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Hypercholesterolemia is a major risk factor for cardiovascular disease. Fish intake is associated with lower risk of cardiovascular disease, whereas supplementation with n-3 long-chain polyunsaturated fatty acids (LC-PUFA) has little effect on the cholesterol concentration. We therefore investigated if cetoleic acid (CA), a long-chain monounsaturated fatty acid (LC-MUFA) found especially in pelagic fish species, could lower the circulating total cholesterol (TC) concentration in rodents. A systematic literature search was performed using the databases PubMed, Web of Science and Embase, structured around the population (rodents), intervention (CA-rich fish oils or concentrates), comparator (diets not containing CA) and the primary outcome (circulating TC). Articles were assessed for risk of bias using the SYRCLE’s tool. A meta-analysis was conducted in Review Manager v. 5.4.1 (the Cochrane Collaboration) to determine the effectiveness of consuming diets containing CA-rich fish oils or concentrates on the circulating TC concentration. Twelve articles were included in the systematic review and meta-analysis, with data from 288 rodents. Consumption of CA-rich fish oils and concentrates resulted in a significantly lower circulating TC concentration relative to comparator groups (mean difference -0.65 mmol/l, 95% confidence interval -0.93, -0.37, P < 0.00001), with high statistical heterogeneity (I2 = 87%). The risk of bias is unclear since few of the entries in the SYRCLE’s tool were addressed. To conclude, intake of CA-rich fish oils and concentrates prevents high cholesterol concentration in rodents, and should be further investigated as functional dietary ingredients or supplements to reduce the risk for developing cardiovascular disease in humans.
Diets deficient in fibre are reported globally. The associated health risks of insufficient dietary fibre are sufficiently grave to necessitate large-scale interventions to increase population intake levels. The Danish Whole Grain Partnership (DWP) is a public-private enterprise model that successfully augmented whole-grain intake in the Danish population. The potential transferability of the DWP model to Slovenia, Romania and Bosnia-Herzegovina has recently been explored. Here we outline the feasibility of adopting the approach in the UK. Drawing on the collaborative experience of DWP partners, academics from the Healthy Soil, Healthy Food, Healthy People (H3) project, and food industry representatives (Food and Drink Federation), this paper examines the transferability of the DWP approach to increase whole grain and/or fibre intake in the UK. Specific consideration is given to the UK’s political, regulatory and socio-economic context. We note key political, regulatory, social and cultural challenges to transferring the success of DWP to the UK, highlighting the particular challenge of increasing fibre consumption among low socio-economic status groups - which were also most resistant to interventions in Denmark. Wholesale transfer of the DWP model to the UK is considered unlikely given the absence of the key ‘success factors’ present in Denmark. However, the DWP provides a template against which a UK-centric approach can be developed. In the absence of a clear regulatory context for whole grain in the UK, fibre should be prioritised and public-private partnerships supported to increase the availability and acceptability of fibre-rich foods.
Dietary intake of long chain omega-3 polyunsaturated fatty acids (n-3 PUFA), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been associated with psychological well-being, but little is known about the n-3 PUFA intake of homeless youth. This study determined the association between depression and anxiety symptoms and n-3 PUFA intake and red blood cell (RBC) status in homeless youth. 114 homeless youth aged 18-24 years were recruited from a drop-in center. n-3 PUFA dietary intake was assessed using a Food Frequency Questionnaire (FFQ), and RBC status was determined by gas chromatography. Linear regression models were used to determine the relationship between psychological well-being and n-3 PUFA intake and status. The mean intakes of EPA and DHA for all participants (0.06 ± 0.13 g/day and 0.11± 0.24 g/d,) were well below recommended levels, and mean RBC EPA + DHA (omega-3 index) in the cohort (2.42%) was lower than reported for healthy, housed adolescents and those with clinical depression. There was no association of n-3 PUFA intake and RBC status with either depression or anxiety. However, the relationships of depression with dietary EPA (p = 0.017), and DHA (p=0.008) as well as RBC DHA (p = 0.007) and omega 3-index (p= 0.009), were significantly moderated by sex even after adjusting for confounders. Specifically, among females, as the intake and status of these n-3 PUFAs decreased, depression increased. Our findings show poor dietary intake and low RBC status of n-3 PUFA among homeless youth, which is associated with depressive symptoms among females.
This study aimed to investigate the cardiovascular effects of epicatechin, a flavonoid found in green tea and cocoa, in attenuating complications associated with metabolic syndrome in diet-induced obese rats.
Male Wistar-Kyoto (WKY) rats aged 16 weeks were fed either standard rat chow (SC) or given a high-fat-high-carbohydrate (HFHC) diet for 20 weeks. Epicatechin treatment (5mg/kg/day) was administered to a subset of WKY rats commencing at week 8 of the 20 week HFHC feeding period. Body weights, food, water and energy intakes, blood pressure, heart rate and glucose tolerance were measured throughout the treatment period. Oxidative stress and inflammatory markers, lipid levels, cardiac collagen deposition, cardiac electrical function, aortic and mesenteric vessel reactivity were examined after the treatment.
Twenty weeks of HFHC feeding in WKY rats resulted in the development of metabolic syndrome indicated by the presence of abdominal obesity, dyslipidaemia, glucose intolerance and increased blood pressure. Epicatechin treatment was found to enhance the oxidative stress status in HFHC groups through an increase in serum nitric oxide levels and a decrease in 8-isoprostane concentrations. Furthermore, WKY-HFHC rats displayed a decrease in interleukin-6 levels. The lipid profiles in HFHC groups showed improvement, with a decrease in LDL cholesterol and triglycerides, and an increase in HDL cholesterol levels observed in WKY-HFHC rats. However, epicatechin was not effective in preventing weight gain, glucose intolerance or hypertension in HFHC fed rats. Overall, the results of this study suggest that epicatechin has the potential to improve the underlying mechanisms associated with metabolic syndrome in obese rats.
This study investigated sex differences in iron status, and associations between iron status and endurance and musculoskeletal outcomes, in military training. 2,277 British Army trainees (581 women) participated. Iron markers and endurance performance (2.4 km run) were measured at the start (week 1) and end (week 13) of training. Whole-body areal body mineral density (aBMD) and markers of bone metabolism were measured at week 1. Injuries during training were recorded. Training decreased haemoglobin in men and women (mean change [95% CI], −0.1 [−0.2, −0.0] and −0.7 [−0.9, −0.6] g∙dL-1, both p < 0.001), but more so in women (p < 0.001). Ferritin decreased in men and women (−27 [−28, −23] and −5 [−8, −1] ug∙L, both p ≤ 0.001), but more so in men (p < 0.001). sTfR increased in men and women (2.9 [2.3, 3.6] and 3.8 [2.7, 4.9] nmol∙L, both p < 0.001), with no difference between sexes (p = 0.872). RDW increased in men (0.3 [0.2, 0.4]%, p < 0.001), but not women (0.1 [−0.1, 0.2]%, p = 0.956). MCV decreased in men (−1.5 [−1.8, −1.1] fL, p < 0.001), but not women (0.4 [−0.4, 1.3] fL, p = 0.087). Lower ferritin was associated with slower 2.4 km run time (p = 0.018), sustaining a lower limb overuse injury (p = 0.048), lower aBMD (p = 0.021), and higher βCTX and P1NP (both p < 0.001) controlling for sex. Improving iron stores before training may protect haemoglobin in women and improve endurance and protect against injury.
In chronic spinal cord injury (SCI), individuals experience dietary inadequacies complicated by an understudied research area. Our objectives were to assess (1) the agreement between methods of estimating energy requirement (EER) and estimated energy intake (EEI) and (2) whether dietary protein intake met SCI-specific protein guidelines. Persons with chronic SCI (n=43) completed 3-day food records to assess EEI and dietary protein intake. EER was determined with the Long and Institute of Medicine (IOM) methods and the SCI-specific Farkas method. Protein requirements were calculated as 0.8-1.0 g/kg of body weight (BW)/day. Reporting accuracy and bias were calculated and correlated to body composition. Compared to IOM and Long methods (P<0.05), the SCI-specific method did not overestimate the EEI (P=0.200). Reporting accuracy and bias were best for SCI-specific (98.9%, -1.12%) compared to Long (94.8%, -5.24%) and IOM (64.1%, -35.4%) methods. BW (r=-0.403), body mass index (r=-0.323), and total fat mass (r =-0.346) correlated with the IOM reporting bias (all, P<0.05). BW correlated with the SCI-specific and Long reporting bias (r=-0.313, P=0.041). Seven (16%) participants met BW-specific protein guidelines. The regression of protein intake on BW demonstrated no association between the variables (β=0.067, P=0.730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0.833 g (P=0.0001). The SCI-specific method for EER had the best agreement with the EEI. Protein intake decreased with increasing BW, contrary to protein requirements for chronic SCI.
We aimed to investigate the effectiveness of omega-3 fatty acids supplementation on the risk of developing depression, depressive symptoms and remission of depression. We searched PubMed, Scopus, and Web of Science from inception to December 2022 to find randomized trials of omega-3 fatty acids supplementation in adults. We conducted random-effects meta-analyses to estimate standardized mean differences (SMD) and 95% confidence intervals (CIs) for continuous outcomes and risk difference and 95%CI for binary outcomes. A total of 67 trials were included. Each 1 g/d omega-3 fatty acids supplementation significantly improved depressive symptoms in adults with and without depression (moderate-certainty evidence), with a larger improvement in patients with existing depression. Dose-response analyses indicated a U shaped effect in patients with existing depression, with the greatest improvement at 1.5 g/d. The analysis showed that omega-3 fatty acid supplementation significantly increased depression remission by 19 more per 100 in patients with depression (low-certainty evidence). Supplementation with omega-3 fatty acids did not reduce the risk of developing depression among the general population, but it did improve the severity of depression among patients with existing depression.
Sterol regulatory element-binding protein 2 (SREBP2) is considered to be a major regulator to control cholesterol homeostasis in mammals. However, the role of SREBP2 in teleost remains poorly understand. Here, we explored the molecular characterization of SREBP2 and identified SREBP2 as a key modulator for 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) and 7-dehydrocholesterol reductase (DHCR7) which were rate-limiting enzymes of cholesterol biosynthesis. Moreover, dietary palm oil (PO) in vivo or palmitic acid (PA) treatment in vitro elevated cholesterol content through triggering SREBP2-mediated cholesterol biosynthesis in large yellow croaker. Furthermore, our results also found that PA-induced activation of SREBP2 was dependent on the stimulating of endoplasmic reticulum stress (ERS) in croaker myocytes and inhibition of ERS by 4-Phenylbutyric acid alleviated PA-induced SREBP2 activation and cholesterol biosynthesis. In summary, our findings reveal a novel insight for understanding the role of SREBP2 in regulation of cholesterol metabolism in fish and may deepen the link between dietary fatty acid and cholesterol biosynthesis.
Systemic inflammation may contribute to the initiation and progression of type 2 diabetes mellitus (T2DM) through diet and lifestyle. We examined the association of dietary inflammation score (DIS), lifestyle inflammation score (LIS), and dietary and lifestyle inflammation score (DLIS) with T2DM and cardiometabolic risk factors among Iranian adults. In this study, we identified and recruited 619 patients with T2DM and 2113 without T2DM from 35–75 years old men and women in the baseline phase of the Sabzevar Persian Cohort Study. Using a validated 115-item semi-quantitative food frequency questionnaire, we calculated a 19-component DIS and a 3-component LIS weighted by circulating inflammation biomarkers. The DIS, LIS, and DLIS associations with diabetes were assessed by multivariable logistic regression analysis. Participants had a mean age of 48.29±8.53 (without T2DM: 47.66±8.42; T2DM: 50.44±8.57). Individuals in the highest compared to the lowest tertiles of DLIS (OR: 3.40; 95% CI: 2.65, 4.35; Ptrend<0.001), DIS (OR: 3.41; 95% CI: 2.66, 4.38; Ptrend<0.001), and LIS (OR: 1.15; 95% CI: 0.90, 1.46; Ptrend=0.521) had increased risk of T2DM. For those in the highest relative to the lowest joint DIS and LIS tertile, the results were OR: 3.37; 95% CI: 2.13, 5.32; Pinteraction<0.001. No significant associations were found between DLIS and cardiometabolic risk factors, including blood pressure, liver enzymes, and glycemic and lipid profiles, except for waist circumference (P<0.001) and waist-to-hip ratio (P=0.010). A higher DIS and DLIS score was associated with a higher risk of T2DM, while the LIS score was not associated with T2DM risk.
Among food groups with putative benefits for brain structures, dairy products (DPs) have been poorly studied. The sample included participants without dementia from the ancillary brain imaging study of the Three-City cohort who were aged 65+ years, had their DPs intake assessed with a Food Frequency Questionnaire at baseline and underwent an anatomical scan 3 years (n=343) or 9 years (n=195) after completing the dietary survey. The frequencies of consumption of total DPs, milk and cheese were not associated with brain structure. Compared to the lowest frequency, the highest frequency of fresh DPs consumption (<0.5 vs. >1.5 times/day) was significantly associated with a lower Medial Temporal Lobe Volume (MTLV) (β = -1.09 cm3, 95% confidence interval -1.83; -0.36) 9 years later. In this population-based study of older adults, the consumption of fresh DPs more than 1.5 times/day was associated with a lower MTLV, which is considered an early biomarker of Alzheimer’s disease, 9 years later. This original study should be replicated in different settings before conclusions are drawn.
Feeding whole prey to felids has shown to benefit their gastrointestinal health. Whether this effect is caused by the chemical or physical nature of whole prey is unknown. Fifteen domestic cats, as a model for strict carnivores, were either fed minced mice (MM) or whole mice (WM), to determine the effect of food structure on digestibility, mean urinary excretion time of 15N, intestinal microbial activity and fermentation products. Faeces samples were collected after feeding all cats a commercially available extruded diet (EXT) for 10 days before feeding for 19 days the MM and WM diets with faeces and urine collected from d11-15. Samples for microbiota composition and determination of mean urinary excretion time were obtained from d16-19. The physical structure of the mice diet (minced or not) did not affect large intestinal fermentation as total SCFA and BCFA, and most biogenic amine (BA) concentrations were not different (P>0.10). When changing from EXT to the mice diets, the microbial community composition shifted from a carbolytic (Prevotellaceae) to proteolytic (Fusobacteriaceae) profile and led to a reduced faecal acetic to propionic acid ratio, SCFA, total BCFA (P<0.001), NH3 (P=0.04), total BA (P<0.001) and para-cresol (P=0.08). The results of this study indicate that food structure within a whole-prey diet is less important than the overall diet type, with major shifts in microbiome and decrease in potentially harmful fermentation products when diet changes from extruded to mice. This urges for careful consideration of the consequences of prey-based diets for gut health in cats.
Although the cardiovascular benefits of an increased urinary potassium excretion have been suggested, little is known about the potential cardiac association of urinary potassium excretion in patients with chronic kidney disease (CKD). In addition, whether the cardiac association of urinary potassium excretion was mediated by serum potassium levels has not been studied yet. We reviewed the data of 1,633 patients from a large-scale multicenter prospective Korean study (2011–2016). Spot urinary potassium to creatinine ratio was used as a surrogate for urinary potassium excretion. Cardiac injury was defined as a highly sensitive troponin T (hs-TnT) ≥ 14 ng/L. Odds ratios (ORs) and 95% confidence intervals (CIs) for cardiac injury were calculated using logistic regression analyses. Of 1,633 patients, the mean spot urinary potassium to creatinine ratio was 49.5 ± 22.6 mmol/g Cr and the overall prevalence of cardiac injury was 33.9%. Although serum potassium levels were not associated with cardiac injury, per 10 mmol/g Cr increase in the spot urinary potassium to creatinine ratio was associated with decreased odds of cardiac injury: OR (95% CI) of 0.917 95% CI (0.841-0.998, P= 0.047) in multivariate logistic regression analysis. In mediation analysis, approximately 6.4% of the relationship between spot urinary potassium to creatinine ratio and cardiac injury was mediated by serum potassium levels, which was not statistically significant (P = 0.368). Higher urinary potassium excretion was associated with lower odds of cardiac injury, which was not mediated by serum potassium levels.
Nordic Nutrition Recommendations recommend reducing red and processed meat and increasing fish consumption, but the impact of this replacement on mortality is understudied. This study investigated the replacement of red and processed meat with fish in relation to mortality. Of 83 304 women in the NOWAC Study, 9 420 died during a median of 21.0 years of follow-up. The hazard ratios (HRs) for mortality were estimated using Cox Proportional Hazards regression with analyses stratified on red and processed meat intake due to non-linearity. Higher processed meat (>30 grams/day), red and processed meat (>50 grams/day), and fatty fish consumption were associated with higher mortality, while red meat and lean fish consumption were neutral or beneficial. Among women with higher processed meat intake (>30 grams/day), replacing 20 grams/day with lean fish, was associated with lower all-cause (HR 0.92, 95% CI 0.89-0.96), cancer (HR 0.92, 95% CI 0.88-0.97) and CVD mortality (HR HR 0.82, 95% CI 0.74-0.90), while replacing with fatty fish was associated with lower CVD mortality (HR 0.87, 95% CI 0.77-0.97), but not with all-cause or cancer mortality. Replacing processed meat with fish among women with lower processed meat intake (≤30 grams/day) or replacing red meat with fish was not associated with mortality. Replacing processed meat with lean or fatty fish may lower the risk of premature deaths in Norwegian women, but only in women with high intake of processed meat. These findings suggest that interventions to reduce processed meat intake should target high consumers.
Retinol binding protein (RBP) is used as a proxy for retinol in population-based assessments of vitamin A deficiency (VAD) for cost-effectiveness and feasibility. When the cutoff of <0.7 mol/L for retinol is applied to RBP to define VAD, an equivalence of the two biomarkers is assumed. Evidence suggests that the relationship between retinol and RBP is not 1:1, particularly in populations with a high burden of infection or inflammation. The goal of this analysis was to longitudinally evaluate the retinol:RBP ratio over one month of follow-up among 52 individuals exposed to norovirus (n26 infected, n26 uninfected); test whether inflammation [measured as alpha-1-acid glycoprotein (AGP) and C-reactive protein (CRP)] affects retinol, RBP, and the ratio between the two; and assess whether adjusting vitamin A biomarkers for AGP or CRP improves the equivalence of retinol and RBP. We found that the median molar ratio between retinol and RBP was the same among infected (0.68) and uninfected (0.68) individuals. AGP was associated with the ratio and RBP individually, controlling for CRP, and CRP was associated with both retinol and RBP individually, controlling for AGP over one month of follow-up. Adjusting for inflammation led to a slight increase in the ratio among infected individuals (0.71) but remained significantly different from the expected value of one. These findings highlight the need for updated recommendations from the World Health Organization on a cutoff value for RBP and an appropriate method for measuring and adjusting for inflammation when using RBP in population assessments of VAD.
Prior meta-analytic investigations over a decade ago rather inconclusively indicated that conjugated linoleic acid (CLA) supplementation could improve anthropometric and body composition indices in the general adult population. More recent investigations have emerged, and an up-to-date systematic review and meta-analysis on this topic must be improved. Therefore, this investigation provides a comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) on the impact of CLA supplementation on anthropometric and body composition (body mass [BM], boy mass index [BMI], waist circumference [WC], fat mass [FM], body fat percentage [BFP], and fat-free mass [FFM]) markers in adults. Online databases search, including PubMed, Scopus, the Cochrane Library, and Web of Science up to March 2022, were utilized to retrieve RCTs examining the effect of CLA supplementation on anthropometric and body composition markers in adults. Meta-analysis was carried out using a random-effects model. The I2 index was used as an index of statistical heterogeneity of RCTs. Among the initial 8351 studies identified from electronic databases search, 70 RCTs with 96 effect sizes involving 4159 participants were included for data analyses. The results of random-effects modeling demonstrated that CLA supplementation significantly reduced BM (WMD: -0.35, 95% CI: -0.54, -0.15, p<0.001), BMI (WMD: -0.15, 95% CI: -0.24, -0.06, p=0.001), WC (WMD: -0.62, 95% CI: -1.04, -0.20, p=0.004), FM (WMD: -0.44, 95% CI: -0.66, -0.23, p<0.001), BFP (WMD: -0.77 %, 95% CI: -1.09, -0.45, p<0.001), and increased FFM (WMD: 0.27, 95% CI: 0.09, 0.45, p=0.003). The high-quality subgroup showed that CLA supplementation fails to change FM and BFP. However, according to high-quality studies, CLA intake resulted in small but significant increases in FFM and decreases in BM and BMI. This meta-analysis study suggests that CLA supplementation may result in a small but significant improvement in anthropometric and body composition markers in an adult population. However, data from high-quality studies failed to show CLA’s body fat-lowering properties. Moreover, it should be noted that the weight loss properties of CLA were small and may not reach clinical importance.
Dogs are considered omnivores based on their evolution, consuming diets that include animal tissue. Few feeding trials evaluating the nutritional suitability of exclusively plant-based (vegan) diets in dogs have been published, and the efficacy of vitamin D2 in maintaining canine serum vitamin D levels has not been clearly determined. A blinded dietary trial included 61 healthy desexed adult dogs: 31 fed an experimental extruded vegan diet (PLANT) and 30 fed a commercial extruded meat-based diet (MEAT) for three months. Dogs were screened via veterinary examination and routine laboratory analyses prior to enrolment in the study, at baseline and exit timepoints. Body composition was measured by dual-energy x-ray absorptiometry and blood was collected for vitamin D profiling. All dogs maintained health parameters, body weight and composition throughout the study. Dogs maintained on PLANT demonstrated a significant reduction in platelet count, creatinine, blood urea nitrogen and cholesterol, though values remained within normal reference ranges. Dogs fed PLANT also demonstrated a shift from vitamin D3 to vitamin D2 metabolites, though total vitamin D analogue levels were unchanged, with the exception of 24,25-dihydroxyvitamin D. Bone mineral content and density did not differ from baseline values. Health status was maintained in dogs fed PLANT and vitamin D2 appeared efficacious in maintaining serum total vitamin D concentrations and bone mineralization. Findings support the hypothesis that PLANT was comparable to MEAT for maintenance of healthy adult dogs for at least three months and identified areas where further research is warranted to elucidate the potential risks and benefits of exclusively plant-based vegan diets.
The association between consumption of dairy products and risk of cardiovascular diseases (CVD) has been inconsistent. There is a lack of studies in populations with high intakes of dairy products. We aimed to examine the association between intake of dairy products and risk of incident major adverse coronary events and stroke in the Swedish Malmö Diet and Cancer cohort study. We included 26,190 participants without prevalent CVD or diabetes. Dietary habits were obtained from a modified diet history and endpoint data were extracted from registers. Over an average of 19 years of follow-up, 3,633 major adverse coronary events cases and 2,643 stroke cases were reported. After adjusting for potential confounders, very high intakes of non-fermented milk (>1000 g/day) compared with low intakes (<200 g/day) were associated with 35% (95% CI 8–69%) higher risk of major adverse coronary events. In contrast, moderate intakes of fermented milk (100-300 g/day) were associated with a lower risk of major adverse coronary events compared with no consumption. Intakes of cheese (only in women) and butter were inversely associated with the risk of major adverse coronary events. We observed no clear associations between any of the dairy products and stroke risk. However, high intake of non-fermented milk was associated with decreased risk of ischemic stroke (P trend=0.05), but increased risk of other stroke types (P trend=0.04). These results highlight the importance of studying different dairy foods separately. Further studies in populations with high dairy consumption are warranted.
Despite observed ethnic differences in eating patterns and obesity, evidence in China is limited. This study examined ethnic differences in eating patterns and their associations with weight outcomes among multi-ethnic adults in West China. A cross-sectional survey collected self-reported data on demographics, eating behaviors, weight and height in 2021. Principal component analysis and multivariate regression was conducted to identify eating patterns and examine their associations with weight outcomes. 4407 subjects aged ≥18 years were recruited across seven provinces in West China. Four eating patterns were identified: “meat-lover” - characterized by frequent consumption of meat and dairy products, “indulgent” - by frequent intakes of added salt, sugar, alcohol, and pickled food, “diversified-eating” - by frequently consuming food with diversified cooking methods and eating out, and “nutri-health-concerned” - by good food hygiene behaviors and reading food labels. Ethnic differences in eating patterns were observed. Compared with Han, Hui were less likely to exhibit meat-lover or diversified-eating patterns; Tibetans were less likely to have meat-lover or nutri-health-concerned patterns; Mongolians were more likely to have indulgent pattern. BMI was positively associated with meat-lover pattern in both genders (exp(β): 1.029; 95% CI: 1.001-1.058 for men; 1.018; 1.000-1.036 for women) and negatively associated with nutri-health-concerned pattern in women (0.983; 0.966-1.000). Mongolians were two times more likely to be overweight/obese than Han (OR: 3.126; 1.688-5.790). Considerable ethnic differences existed in eating patterns in West China. Mongolians were more likely to be overweight/obese, which was associated with their indulgent eating patterns. Ethnic-specific healthy eating intervention programs are needed.
Breast milk iodine concentration (BMIC) is a promising indicator of iodine status in lactating women. However, there is limited data on its usefulness to reflect maternal iodine deficiency. Therefore, the aim of our study was to assess iodine concentration in breast milk and urine samples in exclusively breastfeeding women. Eligible pregnant women undergoing routine antenatal care in a large hospital in Shaanxi Province, China, were followed up from the third trimester of pregnancy until the first week of lactation. Urine samples (20 mL) were collected during pregnancy and lactation. Iodine concentration in samples were measured based on Sandell-Kolthoff reaction. Breast milk samples (5 mL) were provided during lactation. A Receiver Operating Curve (ROC) was constructed to determine the diagnostic performance of BMIC. An iodine-specific food frequency questionnaire (FFQ) was completed twice during pregnancy and lactation. A total of 200 women completed the study. The overall median BMIC was 89 μg/L, indicating iodine sufficiency (i.e., BMIC reference range between 60 and 465 μg/L). Women reported similar median UIC during pregnancy and lactation (112 and 113 μg/L, respectively), but their iodine status differed — mild-to-moderate iodine deficiency during pregnancy and iodine sufficiency during lactation. The ROC for BMIC using UIC as a reference standard was 0.755 (95% CI: 0.644., 0.866). In conclusion, this study demonstrated that women were iodine sufficient in the first week of lactation as assessed by UIC, which was consistent with BMIC. These findings suggested that BMIC is a useful biomarker to assess iodine status in lactating women.
An increasing number of food-based recommendations promote a plant-based diet to address health concerns and environmental sustainability in global food systems. As the main sources of iodine in many countries are fish, eggs, and dairy products, it is unclear whether plant-based diets, such as the EAT-Lancet reference diet, would provide sufficient iodine. This is important as thyroid hormone production requires iodine for growth and brain development; adequate iodine intake is especially important before and during pregnancy. In this narrative review, we evaluated the current literature and estimated iodine provision from the EAT-Lancet reference diet. There is evidence that those following a strict plant-based diet, such as vegans, cannot reach the recommended iodine intake from food alone and are reliant on iodine supplements. Using the EAT-Lancet reference diet recommendations for intake and iodine values from UK food tables, we calculated that the diet would provide 128 μg/day (85% of the adult recommendation of 150 μg/d and 51-64% of the pregnancy recommendation of 200-250 μg/d). However, if milk is replaced with unfortified plant-based alternatives, total iodine provision would be just 54 μg/day (34% and 22-27% of the recommendations for adults and pregnancy, respectively). Plant-based dietary recommendations might place consumers at risk of iodine deficiency in countries without a fortification programme and where animal products provide the majority of iodine intake, such as the UK and Norway. It is essential that those following a predominantly plant-based diet must be given appropriate dietary advice to ensure adequate iodine intake.