Association of Dietary Fiber and Measures of Physical Fitness with High-Sensitivity C-Reactive Protein.

Dietary fiber intake and physical fitness are independently associated with high-sensitivity C-reactive protein (hs-CRP) levels. Nevertheless, the association between dietary fiber intake, measures of physical fitness, and hs-CRP levels has not yet been fully evaluated. We investigated the influence of a combination of dietary fiber intake and measures of physical fitness, including hand grip strength, resistance training, and metabolic equivalents of tasks, on hs-CRP levels. Data collected from the Korea National Health and Nutrition Examination Survey (KNHANES) spanning 2015 to 2018 were used in this study. A total of 16,934 participants (7434 men and 9500 women aged ≥19 years) were included in this study. After adjusting for confounding factors (age, education, income, marital status, smoking status, drinking habits, total energy intake, and aerobic physical activity), we employed a multivariable logistic model to examine the association of dietary fiber intake and measures of physical fitness with hs-CRP levels. Among women, the odds of high hs-CRP levels were lower in those with the highest dietary fiber intake and superior grip strength compared to in women with the lowest dietary fiber intake and weaker grip strength (odds ratio [OR] = 0.40, 95% confidence interval [CI] = 0.24-0.68). The highest dietary fiber intake who participated in resistance exercise at least three times per week had a reduced odds of high hs-CRP levels compared with those with the lowest dietary fiber intake who did not engage in resistance exercise in both men and women (OR = 0.53, 95% CI = 0.32-0.89; OR = 0.40, 95% CI = 0.19-0.84, respectively). Our findings indicate that dietary fiber intake and high levels of physical fitness were associated with reduced odds of elevated hs-CRP levels.

Unveiling the Therapeutic Potential and Healthcare Applications of Marine Therapy: A Systematic Review with Meta-Analysis and Meta-Regression.

This study was conducted to estimate the effectiveness of marine-derived resources for treating specific diseases, as well as identify the most effective methods for applying such resources in therapeutic applications. Bibliographic databases (PubMed, Embase, and Cochrane) were searched from their inception until May 2023 using Medical Subject Headings terms and text keywords related to seawater, mineral water, or ocean therapy. Fifteen eligible studies were included, involving 1325 participants aged 42.7-63.0 years. In the subgroup analysis based on treatment type, the mean difference was -1.581 (95% CI: -1.889, -1.274) for seawater with sun exposure and -1.210 (95% CI: -1.417, -1.002) for seawater with sun exposure, mud pack application, and sulfur pool therapy. The pooled standardized mean difference was calculated for different outcomes; the results were -1.110 (95% CI: -3.028, 0.806) for osteoarthritis severity, -0.795 (95% CI: -0.982, -0.607) for arthritis pain, -1.623 (95% CI: -2.036, -1.209) for fibromyalgia pain, and -1.498 (95% CI: -1.888, -1.108) for quality of life. Marine therapy is, therefore, promising for treating chronic skin issues, easing musculoskeletal discomfort, and enhancing the quality of life among patients with musculoskeletal pain.

Interactions between Bitter Taste Receptor Gene Variants and Dietary Intake Are Associated with the Incidence of Type 2 Diabetes Mellitus in Middle-Aged and Older Korean Adults.

The relationship between the variants of bitter taste receptor gene TAS2R4, dietary intake, and incidence of type 2 diabetes mellitus (T2DM) remains unclear. Hence, we aimed to examine the association of TAS2R4 rs2233998 variants with T2DM incidence in middle-aged and older Korean adults to understand if their association was modulated by dietary intake. Data of the Ansan-Ansung cohort from the Korean Genome and Epidemiology Study were used in this study. A total of 4552 Korean adults aged 40-69 years with no history of T2DM or cancer at baseline were followed-up for 16 years. Dietary intake was assessed using a 103-item food frequency questionnaire, and new T2DM cases were defined based on the World Health Organization and International Diabetes Federation criteria. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for T2DM incidence. During the mean follow-up period of 11.97 years, 1082 (23.77%) new T2DM cases were identified. Women carrying the TT genotype of TAS2R4 rs2233998 exhibited 1.48 times higher incidence of T2DM (HR: 1.48; 95 CI: 1.13-1.93) than those carrying the CC genotype. TAS2R4 rs2233998 variants were positively associated with the incidence of T2DM among Korean women with high intakes of carbohydrates or sugars and low intakes of fruits or vegetables. TT carrier women in the highest tertile of carbohydrate or sugar intake exhibited an increased incidence of T2DM (HR: 2.08, 95% CI: 1.33-3.27 for carbohydrates; HR: 2.31, 95% CI: 1.53-3.51 for sugars) than CC carrier women. Women carrying the TT genotype in the lowest tertile exhibited an increased incidence of T2DM (HR: 1.55, 95% CI: 1.02-2.37 for vegetables; HR: 1.62, 95% CI: 1.06-2.48 for fruits) than women carrying the CC genotype in the highest tertile of vegetable or fruit consumption. However, no association was observed between TAS2R4 rs2233998 variants and dietary intake with T2DM incidence in Korean men. Our findings suggest that variants of TAS2R4 rs2233998 are associated with T2DM incidence, and their associations are strengthened by excessive intake of carbohydrates or sugars and inadequate intake of fruits or vegetables. Diet encompassing optimal intake of carbohydrates or sugars and high intake of fruits or vegetables may minimize the risk of developing T2DM.

Concurrent presence of high serum uric acid and inflammation is associated with increased incidence of type 2 diabetes mellitus in Korean adult population.

Although serum uric acid level and systemic inflammation have been highlighted as risk factors for type 2 diabetes mellitus (T2DM), little is known about these associations in the Korean population. Thus, we examined the individual and combined associations of serum uric acid and systemic inflammation (evaluated using high-sensitivity C-reactive protein [hs-CRP] measurement) with the future risk of T2DM. A total of 4152 Korean adults aged 45-76 years without T2DM, cancer, or gout at baseline in 2007-2008 from the Korean Genome and Epidemiology Study were followed up until 2016. Cox proportional hazard models were used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of T2DM according to sex-specific tertiles of serum uric acid and hs-CRP levels after adjustment for confounders. During the mean follow-up of 7.3 years, 548 participants developed T2DM. High serum uric acid and hs-CRP levels were independently associated with an increased incidence of T2DM. The multivariable-adjusted HRs (95% CIs) for the incidence of T2DM in the highest tertiles of serum uric acid and hs-CRP were 1.54 (1.24-1.93) and 1.90 (1.48-2.43), respectively. High levels of serum uric acid and hs-CRP in combination were associated with an increased incidence of T2DM (HR: 4.69; 95% CI: 2.81-7.84) compared to low levels of serum uric acid and hs-CRP. These findings suggest that the combination of high serum uric acid and hs-CRP levels was significantly associated with an elevated incidence of T2DM; however, their synergistic effects were not observed in middle-aged and elderly Korean adults.

High pre-pregnancy BMI with a history of gestational diabetes mellitus is associated with an increased risk of type 2 diabetes in Korean women.

Despite the importance of pre-pregnancy body mass index (BMI) and a history of gestational diabetes mellitus (GDM) in the progression of GDM to type 2 diabetes, few studies have evaluated the combined effect of high pre-pregnancy BMI and GDM status on the future development of type 2 diabetes in Korean women. This study aimed to examine the relationship of pre-pregnancy BMI and GDM history with the risk of type 2 diabetes among Korean women. In addition, the effects of pre-pregnancy BMI and current BMI on the risk of type 2 diabetes were evaluated. Women who gave birth in the Health Examinees Study of the Korean Genome and Epidemiology Study from 2004 to 2013 (n = 59,258) were included in this study. Multivariable logistic regression was used to examine the association of pre-pregnancy BMI categories (underweight: <18.5 kg/m2; normal: 18.5-22.9 kg/m2; overweight: 23.0-24.9 kg/m2; obese: ≥25.0 kg/m2) and GDM history with the risk of type 2 diabetes after controlling for the following covariates: age, education, income, smoking status before the first pregnancy, alcohol consumption, regular exercise, menarche age, first pregnancy age, and first pregnancy outcome. Compared to women with normal pre-pregnancy BMIs, women with overweight and obese pre-pregnancy BMIs had higher odds of developing type 2 diabetes (adjusted odds ratio [AOR]: 1.13, 95% confidence interval [CI]: 1.02-1.25 and AOR: 1.29, 95% CI: 1.10-1.50, respectively) after controlling for covariates. Women with pre-pregnancy BMIs <23 kg/m2 and current BMIs ≥23 kg/m2 had increased odds of developing type 2 diabetes (AOR: 1.64, 95% CI: 1.51-1.78) compared to those with pre-pregnancy BMIs <23 kg/m2 and current BMIs <23 kg/m2. Among women without a history of GDM, those with overweight and obese pre-pregnancy BMIs had increased odds of developing type 2 diabetes compared to those with normal pre-pregnancy BMIs (AOR: 1.12, 95% CI: 1.01-1.24 and AOR: 1.23, 95% CI: 1.05-1.44, respectively). Among women with GDM, those with obese pre-pregnancy BMIs had increased odds of developing type 2 diabetes (AOR: 3.84, 95% CI: 1.52-9.87). This study showed that there was a higher likelihood of developing type 2 diabetes in women who were overweight or obese before pregnancy with a history of GDM compared to their counterparts without a history of GDM. Furthermore, high pre-pregnancy BMI or high current BMI increased the risk of type 2 diabetes in Korean women, regardless of GDM history. This emphasizes the importance of maintaining a healthy weight status before and after pregnancy to prevent the future risk of type 2 diabetes.

Positive association between dietary acid load and future insulin resistance risk: findings from the Korean Genome and Epidemiology Study.

BACKGROUND: Acid-base homeostasis is increasingly being recognized to play an important role in normal metabolic function. However, prospective studies on the relationship between diet-induced acid-base imbalance and insulin resistance among Asian populations have been limited. Thus, we investigated whether diet-induced metabolic acidosis was prospectively associated with insulin resistance risk in middle-aged and older Korean adults. METHODS: In total, 5406 participants from the Korean Genome and Epidemiology Study without type 2 diabetes, insulin resistance, cancer, or renal diseases at baseline examination were included in this study. To estimate diet-induced metabolic acidosis, we used potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores calculated from the usual dietary intake assessed by a validated 103-item food frequency questionnaire at baseline. Multivariable Cox proportional hazard models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of insulin resistance incidence. RESULTS: During a mean follow-up period of 7.4 years, we documented 3449 insulin resistance cases. In the fully adjusted model, the future insulin resistance risk was significantly higher among participants in the highest quartiles of PRAL (HR: 1.30, 95% CI: 1.13-1.48, Ptrend = 0.0002) and NEAP (HR: 1.30, 95% CI: 1.14-1.49, Ptrend = 0.0008) than among those in the lowest quartiles. Associations were slightly strengthened among men, adults < 50 years old, obese participants, or those with low physical activity levels. CONCLUSIONS: Our findings suggested that diet-dependent acid load was positively associated with the future development of insulin resistance, suggesting effect modification by sex, age, the presence of obesity, and physical activity levels.

Dietary Protein and Fat Intake Affects Diabetes Risk with CDKAL1 Genetic Variants in Korean Adults.

Cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) is one of the strongest diabetes loci identified to date; evidence suggests that it plays an important role in insulin secretion. Dietary factors that affect insulin demand might enhance the risk of diabetes associated with CDKAL1 variants. Our aim was to examine the interactions between dietary protein and fat intake and CDKAL1 genetic variants in relation to the risk of diabetes in Korean adults. Single nucleotide polymorphisms (SNPs) were selected with a genome-wide association study (GWAS) for diabetes after adjustment for age, gender, and examination site. Using data from the Health Examinees (HEXA) Study of the Korean Genome and Epidemiology Study (KoGES), 3988 middle-aged Korean adults between 40-76 years of age (2034 men and 1954 women) were included in the study. Finally, rs7756992 located within the CDKAL1 gene region was selected from GWAS (p-value < 5 × 10-8). Multivariable logistic regression models were used to evaluate the interactions between genotypes and dietary protein and fat intake in relation to diabetes risk after adjustment for age, gender, BMI, waist circumference, physical activity, smoking status, drinking habits, and examination site. Significant interactions between CDKAL1 rs7756992 and dietary protein and fat intake for the risk of diabetes were observed in men (p-value < 0.05). In women, significant interactions between dietary protein and fat intake and CDKAL1 variants (rs7756992) were associated with increased risk of diabetes (p-value < 0.05). Dietary protein and fat intake interacted differently with CDKAL1 variants in relation to the risk of diabetes in Korean adults of both genders. These findings indicate that CDKAL1 variants play a significant role in diabetes and that dietary protein and fat intake could affect these associations.

Association of Night Eating with Depression and Depressive Symptoms in Korean Women.

This study examined the associations of night eating with depression and depressive symptoms in Korean adults. The study used a nationally representative sample of 31,690 Korean adults (≥19 years old) from the Korea National Health and Nutrition Examination Survey from 2008 to 2013. The participants were divided into two groups based on status of night eating: night eaters (consuming ≥25% of total daily energy intake between 21:00 and 06:00) and non-night eaters. Depression was defined based on diagnosis by a doctor, whereas depressive symptoms were defined as feelings of sadness or desperation for more than two weeks in the last one year. Multivariable logistic regression analyses were performed to examine the relationship between night eating and odds of depression and depressive symptoms after controlling for age, education, income, marital status, drinking, smoking, day of recalled intake, physical activity, body mass index, menopausal status (women only), total energy intake, and sleep duration. A total of 14.3% of Korean adults were night eaters. Night eaters were more likely to be men, young, less educated, single, drinkers, current smokers, and not employed (all ps < 0.05). In women, night eaters had higher odds of depression (adjusted odds ratio [AOR], 1.33; 95% confidence interval [CI], 1.02-1.75; p for trend = 0.0389) and depressive symptoms (AOR, 1.20; 95% CI, 1.01-1.41; p for trend = 0.0382) compared with non-night eaters. However, no associations of night eating with depression and depressive symptoms were found in men. Night eaters had higher odds of depression and depressive symptoms only in Korean women. Future studies are warranted to elucidate the underlying psychological and behavioral mechanisms that in turn may shed light on the factors influencing both night eating and odds of depression and depressive symptoms.

Dietary inflammatory index is positively associated with serum high-sensitivity C-reactive protein in a Korean adult population.

OBJECTIVE: To our knowledge, only a few studies have explored the relationship between the inflammatory potential of diet and serum inflammatory markers in Korean adults. The likely novel aim of this study was to examine the association between the dietary inflammatory index (DII) and serum high-sensitivity C-reactive protein (hs-CRP) in a Korean adult population. METHODS: A cross-sectional study was conducted using the data set from the Korea National Health and Nutrition Examination Survey (KNHANES) 2015. Korean adults ≥19 y of age with hs-CRP values were included in this study. After excluding individuals with missing variables for covariates, the final analytic sample for the study was 3014 adults (1295 men and 1719 women). DII scores were calculated from a 1-d 24-h dietary recall, and hs-CRP was measured using the immunoturbidimetric method. Multivariable logistic regression analyses were performed to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to test the effect of the DII score on serum hs-CRP as dichotomous (>2 versus ≤2 mg/L). RESULTS: A significant association was observed between increasing DII scores and elevated hs-CRP. Korean adults in the highest quintile of the DII (indicating the most proinflammatory diet), compared with the lowest quintile of the DII (indicating the most anti-inflammatory diet), had increased odds of having elevated hs-CRP concentrations (>2 mg/L; AOR, 1.70; 95% CI, 1.07-2.69; Ptrend < 0.0001) after controlling for age, sex, education, marital status, alcohol consumption, smoking status, body mass index, high-density lipoprotein cholesterol, and physical activity. CONCLUSION: Higher DII scores were positively associated with elevated hs-CRP levels in Korean adults. Because inflammation affects the risk for cancer, cardiovascular disease, and other inflammation-related conditions, future studies are warranted to examine the effect of the DII on other inflammatory biomarkers and chronic disease outcomes among the Korean population.

Compliance to Prenatal Iron and Folic Acid Supplement Use in Relation to Low Birth Weight in Lilongwe, Malawi.

Prenatal iron and folic acid (IFA) supplements are offered free to all pregnant women in Malawi to reduce maternal anemia and improve birth outcomes. We investigated the association between self-reported compliance to IFA intake and risk of low birth weight (LBW). Pregnant women who attended Bwaila Maternity Wing of Lilongwe District Hospital for delivery were recruited (n = 220). We used a questionnaire to collect self-reported information on IFA use and maternal sociodemographic data. Before delivery, blood samples for maternal hemoglobin (Hb) and folate status, and upon delivery, birth weight, and other newborn anthropometrics were measured. We used multivariable logistic regression to determine risk of LBW by prenatal IFA intake. The self-reported number of IFA pills taken during pregnancy was positively associated with Hb, but not serum and RBC folate concentration: <45, 45⁻89 and ≥90 pills taken corresponded with mean (SD) Hb 10.7 (1.6), 11.3 (1.8), and 11.7 (1.6) g/dL, respectively (p = 0.006). The prevalence of LBW was 20.1%, 13.5% and 5.6% for those who reported taking IFA pills <45, 45⁻89, and ≥90 pills, respectively (p = 0.027). Taking >60 IFA pills reduced risk of LBW delivery (OR (95% CI) = 0.15 (0.03⁻0.70), p = 0.033) than taking ≤30 pills. Self-reported compliance to IFA use is valid for assessing prenatal supplement program in Malawi, especially Hb status, and can reduce the rate of LBW.

Eating Alone is Differentially Associated with the Risk of Metabolic Syndrome in Korean Men and Women.

Few studies have examined overall patterns of eating alone in relation to the risk of metabolic syndrome (MetS) in Korean populations. The present study aimed to examine the relationship between patterns of eating alone and the risk of MetS in Korean adults. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) for 2013⁻2015 were used, with 8988 Korean adult participants, including 3624 men and 5364 women, aged 18 to 64 years. Patterns of eating alone were categorized into eight groups based on the total frequency of eating alone on a daily basis in the past one year: (1) three times for breakfast, lunch, and dinner; (2) twice for breakfast and dinner; (3) twice for lunch and dinner; (4) twice for breakfast and lunch; (5) once for breakfast only; (6) once for lunch only; (7) once for dinner only; and (8) never eating alone. The presence of MetS has been defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF). Multivariable logistic regression analyses were performed to assess the association between patterns of eating alone versus the risk of MetS after controlling for age, income, occupation, number of family members, generation types, marital status, smoking status, and physical activity. The prevalence of MetS was the highest in men and women aged 40⁻64 who had breakfast, lunch, and dinner alone (50.1% and 36.8%, respectively). Men who had dinner alone or lunch and dinner alone compared with those who eat with others had a significantly higher risk of MetS, with adjusted odds ratios (AOR) of 1.51, and a 95% confidence interval (CI) of 1.06⁻2.16; and an AOR of 1.54, with a 95% CI of 1.05⁻2.25, respectively. Women who had breakfast alone compared with those who ate with others had a significantly lower risk of MetS (AOR 0.70, 95% CI 0.53⁻0.94). In conclusion, patterns of eating alone are differentially associated with the risk of MetS in a representative sample of Korean adults. Future studies are warranted to identify dietary patterns across the different eating alone patterns in relation to various health outcomes in Korean adult populations.

Pre-Pregnancy Body Mass Index Is Associated with Dietary Inflammatory Index and C-Reactive Protein Concentrations during Pregnancy.

There have been a limited number of studies examining the association between pre-pregnancy body mass index (BMI) and dietary inflammation during pregnancy. Our aim is to examine the association between pre-pregnancy BMI and the Dietary Inflammatory Index (DII)™ and C-reactive protein (CRP) concentrations during pregnancy. The study included 631 pregnant American women from the National Health and Nutrition Examination Survey (NHANES) cross-sectional examinations from 2003 to 2012. Pre-pregnancy BMI was calculated based on self-reported pre-pregnancy weight and measured height. The cut-offs of <18.5 (underweight), 18.5-24.9 (normal), 25.0-29.9 (overweight), and ≥30 kg/m² (obese) were used to categorize the weight status of pregnant women prior to pregnancy. The DII, a literature-based dietary index to assess the inflammatory properties of diet, was estimated based on a one-day 24-h recall. Multivariable linear and logistic regressions were performed to estimate beta coefficients and the adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) on the association of pre-pregnancy BMI categories with the DII and CRP concentrations during pregnancy. After controlling for variables including: race/ethnicity, family poverty income ratio, education, marital status, month in pregnancy, and smoking status during pregnancy; women who were obese before pregnancy (n = 136) had increased odds for being in the highest tertile of the DII and CRP concentrations compared to women with normal weight (AORs 2.40, 95% CIs 1.01-5.71; AORs 24.84, 95% CIs 6.19-99.67, respectively). These findings suggest that women with pre-pregnancy obesity had greater odds of reporting higher DII and having elevated CRP. In conclusion, high pre-pregnancy BMI was associated with increased odds of pro-inflammatory diet and elevated CRP levels during pregnancy in the USA.

Dietary Patterns During Pregnancy are Associated with Gestational Weight Gain.

Objective The role of diet during pregnancy on gestational weight gain is unclear. This study aimed to evaluate the hypothesis that dietary patterns during pregnancy are differentially associated with the adequacy of gestational weight gain at different stages of pregnancy. Methods A total of 391 pregnant women in National Health and Nutrition Examination Survey (NHANES) 2003-2006 were included. Dietary intake was obtained using a National Cancer Institute's food-frequency questionnaire. Results Three dietary patterns were identified by factor analysis with 36 food groups among pregnant women, and they were named according to food group factor loadings: 'mixed', 'healthy', and 'western'. The 'mixed' pattern characterized by a high intake of meat, dairy products, fruits, vegetables, potatoes, nuts and seeds and sweets. After adjusting for maternal sociodemographic variables and physical activity level, women in the highest tertile of 'mixed' pattern score had significantly greater odds of being in the inadequate gestational weight gain compared to those in the lowest tertile (adjusted odds ratio (AOR) 4.72; 95 % CI 1.07-20.94). Women in the mid tertile of the 'mixed' pattern had significantly lower odds of being in the excessive gestational weight gain compared to those in the lowest tertile (AOR 0.39; 95 % CI 0.15-0.99). Conclusion These results suggest that a diet high in meat, dairy products, fruits, vegetables, potatoes, and nuts and seeds during pregnancy might be associated with reducing excessive gestational weight gain.

Soy isoflavones as safe functional ingredients.

In recent years, isoflavones have increased in popularity as an alternative to estrogen therapy, particularly after the Women's Health Initiative demonstrated an increased risk of breast cancer, stroke, and heart attacks in response to estrogen and progesterone intervention. Isoflavones are heterocyclic phenols with structural similarity to estradiol-17beta and selective estrogen receptor modulators. Actions at the cellular level depend on the target tissue, receptor status of the tissue, and the level of endogenous estrogen. Clinical studies of soy-based diets evaluating the relation between soy consumption and serum lipid concentrations revealed that soy consumption significantly decreased total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. Epidemiological studies suggest a protective effect of soy protein on breast tissue as evidenced by the lower rates of breast cancer in East Asian countries where soy is a predominant part of the diet. Soy products also alleviate menopausal symptoms by reducing hot flashes. However, whether these biological effects of soy products originated from isoflavones is not clear. Furthermore, data available from human studies on the effect of isoflavones on osteoporosis are limited, and additional studies are needed to support a role in osteoporosis prevention. To date, no adverse effects of short- or long-term use of soy proteins are known in humans, and the only adverse effects known are those reported in animals. In conclusion, isoflavones are biologically active compounds, and current data are insufficient to draw definitive conclusions regarding the use of isoflavones as an alternative to estrogen for hormone replacement in postmenopausal women. Large, long-term intervention studies examining adverse effects and disease outcomes are needed before definitive conclusion can be drawn.