BMJ Nutrition, Prevention and Health最新文献

{"title":"Association between nutritional status and severity of RSV-associated lower respiratory tract infection: a retrospective study in hospitalised children under 5 years of age.","authors":"Jittima Monwiratkul, Kornthip Jeephet, Klaita Srisingh","doi":"10.1136/bmjnph-2025-001281","DOIUrl":"10.1136/bmjnph-2025-001281","url":null,"abstract":"<p><strong>Introduction: </strong>Severe lower respiratory tract infection (LRTI) caused by respiratory syncytial virus (RSV) is a major cause of respiratory morbidity in children. Nutritional status is hypothesised to influence the severity of RSV infection, affecting clinical outcomes.</p><p><strong>Objective: </strong>To evaluate the association between malnutrition and the severity of RSV-related LRTI in children.</p><p><strong>Methods: </strong>A retrospective study was conducted at Naresuan University Hospital, including children under 5 years of age diagnosed with RSV LRTI between January 2014 and December 2018. Nutritional status was assessed using Z-scores for wasting (weight-for-height), underweight (weight-for-age), stunting (height-for-age) and both undernutrition and overnutrition (body mass index). Data were analysed using STATA V.18. Univariate analysis used t-test and χ² test. Variables with p<0.2 entered multivariate logistic regression to identify risk factors. Adjusted ORs (aORs) with 95% CI were reported; p<0.05 was significant.</p><p><strong>Results: </strong>A total of 250 children met the inclusion criteria, with 36 (14.4%) classified as having severe RSV LRTI and 214 (85.6%) as non-severe cases. Among those with severe RSV-related LRTI, 16 (44.4%) were male and 20 (55.6%) were female, whereas in the non-severe group, 119 (55.6%) were male and 95 (44.4%) were female. Multivariable analysis revealed that severe wasting (aOR=3.70; 95% CI 1.01 to 13.55; p=0.048) and severe underweight (aOR=9.09; 95% CI 2.62 to 31.50; p=0.001) were strongly correlated with severe RSV LRTI.</p><p><strong>Discussion: </strong>Severe wasting and severe underweight are significant risk factors for severe RSV LRTI in children. These findings suggest that improving nutritional status may help reduce the severity of RSV LRTI.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001281"},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327485","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":"Randomised trial of Aureobasidium pullulans-produced beta 1,3-1,6-glucans in patients with Duchenne muscular dystrophy: favourable changes in gut microbiota and clinical outcomes indicating their potential in epigenetic manipulation.","authors":"Kadalraja Raghavan, Vidyasagar Devaprasad Dedeepiya, Naoki Yamamoto, Nobunao Ikewaki, Masaru Iwasaki, Ashwamed Dinassing, Rajappa Senthilkumar, Senthilkumar Preethy, Samuel J K Abraham","doi":"10.1136/bmjnph-2023-000776","DOIUrl":"10.1136/bmjnph-2023-000776","url":null,"abstract":"<p><strong>Objective: </strong>Duchenne muscular dystrophy (DMD) is an X-linked neuromuscular disorder that leads to increasing muscle weakening and early death. Steroids, the standard treatment of choice in slowing down disease progression, are plagued with adverse effects. Anti-inflammatory, antifibrotic effects and enhancement of muscle regeneration biomarkers after oral consumption of <i>Aureobasidium pullulans</i> strain N-163-produced beta 1,3-1,6-glucan (Neu REFIX) having been demonstrated in clinical and preclinical studies of DMD; in this study, we have investigated the effects on the gut microbiome in patients with DMD.</p><p><strong>Design: </strong>Twenty-seven patients with DMD were included in the study (control (n=9), N-163 (n=18)). Whole-genome metagenomic sequencing was performed in pre-N-163 and post-N-163 intervention faecal samples of each of these participants.</p><p><strong>Results: </strong>After N-163 beta-glucan administration, the constitution of the gut microbiome in all the participants was modified to one with positive outcomes on health. There was an increase in butyrate-producing species such as <i>Roseburia</i> and <i>Faecalibacterium prausnitzii</i>. There was a decrease in harmful bacteria associated with inflammation such as enterobacteria and <i>Alistipes</i>.</p><p><strong>Conclusion: </strong>Beneficial reconstitution of the gut microbiome after Neu REFIX beta-glucan administration and its safety have been confirmed. These outcomes correlating with the anti-inflammatory, anti-fibrotic effects along with increase in dystrophin in skeletal muscle and plasma, reported earlier make us recommend further in-depth exploration on its role in epigenetic manipulation which when found encouraging might help other genetic diseases as well.</p><p><strong>Trial registration number: </strong>CTRI/2021/05/033346.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e000776"},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327377","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":"Advancing nutritional genomics in the era of big data, multiomics and artificial intelligence.","authors":"Sara Mahdavi","doi":"10.1136/bmjnph-2025-001238","DOIUrl":"10.1136/bmjnph-2025-001238","url":null,"abstract":"","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001238"},"PeriodicalIF":2.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327567","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":"Prevalence of polypharmacy and associated side effects in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD): a systematic review and meta-analysis.","authors":"Sarah Armes, Jenneffer Tibaes, Ramya Rajaram, Mark W Ruddock, Mary Jo Kurth, Peter Fitzgerald, Rajna Golubic, Sumantra Ray","doi":"10.1136/bmjnph-2025-001236","DOIUrl":"10.1136/bmjnph-2025-001236","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent chronic condition often accompanied by multiple comorbidities requiring complex pharmacological management. This review aims to examine the prevalence of polypharmacy in patients with MASLD, alongside an exploration of reported associations with side effects and observed relationships with patient-reported outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review using MEDLINE, CINAHL, Embase, Cochrane CENTRAL and Scopus databases, supplemented by a grey literature search, from inception to August 2024. Inclusion criteria were randomised controlled trials, cohort studies or case-control studies that evaluated the prevalence of polypharmacy and its consequences in adults with MASLD. Three reviewers independently performed study selection and data extraction. The quality of included studies was assessed using the Newcastle-Ottawa Scale. The primary outcome was the prevalence of polypharmacy, with secondary outcomes including side effects and quality of life (QoL). A meta-analysis with a random-effect model was performed.</p><p><strong>Results: </strong>Six studies were included, of which three (totalling 2194 participants) were used in a meta-analysis. Polypharmacy prevalence ranged from 25% to 89%, with a pooled prevalence of 81% (95% CI 59 to 93), I²=99.5%. Adverse outcomes associated with polypharmacy included increased risk of hepatic encephalopathy-related hospitalisations, reduced QoL across physical and mental health domains, and augmented liver disease progression, particularly in individuals with advanced MASLD. Commonly used medications, such as anticholinergics and insulin, were linked to significant symptom burdens and metabolic dysregulation. Risk of bias assessments revealed that 50% of included studies had high risk due to limitations in study design, such as cross-sectional design and inconsistent definitions of polypharmacy, which reduced the certainty of evidence.</p><p><strong>Conclusions: </strong>Polypharmacy is highly prevalent in MASLD and associated with poorer clinical outcomes and reduced QoL. Interventions such as deprescribing programmes and enhanced medication management strategies are needed to mitigate risks and optimise patient care.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001236"},"PeriodicalIF":2.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327365","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":"Development and validation of a Jordan-specific risk score for type 2 diabetes mellitus.","authors":"Asalah Alareeki, Susanne F Awad, Julia A Critchley, Kamel M Ajlouni, Yousef Khader, Laith J Abu-Raddad","doi":"10.1136/bmjnph-2024-001027","DOIUrl":"10.1136/bmjnph-2024-001027","url":null,"abstract":"<p><strong>Background: </strong>Jordan has a high prevalence of type 2 diabetes mellitus (T2DM), but it is estimated that nearly half of all cases in the Middle East and North Africa region remain undiagnosed. This study aimed to develop, validate and assess the diagnostic performance of a diabetes risk score to identify Jordanians at high risk of T2DM.</p><p><strong>Methods: </strong>Random samples of 5000 Jordanians aged 20-79 years were simulated at different time points using an existing mathematical model describing T2DM epidemiology in Jordan. The risk score was derived through logistic regression applied to the simulated samples, using age, sex, obesity, smoking and physical inactivity as predictive variables. Cut-off values were determined based on the maximum sum of sensitivity and specificity.</p><p><strong>Results: </strong>In 2020, the estimated area under the curve (AUC), sensitivity and specificity of the derived Jordan Diabetes Risk Score were 0.79 (95% CI: 0.77 to 0.80), 78.7% (95% CI: 77.5 to 79.8%) and 64.2% (95% CI: 62.9 to 65.6%), respectively. The positive and negative predictive values were 29.7% (95% CI: 28.4 to 31.0%) and 94.0% (95% CI: 93.3 to 94.7%), with 42.7% of Jordanians at high risk for diabetes. Similar diagnostic metrics were observed for the 2030 and 2050 risk scores, with AUCs of 0.78 (95% CI: 0.77 to 0.80) and 0.77 (95% CI: 0.76 to 0.79), respectively. The performance of the derived model-based score was comparable to a survey-based score and demonstrated better performance within the Jordanian population compared with existing regional and international scores.</p><p><strong>Conclusions: </strong>The Jordan Diabetes Risk Score demonstrated strong diagnostic performance, offering an effective, non-invasive and accessible tool for diabetes screening. This tool can facilitate early detection, timely intervention and increased awareness, ultimately aiming to reduce the burden of T2DM and its complications in Jordan.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001027"},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327559","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":"Association between calcium intake and sleep quality: a systematic review.","authors":"Ami Isoda, Junko Kiriya, Masamine Jimba","doi":"10.1136/bmjnph-2024-001130","DOIUrl":"10.1136/bmjnph-2024-001130","url":null,"abstract":"<p><strong>Background: </strong>As the prevalence of sleep disorders has grown, studies on sleep quality are increasingly required. Recent evidence suggests that calcium intake may influence sleep quality and duration, but few studies have investigated factors associated with sleep quality. This systematic review aimed to examine and synthesise existing evidence on the association between calcium intake and sleep quality and sleep duration.</p><p><strong>Methods: </strong>We searched randomised controlled trials, case-control studies, cohort studies and cross-sectional studies from multiple databases, including PubMed, Web of Science, Cochrane Library, Scopus and CINAHL Plus, followed by keyword search at Google Scholar and reference review of included articles.</p><p><strong>Results: </strong>A total of seven independent studies presented in nine reports met the inclusion criteria. Six of them were cross-sectional studies. The studies suggested a positive association between calcium intake and sleep quality, although the results were not statistically significant in some cases. Studies also indicated that lower calcium intake was associated with inappropriate sleep duration. We decided not to conduct a meta-analysis because of the insufficient number of studies.</p><p><strong>Conclusion: </strong>The findings suggest a potential positive relationship between calcium intake and sleep quality, though the quality of evidence is unsatisfactory. To test the effectiveness of calcium intake on sleep quality, a randomised controlled trial is required, including many countries from different regions.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001130"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327482","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":"Association of the TCF7L2 rs7903146 variant with type 2 diabetes mellitus and related biomarkers: a systematic review.","authors":"Prantu Sen, Syeda Saima Alam, Israt Jahan, Priya Saha, Farhana Akter, Lincon Chandra Shill","doi":"10.1136/bmjnph-2025-001205","DOIUrl":"10.1136/bmjnph-2025-001205","url":null,"abstract":"<p><strong>Background: </strong>Asia is experiencing a rapid rise in the incidence of type 2 diabetes mellitus (T2DM), characterised by impaired glucose tolerance and insulin resistance. Environmental variables such as dietary habits, physical inactivity, and urbanisation, as well as genetic vulnerability, contribute to the development of T2DM. Mutations in the TCF7L2 gene, particularly rs7903146, have been extensively researched for their potential significance in disease development and metabolic abnormalities, including dyslipidaemia leading to cardiovascular disease.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 principles. We reviewed six electronic databases-PubMed, Google Scholar, ResearchGate, Scopus, ScienceDirect and Web of Science-for studies published before 21 January 2024. Eligible studies comprised cross-sectional, case-control, cohort and meta-analysis that investigated the link between the TCF7L2 rs7903146 variation and T2DM, as well as its relationship to biomarkers.</p><p><strong>Results: </strong>A total of 22 articles were included. Among these, 17 studies showed a significant association of the rs7903146 polymorphism in the TCF7L2 gene with T2DM, while 5 studies did not. Based on 14 eligible studies of Asian populations, a forest plot was established, most of the studies showing ORs greater than 1.0 and association with T2DM. The significant result was discovered in a Chinese study (OR=1.98, 95% CI: 1.13 to 3.49), and the pooled trend was suggestive for a higher risk of T2DM for the T allele carriers. Effect size estimates were heterogeneous, and some margins of East Asian genetic variants were non-significant. Furthermore, TCF7L2 variants have been associated with a variety of biomedical markers, including lipid profiles, glucose, triglycerides and total cholesterol; however, the results from different investigations are conflicting.</p><p><strong>Conclusions: </strong>The TCF7L2 rs7903146 variation has been systematically linked to an increased risk of T2DM, indicating its potential as a genetic risk marker. However, the diversity in its relationship with biomarkers implies that additional factors, such as gene-environment interactions and population-specific genetic backgrounds, play important roles in disease development. A comprehensive understanding of this variation may benefit in T2DM prevention and individualised treatment approaches.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001205"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327547","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":"Socioeconomic inequalities in receiving vitamin A supplementation among children 6-59 months in South and Southeast Asia: a population-based study.","authors":"Satyajit Kundu, Qorinah Estiningtyas Sakilah Adnani, Md Ashfikur Rahman, Syed Sharaf Ahmed Chowdhury, Rakhi Dey, Azaz Bin Sharif, Faruk Ahmed","doi":"10.1136/bmjnph-2024-001118","DOIUrl":"10.1136/bmjnph-2024-001118","url":null,"abstract":"<p><strong>Introduction: </strong>Vitamin A supplementation (VAS) is strongly recommended for children aged 6-59 months to reduce vitamin A deficiency and consequent morbidity and mortality. So, understanding country-specific and regional inequalities in VAS is crucial for targeting high-risk populations in the region. Therefore, we aimed to examine the socioeconomic inequalities in receiving VAS among children aged 6-59 months within and between 11 South and Southeast Asian countries.</p><p><strong>Methods: </strong>We used population-representative cross-sectional data from the demographic and health surveys conducted between 2003 and 2022 for 11 South and Southeast Asian countries (Afghanistan, Bangladesh, Cambodia, India, Indonesia, Maldives, Myanmar, Nepal, Pakistan, Philippines and Timor-Leste). We conducted an analysis using the slope index of inequality (SII) and relative index of inequality to measure absolute and relative inequalities in VAS coverage over time.</p><p><strong>Results: </strong>The prevalence of receiving VAS among children varied from 15.66% in India in 2006 to 87.52% in Nepal in 2006. In most countries, the coverage of VAS disproportionately affected the population with the poorest wealth status and no formal education. Meta-analysis revealed a similar pooled prevalence of receiving VAS in South Asia (66.27%) and Southeast Asia (66.33%). The highest wealth-driven inequality was observed in the Philippines in 2003 (SII 29.26, 95% CI 28.75, 29.76), followed by Indonesia in 2007 (SII 25.30, 95% CI 10.72, 39.88). The highest education-based inequality was manifested in Maldives in 2009 (SII -29.28, 95% CI -33.98, -24.59), followed by Timor-Leste in 2016 (SII 29.26, 95% CI 28.75, 29.76). Overall, most countries' absolute and relative measures of inequalities fluctuated over time.</p><p><strong>Conclusion: </strong>Significant geographical and socioeconomic inequalities in receiving VAS persist in South and Southeast Asian countries, particularly among those with the lowest wealth and without formal education. Using only descriptive analysis limits causal interpretation, and future research should explore underlying drivers using multivariable or longitudinal approaches. VAS programmes should be better tailored to address equity gaps in high-risk groups.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001118"},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327412","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":"Where is the nutrition? Content analysis of learning objectives within tertiary medicine and health degree programs at an Australian university.","authors":"Mackenzie G Derry, Lauren Ball, Breanna Lepre","doi":"10.1136/bmjnph-2025-001263","DOIUrl":"10.1136/bmjnph-2025-001263","url":null,"abstract":"<p><strong>Background: </strong>Poor diet is a leading cause of mortality and morbidity globally. Given their frequent engagement with the community, medical and healthcare professionals can support improved dietary behaviours, as key brokers of nutritional knowledge. Yet, medical and healthcare professionals report receiving suboptimal nutrition education to support practice.</p><p><strong>Objective: </strong>This project aimed to identify the nutrition education content provided across tertiary medicine and health degree programmes at an Australian university.</p><p><strong>Methods: </strong>A list of programmes and core courses was compiled using publicly available information in 2023. Learning objectives of core courses were compared against a Nutrition Competency Framework for Australian Medical Training to identify the nutrition education provided.</p><p><strong>Results: </strong>A total of 13 programmes and 176 core courses were included. No programme made reference to all competencies from the Nutrition Competency Framework for Medicine. The Master of Dietetics Studies programme made the greatest number of references to nutrition (n=39), followed by the Bachelor of Physiotherapy (Hons) (n=36) and the Bachelor of Nursing and Midwifery (n=31). The Master of Organisational Psychology programme made the least number of references to nutrition (n=2), followed by the Master of Psychology (n=5) and Master of Clinical Psychology (n=8). Programmes most frequently included foundational (knowledge-based) nutrition competencies (n=103, 51%), with limited application to clinical practice.</p><p><strong>Conclusions: </strong>There is a need for increased skills-based nutrition education in medicine and health degree programmes to support the translation of knowledge to future practice. Interprofessional competencies provide an opportunity for synergy across programmes.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001263"},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327398","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":"Genetic analysis of congenital and adult-onset lactose intolerance points to anti-inflammatory effects of dairy products.","authors":"Aytac Gul, Oliver F Ryder, Elham Alhathli, Alan Kelsall, Thomas Julian, Johnathan Cooper-Knock","doi":"10.1136/bmjnph-2024-001036","DOIUrl":"10.1136/bmjnph-2024-001036","url":null,"abstract":"<p><strong>Objective: </strong>Dairy intake has been reported to be both pro-inflammatory and anti-inflammatory; this inconsistency has led to uncertainty in the field. We aimed to address this using genetic data to perform a causal analysis of the link between lactose intolerance, rheumatoid arthritis (RhA) and body mass index (BMI). Lactose intolerance necessarily leads to reduced dairy intake. RhA is an autoimmune disease, which has been linked to both increased and reduced dairy intake. Dairy intake has also been associated with elevated BMI, which is itself pro-inflammatory and is associated with increased risk of RhA.</p><p><strong>Methods: </strong>We separately considered congenital lactose intolerance, and adult-onset lactose intolerance where a prolonged period of dairy intake has already occurred. We combined Mendelian randomisation (MR) and rare genetic variant association testing to determine the relationship between genetic liability to lactose intolerance, risk of RhA and BMI. As a positive control to optimise instruments for measurement of lactose intolerance, we used the causal link between lactose intolerance and osteoporosis. Rare variant analysis was performed under a recessive model. Conditional analysis of the effect of lactose intolerance on the risk of RhA via BMI used multivariable MR.</p><p><strong>Results: </strong>We observed an opposite effect of congenital and adult-onset lactose intolerance on RhA risk. Congenital lactose intolerance increases the risk of RhA, but adult-onset lactose intolerance reduces the risk of RhA. The protective effect of adult-onset lactose intolerance on RhA is conditional on reduced BMI.</p><p><strong>Discussion: </strong>We conclude that dairy intake is anti-inflammatory, which explains why congenital lactose intolerance and lifetime avoidance of dairy foods increases the risk of RhA. However, adult-onset lactose intolerance can reduce the risk of RhA because of an association with reduced BMI, which is also anti-inflammatory.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 2","pages":"e001036"},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917515","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}