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1.
Eur J Nutr ; 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31728680

RESUMO

PURPOSE: To investigate the longitudinal association between the macronutrient composition of the diet and frailty. METHODS: Data were obtained from 5205 Dutch middle-aged and older adults participating in the Rotterdam Study. Frailty was measured using a frailty index based on the accumulation of 38 health-related deficits, score between 0 and 100, and a higher score indicating more frailty. Frailty was assessed at baseline and 11 years later (range of 23 years). Macronutrient intake was assessed using food-frequency questionnaires. The association between macronutrients and frailty over time was evaluated using multivariable linear regression, adjusted for the frailty index at baseline, energy intake, and other relevant confounders. All analyses were performed in strata of BMI. RESULTS: Median frailty index score was 13.8 points (IQR 9.6; 19.1) at baseline and increased by a median of 2.3 points (IQR - 2.0; 7.6) after 11 years. Overall, we found no significant associations between intake of carbohydrates or fat and frailty over time. We did observe a significant positive association between an iso-energetic intake of 10 g protein and frailty over time (ß 0.31 (95% CI 0.06; 0.55)) which was mainly driven by animal protein (ß 0.31 (95% CI 0.07; 0.56)). It did not depend on whether it was substituted fat or carbohydrates. CONCLUSIONS: Our findings suggest that a reduction in the intake of animal protein may improve the overall health status over time in a relatively healthy population. More research is needed on the optimal macronutrient composition of the diet and frailty in more vulnerable populations.

2.
Calcif Tissue Int ; 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31608419

RESUMO

Loop diuretics (LD) may affect bone health by inhibiting renal calcium reuptake. However, whether vitamin D status and dietary calcium intake modify the association between LD and bone outcome is unclear. Therefore, this study aimed to evaluate whether vitamin D level or calcium intake modify the association between LD and various indices of bone health including bone mineral density (BMD) and Trabecular Bone Score (TBS). From The Rotterdam Study, a prospective population-based cohort study, we used data from 6990 participants aged > 45 year with a DXA scan (2002-2008), 6908 participants with femoral neck (FN)-BMD, 6677 participants with lumbar spine (LS)-BMD and 6476 participants with LS-TBS measurements. Use of LD was available from pharmacy dispensing records. Vitamin D (25(OH)D) level was measured in serum, and dietary calcium intake was measured with a validated food frequency questionnaire. Almost eight percent of the participants used LD. The association between LD (past-users compared to never-users) and LS-TBS was significantly different by 25(OH)D concentrations (P for interaction = 0.04). A significantly lower LS-TBS among LD past-users was observed for 25(OH)D ≥ 50 nmol/l compared to ≤ 20 and 20-50 nmol/l (ß = - 0.036, 95% CI - 0.060; - 0.013 vs. ß = - 0.012, 95% CI - 0.036; 0.013 and ß = - 0.031, 95% CI - 0.096; 0.034, respectively). However, no other significant effect modification by 25(OH)D and dietary calcium intake was found in the associations between LD use and bone health outcomes (P-interaction > 0.13). This study suggests that the association between LD use and indices of bone health is not consistently modified by vitamin D or dietary calcium intake.

3.
Pediatrics ; 144(4)2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31492765

RESUMO

BACKGROUND AND OBJECTIVES: Celiac disease (CeD) is associated with psychopathology in children. It is unknown whether this association is present in children with celiac disease autoimmunity (CDA) identified by screening. We examined the associations between subclinical CDA and emotional and behavioral problems in children without previous CeD diagnosis. METHODS: In a population-based cohort study of 3715 children (median age: 6 years), blood titers of tissue transglutaminase autoantibodies were analyzed. CDA was defined as a measurement of tissue transglutaminase autoantibodies ≥7 U/mL (n = 51). Children with previous CeD diagnosis or children on a gluten-free diet, were excluded. The Child Behavior Checklist (CBCL) was filled in by parents and was used to assess behavioral and emotional problems of children at a median age of 5.9 years. Multiple linear regression models were applied to evaluate the cross-sectional associations between CDA and CBCL scores. Sensitivity analyses were done in a subgroup of children who were seropositive carrying the HLA antigen risk alleles for CeD. RESULTS: In basic models, CDA was not associated with emotional and behavioral problems on the CBCL scales. After adjustment for confounders, CDA was significantly associated with anxiety problems (ß = .29; 95% confidence interval 0.02 to 0.55; P = .02). After exclusion of children who did not carry the HLA-DQ2 and/or HLA-DQ8 risk alleles (n = 4), CDA was additionally associated with oppositional defiant problems (ß = .35; 95% confidence interval 0.02 to 0.69). Associations were not explained by gastrointestinal complaints. CONCLUSIONS: Our results reveal that CDA, especially combined with the HLA-DQ2 and HLA-DQ8 risk alleles, is associated with anxiety problems and oppositional defiant problems. Further research should be used to establish whether behavioral problems are a reflection of subclinical CeD.

4.
Eur J Epidemiol ; 34(9): 853-861, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31399939

RESUMO

Intake of individual antioxidants has been related to a lower risk of type 2 diabetes. However, the overall diet may contain many antioxidants with additive or synergistic effects. Therefore, we aimed to determine associations between total dietary antioxidant capacity and risk of type 2 diabetes, prediabetes and insulin resistance. We estimated the dietary antioxidant capacity for 5796 participants of the Rotterdam Study using a ferric reducing ability of plasma (FRAP) score. Of these participants, 4957 had normoglycaemia and 839 had prediabetes at baseline. We used covariate-adjusted proportional hazards models to estimate associations between FRAP and risk of type 2 diabetes, risk of type 2 diabetes among participants with prediabetes, and risk of prediabetes. We used linear regression models to determine the association between FRAP score and insulin resistance (HOMA-IR). We observed 532 cases of incident type 2 diabetes, of which 259 among participants with prediabetes, and 794 cases of incident prediabetes during up to 15 years of follow-up. A higher FRAP score was associated with a lower risk of type 2 diabetes among the total population (HR per SD FRAP 0.84, 95% CI 0.75; 0.95) and among participants with prediabetes (HR 0.85, 95% CI 0.73; 0.99), but was not associated with risk of prediabetes. Dietary FRAP was also inversely associated with HOMA-IR (ß - 0.04, 95% CI - 0.06; - 0.03). Effect estimates were generally similar between sexes. The findings of this population-based study emphasize the putative beneficial effects of a diet rich in antioxidants on insulin resistance and risk of type 2 diabetes.


Assuntos
Antioxidantes/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Dieta , Resistência à Insulina , Avaliação Nutricional , Estado Pré-Diabético/metabolismo , Adulto , Idoso , Antioxidantes/administração & dosagem , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Frutas , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Fatores de Risco
5.
Am J Clin Nutr ; 110(2): 437-450, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31165884

RESUMO

BACKGROUND: Folate and vitamin B-12 are essential micronutrients involved in the donation of methyl groups in cellular metabolism. However, associations between intake of these nutrients and genome-wide DNA methylation levels have not been studied comprehensively in humans. OBJECTIVE: The aim of this study was to assess whether folate and/or vitamin B-12 intake are asssociated with genome-wide changes in DNA methylation in leukocytes. METHODS: A large-scale epigenome-wide association study of folate and vitamin B-12 intake was performed on DNA from 5841 participants from 10 cohorts using Illumina 450k arrays. Folate and vitamin B-12 intakes were calculated from food-frequency questionnaires (FFQs). Continuous and categorical (low compared with high intake) linear regression mixed models were applied per cohort, controlling for confounders. A meta-analysis was performed to identify significant differentially methylated positions (DMPs) and regions (DMRs), and a pathway analysis was performed on the DMR annotated genes. RESULTS: The categorical model resulted in 6 DMPs, which are all negatively associated with folate intake, annotated to FAM64A, WRAP73, FRMD8, CUX1, and LCN8 genes, which have a role in cellular processes including centrosome localization, cell proliferation, and tumorigenesis. Regional analysis showed 74 folate-associated DMRs, of which 73 were negatively associated with folate intake. The most significant folate-associated DMR was a 400-base pair (bp) spanning region annotated to the LGALS3BP gene. In the categorical model, vitamin B-12 intake was associated with 29 DMRs annotated to 48 genes, of which the most significant was a 1100-bp spanning region annotated to the calcium-binding tyrosine phosphorylation-regulated gene (CABYR). Vitamin B-12 intake was not associated with DMPs. CONCLUSIONS: We identified novel epigenetic loci that are associated with folate and vitamin B-12 intake. Interestingly, we found a negative association between folate and DNA methylation. Replication of these methylation loci is necessary in future studies.

6.
Eur J Nutr ; 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31076856

RESUMO

PURPOSE: Higher folate and vitamin-B12 have been linked to lower risk of overweight. However, whether this is a causal effect of these B-vitamins on obesity risk remains unclear and evidence in older individuals is scarce. This study aimed to assess the role of B-vitamin supplementation and levels on body composition in older individuals. METHODS: A double-blind, randomized controlled trial in 2919 participants aged ≥ 65 years with elevated homocysteine levels. The intervention comprised a 2-year supplementation with a combination of folic acid (400 µg) and vitamin B12 (500 µg), or with placebo. Serum folate, vitamin-B12, active vitamin-B12 (HoloTC), methylmalonic acid (MMA), and anthropometrics were measured at baseline and after 2 years of follow-up. Dietary intake of folate and vitamin-B12 was measured at baseline in a subsample (n = 603) using a validated food-frequency questionnaire. Fat mass index (FMI) and fat-free mass index (FFMI) were assessed with Dual Energy X-ray absorptiometry (DXA). RESULTS: Cross-sectional analyses showed that a 1 nmol/L higher serum folate was associated with a 0.021 kg/m2 lower BMI (95% CI - 0.039; - 0.004). Higher HoloTC (per pmol/L log-transformed) was associated with a 0.955 kg/m2 higher FMI (95% CI 0.262; 1.647), and higher MMA (per µgmol/L) was associated with a 1.108 kg/m2 lower FMI (95% CI - 1.899; - 0.316). However, random allocation of B-vitamins did not have a significant effect on changes in BMI, FMI or FFMI during 2 years of intervention. CONCLUSIONS: Although observational data suggested that folate and vitamin B12 status are associated with body composition, random allocation of a supplement with both B-vitamins combined versus placebo did not confirm an effect on BMI or body composition.

7.
J Clin Endocrinol Metab ; 104(12): 6325-6337, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30977830

RESUMO

OBJECTIVE: Our group recently showed that animal protein was independently associated with nonalcoholic fatty liver disease (NAFLD). We hypothesize that this may be explained by a high diet-dependent acid load [dietary acid load (DAL)]. METHODS: This cross-sectional study is embedded in a prospective population-based cohort. We estimated DAL proxies via food-frequency questionnaires using potential renal acid load (PRAL; using dietary protein, phosphorus, potassium, calcium, and magnesium intake), net endogenous acid production (NEAP; using protein and potassium intake), and the animal protein-to-potassium ratio (A:P). We defined NAFLD using ultrasound after excluding secondary steatogenic causes. We used logistic regression models-adjusted for sociodemographic, lifestyle, and metabolic traits-on categorized [quartile (Q)1 to 4] and continuous DAL proxies (allowing for nonlinearity) and NAFLD. RESULTS: We included 3882 participants, of which 1337 had NAFLD. All DAL proxies were higher, meaning more acidic, in individuals with NAFLD (PRAL, -2.9 vs -5.5 mEq/d; NEAP, 37.0 vs 35.1 mEq/d; and A:P, 13.3 vs 12.4; all P < 0.001). The highest Q of DAL proxies was associated with NAFLD independent of sociodemographic and lifestyle confounders, but significance dissipated after correction for metabolic confounders and multiple testing. However, the P value for nonlinearity was significant in all DAL proxies (P < 0.001). Natural cubic splines performed better with than without DAL proxies in the fully adjusted model (all P ≤ 0.038). The highest probability of NAFLD was found for an acidic diet. CONCLUSIONS: This study showed an independent nonlinear association between an acidic diet and NAFLD. Further studies with acid-base biomarkers are needed, but our findings might provide a mechanistic explanation for the harmful association between an animal protein-rich diet and NAFLD.

8.
Br J Nutr ; 122(5): 583-591, 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-30832747

RESUMO

The role of diet on breast cancer risk is not well elucidated but animal food sources may play a role through, for example, the pathway of the insulin-like growth factor 1 system or cholesterol metabolism. The aim of this study was to evaluate the association between animal foods and the risk of postmenopausal breast cancer. This study was embedded in the Rotterdam Study, a population-based prospective cohort study of subjects aged 55 years and over (61 % female). Dietary intake of different animal foods was assessed at baseline using a validated FFQ and adjusted for energy intake using the residual method. We performed Cox proportional hazards modelling to analyse the association between the intake of the different food sources and breast cancer risk after adjustment for socio-demographic, lifestyle and metabolic factors. During a median follow-up of 17 years, we identified 199 cases of breast cancer (6·2 %) among 3209 women. After adjustment for multiple confounders, no consistent association was found between the intake of red meat intake, poultry, fish or dairy products and breast cancer risk. However, we found that egg intake was significantly associated with a higher risk of breast cancer (hazard ratioQ4 v. Q1: 1·83; 95 % CI 1·20, 2·79; Ptrend=0·01). In conclusion, this study found that dietary egg intake but no other animal foods was associated with a higher risk of postmenopausal breast cancer. Further research on the potential mechanisms underlying this association is warranted.

9.
Eur J Nutr ; 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30734846

RESUMO

PURPOSE: Several studies have reported seasonal variation in intake of food groups and certain nutrients. However, whether this could lead to a seasonal pattern of diet quality has not been addressed. We aimed to describe the seasonality of diet quality, and to examine the contribution of the food groups included in the dietary guidelines to this seasonality. METHODS: Among 9701 middle-aged and elderly participants of the Rotterdam Study, a prospective population-based cohort, diet was assessed using food-frequency questionnaires (FFQ). Diet quality was measured as adherence to the Dutch dietary guidelines, and expressed in a diet quality score ranging from 0 to 14 points. The seasonality of diet quality and of the food group intake was examined using cosinor linear mixed models. Models were adjusted for sex, age, cohort, energy intake, physical activity, body mass index, comorbidities, and education. RESULTS: Diet quality had a seasonal pattern with a winter-peak (seasonal variation = 0.10 points, December-peak) especially among participants who were men, obese and of high socio-economic level. This pattern was mostly explained by the seasonal variation in the intake of legumes (seasonal variation = 3.52 g/day, December-peak), nuts (seasonal variation = 0.78 g/day, January-peak), sugar-containing beverages (seasonal variation = 12.96 milliliters/day, June-peak), and dairy (seasonal variation = 17.52 g/day, June-peak). CONCLUSIONS: Diet quality varies seasonally with heterogeneous seasonality of food groups counteractively contributing to the seasonal pattern in diet quality. This seasonality should be considered in future research on dietary behavior. Also, season-specific recommendations and policies are required to improve diet quality throughout the year.

11.
Artigo em Inglês | MEDLINE | ID: mdl-30341095

RESUMO

BACKGROUND: Folic acid and vitamin-B12 play key roles in one-carbon metabolism. Disruption of one-carbon metabolism may be involved in the risk of cancer. Our aim was to assess the long-term effect of supplementation with both folic acid and vitamin-B12 on the incidence of overall cancer and on colorectal cancer in the B-PROOF trial. METHODS: Long-term follow-up of B-PROOF trial participants (N=2,524), a multi-center, double-blind randomized placebo-controlled trial designed to assess the effect of 2-3 years daily supplementation with folic acid (400 µg) and vitamin-B12 (500 µg) versus placebo on fracture incidence. Information on cancer incidence was obtained from the Netherlands cancer registry (Integraal Kankercentrum Nederland), using the International Statistical Classification of Disease (ICD-10) codes C00-C97 for all cancers (except C44 for skin cancer), and C18-C20 for CRC. RESULTS: Allocation to B-vitamins was associated with a higher risk of overall cancer (171 [13.6%] vs. 143 [11.3%]), HR 1.25; 95%CI 1.00-1.53, p=0.05). B-vitamins were significantly associated with a higher risk of colorectal cancer (43[3.4%] vs. 25[2.0%]), HR 1.77; 95%CI 1.08-2.90, p=0.02). CONCLUSION: Folic acid and vitamin-B12 supplementation was associated with an increased risk of colorectal cancer. IMPACT: Our findings suggest that folic acid and vitamin-B12 supplementation may increase the risk of colorectal cancer. Further confirmation in larger studies and in meta-analyses combining both folic acid and vitamin-B12 are needed to evaluate whether folic acid and vitamin B12 supplementation should be limited to patients with a known indication such as a proven deficiency.

12.
Am J Ophthalmol ; 2018 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-30312575

RESUMO

PURPOSE: What patients should eat to reduce their risk of age-related macular degeneration (AMD) is still unclear. We investigated the effect of a diet recommended by Health Councils on AMD. DESIGN: Prospective population-based cohort study. METHODS: 4202 participants from the Rotterdam Study aged 55+ years, free of AMD at baseline, were included and followed up for 9.1±5.8 years. Incident AMD was graded on fundus photographs. Dietary data were collected using a validated 170-item food frequency questionnaire, and food intakes were categorized into food patterns based on guidelines from Health Councils. Associations with incident AMD were analyzed using Cox-proportional hazards models, and adjusted for age, sex, total energy intake, smoking, body mass index, hypertension, education, and income. RESULTS: A total of 754 persons developed incident AMD. Intake of the recommended amounts of vegetables (≥200gr/day), fruit (2x/day), and fish (2x/week) was 30.6%, 54.9% and 12.5%, respectively. In particular the intake of fish (2x/week) decreased the risk of incident AMD; hazard ratio (HR) 0.76 [95% Confidence Interval (CI) 0.60-0.97]). Intake of the recommended amounts of all three food groups was only 3.7%, but adherence to this pattern showed a further reduction of the risk of incident AMD (HR 0.58 [95%CI 0.36-0.93]). Younger age, higher income, and nonsmoking were associated with this food pattern, but risk lowering effects remained significant after additional adjustment for these factors. CONCLUSION: A diet of 200 grams of vegetables/day, 2x fruit/day, and 2x fish/week is associated with a significantly reduced risk of AMD.

13.
Ned Tijdschr Geneeskd ; 1622018 09 19.
Artigo em Holandês | MEDLINE | ID: mdl-30306761

RESUMO

OBJECTIVE: We aimed to evaluate the criterion validity of the 2015 food-based Dutch dietary guidelines, which were formulated based on evidence on the relation between diet and major chronic diseases. DESIGN: We studied 9,701 participants of the Rotterdam Study, a population-based prospective cohort in individuals aged 45 years and over. METHOD: Dietary intake was assessed at baseline with a food-frequency questionnaire. For all participants, we examined adherence (yes/no) to fourteen items of the guidelines: vegetables (≥200g/d), fruit (≥200g/d), whole-grains (≥90g/d), legumes (≥135g/wk), nuts (≥15g/d), dairy (≥350g/d), fish (≥100g/wk), tea (≥450mL/d), ratio whole-grains:total grains (≥50%), ratio unsaturated fats & oils:total fats (≥50%), red and processed meat (<300g/wk), sugar-containing beverages (<150mL/d), alcohol (<10 g/d) and salt (≤6g/d). Total adherence was calculated as sum-score of the adherence to the individual items (0-14). Information on disease incidence and all-cause mortality was collected during a median follow-up period of 13.5 years (range 0-27.0). RESULTS: Using Cox proportional-hazards models adjusted for confounders, we observed that every additional component adhered to was associated with a 3% lower mortality risk (HR=0.97,95% CI=0.95 - 0.98), lower risk of stroke (HR=0.95,95%CI 0.92;0.99), chronic obstructive pulmonary disease (HR=0.94,95%CI=0.91-0.98), colorectal cancer (HR=0.90,95%CI=0.84;0.96), and depression (HR=0.97,95%CI=0.95-0.999), but not with incidence of coronary heart disease, type 2 diabetes, heart failure, lung cancer, breast cancer, or dementia. CONCLUSION: Adherence to the Dutch dietary guidelines was associated with a lower mortality risk and a lower risk of developing some but not all of the chronic diseases on which the guidelines were based.

14.
Ophthalmology ; 2018 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-30114418

RESUMO

PURPOSE: To investigate associations of adherence to the Mediterranean diet (MeDi) with incidence of advanced age-related macular degeneration (AMD; the symptomatic form of AMD) in 2 European population-based prospective cohorts. DESIGN: Prospective cohort study of the Rotterdam Study I (RS-I) and the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (Alienor) Study populations. PARTICIPANTS: Four thousand four hundred forty-six participants 55 years of age or older from the RS-I (The Netherlands) and 550 French adults 73 years of age or older from the Alienor Study with complete ophthalmologic and dietary data were included in the present study. METHODS: Examinations were performed approximately every 5 years over a 21-year period (1990-2011) in RS-I and every 2 years over a 4-year period (2006-2012) in the Alienor Study. Adherence to the MeDi was evaluated using a 9-component score based on intake of vegetables, fruits, legumes, cereals, fish, meat, dairy products, alcohol, and the monounsaturated-to-saturated fatty acids ratio. Associations of incidence of AMD with MeDi were estimated using multivariate Cox proportional hazard models. MAIN OUTCOMES MEASURES: Incidence of advanced AMD based on retinal fundus photographs. RESULTS: Among the 4996 included participants, 155 demonstrated advanced incident AMD (117 from the RS-I and 38 from the Alienor Study). The mean follow-up time was 9.9 years (range, 0.6-21.7 years) in the RS-I and 4.1 years (range, 2.5-5.0 years) in the Alienor Study. Pooling data for both the RS-I and Alienor Study, participants with a high (range, 6-9) MeDi score showed a significantly reduced risk for incident advanced AMD compared with participants with a low (range, 0-3) MeDi score in the fully adjusted Cox model (hazard ratio, 0.59; 95% confidence interval, 0.37-0.95; P = 0.04 for trend). CONCLUSIONS: Pooling data from the RS-I and Alienor Study, higher adherence to the MeDi was associated with a 41% reduced risk of incident advanced AMD. These findings support the role of a diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes, and fish in the prevention of AMD.

15.
Gut ; 2018 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-30064987

RESUMO

OBJECTIVE: A healthy lifestyle is the first-line treatment in non-alcoholic fatty liver disease (NAFLD), but specific dietary recommendations are lacking. Therefore, we aimed to determine whether dietary macronutrient composition is associated with NAFLD. DESIGN: Participants from the Rotterdam Study were assessed on (1) average intake of macronutrients (protein, carbohydrate, fat, fibre) using a Food Frequency Questionnaire and (2) NAFLD presence using ultrasonography, in absence of excessive alcohol, steatogenic drugs and viral hepatitis. Macronutrients were analysed using the nutrient density method and ranked (Q1-Q4). Logistic regression analyses were adjusted for sociodemographic, lifestyle and metabolic covariates. Moreover, analyses were adjusted for and stratified by body mass index (BMI) (25 kg/m2). Also, substitution models were built. RESULTS: In total, 3882 participants were included (age 70±9, 58% female). NAFLD was present in 1337 (34%) participants of whom 132 were lean and 1205 overweight. Total protein was associated with overweight NAFLD after adjustment for sociodemographic and lifestyle covariates (ORQ4vsQ1 1.40; 95% CI 1.11 to 1.77). This association was driven by animal protein (ORQ4vsQ1 1.54; 95% CI 1.20 to 1.98). After adjustment for metabolic covariates, only animal protein remained associated with overweight NAFLD (ORQ4vsQ1 1.36; 95% CI 1.05 to 1.77). Monosaccharides and disaccharides were associated with lower overall NAFLD prevalence (ORQ4vsQ1 0.66; 95% CI 0.52 to 0.83) but this effect diminished after adjustment for metabolic covariates and BMI. No consistent associations were observed for fat subtypes or fibre. There were no substitution effects. CONCLUSION: This large population-based study shows that high animal protein intake is associated with NAFLD in overweight, predominantly aged Caucasians, independently of well-known risk factors. Contrary to previous literature, our results do not support a harmful association of monosaccharides and disaccharides with NAFLD.

16.
J Invest Dermatol ; 2018 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-30130619

RESUMO

Current treatments for seborrheic dermatitis provide only temporary relief. Therefore, identifying modifiable lifestyle factors may help reduce disease burden. The objective of this study was to determine whether specific dietary patterns or total antioxidant capacity are associated with seborrheic dermatitis. Participants of the Rotterdam Study with a skin examination and a food frequency questionnaire were included. Total antioxidant capacity was assessed on the basis of ferric reducing antioxidant potential of each food item. Dietary patterns were identified with principal component analysis (PCA). Multivariable logistic regression analyses were used to assess the association between total antioxidant capacity, dietary pattern-derived PCA factors, and seborrheic dermatitis adjusted for confounders. In total, 4,379 participants were included, of whom 636 (14.5%) had seborrheic dermatitis. The PCA identified vegetable, Western, fat-rich and fruit dietary patterns. The fruit pattern was associated with a 25% lower risk (quartile 1 vs. quartile 4: adjusted odds ratio = 0.76, 95% confidence interval = 0.58-0.97, P = 0.03), and the Western pattern with a 47% increased risk (quartile 1 vs. quartile 4: adjusted odds ratio = 1.47; 95% confidence interval = 0.98-2.20, P = 0.03), but only for females. Other factors were not associated with seborrheic dermatitis. In conclusion, a high fruit intake was associated with less seborrheic dermatitis, whereas high adherence to a "Western" dietary pattern in females was associated with more seborrheic dermatitis.

17.
Semin Liver Dis ; 38(3): 193-214, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30041273

RESUMO

Coffee, the most consumed hot beverage worldwide, is composed of many substances, of which polyphenols, caffeine, and diterpenoids are well studied. Evidence on potential effects of coffee on human health has been accumulating over the past decades. Specifically, coffee has been postulated to be hepatoprotective in several epidemiological and clinical studies. Several underlying molecular mechanisms as to why coffee influences liver health have been proposed. In this review, the authors summarized the evidence on potential mechanisms by which coffee affects liver steatosis, fibrosis, and hepatic carcinogenesis. The experimental models reviewed almost unanimously supported the theorem that coffee indeed may benefit the liver. Either whole coffee or its specific compounds appeared to decrease fatty acid synthesis (involved in steatogenesis), hepatic stellate activation (involved in fibrogenesis), and hepatic inflammation. Moreover, coffee was found to induce apoptosis and increased hepatic antioxidant capacity, which are involved in carcinogenesis.

18.
Maturitas ; 111: 100-109, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29673827

RESUMO

Alcohol intake affects the female body differently than it affects the male body. This is caused by females' lower levels of dehydrogenase enzymes, the enzyme that breaks down alcohol, coupled with the higher fat/water ratio of the female body. Both these factors cause alcohol levels to rise more quickly after ingestion in women than in men. This makes females more vulnerable to alcohol's harmful effects, and consequently women tend to develop alcohol-related diseases earlier in life than do men. As women age and go through menopause, they experience changes in body composition and life changes like retirement or loss of a loved one. The disparity between men's and women's rates of alcohol consumption decreases, especially in last 2 decades. Stress and depression related to menopause may trigger the onset of alcohol abuse or worsen established alcohol misuse. Alcohol abuse decreases quality of life and any potential positive effects of moderate alcohol intake are minuscule in comparison to the adverse effects caused by alcohol abuse. Further, due to social stigmas, women tend to have more difficulty gaining access to treatment and recovering from alcohol dependence than do men. Current research on interventions and treatments that aim to reduce alcohol use disorder (AUD) or to prevent its occurrence in middle-aged and elderly women is limited. We provide an overview of drinking patterns, and of the prevalence, risk factors, health impacts and treatment challenges of AUD for women as they progress through middle and older age.


Assuntos
Envelhecimento/psicologia , Alcoolismo/complicações , Alcoolismo/epidemiologia , Menopausa/psicologia , Alcoolismo/etiologia , Alcoolismo/terapia , Depressão/psicologia , Feminino , Humanos , Prevalência , Qualidade de Vida , Fatores de Risco
19.
J Am Acad Dermatol ; 2018 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-29601935

RESUMO

BACKGROUND: Little is known about the effects of different dietary patterns on facial wrinkling. OBJECTIVE: We aimed to investigate the association between diet and facial wrinkles in a population-based cohort of 2,753 elderly participants of the Rotterdam Study. METHODS: Wrinkles were digitally quantified as the area in facial photographs they occupied as a percentage of the total skin area. Diet was assessed using the Food Frequency Questionnaire. Adherence to the Dutch Healthy Diet Index (DHDI) was calculated. In addition, we used Principal Component Analysis (PCA) to extract relevant food patterns in men and women separately. All food patterns and the DHDI were analyzed for association with wrinkle severity using multivariable linear regression. RESULTS: Better adherence to the Dutch guidelines was significantly associated with less wrinkles among women but not in men. In women, a red meat and snack dominant PCA pattern was associated with more facial wrinkles whereas a fruit dominant PCA pattern associated with fewer wrinkles. LIMITATIONS: Due to the cross-sectional design of our study, no causation can be proved. Health-conscious behavior could have influenced our results. CONCLUSION: Dietary habits associate with facial wrinkling in women. Global disease prevention strategies might benefit from emphasizing that a healthy diet is also linked to less facial wrinkling.

20.
Arch Gerontol Geriatr ; 76: 85-91, 2018 May - Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29477949

RESUMO

OBJECTIVE: To evaluate the associations of four individual lifestyle factors with frailty. METHODS: We used cross-sectional data from 11,539 participants of the Rotterdam Study, a population-based cohort, running from 1990 till now. A frailty index was used with a range from 0 to 100 (higher values indicating increasing frailty). We examined physical activity, dietary quality, alcohol intake, and smoking and calculated a sum-score of these, with a range from 0 (lowest) to 8 (highest). The associations between each lifestyle factor and the lifestyle score with frailty were evaluated. RESULTS: Each lifestyle factor was independently associated with frailty. Participants with high physical activity levels had lower frailty scores than participants with low physical activity (ß = -4.70,95%CI = -5.10,-4.30). High diet quality, compared to low diet quality was associated with less frailty (ß=-0.88,95%CI = -1.35,-0.42). Low alcohol intake was associated more frailty (ß = 0.84, 95%CI = 0.39, 1.29). Never-smokers or former smokers had on average 1.15 (95%CI = -1.60,-0.69) and 1.28 (95%CI = -1.78,-0.79) better frailty scores than smokers. A one-unit increment of the lifestyle score was associated with lower frailty (ß = -0.62;95%CI = -0.84,-0.53). CONCLUSIONS: The prevention of frailty can lead to lower health care costs and a higher quality of life among the growing group of elderly people. Our results emphasize that there is an urgent need for preventions that combine several lifestyle factors to improve healthy ageing.

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