Unraveling the role of BMI and blood markers in the relationship between plant-based diets and osteoporosis: A prospective cohort study.

BACKGROUND: The potential adverse effects of plant-based diets on bone health have raised significant concern, while the prospective evidence is limited. This study aimed to evaluate the association between plant-based diet indexes and incident osteoporosis while exploring the underlying mechanisms involved in this relationship. METHODS: The analysis included 202,063 UK Biobank participants conducted between 2006 and 2022. Plant-based diet indexes (hPDI and uPDI) were calculated using the 24-h dietary questionnaire. Cox proportional risk regression and mediation analysis were used to explore the associations of plant-based diet indexes with osteoporosis, estimating the contribution of BMI and blood markers. RESULTS: We found the highest quintile for hPDI (HR = 1.16; 95% CI: 1.05 to 1.28) and uPDI (HR = 1.15; 95% CI: 1.05 to 1.26) were associated with an increased risk of osteoporosis. BMI was identified as an important mediator in the association between hPDI and osteoporosis, with mediation proportions of 46.17%. For blood markers, the mediating (suppressing) effects of C-reactive protein, alkaline phosphatase, and insulin-like growth factor-1 on the association between uPDI (hPDI) and osteoporosis were significant, ranging from 5.63%-16.87% (4.57%-6.22%). CONCLUSION: Adherence to a plant-based diet is associated with a higher risk of osteoporosis, with BMI and blood markers potentially contributing to this relationship. Notably, even a healthy plant-based diet necessitates attention to weight management to mitigate its impact on bone loss. These findings emphasize the importance of personalized dietary recommendations and lifestyle interventions to decrease the risk of osteoporosis.

Association of plant-based diets with total and cause-specific mortality across socioeconomic deprivation level: a large prospective cohort.

PURPOSE: Current evidence on the association between plant-based diet indices (PDIs) and mortality is inconsistent. We aimed to investigate the association of PDIs with all-cause and cause-specific mortality and to examine whether such associations were modified by socioeconomic deprivation level. METHODS: A total of 189,003 UK Biobank participants with at least one 24-h dietary assessment were included. All food items were categorised into three groups, including healthy plant foods, less healthy plant foods, and animal foods. Three PDIs, including the overall PDI (positive scores for all plant-based food intake and inverse scores for animal-based foods), the healthful PDI (hPDI) (positive scores only for healthy plant food intake and inverse scores for others), and the unhealthful PDI (uPDI) (positive scores only for less healthy plant food intake and inverse scores for others), were calculated according to the quantities of each food subgroup in three categories. The Townsend deprivation index was used as the indicator of socioeconomic deprivation level. Cox proportional hazard models were used to estimate the hazard ratios (HRs) of PDIs for all-cause and cause-specific mortality. The modification effects of socioeconomic deprivation levels on these associations were evaluated. RESULTS: During a median follow-up of 9.6 years, 9335 deaths were documented. Compared with the lowest quintile, the highest quintile of overall PDI was associated with adjusted HRs of 0.87 (95% CI 0.81-0.93) for all-cause mortality and 0.77 (0.66-0.91) for cardiovascular mortality. Compared with the lowest quintile, the highest quintile of hPDI was associated with lower risks of all-cause mortality (0.92, 0.86-0.98), and death caused by respiratory disease (0.63, 0.47-0.86), neurological disease (0.65, 0.48-0.88), and cancer (0.90, 0.82-0.99). Compared with the lowest quintile, the highest quintile of uPDI was associated with an HR of 1.29 (1.20-1.38) for all-cause mortality, 1.95 (1.40-2.73) for neurological mortality, 1.54 (1.13-2.09) for respiratory mortality, and 1.16 (1.06-1.27) for cancer mortality. The magnitudes of associations of hPDI and uPDI with mortality were larger in the most socioeconomically deprived participants (the highest tertile) than in the less deprived ones (p-values for interaction were 0.039 and 0.001, respectively). CONCLUSIONS: This study showed that having a high overall PDI and hPDI were related to a reduced risk of death, while the uPDI was linked to a higher risk of death. Sticking to a healthy plant-based diet may help decrease mortality risks across socioeconomic deprivation levels, especially for those who are the most socioeconomically deprived.

Development of a sustainable diet index in US adults.

BACKGROUND: A transformation towards healthy diets through a sustainable food system is essential to enhance both human and planet health. Development of a valid, multidimensional, quantitative index of a sustainable diet would allow monitoring progress in the US population. We evaluated the content and construct validity of a sustainable diet index for US adults (SDI-US) based on data collected at the individual level. METHODS: The SDI-US, adapted from the SDI validated in the French population, was developed using data on US adults aged 20 years and older from the National Health and Nutrition Examination Survey, 2007-2018 (n = 25,543). The index consisted of 4 sub-indices, made up of 12 indicators, corresponding to 4 dimensions of sustainable diets (nutritional quality, environmental impacts, affordability (economic), and ready-made product use behaviors (sociocultural)). A higher SDI-US score indicates greater alignment with sustainable diets (range: 4-20). Validation analyses were performed, including the assessment of the relevance of each indicator, correlations between individual indicators, sub-indices, and total SDI-US, differences in scores between sociodemographic subgroups, and associations with selected food groups in dietary guidelines, the alternative Mediterranean diet (aMed) score, and the EAT-Lancet diet score. RESULTS: Total SDI-US mean was 13.1 (standard error 0.04). The correlation between SDI-US and sub-indices ranged from 0.39 for the environmental sub-index to 0.61 for the economic sub-index (Pearson Correlation coefficient). The correlation between a modified SDI-US after removing each sub-index and the SDI-US ranged from 0.83 to 0.93. aMed scores and EAT-Lancet diet scores were significantly higher among adults in the highest SDI-US quintile compared to the lowest quintile (aMed: 4.6 vs. 3.2; EAT-Lancet diet score: 9.9 vs. 8.7 p < .0001 for both). CONCLUSIONS: Overall, content and construct validity of the SDI-US were acceptable. The SDI-US reflected the key features of sustainable diets by integrating four sub-indices, comparable to the SDI-France. The SDI-US can be used to assess alignment with sustainable diets in the US. Continued monitoring of US adults' diets using the SDI-US could help improve dietary sustainability.

Associations between Plant-Based Dietary Patterns and Sensory Impairments among Chinese Older Adults: Based on the Chinese Longitudinal Healthy Longevity Survey.

INTRODUCTION: The aim of this study was to investigate the relationship between the plant-based dietary index and vision impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI) among Chinese aged 65 and older. METHODS: Based on the 2018 data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a cross-sectional study was conducted on 14,859 samples. The assessment of dietary quality utilized the plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Logistic regression analysis was used to examine the associations between PDIs and sensory impairments. Additionally, restricted cubic spline analysis was utilized to investigate the nonlinear association between PDIs and sensory impairments. RESULTS: Participants in the highest quintile of PDI exhibited reduced prevalence of VI (OR 0.78, 95% CI: 0.67-0.90, ptrend <0.001), HI (OR 0.83, 95% CI: 0.70-0.99, ptrend <0.001), and DSI (OR 0.62, 95% CI: 0.51-0.77, ptrend <0.001) relative to those in the lowest quintile. Moreover, individuals who ranked in the highest quintile for hPDI exhibited a 25% reduced risk of VI disease. Conversely, those in the highest quintile of uPDI were associated with increased prevalence of VI (OR 1.37, 95% CI: 1.17-1.61, ptrend <0.001), HI (OR 1.36, 95% CI: 1.12-1.65, ptrend <0.001), and DSI (OR 1.56, 95% CI: 1.25-1.95, ptrend <0.001). The relationship between PDIs increasing by every 10 units and sensory impairments showed similar patterns. Notably, hPDI demonstrated a nonlinear relationship with HI (pfor nonlinearity = 0.001), while the others exhibited linear associations. CONCLUSION: The increase in PDI and hPDI correlates with a reduced prevalence of one or more sensory impairments. Conversely, an increase in uPDI is associated with an elevated prevalence of multiple sensory impairments. Our study findings emphasize the significance of plant-based food quality, advocating for adherence to a plant-based dietary pattern while reducing the intake of less healthy plant foods and animal-based products.

Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria.

BACKGROUND: The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of healthy food purchases among employees and to what extent health promotion activities should be tailored to the demographic characteristics of the employees. The purpose of this study was to (1) assess the nutritional quality of lunchtime meal purchases by employees in cafeterias of a large organization, (2) examine associations between lunchtime meal quality selection and the demographic characteristics of employees, and (3) determine the healthfulness of foods and beverages offered in the cafeterias of this organization. METHODS: A cross-sectional analysis was conducted using secondary data from a food labeling study implemented in three worksite cafeterias. Demographic data was collected via surveys and meal data was collected using a photo capture system for 378 participants. The Healthy Eating Index 2015 (HEI-2015) was used to determine meal quality and a total score for the menu of options available in the cafeterias during the study period. Summary statistics were generated, and the analysis of variance (ANOVA) was used to compare the HEI-2015 scores between groups. RESULTS: The mean HEI-2015 total score for the menu items offered (n = 1,229) in the cafeteria during the study period was 63.1 (SD = 1.83). The mean HEI-2015 score for individual lunchtime meal observations (n = 378) was 47.1 (SD = 6.8). In general, HEI-2015 total scores were higher for non-smokers, individuals who self-identified as Asian, had higher physical activity levels, scored higher on numeracy and literacy assessments, and reported higher education levels, incomes, and health status. CONCLUSIONS: The overall HEI-2015 scores indicate that the menu of options offered in the cafeterias and individual meal selections did not align with the Dietary Guidelines for Americans, and there were significant associations between average lunchtime meal quality scores and several demographic characteristics. These results suggest that healthy eating promotion activities in workplaces may need to be tailored to the demographic characteristics of the employees, and efforts to improve the food environment in the workplace could improve meal quality for all employees.

Association between joint physical activity and healthy dietary patterns and hypertension in US adults: cross-sectional NHANES study.

BACKGROUND: Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults. METHODS: We used data collected from the 2007-2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension. RESULTS: A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65-0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76-1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76-1.06) were not associated with hypertension. CONCLUSION: In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.

Associations of the planetary health diet index (PHDI) with asthma: the mediating role of body mass index.

BACKGROUND: Given the global shifts in environmental conditions and dietary habits, understanding the potential impact of dietary factors and body mass index (BMI) on respiratory diseases, including asthma, is paramount. Investigating these relationships can contribute to the formulation of more effective prevention strategies. The Planetary Health Diet Index (PHDI), a dietary scoring system that balances human health with environmental sustainability, underscores the importance of increasing the consumption of plant-based foods while reducing the intake of red meat, sugar, and highly processed foods. The objective of this study was to assess the association between PHDI and the prevalence of asthma and the mediation effect of BMI in a US general population. METHODS: This study utilized data from 32,388 participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018. Multivariate logistic regression and weighted quantile sum (WQS) regressions were employed to investigate the association between PHDI, individual nutrients, and asthma. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between PHDI and asthma. Interaction analyses were conducted on subgroups to validate the findings. Mediation analysis was performed to examine the effect of BMI on the relationship between PHDI and asthma. RESULTS: There was a significant negative association between PHDI and asthma. After adjusting for covariates, for every 10-point increase in PHDI, there was a 4% decrease in the prevalence of asthma (P = 0.025). Moreover, as PHDI increased, there was a trend towards lower asthma prevalence (P for trend < 0.05). WQS analyses showed consistent associations (OR = 0.93, 95%CI: 0.88, 0.98), with Fiber, Vitamin C, and Protein significant factors. The dose-response curve indicated a linear association between PHDI and asthma, with higher PHDI associated with lower asthma prevalence. Additionally, BMI is significantly positively associated with asthma (P < 0.001), and BMI decreases as the PHDI increases (ß = -0.64, P < 0.001). Mediation analysis indicates that BMI significantly mediates the relationship between PHDI and asthma, with a mediation proportion of 33.85% (P < 0.001). CONCLUSION: The results of this study show a strong negative correlation between PHDI and the prevalence of asthma. In addition, BMI mediated this negative relationship.

The relationship between perceived stress and emotional eating in bus drivers: the effect of shift work.

This study discusses the relationship between perceived stress and emotional eating based on shiftwork in city bus drivers. It was conducted with 1403 male city bus drivers working in Istanbul. Questions about the drivers' physical activity and dietary habits, the Healthy Diet Index (HDI), Emotional Appetite Questionnaire and Perceived Stress Scale-10 data were collected and evaluated in two groups: shift and non-shift employees. It was found that the shift workers (SWs) have lower perceived stress, physical activity, HDI and positive emotional appetite averages. In addition, for SWs, a positive correlation was found between negative emotional appetite scores and physical activity and HDI scores. In conclusion, the drivers working in shifts were found to be slightly overweight and had lower physical activity levels, had lower HDI scores, and their nutritional status was more negatively impacted than their counterparts.

[Dietary quality and its relationship with metabolic syndrome in the population aged 45 to 59 in Zhejiang Province in 2022].

OBJECTIVE: To explore the relationship between dietary quality and metabolic syndrome(MS) in the population aged 45 to 59 in Zhejiang Province. METHODS: Selecting the 45-59 year old population as the research object from the 2022 nutrition and health monitoring data of residents in Zhejiang Province. Dietary data was obtained by the 24-hour dietary review method on 3 consecutive days and the weighing method of household cooking oil and condiments, and dietary quality was evaluated using the China health diet index(CHDI), which was categorized into four groups according to quartiles of CHDI scores. Multivariate logistic regression model was used to analyze the relationship between different CHDI score groups and MS and its components. RESULTS: A total of 1421 study participants were included, with a mean CHDI score of(56.83±11.80) and a prevalence of MS of 24.5%. After adjusting for gender, age, smoking, and physical activity, the Q4 group with the highest CHDI score had a decreased risk of developing MS(OR=0.57, 95%CI 0.40-0.82), hypertension(OR=0.60, 95% CI 0.44-0.81), and elevated fasting blood glucose(OR=0.41, 95%CI 0.26-0.65) compared to the Q1 group with the lowest CHDI score. After conducting gender subgroup analysis, it was found that: the risk of developing MS, hypertension and high triglycerides was decreased in the Q4 group of CHDI scores in females compared with the Q1 group(P<0.05), whereas in males only high CHDI scores were found to be a protective factor for elevated fasting blood glucose(P<0.05). CONCLUSION: The quality of diet is negatively associated with the risk of MS, hypertension and hyperglycemia in people aged 45-59 years in Zhejiang Province, and there are gender differences in the relationship between CHDI and MS and its components.

Association between plant-based dietary pattern and biological aging trajectory in a large prospective cohort.

BACKGROUND: Aging is a dynamic and heterogeneous process that may better be captured by trajectories of aging biomarkers. Biological age has been advocated as a better biomarker of aging than chronological age, and plant-based dietary patterns have been found to be linked to aging. However, the associations of biological age trajectories with mortality and plant-based dietary patterns remained unclear. METHODS: Using group-based trajectory modeling approach, we identified distinctive aging trajectory groups among 12,784 participants based on a recently developed biological aging measure acquired at four-time points within an 8-year period. We then examined associations between aging trajectories and quintiles of plant-based dietary patterns assessed by overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) among 10,191 participants who had complete data on dietary intake, using multivariable multinomial logistics regression adjusting for sociodemographic and lifestyles factors. Cox proportional hazards regression models were applied to investigate the association between aging trajectories and all-cause mortality. RESULTS: We identified three latent classes of accelerated aging trajectories: slow aging, medium-degree, and high-degree accelerated aging trajectories. Participants who had higher PDI or hPDI had lower odds of being in medium-degree (OR = 0.75, 95% CI: 0.65, 0.86 for PDI; OR = 0.73, 95% CI: 0.62, 0.85 for hPDI) or high-degree (OR = 0.63, 95% CI: 0.46, 0.86 for PDI; OR = 0.62, 95% CI: 0.44, 0.88 for hPDI) accelerated aging trajectories. Participants in the highest quintile of uPDI were more likely to be in medium-degree (OR = 1.72, 95% CI: 1.48, 1.99) or high-degree (OR = 1.70, 95% CI: 1.21, 2.38) accelerated aging trajectories. With a mean follow-up time of 8.40 years and 803 (6.28%) participants died by the end of follow-up, we found that participants in medium-degree (HR = 1.56, 95% CI: 1.29, 1.89) or high-degree (HR = 3.72, 95% CI: 2.73, 5.08) accelerated aging trajectory groups had higher risks of death than those in the slow aging trajectory. CONCLUSIONS: We identified three distinctive aging trajectories in a large Asian cohort and found that adopting a plant-based dietary pattern, especially when rich in healthful plant foods, was associated with substantially lowered pace of aging.

Association between plant-based diets and metabolic syndrome in obese adults from Iran: a cross-sectional study.

BACKGROUND: Metabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity. METHODS: In Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed. RESULTS: The average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m2. There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54-1.47), hPDI (OR: 0.82; 95% CI: 0.48-1.40), and uPDI (OR: 0.83; 95% CI: 0.87-2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13-5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04-6.04) and second (OR: 2.58; 95% CI: 1.05-6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass. CONCLUSION: We found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings.

Association between the quality of plant-based diets and periodontitis in the U.S. general population.

AIM: To investigate the relationship between plant-based diet indices (PDIs) and periodontitis and serum IgG antibodies against periodontopathogens in the U.S. MATERIALS AND METHODS: We analysed cross-sectional data on 5651 participants ≥40 years of age from the Third National Health and Nutrition Examination Survey. Food frequency questionnaire data were used to calculate the overall PDI, healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Periodontitis was defined using a half-reduced Centers for Disease Control and Prevention and American Academy of Periodontology case definition. Serum antibodies against 19 periodontopathogens were used to classify the population into two subgroups using hierarchical clustering. Survey-weighted multivariable logistic regressions were applied to assess the associations of PDI/hPDI/uPDI z-scores with periodontitis and hierarchical clusters after adjusting for potential confounders. RESULTS: A total of 2841 (50.3%) participants were defined as having moderate/severe periodontitis. The overall PDI z-score was not significantly associated with the clinical and bacterial markers of periodontitis. By considering the healthiness of plant foods, we observed an inverse association between hPDI z-score and periodontitis (odds ratio [OR] = 0.925, 95% confidence interval [CI]: 0.860-0.995). In contrast, higher uPDI z-score (adherence to unhealthful plant foods) might increase the risk of periodontitis (OR = 1.100; 95% CI: 1.043-1.161). Regarding antibodies against periodontopathogens, the participants in cluster 2 had higher periodontal antibodies than those in cluster 1. The hPDI z-score was positively associated with cluster 2 (OR = 1.192; 95% CI: 1.112-1.278). In contrast, an inverse association between uPDI z-score and cluster 2 was found (OR = 0.834; 95% CI: 0.775-0.896). CONCLUSIONS: Plant-based diets were associated with periodontitis, depending on their quality. A healthy plant-based diet was inversely related to an increased risk of periodontitis but positively related to elevated antibody levels against periodontopathogens. For an unhealthy plant-based diet, the opposite trends were observed.

The association between adherence to alternative healthy Diet Index (AHEI) and severity, disability, duration, and frequency of migraine headache among women: a cross-sectional study.

BACKGROUND: Migraine is a common brain disorder characterized by recurrent seizures lasting between 4 and 72 h. Dietary factors can affect migraine headaches. The Alternative Healthy Diet Index (AHEI) is a measure of diet quality and adherence to healthy dietary patterns. This study aimed to assess the association of adherence to AHEI and severity, disability, duration, and frequency of migraine headaches. METHODS: In this cross-sectional study, 266 women who suffered from migraines were selected. Usual dietary intakes were assessed using a semi-quantitative, 147-item, food frequency questionnaire (FFQ). AHEI was calculated based on FFQ. The Migraine Disability Assessments (MIDAS) and Visual Analog Scale (VAS) questionnaires were used to evaluate migraine disability, severity and the pain, duration and frequency of headaches. RESULTS: People with high adherence to AHEI, compared with low adherence, had a 43% reduction in headache duration in the crude model (OR = 0.57; 95% CI 0.34, 0.97; P = 0.03), which remained significant after adjusting for potential confounders (OR = 0.56; 95% CI 0.31, 0.99; P = 0.04). No association was found between the frequency of migraine and AHEI in both crude and adjusted models (OR = 1.19; 95% CI 0.66, 2.14; P = 0.55). In addition, no significant association was found between high adherence of AHEI and odds of severe and moderate headaches (P > 0.05). CONCLUSION: The results of our study showed that people with high adherence of AHEI had a 43% reduction in duration of migraine. More studies are needed to evaluate and better understand this relationship.

The maternal diet index in pregnancy is associated with offspring allergic diseases: the Healthy Start study.

BACKGROUND: A systematic review showed limited associations between pregnancy diet and offspring allergy. We developed a maternal diet index during pregnancy that was associated with offspring allergy outcomes. METHODS: Data came from Healthy Start, a Colorado pre-birth cohort of mother/offspring dyads. Food propensity questionnaires were completed during pregnancy. Offspring allergic rhinitis, atopic dermatitis, asthma, wheeze, and food allergy diagnosis up to age four were verified from electronic medical records. Data were randomized into test and replication sets. The index included the weighted combination of variables that best predicted a combined outcome of any allergy in the test set. Index utility was verified in the replication set. Separate adjusted and unadjusted logistic models estimated associations between the index and each offspring allergy diagnosis in the full sample. RESULTS: The index included weighted measures of intake of vegetables, yogurt, fried potatoes, rice/grains, red meats, pure fruit juice, and cold cereals. Vegetables and yogurt were associated with the prevention of any allergy, while other components were associated with increased disease. In adjusted models, a one-unit increase in the index was significantly associated with reduced odds of offspring allergic rhinitis (odds ratio (CI) 0.82 [0.72-0.94]), atopic dermatitis (0.77 [0.69-0.86]), asthma (0.84 [0.74-0.96]), and wheeze (0.80 [0.71-0.90]), but not food allergy (0.84 [0.66-1.08]). CONCLUSIONS: This is the first study that has shown associations between an index of maternal dietary intake during pregnancy and multiple offspring allergic diseases. The results give hope for prevention of allergic diseases in utero.

Association between different types of plant-based diet and dyslipidaemia in Korean adults.

This study investigated the association between the different types of plant-based diets and dyslipidaemia in Korean adults using data from the nationally representative sample. Using the 2012­2016 Korea National Health and Nutrition Survey data, a total of 14 167 adults (≥19 years old) participated in this study. Dietary intake was assessed by a semi-quantitative FFQ. Three different plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI)), were calculated. Dyslipidaemia and its components (hypertriacylglycerolaemia, hypercholesterolaemia, low HDL-cholesterol, high LDL-cholesterol, use of anti-hyperlipidaemia agent) were measured. Multivariable logistic regression analysis was used to examine the associations between plant-based diet and dyslipidaemia and individual lipid disorders. Totally, 47% of overall population had dyslipidaemia. Individual in the highest quintile of uPDI had 22% greater odds of dyslipidaemia (95 % CI 1·05, 1·41) and 48 % higher odds of hypertriacylglycerolaemia (95 % CI 1·21, 1·81) and 16% higher odds of low HDL-cholesterol (OR: 1·16, 95 % CI 1·00, 1·35) than those in the lowest quintile of uPDI. PDI was associated with 16 % higher odds of low HDL-cholesterol, and hPDI was associated with 25% lower odds of high LDL-cholesterol. However, neither PDI nor hPDI was significantly associated with the prevalence of dyslipidaemia. Greater adherence to unhealthful plant-based diets was associated with greater odds of the dyslipidaemia and its components suggesting the importance of the quality of plant-based diet in South Korean adults for dyslipidaemia prevention.

Adherence to the Dutch healthy diet index and change in glycemic control and cardiometabolic markers in people with type 2 diabetes.

PURPOSE: To investigate whether adherence to the Dutch Healthy Diet index 2015 (DHD15-index) is associated with change in glycemic control and cardio-metabolic markers over two-year follow-up in people with type 2 diabetes (T2D). METHODS: This prospective cohort study included 1202 individuals with T2D (mean age 68.7 ± 9.0 years; 62.5% male; mean HbA1c 53.8 ± 11.7 mmol/mol) from the Diabetes Care System cohort. Baseline dietary intake was assessed using a validated food frequency questionnaire, and adherence to the DHD15-index was estimated (range 0-130). HbA1c, fasting glucose, blood lipids (HDL and LDL cholesterol, cholesterol ratio), blood pressure, estimated glomerular filtration rate (eGFR), and BMI were measured at baseline, and after one- and two-year follow-up. Linear mixed model analyses were conducted to examine the associations between adherence to the DHD15-index and glycemic control and the cardio-metabolic outcomes, adjusting for energy intake, sociodemographic and lifestyle characteristics, and medication. RESULTS: Highest adherence (T3) to the DHD15-index was not associated with change in HbA1c, compared to lowest adherence (T1) [ßT3vsT1: 0.62 mmol/mol (- 0.94; 2.19), Ptrend = 0.44]. There was a non-linear association with fasting glucose, where moderate adherence (T2) was associated with a decrease in fasting glucose [ßT2vsT1: - 0.29 mmol/L (- 0.55; - 0.03), Ptrend = 0.30]. Higher adherence to the DHD15-index was associated with a decrease in BMI [ß10point: - 0.41 kg/m2 (- 0.60; - 0.21), Ptrend < 0.001], but not with blood lipids, blood pressure or kidney function. CONCLUSION: In this well-controlled population of people with T2D, adherence to the DHD15-index was associated with a decrease in BMI, but not with change in glycemic control or other cardio-metabolic parameters.

Plasma boron concentrations in the general population: a cross-sectional analysis of cardio-metabolic and dietary correlates.

PURPOSE: Experimental evidence suggests positive effects of boron on health and metabolism, but human data are still scarce. We aimed to identify dietary and cardio-metabolic correlates of plasma boron concentrations in the general population. METHODS: In a community-based sample (n = 899, 57% men, mean age 61 years), plasma boron (median [IQR]: 33.80 µg/L [25.61; 44.65]) concentrations were measured by inductively coupled plasma-mass spectrometry. Overall (PDI), healthy (hPDI), and unhealthy (uPDI) plant-based diet indices were derived from a validated food frequency questionnaire. Reduced rank regression (RRR) yielded a dietary pattern explaining 30% of the variation of circulating boron. Cross-sectional associations of dietary indices and cardio-metabolic traits with plasma boron concentrations were assessed using multivariable-adjusted linear regression analysis. RESULTS: The RRR pattern was characterized by high intake of fruits, nuts/seeds, tea, wine and low intake of e.g. bread, poultry, processed meat, chocolate/sweets, and soft drinks. 10-point increments in PDI, hPDI, and uPDI were associated with 8.7% (95% CI: 4.2; 13.4), 10.4% (95% CI: 6.6; 14.3), and -8.8% (95% CI: -12.1; -5.4) change in plasma boron concentrations, respectively. Age and phosphate were directly, while BMI, plasma lipid concentrations, and CRP were inversely associated with circulating boron. Plasma boron concentrations were higher in summer vs. winter, in individuals taking vs. not taking antihypertensive medication, and in individuals with high or medium vs. low education level. CONCLUSION: Higher plasma boron concentrations appeared to associate with a healthier diet, were related to lower BMI and a more favorable cardio-metabolic risk profile, and showed seasonal variations.

Association of eating habits and Firmicutes/Bacteroidetes ratio among Japanese female university students: A cross-sectional study.

Background & Aims: University students are prone to changes in their health status and lifestyle due to changes in their living environment and associated stress and anxiety. These changes may affect them in later life. This study utilized a cross-sectional study among Japanese female university students to examine dietary factors affecting their fecal microbiota. Methods: Sixty-eight healthy female university students were evaluated using an eating behavior assessment and diet history questionnaire. The 12-component Japanese diet index (JDI-12) was then calculated. A quantitative real-time PCR method was used to analyze the predominant bacterial species in the gut, and the Firmicutes/Bacteroidetes ratio (F/B ratio) at the phylum level was calculated. The partial correlation between the fecal microbiota and eating behavior abnormality score was assessed, and dietary habits associated with the F/B ratio were analyzed. Results: A significant correlation was identified between F/B ratios and the eating behavior abnormality score (r = 0.26, FDR = 0.064). Additionally, multiple regression analysis identified a negative correlation trend between the F/B ratio and JDI-12 score (ß = -0.22; p = 0.091), and exploratory analysis found a negative association between the F/B ratio and consumption of beef and pork, one of the less beneficial JDI-12 components (ß = -0.33, FDR = 0.120). Conclusion: In healthy female university students, there was a positive correlation between eating behavior abnormality and the F/B ratio, indicating that adherence to the Japanese diet pattern may be associated with a lower F/B ratio.

Plant-Based Diet Index and Metabolic Risk in Men: Exploring the Role of the Gut Microbiome.

BACKGROUND: Healthy plant-based diet index (hPDI) is associated with a lower risk of cardiometabolic conditions, but its association as well as interactions with microbiome have not been elucidated. OBJECTIVES: We aimed to investigate the interrelations between hPDI, gut microbiome, and cardiometabolic risk markers. METHODS: hPDI was derived from dietary assessments by a validated FFQ and was examined in relation to metagenomic profiles of 911 fecal samples collected from 303 men aged 71 ± 4 y with an average BMI (in kg/m2) of 25.2 ± 3.6 in the Men's Lifestyle Validation Study. Principal coordinate (PCo) analysis based on Bray-Curtis dissimilarity was conducted, and interactions between hPDI and PCo were examined by using a metabolic risk score composed of blood lipids, BMI, and glycated hemoglobin. RESULTS: After multivariable adjustment, hPDI was significantly associated with the relative abundance of 7 species and 9 pathways. In particular, higher hPDI was significantly associated with a higher relative abundance of Bacteroides cellulosilyticus and Eubacterium eligens, amino acid biosynthesis pathways (l-isoleucine biosynthesis I and III and l-valine biosynthesis), and the pathway of pyruvate fermentation to isobutanol. A favorable association between hPDI and the metabolic risk score was more pronounced among men with a higher PCo characterized by higher abundance of Bacteroides uniformis and lower abundance of Prevotella copri. At the individual species level, a similar interaction was also observed between hPDI and P. copri, as well as with Clostridium clostridioforme or Blautia hydrogenotrophica (all P-interaction < 0.01). CONCLUSION: A greater adherence to a healthy plant-based diet by older men was associated with a microbial profile characterized by a higher abundance of multiple species, including B. cellulosilyticus and E. eligens, as well as pathways in amino acid metabolism and pyruvate fermentation. In addition, inverse associations between healthy plant-based diet and human metabolic risk may partially depend on microbial compositions.

Established diet quality indices are not universally associated with body composition in young adult women.

OBJECTIVE: To determine which established diet quality indices best predict weight-related outcomes in young women. DESIGN: In this cross-sectional analysis, we collected dietary information using the Harvard FFQ and measured body fat percentage (BF%) by dual-energy X-ray absorptiometry. We used FFQ data to derive five diet quality indices: Recommended Food Score (RFS), Healthy Eating Index 2015 (HEI-2015), Alternate Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet Score (aMED) and Healthy Plant-Based Diet Index (HPDI). SETTING: University of Massachusetts at Amherst. PARTICIPANTS: Two hundred sixty healthy women aged 18-30 years. RESULTS: The AHEI-2010 and HPDI were associated with BMI and BF%, such that a ten-point increase in either diet score was associated with a 1·2 percentage-point lower BF% and a 0·5 kg/m2 lower BMI (P < 0·05). Odds of excess body fat (i.e. BF% > 32 %) were 50 % lower for those in the highest v. lowest tertile of the AHEI-2010 (P = 0·04). Neither the RFS nor HEI-2015 was associated with BMI or BF%; the aMED was associated with BMI but not BF%. CONCLUSIONS: These results suggest that diet quality tends to be inversely associated with BMI and BF% in young women, but that this association is not observed for all diet quality indices. Diet indices may have limited utility in populations where the specific healthful foods and food groups emphasised by the index are not widely consumed. Future research should aim to replicate these findings in longitudinal studies that compare body composition changes over time across diet indices in young women.