Association of serum calcium and metabolically healthy obese in US adults: a cross-sectional study.

OBJECTIVES: The relationship between serum calcium and occurrence of MHO (metabolically healthy obesity) and MUNO (metabolically unhealthy non-obesity) remains unclear, and distinguishing these two phenotypes is difficult within primary healthcare units. This study explores that relationship. METHODS: This survey included 28590 adults from the National Health and Nutrition Examination Survey (NHANES) 2001-2018. Obesity phenotypes were categorized based on BMI and presence or absence of metabolic syndrome components. Weighted multivariate logistic regression analyses were used to assess the association between serum calcium levels and the obesity phenotype. Restricted cubic spline analysis characterized dose-response relationships, and stratified analyses explored these relationships across sociodemographic and lifestyle factors. RESULTS: The overall prevalence of MHO and MUNO were 2.6% and 46.6%, respectively. After adjusting for covariates, serum calcium exhibited a negative association with MHO [OR (95%): 0.49 (0.36,0.67), p < 0.001], while exhibiting a positive association with MUNO [OR (95%): 1.48 (1.26,1.84), p < 0.001]. Additionally, we found a non-linear association between serum calcium levels and the incidences of MHO and MUNO. Stratified analyses demonstrated a strong negative correlation between serum calcium levels and MHO occurrence across various subgroups. There was no significant interaction between calcium and stratified variables except sex; the association between calcium and the occurrence of MHO was remarkable in female patients. Meanwhile, the predictive ability of serum calcium level for the occurrence of MUNO among all patients was consistent across various subgroups. There was a significant interaction between calcium level and stratified variables based on age, sex, race, and smoking status; the association was remarkable in older (≥ 40 years old), white, none or less smoking, and female patients. CONCLUSIONS: A significant correlation was identified between serum calcium levels and MHO or MUNO. The findings suggest that serum calcium levels may serve as an indicator for more accurate assessment and diagnosis of MUNO and MHO, especially among individuals with abdominal obesity.

Serum calcium levels exhibited an inverse relationship with metabolically healthy obesity (MHO) and a positive relationship with metabolically unhealthy non-obese (MUNO).A nonlinear association exists between serum calcium levels and the incidence of both MHO and MUNO.Serum calcium has the potential to enhance evaluation and screening for MUNO or MHO in the general US adult population.

Exploring the impact of women-specific reproductive factors on phenotypic aging and the role of life's essential 8.

BACKGROUND: Aging is an inevitable biological process. Accelerated aging renders adults more susceptible to chronic diseases and increases their mortality rates. Previous studies have reported the relationship between lifestyle factors and phenotypic aging. However, the relationship between intrinsic factors, such as reproductive factors, and phenotypic aging remains unclear. METHODS: This study utilized data from the National Health and Nutrition Examination Survey (NHANES), spanning from 1999 to 2010 and 2015-2018, with 14,736 adult women. Random forest imputation was used to handle missing covariate values in the final cohort. Weighted linear regression was utilized to analyze the relationship between women-specific reproductive factors and PhenoAgeAccel. Considering the potential impact of menopausal status on the results, additional analyses were conducted on premenopausal and postmenopausal participants. Additionally, the Life's Essential 8 (LE8) was used to investigate the impact of healthy lifestyle and other factors on the relationship between women-specific reproductive factors and PhenoAgeAccel. Stratified analyses were conducted based on significant interaction p-values. RESULTS: In the fully adjusted models, delayed menarche and gynecological surgery were associated with increased PhenoAgeAccel, whereas pregnancy history were associated with a decrease. Additionally, early or late ages of menopause, first live birth, and last live birth can all negatively impact PhenoAgeAccel. The relationship between women-specific reproductive factors and PhenoAgeAccel differs between premenopausal and postmenopausal women. High LE8 scores positively impacted the relationship between certain reproductive factors (age at menarche, age at menopause, age at first live birth, and age at last live birth) and phenotypic age acceleration. Stratified analysis showed significant interactions for the following variables: BMI with age at menarche, pregnancy history, and age at menopause; ethnicity with age at menopause, age at first live birth, and parity; smoking status with use of contraceptive pills and gynecologic surgery; hypertension with use of contraceptive pills, pregnancy history, and age at menopause. CONCLUSION: Delayed menarche, gynecological surgery, and early or late ages of menopause, first live birth, and last live birth are associated with accelerated phenotypic aging. High LE8 score may alleviate the adverse effects of reproductive factors on phenotypic aging.

Dietary antioxidant and inflammatory potential in asthmatic patients and its association with all-cause mortality.

BACKGROUND: The occurrence and progression of asthma can be influenced by the components in food. Our study aims to determine whether dietary antioxidant and inflammatory potential are associated with the risk of mortality in asthma patients. METHODS: Participants from the 2001-2018 National Health and Nutrition Examination Survey (NHANES) aged 20 years and older with a diagnosis of asthma were included. Mortality status was obtained according to death certificate records from the National Death Index. The antioxidant and inflammatory potential of the diet was assessed using two widely used and dependable indices, Composite Dietary Antioxidant Index (CDAI) and Dietary Inflammatory Index (DII). Restricted cubic spline (RCS) regression was used to analyze the non-linear relationship between the two indexes and mortality. Multivariable Cox proportional risk models were used to estimate hazard ratio and 95% confidence intervals for mortality. Finally, the relationship between CDAI and DII was analyzed. RESULTS: A total of 4698 NHANES participants represented 23.2 million non-institutionalized residents of the US were enrolled in our study. Patients with higher CDAI or lower DII exhibited longer survival times. RCS regression showed a linear relationship of CDAI or DII with mortality. In the Cox regression, both crude and adjusted models demonstrated that higher CDAI or lower DII was linked to a reduced risk of all-cause mortality. Similar associations were found in subgroup analysis. Finally, a negative relationship was found between CDAI and DII. CONCLUSION: Reducing pro-inflammatory or increasing antioxidant diets could reduce all-cause mortality among adult asthma patients.

Association of habitual sleep duration with abnormal bowel symptoms: a cross-sectional study of the 2005-2010 national health and nutrition examination survey.

OBJECTIVES: Nowadays, few studies have examined the relationships between sleep duration and abnormal gut health. In this study, we used data from the National Health and Nutrition Examination Survey (NHANES) to investigate the correlations between habitual sleep duration and abnormal bowel symptoms in adults. METHODS: This study included 11,533 participants aged ≥ 20 years from the NHANES conducted during 2005-2010. Chronic constipation and chronic diarrhea were defined based on the Bristol Stool Form Scale (BSFS) and frequency of bowel movements. Sleep duration was assessed based on the self-report questionnaire and classified into three groups: short sleep duration (< 7 h), normal sleep duration (7-9 h), and long sleep duration (> 9 h). Weighted data were calculated according to analytical guidelines. Logistic regression models and restricted cubic spline curves (RCS) were used to assess and describe the association between sleep duration and chronic diarrhea and constipation. Univariate and stratified analyses were also performed. RESULTS: There were 949 (7.27%) adults aged 20 years and older with chronic diarrhea and 1120 (8.94%) adults with constipation among the 11,533 individuals. A positive association was found between short sleep duration and chronic constipation, with a multivariate-adjusted OR of 1.32 (95% CI: 1.05-1.66). Additionally, long sleep duration was significantly associated with an increased risk of chronic diarrhea (OR: 1.75, 95% CI: 1.08-2.84, P = 0.026). The RCS models revealed a statistically significant nonlinear association (P for non-linearity < 0.05) between sleep duration and chronic diarrhea. Furthermore, obesity was found to modify the association between sleep duration and chronic diarrhea and constipation (p for interaction = 0.044). CONCLUSIONS: This study suggests that both long and short sleep durations are associated with a higher risk of chronic diarrhea and constipation in the general population. Furthermore, a non-linear association between sleep duration and these conditions persists even after adjusting for case complexities.

Association of tooth loss and gallstones: National Health and Nutrition Examination Survey 2017-2018.

Introduction: Gallstones are one of the most common digestive diseases globally, with an estimated affected population of 15% in the United States. Our aim is to assess the current association between oral health and gallstones, exploring potential mediation factors. Methods: Self-reported gallstones were determined based on medical condition questionnaires. Dental status was assessed by dental professionals and oral health questionnaire. Mediation analysis was conducted for body mass index, blood glucose, triglycerides, and cholesterol, and the percentage of mediation effects was calculated. Results: We included 444 patients with gallstones and 3565 non-gallstone participants from National Health and Nutrition Examination Survey. After fully adjusting for all covariates, the prevalence of gallstones is higher when the number of missing teeth is at T3 compared to T1 (odds ratio [OR]: 1.93, confidence interval [CI]: 1.14 - 3.26, p = 0.02, p-trend = 0.01), and there was an inverted L-shaped association between missing teeth and gallstones, with an inflection point of 17. Bone loss around mouth was also associated with gallstones (OR: 1.78, 95% CI: 1.27 - 2.48, p = 0.002), but not root caries and gum disease. Mediation analysis identified blood glucose as a crucial mediator, with a mediation effect ratio of 4.91%. Conclusions: Appropriate lifestyle interventions for patients with missing teeth may help delay the onset of gallstones, such as healthy dietary habits, trace elements supplementing, and managing weight and blood sugar levels. Further exploration of the relationship between oral health and overall health contributes to disease prevention and comprehensive medical management.

Association of serum 25-hydroxyvitamin D concentrations with all-cause and cause-specific mortality among individuals with gout and hyperuricemia.

BACKGROUND: We aimed to probe the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among patients with gout and hyperuricemia (HUA). METHODS: The study included 1169 gout patients and 7029 HUA patients from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 and 2001-2018, respectively. The association between serum 25(OH)D and mortality was evaluated by Cox proportional hazard and restricted cubic spline models. RESULTS: Among participants with gout and HUA, the weighted mean concentrations of serum 25(OH)D were 71.49 ± 30.09 nmol/L and 64.81 ± 26.92 nmol/L, respectively. Vitamin D deficiency occurred in 29.68% of gout patients and 37.83% of HUA patients. During 6783 person-years of follow-up among gout patients, 248 all-cause deaths occurred, among which 76 died from cardiovascular disease (CVD) and 49 died from cancer. 1375 HUA patients were recorded for all-cause mortality during 59,859 person-years of follow-up, including 427 CVD deaths and 232 cancer deaths. After multifactorial adjustment, per one-unit increment in natural log-transformed 25(OH)D was associated with lower risk of 55% all-cause mortality and 61% CVD mortality among gout patients, and a 45% reduced risk of cancer mortality among HUA patients. Restricted cubic splines showed a U-shaped relationship with all-cause and CVD mortality among HUA patients, with inflection points of 72.7 nmol/L and 38.0 nmol/L, respectively. The results were robust in subgroup and sensitivity analyses. CONCLUSIONS: Serum 25(OH)D was negatively linearly correlated with mortality among gout patients, whereas U-shaped correlated with mortality in HUA patients. These results indicate that adequate vitamin D status could prevent premature death.

Association of breakfast skipping on nutrient intake and adiposity in Malaysian children: Findings from SEANUTS II.

Malaysian children often skip breakfast, an important meal providing essential nutrients for optimal growth and maintaining proper nutritional status. Therefore, this study aims to investigate the associations between breakfast skipping with dietary intake, diet quality, and adiposity indicators among primary schoolchildren aged 6.0-12.9 years. This study involved 1383 children from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia. Information collected through questionnaires included sociodemography and breakfast consumption, defined as the first meal before noon. Breakfast skipping was identified as skipping breakfast at least once a week. Anthropometric measures, including height, body weight, and waist circumference, as well as percentage of body fat, were collected. Body mass index (BMI) and waist-to-height ratio were calculated, and BMI-for-age-z-scores was determined using WHO (2007) growth reference. A one-day 24-hour dietary recall was employed to assess dietary intake, and diet quality was analyzed using Malaysian Healthy Eating Index. Binary logistic regression was applied to examine relationship between breakfast skipping on diet quality and adiposity indicators. Over one-third (36.0%) of children skipped breakfast at least once a week, resulting in lower intakes of energy, nutrients, cereals/grains, vegetables, and milk/dairy products, though not affecting total diet quality score. Breakfast skipping was associated with higher odds of overweight/obesity (aOR 2.04, 95%CI: 1.52-2.76) and central obesity (aOR 1.87, 95%CI 1.34-2.61). In conclusion, primary schoolchildren in Peninsular Malaysia who skipped breakfast tended to have lower consumption of nutrients and specific basic food groups, as well as increased body fat. This study highlights the importance of continuing to educate parents and children about healthy eating habits, especially the need to adhere to dietary recommendations, with an emphasis on breakfast consumption.

Seafood intake in childhood/adolescence and the risk of obesity: results from a Nationwide Cohort Study.

BACKGROUND & AIMS: Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort. METHODS: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611-2018). RESULTS: During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance. CONCLUSION: Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.

Very high high-density lipoprotein cholesterol may be associated with higher risk of cognitive impairment in older adults.

BACKGROUND: Previous studies have shown that high-density lipoprotein cholesterol (HDL-C) levels are positively associated with cognitive function across a range of concentrations. However, recent studies have suggested that very high HDL-C levels may lead to poorer outcomes. Therefore, we aimed to investigate the relationship between different concentrations of HDL-C and cognitive impairment risk. METHODS: We collected data from 3632 participants aged over 60 years from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014 to assess the relationship between HDL-C and cognitive function. Cognitive function was evaluated with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the animal fluency test (AFT), and the digit symbol substitution test (DSST). We used restricted cubic spline models and logistic regression to examine the association between HDL-C and cognitive function. RESULTS: A U-shaped was observed between HDL-C and cognitive outcomes, individuals with higher risk in those with both low and very high HDL-C levels compared with those with midrange values. Very high HDL-C levels (≥ 2.50 mmol/L) were associated with increased risk of cognitive impairment (OR = 2.19; 95% CI, 1.12-4.28) compared with those with HDL-C levels in the range of 1.50 to 1.99 mmol/L in older adults after adjustment for confounding factors. Interaction test demonstrated that relationship between very high HDL-C and the risk of cognitive impairment was not changed in different sex and race group (P for interaction > 0.05). CONCLUSIONS: Very high HDL-C levels were associated with an increased risk of cognitive impairment. HDL-C may not be a protective factor for maintaining brain health in older adults at very high levels.

Lower energy intake associated with higher risk of cardiovascular mortality in chronic kidney disease patients on a low-protein diets.

OBJECTIVE: An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD. METHODS: This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD. RESULTS: Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83). CONCLUSION: CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD.

Dietary patterns and the risk of diabetes in Korean adults: A cross-sectional and prospective cohort study.

OBJECTIVE: The aim of this study was to identify dietary patterns associated with diabetes in Korean adults and to investigate their association with diabetes risk in both a cross-sectional and prospective study. METHODS: Predefined food groups collected by the Korea National Health and Nutrition Examination Survey (KNHANES 2015-2018, n = 19 721) were entered in a reduced rank regression (RRR) model, followed by stepwise linear regression analyses to identify the most predictive dietary patterns. We evaluated the construct validity of dietary patterns in two independent samples from KNHANES 2019 to 2021 (n = 14 223) and the Health Examinees (HEXA) cohort study (n = 30 013). Associations between dietary patterns and diabetes risk were examined using multivariable regression and multivariable-adjusted Cox proportional hazard models, respectively. RESULTS: A dietary pattern was identified with high positive loadings for refined white rice, kimchi and salted vegetables, wheat flour and bread, and seasonings, and high negative loadings for whole grains, legumes with tofu and soymilk, poultry, eggs, and plant oils. The higher pattern scores were significantly associated with diabetes risk in KNHANES 2015 to 2018 (male: odds ratio [OR]: 1.59; 95% confidence interval [CI]: 1.35, 1.88; female: OR: 1.37; 95% CI: 1.18, 1.52), KNHANES 2019 to 2021 (male: OR: 1.47; 95% CI: 1.01, 1.69; female: OR: 1.37; 95% CI: 1.18, 1.54), and HEXA study (male: hazard ratio [HR]: 1.10; 95% CI: 1.01, 1.34; female: HR: 1.24; 95% CI: 1.02, 1.52). CONCLUSIONS: Dietary patterns derived by RRR followed by stepwise linear regression analyses were associated with increased risks of diabetes among Korean adults.

Association of weight-adjusted waist index with all-cause mortality among non-Asian individuals: a national population-based cohort study.

INTRODUCTION: The Weight-Adjusted Waist Index (WWI) is a new indicator of obesity that is associated with all-cause mortality in Asian populations. Our study aimed to investigate the linear and non-linear associations between WWI and all-cause mortality in non-Asian populations in the United States, and whether WWI was superior to traditional obesity indicators as a predictor of all-cause mortality. METHODS: We conducted a cohort study using data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES), involving 18,592 participants. We utilized Cox proportional hazard models to assess the association between WWI, BMI, WC, and the risk of all-cause mortality, and performed subgroup analyses and interaction tests. We also employed a receiver operating characteristics (ROC) curve study to evaluate the effectiveness of WWI, BMI, and WC in predicting all-cause mortality. RESULTS: After adjusting for confounders, WWI, BMI, and WC were positively associated with all-cause mortality. The performance of WWI, BMI, and WC in predicting all-cause mortality yielded AUCs of 0.697, 0.524, and 0.562, respectively. The data also revealed a U-shaped relationship between WWI and all-cause mortality. Race and cancer modified the relationship between WWI and all-cause mortality, with the relationship being negatively correlated in African Americans and cancer patients. CONCLUSIONS: In non-Asian populations in the United States, there is a U-shaped relationship between WWI and all-cause mortality, and WWI outperforms BMI and WC as a predictor of all-cause mortality. These findings may contribute to a better understanding and prediction of the relationship between obesity and mortality, and provide support for effective obesity management strategies.

Implications of Race Adjustment in Lung-Function Equations.

BACKGROUND: Adjustment for race is discouraged in lung-function testing, but the implications of adopting race-neutral equations have not been comprehensively quantified. METHODS: We obtained longitudinal data from 369,077 participants in the National Health and Nutrition Examination Survey, U.K. Biobank, the Multi-Ethnic Study of Atherosclerosis, and the Organ Procurement and Transplantation Network. Using these data, we compared the race-based 2012 Global Lung Function Initiative (GLI-2012) equations with race-neutral equations introduced in 2022 (GLI-Global). Evaluated outcomes included national projections of clinical, occupational, and financial reclassifications; individual lung-allocation scores for transplantation priority; and concordance statistics (C statistics) for clinical prediction tasks. RESULTS: Among the 249 million persons in the United States between 6 and 79 years of age who are able to produce high-quality spirometric results, the use of GLI-Global equations may reclassify ventilatory impairment for 12.5 million persons, medical impairment ratings for 8.16 million, occupational eligibility for 2.28 million, grading of chronic obstructive pulmonary disease for 2.05 million, and military disability compensation for 413,000. These potential changes differed according to race; for example, classifications of nonobstructive ventilatory impairment may change dramatically, increasing 141% (95% confidence interval [CI], 113 to 169) among Black persons and decreasing 69% (95% CI, 63 to 74) among White persons. Annual disability payments may increase by more than $1 billion among Black veterans and decrease by $0.5 billion among White veterans. GLI-2012 and GLI-Global equations had similar discriminative accuracy with regard to respiratory symptoms, health care utilization, new-onset disease, death from any cause, death related to respiratory disease, and death among persons on a transplant waiting list, with differences in C statistics ranging from -0.008 to 0.011. CONCLUSIONS: The use of race-based and race-neutral equations generated similarly accurate predictions of respiratory outcomes but assigned different disease classifications, occupational eligibility, and disability compensation for millions of persons, with effects diverging according to race. (Funded by the National Heart Lung and Blood Institute and the National Institute of Environmental Health Sciences.).

Coffee consumption might be associated with lower potential risk and severity of metabolic syndrome: national health and nutrition examination survey 2003-2018.

BACKGROUND: Metabolic syndrome (MetS) is a clinical syndrome characterized by multiple metabolic disorders and is a serious global health problem. The coffee effect, acting as one of the most prevalent beverages on metabolic syndrome, is debatable. METHODS: We included patients from the National Health and Nutrition Examination Survey 2003-2018 and used a comprehensive evaluation called the MetS z-score to assess the severity of metabolic syndrome. The relationship between coffee, decaffeinated coffee, tea, and MetS z-scores was explored using a weighted linear regression. We also divided the participants into metabolic and non-metabolic syndrome groups according to the NCEP/ATP III criteria for the subgroup analysis. RESULTS: A total of 14,504 participants were included in this study. The results demonstrated that drinking more than three cups of coffee daily was significantly linked to lower MetS z-scores (p < 0.001). Daily coffee consumption was also associated with lower BMI (p = 0.02), systolic blood pressure (p < 0.001), Homeostatic Model Assessment for Insulin Resistance (p < 0.001), and triglycerides (p < 0.001), while it was positively correlated with HDL-C (p = 0.001). Participants who consumed more than three cups of coffee daily had a lower MetS z-score in the MetS (p < 0.001) and non-MetS (p = 0.04) groups. CONCLUSION: This research indicates that coffee consumption is linked to MetS severity. However, decaffeinated coffee and tea intake were unrelated to MetS severity.

Dietary inflammatory potential and the risk of nonfatal cardiovascular diseases in the China Health and Nutrition Survey.

BACKGROUND: To our knowledge, no evidence exists to link dietary inflammatory potential to cardiovascular disease (CVD) in China. Furthermore, the precise mechanisms underlying the link between a pro-inflammatory diet and CVD remain incompletely understood. OBJECTIVE: We aimed to investigate the relationship between dietary inflammatory potential and nonfatal CVD in the Chinese population and to explore the mediating role of insulin resistance. METHODS: A total of 4822 adults who participated in the China Health and Nutrition Survey (CHNS) were included in this analysis. The dietary inflammatory index (DII) was used to assess dietary inflammatory potential. Cox proportional hazards models and restricted cubic spline were applied to assess the longitudinal associations. The triglyceride-glucose (TyG) index was calculated to measure insulin resistance. Mediation analysis using a two-stage regression method for survival data was employed to explore the mediating effects of the TyG index on the association between DII score and nonfatal CVD. RESULTS: During a median follow-up of 18 y, 234 incident cases of nonfatal CVD, including 136 strokes and 114 myocardial infarctions (MIs), were observed. For each standard deviation of the DII score, nonfatal CVD incidence increased by 15% (hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.01-1.31), and stroke incidence increased by 22% (HR = 1.22, 95% CI: 1.03-1.45). DII score displayed a linear association with nonfatal CVD and stroke (P for nonlinearity = 0.250 and 0.238, respectively). No significant association was found between the DII score and MI. Mediation analyses showed that the TyG index mediated 5.90% and 9.35% of the total association between DII score and nonfatal CVD and stroke, respectively. CONCLUSIONS: This study provides evidence that dietary inflammatory potential is positively associated with nonfatal CVD and stroke in Chinese adults, and the association was partly mediated by insulin resistance.

National trends in nine key minerals intake (quantity and source) among U.S. adults, 1999 to march 2020.

BACKGROUND: Changes in economy and dietary guidelines brought a great shock to diet quality and meal behaviors, but if these transformations have extended to minerals intake and their sources was still poorly understood. It is essential to evaluate time trends in minerals intake and their sources to inform policy makers. OBJECTIVE: To investigate trends in minerals intake and their sources among U.S. adults. METHODS: This analysis used dietary data collected by 24-h recalls from U.S. adults (≥ 20 years) in NHANES (1999-March 2020). Minerals intake, age-adjusted percentage of participants meeting recommendations, and minerals sources were calculated among all participants and by population subgroups in each NHANES survey cycle. Weighted linear or logistic regression models were used to examine the statistical significance of time trends. RESULTS: A total of 48223 U.S. adults were included in this analysis. From 1999 to March 2020, intake of calcium (from 0.94 to 1.02 g/day), magnesium (from 308.07 to 321.85 mg/day), phosphorus (from 1.24 to 1.30 g/day), and sodium (from 3.24 to 3.26 mg/day) from food and beverages (FB) and dietary supplements (DSs) significantly increased, and intake of iron (from 19.17 to 16.38 mg/day), zinc (from 16.45 to 14.19 mg/day), copper (from 1.79 to 1.38 mg/day), and potassium (from 2.65 to 2.50 g/day) from FB + DSs decreased (all FDR < 0.05). Additionally, age-adjusted percentage of participants meeting recommendations for calcium, phosphorus, sodium, and selenium significantly increased, that for iron, potassium, zinc, and copper decreased (all FDR < 0.05). Minerals intake and time trends in minerals intake were highly variable depending on age, gender, race/ethnicity, education, and income. For example, white, higher socioeconomic status participants had a higher minerals intake (e.g. iron, zinc, and copper), but had a greater decrease in minerals intake. Furthermore, the percentage of minerals from milks and DSs decreased, and that from beverages increased. CONCLUSION: From 1999 to March 2020, both minerals intake and their sources experienced a significant alteration among U.S. adults. Many differences in minerals intake and their food sources across sociodemographic characteristics appeared to narrow over time. Although some improvements were observed, important challenges, such as overconsumption of sodium and underconsumption of potassium, calcium, and magnesium, still remained among U.S. adults.

Higher oxidative balance score was associated with decreased risk of erectile dysfunction: a population-based study.

BACKGROUND: Erectile dysfunction (ED) is a prevalent condition that is thought to be significantly impacted by oxidative stress. The oxidative balance score (OBS) has been built to characterize the state of antioxidant/pro-oxidant balance. There is less known regarding the relationship of OBS with ED. METHODS: This study conducted cross-sectional analyses on 1860 males who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004. OBS was constructed by the 16 dietary components and 4 lifestyle factors. Self-reported ED was defined as men who indicated that they "never" or "sometimes" could achieve or keeping an erection adequate for satisfactory intercourse. Multivariate logistic regression models were applied to examine the association between OBS and the risk of ED. RESULTS: Among 1860 participants, the median OBS was 20 (IQR 15-26), and OBS was lower in males with ED vs. those without ED (P = 0.001). The results of our analyses indicated a negative correlation between OBS and ED among male subjects. Specifically, each one-unit increase in the continuous OBS was relate to 3% reduction in the odds of ED after full adjustment. Moreover, when extreme OBS quartiles were compared, the adjusted odds ratio (95% confidence interval) for the 4th OBS category was 0.53 (0.32 to 0.88) after full adjustment (P for trend < 0.05). There was also statistical significance in the relationships between dietary/lifestyle OBS with ED, and the association between lifestyle OBS and ED may be even tighter. For each unit increase in lifestyle OBS, the odds of ED decreased by 11% after full adjustment. CONCLUSION: Higher OBS was associated with reduced risk of ED in U.S. males. These findings suggested that adopting an antioxidant-rich diet and engaging in antioxidant-promoting lifestyle behaviors may contribute to a lower incidence of ED. These results provided recommendations for a comprehensive dietary and lifestyle antioxidants for ED patients.

Association of the live microbe intake from foods with all-cause and cardiovascular disease-specific mortality: a prospective cohort study.

BACKGROUND: Live dietary microbes have been hypothesized to promoting human health. However, there has been lacking perceptions to crystallize nexus between consumption of foods with live microbes and mortality. OBJECTIVE: To investigate the association of consumption of foods with medium to high amounts of live microbes with all-cause, cancer-specific, and cardiovascular disease (CVD)-specific mortality. METHODS: The data were obtained from the National Health and Nutrition Examination Survey 1999-2018 at baseline linked to the 2019 National Death Index records. Based on consumption of foods that were categorized as either having medium or high microbial content (MedHi foods), participants were classified into three groups. Kaplan-Meier survival curves and multivariable Cox regression models were used to estimate the association of consumption of MedHi foods with mortality. Population-attributable fractions (PAFs) of consumption of MedHi foods in relation to mortality risk were also estimated. RESULTS: A total of 35,299 adults aged ≥ 20 years were included in this study. During a median follow-up of 9.67 years, compared with adults in G1, those in G3 had 16% (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.77-0.90) reduced risk of all-cause mortality, and 23% (HR, 0.77; 95% CI, 0.67-0.89) reduced risk of CVD-specific mortality. The PAF of high (G3) vs. intermediate or low consumption of MedHi foods (G1 + G2) with all-cause and CVD-specific mortality was 3.4% and 4.3%, respectively. CONCLUSIONS: Consumption of foods with higher microbial concentrations is associated with a reduced risk of all-cause and CVD-specific mortality in US adults.

Nonlinear relationship between oxidative balance score and hyperuricemia: analyses of NHANES 2007-2018.

BACKGROUND: Limited data regarding the correlation between oxidative balance score (OBS) and hyperuricemia highlights the necessity for thorough investigations. This study aims to examine the link between OBS, which incorporates dietary and lifestyle factors, and the occurrence of hyperuricemia. METHODS: We conducted a cross-sectional study involving 13,636 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). The oxidative balance score (OBS) was determined based on four lifestyle factors and sixteen dietary nutrients. We assessed the levels of serum uric acid (SUA) and the occurrence of hyperuricemia as outcomes. Weighted logistic regression and linear models were used for statistical analysis, using Restricted Cubic Splines (RCS) to examine potential nonlinear associations. Subgroup analysis and sensitivity assessments were performed to identify any variations and ensure the robustness of the findings. RESULTS: Higher OBS was consistently correlated with decreased SUA levels and a reduced prevalence of hyperuricemia. RCS highlighted a significant negative nonlinear association, particularly in females. Subgroup analysis revealed gender-based differences and interactive correlation, providing additional insights regarding OBS and hyperuricemia relationship. CONCLUSION: This study underscores a robust negative correlation between OBS and SUA levels as well as the incidence of hyperuricemia, emphasizing the importance of dietary and lifestyle factors. Incorporating RCS, subgroup analysis, and sensitivity assessments enhances the depth of our findings, providing valuable insights for further research.