Clinical nutrition最新文献

{"title":"Replies - Letter to the Editor - “Effect of a comprehensive lifestyle intervention program on body weight and health behavior in women with breast cancer: Results from a randomized controlled trial”","authors":"D. Hauner, J. Günther, F. Schederecker, L. Donik, D. Meyer, J. Hermsdörfer, T.W.P. Friedl, B. Rack, M.W. Beckmann, W. Janni, H. Hauner","doi":"10.1016/j.clnu.2024.10.030","DOIUrl":"10.1016/j.clnu.2024.10.030","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 243-244"},"PeriodicalIF":6.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed food consumption, plasma metabolite profile, and risk of all-cause and cause-specific mortality in a population-based cohort","authors":"Yufeng Du ,&nbsp;Shunming Zhang ,&nbsp;Johanne Slørdal Schjølberg ,&nbsp;Deja Hadden ,&nbsp;J. Gustav Smith ,&nbsp;Lu Qi ,&nbsp;Emily Sonestedt ,&nbsp;Yan Borné","doi":"10.1016/j.clnu.2024.10.023","DOIUrl":"10.1016/j.clnu.2024.10.023","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Epidemiological evidence on ultra-processed food (UPF) and cause-specific mortality remains limited and mixed. Molecular mechanisms underlying UPF intake and mortality remain unexplored. This study aimed to evaluate the associations between UPF consumption, metabolic signatures, and all-cause, premature, and cause-specific mortality.</div></div><div><h3>Methods</h3><div>This study included 27670 participants (mean age 58.1 years) from the Malmö Diet and Cancer (MDC) cohort study. Consumption of UPF was assessed using a food frequency questionnaire and a 7-day food diary. In a subset of the MDC (n = 879), the associations of UPF with 991 plasma metabolites were investigated. An elastic net regression model was used to establish the metabolic signature of UPF. Cox proportional hazards regression model was used to determine the association between UPF intake, metabolic signature, and mortality risk.</div></div><div><h3>Results</h3><div>During a median follow-up of 23.3 years, a total of 11333 participants died. UPF intake showed a nonlinear positive association with all-cause mortality, with more pronounced associations found in females (P_interaction = 0.044); in females, UPF was linked to a higher mortality risk in a linear manner, while the association was J-shaped in males. Each standard deviation (SD) increment in UPF intake was associated with an increased risk of premature mortality (HR, 1.06; 95 % CI, 1.03–1.09), cardiovascular disease (CVD) mortality (HR, 1.05; 95 % CI, 1.01–1.08) or respiratory disease mortality (HR, 1.08; 95 % CI, 1.01–1.15), but not cancer mortality. The metabolic signature for UPF consumption (with 93 metabolites) was positively associated with all-cause mortality risk (HR per 1 SD, 1.23; 95 % CI, 1.06–1.42).</div></div><div><h3>Conclusions</h3><div>Our results suggest that higher UPF intake is associated with increased risk of all-cause, premature, CVD, and respiratory disease mortality, with the association varying across sex for all-cause mortality. The plasma metabolic signature of UPF showed a positive association with all-cause mortality.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 184-193"},"PeriodicalIF":6.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint associations of handgrip strength and physical activity with incident cardiovascular disease and overall mortality in the UK Biobank","authors":"Ana Polo-López ,&nbsp;Joaquín Calatayud ,&nbsp;Patricia Palau ,&nbsp;Laura López-Bueno ,&nbsp;Rodrigo Núñez-Cortés ,&nbsp;Lars Louis Andersen ,&nbsp;Rubén López-Bueno","doi":"10.1016/j.clnu.2024.10.022","DOIUrl":"10.1016/j.clnu.2024.10.022","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Questions remain whether higher handgrip strength confers additional health advantages beyond adherence to current physical activity guidelines. We aimed to evaluate prospective associations of joint objectively measured handgrip strength and physical activity with incident cardiovascular disease (CVD) and all-cause mortality.</div></div><div><h3>Methods</h3><div>We analysed the UK Biobank study in a cohort of participants who wore accelerometers for one week, with follow-up based on hospital records until 2022. Patterns of physical activity were compared: participants who met current moderate-vigorous physical activity guidelines (150 min per week) and those who did not. Handgrip strength was classified into sex- and age-specific tertiles. CVD events were identified as primary or secondary by examination of inpatient records and data extracted from the death registry. CVD-related deaths were also identified from the death registry. We examined prospective associations of moderate-vigorous physical activity with incident CVD and all-cause mortality by level of handgrip using Cox regressions, adjusted for confounding factors.</div></div><div><h3>Results</h3><div>A total of 76 074 persons were included (mean 55.2 years). Meeting physical activity guidelines is necessary to reduce all-cause mortality in those at the lower and middle thirds of handgrip strength. However, meeting physical activity guidelines did not confer additional reduction of all-cause mortality of those with high handgrip strength. Those with the lowest handgrip strength showed the greatest benefit from meeting physical activity guidelines for reducing all-cause mortality (HR 0.74; 95 % CI 0.65–0.85).</div></div><div><h3>Conclusion</h3><div>Our results indicate that, while following physical activity guidelines does not reduce mortality in individuals with high handgrip strength, it is essential for preventing cardiovascular disease across all levels of handgrip strength. This underscores the importance of these guidelines for cardiovascular health.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 218-224"},"PeriodicalIF":6.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging EAT-Lancet planetary health diet is associated with major cardiovascular diseases and all-cause mortality: A global systematic review and meta-analysis","authors":"Jieyu Liu ,&nbsp;Qingqing Shen ,&nbsp;Xinxin Wang","doi":"10.1016/j.clnu.2024.10.021","DOIUrl":"10.1016/j.clnu.2024.10.021","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>In 2019, the EAT-Lancet Commission promoted a plant-based diet, emphasizing its potential to enhance human health and environmental sustainability. Nevertheless, a thorough evaluation of health benefits associated with EAT-Lancet diet requires robust statistical backing. This synthesis seeks to compile evidence related to the effects of the EAT-Lancet diet on major cardiovascular disease (CVD) and mortality.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted utilizing data from MEDLINE, EMBASE, PubMed, Web of Science, and medRxiv, covering the period from January 2019 to October 8, 2024. We included all cohort and case–control studies that investigated the association between the emerging EAT-Lancet diet and outcomes such as diabetes, CVD, all-cause mortality, and cancer. Summary effect size estimates are presented as hazard ratios (HRs) and were analyzed using random-effects models. Study heterogeneity was assessed with the Q statistic and I² statistic. Subgroup analyses were performed to identify potential sources of variability, while publication bias was evaluated using Begg's and Egger's tests. Additionally, sensitivity analyses were conducted to assess the robustness of the results.</div></div><div><h3>Results</h3><div>We identified 28 publications that included a total of over 2.21 million participants. Adhering to the EAT-Lancet dietary patterns was negatively associated with diabetes, CVD (mortality), all-cause mortality, and cancer (mortality), with HRs of 0.78 (95 % CI: 0.65–0.92), 0.84 (95 % CI: 0.81–0.87), 0.83 (95 % CI: 0.78–0.89), and 0.86 (95 % CI: 0.80–0.92), respectively. Significant heterogeneity was observed for diabetes (I² = 94.0 %), all-cause mortality (I² = 85.5 %), and cancer incidence (I² = 79.3 %). Importantly, no evidence of publication bias was found for any of the clinical outcomes analyzed. Sensitivity analyses confirmed the robustness of the results across various dietary scoring systems for CVD mortality, all-cause mortality, and cancer.</div></div><div><h3>Conclusion</h3><div>Following the EAT-Lancet diet was significantly associated with reduced odds of diabetes, CVD, cancer and mortality. These findings are clinically important, highlighting the beneficial effects of the recent EAT-Lancet diet on various health outcomes.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 167-179"},"PeriodicalIF":6.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply-Letter to the Editor–“Ultra-processed products and risk of liver cancer: A prospective cohort study”","authors":"Longgang Zhao,&nbsp;Xinyuan Zhang,&nbsp;Xuehong Zhang","doi":"10.1016/j.clnu.2024.10.019","DOIUrl":"10.1016/j.clnu.2024.10.019","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Page 251"},"PeriodicalIF":6.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor - “Dietary patterns, inflammatory biomarkers and cognition in older adults: An analysis of three population-based cohorts”","authors":"Lingjuan Jia,&nbsp;Xiangfeng Tian,&nbsp;Yongsheng Zhang","doi":"10.1016/j.clnu.2024.10.012","DOIUrl":"10.1016/j.clnu.2024.10.012","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 138-139"},"PeriodicalIF":6.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of lipid-lowering treatment on indices of MASLD in familial hypercholesterolemia patients","authors":"Chrysoula Boutari ,&nbsp;Christos V. Rizos ,&nbsp;George Liamis ,&nbsp;Ioannis Skoumas ,&nbsp;Loukianos Rallidis ,&nbsp;Anastasia Garoufi ,&nbsp;Genovefa Kolovou ,&nbsp;George Sfikas ,&nbsp;Konstantinos Tziomalos ,&nbsp;Emmanouil Skalidis ,&nbsp;Vasileios Kotsis ,&nbsp;Michalis Doumas ,&nbsp;Kimon Stamatelopoulos ,&nbsp;Vaia Lambadiari ,&nbsp;Panagiotis Anagnostis ,&nbsp;Amalia Boufidou ,&nbsp;Vasiliki Giannakopoulou ,&nbsp;Georgia Anastasiou ,&nbsp;Ermioni Petkou ,&nbsp;Charalambos Vlachopoulos ,&nbsp;Christos S. Mantzoros","doi":"10.1016/j.clnu.2024.10.020","DOIUrl":"10.1016/j.clnu.2024.10.020","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The effect of lipid-lowering treatment (LLT) on metabolic dysfunction associated steatotic liver disease (MASLD) is unclear. This is relevant for patients with familial hypercholesterolemia (FH) who are on lifelong LLT. We aimed to evaluate the effect of LLT on MASLD indices in this population.</div></div><div><h3>Methods</h3><div>Patients with at least possible diagnosis of FH were included into the Hellenic FH Registry (HELLAS-FH) registry. We analyzed the effect of statin monotherapy, statin/ezetimibe and statin/ezetimibe/proprotein convertase subtilisin/kexin 9 inhibitors (PCSK9i) on MASLD indices, i.e., original triglyceride-glucose index (TyGO) and triglyceride-glucose index (TyG). We compared changes of TyG and TyGO before any treatment and after at least one year of stable LLT.</div></div><div><h3>Results</h3><div>We included 1289 patients: n = 569 in the statin monotherapy group (mean age = 51 ± 15 years, 52.7 % males), n = 629 in the statin/ezetimibe group (52 ± 14 years, 51.8 %), and n = 91 in the statin/ezetimibe/PCSK9i group (54 ± 13 years, 58.2 %). Compared with baseline, TyGO and TyG decreased significantly following statin monotherapy (8.61 vs 8.49 and 4.65 vs 4.59, respectively, both <em>p</em> &lt; 0.01), statin/ezetimibe (8.59 vs 8.41 and 4.64 vs 4.55, respectively, both <em>p</em> &lt; 0.01) and statin/ezetimibe/PCSK9i (8.79 vs 8.55 and 4.74 vs 4.62, respectively, both <em>p</em> &lt; 0.01). There was no difference regarding the change of TyGO and TyG between groups after adjusting for baseline levels. A greater percentage of patients in the statin/ezetimibe and statin/ezetimibe/PCSK9i groups exhibited TyGO-defined MASLD resolution compared with statin monotherapy (<em>p</em> &lt; 0.05). After adjustment for possible confounders, LLT was significantly associated with MASLD resolution.</div></div><div><h3>Conclusions</h3><div>MASLD indices were significantly improved in all LLT groups in FH patients. Statin/ezetimibe and statin/ezetimibe/PCSK9i were associated with greater TyGO-defined MASLD resolution compared with statin monotherapy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 84-91"},"PeriodicalIF":6.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of myosteatosis in pancreatic cancer: A systematic review and meta-analysis","authors":"Hong-Bo Chen ,&nbsp;Qi Miao ,&nbsp;Ya-Shu Liu ,&nbsp;Xin-Yu Lou ,&nbsp;Lu-Dan Zhang ,&nbsp;Xiao-Dong Tan ,&nbsp;Ke-Ke Liang","doi":"10.1016/j.clnu.2024.10.017","DOIUrl":"10.1016/j.clnu.2024.10.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>The phenomenon of myosteatosis, characterized by the accumulation of ectopic fat within and surrounding skeletal muscle, has been identified as a potential adverse factor in the prognosis of individuals with cancer. This systematic review and meta-analysis sought to examine the association between myosteatosis and survival rates as well as postoperative complications in patients diagnosed with pancreatic cancer (PC).</div></div><div><h3>Methods</h3><div>A systematic search was conducted on Web of Science, Embase, and Pubmed until March 25, 2024, to identify pertinent articles assessing the prognostic significance of myosteatosis in patients with PC, utilizing the search terms: myosteatosis, PC, and prognosis. The selected studies were utilized to investigate the prognostic impact of myosteatosis on the survival of PC patients. Forest plots and pooled effects models were employed to present the findings of this meta-analysis. The quality of the included studies was evaluated using the Newcastle–Ottawa Scale (NOS). A total of 565 studies were initially identified from the three databases, with 14 retrospective cohort studies ultimately included in the final quantitative analysis.</div></div><div><h3>Results</h3><div>The meta-analysis revealed a significant association between myosteatosis and both overall survival (OS) [Hazard Ratio (HR): 1.55, 95 % Confidence Interval (CI): 1.40–1.72, <em>P</em> &lt; 0.001, I² = 0.0 %] and recurrence-free survival (RFS) (HR 1.48, 95 % CI: 1.17–1.86, <em>P</em> = 0.001, I² = 0.0 %) in patients diagnosed with PC. Subgroup analyses revealed that myosteatosis continued to be a negative prognostic factor in PC across various treatment modalities, patient populations, and myosteatosis assessment methods. Additionally, myosteatosis was identified as a risk factor for postoperative complications, with a pooled odds ratio of 2.20 (95 % CI: 1.45–3.35, <em>P</em> &lt; 0.001, I² = 37.5 %). All included studies achieved NOS scores of 6 or higher, indicating a relatively high level of methodological quality.</div></div><div><h3>Conclusion</h3><div>These results suggest that myosteatosis is significantly associated with both survival outcomes and postoperative complications in patients with PC.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 116-123"},"PeriodicalIF":6.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of apraglutide in short bowel syndrome with intestinal failure and colon–in–continuity: A multicenter, open-label, metabolic balance study","authors":"Astrid Verbiest ,&nbsp;Mark Krogh Hvistendahl ,&nbsp;Federico Bolognani ,&nbsp;Carrie Li ,&nbsp;Nader N. Youssef ,&nbsp;Susanna Huh ,&nbsp;Alex Menys ,&nbsp;Gauraang Bhatnagar ,&nbsp;Ragna Vanslembrouck ,&nbsp;Ronald Peeters ,&nbsp;Riccardo Sartoris ,&nbsp;Pieter Vermeersch ,&nbsp;Lucas Wauters ,&nbsp;Kristin Verbeke ,&nbsp;Palle Bekker Jeppesen ,&nbsp;Francisca Joly ,&nbsp;Tim Vanuytsel","doi":"10.1016/j.clnu.2024.10.011","DOIUrl":"10.1016/j.clnu.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Apraglutide is a novel long-acting GLP-2 analog in development for short bowel syndrome with intestinal failure (SBS-IF). This multicenter, open-label, phase 2 study in SBS-IF and colon-in-continuity (CiC) investigates the safety and efficacy of apraglutide.</div></div><div><h3>Methods</h3><div>This was a 52-week phase 2 metabolic balance study (MBS) in 9 adult patients with SBS-IF-CiC receiving once-weekly subcutaneous apraglutide injections. Safety was the primary endpoint. Secondary endpoints included changes in absorption parameters (MBS at baseline, after 4 weeks with stable parenteral support (PS), and 48 weeks), PS needs (48-week PS adjustment period based on monthly 48-h fluid balances) and intestinal morphology and motility (static and cine MRI at baseline and 4, 24 and 48 weeks).</div></div><div><h3>Results</h3><div>PS volume decreased by −4702 mL/week (−52 %; p &lt; 0.001) at week 52. Seven patients (78 %) achieved ≥1 day off PS at week 52. At 4 weeks, fecal output was reduced by 253 g/day (p = 0.013). At 48 weeks, increases in wet weight absorption by 316 g/day (p = 0.039), energy absorption by 1134 kJ/day (p = 0.041) and carbohydrate absorption by 56.1 g/day (p = 0.024) were observed. Moreover, small bowel length increased from 29.7 to 40.7 cm (p = 0.012), duodenal wall thickness increased by 0.8 mm (p = 0.02) and motility in the proximal colon was reduced (p = 0.031). A total of 127 adverse events was reported, which were mostly mild to moderate.</div></div><div><h3>Conclusion</h3><div>Apraglutide had an acceptable safety profile and was associated with significant reductions in PS needs and days off PS, improvements in intestinal absorption, and structural and functional intestinal changes in patients with SBS-IF-CiC.</div><div>ClinicalTrials.gov, Number NCT04964986.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 158-166"},"PeriodicalIF":6.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of lifestyle trajectory and total lifestyle change score with risk of metabolic syndrome: The prospective community-based Ansung-Ansan cohort study","authors":"Jialei Fu ,&nbsp;Sangah Shin","doi":"10.1016/j.clnu.2024.10.018","DOIUrl":"10.1016/j.clnu.2024.10.018","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>We aimed to examine the association of lifestyle trajectory and total lifestyle change score with the risk of metabolic syndrome (MetS).</div></div><div><h3>Methods</h3><div>We analyzed 2048 participants aged 40–69 years without MetS at baseline in the Ansung-Ansan cohort study. Lifestyle trajectories were identified using group based trajectory analysis, and total lifestyle change score were identified using index analysis. Healthy lifestyle trajectory and total lifestyle change score as exposure, and MetS as outcome. Cox proportional-hazards regression was used to examine the hazard ratios (HRs) for the exposure-outcome association.</div></div><div><h3>Results</h3><div>During the median 9.8-year follow-up, 756 cases were recorded. Compared with those in the stable low healthy lifestyle trajectory, the stable high healthy lifestyle trajectory showed a protective effect on reducing the risk of MetS (men: HR, 0.47; 95 % confidence interval [95 % CI], 0.34–0.66; women: HR, 0.62; 95 % CI, 0.43–0.91). Similar results were observed in the index based analysis, compared with those with lower total lifestyle change scores, men and women with higher scores had 46 % and 47 % lower risks of developing MetS, respectively (men: HR, 0.54; 95%CI, 0.41–0.71; women: HR, 0.53; 95 % CI, 0.41–0.68).</div></div><div><h3>Conclusions</h3><div>Stable healthy lifestyle trajectory was associated with a reduced risk of MetS among Korean adults. Furthermore, a higher total lifestyle change score was inversely associated with the risk of MetS.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 109-115"},"PeriodicalIF":6.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}