Dietary patterns and C-reactive protein in Japanese men and women

BACKGROUND: Inflammation may be involved in the pathogenesis of atherosclerosis, type 2 diabetes mellitus, and cancer. Many studies have reported the relation of specific foods and nutrients to inflammation, but few studies have examined the relation of dietary patterns to inflammatory markers. OBJECTIVE: We investigated the relation between dietary patterns and circulating high-sensitivity C-reactive protein (hs-CRP) in Japanese men and women. DESIGN: The subjects were participants in the baseline survey of an ongoing cohort study of lifestyle-related diseases between February 2004 and July 2006. We excluded persons with life-limiting or possible inflammation-related diseases and those using analgesics. After further exclusion of subjects with a CRP concentration > 3 mg/L, 7802 subjects remained in the analysis. The dietary patterns were derived from principal component analysis of the frequency of consumption of 49 food items ascertained by the food-frequency questionnaire. RESULTS: We identified 4 dietary patterns: healthy, high-fat, seafood, and Westernized breakfast patterns. The healthy dietary pattern, characterized by high intakes of vegetables, fruit, soy products, and fish, was significantly and inversely related to hs-CRP concentrations, even after adjustment for age, body mass index, smoking, alcohol consumption, and physical activity in both men and women. Although hs-CRP concentrations were slightly elevated in persons with a high score for the seafood pattern, multivariate-adjusted means did not show a significant trend. Neither the high-fat dietary pattern nor the Westernized breakfast pattern was related to hs-CRP concentrations. CONCLUSION: The healthy dietary pattern may be related to suppression of inflammation.     

Dietary patterns and attention deficit hyperactivity disorder among Iranian children

ObjectiveThis study was conducted to assess the relation of major dietary patterns identified by factor analysis to attention-deficit/hyperactivity disorder (ADHD) in a group of Iranian school-age children.MethodsThis cross-sectional study was conducted in 375 school-age children in Tehran, Iran. We assessed usual dietary intakes by a semiquantitative food-frequency questionnaire. The presence of ADHD was diagnosed using the questionnaire of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Major dietary patterns were identified by factor analysis.ResultsThe prevalence of ADHD was 9.7% in this population. We identified four major dietary patterns: “healthy,” “Western,” “sweet,” and “fast food.” After controlling for potential confounders, children in the top quintile of the sweet dietary pattern score had greater odds for having ADHD compared with those in the lowest quintile (odds ratio 3.95, 95% confidence interval 1.16–15.31, P for trend = 0.03). Greater adherence to the fast-food dietary pattern was significantly associated with a higher risk of having ADHD (odds ratio 3.21, 95% confidence interval 1.05–10.90, P for trend = 0.03). No overall significant associations were seen between the healthy or Western dietary pattern and ADHD.ConclusionWe found significant independent associations between the sweet and fast-food dietary patterns and the prevalence of ADHD. Prospective studies are required to confirm these findings.     

Dietary Patterns and Foods Associated With Cognitive Function in Taiwanese Older Adults: The Cross-sectional and Longitudinal Studies

ObjectivesTo find dietary patterns and foods associated with cognitive function.DesignA cross-sectional study of short-term effects and a prospective study for long-term effects.SettingNutrition and Health Survey in Taiwan (NAHSIT) 2014-2016 and NAHSIT 1999-2000.ParticipantsA total of 1245 older patients enrolled in the NAHSIT 2014-2016 and 1436 in the NAHSIT 1999-2000.MeasurementsDietary intake was appraised with a food-frequency questionnaire. Cognitive function was assessed by the Mini-Mental State Examination score (MMSE).ResultsUsing reduced rank regression to data-mine NAHSIT 2014-2016 cross-sectional data, we found in both genders a dietary pattern associated with high MMSE score, which was characterized by higher intakes of fresh fruits, nuts and seeds, whole grains, breakfast cereals, coffee, dairy products, seafood products, and fish. Moreover, in women, the pattern included a few additional items: tea, eggs, soybean products, and vegetables. Presence of mild cognitive impairment was inversely associated with the dietary pattern score, with declined adjusted odds ratio (95% confidence interval) from tertile 1 (as reference), tertile 2, to tertile 3 in both men [1 → 0.85(0.45-1.61) → 0.32 (0.14-0.78)] and women [1→0.44 (0.25-0.76) → 0.39 (0.20-0.75)]. Using the NAHSIT 1999-2000 as a baseline, along with 11 years of follow-up, we found with the Cox proportional hazards model that higher intake (≥4 vs <1 time/wk) of either tea or fish, but not other foods, was associated with a lower risk of developing dementia. Higher intakes of both tea and fish were associated with an even lower risk.Conclusions/ImplicationsA dietary pattern characterized by high intakes of phytonutrient-rich plant foods (fruits, whole grains, nuts/seeds, and vegetables), tea and coffee, and protein-rich foods such as eggs, dairy products, and fish, was associated with the presence of better cognitive function in older adult. Higher intakes of fish and tea combined showed a long-term protective effect. Further research is warranted to understand the long- and short-term effects of diet.     

Dietary sugar intake and dietary behaviors in Korea: a pooled study of 2,599 children and adolescents aged 9-14 years

BACKGROUND/OBJECTIVESDietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents.SUBJECTS/METHODSWe pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records.RESULTSMean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls).CONCLUSIONSThese results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.     

Breakfast in Latin America: Evaluation of Nutrient and Food Group Intake Toward a Nutrient-Based Recommendation

BackgroundLittle is known about breakfast habits of the Latin American (LA) population to support nutritional recommendations for a balanced breakfast in this region.ObjectiveTo evaluate the nutritional composition of breakfast in the LA population and to propose recommendations for a balanced breakfast.DesignThis multicenter cross-sectional study evaluated food and nutrient intake of nationally representative samples of urban populations of 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015.Participants/settingThe sample comprised 8714 participants from the Latin American Study of Nutrition and Health, aged 15 to 65 years, randomly recruited according to geographical location, sex, age, and socioeconomic level.Main outcome measuresTwo 24-hour recalls were used to examine dietary intake. Breakfast consumers were stratified by tertiles of Nutrient-Rich Foods Index 9.3 (NRF9.3) to assess the overall diet quality of individuals. Nutrient intake at breakfast of those in the upper tertile of NRF9.3 pooled for the 8 countries was used as a reference for the development of recommendations for LA adolescents and adults.Statistical analysesComparison of food and nutrient intake of breakfast across NRF9.3 tertiles were analyzed using the Kruskal-Wallis rank sum test.ResultsOverall breakfast was an important contributor to protein, carbohydrate, and B vitamin intakes but also to added sugar and total and saturated fat intakes relative to daily intakes. Individuals in the upper NRF9.3 tertile had higher intake of key micronutrients such as calcium and potassium at breakfast compared with other tertiles. White breads/rolls/tortillas were the most consumed food group (60%), followed by butter/margarine (40%) and coffee/tea without milk (34%-50%).ConclusionsBreakfast contributed to the daily intake of B vitamins, protein, and carbohydrates but also added sugar and total and saturated fat intakes for all countries. The proposed recommendations support the nutrient density of existing highest-quality breakfast in the LA population while addressing concerns about nutrients to be encouraged or reduced.     

The prevalence of folic acid deficiency among adolescent girls living in Edirne,Turkey

PurposeA high incidence of iron-deficiency is a common observation among adolescent girls, whereas only limited data are available regarding the folic acid status of this group. This study was designed to determine the prevalence of biochemical folic acid deficiency in a group of Turkish adolescent girls.MethodsWe surveyed the serum folic acid, complete blood count, and dietary folic acid intake of Turkish adolescent girls after using three-day self-reported food intakes in urban and rural areas of Edirne, Turkey.ResultsA sample population was composed of 704 adolescent girls; their serum folic acid levels were found to be adequate for 37.6% (≥ 6 ng/mL), marginal for 46% (3 to 5.9 ng/mL), and at deficient levels for 16.3% (< 3 ng/mL). Folic acid deficiencies were found in 20.1% (36 of 179) and 14.7 % (61 of 416) of adolescent girls from rural and urban areas, respectively. Self-reported three-day folic acid intakes were correlated with the corresponding blood values for this nutrient. In the logistic regression analysis, three factors emerged as significant independent predictors of folic acid deficiency: low income (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.3–4.2, p < .001), low vitamin C (OR: 1.9, 95% CI: 1.1–3.5, p < .05), and folic acid intake (OR: 4.8, 95% CI: 2.8–8.1, p < .001).ConclusionData from the present study may indicate that serum folic acid is low in a group of Turkish adolescent girls. These low values appear to be associated with low income, and low dietary intakes of folic acid and vitamin C.     

Dietary Patterns and the Risk of Dyslipidemia in Korean Adults: A Prospective Cohort Study Based on the Health Examinees (HEXA) Study

BackgroundIdentifying dietary patterns that contribute to dyslipidemia development can inform prevention, nutritional counseling, and other treatment recommendations.ObjectiveThis study aimed to identify major dietary patterns and examine the association between these dietary patterns and dyslipidemia incidence by sex among Koreans.DesignThe Health Examinees (HEXA) study is a community-based prospective cohort study. The baseline and follow-up surveys were conducted in 2004-2013, and 2012-2016, respectively, at 38 health examination centers and training hospitals located in eight regions in Korea. Dietary intake data were collected using a web-based, validated semiquantitative food frequency questionnaire (FFQ) at baseline.Participants/settingAmong 65,642 participants who completed the baseline and follow-up survey, data from 38,170 participants without dyslipidemia and other related chronic diseases at baseline were analyzed.Main outcome measuresIncidence of dyslipidemia and its components (hypercholesterolemia, hyper-low-density lipoprotein [LDL] cholesterolemia, hypo-high-density lipoprotein [HDL] cholesterolemia, and hypertriglyceridemia) after baseline but before the follow-up examination was examined.Statistical analysesFactor analysis was conducted on data from the semiquantitative FFQ to identify major dietary patterns for Korean adults. Cox proportional hazards regression analysis was performed to estimate the relative risk (RR) and 95% confidence interval (CI) according to the quintiles of three dietary pattern scores, after adjusting for potential confounders by sex.ResultsOf the three identified dietary patterns, the higher “prudent” pattern score was associated with a lower incidence of dyslipidemia (RR, 0.90; 95% CI, 0.82-0.99; P = .02) after adjusting for potential confounders in women. Higher “flour-based food and meats” pattern score was associated with a higher incidence of hypercholesterolemia (men: RR, 1.63; 95% CI, 1.21-2.20; P = .003; women: RR, 1.47; 95% CI, 1.30-1.67; P < .001), hyper-LDL cholesterolemia (men: RR, 1.45; 95% CI, 1.03-2.04, P = .06; women: RR, 1.35; 95% CI, 1.16-1.58, P < .001), and dyslipidemia (men: RR, 1.30; 95% CI, 1.09-1.54; P = .009; women: RR, 1.28; 95% CI, 1.16-1.42; P < .001) in both men and women. The “white rice” pattern score was associated with a lower incidence of hypo-HDL cholesterolemia (RR, 0.75; 95% CI, 0.58-0.96; P = .01) and dyslipidemia (RR, 0.90; 95% CI, 0.81-0.99; P = .07) in women.ConclusionsAdherence to the “prudent” and “white rice” patterns was associated with a lower dyslipidemia risk in Korean women, whereas adherence to the “flour-based food and meats” pattern was associated with increased risks of dyslipidemia and its components (hypercholesterolemia and hyper-LDL cholesterolemia) in both Korean men and women.     

Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk

BACKGROUND: Although the effects of individual foods or nutrients on the development of diseases and their risk factors have been investigated in many studies, little attention has been given to the effect of overall dietary patterns. OBJECTIVE: Our objective was to examine the associations of 2 major dietary patterns, Western and prudent, with biomarkers of obesity and cardiovascular disease (CVD) risk. DESIGN: We used factor analysis to define major dietary patterns for a subsample of men (n = 466) from the Health Professionals Follow-up Study by using dietary information collected from food-frequency questionnaires (FFQs) in 1994. We calculated partial correlation coefficients between pattern scores and biomarker values adjusted for age, smoking status, energy and alcohol intake, physical activity, hours of television watching, and body mass index. RESULTS: We derived 2 major dietary patterns that were generally reproducible over time. The first pattern (prudent) was characterized by higher intakes of fruit, vegetables, whole grains, and poultry. The second pattern (Western) was characterized by higher intakes of red meats, high-fat dairy products, and refined grains. Using pattern scores from 1994 and adjusting for potential confounders, we found significant positive correlations between the Western pattern and insulin, C-peptide, leptin, and homocysteine concentrations, and an inverse correlation with plasma folate concentrations. The prudent pattern was positively correlated with plasma folate and inversely correlated with insulin and homocysteine concentrations. CONCLUSION: Major dietary patterns are predictors of plasma biomarkers of CVD and obesity risk, suggesting that the effect of overall diet on CVD risk may be mediated through these biomarkers.     

Breakfast eating pattern and its association with dietary quality indices and anthropometric measurements in young women in Isfahan

ObjectiveTo assess the association between consuming or skipping breakfast and dietary quality indices such as the Healthy Eating Index (HEI), the Dietary Diversity Score (DDS), diversity scores of different food groups, and anthropometric measurements in young Isfahanian women.MethodsWomen 18 to 28 y old were selected randomly from among university students (n = 411) in Isfahan, Iran. A validated semiquantitative questionnaire was used to assess dietary intake. Five food groups of the Food Guide Pyramid were considered for calculating the DDS and diversity score of the food groups. Subjects were categorized based on consuming or skipping breakfast. The HEI was calculated based on 10 components including the five food groups, different fat and sodium intakes, and the DDS.ResultsBreakfast consumers versus skippers had higher scores for the HEI (66 ± 13 versus 47 ± 13, P = 0.001), the DDS (6.8 ± 1.2 versus 4.9 ± 0.7, P = 0.001), and the DDSs for fruits (1.3 ± 0.2 versus 0.9 ± 0.1, P = 0.001), vegetables (1.6 ± 0.2 versus 1.2 ± 0.1, P = 0.001), and whole grains (1.3 ± 0.2 versus 0.9 ± 0.1, P = 0.001). Also, eating breakfast was associated with lower values for dietary energy density (0.96 ± 0.25 versus 1.04 ± 0.40, P = 0.01), the body mass index (20.0 ± 1.8 versus 23.3 ± 2.7, P = 0.001), and waist circumference (69.2 ± 7.6 versus 72.5 ± 8.7, P = 0.001). There was a higher prevalence of breakfast consumers in the third tertiles of the HEI and DDS. However, there was a smaller percentage of breakfast consumers in the third tertiles of the body mass index and waist circumference.ConclusionsBreakfast consumption was associated with higher scores of the dietary quality indices and lower values for the body mass index and waist circumference in young Isfahanian women. Further studies should be performed to determine the relation between the kind of breakfast consumed and the dietary quality indices.     

Dietary patterns associated with risk factors for cardiovascular disease in healthy US adults

BACKGROUND: Certain nutrients are well established as dietary risk factors for cardiovascular disease (CVD), but dietary patterns may be a better predictor of CVD risk. OBJECTIVE: This study tested the hypothesis that the complex dietary behaviors of US adults can be grouped into major dietary patterns that are related to risk factors for CVD. DESIGN: With the use of food-frequency questionnaire data from the third National Health and Nutrition Examination Survey, dietary patterns of healthy US adults (>/or =20 y old; n = 13 130) were identified by factor analysis. Log-transformed biomarker data were associated with major dietary patterns after control for confounding variables in regression analyses. All statistical analyses accounted for the survey design and sample weights. RESULTS: Of 6 dietary patterns identified, 2 patterns emerged as the most predominant: the Western pattern was characterized by high intakes of processed meats, eggs, red meats, and high-fat dairy products, and the American-healthy pattern was characterized by high intakes of green, leafy vegetables; salad dressings; tomatoes; other vegetables (eg, peppers, green beans, corn, and peas); cruciferous vegetables; and tea. The Western pattern was associated (P < 0.05) positively with serum C-peptide, serum insulin, and glycated hemoglobin and inversely with red blood cell folate concentrations after adjustment for confounding variables. The American-healthy pattern had no linear relation with any of the biomarkers examined. CONCLUSIONS: The identification of common dietary patterns among free-living persons is promising for characterizing high-risk groups at the US population level. The dietary patterns identified here are similar to those reported in other nonrepresentative samples and are associated with biomarkers of CVD risk, which confirms that dietary pattern analysis can be a valuable method for assessing dietary intakes when predicting CVD risk.     

Dietary Patterns and Breast Cancer Risk in Black Urban South African Women: The SABC Study

A total of 396 breast cancer cases and 396 population-based controls from the South African Breast Cancer study (SABC) matched on age and demographic settings was included. Validated questionnaires were used to collect dietary and epidemiological data. Dietary patterns were derived using principal component analysis with a covariance matrix from 33 food groups. Odds ratios and 95% confidence intervals were estimated using conditional logistic regression. A traditional, a cereal-dairy breakfast and a processed food dietary pattern were identified, which together explained 40.3% of the total variance in the diet. After adjusting for potential confounders, the traditional dietary pattern and cereal-dairy breakfast dietary pattern were inversely associated with breast cancer risk (highest tertile versus lowest tertile) (OR = 0.72, 95%CI: 0.57–0.89, p-trend = 0.004 and OR = 0.73, 95%CI: 0.59–0.90, p-trend = 0.004, respectively). The processed food dietary pattern was not significantly associated with breast cancer risk. The results of this study show that a traditional dietary pattern and a cereal-dairy breakfast dietary pattern may reduce the risk of developing breast cancer in this population.     

A study of dietary intakes and dietary preferences by questionnaire at a health facility in an urban area]

Dietary preferences and intakes of 2504 patients in a human dock in Tokyo were studied by questionnaire and analyzed according to: 1. Comparison of dietary patterns for breakfast to that for lunch and dinner. 2. Consistency between dietary patterns according to Category Score Table for Breakfast and that from Hayashi's Quantification Theory Type III (QIII). Dietary patterns for breakfast were shown to fall into four Types based on dietary intakes and dietary preferences: Balanced Diet-Japanese Style (Type 1); Balanced Diet-Western Style (Type 2); Unbalanced Diet-Western Style (Type 3); and Unbalanced Diet-with drinks (Type 4). Based on the responses to the questionnaire, there was no correlation between the dietary pattern for lunch to that for breakfast. On the other hand, the dietary pattern for dinner tended to correlate with breakfast. The sample population was divided into two random groups A and B. Group A was analyzed by QIII, and B by the four types of breakfast dietary patterns. Comparison of scores for categorized values for Group A with those of the Group B indicated 91.8% consistent rate. These results, demonstrate that this questionnaire can be used effectively to sort intakes into four dietary patterns, and may be useful in preventive health care studies.     

Relation of insulin-like growth factor (IGF) I and IGF-binding protein 3 concentrations with intakes of fruit, vegetables, and antioxidants

BACKGROUND: Fruit, vegetable, and antioxidant intakes may reduce the risk of several insulin-like growth factor (IGF)-related chronic diseases, such as certain types of cancers and cardiovascular diseases. OBJECTIVE: This study investigated whether intakes of fruit, vegetables, and antioxidants (beta-carotene, lycopene, and vitamin C) are associated with plasma IGF-I and IGF-binding protein 3 (IGFBP-3) concentrations. DESIGN: Plasma IGF-I and IGFBP-3 concentrations were measured in 1542 healthy women by enzyme-linked immunosorbent assay. A self-administered semiquantitative food-frequency questionnaire was used to estimate mean daily dietary intakes of fruit, vegetables, and antioxidants over the year preceding blood sampling. Multivariate analyses were performed by using generalized linear models to evaluate the association of quintiles of daily intakes with concentrations of growth factors. RESULTS: A higher intake of citrus fruit was associated with higher concentrations of IGF-I (215 ng/mL for quintile 5 compared with 205 ng/mL for quintile 1; P for trend = 0.04) and with lower concentrations of IGFBP-3 (4803 ng/mL for quintile 5 compared with 4960 ng/mL for quintile 1; P for trend = 0.04). Higher dietary vitamin C intake was associated with higher concentrations of IGF-I (214 ng/mL for quintile 5 compared with 204 ng/mL for quintile 1; P for trend = 0.02) and lower concentrations of IGFBP-3 (4813 ng/mL for quintile 5 compared with 4953 ng/mL for quintile 1; P for trend = 0.03). Total intake of fruit and vegetables and intakes of other botanical fruit and vegetable subgroups, beta-carotene, and lycopene were not related to either IGF-I or IGFBP-3 concentrations. CONCLUSION: Women with higher intakes of citrus fruit or dietary vitamin C tend to have higher plasma concentrations of IGF-I and lower plasma concentrations of IGFBP-3.     

Dietary Patterns and Total Mortality in a Mediterranean Cohort: The SUN Project

BackgroundDifferent dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations.ObjectiveThe aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality.DesignThe Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort.Participants/settingParticipants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire.Main outcome measuresDeaths were confirmed by review of medical records and of the National Death Index.Statistical analysisDietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality.ResultsThree major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality.ConclusionsGreater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults.     

Maternal Diet,C-Reactive Protein,and the Outcome of Pregnancy

Objective: To examine the association of high-sensitivity C-reactive protein (hsCRP), a systemic biomarker for the inflammatory process at entry to care, with pregnancy-induced hypertension/preeclampsia, adverse outcomes of pregnancy, and the maternal diet.

Design: Random sample (N = 520) with normal glucose tolerance from a large prospective cohort study of urban, low income, minority gravidae.

Results: During pregnancy, the highest tertile of hsCRP (range, 7.06–137.41 mg/L) was associated with significantly increased risks for early preterm delivery (<34 weeks). However, after stratification by maternal pregravid body mass index (BMI), risk for early preterm delivery <34 weeks (adjusted odds ratios [AOR] = 3.58, 95% confidence interval [CI] = 1.05–12.27), and pregnancy-induced hypertension (AOR = 2.66, 95% CI = 1.03–6.86) including preeclampsia (AOR = 2.72, 95% CI = 1.08–6.85) was shown to be specific to lean women (BMI <25) with high hsCRP. Increased hsCRP was unrelated to risk among overweight and obese gravidae. We found high hsCRP to be associated with diet. After stratification by BMI, dietary differences (higher intakes of protein and cholesterol with a lower intake of carbohydrate and a higher entry dietary glycemic index) were associated with increased hsCRP only among lean gravidae and not among those who were overweight or obese.

Conclusions: High hsCRP is a diet-related biomarker for serious complications and poor outcome in lean women with normal glucose tolerance.     

Dietary pattern and incidence of chronic kidney disease among adults: a population-based study

Background & Aims

Although dietary patterns have been linked to chronic diseases such as cardiovascular disease, sparse data are available for a relationship between dietary patterns and incident chronic kidney disease (CKD) in West Asian populations. The aim of this study was to evaluate the association of population-based dietary pattern with the risk of incident CKD after 6.1?years of follow-up.

Methods

At baseline, habitual dietary intakes of 1630 participants of the Tehran Lipid and Glucose Study (TLGS) who were free of CKD was assessed by a valid and reliable food-frequency questionnaire. The following three major dietary patterns were identified using a principal components analysis: Lacto-vegetarian dietary pattern, traditional Iranian dietary pattern, and high fat, high sugar dietary pattern. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease (MDRD) Study equation and CKD was defined as eGFR <?60?mL/min/1.73m². Odds ratio (OR) using multivariable logistic regression was calculated for the association of incident CKD with the extracted dietary patterns.

Results

After adjusting for age, sex, smoking, total energy intake, physical activity, body mass index, diabetes, and hypertension the OR for participants in the highest compared with those in the lowest tertile of the lacto-vegetarian dietary pattern was 0.57 (95% confidence interval [CI]: 0.41 to 0.80, P-trend?=?0.002). In contrast, the high fat, high sugar dietary pattern was positively associated with the incidence of CKD (OR for the third tertile compared with first tertile: 1.46; 95% CI: 1.03–2.09; P-trend?=?0.036). Traditional Iranian dietary pattern was not associated with incident CKD.

Conclusion

The high fat, high sugar dietary pattern was associated with significantly increased (46%) odds of incident CKD, whereas a lacto-vegetarian dietary pattern may be protective against the occurrence of CKD by 43%.

     

The effect of body mass index on adequacy of serum 25-hydroxyvitamin D levels in US adults: the National Health and Nutrition Examination Survey 2001 to 2006

PurposeTo investigate the relationship between body mass index (BMI) and vitamin D adequacy among US adults.MethodsWe used data for US adults aged 18 years or older (n = 12,927) who participated in the 2001 to 2006 United States National Health and Nutrition Examination Survey. Log-binomial regression was used to estimate the strength of association between BMI categories and the prevalence of serum 25-hydroxyvitamin D [25(OH)D] greater than or equal to 20 ng/mL before and after controlling for selected characteristics. An interaction term between race or ethnicity and BMI categories was tested.ResultsAmong US adults, 67.2% had serum 25(OH)D greater than or equal to 20 ng/mL, a cut point suggested by the Office of Dietary Supplements for adequate bone and general health. Overweight and obese adults were 8% (95% confidence interval, 0.89–0.95) and 26% (95% confidence interval, 0.71–0.78), respectively, less likely to have serum 25(OH)D greater than or equal to 20 ng/mL than their normal weight counterparts after controlling for age, gender, race/ethnicity, nativity and marital status, as well as education and income. No heterogeneity of the association between BMI categories and the prevalence of 25(OH)D greater than or equal to 20 ng/mL was observed by race or ethnicity.ConclusionsThe low prevalence of 25(OH)D greater than equal to 20 ng/mL among overweight and obese adults in the US population underscores the need to comparatively assess vitamin D intakes across different BMIs.     

Current Zinc Intake and Risk of Diabetes and Coronary Artery Disease and Factors Associated with Insulin Resistance in Rural and Urban Populations of North India

Objective: To determine the association between current zinc intake and prevalence of coronary artery disease (CAD) and diabetes as well as factors associated with insulin resistance.

Design, Subjects and Methods: In this cross sectional survey, 3575 subjects, aged 25 to 64 years, including 1769 rural (894 men, 875 women) and 1806 urban (904 men, 902 women) subjects were studied. The survey methods included questionnaires for 7-day food intake record, physical examination, and electrocardiography using World Health Organization criteria.

Results: The prevalence of CAD, diabetes and glucose intolerance was significantly higher among subjects consuming lower intakes of dietary zinc. There was a higher prevalence of hypertension, hypertriglyceridemia and low high-density lipoprotein cholesterol levels which showed significant upward trend with lower zinc intakes. Serum lipoprotein (a) and 2-hour plasma insulin levels also were associated with low zinc intake. Multivariate logistic regression analysis after adjustment for age showed that zinc intake and CAD were inversely associated. Serum zinc (odds ratio:men 0.77, women 0.57), serum triglycerides (men 0.86, women 0.81), blood pressure (0.83 men, women 0.76), diabetes mellitus (men 0.90, women 0.85), central obesity (men 0.88, women 0.87), glucose intolerance (men 0.66, women 0.57) and low high-density lipoprotein cholesterol (men 0.72, women 0.70) were significant risk factors for CAD (explained by tertiles of zinc status) in urban subjects. These associations were not observed in rural subjects.

Conclusion: Lower consumption of dietary zinc and low serum zinc levels were associated with an increased prevalence of CAD and diabetes and several of their associated risk factors including hypertension, hypertriglyceridemia and other factors suggestive of mild insulin resistance in urban subjects.     

Dihydrophylloquinone intake is associated with low bone mineral density in men and women

BACKGROUND: Poor diet may affect bone status by displacing nutrients involved in bone health. Dihydrophylloquinone, a form of vitamin K present in foods made with partially hydrogenated fat, is a potential marker of a low-quality dietary pattern. OBJECTIVE: Our objective was to examine the cross-sectional associations between dihydrophylloquinone intake and bone mineral density (BMD) of the hip and spine in men and women. DESIGN: Dihydrophylloquinone intake was estimated with a food-frequency questionnaire, and BMD (in g/cm(2)) was measured by dual-energy X-ray absorptiometry in 2544 men and women (mean age: 58.5 y) who had participated in the Framingham Offspring Study. General linear models were used to examine the associations between dihydrophylloquinone intake (in tertiles: <15.5, 15.5-29.5, and >29.5 microg/d) and hip and spine BMD after adjustment for age, body mass index, energy intake, calcium intake, vitamin D intake, smoking status, physical activity score, and, for women, menopause status and estrogen use. RESULTS: Higher dihydrophylloquinone intakes were associated with lower mean BMD at the femoral neck [lowest-to-highest tertiles (95% CI): 0.934 (0.925, 0.942), 0.927 (0.919, 0.935), and 0.917 (0.908, 0.926), P for trend = 0.02], the trochanter [lowest-to-highest tertiles (95% CI): 0.811 (0.802, 0.820), 0.805 (0.797, 0.813), and 0.795 (0.786, 0.804), P for trend = 0.02], and the spine [lowest-to-highest tertiles (95% CI): 1.250 (1.236, 1.264), 1.243 (1.242, 1.229), and 1.227 (1.213, 1.242), P for trend = 0.03] in men and women after adjustment for the covariates. Further adjustment for markers of healthy and low-quality dietary patterns did not affect the observed associations. CONCLUSIONS: Higher dihydrophylloquinone intakes are associated with lower BMD in men and women. This association remains significant after adjustment for other markers of diet quality.     

Dietary Intakes of Vitamin B-2 (Riboflavin), Vitamin B-6, and Vitamin B-12 and Ovarian Cycle Function among Premenopausal Women

BackgroundRiboflavin, vitamin B-6, and vitamin B-12 are key players in one-carbon metabolism as enzymatic cofactors, and deficiency of these nutrients may influence reproductive outcomes possibly through affecting reproductive hormones.ObjectiveThe goal was to investigate associations between dietary intakes of riboflavin, vitamin B-6, and vitamin B-12, and menstrual function among premenopausal women.DesignThis was a secondary analysis of a prospective cohort study conducted at the University at Buffalo during 2005 to 2007.Participants/settingParticipants were 259 healthy, regularly menstruating women (aged 18 to 44 years) with self-reported menstrual cycles between 21 and 35 days, who were not trying to conceive, and who had not used hormonal contraception during the past 3 months.Main outcome measuresIntakes of B vitamins were assessed via 24-hour dietary recalls four times per menstrual cycle for two cycles. Serum reproductive hormones and plasma homocysteine were measured eight and three times, respectively, per cycle for two cycles. Anovulatory cycles were determined by progesterone concentrations ≤5 ng/mL (15.9 nmol/L) and no observed serum luteinizing hormone peak during the mid or late luteal phase visit.Statistical analysisWeighted linear mixed regressions were used to evaluate associations between cycle-averaged B vitamin intakes and hormones and homocysteine, and generalized linear regressions for associations with anovulation. Models were adjusted for age, race, body mass index, physical activity, alternate Mediterranean diet score, intakes of total energy, protein, fiber, and folate, and percentage of energy intake from fat.ResultsHigher intakes of riboflavin (per 0.1 mg increase in intake) were inversely correlated with estradiol (−0.87%, 95% CI −1.67 to −0.06) and homocysteine levels (−0.61%, 95% CI −1.10 to −0.12). Higher vitamin B-6 intakes were suggestive of higher follicle-stimulating hormone, although the results were not statistically significant (0.63% difference, 95% CI −0.03 to 1.29, per 0.1 mg increase in intake; P=0.06). Small increases in testosterone and decreases in homocysteine were found with vitamin B-12 intake. No associations were observed between intake of B vitamins and a risk of sporadic anovulation.ConclusionsHigher intakes of riboflavin were associated with a small decrease in serum estradiol among healthy, regularly menstruating women. Higher intakes of riboflavin and vitamin B-12 were associated with lower plasma homocysteine concentrations. Overall, riboflavin, vitamin B-6, and vitamin B-12 that are one-carbon nutrients do not appear to influence the ovarian cycle among premenopausal women.