Tag: Vegetables

The association between diet and colorectal cancer risk

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In a nested case-control study published in JAMA Network Open, researchers from South Korea investigated the genetic variants that modify the association between diet and colorectal cancer (CRC) risk.

They found that single-nucleotide polymorphisms (SNPs) in the EPDR1 gene can modify the impact of fish intake on the risk of CRC.

Further, they highlighted the potential pathways underlying the link between the consumption of tea, milk, cheese, and alcohol and the development of CRC.

Study: Genome-Wide Interaction Study of Dietary Intake and Colorectal Cancer Risk in the UK Biobank. Image Credit: BlurryMe/Shutterstock.com

Background

CRC is the second most prevalent cancer in Europe (12.9%) and stands among the top three most-diagnosed cancers in both men and women in the United Kingdom (UK). Evidence suggests that the consumption of meat and alcohol is associated with an increased risk of CRC.

On the other hand, the intake of fish, milk, fruits, and vegetables shows an inverse association with CRC-risk. Genetic factors, accounting for 3.5% to 10.5% of variations, may influence dietary habits and CRC-risk.

For example, specific genes impact the metabolism of carcinogens in cooked meat and modify associations. Similarly, cruciferous vegetables are found to be inversely linked to CRC in individuals with certain enzyme deficiencies.

Advances in technology have enabled genome-wide association studies that reveal genetic susceptibility loci and facilitate the assessment of gene-diet interactions across the genome.

Dietary factors may influence CRC pathogenesis by modulating gene expression through metabolites or activating complex metabolic pathways.

Previous studies explored the role of nutrition in various carcinogenesis pathways, including deoxyribonucleic acid (DNA) synthesis, epigenetic control via one-carbon metabolism, DNA damage, phase 1 and 2 enzymes, tumor promotion, and polynucleotide repair.

Although potential mechanisms suggesting the association between dietary intake and CRC have been proposed, the specific genes and pathways involved in this association have not been extensively documented.

Therefore, researchers in the present study conducted a gene-diet interaction analysis using genetic data and CRC cases to identify genetic variants that influence the association between diet and CRC-risk.

About the study

Data was obtained from the UK Biobank of participants enrolled between 2006 and 2010. Individuals with sex mismatches, putative sex chromosome aneuploidy, non-White racial background, and prevalent cancer at recruitment were excluded.

A total of 4,686 participants (mean age 60.7 years) and 14,058 matched controls (mean age 60.4 years) were included in the study. In both the cohorts, 57.8% of participants were male.

Dietary intake information, including milk, cheese, poultry, red meat, processed meat, fish, coffee, tea, alcohol, and total fruit and vegetables, was collected through a touchscreen food frequency questionnaire.

Although the median follow-up was 12.4 years, only 10.2% of participants had data from more than one follow-up visit. Imputed genotyping data underwent quality control, resulting in 4,122,345 variants for the genome-wide interaction (GWI) analysis.

CRC cases were identified based on the International Statistical Classification of Diseases and Related Health Problems (revision 10).

Gene-based and gene-enrichment analyses were conducted. Statistical analysis involved the Cochran-Mantel-Haenszel χ2 test, conditional logistic model, principal component analysis, and p-values for gene or gene-set levels interactions.

Results and discussion

As compared to controls, the cases had a higher proportion of smokers, higher frequency of alcohol consumption, and higher prevalence of obesity.

Individuals consuming red meat ≥3 times per week and processed meat ≥2 times per week showed a higher CRC-risk (odds ratio 1.16) after adjusting for confounding factors.

Additionally, those who consumed alcohol more than thrice a week showed an increased CRC-risk compared to those with alcohol intake less than once a week. Notably, a protective association against CRC was found for participants consuming ≥4 servings of fruit daily compared to those with ≤ 2 servings daily.

324 SNPs were suggested to interact with dietary intake without statistical significance. Genes EPDR1 and ZNRF2 were identified in the gene-based analysis, with EPDR1 showing significance with fish consumption through multiple SNPs.

Further, gene-set enrichment analysis revealed overrepresented pathways (OR, ART, KRT, PRM, and TNP) for genes interacting with cheese, milk, tea, and alcohol consumption, respectively.

The study’s findings could contribute to personalized preventive strategies and interventions for CRC.

However, the study is limited by the analysis of CRC-risk based on dietary information from a single time point, limited availability of dietary data at multiple follow-up visits, potential instability in certain nutritional factors, inability to confirm specific SNPs modifying diet-CRC associations, and a lack of validation in non-European populations.

Conclusion

In conclusion, the study reveals several SNPs showing suggestive interactions with dietary intake, particularly significant interactions between EPDR1 and total fish consumption affecting CRC- risk.

The findings point to various biological and functional pathways potentially underlying the association and highlight the need for further investigation through experimental studies.

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March 1, 2024
Better cognition and academic performance are associated with Mediterranean diet adherence

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In a recent study published in Nutrients, researchers investigated the relationship between various Mediterranean-style eating patterns and cognitive and academic performance among adolescent residents of Chile.

Study: Adolescents with a Favorable Mediterranean-Style-Based Pattern Show Higher Cognitive and Academic Achievement: A Cluster Analysis—The Cogni-Action Project. Image Credit: YuliiaHolovchenko/Shutterstock.com

Background

The Mediterranean diet (MedDiet) is a healthy eating pattern associated with higher cognitive and academic success among teenagers in developing nations.

It consists of high extra-virgin olive oil, vegetable, fruit, grain, nut, and legume consumption, moderate fish, meat, and dairy product consumption, and low egg and sweet consumption. The MedDiet promotes reducing the intake of processed and sugary foods, alcohol, and smoking.

The Western diet (WD), which includes ultra-processed foods, refined carbohydrates, and sugar, has been associated with cognitive decline in youngsters. In contrast, the MedDiet increases well-being and increased cognitive function.

However, the association between MedDiet and academic and cognitive abilities in teenagers has not been thoroughly explored in Latina communities.

About the study

In the present study, researchers explored the association between different Mediterranean-style eating patterns and cognitive and academic ability in Chilean adolescents.

The study was part of the Cogni-Action Project, which ran from March 2017 to October 2019 and involved 1,296 Chilean adolescents (males and females in a 1:1 ratio) aged 10 to 14 years from private, public, and subsidized (government-funded) schools in Chile.

The researchers performed a cluster analysis to uncover dietary trends and mixed modeling to examine the associations of diet clusters with cognition and academics.

The researchers used the MedDiet Quality Index to measure MedDiet adherence in children and adolescents and the NeuroCognitive Performance Test (NCPT) to assess cognitive performance.

They used principal component analysis (PCA) to uncover four cognitive domains: cognitive flexibility (CF), working memory (WM), fluid reasoning (FR), and inhibitory control (IC).

They assessed CF basis Trail-making tests A and B and Digit coding symbol tasks. WM tasks included memory forward and memory reverse, and the IC and FR assessments included the Go/No-Go and problem-solving tasks, respectively.

The researchers assessed academic success across five school disciplines (English, Language, Science, History, and Mathematics), including the Academic-Programme for International Student Assessment (PISA) score calculated as the mean of Mathematics, Science, and Language scores.

The study consisted of two sessions of participant evaluation spread over eight days. The first session evaluated body weight, height, waist circumference, eating habits, sociodemographic information, and a cognitive battery. The second session evaluated physical fitness using three factors (sex, maturity, and global fitness score).

Results

The team identified the following diet patterns: Western diet (WD, 4.3%), low fruits and vegetables, high-sugar diet (LFV-HSD, 28%), low fruits and vegetables, low-sugar diet (LFV-LSD, 42%), and MedDiet (25%).

There was a remarkable difference among the dietary clusters, primarily related to ultra-processed food, sugar, vegetable, and fruit intake.

Individuals in the Mediterranean diet group scored better in all cognitive domains compared to the Western diet, LFV-LSD, and LFV-HSD groups. The Western diet group underperformed academically in all assessments compared to other groups.

The Mediterranean diet was unique, attaining positive differences among all subjects compared to the LFV-HSD and Western diet groups.

The WD group exhibited lower performance across all cognitive domains than the MedDiet group except for inhibitory control. The MedDiet group showed positive differences in total cognitive performance, cognitive flexibility, inhibitory control, and working memory compared to the LFV-LSD cluster. However, fluid reasoning was not significantly different.

The Western diet group individuals underperformed in academic analyses than those in other groups. The Mediterranean diet cluster showed a significant difference in school students compared to the LFV-HSD and WD groups.

The MedDiet group scored better across all academic subjects than their LFV-LSD group counterparts; however, the differences did not attain statistical significance.

Conclusions

The study findings showed that Mediterranean-style eating patterns and higher-quality food preferences are related to superior adolescent academic and cognitive outcomes.

The study highlighted four dietary patterns: Western diet, LFV-LSD, LFV-HSD, and MedDiet, determined by adolescent adherence to or lack of particular MedDiet components. These clusters had significant disparities in the intakes of fruits, vegetables, junk food items, sugar, and fish.

The study implies that implementing total and intermediate adherence to MedDiet patterns in non-Mediterranean teenagers might be a viable first step in nutrition and public health, with superior outcomes in brain health and academic attainment.

A complete Mediterranean-style diet was associated with better academics and cognitive status than the Western diet.

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February 27, 2024
Healthy plant-based diets linked to lower risk of obstructive sleep apnea

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People who eat a healthy, plant-based diet that is high in vegetables, fruit, whole grains and nuts are less likely to suffer with obstructive sleep apnea (OSA), according to a study published today (Wednesday) in ERJ Open Research. However, people eating an unhealthy plant-based diet, high in refined carbohydrates, sugary drinks, high-sugar and high-salt foods, are at a higher risk of OSA.

People with OSA often snore loudly, their breathing starts and stops during the night, and they may wake up several times. Not only does this cause tiredness, but it can also increase the risk of high blood pressure, stroke, heart disease and type 2 diabetes.

The new study is one of the first large-scale analyses to investigate the correlation between plant-based diets and OSA risk. Researchers say its findings suggest that eating a healthy, plant-based diet may help prevent or treat OSA.

The research was led by Dr Yohannes Melaku from Flinders University in Adelaide, Australia.

Risk factors for obstructive sleep apnoea may stem from genetics or behavior, including diet. Previous research has primarily focused on the impact of calorie restriction, specific dietary elements and weight loss. There’s a gap in our knowledge of how overall dietary patterns affect OSA risk. With this study, we wanted to address that gap and explore the association between different types of plant-based diets and the risk of OSA.”

Dr Yohannes Melaku from Flinders University

The research included data on 14,210 people who were taking part in the US National Health and Nutrition Examination Survey.

Participants were asked to explain everything they had eaten over the last 24 hours. Researchers categorized this information according to whether people were eating a healthy plant-based diet (including whole grains, fruits, vegetables, nuts, legumes, tea and coffee) or a diet high in animal foods (including animal fat, dairy, eggs, fish or seafood and meat). They also looked at whether people were eating an unhealthy, plant-based diet (including refined grains, potatoes, sugar-sweetened drinks, sweets, desserts and salty foods).

Participants also answered a questionnaire designed to gauge whether they are likely to be suffering from OSA.

People with diets highest in plant-based food were 19% less likely to be suffering with OSA, compared with those eating diets lowest in plant-based food. Those eating a largely vegetarian diet were also at a lower risk. However, people eating a diet high in unhealthy plant-based foods were at a 22% higher risk, compared to those eating low amounts of these foods.

The researchers also found differences in the risks for women and men, with a plant-based diet having a stronger correlation with OSA risk for men and an unhealthy plant-based diet having a bigger increase on women’s risk.

Dr Melaku said: “These results highlight the importance of the quality of our diet in managing the risk of OSA. It’s important to note these sex differences because they underscore the need for personalized dietary interventions for people with OSA.

“This research doesn’t tell us why diet is important, but it could be that a healthy plant-based diet reduces inflammation and obesity. These are key factors in OSA risk. Diets rich in anti-inflammatory components and antioxidants, and low in harmful dietary elements, can influence fat mass, inflammation, and even muscle tone, all of which are relevant to OSA risk.”

The researchers now plan to investigate the links between eating ultra-processed food and OSA risk in the same group of people. They also intend to study the interaction between diet and OSA risk over the longer term.

Professor Sophia Schiza is Head of the European Respiratory Society’s assembly on sleep disordered breathing, based at the University of Crete, Greece, and was not involved in the research. She said: “Obstructive sleep apnoea is a frequently occurring condition, and a significant number of individuals remain unaware of their own diagnosis despite the associated risks. There are treatments available for OSA, and patients can also take certain steps to improve their condition. This involves refraining from smoking, maintaining a healthy weight, and staying physically active.

“The findings of this study propose that modifying our diet might be beneficial in managing or avoiding OSA. Being aware that incorporating a wide variety of vegetables, fruits, and whole grains into our diet while minimizing the consumption of unhealthy foods and sugary drinks can greatly improve our overall health. We need to make it as easy as possible for everyone to adopt a healthy diet.”

Source:

European Respiratory Society

Journal reference:

Melaku, Y. A., et al. (2024) Plant-based and vegetarian diets are associated with reduced obstructive sleep apnoea risk. ERJ Open Research. doi.org/10.1183/23120541.00739-2023.

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February 21, 2024
A plant-based diet and its relationship with oxidative biomarkers in footballers

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In a recent study published in Scientific Reports, researchers investigated the association between plant-based diets and oxidative biomarkers by calculating the plant-based diet index score and determining the levels of urinary biomarkers for oxidative stress in professional footballers.

Study: Effect of a plant-based diet on oxidative stress biomarkers in male footballers. Image Credit: zi3000/Shutterstock.com

Background

The accumulation of reactive oxygen species in the body leads to the damage of protein, lipids, and deoxyribonucleic acid (DNA), which is known as oxidative stress. The concentrations of 8-hydroxy-2′-deoxyguanosine (8-OHdG) and F_2alpha-isoprostane (F_2a-IP) in urine have often been used as markers of oxidative stress. Diets that are largely plant-based have been thought to reduce oxidative stress and protect against reactive oxygen species.

Plant-based diets are also becoming increasingly popular, especially among athletes who have high energy and endurance requirements. These diets are categorized based on the proportion of plant to animal-based components in the diet. They range from completely plant-based, such as vegan diets, to semi-vegetarian diets that include some animal-based components.

Given that football is a sport that consists of activities such as intense bursts of running, jumps, and sprints that require high energy levels, adherence to nutritional diets is vital to the performance of footballers. They provide an ideal group to investigate how plant-based diets are associated with oxidative stress.

About the study

In the present study, the researchers compared the levels of urinary biomarkers F_2a-IP and 8-OHdG and the plant-based diet index scores between professional male footballers and matched non-athlete controls to examine whether plant-based diets were associated with decreased oxidative stress.

Footballers who had at least two years of professional experience and had strict training schedules were included in the study if their metabolic equivalent of the task was greater than 3000 minutes per week. They were also required to be non-smokers and not consume alcohol or take any antioxidant supplements. Healthy males with matched ages and body mass index (BMI) measures who had a metabolic equivalent of task between 600 and 3000 minutes per week were included as controls.

Interviews were conducted to determine the medical history, food intake data, physical activity levels, and general information on nutrition from all the participants. Anthropometric measurements such as height and weight were measured to calculate the BMI, and urine samples were obtained to measure the oxidative stress biomarker levels. A questionnaire was also used to determine physical activity levels.

A semi-quantitative food-frequency questionnaire was used to determine the food intake of all the participants over the previous year, including the consumption of specific items being determined in terms of grams per day. The plant-based diet index score was calculated using this information, and the results were used to classify the diets into three major groups — healthy plant foods, less healthy plant foods, and animal foods.

The healthy plant foods diets consisted of vegetables, fruits, nuts, whole grains, legumes, coffee, tea, and vegetable oils, while the less healthy plant food diets consisted more of refined grains and sugar-sweetened beverages and desserts. The diets that were predominantly animal food-based consisted mainly of meat, eggs, seafood, fish, dairy, and animal fat.

Results

The results showed that the plant-based diet index score of the footballers was significantly higher than that of the matched non-athlete controls, but the healthy and unhealthy plant-based diet index scores that were separately calculated based on the diet groups were not significantly different for the footballers and non-athletes.

Furthermore, plant-based diets were found to be linked to lower levels of the oxidative stress biomarker F_2a-IP in the urine samples of all participants, indicating improved antioxidant status due to plant-based diets. Compared to non-athletes, footballers were also found to be more adherent to plant-based diets, as hypothesized by the researchers.

Footballers were found to consume more vegetables, fruits, legumes, and nuts than non-athletes, while the consumption of total and animal fats was lower among footballers than non-athletes.

The researchers also discussed the potential role of antioxidants and polyphenols present in plant-based diets in lowering oxidative stress. They also discussed findings from other studies that found inverse associations between F_2a-IP concentrations and vegetable components such as lycopene, beta-carotene, and lutein, suggesting that diets rich in vegetables lower oxidative stress.

Furthermore, dietary fats are known to increase the production of F_2a-IP and influence the concentrations of F_2a-IP transporters in plasma, which could potentially explain why diets low in dietary fats were associated with lower F_2a-IP levels in the urine.

Conclusions

Overall, the results suggested that adherence to plant-based diets among footballers was linked to lower levels of the oxidative stress biomarker F_2a-IP in urine. Additionally, the plant-based diet scores also showed that footballers were more likely to adhere to nutritional plant-based diets than non-athletes.

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February 16, 2024
Impact of diet on health outcomes among United Kingdom Biobank participants

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In a recent study published in Nutrients, researchers assessed the association between diet and health outcomes among United Kingdom Biobank (UKBB) participants.

Study: Associations of Diet with Health Outcomes in the UK Biobank: A Systematic Review. Image Credit: Yulia Furman/Shutterstock/com

Background

Diet is crucial in preventing and controlling chronic diseases, with dietary patterns associated with cardiovascular diseases and cancer. Understanding the association between nutrition and disease necessitates a comprehensive approach considering environmental, genetic, psychological, and behavioral aspects.

Large epidemiological studies, like the UKBB, which leverage big data, can provide valuable insights into the association between diet and disease. However, qualitative and quantitative reviews of previous research are required to acquire a comprehensive overview of the progress made with these data.

About the study

In the present systematic review, researchers evaluated the impact of diet on health outcomes among UK Biobank participants aged between 40 and 69 years, focusing on the relationship between diet and non-communicable disease (NCD) incidence.

The team searched the Web of Science and PubMed databases for relevant studies published from 2018 to 2022.

Eligible studies evaluated the diet of UKBB participants using 24-hour Oxford WebQ dietary recalls, food frequency questionnaires (FFQs), and food preference questionnaires (FPQs).

The studies assessed individual food components, dietary patterns, a priori-determined diets and health indices, and specific nutrients as estimation variables and the relationship between food and non-communicable diseases, with known risk factors as environmental variables (e.g., diabetes, cancer, hypertension, and cardiovascular disease).

The team excluded studies focusing on dietary intake for deficiencies, exploring dietary influence on cognitive function-related NCDs (such as Alzheimer’s disease and dementia), or individual studies examining a particular disease.

They used the Newcastle-Ottawa scale (NOS) to assess study quality. The effect estimate summary was gathered from multiple studies using hazard ratio (HR) values of models maximally adjusted for identical dietary exposures.

The team used risk estimates to compare the most and least adherence categories for healthy diets, focusing on healthy patterns and comparing their risk estimates to unhealthy ones.

For studies recording varying food proportions, they obtained risk estimates from the most to the least intake and converted odds ratios (OR) as HR values.

They used bubble plots to visually depict effect distribution, while descriptive statistics and box-and-whisker plots assessed effect distribution by disease types.

Results

Initially, the team identified 346 records, of which they considered only 36 for the systematic review, including 11 studies on cardiovascular diseases (CVDs), eight on T2DM, ten on cancer, and seven on other non-communicable diseases.

The number of participants in the included studies ranged between 5,000 and 400,000. Almost all (except one of medium quality) studies were high quality.

Most studies focused on specific macronutrients or food categories, with only a handful examining dietary patterns. Several studies found that eating more processed and red meat increases the chance of developing colorectal and lung cancer.

Fish-eating and vegetarian diets can reduce cancer incidence. A well-balanced diet with high diet quality scores could lower diabetes risk. A study reported that eating dried fruit reduced the risk of breast and lung cancer.

The study findings indicated that higher adherence to healthy diets (eating a variety of foods with a minimum of three servings of whole grains, vegetables, and fruits per day and limiting processed meat intake to once a week) modestly lowers the incidence of cardiovascular disease, T2DM, and colorectal cancer.

Healthy diets include a higher intake of plant-based foods and a lower intake of processed meats, refined grains, sugar-sweetened beverages, and foods rich in saturated fat, added sugars, and sodium.

Studies found a favorable relationship between processed foods and CVD incidence but not death. Consuming raw vegetables reduces the risk of CVD, whereas cooked vegetables do not. High fiber, sugar, and saturated fat consumption may impact their effects.

However, genetics may be more significant than nutrition in avoiding colorectal cancer. A healthy diet, red meat consumption, and processed meat consumption all produced consistent findings for CVD, T2DM, and some cancer types. A healthy diet had median HRs of 0.9 for colorectal cancer, 0.8 for CVD, and 0.9 for T2DM.

Conclusion

Overall, the study findings showed that a healthy eating pattern considerably lowers the risk of cardiovascular disease, colon cancer, and type 2 diabetes.

The UK Biobank cohort data confirms these findings, with high consumption of whole grains, fruits, vegetables, and meat marginally decreasing the incidence of type 2 diabetes, cardiovascular disease, and colorectal cancer.

Future research should use multi-omics data and machine learning algorithms to account for the intricate interactions between dietary components and their impact on disease risk.

Focusing on healthy dietary patterns that include a range of foods can strengthen correlations with CVD and T2DM.

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February 16, 2024
Nutrition labels lead to healthier eating in teens, study finds
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In a recent study published in Nutrients, researchers at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin explored how nutrition labels affect eating behaviors among middle-school and high-school students in Texas.

Study: Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey. Image Credit. progressman/Shutterstock.com

Based on self-reported information, their results indicate that improving nutrition literacy and using food labels could significantly enhance the quality of diet for school-going adolescents.

Background

Nutrition labels can help people compare different food items and inform healthier decision-making. In recent years, the use of food labels has increased dramatically among American adults, with around 80% making purchase decisions based on label information. Using labels is related to better dietary quality and health outcomes.

Adolescent health is a policy priority since this period of life is critical for well-being in adulthood. Today, nearly one in four American adolescents are categorized as obese, but studies on nutrition label use among this group have shown contradictory results.

While one study found high levels of label use among adolescents, this did not translate to having a healthier diet. Another found far lower levels of label use. These conflicting results highlight a critical need for further research to understand how best to address and prevent adolescent obesity.

About the study

In this study, researchers used a cross-sectional design with data collected through the Survey of Physical Activity and Nutrition in Texas from 2019 to 2020. During the academic year, students in the eighth and eleventh grades filled out survey questionnaires and answered questions about demographic information, physical activity, nutrition, dental habits, and screen time.

Their weight and height were also assessed to calculate their body mass index (BMI). Students were also asked whether they used food labels to inform their food choices. They were asked to respond on a Likert scale with five points ranging from ‘Always’ to ‘Never.’ This was the primary predictor.

The students’ dietary behavior was assessed using questions on how frequently they reported consuming various food items the previous day. The list contained 13 healthy foods, such as brown rice, vegetables, whole fruit, and baked meat, and 13 unhealthy foods, such as flavored milk, fried meat, caffeinated beverages, and frozen desserts. To include weekday consumption, the food consumption surveys were administered from Tuesday to Friday.

This information informed the calculation of the healthy eating index (HEI) and the health foods index (HFI) from 0 to 100, where a higher score indicated a healthier diet. The study’s primary outcomes were the HEI, HFI, and unhealthy foods index (UFI). The data was analyzed using adjusted and weighted linear and logistic regression models.

Findings

The sample included 4,730 students, of whom 49% were female, more than half were Hispanic, and had an average age of 14.7 years old. Most students were not economically advantaged, and nearly 15% had limited English proficiency. About 60% reported that they never or rarely used food labels to make decisions about eating. Only 11% said they always relied on labels to make food choices.

The regression analyses showed that using food labels was significantly positively associated with HEI and HFI scores and negatively associated with UFI scores. The researchers observed a dose-response relationship where stronger associations were observed as the frequency of label use increased.

Individuals who consistently or almost always used the food labels were likelier to eat healthy foods such as nuts, brown bread, baked meat, fruit, and vegetables; they also reported consuming lower amounts of chips, soda, and candy.

Conclusions

The findings from this study clearly showed a dose-response relationship. The benefits of using food labels were greater for those who used them more frequently, and students who always used food labels had significantly healthier diets than other groups. However, only 11% of the students made use of food labels all the time, indicating that not many are utilizing this resource.

Despite these benefits, many adolescents may struggle to understand the complex nutritional information on the labels. Using this information to guide food-related decision-making requires comprehending and responding to information on which nutrients should be avoided or limited (sodium, added sugars, and saturated fats) and those that are healthy (e.g., minerals and dietary fibers).

The strengths of this study included its state-level representative design; however, the study was also observational, which did not allow for causal inference, and relied on self-reported data, which is subject to recall and social desirability biases.

Future studies can explore the mechanisms behind the associations observed, how to encourage food literacy and label use among the youth, and explore possible sex-based differences to address the specific needs of female and male students.
Journal reference:

Pfledderer C, Ranjit N, Perez A, et al. (2024). Using the nutrition facts label to make food choices is associated with healthier eating among 8^th and 11^th-grade students: an analysis of statewide representative data from the 2019-2020 Texas school physical activity and nutrition survey. Nutrients. doi: 10.3390/nu16020311. https://www.mdpi.com/2072-6643/16/2/311
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February 11, 2024
The impact of drinking water quality on mental health and the modifying role of diet
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In a recent study published in BMC Medicine, researchers estimate how exposure to various trace elements in drinking water increases the risk of depression and anxiety.

Study: Association between drinking water quality and mental health and the modifying role of diet: a prospective cohort study. Image Credit: New Africa / Shutterstock.com

Background

Mental health disorders, particularly depression and anxiety, remain a leading cause of both disability and premature death throughout the world. Following the coronavirus disease 2019 (COVID-19) pandemic, the prevalence of both anxiety and depression throughout the world rose by about 25%, thus exemplifying the widespread prevalence of these mental diseases.

Several factors may increase an individual’s risk of depression or anxiety, including genetics, social environment, and physical environment. Within the physical environment, exposure to heavy metals like cadmium has been shown to increase the risk of depression and anxiety, whereas other elements like manganese, copper, and selenium, all of which combat oxidative stress, have the potential to reduce the risk of depression.

To date, most studies investigating the impact of environmental risk factors on the incidence of depression and anxiety have been cross-sectional. Within China, few longitudinal studies have examined how exposure to metal and nonmetal elements in drinking water may impact the risk of depression and anxiety.

About the study

In the present study, researchers identified people diagnosed with depression and anxiety from the Yinzhou district using International Classification of Disease codes F32 and F41, respectively, in data retrieved from the Yinzhou Health Information System (YHIS). Atomic absorption spectrophotometry (AAS) was used to measure manganese, zinc, copper, iron, aluminum, cadmium, selenium, and fluorine levels in tap water samples collected from 37 sites in the Yinzhou district.

Water samples were collected four times each year, with at least one sample collected each season. Exposures were assigned to participants based on their residential addresses and the location of tap water collection sites. Daily exposure to all trace elements in drinking water was calculated and adjusted based on the daily drinking water intake of participants, as well as their age and gender.

A baseline survey was administered to collect data on participants’ frequency of consuming leafy vegetables, meat, fruits, and fish, with their intake of these dietary components categorized as low, moderate, or high. Data on sociodemographic status, lifestyle, and medical history were also acquired.

Study findings

The final analysis included 24,285 individuals between 2016 and 2021 without a history of depression or anxiety. From these individuals, 765 and 1,316 depression and anxiety cases, respectively, were reported during a median follow-up period of 4.72 and 4.68 years, respectively.

Females, as well as those who never smoked or drank, were more likely to have depression, in addition to a greater risk of hypertension, dyslipidemia, cancer, and stroke. Comparatively, females, less educated individuals, older individuals, never drinkers, non-smokers, and those with a lower income were more likely to have anxiety, diabetes, dyslipidemia, cancer, and stroke, in addition to lower levels of seafood and meat consumption.

Exposure to aluminum in drinking water was more commonly reported in individuals diagnosed with depression, whereas exposure to manganese, iron, and aluminum in drinking water was higher in individuals with anxiety. Individuals with anxiety were also exposed to lower levels of zinc as compared to healthy participants.

Long-term exposure to zinc, iron, aluminum, selenium, and fluorine did not impact the risk of depression. Likewise, long-term exposure to zinc, copper, aluminum, cadmium, and fluorine did not increase the risk of anxiety.

Diet did not have a significant effect on the relationship between the risk of depression and manganese, copper, and cadmium exposure in drinking water. However, the risk of anxiety was greater in individuals who consumed less fruits, more seafood, and meat and who were also exposed to manganese and iron in drinking water. Long-term exposure to copper, selenium, and fluorine was also associated with a greater risk of anxiety in individuals who consumed less leafy vegetables and fruits.

Lower socioeconomic level was associated with increased exposure to heavy metals, particularly copper, in drinking water. Additionally, older, low-income, and less educated individuals who were exposed to cadmium in drinking water were also at a greater risk of depression.

Higher education levels were more commonly observed in anxious individuals who were exposed to manganese and selenium in drinking water. Comparatively, exposure to iron in drinking water was also more common in older and less educated individuals with anxiety.

Conclusions

The present study findings underscore the need to improve the quality of drinking water and adopt healthy dietary habits to reduce the burden of depression and anxiety, as these measures may contribute to the pathophysiology of depression and anxiety. Public health policies should also address the inequitable effect of exposure to various trace elements in drinking water in relation to the increased risk of mental diseases among people in low socioeconomic strata.
Journal reference:

Zhou, S., Su, M., Shen, P. et al. (2024). Association between drinking water quality and mental health and the modifying role of diet: a prospective cohort study. BMC Medicine 22(53). doi:10.1186/s12916-024-03269-3
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February 8, 2024
Exploring how diets rich in saturated fats and cholesterol influence periodontal diseases

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In a research, led by the University of Granada, in which researchers from the Universidad Europea del Atlántico (European University of the Atlantic, UNEATLANTICO), such as Mario Cordero and Maurizio Battino, it has been studied how diets rich in saturated fats and cholesterol influence certain aspects of periodontal diseases. This international research also involved the collaboration of researchers from Newcastle University in the United Kingdom, the Marche Polytechnic University in Italy, Jiangsu University and Northwestern University, both in China.In a research, led by the University of Granada, in which researchers from the Universidad Europea del Atlántico (European University of the Atlantic, UNEATLANTICO), such as Mario Cordero and Maurizio Battino, it has been studied how diets rich in saturated fats and cholesterol influence certain aspects of periodontal diseases. This international research also involved the collaboration of researchers from Newcastle University in the United Kingdom, the Marche Polytechnic University in Italy, Jiangsu University and Northwestern University, both in China.

The study entitled “A Diet Rich in Saturated Fat and Cholesterol Aggravates the Effect of Bacterial Lipopolysaccharide on Alveolar Bone Loss in a Rabbit Model of Periodontal Disease” was published in the Nutrients journal in which they found an intriguing connection between the foods consumed and gum health.

According to the study, a diet rich in saturated fats and cholesterol could aggravate alveolar bone loss caused by periodontal disease. Periodontitis, a serious condition that affects the gums and the support of the teeth, has been linked to other systemic diseases such as metabolic syndrome, atherosclerosis, and liver disease due to fat accumulation. While the relationship is complex, these results suggest that diet may play a key role in long-term dental health.

One of the most striking findings of this study was the impact of a diet rich in saturated fat and cholesterol on alveolar bone loss in animal models. The researchers used rabbits in their experiment and found that those consuming a diet high in saturated fat and cholesterol experienced more pronounced bone loss when exposed to bacterial lipopolysaccharides associated with periodontal disease. In turn, these rabbits also showed increased acinar inflammation in the liver and elevated blood levels of triglycerides and phospholipids.

While more research is needed to fully understand how diet affects periodontal disease in humans, being aware of saturated fat and cholesterol intake could be beneficial to long-term gum health. Making smart dietary choices, including a balanced diet with a focus on fruits, vegetables, and healthy sources of protein can have a positive impact on the prevention and treatment of periodontal disease.

In addition to reducing the intake of saturated fats and cholesterol, it is recommended to improve other dietary guidelines, such as limiting the consumption of sugars, increasing the consumption of fruits and vegetables, and maintaining adequate hydration. Proper tooth brushing, flossing and regular visits to the dentist are also key practices for maintaining a healthy mouth. This information may be especially relevant for those who already have risk factors such as diabetes, cardiovascular disease, or tobacco use, as understanding and controlling their diet could help prevent possible periodontal complications.

In summary, this revealing study shows that there is a clear connection between diet and gum health.

Source:

Universidad Europea del Atlántico

Journal reference:

Varela-López, A., et al. (2020). A Diet Rich in Saturated Fat and Cholesterol Aggravates the Effect of Bacterial Lipopolysaccharide on Alveolar Bone Loss in a Rabbit Model of Periodontal Disease. Nutrients. doi.org/10.3390/nu12051405.

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February 5, 2024
High diet quality in early life associated with reduced risk of IBD

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A high quality diet at the age of 1 may curb the subsequent risk of inflammatory bowel disease, suggests a large long term study, published online in the journal Gut.

Plenty of fish and vegetables and minimal consumption of sugar-sweetened drinks at this age may be key to protection, the findings indicate.

A linked editorial suggests that it may now be time for doctors to recommend a ‘preventive’ diet for infants, given the mounting evidence indicative of biological plausibility.

Cases of inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, are increasing globally. Although there is no obvious explanation for this trend, changes in dietary patterns are thought to have a contributory role, because of their impact on the gut microbiome.

While various studies have looked at the influence of diet on IBD risk in adults, there is little in the way of research on the potential influence of early childhood diet on risk.

In a bid to plug this knowledge gap, the researchers drew on survey data from the All Babies in Southeast Sweden study (ABIS) and The Norwegian Mother, Father and Child Cohort Study (MoBa).

ABIS includes 21,700 children born between October 1997 and October 1999; MoBa includes 114, 500 children, 95,200 mothers, and 75,200 fathers recruited from across Norway between 1999 and 2008.

Parents were asked specific questions about their children’s diet when they were aged 12-18 months and 30-36 months. The final analysis included dietary information for 81,280 1 year olds: 11,013 (48% girls) from ABIS and 70, 267 (49% girls) from MoBa.

Diet quality, gleaned from measuring intake of meat, fish, fruit, vegetables, dairy, sweets, snacks, and drinks, was assessed using a modified version of the Healthy Eating Index (HEI) scoring system, adapted for children. The weekly frequency of specific food groups was also assessed.

Higher diet quality-;a higher intake of vegetables, fruit, and fish, and a lower intake of meat, sweets, snacks, and drinks-;was reflected in a higher HEI score.The total score was divided into thirds to indicate a low, medium, or high quality diet.

Data on age at weaning, antibiotic use, and formula feed intake were also reported at age 12 (ABIS) and 18 months (MoBa).

The children’s health was monitored for an average of 21 (ABIS) and 15 (MoBa) years from the age of 1 until 31 December 2020-21.

During this period, 307 children were diagnosed with IBD (131 with Crohn’s disease; 97 with ulcerative colitis; and 79 with unclassified IBD). The average age at diagnosis was 17 (ABIS) and 12 (MoB).

Medium and high quality diets at the age of 1 were associated with an overall 25% lower risk of IBD compared with a low quality diet at this age, after adjusting for potentially influential factors, such as parental history of IBD, the child’s sex, ethnic origin, and education and co-existing conditions in the mother.

Specifically, high fish intake at the age of 1 was associated with a lower overall risk compared with its opposite, and a 54% lower risk of ulcerative colitis in particular.

Higher vegetable intake at 1 year of age was also associated with a reduced risk of IBD. On the other hand, consumption of sugar-sweetened drinks was associated with a 42% heightened risk.

There were no obvious associations between any of the other food groups, including meat, dairy, fruit, grains, potatoes and foods high in sugar and/or fat, and overall IBD or Crohn’s disease or ulcerative colitis risks.

By the age of 3, only high fish intake was associated with reduced IBD risk, and ulcerative colitis in particular.

The findings remained unchanged after accounting for household income and the child’s formula intake and antibiotic use by the age of 1.

This is an observational study, and as such, can’t establish cause. And the researchers acknowledge that while the ABIS participation rate was high (79%), it was only 41% for MoBa. And because Sweden and Norway are two high-income countries, findings may not be generalisable to low- or middle-income countries with other dietary habits, they add.

“While non-causal explanations for our results cannot be ruled out, these novel findings are consistent with the hypothesis that early-life diet, possibly mediated through changes in the gut microbiome, may affect the risk of developing IBD,” they conclude.

In a linked editorial, gastroenterologist Dr Ashwin Ananthakrishnan of Massachusetts General Hospital, Boston, USA, cautions that the questionnaires didn’t capture elements, such as additives and emulsifiers which are common in baby food, and which may contribute to the development of IBD.

Accurate measures of food intake in infants and young children are inherently fraught with difficulty, he adds.

But he goes on to say that it may nevertheless be time to recommend a ‘preventive’ diet, particularly as this is likely to have other health benefits.

“Despite the absence of gold standard interventional data demonstrating a benefit of dietary interventions in preventing disease, in my opinion, it may still be reasonable to suggest such interventions to motivated individuals that incorporate several of the dietary patterns associated with lower risk of IBD from this and other studies.

“This includes ensuring adequate dietary fiber, particularly from fruit and vegetables, intake of fish, minimizing sugar-sweetened beverages and preferring fresh over processed and ultra-processed foods and snacks.”

Source:

Journal reference:

Guo, A., et al. (2024). Early-life diet and risk of inflammatory bowel disease: a pooled study in two Scandinavian birth cohorts. Gut. doi.org/10.1136/gutjnl-2023-330971.

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January 31, 2024