bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Early Market Introduction of Iodized Salt on Pregnancy and Birth Outcomes in a Randomized Clinical Trial in the Amhara Region of Ethiopia
Authors: Mohammed Husein , Marquis Grace , Aboud Frances , Bougma Karim , Harding Kimberly B , Samuel Aregash
Published: November 2023

Iodine deficiency has been shown to lead to adverse pregnancy and birth outcomes. This study examined the effect of early introduction of iodized salt on pregnancy and birth outcomes in a moderately iodine deficient area. Sixty randomly selected districts across six zones in the Amhara region of Ethiopia were randomly assigned to receive the intervention (early access to iodized salt) or serve as the control (later access through normal market forces). One village each in twenty‐two of the intervention districts and 22 of the control districts was randomly selected for data collection. A total of 1220 pregnant women who conceived after the intervention began were assessed for their iodine and iron status, and their household salt was tested for iodine. Additional data were collected on their household socio‐demographic status and iodized salt, gestational history, adverse pregnancy and birth outcomes, and child nutritional status 2 to 13 months old after mothers gave birth. The mothers had an average age of 28 ± 6 y with low education (77% illiteracy), low household assets (42% scored <3 out of 10), and poor water and sanitation (61%). The median maternal urinary iodine concentration was adequate and significantly higher in the intervention communities than that of the controls (163 vs 121 μg/L, p<0.0001). Additionally, fewer pregnant women (28% vs 41%, p<0.05) and their children (13% vs 20%, p=0.06) had urinary iodine less than 50 μg/L in the intervention than control communities. After accounting for the effect of cluster and gestational history, the intervention did not significantly reduce miscarriages (OR (95% CI): 2.5 (0.9, 6.9)), stillbirths (OR (95% Cl): 1.0 (0.4, 2.8)), or infant mortality (OR (95%CI): 0.9 (0.5, 1.6)). Our inability to detect an effect of early access to iodized salt on birth outcomes may be due to (i) higher than expected access to iodized salt among the controls, (ii) lower than expected prevalence of poor birth outcomes, and (iii) inadequate sample size. The intervention improved pregnant women's iodine status and governments should pursue universal salt iodization program for the multiple known benefits.

Support or Funding Information

Sponsored by Micronutrient Initiative, Canada
Nutrition in Transition: Building Clinical Nutrition Capacity to Train Dietitians in Lao PDR
Authors: Cummings Joanna , Stadler Diane
Published: November 2023

Lao PDR has some of the highest rates of undernutrition in the world. Nearly 36% of children under the age of five are stunted and 27% are underweight. Food taboos influencing maternal and child health, delayed initiation of breastfeeding, early introduction of complementary foods, and limited dietary diversity impact the country's nutritional profile. Although improvements in nutrition have been made, gaps remain. A unique collaboration between Oregon Health & Science University, Lao PDR Ministry of Health and the US Government has led to the innovative creation of the Lao‐American Nutrition Institute. The institute is charged with building capacity to train clinical nutritionists and dietitians in the country of Lao PDR. A rapidly growing population compounded with increasing double burden of disease, escalating rates of chronic disease, and on‐going acute and chronic malnutrition indicate an immediate need for dietitians to help improve access and diversity of healthful foods while driving innovation to guide policy development and implementation and scale up targeted nutrition interventions for the most vulnerable populations across the country. Challenges and successes encountered in cultivating champions of dietitians within the health care system, developing a culturally appropriate nutrition curriculum, recruiting the first cohort of established medical professionals to become the mentors and using a “train the trainer” model to build capacity and improve the health of all people in Lao will be discussed.

Support or Funding Information

Supported by the Lao Ministry of Health, OHSU Global ‐ SE Asia Foundation and the Vejdusit Foundation
Iron Content in Groundwater Associated with Anemia among Children 6–37 Months in Rural Bangladesh
Authors: Wendt Amanda S , Waid Jillian L , Gabrysch Sabine
Published: November 2023

Objectives

Elevated iron content in groundwater has been cited as a significant dietary iron source. We explored this in order to further understand the etiology of anemia among children in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) population.

Methods

We used baseline data from the FAARM cluster randomized trial (https://clinicaltrials.gov/ct2/show/NCT02505711) collected in early 2015 among 1,133 children aged 6–37 months in 96 clusters. Levels of drinking water iron were measured by household member self‐report using a 4‐point scale (none, a little, medium, a lot), which was dichotomized into any or none.

Results

Half of the children (51%) were anemic (mean hemoglobin: 10.8 g/dL) and 46% were stunted (mean Z‐score: −1.9). Only 23% of children ate a minimum adequate diet. Every second child (47%) lived in a household that reported iron in their drinking water. In a random‐effects logistic regression model, perceived iron in groundwater was negatively associated with anemia (aOR: 0.67; 95%CI: 0.50, 0.86) after adjusting for child age, iron‐rich food consumption, and household wealth. Iron‐rich food consumption was not significantly associated with anemia.

Conclusion

These findings provide further evidence of the importance of groundwater iron intake. The effect in children was much stronger than in women of the same population where iron in drinking water was negatively associated with anemia only among those consuming an iron‐poor diet. These findings demonstrate the utility of asking perceived groundwater iron content as a simple method to assess iron in drinking water and should be considered in regions with groundwater iron.

Support or Funding Information

This trial is funded by the German Federal Ministry for Education and Research (BMBF) and surveillance by DFID through the Nutrition Embedding Evaluation Programme (NEEP). The intervention is funded jointly by BMBF, and through the following private donations: the Carrefour Foundation, TWFA, and Best‐in‐Brands.
Assessing the reach of MyPlate in the U.S. population: An analysis using NHANES data
Authors: Raghavan Ramkripa , Schap TusaRebecca , Haven Jackie , Tagtow Angie
Published: November 2023

Objective

The Dietary Guidelines for Americans (DGA) serves as a basis for developing federal nutrition education materials in the U.S. The MyPlate icon was released in 2011 as a tool to communicate 2010 DGA and help consumers make healthy choices. The objective of this study was to evaluate the reach of MyPlate in the U.S. population and understand the characteristics of Americans that have heard about MyPlate.

Methods

Data from the NHANES (2013–2014) was used for this analysis. In the diet, behavior and nutrition component of NHANES, eligible respondents (n=6,464) over 16 years of age were asked three questions to ascertain their familiarity with MyPlate: 1) Have you heard of MyPlate; 2) Have you looked up MyPlate on the internet; and 3) Have you tried to follow the plan recommended in MyPlate. The survey also collected demographic, income, diet and health related information that was used in this analyses. Survey weights were used in the analysis to account for non‐response and over‐sampling.

Results

One in five (20.2%) adolescents and adults in the U.S. had heard of MyPlate. Of these, a third looked up MyPlate on the internet (33.2%) and slightly over a third (35.3%) tried to follow the plans recommended in MyPlate. Within demographic characteristics of interest, familiarity varied. The groups more likely to have heard of MyPlate were for gender ‐ women (25.9%), age‐adolescents (30.6%), race‐ethnicity – non‐Hispanic White (23.5%), and income – those with higher incomes (28.0%). Self‐reported superior diet quality was correlated with reported awareness of MyPlate and their inclination to try recommendations tied to MyPlate recommendations. Healthy choices while eating away from home both in fast food/pizza places and restaurants was associated with reported familiarity of MyPlate. For example, those that had heard of MyPlate were more likely to have seen nutrition information on the menu and use that information to order foods in restaurants (50.5% vs. 39.2%; p value = 0.04) and fast food places (54% vs. 38.8%; p value = 0.003), when compared to those that had not heard of MyPlate. Familiarity with MyPlate was not correlated with recent participation in WIC or SNAP.

Conclusion

Two years after the launch of MyPlate, one in five Americans had heard of MyPlate – the primary tool to communicate DGA. There may be a correlation between familiarity with MyPlate and other health‐seeking behaviors. Targeted efforts may be undertaken to disseminate MyPlate messaging to certain sub‐groups such as older adults, men, racial ethnic minorities and those of lower socio‐economic status to improve MyPlate's reach and amplify impact.

Support or Funding Information

None
Impacts on student fruit and vegetable consumption and snack participation in the Canned, Frozen, and Dried pilot project of the Fresh Fruit and Vegetable Program (FFVP)
Authors: Niland Katherine , Gothro Andrew , Cannon Judith , Crepinsek Mary Kay , Washburn Liana , Melia Micah , Magness Allison , Briefel Ronette
Published: November 2023

This congressionally mandated study of the Canned, Frozen, and Dried pilot project for the Fresh Fruit and Vegetable Program (FFVP‐CFD) assessed the impact of the pilot on students' fruit and vegetable consumption and wastage, FFVP participation, and schools' implementation strategies. The pilot allowed, but did not require, elementary schools that reported problems with access to fresh fruits and vegetables (FVs) to offer CFD snacks in the FFVP in school year (SY) 2014–2015. The evaluation used a pre/post design, comparing data from the fall of 2014, when the standard FFVP was in place, to data from the spring of 2015, when the FFVP‐CFD pilot was in place. For an evaluation of the pilot, we collected student dietary recalls to measure detailed food and nutrient intake in‐school, a student survey to assess student attitudes on FFVP snacks and FV preferences, and we observed one week of FFVP snack offerings in 101 classrooms in 34 pilot schools in four pilot states (Alaska, Delaware, Kansas, and Maine) in both fall and spring of SY 2014–2015. Although FFVP‐CFD study findings are not generalizable to other schools in the FFVP nationwide, they do provide important information on students' attitudes and preferences for specific fruits and vegetables in selected small and rural schools in four pilot states, including Alaska, which is often excluded from national school nutrition evaluations. The final evaluation report is in clearance at USDA. It is anticipated that the report will be cleared by April 2017 and that we will present the impact findings for the first time publicly at EB 2017.

Support or Funding Information

Evaluation funded by the Food and Nutrition Service, USDA.
How to Make Kids Eat Healthier in School Cafeterias: An Evidence from Smarter Lunchrooms Program in North East U.S.
Authors: Just David R , Wansink Brian , Gabrielyan Gnel , Hanks Andrew S. , Brumberg Adam
Published: November 2023

Obesity numbers has been increasing rapidly in the last decades bringing the problem into the center of conversation. Children are thought to be the most vulnerable group affected by obesity epidemic since they haven't formed any food preferences at their age. Children are also very sensitive to nutritional impulses and calorie content in the food, and they are also very sensitive to sweet and fat foods. By providing free or reduced price meal to over 30 million children through it National School Lunch Program, USDA plays a very important role in feeding kids in the US. The purpose of this study is to identify the impact of Smarter Lunchroom techniques for school cafeterias and its overall sustainability. Pre and post intervention analysis were conducted by researchers in spring 2012. To check the sustainability of the program, researchers revisited some of these schools in 2015. The findings show mixed results for fruit and vegetable selection and consumption.
Dietary Patterns Derived By Reduced Rank Regression Are Associated With Cardiometabolic Disease
Authors: Livingstone Katherine M , McNaughton Sarah
Published: November 2023

Objective

This study aimed to investigate associations between whole diet, or dietary patterns (DPs), and risk markers for cardiometabolic disease.

Methods

Adults (n=2120; 19–85 years) were included from the cross‐sectional Australian Health Survey 2011–13. Two 24‐hour dietary recalls estimated food and nutrient intakes. Reduced rank regression derived DPs using fibre density (g/MJ), SFA: PUFA and sugars intake (%E) as response variables. Linear regression analyses present B coefficients (95% CI) for associations across tertiles of DPs and measures of adiposity (body mass index [BMI], body weight [BW] and waist circumference [WC]), metabolic markers (glycated haemoglobin, glucose, total cholesterol, high and low density lipoprotein cholesterol [HDL‐C and LDL‐C], and triglycerides [TAG]) and systolic and diastolic blood pressure (SBP and DBP). An overall cardiometabolic risk score was estimated based on WC, HDL‐C, TAG, glucose and mean blood pressure.

Results

DP‐1, positively correlated with fibre intake and inversely correlated with SFA: PUFA and sugars intake, was characterised by higher intakes of wholegrain cereals, fruit and vegetables, and low‐fat milk and lower intakes of processed meat, confectionary and alcohol. DP‐1 was associated with lower BMI (−0.03; −0.04 to −0.01), BW (−0.03; −0.04 to −0.01) and WC (−0.03; −0.05 to −0.02). DP‐1 was not associated with metabolic markers, blood pressure or cardiometabolic risk score. DP‐2, positively correlated with fibre, SFA: PUFA and sugars intake, was characterised by higher intakes of wholegrain cereals, fruit and vegetables and low and high fat milk, and lower intakes of fish, snacks and alcohol. DP‐2 was associated with lower HDL‐C (−0.03; −0.05 to −0.01) and there was a trend towards lower DBP (−0.92; −1.89 to 0.06) and cardiometabolic risk score (−0.20; −0.41 to −0.01). DP‐1 was not associated with adiposity or other metabolic markers.

Conclusion

A high fibre and low SFA: PUFA and sugars DP was associated with lower adiposity, while a high fibre, SFA: PUFA and sugars DP was associated with lower metabolic markers and a trend towards lower blood pressure and overall cardiometabolic risk score. These findings suggest that there may be differing mechanisms through which dietary components, such as SFA, influence cardiometabolic risk. To account for these dietary complexities, public health policies would benefit from developing recommendations based on whole diets.

Support or Funding Information

KML acknowledges support from the Alfred Deakin Postdoctoral Research Fellowship. SAM acknowledges support from the NHMRC Career Development Fellowship (ID1104636).
Impact of food fortification on dietary folate intake and adequacy in a representative sample of urban Costa Rican population: results from the Latin American Study of Nutrition and Health (ELANS)
Authors: Gomez Georgina , Ramírez Andrea , Sheik Amed , Chinnock Anne , Monge Rafael
Published: November 2023

Object

The study aimed to evaluate the impact of mandatory and voluntary fortification on folate intake adequacy in urban Costa Rican population.

Methods

ELANS is a multicenter cross‐sectional study including a representative sample of urban population from eight LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela). In Costa Rica, 798 participants (15–65 years old) provided two 24‐h dietary recalls. Nutritional data was entered into the Nutrition Data System for Research (NDS‐R) after a harmonization process between local foods and NDS‐R database, and adjusting for mandatory folic acid fortification of rice, wheat flour and corn flour. Total folate intake was expressed as dietary folate equivalents (DFE) = mg food folate + (mg dietary folic acid × 1.7). The prevalence of inadequate folate intake was calculated using Estimate Average Requirement of 330μg DEF/day for adolescents and 320μg DFE/day for men and women. The Mann‐Whitney test was used to analyze the differences between age groups and gender, and Chi‐square tests to analyzed differences of folate inadequacy between groups, considering p<0.05 as statistical significant.

Results

Sample comprised 49.4% men and 50.6% women and included 15%, 38%, 28% and 19% in the age groups 15–19y, 20–34y, 35–49y and 50–65y, respectively. Usual median DFE intake was 566mg/d, higher in men (639mg/d) than in women (486mg/d) (p<0.05). The older group (50–65y) showed the lowest intakes of DFE (497mg/d) (p<0.05). The overall prevalence of DFE inadequacy was 5.3% of the urban Costa Rican population, and higher in women than in men in all age groups (p<0.05). Women aged 15–19y and 50–65 showed the highest prevalence of inadequacy (11% and 10% respectively). Synthetic folate from fortified foods (mainly from rice, bread, pasta and milk) contributed 30% total folate intakes. In this study, folic acid intakes exceeding the Tolerable Upper Intake Level (1000 mg DFE/d) from food only was observed in 1.6% of the population (n=13).

Conclusion

The probability of folate intake being inadequate for the urban Costa Rican population is higher among women in the youngest and oldest age groups. This data should be taken into account to evaluate future policy decisions regarding food fortification and public health programs to educate in better food choices to increase folate intake mainly among women of childbearing‐age.

Support or Funding Information

The Coca‐Cola Company
Consumers Of Frozen Fruits And Vegetables Eat More Fruits And Vegetables Overall
Authors: Storey Maureen , Anderson Patricia
Published: November 2023

Emphasis on fresh fruits and vegetables (FV) as the preferred form of FV may convey that other forms, such as frozen FV, are less desirable or nutritious. Yet, research shows that frozen and fresh FV have few differences in nutrient content. This analysis used appropriate survey weights to estimate energy intake, BMI and consumption of total and frozen FV across age, gender and income groups using day one dietary data from NHANES 2011–12. On average, all consumers 2–99 y of frozen vegetables (V) and frozen fruit (F) consumed 0.4 and 0.5 cup equivalents per day (CE/d), respectively, and they consumed more total V and F than did non‐consumers (1.6 vs. 1.4 CE/d V and 1.4 vs. 0.9 CE/d of F, respectively). Individuals with low‐income (poverty‐to‐income ratio [PIR] <131%) consumed less frozen FV than those with higher income >131% PIR. On average, energy intake tended to be higher among consumers 2–18 y of frozen FV than non‐consumers (1983 kcal/d vs. 1927 kcal/d, respectively), but the difference was not statistically significant. Using BMI‐for‐age categories, about 29% of frozen FV consumers 2–18 y were overweight, whereas 33% of non‐consumers were overweight, but the difference was not significant. Among adults 19–99 y, mean energy intake was similar among consumers and non‐consumers of frozen FV (2199 and 2203 kcal/d, respectively); average BMI of frozen FV consumers and non‐consumers were not significantly different (28.2 and 28.7 kg/m2, respectively). These results suggest that when frozen FV are not consumed, other forms, such as fresh, canned or dried, do not fill the FV gap. Government food programs and health professionals should encourage frozen FV as a way to increase FV consumption.

Support or Funding Information

Supported by the Frozen Food Foundation
Evaluating the global epidemic of non‐communicable disease through a nutritional perspective by income levels
Authors: Kang Sooyoung , Lim Hyunjung
Published: November 2023

Background

Non‐communicable diseases (NCDs) were defined as one of the major challenges for sustainable development. NCDs are the leading causes of death worldwide especially among lower and middle income countries. Although NCDs and diet/nutrition are closely connected, the diet‐related health burdens due to NCDs by country income levels is still unclear.

Aim

We investigated the relationship between dietary factors and NCDs by income levels.

Method

The most recent data which indicate the prevalence of NCDs, nutrition and socioeconomic factors of countries are obtained from World Health Organization, Food and Agriculture Organization and World bank, respectively. Data were weighted by total population size. 151 countries included for analysis. The trends between factors were assessed by variance‐weighted least squares linear regression analysis. To visualize spatial relationships, ArcGIS was used (ArcGIS 10.4.1, Esri, Berkeley, CA, USA).

Result

The deaths caused by NCDs were 367, 567, 675 and 586 per 100,000 population in high, upper‐middle, lower‐middle and low income countries, respectively. There is an inverse association between country income level and the deaths caused by NCDs (P‐trend<0.001). Proportions of calories driven from carbohydrates were 51.0 % to 73.2% by income levels. When countries had lower income, the proportions of carbohydrate intakes were likely to increase after adjusting for covariates (P‐trend<0.001). Daily intake of sugar and sweetener from high income countries was 415.4 kcal/capita/day. In low income countries, it decreased to 98.7 kcal/capita/day. Sugar and sweetener intakes might be related to income level of countries (P‐trend<0.001). Cereals intakes of high income countries was 934.5 kcal/capita/day. The highest cereal intake was 1,406.5 kcal/capita/day from lower‐middle income countries. Higher income countries tended to intake less cereals (P‐trend<0.001).

Conclusions

Pattern and prevalence of NCDs through a nutritional perspective may be different according to income levels of countries. More strong research are needed to identify major nutrition‐related factors that lead to increased prevalence of NCDs (e.g., coronary heart disease) in different income level countries.
Dietary Behaviors Characteristic for the Patients with Type 2 Diabetes Mellitus
Authors: Nakao Motoyuki , Ishihara Yoko
Published: November 2023

Background

The prevalence of type 2 diabetes mellitus and borderline diabetes is increasing. The social and economic burden and the shortening of healthy life expectancy due to diabetes mellitus and its complications were concerned worldwide. Dietary instruction to the patients for the prevention of exacerbation emphasized the restriction of calorie intake hitherto. Aside from calorie intake, various dietary behavior and lifestyles are involved in the development of diabetes mellitus and its complications. Therefore, in this study, we investigated that the dietary pattern and other factors of the general population to identify the factors contributing Type 2 diabetes mellitus.

Methods

Subjects were recruited at the healthcare center in Kyushu, Japan. 1,058 subjects were involved in this study. The male‐to‐female ratio was 7:3. Administration of the self‐completed questionnaire including the question regarding dietary behavior and medical examination were performed in Japanese subjects aged 40–79 years. The dependent variable of logistic regression was physician‐diagnosed Type 2 diabetes mellitus, and the odds ratios (ORs) were adjusted by age, gender, body mass index, smoking status, physician‐diagnosed hypertension and eight scales of dietary behavior.

Results

Among the participants, approximately 10% of subjects were diagnosed as type 2 diabetes mellitus and 35% was physician‐diagnosed hypertension. More than 5% of the subjects were suffered by both diseases. Logistic regression analysis revealed that older age, male, higher body mass index, physician‐diagnosed hypertension, frequent eating‐out, and lack of consideration of calorie intake at eating‐out showed significantly high ORs. These ORs maintained significance after adjustment. Additionally, OR of current smoking status became significant by adjustment. These results suggest that the subjects with diabetes mellitus tend to preserve unhealthy lifestyle than those without diabetes. In contrast, increased snack intake and sweetened beverage intake showed significantly lower ORs, and the OR of snack intake lost significance after adjustment. This result suggests that the patients with diabetes mellitus abstained snack and sweetened beverage intake probably due to the physician's instruction. There was no significance in the scores representing salt intake including frequent intake of salted food, seasoning usage, and soup intake (e.g., soup with noodles).

Conclusions

The results illustrate that obese, hypertensive, and older male who is a current smoker is suggested to be a typical patient with type 2 diabetes mellitus in Japan. Although the patients with diabetes mellitus abstained sugar intake, the results showed that they dine out more frequent than those without diabetes mellitus, and do not consider calorie intake at the restaurant. Therefore, the instruction and intervention relating to eating out behavior was required for the patients with diabetes mellitus in Japan.
The Association Between Eating Frequency and Risk of Type 2 Diabetes: The Women's Health Initiative Dietary Modification Trial
Authors: Clowry Catherine M , Beatty Sarah J , Thomson Cynthia A , Wertheim Betsy C , Neuhouser Marian L
Published: November 2023

Objective

The relationship between eating frequency (EF) and health is uncertain. We investigated the association between EF and incident diabetes in postmenopausal women participating in the Women's Health Initiative Dietary Modification Trial (WHI‐DM). The WHI‐DM was a low‐fat dietary intervention trial; 24‐hour dietary recalls were administered in year 3 of the trial as part of trial adherence activities. For this analysis, the recall data were used to examine the relationship between number of daily eating occasions and risk for diabetes. Outcomes data were collected by annual self‐report.

Methods

This prospective cohort study included 2,159 post‐menopausal women aged 50 to 79 y, of diverse socioeconomic and ethnic backgrounds and represented a subset of WHI‐DM participants. Participants were categorized into groups according to their reported meal frequency: 1–3 meals per day, 4 meals per day, and ≥5 meals per day. Cox proportional hazard regression was used to investigate the relationship of eating frequency with risk of Type 2 diabetes. All models were adjusted for socio‐economic status, race/ethnicity, BMI, waist circumference, energy intake from the recall, time between study enrollment and recall administration and clinical trial arm assignment. Further analyses were stratified by baseline BMI, race/ethnicity, and age.

Results

Most women reported intake of 1–3 meals or 4 meals (n=795 and 713, respectively); only 86 women reported EF >5 servings/day. Eating frequency was inversely associated with age and positively associated with income, BMI and energy intake. Multivariate models indicated that eating 4 meals per day was associated with an increased risk for incident diabetes (HR = 1.36, 95% CI: 1.04–1.79) as compared to eating 1–3 meals per day. No significant association was observed between the highest (5+ meals/day) and lowest (1–3 meals/day) groups. The increased risk observed for the group eating 4 meals per day did not differ across BMI groups or by race/ethnicity; however associations were stronger in those > 60 y.

Conclusion

This study showed that women eating 4 versus 1–3 meals per day experienced a greater risk for diabetes. Potential underlying mechanisms include increased number of glucose and insulin excursions with more frequent meal consumption. Since diabetes is one of the most common and serious chronic diseases facing postmenopausal women, identification of strategies for prevention is an important public health goal. Additional large‐scale studies are warranted to confirm these associations.

Support or Funding Information

The WHI Dietary Modification Trial was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
Association between circulating magnesium levels and risk of coronary heart diseases, hypertension, and type 2 diabetes mellitus: a meta‐analysis of prospective cohort studies
Authors: Xun Pengcheng , Wu Jiang , Tang Qingya , Cai Wei , He Ka
Published: November 2023

Objective

To examine circulating magnesium (Mg) levels in relation to incidence of coronary heart diseases (CHD), hypertension, and type 2 diabetes (T2DM).

Design

Meta‐analysis of prospective cohort studies.

Data sources

Studies published before September 2016 were searched through PubMed, EmBase, and Google Scholar.

Eligibility criteria

Prospective cohort studies that reported relative risk (RR), hazard ratio, or odds ratio and a 95% confidence interval (CI) between baseline serum or plasma Mg levels and incidences of the outcomes of interest.

Results

Ten studies were identified. Of them, 5 reported results on CHD (38,808 individuals [4,437 cases] with a 10.5‐year follow‐up), 3 on hypertension (14,876 participants [3,149 cases] with an average 6.7‐year follow‐up), and 3 on T2DM (22,729 participants [1,874 cases] with a 9.7‐year follow‐up). Comparing the highest to the lowest category of circulating Mg concentrations, the pooled RRs (95% CIs) were 0.86 (0.74, 0.996), 0.91 (0.80, 1.02), and 0.66 (0.49, 0.90) for incidence of CHD, hypertension, and T2DM, respectively. Every 0.1 mmol/L increment in circulating Mg levels was associated with 4% [RR: 0.96 (0.94, 0.99)] reduction in hypertension incidence. No significant linear association was found between circulating Mg levels and incidence of CHD [0.89 (0.77, 1.03)] and T2DM [0.92 (0.81, 1.04)].

Conclusions

Findings from this meta‐analysis suggest that circulating Mg levels are inversely associated with incidence of CHD, hypertension, and T2DM. Further studies are warranted to establish a causal‐relationship and to identify the optimal range of circulating Mg concentration with respect to the primary prevention of CHD, hypertension, and T2DM.

Support or Funding Information

This study was supported by one grant from Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition (14DZ2272400, to W.C.) and one grant from the National Institute of Health (R01ES021735, to K.H.).
Associations of Whole and Refined Grain Intakes with Adiposity‐Related Cancer Risk in the Framingham Offspring Cohort (1991–2013)
Authors: Makarem Nour , Bandera Elisa V. , Lin Yong , McKeown Nicola , Parekh Niyati
Published: November 2023

Objective

The objective of this prospective cohort study is to evaluate associations between whole and refined grains and their food sources in relation to risk of adiposity‐related cancers combined and three of the most commonly diagnosed site‐specific cancers in the US: breast, prostate, and colorectal cancers.

Methods

Participants were adults from the Framingham Offspring cohort (N=3,184). Dietary intakes were measured using a food frequency questionnaire at clinical exam 5 (1991–1995). Medical and lifestyle data was also available at this exam. Between 1991 and 2013, 565 adiposity‐related cancers (124 breast, 157 prostate, and 68 colorectal) were ascertained using medical and pathology reports. Cox‐ proportional hazards models were used to estimate age‐ and multivariable‐adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the associations between whole grains, refined grains and their major food sources in relation to cancer.

Results

There were no significant associations between whole and refined grain intakes and incidence of adiposity‐related cancers combined (HR:0.94; 95%CI:0.71–1.23 and 0.98; 95%CI:0.70–1.38, respectively). When assessed separately for cancer sites, null results were also observed for prostate and colorectal cancers. However, higher whole grain intakes were associated with a 39% reduction in risk for breast cancer in multivariable‐adjusted models (HR: 0.61;95%CI:0.38–0.98). When consumption of whole and refined grain food sources was examined, higher consumption of whole grain food sources, collectively, was associated with 47% lower breast cancer risk (HR:0.53;95%CI:0.33–0.86). Among individual whole grain foods, consumption of popcorn was associated with 25% higher risk of adiposity‐related cancers (HR:1.25;95%CI: 1.01–1.26)(p‐trend=0.033). No associations were observed for the other examined cancers.

Conclusions

Higher consumption of whole grains may protect against breast cancer, but associations are less clear for other cancer sites. Further research is warranted for cancers at specific anatomical sites and in other ethnic groups for which associations between nutritional factors and cancer risk may vary.

Support or Funding Information

This research was supported by the American Cancer Society Research Scholar Grant (#RSG‐12‐005‐01‐CNE)
The Impact of Diabetes on Typical Manifestation of Tuberculosis and the Nutritional Status
Authors: Wang Qiuzhen , Ma Aiguo , Zhao Shanliang , Cai Jing , Zhang Yu , Han Xiaohong , Kou Tingyan , Du Baoli , Song Jiaqi
Published: November 2023

It has been reported that pulmonary tuberculosis (TB) in diabetic patients (DM) presents an atypical radiographic pattern, together with an aggravated clinical manifestation. However, the results vary substantially between studies. We investigated the lung damage of the TB patients with and without DM detected by computer tompgraphic (CT) in a chest hospital from January, 2014 to June, 2015. Totally, 278 TB patients with DM (TB‐DM) and 348 TB patients without DM were recruited. The results showed that TB‐DM had a significantly higher prevalence of lung cavity and infiltrate than TB (59.0% vs 43.0%, p<0.001; 80.1% vs 69.4%, p<0.01, respectively) and more lower‐lobe lesion was observed in TB‐DM (p<0.05). TB‐DM patients had a higher incidence of haemoptysis, sputum positive, especially >10 bacilli per oil immersion field (all p<0.05). There existed sever kind of malnutrition in TB‐DM patients. Nearly 70% patients had lymphocyte reduction, nearly 30% hadanemia and hypertriglyceridemia. Also, there exsited hypoalbuminemia and hypercholesterolemia in the subjects. In conclusion, TB‐DM patients showed more severe lung damage and more frequent lower‐lobe lesion, which indicates that it is of great importance to distinguish the disease from community‐acquired pneumonia since most of the later reports are based on the results of radiographs of lower‐lobe manifestation. And malnutrition may be associated with the prevalence of TB‐DM.

Support or Funding Information

Supported by NSFC‐81472983
Resveratrol inhibits ovarian cancer cell growth through epigenetic regulation of Wnt antogonist SFRP5
Authors: Liu Chin‐yu , Yen Hsing‐yu , Tsao Chih‐Wei , Su Her‐Young , Lin Ya‐Wen
Published: November 2023

Ovarian cancer (OC) is the most lethal gynecologic malignancy. OC is the top ten of cancer in females in Taiwan and all over the world. Cancer metastasis follows with epithelial mesenchymal transition (EMT). The Wnt/β‐catenin signaling pathway is associated with EMT. The secreted frizzled‐related proteins (SFRPs) act as antagonists of the Wnt ligands and inhibit the Wnt/β‐catenin signaling pathway. In the past research indicated the resveratrol has the capacity for anti‐ inflammatory, anti‐ oxidant and anti‐cancer effects as well as involve in the DNA methylation regulation. It is helpful for inhibiting the tumor suppressor gene methylated and re‐expression. Therefore, the aim of this study is to investigate the effects of resveratrol on DNA methylation modification in ovarian cancer cell (SKOV3). Cell was treated with DMSO, 10 μM 5‐aza‐2′‐deoxycytidine (DAC), 5 μM DAC, 45 μM resveratrol, and resveratrol combined with 5 μM DAC in 96 hours, extracting the DNA and protein for further analyze, respectively. The data show that resveratrol may inhibit total DNMT activity, DNMT3a protein expression, regulate tumor suppressor gene SFRP5 expression by combined with 5 μM DAC and regulate Wnt/β‐catenin signaling pathway, as a result, it can attenuate or inhibit the ovarian cancer development.

Support or Funding Information

MOST 105‐2314‐B‐030‐003, Ministry of Science and Technology, Taiwan
Epigallocatechin‐3‐gallate sensitizes multidrug‐resistant oral squamous carcinoma cells to vincristine sulfate involving angiogenesis inhibition via down‐regulating VEGF in vivo
Authors: Hu Ye , Chen Li , Zhang Guo , Li Li , Liang Gang
Published: November 2023

Multidrug resistance (MDR) is a formidable obstacle to effective chemotherapy of oral squamous cell carcinoma (OSCC). Recently, emerging evidences have demonstrated that (−)‐Epigallocatechin gallate (EGCG), a major constituent of green tea, may be a promising candidate in the quest for overcoming MDR in human cancer cells, yet, its detailed mechanisms remain unclear. Herein, this study aimed to investigate the effects of EGCG on multidrug‐resistant human OSCC and the underlying mechanisms. Firstly, KBV200 cells‐inoculated nude mice xenograft, a presentative MDR OSCC model, was established and then treated with different compounds. Compared to vincristine sulfate (VCR) treated group, EGCG and VCR combined treatment caused a dramatically tumor growth inhibition in a dose‐dependent manner, while EGCG alone could not inhibit growth of KBV200 xenograft. Consistently, by counting the micro‐vessel density (MVD) via immunohistochemistry, EGCG together with VCR exhibited a stronger inhibitory effect on the tumor angiogenesis. Furthermore, the synergistic anti‐angiogenesis role by EGCG and VCR was found to be related to the expression of vascular endothelial growth factor (VEGF) in these models. The VEGF mRNA and protein levels were much lower in KBV200 xenograft treated with combined regime than VCR alone. Taken together, the current study indicated that EGCG sensitizes therapeutic efficacy of VCR on multidrug‐resistant OSCC probably in part by inhibiting angiogenesis via down‐regulation of VEGF.

Support or Funding Information

Supported by NSFC Grants 881172260, 30630145, 81360077 and GXNSFC Grants 2015GXNSFDA139022 to Guo Zhang
Dry Bean Consumption Inhibits Colorectal Tumorigenesis in Preclinical Studies: A Meta‐Analysis of Animal Studies
Authors: Perera Thushanthi , Takata Yumie , Bobe Gerd
Published: November 2023

Background

Chemo‐protective effect of dry beans against colorectal tumorigenesis in humans has been proposed, but the number of studies examining this effect is limited. To evaluate whether further human studies are warranted, we conducted a meta‐analysis of preclinical studies in animals examining the relation between dry bean consumption and colorectal tumorigenesis.

Methods

Ten preclinical studies were included in the meta‐analysis to evaluate the effect of consumption of whole dry beans and dry bean fractions (fiber fractions, ethanol extract, and ethanol extract residue) at varying concentrations of the diet (10–75% of dry beans of the overall diet) on colorectal tumorigenesis. Tumor endpoints were incidence and multiplicity of adenocarcinoma, adenoma + adenocarcinoma, tumor, or aberrant crypt foci (ACF; only multiplicity). Risk estimates for tumors, comparing cancer‐induced rats (n=277) and mice (n=53) consuming dry beans versus cancer‐induced rats (n=173) and mice (n=52) consuming a control diet, all of which were male, were calculated using pooled risk ratios (RR) and 95% confidence intervals (CI) through a random‐effects model in STATA. For calculating risk estimates of tumor and ACF multiplicity, we calculated standardized mean differences and variation from reported means and standard errors.

Results

Cancer‐induced male rats or mice consuming dry beans had a lower colorectal tumor risk than those consuming control diet: colorectal adenocarcinoma incidence (RR=0.38; 95% CI: 0.20–0.74) and multiplicity (RR=0.52; 95% CI: 0.27–0.98), combined adenoma + adenocarcinoma incidence (RR=0.25; 95% CI: 0.16–0.40) and multiplicity (RR=0.52; 95% CI: 0.31–0.89), tumor incidence (RR=0.21; 95% CI: 0.11–0.43) and multiplicity (RR=0.24; 95% CI: 0.16–0.36), and ACF multiplicity (RR=0.11; 95% CI: 0.04–0.27).

Conclusions

Dry bean consumption inhibits colorectal tumorigenesis in male animal models of human CRC. However, long‐term dry bean CRC prevention intervention studies in humans are warranted to further elucidate the effects of daily dry bean consumption on different stages of colorectal tumorigenesis.
Effect of Watermelon Powder Supplementation on Azoxymethane‐Induced Colon Carcinogenesis in Rats
Authors: Glenn Keith , Klarich DawnKylee S , Figueroa Arturo , Hooshmand Shirin , Kern Mark , Hong Mee Young
Published: November 2023

Colorectal cancer (CRC) is a public health concern and one of the most common cancers in men and women globally. Given the substantial morbidity and mortality associated with this disease, methods for prevention, in part through a diet high in fruits and vegetables, are under investigation. Specifically, watermelon may be a practical method for reducing CRC risk factors due to its high concentration of L‐citrulline, a precursor to L‐arginine, which plays a crucial role in endothelial nitric oxide (NO) production. Evidence suggests that increased levels of NO have tumoricidal effects; therefore, the purpose of this study was to determine the effects of watermelon powder supplementation on aberrant crypt foci (ACF) formation, precancerous lesions, and biomarkers that are associated with colon carcinogenesis in rats. Thirty‐two male Sprague‐Dawley rats, at 21 days old, were divided into three groups: control, 0.36% L‐arginine, or 0.5% watermelon powder. The 0.5% watermelon powder diet provided 0.36% of L‐arginine+L‐citrulline. Rats were injected subcutaneously with azoxymethane (dose of 15 mg/kg body weight), a carcinogenic agent, at the beginning of weeks 3 and 4. The watermelon group exhibited higher blood NO levels compared to the control group (P < 0.05). Both the L‐arginine and watermelon powder groups exhibited lower total numbers of ACF and high multiplicity aberrant crypt foci (HMACF, > 4 aberrant crypts/focus) (P < 0.01). The watermelon powder group exhibited lower 8‐hydroxyguanosine DNA damage in the blood (P < 0.05) compared to controls. Watermelon powder and L‐arginine downregulated 8‐oxoguanine DNA glycosylase (OGG1) gene expression (P < 0.05) and upregulated O6‐methylguanine DNA methyltransferase (MGMT) gene expression (P < 0.01). Cyclooxgenase‐2 (COX‐2) gene expression in the colon mucosa of the watermelon group was lower compared to the control group (P < 0.05). These results suggest that watermelon powder or L‐arginine consumption may reduce the risk of colon cancer by suppressing ACF formation through lowering oxidative DNA damage and inflammation, modulating DNA repair enzyme expression, and enhancing NO production.

Support or Funding Information

The study was funded by The US National Watermelon Promotion Board.
Calcium to Magnesium Intake Ratio and Prostate Cancer Aggressiveness
Authors: Omofuma Omonefe , Arab Lenore , Su L. Joseph , Bensen Jeannette T. , Fontham Elizabeth T.H. , Mohler James L. , Steck Susan E.
Published: November 2023

Objective

Experimental studies suggest that calcium and magnesium compete for membrane binding sites. An imbalance in the level of these micronutrients has been associated with multiple chronic diseases, though few studies to date have examined the relationship with prostate cancer. The goal of this study was to examine the dietary intake ratio of calcium to magnesium and its association with prostate cancer aggressiveness in African Americans (AAs) and European Americans (EAs).

Method

Calcium and magnesium intakes were estimated using a food frequency questionnaire in 996 AA and 1064 EA men with a recent histologically confirmed diagnosis of prostate cancer from the North Carolina – Louisiana Prostate Cancer Project (PCaP). High aggressive disease was defined as Gleason sum ≥8, or PSA> 20ng/ml, or Gleason score ≥7 AND clinical stage T3–T4, and the comparison group was all other prostate cancer cases. Logistic regression was used to determine the adjusted odds ratio (OR) and 95% confidence intervals (95% CI) for high aggressive prostate cancer by quartile of calcium to magnesium intake ratio.

Results

There was a positive association for prostate cancer aggressiveness across the quartiles of calcium to magnesium intake ratio, with odds of high aggressive prostate cancer in the upper quartiles; ORQ2VS.Q1:1.46. 95% CI: 1.02 – 2.07, ORQ3VS.Q1:1.42. 95% CI: 1.00 – 2.03 and ORQ4VS.Q1: 1.69, 95% CI: 1.19 – 2.40. When stratified by race, the association was observed in both AA men, ORQ4VS.Q1: 1.72, 95% CI: 1.08–2.74 and EA men ORQ4VS.Q1: 1.89, 95% CI: 1.12 – 3.19.

Conclusion

Among both African American and European American men diagnosed with prostate cancer, a higher calcium to magnesium intake ratio as reported in the year prior to diagnosis was associated with higher odds of high aggressive prostate cancer.

Support or Funding Information

The North Carolina‐Louisiana Prostate Cancer Project