Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study.

BACKGROUND AND AIMS: Carotid atherosclerosis indicates an increased risk for cardiac-cerebral vascular disease. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. As soft drinks contain a high amount of fructose, they may be a risk factor of carotid atherosclerosis. A prospective cohort study was conducted to investigate the association between soft drink consumption and the incidence of carotid atherosclerosis in a Chinese adult population. METHODS AND RESULTS: A total of 3828 participants (men: 2007 and women: 1821) were included. Carotid atherosclerosis was measured by using ultrasonography and was defined by increased carotid intima-media thickness and/or carotid plaques. Soft drink consumption was assessed using a validated food frequency questionnaire. Cox proportional hazards regression analysis was used to assess the association of soft drink consumption categories with the incidence of carotid atherosclerosis. During a mean follow-up of 3.20 years, 1009 individuals of the 3828 eligible participants developed carotid atherosclerosis. After adjusting for potential confounding factors, we compared the higher levels to the lowest level of soft drink consumption in women, and we estimated the multivariable hazard ratios and 95% confidence intervals of incident carotid atherosclerosis to be 1.09 (0.80, 1.50), and 1.56 (1.14, 2.13) (P for trend <0.05). However, there was no significant association between soft drink consumption and the incidence of carotid atherosclerosis in men or total population. CONCLUSION: The result indicated that soft drink consumption was associated with a higher incidence of carotid atherosclerosis in women. TRIAL REGISTERED: UMIN Clinical Trials Registry. TRIAL REGISTRATION NUMBER: UMIN000027174. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.

Association Between Handgrip Strength and Type 2 Diabetes: A Prospective Cohort Study and Systematic Review With Meta-analysis.

BACKGROUND: Both absolute (kg) and relative (kg per kg of body weight) handgrip strength (HGS) have been used as indicators of HGS. Multiple studies have explored HGS associations with type 2 diabetes (T2DM); however, prognostic values were inconsistent. We aimed to examine the associations between both absolute and relative HGS and incident T2DM. METHODS: A total of 12,957 participants aged 40 years and older (mean age 51.0 years, 58.4% men) were followed and enrolled in the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Cox proportional hazards regression models were used to examine the association of HGS with incident T2DM. Other prospective studies on HGS and risk of T2DM were identified by searching several electronic databases up to November 31, 2021. Meta-analysis was performed by combining the results from the TCLSIH study and previous prospective cohort studies. RESULTS: From the TCLSIH Cohort study, after adjustment, relative HGS was inversely associated with T2DM (hazard ratio per 0.1 higher relative HGS 0.667, 95% confidence interval [CI] 0.616, 0.722). However, no significant association between absolute HGS and incident T2DM was found. The meta-analyses showed that per 5 kg higher HGS was associated with a 5% (95% CI 2%, 8%) lower risk of T2DM and each 0.1 higher relative HGS was associated with a 22% (95% CI 14%, 29%) lower risk of T2DM. CONCLUSION: The results from our cohort study and meta-analysis suggest that relative HGS was better than absolute HGS in predicting incident T2DM. Adiposity was an important factor that mediates the association between HGS and T2DM.

Relationship between the consumption of wholegrain and nonalcoholic fatty liver disease: The TCLSIH cohort study.

BACKGROUND & AIMS: Wholegrain contributes a range of beneficial nutrients and is considered to play a role in the prevention of chronic diseases, but evidence of their influence on nonalcoholic fatty liver disease (NAFLD) is limited. We conducted this study to investigate the prospective association between daily wholegrain consumption and NAFLD in the general population. METHODS: This prospective cohort study included a total of 14,968 (42.2% men) inhabitants living in Tianjin, China. Participants without a history of CVD, cancer, alcoholic fatty liver disease, other liver diseases, or NAFLD were followed up for 1-6 years with a median follow-up duration of 4.2 years. Wholegrain consumption was assessed using a validated self-administered food frequency questionnaire. NAFLD was diagnosed with the results of liver ultrasonography without significant alcohol consumption and other causes of liver disease. Cox proportional hazards regression models were used to estimate the association between wholegrain consumption and NAFLD. RESULTS: A total of 3505 (2171 men) first incident cases of NAFLD occurred during 53,303 person-years of follow-up (median follow-up of 4.2 years). After adjusting for several potential confounders and setting "almost never" as the control group, the multivariable hazard ratios (95% confidence intervals) of the NAFLD were 0.82 (0.73, 0.92) when they consuming ≤1 time/week, 0.78 (0.69, 0.88) when they consuming 2-6 time/week and 0.77 (0.66, 0.90) when they consuming ≥1 time/day (p for trend <0.001). CONCLUSION: The results from our prospective study demonstrated that the higher consumption of wholegrain is associated with a decreased risk of NAFLD in Chinese adults.

Green tea consumption and risk of depressive symptoms: Results from the TCLSIH Cohort Study.

BACKGROUND: The prospective studies on the effect of particular type of tea consumption, especially green tea, on depressive symptoms are limited. OBJECTIVE: The aim of this study is to investigate the prospective association between green tea consumption and depressive symptoms in a large general adult population. METHODS: This prospective cohort study investigated 7524 participants aged 25 to 90 years from May 2013 to December 2018 and they were free of cardiovascular disease, cancer, and depressive symptoms at baseline. Green tea consumption was obtained through a validated food frequency questionnaire. Depressive symptoms were assessed by using the Self-Rating Depressive Scale (SDS). The association between green tea consumption and depressive symptoms was analyzed by Cox proportional hazards regression models. RESULTS: A total of 1064 first incident cases of depressive symptoms (SDS ≥45) occurred during 14,661 person-years of follow-up (median follow-up of 2.0 years). In the crude model, the hazard ratios (95% confidence intervals) were 1.00 (reference), 0.95 (0.81, 1.12), 0.97 (0.83, 1.14) and 0.95 (0.79, 1.14), respectively. After adjusting for demographic characteristics, lifestyle factors, and dietary intake, the multivariable adjusted hazard ratios (95% confidence intervals) were 1.00 (reference), 0.88 (0.74, 1.05), 0.84 (0.69, 1.02) and 0.78 (0.63, 0.97), respectively. CONCLUSIONS: The prospective study suggests that frequent green tea consumption is associated with a decreased risk of depressive symptoms in the general Chinese population.

The longitudinal associations between sweet potato intake and the risk of non-alcoholic fatty liver disease: the TCLSIH cohort study.

This study aimed to evaluate the longitudinal association between sweet potato intake and risk of NAFLD in the general adult population. In total, the number of 15,787 participants (males, 42.4%) was included in this prospective cohort study. Sweet potato intake was assessed by using a validated food frequency questionnaire. NAFLD was diagnosed by transabdominal sonography during an annual health examination. Cox proportional hazards regression models were fitted to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) across categories of energy-adjusted sweet potato intake. Compared to participants with the lowest tertile of sweet potato intake, the finally adjusted HRs (95% CIs) of incident NAFLD for those with the highest tertile were 0.87 (0.78, 0.97) in males (p for trend = 0.009); and 1.05 (0.92, 1.21) in females (p for trend = 0.52). Our study revealed that sweet potato intake was inversely associated with the risk of NAFLD in males.

Ultra-processed food consumption and the risk of subclinical thyroid dysfunction: a prospective cohort study.

Background: prospective cohort studies linking ultra-processed foods (UPF) and subclinical thyroid dysfunction (SCTD) are limited, especially in Chinese adults. Objective: we designed a large-scale cohort study to examine whether UPF consumption is a risk factor for SCTD in adults. Methods: this prospective cohort study investigated 8732 participants (mean age: 44.7 ± 10.7 years; 53.3% men). UPF consumption was measured at the baseline using a validated food frequency questionnaire and classified according to the NOVA classification system. SCTD was characterized by abnormal serum thyroid-stimulating hormone levels and normal free thyroxine. Cox proportional hazards regression models were used to examine the association of UPF consumption with the risk of various types of SCTD. Results: during the follow-up period, the incidence rate of subclinical hypothyroidism was 8.3/1000 person-years and that of subclinical hyperthyroidism was 7.0/1000 person-years. After adjusting the potential confounding factors, the multivariable hazard ratios (HRs) (95% confidence intervals) across increasing tertiles of energy-adjusted UPF consumption for subclinical hypothyroidism were 1.00 (reference), 0.82 (0.57, 1.18) and 0.87 (0.60, 1.27) (P for trend = 0.47) and for subclinical hyperthyroidism were 1.00 (reference), 1.09 (0.71, 1.68) and 1.69 (1.12, 2.56) (P for trend = 0.01). Per one standard deviation (58.0 g per 1000 kcal per day) increase in ultra-processed food consumption a 14% increase in risk of subclinical hyperthyroidism was observed (HR = 1.14; 95% CI: 1.00, 1.30; P = 0.04). Further sensitivity analysis showed that the fully adjusted HRs (95% CIs) of subclinical hyperthyroidism across tertiles of the proportion of UPF in weight for subclinical hyperthyroidism were 1.00 (reference), 1.06 (0.69, 1.63) and 1.63 (1.09, 2.46) (P for trend = 0.01). Conclusions: this population-based prospective cohort study has firstly demonstrated that higher UPF consumption was associated with higher risk of subclinical hyperthyroidism in adults. The UMIN clinical trial registry number is UMIN000027174 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137).

Dietary patterns and risk for hyperuricemia in the general population: Results from the TCLSIH cohort study.

OBJECTIVE: Prospective cohort studies linking dietary patterns and hyperuricemia (HUA) are limited, especially in Asian populations. The aim of this study was to prospectively investigate the association between various dietary patterns and risk for HUA in a general adult population. METHOD: We used data from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study of 20 766 men and women who were free from HUA, cancer, and cardiovascular disease at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated 81-item food frequency questionnaire. HUA was defined as serum uric acid levels >420 µmol/L in men and >350 µmol/L in women. Cox proportional hazards regression models were used to examine the association of dietary patterns with incident HUA. RESULTS: In all, 4389 first incident cases of HUA occurred during 73 822 person-years of follow-up (median follow-up of 4.2 y). Three main dietary patterns were extracted. They were the vegetable, sweet food, and animal food patterns. After adjusting for demographic characteristics, lifestyle factors, other dietary pattern scores, and inflammatory markers, comparing the highest with the lowest quartiles of dietary pattern scores, the multivariable hazard ratios (95% confidence interval) of HUA were 0.79 (0.72-0.87; Ptrend < 0.0001) for the vegetable pattern, 1.22 (1.12-1.33; Ptrend < 0.0001) for the sweet food pattern, and 1.24 (1.13-1.37; Ptrend < 0.0001) for the animal food pattern. CONCLUSIONS: Dietary patterns rich in animal or sweet foods were positively associated with a higher risk for HUA, whereas the vegetable pattern was negatively associated.

Ultra-processed food intake is associated with grip strength decline in middle-aged and older adults: a prospective analysis of the TCLSIH study.

PURPOSE: Ultra-processed foods make up more than 50% of daily energy consumed in Western countries and are rapidly increasing in China. However, little is known about the association between ultra-processed food intake and muscle strength, a predictor for physical disability in senior years. We aimed to investigate the association of ultra-processed food intake with longitudinal changes in grip strength among middle-aged and older Chinese adults. METHODS: This prospective cohort study included a total of 5409 adults aged 40 years and over (61.3% men). Ultra-processed food intake was obtained by means of a validated food frequency questionnaire and classified according to the NOVA classification system. Grip strength was measured annually using a handheld digital dynamometer. Multivariable linear regression models were used to examine the association between ultra-processed food intake and annualized change in grip strength and weight-adjusted grip strength. RESULTS: In the fully adjusted models, annualized changes in grip strength and weight-adjusted grip strength per 10% increment in the proportion of ultra-processed foods in the diet were - 0.3708 kg (95% confidence interval - 0.5687, - 0.1730; P < 0.001) and - 0.0057 kg/kg (95% confidence interval - 0.0086, - 0.0029; P < 0.0001), respectively. In analyses stratified by age, sex, body mass index, physical activity, hypertension, hyperlipidemia, diabetes, and healthy diet score, such associations were largely consistent in most subgroups (all P for interaction > 0.05). CONCLUSIONS: Our data indicate that higher ultra-processed food intake was associated with faster grip strength decline in middle-aged and older Chinese adults.

Edible mushroom consumption and incident hyperuricemia: results from the TCLSIH cohort study.

Background: Basic studies have found that xanthine oxidase inhibitors extracted from mushrooms have inhibitory effects on hyperuricemia. However, the association between mushroom consumption and hyperuricemia is unknown in humans. Objective: We therefore designed a large-scale cohort study to examine whether mushroom consumption is a protective factor for developing hyperuricemia in adults. Methods: This prospective cohort study investigated 19 830 participants (mean age: 39.4 years; and 9906 [50.0%] men) who were free of hyperuricemia, cardiovascular disease, and cancer at the baseline. Mushroom consumption was measured at the baseline using a validated food frequency questionnaire. Hyperuricemia is defined as serum uric acid levels >420 µmol L-1 in men and >350 µmol L-1 in women. Cox proportional hazards regression models were used to examine the association of mushroom consumption with incident hyperuricemia. Restricted cubic spline regression was used to estimate the dose-response relationship between mushroom consumption and risk of hyperuricemia. Results: A total of 4260 first incident cases of hyperuricemia occurred during 61 421 person-years of follow-up (median follow-up of 4.2 years). After adjusting for demographic characteristics, lifestyle factors, dietary intake, and inflammatory markers, the multivariable hazard ratios (95% confidence intervals) for incident hyperuricemia were 1.00(reference) for <1.76 g per 1000 kcal per day, 0.93(0.86, 1.01) for 1.76-2.84 g per 1000 kcal per day, 0.93(0.85, 1.01) for 2.85-5.52 g per 1000 kcal per day, and 0.88 (0.80, 0.96) for >5.52 g per 1000 kcal per day, respectively (P for trend = 0.007). Conclusions: This population-based prospective cohort study has firstly demonstrated that higher mushroom consumption is significantly associated with lower incidence of hyperuricemia among general adults.

Association between consumption of edible seaweeds and newly diagnosed non-alcohol fatty liver disease: The TCLSIH Cohort Study.

BACKGROUND & AIMS: Seaweeds are rich sources of anti-oxidants and anti-inflammatory properties, which are beneficial to non-alcoholic fatty liver disease (NAFLD). However, whether seaweed consumption is associated with NAFLD is unknown. We investigated the association of seaweed consumption with newly diagnosed NAFLD in a large-scale adult population. METHODS: This cross-sectional study involved 24 572 participants aged over 18 years. NAFLD was diagnosed by results of liver ultrasonography and alcohol intake. Dietary information was assessed using a validated and standardized 100-item food frequency questionnaire. Multivariate logistic analysis was used to evaluate the association between seaweed consumption and NAFLD. RESULTS: The prevalence of newly diagnosed NAFLD was 20.1%. After adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the multivariable adjusted odds ratios (95% confidence intervals) of newly diagnosed NAFLD across seaweed consumption were 1.00 (reference) for almost never, 1.03 (0.93, 1.15) for <1 time/wk, 1.01 (0.90, 1.13) for 1 time/wk, and 0.84 (0.73, 0.96) for >1 times/wk (P for trend < .001). Stratified analyses suggested a potential effect modification by obesity status; the odds ratios (95% confidence intervals) across extreme quartiles was 0.77 (0.66, 0.91) in non-obese participants and 1.02 (0.79, 1.33) in obese participants (P for interaction < .001). CONCLUSION: Seaweed consumption is negatively associated with NAFLD, especially in non-obese participants.