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...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.展开更多
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 esti...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.展开更多
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 C...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.展开更多
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-h...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.展开更多
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...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.展开更多
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 a...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.展开更多
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 consumpti...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.展开更多
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 r...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.展开更多
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 individu...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.展开更多
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...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.展开更多
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 wi...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.展开更多
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 assoc...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.展开更多
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 resou...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.展开更多
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 ...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.展开更多
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 environ...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.展开更多
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 th...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.展开更多
Heart failure(HF)is characterized by high symptom burden including,but not limited to fatigue,dyspnea,and edema.Up to 21.5%of HF patients experience significant depressive symptoms,much higher than 7.1%in adults witho...Heart failure(HF)is characterized by high symptom burden including,but not limited to fatigue,dyspnea,and edema.Up to 21.5%of HF patients experience significant depressive symptoms,much higher than 7.1%in adults without HF.Diet,metabolites,and other inflammatory mechanisms have gained notable attention in recent studies for contributions to symptoms in HF.Symptoms for black adults(B/As)with HF are often influenced by lifestyle factors,which may influence their higher mortality rates;few studies address these factors.Distinguishing the links between key elements with diet,inflammation,and symptoms may bring clarity for new dietary strategies in HF clinical care.The purpose of this integrative review is to examine the existing literature regarding relationships among physiologic pathways in HF along with physical and emotional symptoms in the context of inflammation,dietary intake,tumor necrosis factor‑alpha(TNF‑a),a biomarker of inflammation,and trimethylamine‑N‑Oxide(TMAO).Based on available evidence,inflammation may be a key link between physical symptoms,diet,depression,TMAO,and TNF‑a in persons with HF and warrants further examination to clarify pathological links to solidify evidence for better guidance with dietary modifications.The literature reviewed in this study demonstrates that more work is needed to examine dietary planning,social support,and differences between men and women in the B/A community.Results of this literature review call attention to the essential,personalized care needs related to symptom monitoring and dietary planning which is expected to decrease symptom burden in the HF population.展开更多
Global challenges such as climate change,biodiversity loss,and health crises necessitate a shift towards sustainable diets.Incorporating sustainability into food-based dietary guidelines(FBDGs)is essential for this sh...Global challenges such as climate change,biodiversity loss,and health crises necessitate a shift towards sustainable diets.Incorporating sustainability into food-based dietary guidelines(FBDGs)is essential for this shift,and cultural considerations also play a vital role,as food culture significantly influences dietary habits.Considering that Asia and Europe exhibit distinct food cultures,tailored approaches are necessary.Additionally,countries face diverse nutritional challenges,ranging from malnutrition to diet-related diseases,and regional variation in environmental impact necessitates context-specific strategies.Achieving sustainable nutrition depends on understanding cultural influences and regional dynamics.This paper compares China’s and Germany’s dietary guidelines and dietary patterns and their impact on sustainability.It shows that Chinese and German FBDGs only slightly differ,despite the different eating cultures and habits of each country.Alone the recommended amounts for eggs and fish are considerably higher in China than in Germany.However,in both China and Germany,actual dietary patterns deviate from the dietary guidelines.In China,concomitant with economic growth and urbanization,a dietary shift towards increased consumption of animal products and decreased consumption of vegetables and cereals has been observed in the last decades,which has led to a decline in nutritional deficiencies but an increase in obesity and overweight.Obesity and overweight are also on the rise in Germany.A dietary shift could therefore also be beneficial for public health.While following the respective national guidelines would benefit the environment,alternative diets such as a plant-based diet offer even lower environmental footprint.Revising guidelines to prioritize sustainability in addition to health aspects while considering regional contexts and cultural preferences is recommended to foster sustainable eating habits globally.This approach is pivotal for promoting dietary shift towards sustainability on a global scale.展开更多
Osteoporosis is a disease that decreases bone mass and increases bone porosity, weakening bones. The Paleo diet is an eating plan that imitates the dietary patterns of the Stone Age. It excludes grains, dairy, and pro...Osteoporosis is a disease that decreases bone mass and increases bone porosity, weakening bones. The Paleo diet is an eating plan that imitates the dietary patterns of the Stone Age. It excludes grains, dairy, and processed foods and emphasizes feeding on lean meats, fruits, vegetables, and nuts. Consumption of the Paleo diet has many positive sides, such as high protein intake and weight loss. Still, excluding dairy products risks calcium and vitamin D deficiencies, which are crucial for bone health. Statistics and simulations that have explored the relationship between the Paleo diet and bone health (especially for people suffering from low bone density) show mixed outcomes on bone health.). While the consumer does get lots of benefits from fruit and vegetable intake in a large sum due to them containing nutrients like magnesium, potassium, and vitamin K (which are also necessary for bone health), the lack of dairy products (gives the maximum amount of calcium and vitamin D) raises concerns about maintaining adequate bone mineral density (BMD). More information on this topic shows the negative impact of this diet on people suffering from osteoporosis due to a lack of nutrient intake that nourishes the bone. Although the Paleo diet can enhance overall health through nutrient-dense foods and reduced processed intake, it can’t be said the same for people suffering from osteoporosis.展开更多
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-secti...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.展开更多
基金supported by grants from the Beijing Nova Program (No. Z201100006820069)CAMS Innovation Fund for Medical Sciences (CIFMS, No. 2021-I2M-1-023, 2021-I2M-1-010)Talent Incentive Program of Cancer Hospital Chinese Academy of Medical Sciences (Hope Star)。
文摘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.
基金NSFC and CNS for funding the projectfunded by the National Natural Science Foundation of China(NSFC,82173500)“CNS-ZD Tizhi and Health Fund”(CNS-ZD2020-163).
文摘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.
文摘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.
基金funded by China Medical Board[CMB Grant 13‐131]the Key Discipline Construction of Public Health of Shang hai[No.15GWZK0402]the National Natural Science Foundation of China[Grant No.81273066]
文摘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.
基金Supported by Ministry of Education,Science and Technological Development of the Republic of Serbia,No.451-03-68/2022-14/200042。
文摘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.
基金funded by a Special Scientific Research Fund of Public Welfare Profession of Chinese Ministry of Health(Grant No.201202012)a fund supported by Chinese Science and Technology Ministry(Grant No.2012BAI02B03)a grant from National Natural Science Foundation of China(Grant No.81372992)
文摘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.
基金This work was supported by the Natural Science Foundation from the Department of Education of Jiangsu Provincial Government (Grant No. OOKJB330002)
文摘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.
文摘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.
文摘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.
基金supported by the Cooperative Project of the China Society of Geriatric Health Care(HZ202102)the“Xinghuo”Scientific Research Project of the First Hospital of Hebei Medical University(XH202206).
文摘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.
文摘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.
基金supported by the National KeyResearch and Development Program(No.2022YFC2009600 and No.2022YFC2009601).
文摘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.
基金National Natural Science Foundation of China,No.42171230,No.42071170。
文摘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.
基金the National Natural Science Foundation of China(Grant No.82325007,81970535,81422009,and 81770560).
文摘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.
文摘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.
基金supported by a grant from the National Nature Science Foundation of China(No.82173539 and No.81874268).
文摘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.
文摘Heart failure(HF)is characterized by high symptom burden including,but not limited to fatigue,dyspnea,and edema.Up to 21.5%of HF patients experience significant depressive symptoms,much higher than 7.1%in adults without HF.Diet,metabolites,and other inflammatory mechanisms have gained notable attention in recent studies for contributions to symptoms in HF.Symptoms for black adults(B/As)with HF are often influenced by lifestyle factors,which may influence their higher mortality rates;few studies address these factors.Distinguishing the links between key elements with diet,inflammation,and symptoms may bring clarity for new dietary strategies in HF clinical care.The purpose of this integrative review is to examine the existing literature regarding relationships among physiologic pathways in HF along with physical and emotional symptoms in the context of inflammation,dietary intake,tumor necrosis factor‑alpha(TNF‑a),a biomarker of inflammation,and trimethylamine‑N‑Oxide(TMAO).Based on available evidence,inflammation may be a key link between physical symptoms,diet,depression,TMAO,and TNF‑a in persons with HF and warrants further examination to clarify pathological links to solidify evidence for better guidance with dietary modifications.The literature reviewed in this study demonstrates that more work is needed to examine dietary planning,social support,and differences between men and women in the B/A community.Results of this literature review call attention to the essential,personalized care needs related to symptom monitoring and dietary planning which is expected to decrease symptom burden in the HF population.
文摘Global challenges such as climate change,biodiversity loss,and health crises necessitate a shift towards sustainable diets.Incorporating sustainability into food-based dietary guidelines(FBDGs)is essential for this shift,and cultural considerations also play a vital role,as food culture significantly influences dietary habits.Considering that Asia and Europe exhibit distinct food cultures,tailored approaches are necessary.Additionally,countries face diverse nutritional challenges,ranging from malnutrition to diet-related diseases,and regional variation in environmental impact necessitates context-specific strategies.Achieving sustainable nutrition depends on understanding cultural influences and regional dynamics.This paper compares China’s and Germany’s dietary guidelines and dietary patterns and their impact on sustainability.It shows that Chinese and German FBDGs only slightly differ,despite the different eating cultures and habits of each country.Alone the recommended amounts for eggs and fish are considerably higher in China than in Germany.However,in both China and Germany,actual dietary patterns deviate from the dietary guidelines.In China,concomitant with economic growth and urbanization,a dietary shift towards increased consumption of animal products and decreased consumption of vegetables and cereals has been observed in the last decades,which has led to a decline in nutritional deficiencies but an increase in obesity and overweight.Obesity and overweight are also on the rise in Germany.A dietary shift could therefore also be beneficial for public health.While following the respective national guidelines would benefit the environment,alternative diets such as a plant-based diet offer even lower environmental footprint.Revising guidelines to prioritize sustainability in addition to health aspects while considering regional contexts and cultural preferences is recommended to foster sustainable eating habits globally.This approach is pivotal for promoting dietary shift towards sustainability on a global scale.
文摘Osteoporosis is a disease that decreases bone mass and increases bone porosity, weakening bones. The Paleo diet is an eating plan that imitates the dietary patterns of the Stone Age. It excludes grains, dairy, and processed foods and emphasizes feeding on lean meats, fruits, vegetables, and nuts. Consumption of the Paleo diet has many positive sides, such as high protein intake and weight loss. Still, excluding dairy products risks calcium and vitamin D deficiencies, which are crucial for bone health. Statistics and simulations that have explored the relationship between the Paleo diet and bone health (especially for people suffering from low bone density) show mixed outcomes on bone health.). While the consumer does get lots of benefits from fruit and vegetable intake in a large sum due to them containing nutrients like magnesium, potassium, and vitamin K (which are also necessary for bone health), the lack of dairy products (gives the maximum amount of calcium and vitamin D) raises concerns about maintaining adequate bone mineral density (BMD). More information on this topic shows the negative impact of this diet on people suffering from osteoporosis due to a lack of nutrient intake that nourishes the bone. Although the Paleo diet can enhance overall health through nutrient-dense foods and reduced processed intake, it can’t be said the same for people suffering from osteoporosis.
基金This research was funded by National Special Program for Science&Technology Basic Resources Investigation of China[Grant Number:2017FY101100 and 2017FY101104].
文摘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.