BMJ Nutrition, Prevention and Health最新文献

{"title":"Plant-based diets and the incidence of cardiovascular disease: the Million Veteran Program","authors":"Yanping Li, Dong D Wang, Xuan-Mai T Nguyen, Rebecca J Song, Yuk-Lam Ho, Frank B Hu, Walter C Willett, Peter W F Wilson, Kelly Cho, John Michael Gaziano, Luc Djousse","doi":"10.1136/bmjnph-2021-000401","DOIUrl":"https://doi.org/10.1136/bmjnph-2021-000401","url":null,"abstract":"Background A healthful plant-based diet was associated with lower risks of coronary heart disease and type 2 diabetes, and a favourable profile of adiposity-associated biomarkers, while an unhealthful plant-based diet was associated with elevated risk of cardiometabolic disease in health professional populations. However, little is known about the associations between plant-based dietary patterns and risk of cardiovascular disease (CVD) in US veterans. Methods The study population consisted of 148 506 participants who were free of diabetes, CVD and cancer at baseline in the Veterans Affairs (VA) Million Veteran Program. Diet was assessed using a Food Frequency Questionnaire at baseline. We calculated an overall Plant-Based Diet Index (PDI), a healthful PDI (hPDI) and an unhealthful PDI (uPDI). The CVD endpoints included non-fatal myocardial infarction (MI) and acute ischaemic stroke (AIS) identified through high-throughput phenotyping algorithms approach and fatal CVD events identified by searching the National Death Index. Results With up to 8 years of follow-up, we documented 5025 CVD cases. After adjustment for confounding factors, a higher PDI was significantly associated with a lower risk of CVD (HR comparing extreme quintiles=0.75, 95% CI 0.68 to 0.82, P trend <0.0001). We observed an inverse association between hPDI and the risk of CVD (HR comparing extreme quintiles=0.71, 95% CI 0.64 to 0.78, P trend <0.001), whereas uPDI was positively associated with the risk of CVD (HR comparing extreme quintiles=1.12, 95% CI 1.02 to 1.24, P trend <0.001). We found similar associations of hPDI with subtypes of CVD; a 10-unit increment in hPDI was associated with HRs (95% CI) of 0.81 (0.75 to 0.87) for fatal CVD, 0.86 (0.79 to 0.94) for non-fatal MI and 0.86 (0.78 to 0.95) for non-fatal AIS. Conclusions Plant-based dietary pattern enriched with healthier plant foods was associated with a substantially lower CVD risk in US veterans.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135218363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to treat the climate and nature crisis as one indivisible global health emergency","authors":"Chris Zielinski","doi":"10.1136/bmjnph-2023-000804","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000804","url":null,"abstract":"","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134973892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing systems biology: a paradigm shift in modern medicine for identifying and treating nutritional deficiencies","authors":"Ramona M Wallace","doi":"10.1136/bmjnph-2023-000787","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000787","url":null,"abstract":"","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135666909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study","authors":"Si Li, Ka U Lio, Truong-An Ho, Yichen Wang, Parth Rali","doi":"10.1136/bmjnph-2023-000705","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000705","url":null,"abstract":"Background To evaluate the occurrence of malnutrition in pulmonary embolism (PE)-related hospitalisations and assess the impact of malnutrition on the outcomes of patients with PE. Methods A retrospective observational study using data extracted from the Nationwide Inpatient Sample from 2016 to 2018. Hospitalisations with a principal diagnosis of PE were obtained using International Classification of Diseases, Tenth Revision codes and divided into groups based on a secondary diagnosis of malnutrition. Results Of 563 135 PE hospitalisations, 30 495 (5.4%) had malnutrition. PE patients with malnutrition were older (mean age±SD, 69.1±14.5 vs 62.3±16.6, p<0.001) and with higher Charlson Comorbidity Index score (3 to 5, 24.8% vs 12.9%, p<0.001). Concurrent malnutrition was associated with higher adjusted OR (aOR) of in-hospital mortality (aOR 2.43, 95% CI 2.18 to 2.70, p<0.001), acute kidney injury (aOR 1.56, 95% CI 1.45 to 1.67, p<0.001), sepsis (aOR 4.37, 95% CI 3.79 to 5.03, p<0.001), shock (aOR 2.52, 95% CI 2.25 to 2.81, p<0.001), acidosis (aOR 2.55, 95% CI 2.34 to 2.77, p<0.001) and mechanical ventilation (aOR 2.95, 95% CI 2.61 to 3.33, p<0.001). Patients with PE and malnutrition had an increased mean length of stay (adjusted difference 3.39 days, 95% CI 3.14 to 3.65, p<0.001), hospital charges (adjusted difference US$34 802.11, 95% CI US$31 005.01 to US$38 599.22, p<0.001) and costs (adjusted difference US$8 332.01, 95% CI US$7489.09 to US$9174.94, p<0.001). Conclusion Concurrent PE and malnutrition were associated with worse outcomes. The study highlights the importance of identifying malnutrition in patients with PE to improve outcomes and reduce healthcare utilisation.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136033813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum lifestyle behaviour among women with prior gestational diabetes mellitus: evidence from the HUNT study","authors":"Hanne Ringvoll, Marit Kolberg, Vegar Rangul, Ingrid Hafskjold, Eirin Beate Haug, Rune Blomhoff, Hege Berg Henriksen, Julie Horn","doi":"10.1136/bmjnph-2022-000612","DOIUrl":"https://doi.org/10.1136/bmjnph-2022-000612","url":null,"abstract":"Introduction Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Recommendations for postpartum follow-up include targeted lifestyle advice to lower the risk. The aim of this study was to compare postpartum lifestyle behaviours and perceptions among women with and without a history of GDM. In addition, we examined whether lifestyle behaviours of women with a history of GDM participating in a lifestyle intervention study differed from lifestyle behaviours of women with a history of GDM in the general population. Research design and methods We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) to information from the Medical Birth Registry of Norway for women with registered births between 2000 and 2019. Using logistic regression, we compared lifestyle behaviours in women with and without GDM. In secondary analyses, lifestyle behaviours in women with GDM participating in a postpartum lifestyle intervention study were compared with HUNT participants with GDM using Fisher’s exact tests/t-tests. Results A high proportion of the women in our population, regardless of GDM history, reported several unhealthy lifestyle behaviours. We found no significant association between history of GDM and lifestyle behaviours. The lifestyle intervention study for women with a history of GDM appeared to recruit women with more favourable lifestyle behaviours. Conclusions Women, regardless of GDM history, could potentially benefit from further support for lifestyle improvement, but it may be especially important in women with a history of GDM given their increased risk of T2DM and CVD. Interventions targeting women with GDM might not reach the women with the unhealthiest lifestyle behaviours, and measures to reach out to all women should be further investigated.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136098453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant-based diet and COVID-19 severity: results from a cross-sectional study","authors":"Samira Soltanieh, Marieh Salavatizadeh, Tooba Ghazanfari, Soodeh Razeghi Jahromi, Zahra Yari, Mohammad Ali Mansournia, Maryam Nazemipour, Jalil Arab Kheradmand, Sussan K Ardestani, Sara Karimi, Azita Hekmatdoost","doi":"10.1136/bmjnph-2023-000688","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000688","url":null,"abstract":"Although previous findings have shown the beneficial role of healthy eating pattern on the human immune system, the association between plant-based diet and COVID-19 severity has not yet been elucidated. This study aimed to determine the possible role of plant-based diet index (PDI) in COVID-19 severity. This cross-sectional, multicentral study was conducted on 141 patients with confirmed COVID-19. Dietary intakes of the patients were evaluated using a validated food frequency questionnaire. Then, PDI was compared between patients who needed to be hospitalised (considered severe cases), and those who got treatment at home (considered non-severe cases). After adjustment for confounders including age, sex, energy intake and body mass index, lower odds of hospitalisation were found for participants having a greater score of overall PDI (OR per 10 units increase: 0.42; 95% CI 0.22 to 0.80) and healthy PDI (OR per 10 unit increase: 0.45; 95% CI 0.26 to 0.78). In conclusion, our data presented that there is a relation between PDI and lower risk of hospitalisation in COVID-19 patients, possibly through boosting the immune function.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135591361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of care group participation on infant and young child feeding, dietary diversity, WASH behaviours and nutrition outcomes in rural Zimbabwe","authors":"Tonderayi Mathew Matsungo, Faith Kamazizwa, Tafadzwa Mavhudzi, Starlet Makota, Blessing Kamunda, Calvin Matsinde, Dexter Chagwena, Kudzai Mukudoka, Prosper Chopera","doi":"10.1136/bmjnph-2023-000627","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000627","url":null,"abstract":"Background The care group approach (CGA) is a community-based nutrition behaviour change strategy centred on ‘peer-to-peer learning’ through women support groups. Objective To assess the impact of the CGA on the adoption of appropriate infant and young child feeding (IYCF), dietary diversity and water, sanitation and hygiene (WASH) practices, and associated nutrition-related outcomes. Methods A retrospective cohort study used a mixed-method approach in selected rural districts in Zimbabwe in June 2022. A structured questionnaire was used to collect data on IYCF, diet quality, WASH and child morbidity. Binary logistic regression was used to evaluate the association between exposure and outcome. Significance was at p<0.05. Results A total of 127 exposed and 234 controls were enrolled. There was no significant difference between exposed and controls on the prevalence of; diarrhoea (p = 0.659), cough (p=0.191) and fever (p=0.916). No significant difference was observed in the proportion ever breastfed (p=0.609), Children with Adequate Dietary Diversity Score (p=0.606) across the two groups. However, the proportion of families with adequate Household Dietary Diversity Score (HDDS) (p=0.005) and Minimum Dietary Diversity for Women (MDD-W) (p=0.009) were significantly higher in exposed than controls. Knowledge on all promoted behaviours was significantly higher in the exposed than in controls with the exception of exclusive breast feeding. While the practices were significantly higher in exposed compared with controls for: ‘Appropriate complementary feeding for children aged 6–24 months’ (p=0.001), ‘good nutrition for women of reproductive age’ (p=0.001), ‘production and consumption of diverse nutritious food’ (p=0.001) and ‘production and consumption of biofortified crops’ (p=0.001). Conclusions The results showed that CGA potential to increase knowledge and achieve nutrition and health-related behaviour change in low-income settings if integrated into existing community programmes. Interestingly, HDDS and MDD-W were significantly higher in exposed than controls. However, more research is required to obtain conclusive results.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134910599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurable and immeasurable spread of knowledge for research impact: a reflection on the validated NutComp tool","authors":"Lauren Ball, Breanna Lepre, Clare Van Dorssen","doi":"10.1136/bmjnph-2023-000723","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000723","url":null,"abstract":"Background Contemporary research now includes effort to generate impact beyond the creation of new knowledge. Methods This report provides an illustrative case study of tactful research planning and dissemination for impact and provides an emerging pathway for others to holistically track reach, spread and uptake, to create a nuanced impact narrative. Results Nutrition Competence Tool (NutComp) is a validated tool that assesses the self-perceived competence of health professionals in providing nutrition care. Since open-access publication in 2015, it has been used by researchers and health professionals in 28 countries across 6 continents. The reach, spread, uptake and impact of NutComp are summarised, including indicators to support impact tracking for knowledge. Conclusion Given the complex phenomenon of research impact, careful planning is required to capture and attribute research impact.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135784344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do markers of adiposity and glycaemia mediate the association between low carbohydrate diet and cardiovascular risk factors: findings from the UK National Diet and Nutrition Survey (NDNS) 2008-2016.","authors":"Cláudia Raulino Tramontt, Saad Mouti, Marjorie Lima Do Vale, Xunhan Li, Rajna Golubic, Sumantra Ray","doi":"10.1136/bmjnph-2022-000551","DOIUrl":"10.1136/bmjnph-2022-000551","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the associations between low carbohydrate diet (LCD) and conventional cardiovascular risk factors and investigate whether these associations are mediated by body mass index (BMI), waist circumference (WC) and haemoglobin A1c (HbA1c) applying causal mediation analyses.</p><p><strong>Methods: </strong>We included 3640 adults aged 45-80 years from the UK National Diet and Nutrition Survey programme (2008-2016) with data on dietary intake, anthropometric and biochemical parameters. Four hypothetical interventions were examined: (1) LCD, (2) Low carbohydrate (LC) and high fibre diet (LCHF), (3) LC and high saturated fat diet (LCHS) and (4) LC and high unsaturated fat diet (LCHU). BMI and WC were used as markers of obesity. Biochemical markers included HbA1c, total cholesterol, high-density lipoprotein and low-density lipoprotein (LDL) cholesterol, triglycerides, systolic and diastolic blood pressure and C reactive protein (CRP). BMI, WC and HbA1c were used as a mediator of the effects. The analysis was adjusted for sociodemographic characteristic, smoking, estimated total energy intake, alcohol consumption and antihypertensive medication. To identify a potential causal effect of LCD on cardiovascular disease (CVD) risk, we estimated the average treatment effect, and corresponding p values and CI for the total, indirect and direct effect of the treatment on the outcome.</p><p><strong>Results: </strong>BMI, WC and HbA1c fully mediated the association between LCD and triglycerides and fully mediated the effects of LCHF on LDL, although BMI and WC were not sufficient to fully mediate the effects of LCHF on triglycerides and CRP. BMI alone fully mediated the effects of LCHS on HbA1c, triglycerides, LDL and CRP. None of these mediators explained the effect of LCHU on CVD risk markers.</p><p><strong>Conclusion: </strong>The causal hypotheses tested in this study demonstrate that individuals on LCD with high fibre intakes improved their CVD markers as expected, but those on LCD who increase fat intake had no effects on CVD markers mediated by obesity and diabetes.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11009521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49168179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of individual nutrition counselling for the prevention of undernutrition among elderly people living in depopulated areas: secondary analysis of a model project in Tsu city.","authors":"Keiko Okumura, Shuhei Ichikawa, Hideki Wakabayashi, Young Jae Hong, Yuko Tokudome, Yousuke Takemura","doi":"10.1136/bmjnph-2022-000576","DOIUrl":"10.1136/bmjnph-2022-000576","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the effectiveness of nutrition counselling (NC) in preventing undernutrition in elderly people living in depopulated areas.</p><p><strong>Design: </strong>Participants were elderly people aged at least 65 years living in a depopulated area. Participants completed self-administered questionnaires evaluating nutritional status, frailty and body composition at the start of the study, after a non-NC period (3-month control) and after an NC period (3-month intervention). During the NC period, participants attended monthly 1-hour NC sessions over 3 months. Sessions were conducted in three areas (A, B and C), and the schedule was staggered so that the NC period in one area was conducted simultaneously with the non-NC period of the next. All sessions within an area were attended by the same registered dietitian. Outcomes were assessed three times: before the non-NC period, after the non-NC period and after the NC period. The effects of NC were assessed by comparing the results between the non-NC and NC periods of all participants, using the Cochran-Mantel-Haenszel stratified test.</p><p><strong>Outcome measures: </strong>The primary outcome was undernutrition, as determined by the Mini Nutritional Assessment-Short Form. Secondary outcomes were Dietary Diversity Score (DVS), body weight and frailty. Body composition was also assessed.</p><p><strong>Results: </strong>Of 106 individuals who joined the project, 61 completed the project and were analysed. The NC in this study had no effect on the primary outcome. DVS in area A was significantly higher after the NC period than after the non-NC period (p=0.012). Frailty in area C was significantly lower after the NC period than after the non-NC period (p=0.025). NC had no significant effects on the other outcomes.</p><p><strong>Conclusions: </strong>NC improved food variety but did not improve nutritional status, frailty or body composition.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11009543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48625992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}