D status in adults is associated with blood pressure, but the impact of vitamin D status in pregnancy and childhood on blood pressure still needs investigation.ObjectiveWe investigated whether fetal rather than current vitamin D status is associated with blood pressure in children.MethodsIn a prospective observational study within the population-based Odense Child Cohort (OCC), we examined serum 25-hydroxyvitamin D2+3 [s-25(OH)D] in early and late pregnancy, cord blood, and at 5 y age, and the associations with systolic and diastolic blood pressure (SBP/DBP) in the 5-y-old children (n = 1,677). Multiple regression models were adjusted for maternal country of origin, parity, smoking during pregnancy, 5-y height, and weight. Two-stage mixed effect modeling was performed, integrating all s-25(OH)D data from pregnancy and cord blood.ResultsThe median (IQR) s-25(OH)D in early pregnancy, late pregnancy, the umbilical cord, and at 5 y was 65.5 (50.7–78.5), 78.5 (60.3– 95.8), 45.4 (31.1– 60.7), and 71.9 (54.6– 86.5) nmol/L, respectively. The mean ±SD 5-y SBP/DBP was 101.0/63.8 (7.1/5.9) mmHg. In adjusted analyses, a 10 nmol/L increase of s-25(OH)D in early pregnancy associated with a 0.3/0.2 mmHg lower SBP/DBP at 5 y (P < 0.05). Optimal s-25(OH)D (>75 nmol/L) in early pregnancy was associated with lower 5-y SBP and DBP, β (95% CI) −1.45 (−2.6, −0.3), and −0.97 (−1.9, −0.1), compared with reference s-25(OH)D (50-74.9 nmol/L). Two-stage analysis combining early pregnancy, late pregnancy, and cord s-25(OH)D data showed an inverse association with 5-y SBP and DBP for boys (P < 0.025) with significant sex-difference for DBP (Pinteraction = 0.004). No associations were found between s-25(OH)D and 5-y BP above the 90th percentile.ConclusionEarly pregnancy s-25(OH)D concentrations, especially >75 nmol/L, were inversely associated with 5-y blood pressure in the offspring. A novel identified protective effect of optimal vitamin D levels in early pregnancy on offspring BP is suggested.
      PubDate: Tue, 03 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac118
      Issue No: Vol. 116, No. 2 (2022)
       
  • Association between postterm pregnancy and adverse growth outcomes in
           preschool-age children

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      Pages: 482 - 490
      Abstract: ABSTRACTBackgroundPostterm pregnancy has been associated with higher risk of perinatal mortality and morbidity, but its long-term health effects on offspring are poorly understood.ObjectivesThe aim of the study was to investigate the prospective associations between maternal postterm pregnancy and adverse growth outcomes in children.MethodsThe Jiaxing Birth Cohort is part of a large population-based health surveillance system in China and recruited pregnant females resident in the Jiaxing area between 1999 and 2013; newborns were followed up for a median duration of 5.8 y until they went to school. Mother–child pairs with maternal gestational information and offspring's anthropometric data at 4–7 y old were included. Postterm pregnancy was defined as maternal gestational age ≥42 and <47 wk, and its associations with offspring obesity, overweight/obesity, and thinness during childhood were determined by using Poisson regression models.ResultsOf the 101,505 included mother–child pairs, 2369 (2.3%) children were born at postterm. Children born at postterm had significantly lower BMI-for-age z score, weight-for-age z score, and height-for-age z score than those born at term; the mean difference (95% CI) was −0.11 (−0.15, −0.06), −0.17 (−0.21, −0.13), and −0.16 (−0.20, −0.12), respectively. When comparing postterm with term pregnancy, the multivariable-adjusted RRs and 95% CIs among preschool-age children were 0.87 (0.68, 1.11) for obesity, 0.82 (0.72, 0.94) for overweight/obesity, and 1.18 (1.09, 1.28) for thinness, respectively. These risk estimates were robust in sensitivity analyses, but were attenuated in several subgroups stratified by age, sex, mode of delivery, and fetal distress.ConclusionsPostterm pregnancy was associated with a higher risk of thinness, and a lower risk of overweight/obesity, as well as lower growth parameters in preschool-age children. These findings imply that postterm pregnancy may impede the long-term growth of offspring.
      PubDate: Wed, 11 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac127
      Issue No: Vol. 116, No. 2 (2022)
       
  • Vitamin D supplementation in chronic obstructive pulmonary disease
           patients with low serum vitamin D: a randomized controlled trial

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      Pages: 491 - 499
      Abstract: ABSTRACTBackgroundVitamin D deficiency is frequently found in patients with chronic obstructive pulmonary disease (COPD). Vitamin D has antimicrobial, anti-inflammatory, and immunomodulatory effects. Therefore, supplementation may prevent COPD exacerbations, particularly in deficient patients.ObjectivesWe aimed to assess the effect of vitamin D supplementation on exacerbation rate in vitamin D–deficient patients with COPD.MethodsWe performed a multicenter, double-blind, randomized controlled trial. COPD patients with ≥1 exacerbations in the preceding year and a vitamin D deficiency (15–50 nmol/L) were randomly allocated in a 1:1 ratio to receive either 16,800 International Units (IU) vitamin D3 or placebo once a week during 1 y. Primary outcome of the study was exacerbation rate. Secondary outcomes included time to first and second exacerbations, time to first and second hospitalizations, use of antibiotics and corticosteroids, pulmonary function, maximal respiratory mouth pressure, physical performance, skeletal muscle strength, systemic inflammatory markers, nasal microbiota composition, and quality of life.ResultsThe intention-to-treat population consisted of 155 participants. Mean ± SD serum 25-hydroxyvitamin D [25(OH)D] concentration after 1 y was 112 ± 34 nmol/L in the vitamin D group, compared with 42 ± 17 nmol/L in the placebo group. Vitamin D supplementation did not affect exacerbation rate [incidence rate ratio (IRR): 0.90; 95% CI: 0.67, 1.21]. In a prespecified subgroup analysis in participants with 25(OH)D concentrations of 15–25 nmol/L (n = 31), no effect of vitamin D supplementation was found (IRR: 0.91; 95% CI: 0.43, 1.93). No relevant differences were found between the intervention and placebo groups in terms of secondary outcomes.ConclusionsVitamin D supplementation did not reduce exacerbation rate in COPD patients with a vitamin D deficiency.This trial was registered at clinicaltrials.gov as NCT02122627.
      PubDate: Wed, 06 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac083
      Issue No: Vol. 116, No. 2 (2022)
       
  • Genetic variants in ALDH1L1 and GLDC influence the serine-to-glycine ratio
           in Hispanic children

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      Pages: 500 - 510
      Abstract: ABSTRACTBackgroundGlycine is a proteogenic amino acid that is required for numerous metabolic pathways, including purine, creatine, heme, and glutathione biosynthesis. Glycine formation from serine, catalyzed by serine hydroxy methyltransferase, is the major source of this amino acid in humans. Our previous studies in a mouse model have shown a crucial role for the 10-formyltetrahydrofolate dehydrogenase enzyme in serine-to-glycine conversion.ObjectivesWe sought to determine the genomic influence on the serine-glycine ratio in 803 Hispanic children from 319 families of the Viva La Familia cohort.MethodsWe performed a genome-wide association analysis for plasma serine, glycine, and the serine-glycine ratio in Sequential Oligogenic Linkage Analysis Routines while accounting for relationships among family members.ResultsAll 3 parameters were significantly heritable (h2 = 0.22–0.78; P < 0.004). The strongest associations for the serine-glycine ratio were with single nucleotide polymorphisms (SNPs) in aldehyde dehydrogenase 1 family member L1 (ALDH1L1) and glycine decarboxylase (GLDC) and for glycine with GLDC (P < 3.5 × 10–8; effect sizes, 0.03–0.07). No significant associations were found for serine. We also conducted a targeted genetic analysis with ALDH1L1 exonic SNPs and found significant associations between the serine-glycine ratio and rs2886059 (β = 0.68; SE, 0.25; P = 0.006) and rs3796191 (β = 0.25; SE, 0.08; P = 0.003) and between glycine and rs3796191 (β = −0.08; SE, 0.02; P = 0.0004). These exonic SNPs were further associated with metabolic disease risk factors, mainly adiposity measures (P < 0.006). Significant genetic and phenotypic correlations were found for glycine and the serine-glycine ratio with metabolic disease risk factors, including adiposity, insulin sensitivity, and inflammation-related phenotypes [estimate of genetic correlation = −0.37 to 0.35 (P < 0.03); estimate of phenotypic correlation = −0.19 to 0.13 (P < 0.006)]. The significant genetic correlations indicate shared genetic effects among glycine, the serine-glycine ratio, and adiposity and insulin sensitivity phenotypes.ConclusionsOur study suggests that ALDH1L1 and GLDC SNPs influence the serine-to-glycine ratio and metabolic disease risk.
      PubDate: Sat, 23 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac091
      Issue No: Vol. 116, No. 2 (2022)
       
  • Development and validation of a metabolite score for red meat intake: an
           

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      Pages: 511 - 522
      Abstract: ABSTRACTBackgroundSelf-reported meat consumption is associated with disease risk but objective assessment of different dimensions of this heterogeneous dietary exposure in observational and interventional studies remains challenging.ObjectivesWe aimed to derive and validate scores based on plasma metabolites for types of meat consumption. For the most predictive score, we aimed to test whether the included metabolites varied with change in meat consumption, and whether the score was associated with incidence of type 2 diabetes (T2D) and other noncommunicable diseases.MethodsWe derived scores based on 781 plasma metabolites for red meat, processed meat, and poultry consumption assessed with 7-d food records among 11,432 participants in the EPIC-Norfolk (European Prospective Investigation into Cancer and Nutrition-Norfolk) cohort. The scores were then tested for internal validity in an independent subset (n = 853) of the same cohort. In focused analysis on the red meat metabolite score, we examined whether the metabolites constituting the score were also associated with meat intake in a randomized crossover dietary intervention trial of meat (n = 12, Lyon, France). In the EPIC-Norfolk study, we assessed the association of the red meat metabolite score with T2D incidence (n = 1478) and other health endpoints.ResultsThe best-performing score was for red meat, comprising 139 metabolites which accounted for 17% of the explained variance of red meat consumption in the validation set. In the intervention, 11 top-ranked metabolites in the red meat metabolite score increased significantly after red meat consumption. In the EPIC-Norfolk study, the red meat metabolite score was associated with T2D incidence (adjusted HR per SD: 1.17; 95% CI: 1.10, 1.24).ConclusionsThe red meat metabolite score derived and validated in this study contains metabolites directly derived from meat consumption and is associated with T2D risk. These findings suggest the potential for objective assessment of dietary components and their application for understanding diet–disease associations.The trial in Lyon, France, was registered at clinicaltrials.gov as NCT03354130.
      PubDate: Mon, 27 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac094
      Issue No: Vol. 116, No. 2 (2022)
       
  • The impacts of measurement errors on a dietary pattern analyses:a
           simulation study based on dietary data from the China Multi-Ethnic Cohort
           (CMEC) study

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      Pages: 523 - 530
      Abstract: ABSTRACTBackgroundMeasurement error is a significant challenge in nutritional epidemiology research. Compared with traditional, isolated-nutrient research, dietary-pattern studies provide a more comprehensive approach to chronic disease prevention and have become popular in recent years. However, few studies have examined the impacts of measurement errors on dietary pattern analyses.ObjectivesWe investigated the impacts of measurement errors on the 2 most commonly used dietary pattern derivation methods: principal component factor analysis (PCFA) and K-means cluster analysis (KCA).MethodsWe conducted a simulation study by taking the dietary data collected in the China Multi-Ethnic Cohort study as the “true values” and adding linear measurement errors for each food group to consider both systematic and random errors. We investigated the impacts of measurement errors from 2 aspects: distortion of the derived dietary patterns and estimated associations between the dietary patterns and disease.ResultsFor both systematic and random errors, larger measurement errors caused more serious distortion of dietary patterns derived by PCFA and KCA, with consistency rates ranging from 67.5% to 100% and from 13.4% to 88.4%, respectively. In addition, for both systematic and random errors, larger measurement errors caused greater attenuation effects on the association coefficients. For a beneficial association (coefficient, −0.5), the estimated coefficients ranged from −0.287 to −0.450 and from −0.231 to −0.394 in the PCFA and KCA, respectively. For a harmful association (coefficient, 0.5), the estimated coefficients ranged from 0.295 to 0.449 and from −0.003 to 0.373 in the PCFA and KCA, respectively. Dietary patterns derived by PCFA with factor loadings of low discrepancies and dietary patterns derived by KCA with small cluster sample sizes are more vulnerable to measurement error.ConclusionsMeasurement errors could distort dietary patterns and attenuate the dietary pattern–disease association. The stability of dietary patterns under measurement errors differs when using PCFA and KCA.
      PubDate: Thu, 07 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac092
      Issue No: Vol. 116, No. 2 (2022)
       
  • Vitamin D and brain health: an observational and Mendelian randomization
           study

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      Pages: 531 - 540
      Abstract: ABSTRACTBackgroundHigher vitamin D status has been suggested to have beneficial effects on the brain.ObjectivesTo investigate the association between 25-hydroxyvitamin D [25(OH)D], neuroimaging features, and the risk of dementia and stroke.MethodsWe used prospective data from the UK Biobank (37–73 y at baseline) to examine the association between 25(OH)D concentrations with neuroimaging outcomes (N = 33,523) and the risk of dementia and stroke (N = 427,690; 3414 and 5339 incident cases, respectively). Observational analyses were adjusted for age, sex, ethnicity, month, center, and socioeconomic, lifestyle, sun behavior, and illness-related factors. Nonlinear Mendelian randomization (MR) analyses were used to test for underlying causality for neuroimaging outcomes (N = 23,901) and dementia and stroke (N = 294,514; 2399 and 3760 cases, respectively).ResultsAssociations between 25(OH)D and total, gray matter, white matter, and hippocampal volumes were nonlinear, with lower volumes both for low and high concentrations (adjusted P-nonlinear ≤ 0.04). 25(OH)D had an inverse association with white matter hyperintensity volume [per 10 nmol/L 25(OH)D; adjusted β: –6.1; 95% CI: –11.5, –7.0]. Vitamin D deficiency was associated with an increased risk of dementia and stroke, with the strongest associations for those with 25(OH)D <25 nmol/L (compared with 50–75.9 nmol/L; adjusted HR: 1.79; 95% CI: 1.57, 2.04 and HR: 1.40; 95% CI: 1.26, 1.56, respectively). Nonlinear MR analyses confirmed the threshold effect of 25(OH)D on dementia, with the risk predicted to be 54% (95% CI: 1.21, 1.96) higher for participants at 25 nmol/L compared with 50 nmol/L. 25(OH)D was not associated with neuroimaging outcomes or the risk of stroke in MR analyses. Potential impact fraction suggests 17% (95% CI: 7.22, 30.58) of dementia could be prevented by increasing 25(OH)D to 50 nmol/L.ConclusionsLow vitamin D status was associated with neuroimaging outcomes and the risks of dementia and stroke even after extensive covariate adjustment. MR analyses support a causal effect of vitamin D deficiency on dementia but not on stroke risk.
      PubDate: Fri, 22 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac107
      Issue No: Vol. 116, No. 2 (2022)
       
  • Bioavailability of phosphorus and kidney function in the Jackson Heart
           Study

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      Pages: 541 - 550
      Abstract: ABSTRACTBackgroundHigh phosphorus (P) exposure may have negative effects on kidney function. Nutrient databases provide total P, but bioavailability varies by source.ObjectivesWe aimed to assess natural, added, and bioavailable P intake, and to relate these to estimated glomerular filtration rate (eGFR) in the Jackson Heart Study (JHS).MethodsA total of 3962 African-American participants of the JHS, aged 21–84 y, with urine albumin:creatinine ratio < 30 mg/g, and eGFR ≥ 60 mL · min−1 · 1.73 m−2, and without self-reported kidney disease, were included. Diet was assessed by FFQ. We assigned P in foods as naturally occurring or added, and weighted intake by P bioavailability, based on published literature. Relations between P variables and eGFR were assessed using multivariable regression.ResultsMean ± SE intakes were 1178 ± 6.7 mg and 1168 ± 5.0 mg for total P, 296 ± 2.8 mg and 291 ± 2.1 mg for bioavailable added P, and 444 ± 2.9 mg and 443 ± 2.2 mg for bioavailable natural P, in participants with eGFR = 60–89 and ≥90 mL · min−1 · 1.73 m−2, respectively. Major sources of total P included fish, milk, beef, eggs, cheese, and poultry; and of added P, fish, beef, processed meat, soft drinks, and poultry. After adjustment for confounders, P intakes, including total (β ± SE: −0.32 ± 0.15; P = 0.03), added (β ± SE: −0.73 ± 0.27; P = 0.01), bioavailable total (β ± SE: −0.62 ± 0.23; P = 0.01), and bioavailable added (β ± SE: −0.77 ± 0.29; P = 0.01), were significantly associated with lower eGFR. However, neither total nor bioavailable P from natural sources were associated with eGFR.ConclusionsAdded, but not natural, P was negatively associated with kidney function, raising concern about P additives in the food supply. Further studies are needed to improve estimation of dietary P exposure and to clarify the role of added P as a risk factor for kidney disease.
      PubDate: Mon, 02 May 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac116
      Issue No: Vol. 116, No. 2 (2022)
       
  • Estimating national and subnational nutrient intake distributions of
           global diets

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      Pages: 551 - 560
      Abstract: ABSTRACTBackgroundAccess to high-quality dietary intake data is central to many nutrition, epidemiology, economic, environmental, and policy applications. When data on individual nutrient intakes are available, they have not been consistently disaggregated by sex and age groups, and their parameters and full distributions are often not publicly available.ObjectivesWe sought to derive usual intake distributions for as many nutrients and population subgroups as possible, use these distributions to estimate nutrient intake inadequacy, compare these distributions and evaluate the implications of their shapes on the estimation of inadequacy, and make these distributions publicly available.MethodsWe compiled dietary data sets from 31 geographically diverse countries, modeled usual intake distributions for 32 micronutrients and 21 macronutrients, and disaggregated these distributions by sex and age groups. We compared the variability and skewness of the distributions and evaluated their similarity across countries, sex, and age groups. We estimated intake inadequacy for 16 nutrients based on a harmonized set of nutrient requirements and bioavailability estimates. Last, we created an R package—nutriR—to make these distributions freely available for users to apply in their own analyses.ResultsUsual intake distributions were rarely symmetric and differed widely in variability and skewness across nutrients and countries. Vitamin intake distributions were more variable and skewed and exhibited less similarity among countries than other nutrients. Inadequate intakes were high and geographically concentrated, as well as generally higher for females than males. We found that the shape of usual intake distributions strongly affects estimates of the prevalence of inadequate intakes.ConclusionsThe shape of nutrient intake distributions differs based on nutrient and subgroup and strongly influences estimates of nutrient intake inadequacy. This research represents an important contribution to the availability and application of dietary intake data for diverse subpopulations around the world.
      PubDate: Fri, 10 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac108
      Issue No: Vol. 116, No. 2 (2022)
       
  • Association of cow's milk intake in early childhood with adiposity and
           cardiometabolic risk in early adolescence

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      Pages: 561 - 571
      Abstract: ABSTRACTBackgroundPrior studies have provided conflicting evidence regarding associations of pediatric milk consumption with subsequent adiposity.ObjectivesWe aimed to estimate associations of the consumption frequency and fat content of early childhood milk intake with early adolescent adiposity and cardiometabolic risk.MethodsWe analyzed data collected prospectively from 796 children in Project Viva, a Boston-area prebirth cohort. Parents reported the frequency (times/day) and fat content [higher-fat: whole (3.25%) or 2% milk; lower-fat: 1% or skim milk] of cow's milk consumed in early childhood (mean, 3.2 years) via food-frequency questionnaires. We measured adiposity and cardiometabolic markers in early adolescence (mean, 13.2 years) and conducted multivariable regressions to assess associations adjusted for baseline parental and child sociodemographic, anthropometric, and dietary factors.ResultsIn early childhood, mean milk intake was 2.3 times/day (SD, 1.2 times/day), and 63% of children drank primarily higher-fat milk. The early childhood BMI z-score (BMIz) was inversely associated with the fat content of milk consumed in early childhood. After adjustment for baseline parent and child factors, early childhood intake of higher-fat compared with lower-fat milk was associated with lower adiposity; however, the 95% CIs for most adiposity outcomes—except for the odds of overweight or obesity (OR, 0.60; 95% CI, 0.38–0.93)—crossed the null after adjustment for the baseline child BMIz and BMIz change between ages 2 and 3 years. Early childhood consumption of higher-fat milk (compared with lower-fat milk) was not associated with adverse cardiometabolic outcomes. The frequency of cow's milk consumption in early childhood was not associated with adiposity or cardiometabolic risk in early adolescence.ConclusionsConsumption of higher-fat cow's milk in early childhood was not associated with increased adiposity or adverse cardiometabolic health over a decade later. Our findings do not support current recommendations to consume lower-fat milk to reduce the risk of later obesity and adverse cardiometabolic outcomes. This trial was registered at clinicaltrials.gov as NCT02820402.
      PubDate: Tue, 19 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac103
      Issue No: Vol. 116, No. 2 (2022)
       
  • The effect of a Mediterranean diet on the symptoms of depression in young
           males (the “AMMEND: A Mediterranean Diet in MEN with Depression”
           study): a randomized controlled trial

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      Pages: 572 - 580
      Abstract: ABSTRACTBackgroundDepression is a common mental health condition that affects 1 in 8 males each year, especially young adults. Young adulthood offers an opportunity for early dietary interventions, with research suggesting that a Mediterranean diet (MD) could be beneficial in treating depression.ObjectivesThis study aimed to determine if an MD can improve depressive symptoms in young males with clinical depression.MethodsA 12-wk, parallel-group, open-label, randomized controlled trial was conducted to assess the effect of an MD intervention in the treatment of moderate to severe depression in young males (18–25 y). Befriending therapy was chosen for the control group. Assessments were taken at baseline, week 6, and week 12. MD adherence was measured with the Mediterranean Diet Adherence Score (MEDAS). The primary outcome measure was the Beck Depression Inventory Scale—version II (BDI-II) and secondary outcome was quality of life (QoL).ResultsA total of 72 participants completed the study. After 12 wk, the MEDAS scores were significantly higher in the MD group compared with the befriending group (mean difference: 7.8; 95% CI: 7.23, 8.37; P < 0.001). The mean change in BDI-II score was significantly higher in the MD group compared with the befriending group at week 12 (mean difference: 14.4; 95% CI: 11.41, 17.39; P < 0.001). The mean change in QoL score was also significantly higher in the MD group compared with the befriending group at week 12 (mean difference: 12.7; 95% CI: 7.92, 17.48; P < 0.001).ConclusionsOur results demonstrate that compared with befriending, an MD intervention leads to significant increases in MEDAS, decreases in BDI-II score, and increases in QoL scores. These results highlight the important role of nutrition for the treatment of depression and should inform advice given by clinicians to this specific demographic population.The trial was registered with Australia and New Zealand Clinical Trials Registry (trial ID ACTRN12619001545156) and has also been registered with the WHO International Clinical Trials Registry Platform (Universal Trial Number U1111-1242-5215).
      PubDate: Wed, 20 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac106
      Issue No: Vol. 116, No. 2 (2022)
       
  • Time to revisit the passive overconsumption hypothesis' Humans show
           sensitivity to calories in energy-rich meals

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      Pages: 581 - 588
      Abstract: ABSTRACTBackgroundA possible driver of obesity is insensitivity (passive overconsumption) to food energy density (ED, kcal/g); however, it is unclear whether this insensitivity applies to all meals.ObjectivesWe assessed the influence of ED on energy intake (kcal) across a broad and continuous range of EDs comprised of noncovertly manipulated, real-world meals. We also allowed for the possibility that the association between energy intake and ED is nonlinear.MethodsWe completed a secondary analysis of 1519 meals which occurred in a controlled environment as part of a study conducted by Hall and colleagues to assess the effects of food ultra-processing on energy intake. To establish the generalizability of the findings, the analyses were repeated in 32,162 meals collected from free-living humans using data from the UK National Diet and Nutrition Survey (NDNS). Segmented regressions were performed to establish ED “breakpoints” at which the association between consumed meal ED and mean centered meal caloric intake (kcal) changed.ResultsSignificant breakpoints were found in both the Hall et al. data set (1.41 kcal/g) and the NDNS data set (1.75 and 2.94 kcal/g). Centered meal caloric intake did not increase linearly with consumed meal ED, and this pattern was captured by a 2-component (“volume” and “calorie content” [biologically derived from the sensing of fat, carbohydrate, and protein]) model of physical meal size (g), in which volume is the dominant signal with lower energy-dense foods and calorie content is the dominant signal with higher energy-dense foods.ConclusionsThese analyses reveal that, on some level, humans are sensitive to the energy content of meals and adjust meal size to minimize the acute aversive effects of overconsumption. Future research should consider the relative importance of volume and calorie-content signals, and how individual differences impact everyday dietary behavior and energy balance.
      PubDate: Sat, 30 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac112
      Issue No: Vol. 116, No. 2 (2022)
       
  • Gastrointestinal dysfunction during enteral nutrition delivery in
           intensive care unit (ICU) patients: Risk factors, natural history, and
           clinical implications. A post-hoc analysis of The Augmented versus Routine
           approach to Giving Energy Trial (TARGET)

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      Pages: 589 - 598
      Abstract: ABSTRACTBackgroundSlow gastric emptying occurs frequently during critical illness and is roughly quantified at bedside by large gastric residual volumes (GRVs). A previously published trial (The Augmented versus Routine approach to Giving Energy Trial; TARGET) reported larger GRVs with energy-dense (1.5 kcal/mL) compared with standard (1.0 kcal/mL) enteral nutrition (EN), warranting further exploration.ObjectiveTo assess the incidence, risk factors, duration, and timing of large GRVs (≥250 mL) and its relation to clinical outcomes in mechanically ventilated adults.MethodsA post-hoc analysis of TARGET data in patients with ≥1 GRV recorded. Data are n (%) or median [IQR].ResultsOf 3876 included patients, 1777 (46%) had ≥1 GRV ≥250 mL, which was more common in males (50 compared with 39%; P < 0.001) and in patients receiving energy-dense compared with standard EN (52 compared with 40%; RR = 1.27 (95% CI: 1.19, 1.36); P < 0.001) in whom it also lasted longer (1 [0–2] compared with 0 [0–1] d; P < 0.001), with no difference in time of onset after EN initiation (day 1 [0–2] compared with 1 [0–2]; P = 0.970). Patients with GRV ≥250 mL were more likely to have the following: vasopressor administration (88 compared with 76%; RR = 1.15 [1.12, 1.19]; P < 0.001), positive blood cultures (16 compared with 8%; RR = 1.92 [1.60, 2.31]; P < 0.001), intravenous antimicrobials (88 compared with 81%; RR = 1.09 [1.06, 1.12]; P < 0.001), and prolonged intensive care unit (ICU) stay (ICU-free days to day 28; 12.9 [0.0–21.0] compared with 20.0 [3.9–24.0]; P < 0.001), hospital stay (hospital-free days to day 28: 0.0 [0.0–12.0] compared with 7.0 [0.0–17.6] d; P < 0.001), ventilatory support (ventilator-free days to day 28: 16.0 [0.0–23.0] compared with 22.0 [8.0–25.0]; P < 0.001), and a higher 90-d mortality (29 compared with 23%; adjusted: RR = 1.17 [1.05, 1.30]; P = 0.003).ConclusionLarge GRVs were more common in males and those receiving energy-dense formulae, occurred early and were short-lived, and were associated with a number of negative clinical sequelae, including increased mortality, even when adjusted for illness severity. This trial was registered at clinicaltrials.gov as NCT02306746.
      PubDate: Tue, 26 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac113
      Issue No: Vol. 116, No. 2 (2022)
       
  • Folate intake and incident chronic kidney disease: a 30-year follow-up
           study from young adulthood to midlife

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      Pages: 599 - 607
      Abstract: ABSTRACTBackgroundThe relation of long-term dietary folate intake with incident chronic kidney disease (CKD) remains uncertain.ObjectivesWe aimed to investigate the association between dietary folate intake and incident CKD in a 30-y follow-up study from young adulthood to midlife.MethodsA total of 4038 American adults aged 18–30 y and without reduced estimated glomerular filtration rate (eGFR) were enrolled in 1985–1986 and monitored until 2015–2016 in the CARDIA (Coronary Artery Risk Development in Young Adults) study. Diet was assessed by a validated dietary history questionnaire at baseline, in 1992–1993, and in 2005–2006. The primary outcome was incident CKD, defined as an eGFR <60 mL · min−1 · 1.73 m−2 or a urinary albumin to creatinine ratio (ACR) ≥30 mg/g. The secondary outcomes included 1) incident decreased eGFR, defined as an eGFR <60 mL · min−1 · 1.73 m−2, and 2) incident albuminuria, defined as an ACR ≥30 mg/g.ResultsDuring the follow-up, 642 (15.9%) participants developed CKD. Overall, there was a significant L-shaped relation of dietary folate with incident CKD after adjustment for potential confounders. Compared with the lowest quintile of total folate intake, the multivariable-adjusted HRs (95% CIs) in quintiles 2–5 for incident CKD were 0.69 (0.56, 0.85), 0.35 (0.27, 0.45), 0.34 (0.26, 0.45), and 0.39 (0.30, 0.51), respectively. Similar results were found for the secondary outcomes. Moreover, the L-shaped association was confirmed in a subset of the cohort (n = 1462) with serum folate measured at baseline, in 1992, and in 2000.ConclusionsHigher folate intake in young adulthood was longitudinally associated with a lower incidence of CKD later in life. Additional studies are warranted to establish the causal inference.
      PubDate: Sat, 23 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac109
      Issue No: Vol. 116, No. 2 (2022)
       
  • Re: Adjustment for energy intake in nutritional research: a causal
           inference perspective

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      Pages: 608 - 609
      Abstract: Dear Editor:
      PubDate: Thu, 28 Apr 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac114
      Issue No: Vol. 116, No. 2 (2022)
       
  • Reply to WC Willett et al.

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      Pages: 609 - 610
      Abstract: Alan Turing Institute10.13039/100012338EP/N510129/1
      PubDate: Wed, 22 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac115
      Issue No: Vol. 116, No. 2 (2022)
       
  • Clarification on our critique of the energy balance hypothesis of obesity

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      Pages: 610 - 611
      Abstract: Dear Editor:
      PubDate: Wed, 08 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac160
      Issue No: Vol. 116, No. 2 (2022)
       
  • Leaving energy balance behind

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      Pages: 611 - 612
      Abstract: Dear Editor:
      PubDate: Wed, 08 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac161
      Issue No: Vol. 116, No. 2 (2022)
       
  • The energy balance model compared with the carbohydrate-insulin model

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      Pages: 612 - 614
      Abstract: Dear Editor:
      PubDate: Wed, 08 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac162
      Issue No: Vol. 116, No. 2 (2022)
       
  • Reply to G Taubes, MI Friedman, and V Torres-Carot et al

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      Pages: 614 - 616
      Abstract: Dear Editor:
      PubDate: Wed, 08 Jun 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac163
      Issue No: Vol. 116, No. 2 (2022)
       
  • Nondietary covariates of colorectal cancer risk in population cohorts

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      Pages: 616 - 617
      Abstract: Dear Editor:
      PubDate: Fri, 15 Jul 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac132
      Issue No: Vol. 116, No. 2 (2022)
       
  • Residual confounding by antioxidants and multicollinearity in the
           polyphenol–colorectal cancer association

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      Pages: 617 - 618
      Abstract: Dear Editor:
      PubDate: Fri, 15 Jul 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac133
      Issue No: Vol. 116, No. 2 (2022)
       
  • Reply to Tasci et al. and Lu et al

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      Pages: 618 - 618
      Abstract: Dear Editor:
      PubDate: Fri, 15 Jul 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac135
      Issue No: Vol. 116, No. 2 (2022)
       
  • ASN highlights the need for multiple methods within nutrition research to
           advance the field

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      Pages: 619 - 619
      Abstract: The more than 8500 nutrition scientists and researchers who make up the American Society for Nutrition (ASN) use a wide variety of methodologies in their research. Each has a place and, when used and interpreted appropriately, helps to build the evidence base required to make informed decisions in basic research and clinical practice, as well as in policy development and implementation. To emphasize this point, in May 2020, the ASN Board of Directors commissioned a task force to prepare a white paper to highlight the strengths, limitations, and interpretations of the broad spectrum of methods used in nutrition science and how they work synergistically. The white paper, “Valuing the Diversity of Research Methods to Advance Nutrition Science,” is published in the Society section of Advances in Nutrition.
      PubDate: Fri, 08 Jul 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac100
      Issue No: Vol. 116, No. 2 (2022)
       
  • Calendar of Events

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      Pages: 620 - 620
      Abstract: Due to the ongoing COVID-19 pandemic, events around the world are being postponed or moved online. For the most current information on events listed below, please visit the meeting's website.
      PubDate: Thu, 04 Aug 2022 00:00:00 GMT
      DOI: 10.1093/ajcn/nqac196
      Issue No: Vol. 116, No. 2 (2022)
       
 
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