American Journal of Clinical Nutrition最新文献

{"title":"Novel strategies for medical management of obesity: mechanisms, clinical implications, and societal impacts-a report from the 25th Annual Harvard Nutrition Obesity Symposium.","authors":"Gitanjali Srivastava, Sophia L Campbell, Conner R Hill, Takara L Stanley, Elizabeth A Lawson, Caroline M Apovian, Jaime P Almandoz, Lorenzo Leggio, Darius N Lakdawalla, Mohammad Dar, Carmela Socolovsky, Fatima Cody Stanford, Sarah Armstrong, Steven K Grinspoon","doi":"10.1016/j.ajcnut.2025.06.015","DOIUrl":"10.1016/j.ajcnut.2025.06.015","url":null,"abstract":"<p><p>Obesity is a chronic, relapsing disease with a multifactorial etiology. Over the past 5 y, obesity medicine has entered a new era with the advent of novel, game-changing pharmacotherapies that achieve weight loss exceeding 15%-20%. Beyond weight loss, these powerful therapies offer additional benefits, such as cardiovascular improvements. These novel agents, such as glucagon-like peptide-1 receptor agonists, work by reducing appetite, slowing gastric emptying, and increasing feelings of fullness. Recent work also points out the potential role of these medications for other medical conditions, including addictive and neurodegenerative disorders. In June 2024, the National Institutes of Health-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition hosted their 25th annual Harvard Nutrition Obesity Symposium, titled \"Novel Strategies for Medical Management of Obesity: Mechanisms, Clinical Implications, and Societal Impacts.\" This paper synthesizes the symposium's discussions, emphasizing the importance of innovative pharmacotherapeutic strategies in addressing the burden of obesity and the associated economic and social inequities, including disparities in access to care in adults and children.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the modified Planetary Health Diet among the working-age population in 185 countries from 1990 to 2018: a population-based study.","authors":"Zeyu Li, Yiming Song, Xiaojie Huang, Shengsheng Dong, Xiaolu Lin, Jinnan Chen, Yujie Zhou, Xinyuan Wang, Zhao Li, Liuyi Yang, Qingran Liu, Zhongge Ji, Sijia Zhai, Ruitian Zeng, Yufei Xiao, Ruijie Han, Yuxin Yang, Qingwei Zhang, Xiaobo Li","doi":"10.1016/j.ajcnut.2025.06.016","DOIUrl":"10.1016/j.ajcnut.2025.06.016","url":null,"abstract":"<p><strong>Background: </strong>Understanding global dietary patterns and their implications for human and planetary health has become increasingly critical. The Planetary Health Diet (PHD), introduced by the EAT-Lancet Commission in 2019, offers a framework to address nutrition-related diseases while mitigating environmental impacts.</p><p><strong>Objectives: </strong>We aimed to analyze adherence to a modified PHD (mPHD) among working-age population (WAP) across 185 countries between 1990 and 2018.</p><p><strong>Methods: </strong>We conducted a serial cross-sectional analysis using data from the Global Dietary Database (GDD) 2018. The modified Planetary Health Diet Index (mPHDI) score was constructed based on consumption of 12 food groups. Each component was scored from 0 to 10, generating a composite score ranging from 0 to 120. Distributive inequalities were assessed using the slope index of inequality and concentration index, which are 2 standard metrics of absolute and relative gradient inequality.</p><p><strong>Results: </strong>Modest overall adherence to the mPHD recommendations [global mPHDI score: 75.2; 95% uncertainty interval (UI): 74.2, 76.3] was observed, with significant regional variations. Sub-Saharan Africa showed the highest adherence (84.5; 95% UI: 83.2, 85.5), whereas Latin America and the Caribbean showed the lowest (66.0; 95% UI: 64.5, 67.7). Excessive consumption of red/processed meat and added sugar was prevalent across various populations. Over the past 28 y, global improvement was minimal (+1.3; 95% UI: -0.1, 2.4), with concerning declines in South Asia (-4.0; 95% UI: -5.7, -2.2), despite substantial improvements in high-income countries (6.5; 95% UI: 4.0, 8.5). The slope index of inequality decreased from -15.48 (95% confidence interval [CI]: -19.2, -11.76) in 1990 to -8.49 (95% CI: -12.26, -4.72) in 2018.</p><p><strong>Conclusions: </strong>Our findings reveal substantial global variations in mPHD adherence among WAP, with concerning trends in certain regions. These results provide crucial insights for developing targeted interventions that consider regional contexts while pursuing the dual objectives of promoting healthier diets and ensuring environmental sustainability.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic sensitivity-a potential biomarker for healthy people.","authors":"Jennie Cecile Brand-Miller","doi":"10.1016/j.ajcnut.2025.05.023","DOIUrl":"10.1016/j.ajcnut.2025.05.023","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective association of the EAT-Lancet reference diet with body weight changes and incidence of overweight and obesity in a French cohort.","authors":"Florine Berthy, Hafsa Toujgani, Pauline Duquenne, Léopold K Fezeu, Denis Lairon, Philippe Pointereau, Mathilde Touvier, Serge Hercberg, Pilar Galan, Benjamin Allès, Julia Baudry, Emmanuelle Kesse-Guyot","doi":"10.1016/j.ajcnut.2025.06.013","DOIUrl":"10.1016/j.ajcnut.2025.06.013","url":null,"abstract":"<p><strong>Background: </strong>Obesity has emerged as a significant public health issue globally. In response to the dual health and environmental challenges posed by dietary patterns, the EAT-Lancet Commission recommended a planetary health diet that promotes well-being.</p><p><strong>Objectives: </strong>This study aimed to investigate the association of the EAT-Lancet reference diet with body weight (BW) changes, incidences of overweight [body mass index (BMI) ≥25 kg/m²], and obesity (BMI ≥30 kg/m²), in a large French cohort.</p><p><strong>Methods: </strong>The study analyzed data from 51,711 adults who participated in the French NutriNet-Santé cohort between 2009 and 2023. Exposure was measured by the level of adherence to the EAT-Lancet reference diet, evaluated through the EAT-Lancet Diet Index (ELD-I), categorized into sex-specific quintiles (Qs), and as a continuous variable. The relationship between ELD-I and changes in BW was examined using multivariable linear mixed models. For the incidences of overweight and obesity, multivariable Cox proportional hazards models were employed.</p><p><strong>Results: </strong>During follow-up (median = 8.7 y), 4250 and 1604 persons became overweight and obese, respectively. We observed an inverse association between the level of ELD-I and gain in BW (in kg) [β_Q5 × time = -0.18; 95% confidence interval (CI): -0.20, -0.16; P < 0.0001]. Higher level of ELD-I was associated with lower risks of reaching overweight [hazard ratio (HR)_{Q5 compared with Q1}: 0.60; 95% CI: 0.54, 0.66; _P-trend<0.0001] and obesity status (HR_{Q5 compared with Q1}: 0·54; 95% CI: 0.45, 0.63; p_-trend <0.0001) during follow-up.</p><p><strong>Conclusions: </strong>This comprehensive prospective observational study revealed that a stronger adherence to the EAT-Lancet reference diet is associated with lower BW and reduced risks of overweight and obesity. Promoting a sustainable plant-based diet seems to be an effective strategy for addressing the global public health challenge of obesity. This trial was registered at clinicaltrials.gov as NCT03335644.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking balanced food supplementation for pregnant women: time to move beyond energy and protein.","authors":"Kathryn G Dewey, Sonja Y Hess, Nancy J Krebs, Christine McDonald, Sophie E Moore, Christine P Stewart, K Ryan Wessells","doi":"10.1016/j.ajcnut.2025.06.008","DOIUrl":"10.1016/j.ajcnut.2025.06.008","url":null,"abstract":"<p><p>The term \"balanced energy and protein (BEP)\" supplementation during pregnancy arose from research conducted >40 y ago, and has been defined as food supplements with <25% of energy from protein. BEP supplementation is recommended for undernourished populations by the World Health Organization, although the evidence base for this includes highly heterogeneous products and comparison groups. In this perspective, we briefly outline limitations in the evidence base for BEP supplementation and argue that the term diverts attention away from other important elements of \"balance,\" such as healthy fats and carbohydrates. We articulate the need to carefully consider the goals of food supplementation during pregnancy, the biological mechanisms underlying effects on key outcomes, the desirability of flexibility in approaches, cost considerations, and the needs of the entire household in the context of food insecurity. We conclude that it is time to redefine the concept of balanced food supplementation for pregnant women, clarify objectives and terminology, and conduct further research relevant to the current global context.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant to animal protein ratio in the diet of the elderly: potential for increase and impacts on nutrient adequacy and long-term health-a diet optimization study.","authors":"Hélène Fouillet, Jean-François Huneau, Elie Perraud, Alison Dussiot, Juhui Wang, Emmanuelle Kesse-Guyot, François Mariotti","doi":"10.1016/j.ajcnut.2025.06.011","DOIUrl":"10.1016/j.ajcnut.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>The percentage of plant protein in the diet (%PP) is increasing in high-income countries, but concerns exist regarding the elderly, who may require more protein and indispensable amino acids (IAA) than younger adults, although this remains debated.</p><p><strong>Objectives: </strong>We aimed to assess how much %PP can be safely increased in older adults depending on estimated protein requirement, and identify nutritional issues and dietary levers as %PP increases.</p><p><strong>Methods: </strong>Observed diets were extracted from dietary intakes of ≥65 y French adults (INCA3, n = 433). Using diet optimization, we modeled diets with graded %PP values ensuring full nutrient adequacy-applying constraints on energy and 34 nutrient intakes (accounting for bioavailability) and considering standard or higher protein requirements (reference intakes of 0.83 or 1 g/kg/d, respectively)-while minimizing chronic disease risk from specific food group over- or underconsumption (based on Global Burden of Disease data), with only as much departure from dietary habits as necessary.</p><p><strong>Results: </strong>All modeled diets differed markedly from the current unhealthy diet. Whatever the protein requirement considered, the same ∼25%-70% %PP range was compatible with minimal chronic disease risk and full nutrient adequacy. As %PP increased, iodine, calcium, eicosapentaenoic acid+docosahexaenoic acid, bioavailable iron, vitamins A, B12, and riboflavin became critical; protein was only a concern at high requirement; IAA were never problematic under protein adequacy. Sensitivity analysis revealed that raising consumption limits for legumes, nuts, vegetables, and fruit could broaden the adequate %PP range by supplying more limiting nutrients.</p><p><strong>Conclusions: </strong>Diets must be sufficiently rich in protein to ensure protein adequacy at higher requirements, with no risk of IAA inadequacy when protein intake is sufficient. For sustainability, %PP can potentially increase from the current ∼1/3 to ∼2/3 in an aging population while improving health and nutrient adequacy, provided sufficient seafood and dairy products remain. Further increases would require nutrient fortification/supplementation and/or new foods.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human milk oligosaccharides and Campylobacter jejuni and Campylobacter coli gastroenteritis risk in a Nicaraguan Birth Cohort.","authors":"Rebecca J Rubinstein, Roberto Herrera, Nadja A Vielot, Christian Toval, Lester Gutiérrez, Yaoska Reyes, Patricia Blandón, Natalie M Bowman, Esteban Chaves-Olarte, Filemón Bucardo, Robert S Sandler, Jessie Edwards, Lars Bode, Sylvia Becker-Dreps, Samuel Vilchez","doi":"10.1016/j.ajcnut.2025.06.009","DOIUrl":"10.1016/j.ajcnut.2025.06.009","url":null,"abstract":"<p><strong>Background: </strong>Campylobacter jejuni and C. coli, leading causes of bacterial acute gastroenteritis worldwide, are associated with childhood malnutrition. Human milk oligosaccharides (HMOs) may prevent campylobacteriosis by acting as \"decoy receptors\" for C. jejuni/coli and by promoting gut microbiota that prevent infection.</p><p><strong>Methods: </strong>Nineteen abundant HMOs in human milk were measured at ∼1.3 mo postpartum (range 0.3-3.2 mo) with high-performance liquid chromatography. We followed children weekly for diarrhea and used polymerase chain reaction and Sanger sequencing to detect C. jejuni/coli in diarrheic stool. We then assessed C. jejuni/coli gastroenteritis risk by HMO concentrations, maternal and child secretor phenotype, and with censoring of weaned children.</p><p><strong>Results: </strong>Of 409 children, 47 (12%) experienced ≥1 episode of C. jejuni/coli gastroenteritis over 24 mo. Strong protective associations were observed for the abundant, neutral HMO lacto-N-neotetraose (LNnT) [RD -0.273 (95% confidence interval (CI): -0.542, -0.004)] and sialyllacto-N-tetraose c (LSTc) [RD -0.176 (95% CI: -0.363, -0.012)], a sialylated derivative of LNnT, but not the abundant α-1,2 fucosylated 2'-fucosyllactose (2'FL) [RD 0.067 (95% CI: -0.023, 0.157)], as hypothesized. Lacto-N-fucopentaose-III (LNFP-III), [RD -0.075 (95% CI: -0.155, 0.005)], another derivative of LNnT was also weakly protective in sensitivity analyses. Most other HMOs were unassociated or positively associated with C. jejuni/coli gastroenteritis.</p><p><strong>Conclusions: </strong>Consuming high concentrations of 2'FL early in infants' lives was not protective against C. jejuni/coli gastroenteritis in this prospective birth cohort. However, high concentrations of LNnT and LSTc, and possibly LNFP-III may be associated with decreased C. jejuni/coli gastroenteritis and warrant investigation as potential supplements for C. jejuni/coli gastroenteritis prevention in chest-fed and formula-fed children. Safety testing for HMOs as supplements is needed for regions with prevalent enteric infections.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of prepregnancy weight change with fetal growth and adverse birth outcomes: a prospective cohort study in China.","authors":"Yuwei Lai, Xianli Li, Yuxiang Wang, Ping Wu, Tingting Geng, Yi-Xiang Ye, Jiaying Yuan, Yayi Hu, Gang Liu, An Pan, Xiong-Fei Pan","doi":"10.1016/j.ajcnut.2025.06.007","DOIUrl":"10.1016/j.ajcnut.2025.06.007","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding prepregnancy weight change (from age 18 to conception) and fetal outcomes remains limited in Asian populations.</p><p><strong>Objectives: </strong>To explore the associations of prepregnancy weight change with fetal growth and adverse birth outcomes, and the joint effects between prepregnancy weight change and gestational weight gain (GWG) among Chinese women.</p><p><strong>Methods: </strong>We included 6330 pregnant women from the Tongji-Huaxi-Shuangliu Birth Cohort. Prepregnancy weight change was defined as the difference between the recalled weight at age 18 and recalled weight just before pregnancy. Ultrasound-assessed fetal growth parameters at 3 gestational intervals (≤24, 25-32, and 33-42 wk) were standardized to Z-scores. Adverse birth outcomes were obtained from medical records. Associations were assessed using linear mixed and logistic regression models.</p><p><strong>Results: </strong>Compared with women with low prepregnancy weight gain (0.0-4.9 kg), those with high prepregnancy weight gain (≥10.0 kg) had significantly higher Z-scores for all fetal growth parameters. Positive associations with femur length and estimated fetal weight were observed across all gestational periods, whereas head circumference, abdominal circumference, and biparietal diameter showed significant associations only after 25 wk. Prepregnancy weight gain exhibited a dose-response association with higher risks of macrosomia and large for gestational age (LGA) (all P < 0.001). Conversely, prepregnancy weight loss was linked to a higher risk of small for gestational age (SGA) in female newborns. Furthermore, women with high prepregnancy weight gain and excessive GWG had the highest risks of macrosomia (odds ratio: 5.55; 95% confidence interval: 3.34, 9.22) and LGA (3.19; 2.37, 4.28).</p><p><strong>Conclusions: </strong>Excessive prepregnancy weight gain was associated with accelerated fetal growth and increased macrosomia and LGA risks, whereas prepregnancy weight loss showed a sex-specific impact on SGA. The combination of high prepregnancy weight gain and excessive GWG was associated with the highest risks of macrosomia and LGA.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A digital behavioral intervention to reduce sugar-sweetened beverage consumption: a randomized, controlled trial.","authors":"Jamie M Zoellner, Wen You, Kathleen Porter, Annie L Reid, Donna-Jean P Brock, Theresa Markwalter, Christina Frederick, Deborah F Tate, Lee Ritterband","doi":"10.1016/j.ajcnut.2025.06.010","DOIUrl":"10.1016/j.ajcnut.2025.06.010","url":null,"abstract":"<p><strong>Background: </strong>Reducing sugar-sweetened beverages (SSB) is a worldwide public health priority. There are United States regions with notable SSB consumption pattern disparities, including Appalachia.</p><p><strong>Objectives: </strong>We aimed to measure the efficacy of a digital behavioral intervention in reducing SSB consumption. Weight and quality of life (QOL) were also explored.</p><p><strong>Methods: </strong>In this 2-group randomized-controlled trial targeting adults living in Appalachia, participants were randomly assigned to either an interactive, structured, digital intervention comprised of 6 cores, behavioral tracking, and personalized action planning, or a static patient education website. At baseline and at 9-wk and 6-mo postintervention, validated measures were used to assess SSB intake and QOL. Weight was captured using cellular-enabled scales.</p><p><strong>Results: </strong>Participants (n = 249) were 88% Caucasian, 83% female, 52% with income <$55,000/y, 86% from more rural counties, and 84% with overweight or obesity. In the digital intervention group, the mean core completion was 5.2 [standard deviation (SD) = 1.6] of 6 cores, and participants tracked a mean of 76% (SD = 29%) of daily SSB diaries and 57% (SD = 31%) of daily weights. At 9-wk, digital intervention participants [-896.1 mL/d; 95% confidence interval (CI): -1043.9, -748.2 mL/d] consumed 289.8 (95% CI: -493.9, -88.7) less SSB mL/d than comparison participants (-606.3 mL/d; 95% CI: -745.3, -467.9 mL/d) [effect size (ES) = 0.37; P = 0.005]. The 6-mo assessment was similar, with digital intervention participants consuming an average of 280.9 (95% CI: -490.9, -68.0) less SSB mL/d than comparison participants (ES = 0.35; P = 0.009). There was no significant between-condition QOL effects, yet QOL improved within both conditions (P < 0.001). At 6-mo, body weight was significantly reduced for digital intervention relative to comparison participants (ES = 0.23; P = 0.046).</p><p><strong>Conclusions: </strong>A digital behavioral intervention was efficacious in reducing SSB consumption among Appalachian adults and yielded high engagement and retention rates. This intervention should be evaluated in other populations with excessive SSB consumption. This trial was registered at clincialtrials.gov as NCT05030753.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal associations between vegetarian dietary habits and site-specific cancers in the Adventist Health Study-2 North American cohort.","authors":"Gary E Fraser, Fayth M Butler, David J Shavlik, Roy O Mathew, Jisoo Oh, Rawiwan Sirirat, Dmitry Abramov, Lars E Sveen","doi":"10.1016/j.ajcnut.2025.06.006","DOIUrl":"10.1016/j.ajcnut.2025.06.006","url":null,"abstract":"<p><strong>Background: </strong>Associations between vegetarian diets and risk of common cancers are somewhat understood, but such data on medium-frequency cancers are scarce and often imprecise.</p><p><strong>Objectives: </strong>The objectives of this study was to describe multivariable-adjusted associations between different types of vegetarian diets (compared with nonvegetarians) and risk of cancers at different bodily sites.</p><p><strong>Methods: </strong>The Adventist Health Study is a cohort of 95,863 North American Seventh-day Adventists established between 2002 and 2007. These analyses used 79,468 participants initially free of cancer. Baseline dietary data were obtained using a food frequency questionnaire and incident cancers by matching with state and Canadian provincial cancer registries. Hazard ratios (HRs) were estimated using proportional hazard regression. Small amounts of missing data were filled using multiple imputations.</p><p><strong>Results: </strong>Overall cancers, all vegetarians combined compared with nonvegetarians, had HR: 0.88; 95% confidence interval (CI): 0.83,0.93; P < 0.001, and for medium frequency cancers, HR: 0.82; 95% CI: 0.76, 0.89; P < 0.001. Of specific cancers, colorectal (HR: 0.79; 95% CI: 0.66, 0.95; P = 0.011), stomach (HR: 0.55; 95% CI: 0.32, 0.93; P = 0.025), and lymphoproliferative (HR: 0.75; 95% CI: 0.60,0.93; P = 0.010) cancers, were significantly less frequent among vegetarians. A joint test that HR = 1.0 for all vegetarian subtypes compared with nonvegetarians was rejected for cancers of the breast (P = 0.012), lymphoma (P = 0.031), all lymphoproliferative cancers (P = 0.004), prostate cancer (P = 0.030), colorectal cancers (P = 0.023), medium frequency cancers (P < 0.001), and for all cancers combined (P < 0.001).</p><p><strong>Conclusions: </strong>These data indicate a lower risk in vegetarians for all cancers combined, as well as for medium-frequency cancers as a group. Specific cancers with evidence of lower risk are breast, colorectal, prostate, stomach, and lymphoproliferative subtypes. Risk at some other sites may also differ in vegetarians, but statistical power was limited.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}