Fruit juice and childhood obesity: a review of epidemiologic studies.

Childhood obesity is a national epidemic, and many efforts have been made to understand its risk factors. The purpose of this review was to provide an updated account of the observational studies evaluating the relationship between 100% fruit juice intake and obesity in children and adolescents, and to highlight the major risk factors that may impact this relationship. PubMed and Scopus were searched for terms related to fruit juice and childhood obesity, and studies assessing 100% fruit juice intake in participants ≤ 19 years old, with obesity-related outcomes (BMI or adiposity), and published before March 9, 2021 were included. There were 17 prospective cohort and 14 cross-sectional studies included in the analysis. Overall, the evidence does not support a relationship between 100% fruit juice intake and measures of obesity in most children. There is some evidence to suggest a minor positive association in some overweight or very young children, but due to fundamental differences and limitations in methodology, further investigation is required. Significant gaps in literature on this topic exist particularly in regards to randomized clinical trials in children, and in studies in racially diverse populations.

Childhood beverage intake and risk of hypertension and hyperlipidaemia in young adults.

An epidemiological analysis assessing beverage consumption and risk factors for cardiovascular disease was conducted. Participants were 9-16 years old at enrolment, completed food frequency questionnaires in 1996-2001 and self-reported outcomes in 2010-2014. Exclusion criteria included missing data on relevant variables and covariates, prevalent disease before 2005, and implausible/extreme weight or energy intake. Intakes of orange juice, apple/other fruit juice, sugar-sweetened beverages and diet soda were related to the risk of incident hypertension or hyperlipidaemia using Cox proportional hazards regression, adjusting for diet, energy intake, age, smoking, physical activity and body mass index. There were 9,043 participants with 618 cases of hypertension and 850 of hyperlipidaemia in 17 years of mean follow-up. Sugar-sweetened beverage intake but not fruit juice nor diet soda was associated with hypertension (hazard ratio (95% confidence interval): 1.16 (1.03, 1.31)) in males. This study can guide beverage consumption as it relates to early predictors of cardiovascular disease.

Nutrient Adequacy Is Associated with Reduced Mortality in US Adults.

BACKGROUND: Americans are underconsuming essential nutrients while overconsuming several nutrients, including sodium, saturated fat, and added sugars. Suboptimal nutrition may be linked with mortality risk; however, few studies have evaluated the associations of underconsumed and overconsumed nutrients in a comprehensive manner among the US population. OBJECTIVES: This study investigated the association between nutrient intake through diet and mortality focusing on adequacy, moderation, and macronutrient quality in US adults. METHODS: Based on the 1999-2010 NHANES, 20,602 adults aged ≥30 y were followed up until December 2015. Nutrient intake was assessed using a 1-d 24-h dietary recall. Adequacy of major underconsumed nutrients in the United States was evaluated using the RDA (percent of RDA) or Adequate Intake (percent of AI). Overconsumed nutrients for which moderation is needed were assessed based on various dietary recommendations. Macronutrient quality was evaluated using the ratio of carbohydrates to dietary fiber, essential amino acids, and EPA + DHA. The association between nutrient intake and mortality was evaluated using Cox proportional hazards regression analysis. RESULTS: Higher intakes of vitamin E, magnesium, iron, dietary fiber, and potassium relative to the RDA/AI were associated with lower all-cause mortality. High intake of vitamin A (tertile 3: ≥80.1% of RDA) was associated with lower mortality from cardiovascular disease (CVD; HR: 0.75; 95% CI: 0.57, 0.99) and cancer (HR: 0.76; 95% CI: 0.62, 0.94), and high intake of calcium (tertile 3: ≥87.8% of RDA) was inversely associated with cancer mortality (HR: 0.72; 95% CI: 0.56, 0.93). Higher intakes of essential amino acids and EPA + DHA evaluated as quartiles were inversely associated with all-cause and CVD mortality. CONCLUSIONS: These findings suggest that higher intakes of underconsumed nutrients and improving macronutrient quality are associated with lower risk of CVD and cancer deaths in US adults.

Orange juice intake and anthropometric changes in children and adolescents.

OBJECTIVE: Evaluate associations between orange juice (OJ) consumption and anthropometric parameters. DESIGN: Prospective cohort study assessing the association between OJ intake and changes in BMI and height-for-age Z-score (HAZ) using mixed linear regression. SETTING: 2004-2008, USA. PARTICIPANTS: Children from the Growing Up Today Study II (n 7301), aged 9-16 years at enrollment. RESULTS: OJ consumption was positively associated with 2-year change in HAZ in girls (mean (se)): 0·03 (0·01) for non-consumers, 0·03 (0·02) for 1-3 glasses/month, 0·06 (0·01) for 1-6 glasses/week and 0·09 (0·02) for ≥1 glass/d after full adjustment (Ptrend = 0·02). However, OJ consumption was not associated with 2-year change in BMI percentile (kg/m2, mean (se)): -0·44 (0·36) for non-consumers, 0·20 (0·41) for 1-3 glasses/month, -0·04 (0·34) for 1-6 glasses/week and -0·77 (0·62) for ≥1 glass/d in girls, Ptrend = 0·81; -0·94 (0·53) for non-consumers, -1·68 (0·52) for 1-3 glasses/month, -0·81 (0·38) for 1-6 glasses per week and -1·12 (0·61) for ≥1 glass/d in boys, Ptrend = 0·49. CONCLUSION: OJ consumption was favourably associated with height growth but unrelated to excess weight gain. OJ may be a useful alternative to whole fruit in the event that whole fruit intake is insufficient.

Anthocyanins, Microbiome and Health Benefits in Aging.

The percentage of individuals over the age of 60 is projected to reach 22% by 2050; chronic diseases associated with aging can present challenges for these individuals. Anthocyanins and the gut microbiome have each been studied as independent influencers of health. Both these factors have shown to have a positive effect on cardiovascular and bone health in individuals, as well as on the prevention or treatment of certain forms of cancers. Anthocyanins have shown to modulate the composition of the gut microbiome and may have overlapping mechanisms in the prevention and treatment of cardiovascular disease, cancer, neurodegenerative disorders and aging-associated bone loss. These health outcomes are responsible for the hospitalization and deaths of millions of Americans every year and they cost the United States billions of dollars each year to maintain, prevent and treat. Alternative methods of treatment and prevention are desired since conventional methods (surgical and pharmacological methods, physical therapy, etc.) can be costly and have significant side effects; evidence suggests that anthocyanins and the gut microbiome may be potential avenues for this. This review evaluates the findings of existing literature on the role of anthocyanins and the gut microbiome on health and their potential as a natural therapeutic agent or a target organ to provide an alternative to the conventional methods of disease prevention and treatment.

Blackcurrants shape gut microbiota profile and reduce risk of postmenopausal osteoporosis via the gut-bone axis: Evidence from a pilot randomized controlled trial.

This study aimed to investigate the effects of blackcurrant (BC) on gut microbiota abundance and composition, inflammatory and immune responses, and their relationship with bone mass changes. The effects of BC on bone mineral density (BMD), gut microbiota, and blood inflammatory and immune biomarkers were evaluated using DXA, stool and fasting blood collected from a pilot three-arm, randomized, double-blind, placebo-controlled clinical trial. Fifty-one peri- and early postmenopausal women aged 45-60 years were randomly assigned into one of three treatment groups for 6 months: control, low BC (392 mg/day) and high BC (784 mg/day); and 40 women completed the trial. BC supplementation for 6 months effectively mitigated the loss of whole-body BMD (P<.05). Six-month changes (%) in peripheral IL-1ß (P=.056) and RANKL (P=.052) for the high BC group were marginally significantly lower than the control group. Six-month changes in whole-body BMD were inversely correlated with changes in RANKL (P<.01). In proteome analysis, four plasma proteins showed increased expression in the high BC group: IGFBP4, tetranectin, fetuin-B, and vitamin K-dependent protein S. BC dose-dependently increased the relative abundance of Ruminococcus 2 (P<.05), one of six bacteria correlated with BMD changes in the high BC group (P<.05), suggesting it might be the key bacteria that drove bone protective effects. Daily BC consumption for 6 months mitigated bone loss in this population potentially through modulating the gut microbiota composition and suppressing osteoclastogenic cytokines. Larger-scale clinical trials on the potential benefits of BC and connection of Ruminococcus 2 with BMD maintenance in postmenopausal women are warranted. Trial Registration: NCT04431960, https://classic.clinicaltrials.gov/ct2/show/NCT04431960.

Blackcurrant Anthocyanins Improve Blood Lipids and Biomarkers of Inflammation and Oxidative Stress in Healthy Women in Menopause Transition without Changing Body Composition.

Recent cell and animal studies suggest the potential of blackcurrants (BCs; Ribes nigrum) as a dietary agent that may reduce the risk of cardiovascular disease (CVD) by improving dyslipidemia, oxidative stress, and inflammation. This study aimed to examine the effects of BC anthocyanin (ACN) extract supplementation on biomarkers of CVD risk in healthy adult women in menopause transition. The effects of BC ACN supplementation on body composition, fasting blood lipids and biomarkers of inflammation and oxidative stress were evaluated using anthropometric measures and blood samples collected from a pilot randomized controlled clinical trial in peri- and early postmenopausal women. Thirty-eight eligible peri- and early postmenopausal women aged 45-60 completed the entire trial, in which they were randomly assigned into one of three treatment groups: placebo (control group), 392 mg/day (low BC group), or 784 mg/day (high BC group) for six months. The significance of differences in outcomes was tested using repeated-measures ANOVA. Overall, following six-month BC consumption, significantly decreased triglyceride (TG) levels were observed between treatment groups (p < 0.05) in a dose-dependent manner. Plasma interleukin-1ß (IL-1ß) was significantly reduced in a dose and time dependent manner (p < 0.05). Significant decreases in thiobarbituric acid reactive substances (TBARS) levels were also observed between treatment groups (p < 0.05) in a dose-dependent manner. Six-month change in oxidized LDL was inversely correlated with changes in catalase (CAT) and total antioxidant capacity (TAC) (p < 0.05), while C-reactive protein (hs-CRP) change was positively correlated with changes in TG and IL-1ß (p < 0.01). Together, these findings suggest that daily BC consumption for six months effectively improved dyslipidemia, inflammation, and lipid peroxidation, thus potentially mitigating the risk of postmenopausal CVD development in study participants. Future studies with larger sample sizes and at-risk populations are warranted to confirm these findings.

Protective effects of polyphenols against endocrine disrupting chemicals.

Endocrine disrupting chemicals (EDCs) are a heterogenous group of compounds dispersed throughout the environment that possess the ability to alter endocrine system function. While there are numerous routes of exposure to EDCs, the predominant source of many of these compounds is diet, largely due to their widespread use in food contact materials. In recent years, there has been a surge of research aimed at assessing exposure to EDCs, identifying their health implications, and developing approaches to minimize the risks they may entail. Due to their antioxidant and anti-inflammatory potential, polyphenols have been purported to confer protection against EDC-induced health detriments. This review discusses the evidence pertaining to dietary exposure to the two predominant EDCs, bisphenol A and phthalates, in the United States, their associations with diabetes, cancer, and cardiovascular disease outcomes, the potential for polyphenols to mitigate their disease-promoting effects, gaps in knowledge, and recommendations for future research.

Urinary excretion of estrogenic chemicals following consumption of capsule coffee and French press coffee: A crossover study.

Background: Coffee brewed from capsules contain estrogenic chemicals (ECs) that may harm the reproductive system. However, there are no studies investigating whether consuming capsule coffee causes these ECs to present in urine. Objective: Compare the effects of consuming capsule coffee vs. a plastic-free (French press) method on the appearance of ECs in urine. Methods: Participants (n = 30) were randomized to consume 540 mL of capsule or French press coffee once, then switched and consumed the other coffee after washout. Urine samples were collected prior to consumption, at 6 h and 24 h. Coffee and urine samples were analyzed for nine ECs using ultra-performance liquid chromatography with tandem mass spectrometry: bisphenol A (BPA), bisphenol F (BPF), bisphenol S, di(2-ethylhexyl) phthalate (DEHP), benzophenone, 4-nonylphenol (4-NP), dibutyl phthalate, caprolactam and dimethyl terephthalate. Results: In coffee samples, BPF (French press: 13.9 ng/mL, capsule: 16.1 ng/mL) and DEHP (capsule: 1.12 ng/mL) were present. In 6 h urine samples, the detection frequency for DEHP was 6.7% in capsule and 13.3% in French press coffee. BPF was detected in only one urine sample post-consumption. Conclusion: Consuming capsule coffee did not increase urinary EC exposure compared to consuming French press coffee.

Impact of coffee preparation on total phenolic content in brewed coffee extracts and their contribution to the body's antioxidant status.

Although coffee has been reported as a major contributor to antioxidants in the diet, there are limited studies assessing how brewing methods and types of coffee affect antioxidant capacity of coffee consumers. This study was aimed to investigate the impact of coffee preparation on total phenolic content in brewed coffee extracts and their contribution to antioxidant status. We examined how the different brewing methods affect total phenolic content and antioxidant capacity in brewed coffee extracts, then assessed the antioxidant status of coffee consumers after drinking coffee. Results showed that consuming capsule versus French press coffee provides a higher total phenolic content and drinking capsule coffee leads to greater antioxidant status as shown by the higher total antioxidant capacity in urine. Further studies can expand on this by using a broader range of brewing methods to evaluate the contribution of brewing methods of coffee to antioxidant status.

The Association between Diet Quality and Health Status in Mobile Food Pantry Users in Northeastern Connecticut.

Low-income Americans tend to have poor diet quality and disease prevalence overall. Mobile food pantries aim to improve these outcomes, and have rarely been studied. This cross-sectional study aimed to evaluate the association between diet quality and health status in mobile food pantry users. Data were collected from two mobile food pantry sites in Northeastern Connecticut (n = 83). Sociodemographic food security and diet quality data were collected. Overall, diet quality was low among all participants with intakes of fruits, vegetables, and whole grains of concern. Participant adherence to the 2020−2025 US Dietary Guidelines were low, with no participants meeting recommendations for whole grains. Obesity, diabetes, and hypertension prevalence in this population exceeded national averages. After adjusting for covariates, hypertension was associated with higher dairy and added sugar intake, as well as a greater intake of added sugar from sugar-sweetened beverages (p < 0.05). Although results were not statistically significant, participants with obesity, diabetes, and hypertension showed a trend of having lower adherence to the guidelines than those without these chronic diseases. Questions assessing participant interest in changing their diets were also posed, indicating overall high interest in learning about current diet quality and weight improvement.

The Effects of Eggs in a Plant-Based Diet on Oxidative Stress and Inflammation in Metabolic Syndrome.

We recently reported that the inclusion of whole eggs in plant-based diets (PBD) increased plasma choline, lutein, and zeaxanthin in individuals with metabolic syndrome (MetS). The objective of the current study was to evaluate whether this dietary pattern would protect against oxidative stress and low-grade inflammation, two common characteristics of MetS. We recruited 24 men and women with MetS, who, after following a PBD for 2 weeks (baseline), were randomly allocated to consume either two whole eggs with 70 g of spinach/day (EGG) or the equivalent amount of egg substitute with spinach (SUB) as breakfast for 4 weeks. After a 3-week washout, they were allocated to the alternate breakfast. We measured biomarkers of oxidation and inflammation at baseline and at the end of each intervention. Tumor necrosis factor-alpha, interleukin-6, monocyte protein attractant-1, liver enzymes, and C-reactive protein, as well as total antioxidant capacity, paraoxonase-1 (PON-1) activity, and other biomarkers of oxidation were not different at the end of EGG or SUB or when compared to baseline. However, plasma malondialdehyde (MDA) concentrations were lower (p < 0.05) during the EGG and baseline compared to SUB. In addition, the increases in dietary lutein and zeaxanthin previously observed had a strong positive correlation with PON-1 activity (r = 0.522, p < 0.01) only during the EGG period, whereas plasma zeaxanthin was negatively correlated with MDA (r = −0.437, p < 0.01). The number of participants with MetS was reduced from 24 during screening to 21, 13, and 17 during the BL, EGG, and SUB periods, respectively, indicating that eggs were more effective in reversing the characteristics of MetS. These data suggest that adding eggs to a PBD does not detrimentally affect inflammation or oxidative stress; on the contrary, eggs seem to provide additional protection against the biomarkers that define MetS.

Blackcurrants Reduce the Risk of Postmenopausal Osteoporosis: A Pilot Double-Blind, Randomized, Placebo-Controlled Clinical Trial.

Beneficial effects of blackcurrant supplementation on bone metabolism in mice has recently been demonstrated, but no studies are available in humans. The current study aimed to examine the dose-dependent effects of blackcurrant in preventing bone loss and the underlying mechanisms of action in adult women. Forty peri- and early postmenopausal women were randomly assigned into one of three treatment groups for 6 months: (1) a placebo (control group, n = 13); (2) 392 mg/day of blackcurrant powder (low blackcurrant, BC, group, n = 16); and (3) 784 mg/day of blackcurrant powder (high BC group, n = 11). The significance of differences in outcome variables was tested by repeated-measures ANOVA with treatment and time as between- and within-subject factors, respectively. Overall, blackcurrant supplementation decreased the loss of whole-body bone mineral density (BMD) compared to the control group (p < 0.05), though the improvement of whole-body BMD remained significant only in the high BC group (p < 0.05). Blackcurrant supplementation also led to a significant increase in serum amino-terminal propeptide of type 1 procollagen (P1NP), a marker of bone formation (p < 0.05). These findings suggest that daily consumption of 784 mg of blackcurrant powder for six months mitigates the risk of postmenopausal bone loss, potentially through enhancing bone formation. Further studies of larger samples with various skeletal conditions are warranted to confirm these findings.

Diet Quality, Nutritional Adequacy, and Sociodemographic Characteristics of Mobile Food Pantry Users in Northeastern Connecticut.

Poor diet quality among low-income populations is a major contributing factor to their poor health and wellbeing, and thus is a focus of many government aid programs. Mobile food pantries are an increasingly popular method of emergency food assistance, targeting the communities most affected by food insecurity; however, little is known about the dietary characteristics of mobile food pantry users. This study aims to characterize the diet quality and nutrient adequacy level and examine its association with sociodemographic characteristics among mobile food pantry users in Windham County, Connecticut. Surveys to assess food insecurity, diet composition, and sociodemographic characteristics were administered to 83 adult food pantry users. Participants (n = 40) completed a three-day dietary record for analysis of diet quality, and were found to have inadequate intakes of fruits, vegetables, whole grains and dairy, as well as some related micronutrients. At least 30% of participants had intakes below the Estimated Average Requirement (EAR) for vitamins A, C, E, calcium, zinc, magnesium, and folate. Intakes of added sugar, sugar sweetened beverages, and saturated fat were also above recommendations according to the United States Dietary Guidelines. Certain sociodemographic factors affected diet quality among this sample. For example, being male was associated with increased sugar-sweetened beverage and added sugar intake. This characterization of mobile pantry users will serve as a reference for developing nutrition education and determining the effectiveness of future interventions.

Nutritional Adequacy and Diet Quality Are Associated with Standardized Height-for-Age among U.S. Children.

Nutritional status affects linear growth and development. However, studies on the associations between nutritional status, diet quality, and age-standardized height in children are limited. The aim of this study was to assess the relationship between macro- and micronutrient intake and food consumption and height-for-age Z score (HAZ) among US children in the National Health and Nutrition Examination Survey (NHANES). This cross-sectional population-based study included 6116 US children aged 2-18 years. The usual dietary intake of nutrients and food groups was estimated by the multiple source method (MSM) using two-day food consumption data from NHANES 2007-2014. After adjusting for covariates, HAZ was positively associated with intakes of energy, protein, carbohydrate, fat, vitamins A, D, E, B6, and B12, thiamin, riboflavin, niacin, calcium, and iron. Children in the highest tertile of HAZ were less likely to consume lower than the EAR for vitamin E and calcium. Major foods consumed by children with lower HAZ were soft drinks, high-fat milk products, cakes, cookies, pastries, and pies, whereas children with higher HAZ tended to consume low-fat milk products, tea, and low-calorie fruit juice. These findings suggest that adequate nutritional intake, diet quality, and nutrient-dense food are important factors for height in children.

Estrogenic activity of capsule coffee using the VM7Luc4E2 assay.

Coffee brewed from capsule machines may contain estrogenic chemicals migrated from plastic, but the estrogenic activity of capsule coffee has not been evaluated. This study evaluated the estrogenic activity of capsule coffee using the VM7Luc4E2 estrogen receptor transcriptional activation assay. Estrogenic potentials of six capsule coffee samples were calculated using relative maximum amplitude response of E2 (>15%RME2 indicative of estrogenic activity) and estradiol equivalent factor (EEF). Estrogenic chemical content was determined using ultra-performance liquid chromatography with tandem mass spectrometry. All capsule coffee samples possessed estrogenic activity (48-56%RME2). EEFs were 6-7 orders of magnitude lower than that of E2, (1.2 × 10-7-1.7 × 10-6), indicating substantially weaker estrogenic potencies. Bisphenol A, bisphenol F, benzophenone, 4-nonylphenol, dibutyl phthalate, and dimethyl terephthalate were detected in capsule coffee. Capsule coffee exhibited estrogenic activity in vitro, and its estrogenic chemical content is likely driving its estrogenicity, warranting further investigations to fully understand the degree to which they are related and to predict the estrogenic potential based on the concentration of estrogenic chemicals.

A Feasibility and Pilot Study of a Personalized Nutrition Intervention in Mobile Food Pantry Users in Northeastern Connecticut.

OBJECTIVE: This pilot study assessed the effectiveness and acceptability of personalized nutrition intervention for mobile food pantry users. METHODS: The 8-week intervention recruited 25 participants in the control (n = 13) and in the treatment (n = 12) groups (60% obese). Personalized nutrition and health reports were generated based on baseline dietary intake and health status. The treatment group received weekly phone counseling and nutrition education, while the control group was only contacted to ensure compliance. The primary outcomes were 8-week changes in weight and diet quality score, assessed by the Healthy Eating Index. RESULTS: The acceptability of the intervention was assessed by the eligibility rate, recruitment rate (62.5%), and drop-out rate (36%). Following the intervention, there was a significant decrease in weight (mean ± standard deviation, -2.3% ± 2.4%) among all participants (p < 0.05). Diet-quality improved (4.54% in treatment vs. 0.18% in control), but was ultimately non-significant (p = 0.284). CONCLUSIONS AND IMPLICATIONS: A personalized nutrition education intervention in mobile food pantry users may be an acceptable and effective intervention to encourage weight loss through dietary improvements.

Associations between fruit juice and milk consumption and change in BMI in a large prospective cohort of U.S. adolescents and preadolescents.

BACKGROUND: There are concerns that fruit juice and milk contribute to childhood obesity. OBJECTIVE: Determine the relationship between fruit juice and milk intakes and body mass index (BMI) change among preadolescents/adolescents. METHODS: Participants aged 9 to 16 years old from the Growing Up Today Study II completed surveys including validated food frequency questionnaires in 2004, 2006 and 2008. The contributions of one serving of juice or milk to total energy intake and 2-year change in BMI were evaluated using multiple linear regression. Additional analyses were conducted with subgroups of juice (orange juice and other fruit juice) and milk (low fat and high fat). Missing values for BMI were imputed using a multiple imputation approach, after which data from 8173 participants and 13 717 2-year interval observations were analysed. RESULTS: Baseline fruit juice consumption was inversely associated with BMI change in girls (ß = -.102 kg/m2 , SE = 0.038, P value = .008) but not boys after controlling for race, age, baseline BMI, and baseline and 2-year changes in total energy intake and physical activity. Orange juice was inversely associated with BMI change among girls (ß = -.137 kg/m2 , SE = 0.053, P value = .010) while other fruit juice, low fat and high fat milk were not associated with BMI change. CONCLUSION: Orange juice was inversely associated with 2-year BMI change among preadolescent/adolescent girls but not boys and there were no significant associations with other juices or milk among either gender.

Citrus Consumption and the Risk of Non-Melanoma Skin Cancer in the Women's Health Initiative.

Evidence from animal studies suggests that furocoumarins, compounds present in citrus products, can increase the risk of non-melanoma skin cancer (NMSC) when combined with ultraviolet radiation. The objective of this study was to determine the relationship between citrus intake and NMSC risk among postmenopausal women from the Women's Health Initiative (WHI) Observational Study, who were aged 50-79 years at enrollment (1993-1998). The consumption of citrus fruit, citrus juice, and non-citrus fruit and juice were measured at the baseline of the study using a food frequency questionnaire (FFQ). NMSC cases (basal or squamous cell carcinomas) were self-reported during annual follow-up surveys. The outcome data used for this analysis were collected through March 2020. The relative risk (RR) for incident NMSC by citrus consumption was calculated. Among 49,007 non-Hispanic white participants, there were 8642 cases of incident NMSC. Using less than one serving of citrus juice per week as reference, the RRs and 95% confidence intervals (CI) for incident NMSC by citrus juice intake were 1.03 (0.95, 1.10) for one serving/week, 1.06 (1.00, 1.12) for two to four servings/week, 0.98 (0.90, 1.07) for five to six servings/week, and 1.08 (1.02, 1.13) for one or more serving/day (p-trend = 0.007). Subgroup analyses did not reveal meaningful associations by sun exposure variables. In conclusion, there were indications of a slightly higher risk of incident NMSC among citrus juice consumers; however, further longitudinal and mechanistic studies are needed to confirm the key risk factors.

Relative Validity of Dietary Total Antioxidant Capacity for Predicting All-Cause Mortality in Comparison to Diet Quality Indexes in US Adults.

While traditionally diet quality index scores (DQIS) as noted later in this abstract have been used to predict health outcomes, dietary total antioxidant capacity (TAC), a useful tool for assessing total antioxidant power in the diet, may also be a novel predictor. This study evaluated the associations between dietary TAC and DQIS and all-cause mortality. Based on the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2006, 23,797 US adults were followed-up until 2015. Dietary TAC and DQIS including the Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH) were calculated using a 1-day 24 h dietary recall. US adults in the highest quintiles of DQIS had lower rates of all-cause mortality compared to those in the lowest quintiles (HEI-2015 hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.77-0.98; AHEI-2010 HR: 0.84, 95% CI: 0.74-0.94; aMED HR: 0.79, 95% CI: 0.69-0.90; DASH HR: 0.80, 95% CI: 0.70-0.92). Similarly, those in the highest quintile of dietary TAC also had a lower all-cause mortality than those in the lowest quintile (HR: 0.88, 95% CI: 0.79-0.98). These findings suggest that dietary TAC might be a relatively valid predictor of all-cause mortality in the US population compared to the DQIS.