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Fe and iodine deficiencies are among the common forms of nutritional deficiencies globally and cause detrimental effects on mother and child. In developing countries, strategies to address these problems rarely use preventative dietary approaches. This cross-sectional study aims to ascertain whether dietary diversity score (DDS) and dietary patterns (DP) can predict the associated risk (AR) of Fe and iodine deficiencies in mother-toddler dyads during the dry/lean season in northern Ghana. Data were collected from women (15-49 years; n 118) and their toddlers (6-23 months, n 121). Dyads DDS and DP were calculated from their food intake recall. Multivariable logistic regression models were used to examine whether DDS, DP and socio-demographic factors predict higher odds of Fe and iodine deficiencies in dyads. DDS and DP predicted Fe and iodine deficiencies AR. Compared with DDS ≥4, women with DDS <4 have higher odds of Fe deficiency (ID) (adjusted OR (AOR) 1·82, 95 % CI 1·03, 3·21) and iodine deficiency (AOR 9·73, 95 % CI 3·19, 29·67). Two DP emerged in principal component analyses, 'rural elites diet' predicted ID risk in mothers (AOR 8·65, 95 % CI 1·76, 42·39), while 'indigenous diet' predicted iodine deficiency risk (AOR 11·41, 95 % CI 1·36, 95·97) in mothers only. The AR of Fe and iodine deficiencies in vulnerable populations may be predicted by diet-based measures in northern Ghana. We recommend further research into DDS and DP to predict Fe and iodine status of mother-toddler dyads in Ghana.
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OBJECTIVE: To investigate trends in total fat and fatty acid intakes and chronic health conditions among Korean adults over nine years between 2007 and 2015. DESIGN: Cross-sectional, observational study using a stratified, multistage probability sampling design at a national level. Intakes of total fat and fatty acids were estimated from 24 h dietary recalls by sex and age groups. Trends of total fat and fatty acid intakes were determined by multiple linear regression after adjusting for covariates. Trends in age-standardized prevalence of obesity, hypercholesterolaemia and hypertriacylglycerolaemia were examined by sex. SETTING: Korea.ParticipantsPopulation data of 47749 healthy adults (aged ≥19 years) derived from the Korea National Health and Nutrition Examination Survey between 2007 and 2015. RESULTS: Over the survey period, daily intakes of energy and total, saturated, monounsaturated, polyunsaturated, n-3 and n-6 fats (grams and percentage of energy (%E)) increased steadily. In all sex and age groups, significant increases were seen in SFA intake from 9·9 g (4·7 %E) to 12·0 g (5·3 %E) and in MUFA intake from 9·9 g (4·6 %E) to 13·3 g (5·8 %E). The prevalence of hypercholesterolaemia increased from 10·7 to 17·9 % over the same period. CONCLUSIONS: In Korean adults, total fat, SFA and other fatty acids have been increasing along with the prevalence of hypercholesterolaemia. This information can help set adequate macronutrient and fatty acid distribution ranges in developing population-specific preventive strategies against diet-related illness.
Subject(s)
Chronic Disease/epidemiology , Diet/trends , Dietary Fats/analysis , Fatty Acids/analysis , Adult , Aged , Cross-Sectional Studies , Female , Humans , Hypercholesterolemia/epidemiology , Male , Middle Aged , Nutrition Surveys , Obesity/epidemiology , Prevalence , Republic of Korea/epidemiology , Young AdultABSTRACT
BACKGROUND: The association between Institute of Medicine (IOM) guidelines and pregnancy outcomes across ethnicities is uncertain. We evaluated the associations of gestational weight gain (GWG) outside 2009 IOM guidelines, with maternal and infant outcomes across the USA, western Europe and east Asia, with subgroup analyses in Asia. The aim was to explore ethnic differences in maternal prepregnancy body mass index (BMI), GWG and health outcomes across these regions. METHODS: Systematic review, meta-analysis and meta-regression of observational studies were used for the study. MEDLINE, MEDLINE In-Process, Embase and all Evidence-Based Medicine (EBM) Reviews were searched from 1999 to 2017. Studies were stratified by prepregnancy BMI category and total pregnancy GWG. Odds ratio (ORs) 95% confidence intervals (CI) applied recommended GWG within each BMI category as the reference. Primary outcomes were small for gestational age (SGA), preterm birth and large for gestational age (LGA). Secondary outcomes were macrosomia, caesarean section and gestational diabetes. RESULTS: Overall, 5874 studies were identified and 23 were included (n = 1,309,136). Prepregnancy overweight/obesity in the USA, Europe and Asia was measured at 42%, 30% and 10% respectively, with underweight 5%, 3% and 17%. GWG below guidelines in the USA, Europe and Asia was 21%, 18% and 31%, and above was 51%, 51% and 37% respectively. Applying regional BMI categories in Asia showed GWG above guidelines (51%) was similar to that in the USA and Europe. GWG below guidelines was associated with a higher risk of SGA (USA/Europe [OR 1.51; CI 1.39, 1.63]; Asia [1.63; 1.45, 1.82]) and preterm birth (USA/Europe [1.35; 1.17, 1.56]; Asia [1.06; 0.78, 1.44]) than GWG within guidelines. GWG above guidelines was associated with a higher risk of LGA (USA/Europe [1.93; 1.81, 2.06]; Asia [1.68; 1.51 , 1.87]), macrosomia (USA/Europe [1.87; 1.70, 2.06]; Asia [2.18; 1.91, 2.49]) and caesarean (USA/Europe [1.26; 1.21, 1.33]; Asia [1.37; 1.30, 1.45]). Risks remained elevated when regional BMI categories were applied for GWG recommendations. More women in Asia were categorised as having GWG below guidelines using World Health Organization (WHO) (60%) compared to regional BMI categories (16%), yet WHO BMI was not accompanied by increased risks of adverse outcomes. CONCLUSIONS: Women in the USA and western Europe have higher prepregnancy BMI and higher rates of GWG above guidelines than women in east Asia. However, when using regional BMI categories in east Asia, rates of GWG above guidelines are similar across the three continents. GWG outside guidelines is associated with adverse outcomes across all regions. If regional BMI categories are used in east Asia, IOM guidelines are applicable in the USA, western Europe and east Asia.
Subject(s)
Fetal Weight/ethnology , Pregnancy Outcome/ethnology , Weight Gain/ethnology , Weight Gain/physiology , Adult , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy ComplicationsABSTRACT
IMPORTANCE: Body mass index (BMI) and gestational weight gain are increasing globally. In 2009, the Institute of Medicine (IOM) provided specific recommendations regarding the ideal gestational weight gain. However, the association between gestational weight gain consistent with theIOM guidelines and pregnancy outcomes is unclear. OBJECTIVE: To perform a systematic review, meta-analysis, and metaregression to evaluate associations between gestational weight gain above or below the IOM guidelines (gain of 12.5-18 kg for underweight women [BMI <18.5]; 11.5-16 kg for normal-weight women [BMI 18.5-24.9]; 7-11 kg for overweight women [BMI 25-29.9]; and 5-9 kg for obese women [BMI ≥30]) and maternal and infant outcomes. DATA SOURCES AND STUDY SELECTION: Search of EMBASE, Evidence-Based Medicine Reviews, MEDLINE, and MEDLINE In-Process between January 1, 1999, and February 7, 2017, for observational studies stratified by prepregnancy BMI category and total gestational weight gain. DATA EXTRACTION AND SYNTHESIS: Data were extracted by 2 independent reviewers. Odds ratios (ORs) and absolute risk differences (ARDs) per live birth were calculated using a random-effects model based on a subset of studies with available data. MAIN OUTCOMES AND MEASURES: Primary outcomes were small for gestational age (SGA), preterm birth, and large for gestational age (LGA). Secondary outcomes were macrosomia, cesarean delivery, and gestational diabetes mellitus. RESULTS: Of 5354 identified studies, 23 (n = 1â¯309â¯136 women) met inclusion criteria. Gestational weight gain was below or above guidelines in 23% and 47% of pregnancies, respectively. Gestational weight gain below the recommendations was associated with higher risk of SGA (OR, 1.53 [95% CI, 1.44-1.64]; ARD, 5% [95% CI, 4%-6%]) and preterm birth (OR, 1.70 [1.32-2.20]; ARD, 5% [3%-8%]) and lower risk of LGA (OR, 0.59 [0.55-0.64]; ARD, -2% [-10% to -6%]) and macrosomia (OR, 0.60 [0.52-0.68]; ARD, -2% [-3% to -1%]); cesarean delivery showed no significant difference (OR, 0.98 [0.96-1.02]; ARD, 0% [-2% to 1%]). Gestational weight gain above the recommendations was associated with lower risk of SGA (OR, 0.66 [0.63-0.69]; ARD, -3%; [-4% to -2%]) and preterm birth (OR, 0.77 [0.69-0.86]; ARD, -2% [-2% to -1%]) and higher risk of LGA (OR, 1.85 [1.76-1.95]; ARD, 4% [2%-5%]), macrosomia (OR, 1.95 [1.79-2.11]; ARD, 6% [4%-9%]), and cesarean delivery (OR, 1.30 [1.25-1.35]; ARD, 4% [3%-6%]). Gestational diabetes mellitus could not be evaluated because of the nature of available data. CONCLUSIONS AND RELEVANCE: In this systematic review and meta-analysis of more than 1 million pregnant women, 47% had gestational weight gain greater than IOM recommendations and 23% had gestational weight gain less than IOM recommendations. Gestational weight gain greater than or less than guideline recommendations, compared with weight gain within recommended levels, was associated with higher risk of adverse maternal and infant outcomes.
Subject(s)
Pregnancy Outcome , Pregnancy/physiology , Weight Gain , Adult , Birth Weight , Body Mass Index , Body Weight , Cesarean Section , Female , Fetal Macrosomia , Humans , Infant, Small for Gestational Age , Premature BirthABSTRACT
BACKGROUND: Children enrolled in Migrant and Seasonal Head Start (MSHS) programs are at high risks of health problems. Although non-family child care providers play important roles on children's health status as role models, educators, program deliverers, and information mediators, little is known about their nutritional health attitudes and behaviors, and weight status. Therefore, we investigated nutritional health attitudes and behaviors and their associations with overweight/obesity among child care providers in Michigan MSHS centers. METHODS: A total of 307 child care providers aged ≥ 18 years working in 17 Michigan MSHS centers were included in this cross-sectional study conducted in 2013. An online survey questionnaire was used to collect data on nutritional health attitudes and behaviors of child care providers. Weight status was categorized into normal weight (18.5 ≤ BMI < 25 kg/m(2)), overweight (25 ≤ BMI < 30 kg/m(2)), and obese (BMI ≥ 30 kg/m(2)) based on child care providers' self-reported height and weight. Factor analysis was performed to investigate patterns of nutritional health attitudes and behaviors. Multivariate logistic regression was conducted to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs) of overweight/obesity across tertiles of pattern scores taking the lowest tertile group as the reference group after adjustment for potential confounding variables. RESULTS: Three patterns of nutritional health attitudes and behaviors were identified: pattern 1) "weight loss practices with weight dissatisfaction", pattern 2) "healthy eating behaviors", and pattern 3) "better knowledge of nutrition and health". The pattern 1 scores were positively associated with overweight/obesity (Tertile 2 vs. Tertile 1: OR = 5.81, 95 % CI = 2.81-12.05; Tertile 3 vs. Tertile 1: OR = 14.89, 95 % CI = 6.18-35.92). Within the pattern 2, the OR for overweight/obesity in individuals with the highest scores was 0.37 (95 % CI = 0.19-0.75) compared with those with the lowest scores. However, the pattern 3 was not associated with the risk of overweight/obesity. CONCLUSIONS: Our findings support that nutrition education or health interventions targeting MSHS child care providers are urgently necessary. These efforts might be an efficient and effective approach for improving the nutritional health status of young children enrolled in MSHS programs.
Subject(s)
Attitude to Health , Caregivers/psychology , Nutritional Status , Obesity/psychology , Overweight/psychology , Adolescent , Body Weight , Child , Child Day Care Centers , Child, Preschool , Cross-Sectional Studies , Feeding Behavior , Female , Humans , Logistic Models , Male , Michigan , Odds Ratio , Risk Factors , Seasons , Surveys and Questionnaires , Transients and MigrantsABSTRACT
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.
Subject(s)
Diet , Energy Intake , Feeding Behavior , Weight Gain , Adult , Female , Fruit , Humans , Nutrition Surveys , Pregnancy , Pregnant Women , VegetablesABSTRACT
Urinary iodine concentrations (UICs) in the US have been reported to be stable since 1988-1994, although those in selected subgroups remained low. We aimed to investigate iodine status among adults (≥20 years) by two different criteria of assessing iodine deficiency in population. Utilizing National Health and Nutrition Examination Surveys 2001-2012, we conducted linear logistic regressions adjusting for covariates. The prevalence of <50 µg/L UIC was higher in women than in men; increased from 11.6% (2001-2004) to 13.2% (2009-2012) at the national level and in young adults, non-Hispanic blacks (NHBs) and non-users of iodine-containing supplements (all, p <0.05); the adjusted odds ratios (95%CI) in young adults (1.54 [1.11-2.15], p = 0.0007) and NHBs (1.70 [1.15-2.52], p = 0.0078). Median UICs confirm women and NHBs being in borderline iodine status. Recognizing the critical consequence of iodine deficiency particularly in women and NHBs, regular monitoring of iodine status is important for public health in the US.
Subject(s)
Iodine/deficiency , Iodine/urine , Adult , Dietary Supplements , Female , Humans , Male , Middle Aged , Odds Ratio , United States , Young AdultABSTRACT
In the present study, we examined the associations of total carbohydrate intake, dietary glycaemic load (DGL) and white rice intake with metabolic syndrome risk factors by sex in Korean adolescents. For the present cross-sectional study, data from the Fourth Korea National Health and Nutrition Examination Survey (2007-9) were used. A total of 2209 adolescents (n 1164 boys and n 1045 girls) aged 10-18 years with complete anthropometric, biochemical and dietary intake data were included in the study. Dietary intake data were obtained using the 24 h recall method, and total carbohydrate intake, DGL and white rice intake were divided into quartiles by sex. The metabolic syndrome and its risk factors were defined using the International Diabetes Federation criteria for children and adolescents. Fasting insulin levels and insulin resistance were included as the metabolic syndrome risk factors. All statistical analyses considered the complex sampling design effect and appropriate sampling weights. Multivariate linear regression analysis was used to estimate means with their standard errors of the mean for the metabolic syndrome risk factors across the quartiles of total carbohydrate intake, DGL and white rice intake. While high DGL was significantly associated with increased fasting glucose levels in boys, high total carbohydrate intake, DGL and white rice intake were consistently associated with reduced HDL-cholesterol levels in girls. High white rice intake was significantly associated with an increased risk of insulin resistance and the metabolic syndrome in girls but not in boys. Optimising dietary carbohydrate intake with respect to the source or amount is fundamental to preventing and managing metabolic diseases in Asian adolescents.
Subject(s)
Diet , Dietary Carbohydrates/administration & dosage , Metabolic Syndrome/etiology , Oryza , Adolescent , Adolescent Nutritional Physiological Phenomena , Blood Glucose/analysis , Child , Cholesterol, HDL/blood , Cross-Sectional Studies , Fasting , Female , Humans , Insulin/blood , Insulin Resistance , Korea , Male , Metabolic Syndrome/epidemiology , Metabolic Syndrome/prevention & control , Nutrition Surveys , Pediatric Obesity/epidemiology , Republic of Korea , Risk Factors , Sex Factors , Waist CircumferenceABSTRACT
Few studies have made distinctions between dietary intake from meals and snacks in relating them to biomarkers. We aimed to examine if snack patterns are associated with biomarkers of glucose metabolism, specifically hemoglobin A1c and HOMA-IR in US adults. Using 24-h dietary recall data from National Health and Nutrition Examination Survey (NHANES) in 2007-2008, we derived snack patterns using factor analyses. Multivariate logistic regressions were performed to estimate adjusted odds ratios (AOR) for biomarkers of glucose metabolism by quintiles of snack pattern scores. Men in the highest quintile of dairy and sugary snack pattern had higher risk of having hemoglobin A1c ≥ 6.5% (AOR: 2.06; 95% CI: 1.20-3.51) and HOMA-IR > 3.0 (AOR: 1.73; 95% CI: 1.01-2.95) than did those in the lowest quintile. No significant association was found in women between snack patterns and biomarkers of glucose metabolism. Dairy and sugary snack patterns of US men had the greatest association with poor control of glucose metabolism.
Subject(s)
Blood Glucose/metabolism , Dairy Products/adverse effects , Diet/adverse effects , Dietary Sucrose/adverse effects , Glycated Hemoglobin/metabolism , Insulin Resistance , Snacks , Adult , Biomarkers/blood , Energy Intake , Female , Humans , Logistic Models , Male , Meals , Middle Aged , Nutrition Surveys , Odds Ratio , Risk Factors , Sex Factors , United States , Young AdultABSTRACT
Hyperlipidemia and elevated circulating C-reactive protein (CRP) and total homocysteine (tHcy) concentrations are cardiovascular disease (CVD) risk factors. Previous studies indicated that higher serum carotenoid concentrations were inversely associated with some of these biomarkers. However, whether dietary carotenoid intake is inversely associated with these CVD risk biomarkers is not well known. We assessed the associations between individual dietary carotenoid intake and CVD risk biomarkers and tested whether the serum carotenoid concentrations explain (mediate) or influence the strength of (moderate) the associations, if any association exists. Dietary data collected from 2 24-h dietary recalls and serum measurements in adult men (n = 1312) and women (n = 1544) from the NHANES 2003-2006 were used. Regression models designed for survey analysis were used to examine the associations between individual dietary carotenoids and log-transformed blood cholesterol, CRP, and tHcy. The corresponding individual serum carotenoid concentration was considered as mediator (and moderator if applicable). After adjustment for covariates, significant inverse associations with LDL cholesterol were observed for dietary ß-carotene (P < 0.05) and lutein + zeaxanthin (P < 0.001), and with tHcy for dietary ß-carotene (P < 0.05), lycopene (P < 0.05), and total carotenoids (P < 0.05). Dietary lutein + zeaxanthin intake was also positively associated with HDL cholesterol concentrations (P < 0.01). Most of these associations were null after additional adjustment for corresponding serum carotenoid concentrations, indicating the complete mediation effects of serum carotenoids. Serum ß-carotene significantly moderated the associations between dietary ß-carotene and CRP (P-interaction < 0.05), and quartile 4 of dietary ß-carotene was associated with lower CRP concentrations only among participants with serum ß-carotene > 0.43 µmol/L. In this population-based cross-sectional study, serum carotenoids were mediators of dietary carotenoids and CVD risk biomarker associations. Serum ß-carotene was also a moderator of the dietary ß-carotene and CRP association. These findings may help in the design of future intervention studies on dietary carotenoids in the prevention of CVD.
Subject(s)
Cardiovascular Diseases/prevention & control , Carotenoids/therapeutic use , Diet , Adult , Biomarkers/blood , C-Reactive Protein/analysis , Cardiovascular Diseases/blood , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Carotenoids/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Cross-Sectional Studies , Diet/adverse effects , Female , Homocysteine/blood , Humans , Hypercholesterolemia/physiopathology , Hyperhomocysteinemia/physiopathology , Lutein/blood , Lutein/therapeutic use , Lycopene , Male , Nutrition Surveys , Risk Factors , United States/epidemiology , Xanthophylls/blood , Xanthophylls/therapeutic use , Zeaxanthins , beta Carotene/blood , beta Carotene/therapeutic useABSTRACT
OBJECTIVE: To validate a brief FFQ developed for capturing short-term antioxidant intake in a sample of US college students. DESIGN: A seventy-four-item antioxidant FFQ was developed based on major antioxidant sources in the American diet. The FFQ was validated against 30 d food records (FR) and plasma antioxidant concentrations. The reliability of the FFQ was evaluated by two FFQ administered at a 1-month interval. Settings University of Connecticut, CT, USA. SUBJECTS: Sixty healthy college students. RESULTS: Estimates of dietary antioxidants from the FFQ were moderately to highly correlated with those estimated from the 30 d FR (r = 0·29-0·80; P < 0·05) except for γ-tocopherol and ß-cryptoxanthin. Total antioxidant capacity from diet only or from diet and supplements estimated by the 30 d FR and FFQ were highly correlated (r = 0·67 and 0·71, respectively; P < 0·0001). The FFQ categorized 91 % of participants into the same or adjacent tertiles of antioxidant intake as the 30 d FR. Most dietary carotenoids estimated from the FFQ were correlated with plasma levels (P < 0·05). Correlation coefficients for test-retest reliability ranged from 0·39 to 0·86. More than 94 % of the participants were classified in the same or adjacent tertiles between the two administrations of the FFQ. CONCLUSIONS: The brief FFQ demonstrated reasonable validity for capturing a comprehensive antioxidant intake profile. This FFQ is applicable in epidemiological or clinical studies to capture short-term antioxidant intake or to simply document the variations of antioxidant intake in intervention trials. Cross-validation studies are warranted in other target populations.
Subject(s)
Antioxidants/administration & dosage , Biomarkers/blood , Diet Records , Dietary Supplements , Feeding Behavior , Surveys and Questionnaires , Adolescent , Adult , Ascorbic Acid/administration & dosage , Ascorbic Acid/blood , Body Mass Index , Carotenoids/administration & dosage , Carotenoids/blood , Connecticut , Cryptoxanthins , Energy Intake , Female , Humans , Lycopene , Male , Reproducibility of Results , Xanthophylls/administration & dosage , Xanthophylls/blood , Young Adult , beta Carotene/administration & dosage , beta Carotene/blood , gamma-Tocopherol/administration & dosage , gamma-Tocopherol/bloodABSTRACT
The Institute of Medicine's gestational weight gain guidelines are intended to reduce pregnancy complications, poor birth outcomes and excessive postpartum weight retention. The specific weight gain guidelines vary by prepregnancy weight status. We evaluated the validity of prepregnancy weight status (underweight, normal weight, overweight and obesity) classified from self-reported prepregnancy height and weight in reference to those from measured data during the first trimester of pregnancy and imputed data for both pregnant and age-matched non-pregnant women included in the National Health and Nutrition Examination Survey 2003-2006. Self-reported prepregnancy weight status was validated by two ideal references: imputed data with the number of imputations as 10 (n = 5,040) using the data of age-matched non-pregnant women who had both self-reported and measured data, and weight status based on height and weight measured during the first trimester (n = 95). Mean differences, Pearson's correlations (r), and Kappa statistics (κ) were used to examine the strength of agreement between self-reported data and the two reference measures. Mean (standard error of the mean) differences between self-reported versus imputed prepregnancy weight was -1.7 (0.1) kg with an r = 0.98 (p < 0.001), and κ = 0.78 which indicate substantial agreement for the 504 pregnant women. Mean (SEM) differences between self-reported prepregnancy weight versus measured weight in the first trimester was -2.3 (0.7) kg with r = 0.98 (p < 0.001), and κ = 0.76, which also showed substantial agreements in 95 pregnant women. Prepregnancy weight status classified based on self-reported prepregnancy height and weight was valid.
Subject(s)
Body Height , Body Weight , Adolescent , Adult , Female , Humans , Nutrition Surveys , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/prevention & control , Pregnancy Trimester, First , Risk Assessment , Self Report , Sensitivity and Specificity , Young AdultABSTRACT
The gestational weight gain (GWG) guidelines of the Institute of Medicine (IOM) aim to optimize birth outcomes and reduce pregnancy complications. The GWG guidelines are set based on the prepregnancy weight status and optimal weight gain at different trimesters of pregnancy. Dietary references intakes (DRIs) of the IOM are set for each trimester of pregnancy for energy intake and other essential nutrients by age groups (≤ 18, 19-30, 31-51 years). The DRIs, however, do not take into account the differing energy and nutrient requirements of women with different prepregnancy weights. In this cross-sectional study, we tested the hypothesis that diet quality during pregnancy is associated with adequate GWG at different stages of pregnancy. Diet quality during pregnancy was assessed from a 24-h recall measured by the healthy eating index of 2005 (HEI-2005). Both GWG and diet quality data were from 490 pregnant women aged 16-43 years included in National Health and Nutrition Examination Survey 2003-2006, a program of studies designed to assess the health and nutritional status of adults and children in the US, during which pregnant women were oversampled. Logistic regression models adjusted for age, trimester of gestation, race/ethnicity, education level, marital status, family poverty income ratio, daily supplement use, physical activity, and prepregnancy BMI were used to investigate if HEI-2005 is a determinant of GWG status at different trimesters of pregnancy. We found that HEI-2005 scores were not determinants of adequate GWG, although inadequate intake of total vegetables (OR 3.8, CI 1.1-13.2, p = 0.03) and oils were associated with excessive GWG (OR 2.8, CI 1.2-6.4, p = 0.02) when covariates were controlled. Although adequate GWG was not associated with diet quality as measured by HEI-2005 during pregnancy in this study, comprehensive prenatal counseling is still important to reduce adverse birth outcomes.
Subject(s)
Diet , Pregnancy/physiology , Weight Gain , Adolescent , Adult , Cross-Sectional Studies , Diet/standards , Diet/statistics & numerical data , Female , Humans , Middle Aged , Nutritional Requirements , Pregnancy Trimesters/physiology , Weight Gain/physiology , Young AdultABSTRACT
A synthetic Militarin analog-1[(2R,3R,4R,5R)-1,6-bis(4-(2,4,4-trimethylpentan-2-yl)phenoxy) hexane-2,3,4,5-tetraol] is a novel derivative of constituents from Cordyceps militaris, which has been used to treat a variety of chronic diseases including inflammation, diabetes, hyperglycemia and cancers. Here, we report for the first time the synthesis of Militarin analog-1 (MA-1) and the apoptotic mechanism of MA-1 against human lung cancer cell lines. Treatment with MA-1 significantly inhibited the viability of 3 human lung cancer cell lines. The inhibition of viability and growth in MA-1-treated A549 cells with an IC50 of 5µM were mediated through apoptosis induction, as demonstrated by an increase in DNA fragmentation, sub-G0/G1-DNA fraction, nuclear condensation, and phosphatidylserine exposure. The apoptotic cell death caused mitochondrial membrane permeabilization through regulation of expression of the Bcl-2 family proteins, leading to cytochrome c release in a time-dependent manner. Subsequently, the final stage of apoptosis, activation of caspase-9/-3 and cleavage of poly (ADP ribose) polymerase, was induced. Furthermore, A549 lung cancer cells were more responsive to MA-1 than a bronchial epithelial cell line (BEAS-2B), involving the rapid generation of reactive oxygen species (ROS), c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MAPK) activation. The pharmacological inhibition of ROS generation and JNK/p38 MAPK exhibited attenuated DNA fragmentation in MA-1-induced apoptosis. Oral administration of MA-1 also retarded growth of A549 orthotopic xenografts. In conclusion, the present study indicates that the new synthetic derivative MA-1 triggers mitochondrial apoptosis through ROS generation and regulation of MAPKs and may be a potent therapeutic agent against human lung cancer.
Subject(s)
Antineoplastic Agents/pharmacology , Apoptosis/drug effects , Glucosides/pharmacology , Malates/pharmacology , Mitochondria/drug effects , Reactive Oxygen Species/metabolism , Animals , Caspase 3/genetics , Caspase 3/metabolism , Caspase 9/genetics , Caspase 9/metabolism , Cell Line, Tumor , Cell Proliferation , Cell Survival , Cytochromes c/metabolism , DNA Fragmentation/drug effects , Female , Glucosides/chemical synthesis , Humans , Inhibitory Concentration 50 , JNK Mitogen-Activated Protein Kinases/genetics , JNK Mitogen-Activated Protein Kinases/metabolism , Lung Neoplasms/metabolism , Malates/chemical synthesis , Membrane Potential, Mitochondrial/drug effects , Mice , Mice, Nude , Mitochondria/metabolism , Poly(ADP-ribose) Polymerases/metabolism , Signal Transduction , bcl-2-Associated X Protein/genetics , bcl-2-Associated X Protein/metabolism , p38 Mitogen-Activated Protein Kinases/genetics , p38 Mitogen-Activated Protein Kinases/metabolismABSTRACT
PURPOSE: To investigate the associations of dietary TAC from diet and supplements with serum antioxidant concentrations and serum C-reactive protein (CRP) and plasma total homocysteine (tHcy) in US adults. METHODS: This was a cross-sectional study. Food consumption data, serum antioxidant levels, and serum CRP and Plasma tHcy concentrations of 4,391 US adults aged ≥19 years in the National Health and Nutrition Examination Survey 2001-2002 were analyzed. The USDA flavonoid and proanthocyanidin databases and dietary supplement data as well as antioxidant capacities of 43 antioxidants were also utilized. RESULT: Serum CRP and plasma tHcy concentrations were higher in older adults, smokers, and those with lower non-leisure time physical activity levels (P < 0.05). Energy-adjusted daily total antioxidant capacity (TAC) from diet and supplements was positively associated with serum vitamin E and carotenoid concentrations (P < 0.05). Adjusted odds ratio (OR) for plasma tHcy >13 µmol/L significantly decreased across quartiles of TAC from diet and supplements (Q1 = 2.18 (1.56-2.77); Q2 = 1.30 (1.00-2.07); Q3 = 1.34 (0.84-2.28); Q4 = 1.00; P for linear trend <0.001). A negative trend across quartiles of TAC from diet and supplements was also observed in OR for serum CRP ≥3 mg/L (Q1 = 1.26 (0.97-1.70); Q2 = 1.21 (0.91-1.66); Q3 = 0.97 (0.80-1.24); Q4 = 1.00; P for linear trend <0.05). CONCLUSIONS: These findings indicated that dietary TAC provided an integrated conceptual tool in assessing serum antioxidants and investigating the associations between antioxidant intake and CVD risk. The implicated applicability of dietary TAC needs further validation in prospective cohort studies.
Subject(s)
Antioxidants/administration & dosage , C-Reactive Protein/metabolism , Dietary Supplements , Homocysteine/blood , Adult , Aged , Cardiovascular Diseases/blood , Cardiovascular Diseases/prevention & control , Carotenoids/administration & dosage , Carotenoids/blood , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nutrition Assessment , Nutrition Surveys , Proanthocyanidins/administration & dosage , Proanthocyanidins/blood , United States , Young AdultABSTRACT
The prevalence of type 2 diabetes is disproportionately high among Asian Indians (AI), one of the fastest growing immigrant groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control. This study examined the association between the degree of acculturation and glycemic control as measured by Hemoglobin A1c in AI adults with type 2 diabetes. A mixed method (quantitative and qualitative) study was conducted among 30 AI adults with type 2 diabetes. Acculturation assessment using the Suinn-Lew Asian Self-identity Instrument was followed by socio-demographic questions, self-reported anthropometric measures, and open ended diabetes self-care questions. A two-step multiple regression analysis and content analysis of verbatim interview transcriptions were conducted. Interactions of acculturation with body mass index (interaction b = 1.11; p = 0.01), annual household income (interaction b = 7.19; p = .01), and diabetes duration (interaction b = .30; p = .02) significantly predicted higher HbA1c levels (R(2) change = .368; F change = 4.21; p = .02). From the qualitative interviews, the following were regarded as US specific facilitators for glycemic control: excellent health care system and facilities, availability of healthy food choices and self-monitoring devices, medical insurance benefits, good quality medications, and improved health awareness. Cultural orientation might be important for patient tailored interventions targeting AI with type 2 diabetes. Therefore, interventions targeted at Asian Indians with diabetes should include culture specific adaptations to nutrition education and support.
Subject(s)
Acculturation , Asian/statistics & numerical data , Diabetes Mellitus, Type 2/therapy , Asian/psychology , Body Mass Index , Diabetes Mellitus, Type 2/ethnology , Diet/statistics & numerical data , Female , Glycated Hemoglobin/analysis , Humans , Income/statistics & numerical data , India/ethnology , Male , Middle Aged , Self Care/statistics & numerical data , United StatesABSTRACT
Having a comprehensive understanding of a population's dietary patterns is a key component of any effective strategy for preventing malnutrition, planning, and putting nutrition interventions and policies into place. It's interesting to note that information on dietary patterns of Ghana's vulnerable subpopulations of women and children is lacking. The purpose of this study is to characterize the dietary patterns of women (15-49 years old) and their young children (0-3 years old), as well as to investigate into the socioeconomic and demographic factors influencing the characterized dietary patterns. The sociodemographic information and food consumption of mother-child dyads (n = 1,548) were collected for this nationally representative cross-sectional study. Principal component analysis and multiple variable logistic regression were used, respectively, to determine the dietary patterns of dyads and the determinants of the identified dietary patterns. For women and children, respectively, four dietary patterns ('Beverage & sugary based', 'Meat based', 'Indigenous- tuber based' and 'Indigenous- grain based') and two ('Indigenous' and 'Milk, Meat, & cereal based') emerged. Ethnicity, wealth quintiles, parity, seasonality, dyad's age, body mass index, education, residency, marital status, and household size were the socioeconomic / demographic determinants of the dietary patterns. To sum up for women and children, meat based and indigenous staple based dietary patterns were identified, with several important socioeconomic and demographic variables acting as predictors of the dietary patterns. The identified dietary patterns and their determinants may serve as a basis for nutrition intervention and policies for women and children in Ghana.
Subject(s)
Ethnicity , Mother-Child Relations , Pregnancy , Humans , Female , Child, Preschool , Adolescent , Young Adult , Adult , Middle Aged , Infant, Newborn , Infant , Ghana , Cross-Sectional Studies , Socioeconomic Factors , DietABSTRACT
Cordycepin (3-deoxyadenosine), found in Cordyceps spp., has been known to have many therapeutic effects including immunomodulatory, anti-inflammatory, antimicrobial, and anti-aging effects. Moreover, anti-tumor and anti-metastatic effects of cordycepin have been reported, but the mechanism causing cancer cell death is poorly characterized. The present study was designed to investigate whether the mechanisms of cordycepin-induced cell death were associated with estrogen receptor in breast cancer cells. Exposure of both MDA-MB-231 and MCF-7 human breast cancer cells to cordycepin resulted in dose-responsive inhibition of cell growth and reduction in cell viability. The cordycepin-induced cell death in MDA-MB-231 cells was associated with several specific features of the mitochondria-mediated apoptotic pathway, which was confirmed by DNA fragmentation, TUNEL, and biochemical assays. Cordycepin also caused a dose-dependent increase in mitochondrial translocation of Bax, triggering cytosolic release of cytochrome c and activation of caspases-9 and -3. Interestingly, MCF-7 cells showed autophagy-associated cell death, as observed by the detection of an autophagosome-specific protein and large membranous vacuole ultrastructure morphology in the cytoplasm. Cordycepin-induced autophagic cell death has applications in treating MCF-7 cells with apoptotic defects, irrespective of the ER response. Although autophagy has a survival function in tumorigenesis of some cancer cells, autophagy may be important for cordycepin-induced MCF-7 cell death. In conclusion, the results of our study demonstrate that cordycepin effectively kills MDA-MB-231 and MCF-7 human breast cancer cell lines in culture. Hence, further studies should be conducted to determine whether cordycepin will be a clinically useful, ER-independent, chemotherapeutic agent for human breast cancer.
Subject(s)
Apoptosis/drug effects , Autophagy/drug effects , Breast Neoplasms/pathology , Deoxyadenosines/pharmacology , Deoxyadenosines/therapeutic use , Receptors, Estrogen/physiology , Apoptosis/physiology , Autophagy/physiology , Breast Neoplasms/drug therapy , Breast Neoplasms/ultrastructure , Cell Line, Tumor , Dose-Response Relationship, Drug , Female , HumansABSTRACT
Proanthocyanidins (PA), the polymers of flavan-3-ols, have cardioprotective and cancer preventive properties as shown in clinical studies. The PA intake in a free-living population has not yet been reported, however. We aimed to estimate the dietary intake of PA and identify its major sources by combining the recently released and expanded USDA PA database with food consumption data of 8809 U.S. adults in the NHANES 1999-2002. U.S. adults over 19 y had a total PA intake of 95 mg/d, in the order of polymers (30%), monomers (22%), dimers (16%), 4-6 mers (15%), 7-10 mers (11%), and trimers (5%). When adjusted for energy intake, the total PA intake increased with age (P < 0.001), was higher in women than men (P < 0.01) and in alcohol consumers compared with nonconsumers (P < 0.05), and was lower in non-Hispanic blacks compared with other ethnicities (P < 0.001). Three major food sources, tea, legumes, and wines, contributed 45 mg (48%) of daily PA intake. The marked differences in PA intake among various sociodemographic subgroups need further investigation in relation to health disparities and chronic disease prevalence in the US.
Subject(s)
Diet/statistics & numerical data , Proanthocyanidins/administration & dosage , Proanthocyanidins/analysis , Adult , Aged , Aged, 80 and over , Aging , Alcohol Drinking , Databases, Factual , Diet/ethnology , Fabaceae/chemistry , Female , Food Analysis , Humans , Male , Middle Aged , Nutrition Surveys , Seeds/chemistry , Sex Characteristics , Tea/chemistry , United States , Wine/analysis , Young AdultABSTRACT
Given the importance of dietary antioxidants in reducing the risks of chronic diseases, the present study aimed to estimate the intake of total antioxidant capacity (TAC) from diet and dietary supplements of US adults. We utilised the US Department of Agriculture flavonoid and proanthocyanidin databases, dietary supplement data and food consumption data of 4391 US adults aged 19+ years in the National Health and Nutrition Examination Survey 2001-2. In order to convert the intake data of individual antioxidant compounds to TAC values, the vitamin C equivalent (VCE) of forty-three antioxidant nutrients measured previously was also applied. Daily TAC averaged 503.3 mg VCE/d (approximately 75 % from diet and 25 % from supplements). The energy-adjusted daily TAC level from diet and supplements was higher in women (except for carotenoids), older adults, Caucasian (except for carotenoids), non-alcohol consumers (for vitamin E and proanthocyanidins), subjects with higher income (except for carotenoids) and higher exercise levels than their counterparts (P < 0.05). TAC was positively associated with daily consumption of fruits and fruit juices, vegetables and vegetable products, beverages, wines and teas (P < 0.001). Teas, dietary supplements, and fruits and fruit juices were the major sources of dietary TAC of the US population (28, 25 and 17 %, respectively), while the contribution of vegetables and vegetable products to TAC was minimal ( < 2 %). The present study indicates that antioxidant intake from various diet and supplements contributes to TAC status. TAC levels are different in sociodemographic subgroups of the US population. The relationship between TAC intake and risks of chronic disease warrants further investigation.