Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.

Association of hypertension and plant-based dietary patterns on cognitive impairment: a nationwide cohort study in China

This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individuals with normal cognition at baseline from the Chinese Longitudinal Healthy Longevity Survey(2011−2018).Cognitive function was assessed by the Mini-mental State Examination(MMSE),and cognitive impairment was defined as an MMSE score below 18 points.Diet patterns were assessed using the overall plant-based diet index(PDI),healthful plant-based diet index(hPDI),and unhealthful plant-based diet index(uPDI)derived from a simplified food frequency questionnaire(FFQ).Blood pressure was measured through physical examination.Cox proportional hazard regression and restricted cubic spline were performed.Participants with hypertension had an increased risk of cognitive impairment compared with normal group.The associations between hypertension and cognitive impairment were more pronounced among participants with lower PDI than those with higher PDI,among participants with lower hPDI than those with higher hPDI,and among participants with higher uPDI than those with lower uPDI.A healthful PBD pattern may attenuate hypertension-induced cognitive impairment,while an unhealthful PBD pattern may exacerbate hypertensioninduced cognitive impairment in elderly.Adherence to healthful PBD pattern could be used to prevent or mitigate adverse neurological effects in the hypertensive population.

Maternal dietary patterns associated with bone density in Chinese lactating women and infants at 6 months postpartum:a prospective study using data from 2018-2019

This cohort study was designed to explore the relationship between maternal dietary patterns(DPs)and bone health in Chinese lactating mothers and infants.We recruited 150 lactating women at 1-month postpartum.The estimated bone mineral density(eBMD)of subjects’calcanei and the information on dietary intake were collected.After 5-month follow-up,the eBMD of mothers and their infants were measured again.Factor analysis was applied to determine maternal DPs.General linear models were used to evaluate the association between maternal DPs and maternal eBMD loss or infants’eBMD.With all potential covariates adjusted,Factor 2(high intake of whole grains,tubers,mixed beans,soybeans and soybean products,seaweeds,and nuts)showed a positive association with the changes of maternal eBMD(β=0.16,95%CI:0.005,0.310).Factor 3(high intake of soft drinks,fried foods,and puffed foods)was inversely correlated with the changes of maternal eBMD(β=-0.22,95%CI:-0.44,0.00).The changes of maternal eBMD were positively associated with 6-month infants’eBMD(β=0.34,95%CI:0.017,0.652).In conclusion,Factor 2 might contribute to the maintenance of eBMD in lactating women,while Factor 3 could exacerbate maternal eBMD loss.Additionally,the changes of maternal eBMD presented a positive correlation with 6-month infants’eBMD.

Dietary patterns and cancer prognosis

Cancer is the leading cause of global mortality,resulting in millions of deaths each year.Even a small attenuation in cancer rates through preventive care can have a significant impact.Dietary habits are closely associated with cancer.Unhealthy eating habits may contribute to traditional risk factors and accelerate the progression of cancer.Recent studies have demonstrated the potential of healthy dietary interventions in the prevention and treatment of various cancers,particularly through dietary patterns such as the Mediterranean diet,Dietary Approaches to Stop Hypertension diet,plant-based diet,and ketogenic diet.This review summarizes several studies on the impact of dietary patterns on cancer prognosis and explores the recent findings regarding themechanisms through which dietary interventions influence cancer progression and prognosis.

Association of Dietary Pattern during Pregnancy and Gestational Diabetes Mellitus： A Prospective Cohort Study in Northern China

Objective To examine the association of maternal dietary patterns during pregnancy with gestationa diabetes mellitus （GDM） in northern China. Methods The dietary intakes of pregnant women were recorded twice by 24-hour dietary recalls for three days prior to having been diagnosed with GDM, at 5-15 and 24-28 gestational weeks, respectively. GDM was diagnosed, and serum glycosylated hemoglobin （HbAlc） was measured at 24-28 weeks. Dietary patterns were assessed by factor analysis. The association of the dietary pattern with GDM and HbAlc was examined by multiple logistic models. Results Of 753 participants, 64 （8.5%） were diagnosed with GDM. Four dietary patterns were identified： Western pattern （dairy, baked/fried food and white meat）, traditional pattern （light-colored vegetables, fine grain, red meat and tubers）, mixed pattern （edible fungi, shrimp/shellfish and red meat） and prudent pattern （dark-colored vegetables and deep-sea fish）. Compared with the prudent pattern, both the Western pattern and the traditional pattern were associated with an increased risk of GDM （aOR = 4.40, 95% CI： 1.58-12.22; aOR = 4.88, 95% Ch 1.79-13.32） and a high level of HbAlc （aOR = 12.37, 95% Ch 1.47-103.91; aOR = 26.23, 95% CI： 2.54-270.74）. Compared to the lowest quartile （Q）, 0.3 of the Western pattern scores and Q3-Q4 of the traditional pattern scores were associated with a higher risk of GDM. Conclusion The consumption of the Western pattern or the traditional pattern during pregnancy may increase the risk of GDM.

Crosstalk between dietary patterns,obesity and nonalcoholic fatty liver disease

The prevalence of nonalcoholic fatty liver disease(NAFLD)is rising worldwide,paralleling the epidemic of obesity.The liver is a key organ for the metabolism of proteins,fats and carbohydrates.Various types of fats and carbohydrates in isocaloric diets differently influence fat accumulation in the liver parenchyma.Therefore,nutrition can manage hepatic and cardiometabolic complications of NAFLD.Even moderately reduced caloric intake,which leads to a weight loss of 5%-10%of initial body weight,is effective in improving liver steatosis and surrogate markers of liver disease status.Among dietary patterns,the Mediterranean diet mostly prevents the onset of NAFLD.Furthermore,this diet is also the most recommended for the treatment of NAFLD patients.However,clinical trials based on the dietary interventions in NAFLD patients are sparse.Since there are only a few studies examining dietary interventions in clinically advanced stages of NAFLD,such as active and fibrotic steatohepatitis,the optimal diet for patients in these stages of the disease must still be determined.In this narrative review,we aimed to critically summarize the associations between different dietary patterns,obesity and prevention/risk for NAFLD,to describe specific dietary interventions’impacts on liver steatosis in adults with NAFLD and to provide an updated overview of dietary recommendations that clinicians potentially need to apply in their daily practice.

Dietary Patterns Associated Metabolic Syndrome in Chinese Adults

Dietary pattern has been revealed to be associated with metabolic syndrome. However, the association was not well documented in Chinese due to the complexity of Chinese foods. We mainly assessed the dietary patterns and examined their effects on metabolic syndrome among Chinese adults. Four dietary patterns including ＇Refined Grains ＆ Vegetables＂ Pattern, ＇Dairy ＆ Eggs＇ Pattern, ＇Organ Meat ＆ Poultry＇ Pattern, and ＇Coarse Grains ＆ Beans＇ Pattern were extracted. ＇Dairy ＆ Eggs＇ Pattern was associated with a decreased odds of metabolic syndrome in women, and ＇Coarse Grains ＆ Beans＇ Pattern was associated with a decreased odds of hypertension in men. These results provided a scientific basis for future research and dietarv euideline Perfection.

Changes in Dietary Patterns and Certain Nutrition-related Diseases in Urban and Rural Residents of Jiangsu Province,China,During the 1990s

Objective To investigate into the changes of dietary patterns and their impacts on health of urban and rural residents in Jiangsu Province, China during the 1990s. Methods On the basis of the results of food consumption survey, the calorie intake was calculated according to the balanced diet method and the quality of diet was assessed by scores of desirable dietary pattern (DDP). Results It was found that food consumption and dietary patterns changed remarkably during the 1990s. Grain consumption was decreasing year by year, but the consumption of animal food was markedly increasing. Although the score of desirable dietary pattern (DDP) in urban residents was more than 90, the deducted score due to over-consumption of animal food increased. The mortality from infectious diseases evidently decreased in the whole province, while the death rates of some chronic diseases, such as diabetes, hypertension, colorectal cancer and breast cancer, were increasing rapidly in urban areas. Conclusions Sufficient attention should be paid to the negative effects of change in dietary patterns on people's health, especially in the urban residents.

Nutritional Assessment and Dietary Pattern of Coronary Heart Disease Patients in Kanpur City

CHD （coronary heart disease） is the single most important cause of death and, more importantly, the single biggest cause of premature death in modem, industrialized countries. On the basis of summarized results in respect to assessing file nutritional status and dietary pattern of coronary heart diseased patients, it was concluded that nutritional status of control group was better as compared to diseased group. The dietary pattern of diseased group was similar to control group.

Mechanistic associations between dietary patterns and colorectal cancer

Colorectal cancer(CRC)is a common cancer with high morbidity and mortality rates.Its occurrence and development are determined by many factors,including genetics,the environment,lifestyle,and so on.The occurrence of CRC is often accompanied by changes in the intestinal microenvironment.Numerous studies have focused on the association between dietary patterns,dietary components,and CRC now.This article reviews five different dietary patterns:the Western diet,the Mediterranean diet,the ketogenic diet,the Dietary Approaches to Stop Hypertension diet,and fasting,and themechanistic associations between their food components and CRC.The finding can provide a reference for further studies on the association between different dietary patterns and CRC and will help clinicians formulate reasonable and feasible dietary interventions.

COVID-19-associated stroke risk:Could nutrition and dietary patterns have a contributing role?

The novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2 has created a life-threatening world pandemic.Unfortunately,this disease can be worse in older patients or individuals with comorbidities,having dangerous consequences,including stroke.COVID-19–associated stroke widely increases the risk of death from COVID-19.In addition to the personal hygiene protocols and preventive policies,it has been proven that immune-compromised,oxidative,and pro-coagulant conditions make a person more susceptible to severe COVID-19 complications,such as stroke;one of the most effective and modifiable risk factors are poor nutritional status.Previous literature has shown that healthy dietary patterns,such as the Mediterranean diet,some food groups,and specific micronutrients,reduce the risk of ischemic and hemorrhagic stroke.In this work,for the first time,we hypothesized that a healthy diet could also be a protective/preventive factor against COVID-19–associated stroke risk.In order to prove this hypothesis,it is required to study nutritional intake and dietary patterns in patients suffering from COVID-19–associated stroke.If this hypothesis is proven,the chronic supportive role of a healthy diet in critical situations will be highlighted once again.

Meta-Analysis of the Breast Cancer Risk Associated with Three Dietary Patterns

Objectives A meta-analysis was conducted to assess the association between breast cancer risk and three common dietary patterns.Methods The PubMed,Web of Science,CNKI,Wanfang,Embase,and Cochrane Library databases were systematically searched(until June 2022)for studies on the association between three common dietary patterns,including the Western dietary pattern,vegetarian dietary pattern and Mediterranean dietary pattern,and the risk of breast cancer.The Newcastle-Ottawa(NOS)scale was used to assess study quality.Results A total of 24 articles published from 2001 to 2021 that met the criteria were included for meta-analysis.The Western dietary pattern was positively associated with the breast cancer risk in women both before and after menopause,although the heterogeneity in the study was high(HR=1.05,95%CI:1.01-1.30,I^(2)=56.2%,P=0.019).There was an inverse association between the vegetarian dietary pattern and breast cancer risk among women(HR=0.87,95%CI:0.78-0.97,I^(2)=73.7%,P<0.001).No association was observed between the Mediterranean dietary pattern and women's risk of breast cancer(HR=0.96,95%CI:0.89-1.02,I^(2)=64.1%,P=0.010).Due to the presence of significant heterogeneity among the studies,we performed a subgroup analysis,meta-regression analysis and sensitivity analysis,and found that factors such as the type of study design were the main sources of heterogeneity in each group.These results remained largely unchanged after excluding studies of a specific type from the sensitivity analysis.Conclusion The Western dietary pattern can increase the risk of breast cancer,while the vegetarian dietary pattern can reduce the risk of breast cancer.No association between the Mediterranean dietary pattern and the risk of breast cancer was observed.

Use of Desirable Dietary Pattern (DDP) for Study of Dietary Pattern in Urban and Rural Residents of Jiangsu

Objective To make retrospective assessment of the quality of diet in the urban and rural residents of Jiangsu province, China, during the 1990′s and a prospective study of the dietary pattern in the year of 2010 with desirable dietary pattern (DDP). Methods The calorie intake was calculated according to the method of balanced diet and the dietary pattern was assessed in terms of DDP score. Results Retrospective study revealed that the DDP score of cereals was decreased and that of animal foods increased remarkably in both the urban and rural residents during the decade. Prospective study showed that the readjustment of dietary structure for the urban residents should be focused on preventing the drop of cereal consumption and further lowering the intake of pork. Promotion of soybean and milk consumption to great extents will be needed to improve the quality of diet for both urban and rural residents of Jiangsu in the future. Conclusion It was illustrated that DDP is feasible for retrospective and prospective studies on dietary pattern as it is simple in calculation, its results are easy to understand and of practical significance to the masses and health workers.

Utilization effect of water-land resources under the evolution of Chinese dietary patterns

Exploring the utilization effect of water-land resources under the evolution of dietary patterns is of great significance in achieving sustainable global food consumption and the effective allocation of national resources.Our selected study area was China,a country with rapidly changing dietary consumption patterns,and the research period was between 1987 and 2020.Based on the material called Chinese Dietary Guidelines 2021,this study introduced the“virtual water”and the“virtual land”to quantify the utilization effect of water-land resources under the evolution of Chinese dietary patterns.Results showed that the dietary patterns gradually changed from“cereal-vegetable-based consumption”to“diversified consumption”.Food consumption’s total water footprint(WF)increased from 471.1 Gm3in 1987 to 848.8 Gm3in 2020,with a growth rate of 80.2%.Moreover,the total land requirement for food(LRF)increased from 88.8 Mha in 1987 to 129.9 Mha in 2020,with a growth rate of 46.3%.Furthermore,the meat consumption was the major contributor to the increase in total WF(104.0%)and LRF(102.1%).In contrast to the balanced diet pattern,there was no waste of water-land resources consumption for the food consumption of urban-rural residents in China between 1987 and 2020.However,the consumption of water resources would gradually approach the resource cost under the balanced diet patterns.It would eventually break through the critical value and reach the state of resource waste.In addition,the findings showed that urban residents’waste rate of water-land resources for meat consumption increased by 142.3%compared with that in 1987.The research results can provide scientific guidance for resolving the food crisis under the supply of water-land resources in China and have an essential reference for national food security and sustainable development of resources and environment.

Dietary pattern and hepatic lipid metabolism

The liver is the leading site for lipid metabolism,involving not only fatty acid beta-oxidation but also de novo synthesis of endogenous triglycerides and ketogenesis.The liver maintains systemic lipid homeostasis by regulating lipid synthesis,catabolism,and transportation.Dysregulation of hepatic lipid metabolism precipitates disorders,such as non-alcoholic fatty liver disease(NAFLD),affecting the whole body.Thus,comprehending and studying hepatic lipid metabolism is crucial for preventing and treating metabolic liver diseases.Traditionally,researchers have investigated the impact of a single nutrient on hepatic lipid metabolism.However,real-life dietary patterns encompass diverse nutrients rather than single components.In recent years,there have been increased studies and notable progress regarding the effects of distinct dietary patterns on hepatic lipid metabolism.This review summarizes the influence of diverse dietary patterns on hepatic lipid metabolism,elucidating underlying molecular mechanisms and appraising the therapeutic potential of dietary patterns in managing hepatic steatosis.

The effect of healthy dietary patterns on male semen quality:a systematic review and meta-analysis

The incidence of infertility has recently risen.Semen quality is an important male fertility indicator,and dietary factors can affect semen quality.We conducted this systematic review and meta-analysis to determine the effects of healthy dietary patterns on semen quality.A literature search was conducted in 3 databases(Embase,Web of Science and PubMed)on August 21,2021.The included cross-sectional studies examined the influence of the Mediterranean,Dietary Approaches to Stop Hypertension(DASH),and prudent diet patterns on semen quality parameters;six studies(1244 subjects)were included.By comparing high consumption with low consumption of healthy dietary patterns,the results of the meta-analysis showed significantly higher sperm concentrations(mean difference[MD]=6.88×10^(6) ml^(−1),95%confidence interval[CI]:1.26×10^(6) ml^(−1)–12.49×10^(6) ml^(−1);P<0.05),a significant increase in total sperm count(MD=16.70×10^(6),95%CI:2.37×10^(6)–31.03×10^(6);P<0.05),and a significant increase in progressive sperm motility(MD=5.85%,95%CI:2.59%–9.12%;P<0.01).The sperm concentration,progressive sperm motility,and total sperm count were significantly higher in men with higher versus lower consumption of healthy dietary patterns.However,the results must be interpreted with caution.

SHIFTING TO A RECOMMENDED DIETARY PATTERN COULD PROMOTE SUSTAINABLE DEVELOPMENT OF THE ENVIRONMENT AND HUMAN HEALTH

With the rapid development of China’s economy,Chinese people tend to eat foods rich in fat,sugar and protein.This change in dietary pattern has brought double challenges to China’s sustainable development of environment and human health.So it has become urgent for the nation to shift to a healthy and sustainable dietary pattern.Based on the China Health and Nutrition Survey database,this study used K-means cluster analysis to classify China’s existing dietary patterns into quasi-southern,quasi-northern and quasi-western patterns.Two alternative recommended dietary patterns,Chinese dietary and planet health patterns,were selected to compare the effects of environment and health.The results show that a shift from the three existing dietary patterns to two alternative dietary patterns could enhance sustainable development of environment,especially for the quasi-western pattern shifting to the planet health pattern.Also,a shift would have of great benefits for human health,effectively reduce the relative risks of diseases such as hypertension,type 2 diabetes and coronary heart disease.The greatest benefits would come from shifting the quasi-western pattern benefits to one of the two alternative dietary patterns in terms of environment effects,and the quasi-southern pattern benefits most in terms of health effects.Shifting to the planet health pattern is more effective than the Chinese dietary pattern both in environment and human health.This paper provides policy recommendations to vigorously advocate dietary balance,scientifically promote dietary patterns,and change consumer dietary behavior.

The impact of short-term changes in sleeping and eating patterns on glucometabolic health and gut microbiota in healthy young adults: a proof-of-concept controlled feeding study

Epidemiological studies showed that night workers are at higher risk of developing chronic metabolic diseases.However,no study has investigated the changes in circadian rhythms caused by a combined effect of sleep and diet in a real-life setting on cardiometabolic health,gut microbiota,and psychological status in healthy people.A 4-week step-wise misaligned-realigned controlled-feeding trial with a 2×2 factorial design(sleep and diet)was conducted on healthy young adults.At first,subjects experienced a one-week circadian rhythm misalignment with a high-fat fast-food diet,extended eating window,and delayed sleep schedules,then gradually transited to a complete circadian rhythm realignment with a high-fiber balanced diet,8-h timerestricted eating,and normal sleep schedules.Circadian rhythm misalignment led to significantly higher levels of fasting glucose and homeostatic model assessment for insulin resistance(HOMA-IR)of subjects compared to baseline and failed to recover to the baseline level in circadian rhythm realignments.Notably,the incremental area under the curve(iAUC)of postprandial glucose decreased with circadian rhythm adjustments as compared to that in circadian rhythm misalignment,suggesting circadian rhythm realignment by sleep or/and diet could partly restore glucose metabolism impaired by a short-term circadian rhythm misalignment.However,circadian rhythm changes did not result in overall perturbations of gut microbiota diversities.

The Patterns of Complementary Feeding and Growth among 12 to 23 Month-Old Children in China

Objective This study aimed to understand the characteristics of dietary patterns among children aged12 to 23 months and discusses the relationship between dietary patterns and the growth of children.Method Cross-sectional data were selected from the National Nutrition and Health Systematic Survey for 0 to 18 year-old children in China(n=2,449)to describe the patterns of complementary feeding and the growth of children.Cluster analysis was used to analyze complementary feeding patterns,and an analysis of variance and Bonferroni test were conducted to analyze the relationship between Z scores and complementary feeding patterns.Results Four dietary patterns were identified among the children via cluster analysis.In Pattern 4(n=104,4.2%),children still consumed milk as their staple food.They displayed the lowest grain,fruit,vegetable,egg,and flesh foods consumption,a medium frequency of breast milk consumption,and a high frequency of dairy product consumption.Pattern 4 had the lowest length-for-age Z scores and weight-for-age Z scores,with-0.10±1.34 and 0.24±1.00,respectively(F=7.940,P<0.001;F=5.317,P<0.001).Conclusion Although China is undergoing rapid urbanization and economic development,there is still a phenomenon of insufficient intake of protein-rich foods and dairy-based dietary patterns at the stage of complementary food introduced among children aged 12 to 23 months.

Dietary phytochemical consumption is inversely associated with liver alkaline phosphatase in Middle Eastern adults

BACKGROUND The hepatoprotective effects of phytochemicals are controversial.A dietary phytochemical index(DPI)has been suggested as an alternative method for quantifying the phytochemical content of foods.AIM To assess the DPI in relation to liver function tests among a representative sample of Iranian adults.METHODS A total of 5111 participants aged 35-70 years old were included in this cross-sectional study by a multistage cluster random sampling method.Dietary intakes were collected by a validated and reliable food frequency questionnaire with 121 items.DPI was calculated by the percent of daily energy intake taken from phytochemical-rich foods.Fasting serum concentrations of alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)and gamma glutamyl transferase(GGT)were determined.Linear regression was used to investigate the association between DPI and levels of liver enzymes using crude and adjusted models.RESULTS There was an inverse association between DPI score and serum ALP in the crude model(β=-0.05;P<0.001).This association remained significant after adjustment for body mass index,age,smoking,energy intake,history of diabetes,and education(β=-0.03;P=0.01).No significant associations were found between DPI score and serum levels of AST,ALT,and GGT.The individuals with the highest DPI scores consumed significantly higher amounts of fruits,vegetables,legumes,nuts,and cereals,yet were shown to have significantly higher serum total cholesterol and low-density lipoprotein cholesterol,as well as several other metabolic abnormalities.CONCLUSION Higher adherence to phytochemical-rich foods was associated with lower levels of ALP,but no change in other liver enzymes.Those with higher DPI scores also consumed food items associated with a healthier overall dietary pattern;however,they also presented several unexpected metabolic derangements.Additional randomised trials are needed to better determine the effects of phytochemical-rich foods on liver function.