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Objectives: There are differing opinions and findings about the accuracy of self-reported data. This study sought to assess the accuracy of self-reported height, weight, and waist circumference (WC) data among adult residents in poor, rural areas of China., Methods: Multi-stage stratified cluster random sampling was used to sample rural adult residents in Jinzhai County. Intraclass correlations (ICCs), Bland-Altman plots with limits of agreements (LOAs), and Cohen's kappa were used to examine the accuracy of self-reported data. Multiple linear regression was used to explore the effect of demographic and socioeconomic variables., Results: Height was over-reported by an average of 0.67 cm, weight and WC were both under-reported, by an average of 0.004 kg and 1.09 cm, respectively. The ICC for height was 0.92, the ICC for weight was 0.93, and the ICC for WC was 0.93. Bland-Altman plots showed no trend in variability with increasing height, weight, and WC, but 95% of the LOAs were wide, especially for WC. The percentage agreement (kappa) for BMI was 82.10% (0.71), and the percentage agreement for WC was 83.56% (0.66). Overall, obesity, overweight, and increased WC were underestimated by 0.56%, 2.64%, and 6.89%, respectively. Assessments of which demographic and socioeconomic factors were associated with statistically significant differences between self-reported and measured data showed that education (junior school vs . primary or below: β = -0.56, 95% CI [-1.01 to -0.11]) and occupation (others vs . professionals: β = 2.16, 95% CI [0.62-3.70]) were associated with differences between measured and self-reported height; occupation (industrial and commercial service vs . professionals: β = 1.57, 95% CI [0.52-2.61]) was associated with differences between measured and self-reported weight; and gender (women vs . men: β = -1.74, 95% CI [-2.51 to -0.97]) and age (60- vs . 18-44: β = -1.62, 95% CI [-2.88 to -0.36]) were associated with differences between measured and self-reported WC., Conclusions: Self-reported height and weight were shown to be reliable in poor, rural areas of China, but self-reported WC should be used with caution. To improve the accuracy of self-reported data, certain subgroups should be targeted for educational interventions., Competing Interests: The authors declare that they have no competing interests., (© 2024 Cao et al.)

Background & Aims: Previous studies have shown that plant-rich dietary patterns, such as the Mediterranean diet, are associated with longer telomeres. However, no association has been found between vegetarian diet and telomere length. We hypothesized that the quality of plant-based diets plays an important role in telomere length., Methods: Data were obtained from the National Health and Nutrition Examination Survey 1999-2002. Diet was assessed using a 24-h recall method. Plant-based diet quality was assessed using the overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI). Telomere length was measured using quantitative PCR. Linear and ordinal logistic regression models were used to assess the association of PDIs with log-transformed telomere length and ordinal quintiles of telomere length in descending order, respectively., Results: In both regression models, the overall PDI was not associated with telomere length. The hPDI was associated with longer telomere length [percentage change = 2.34%, 95% confidence interval (CI): 0.42%, 4.31%, P trend  = 0.016; odds ratio (OR) = 0.81, 95% CI: 0.69, 0.95, P trend  = 0.013]. However, uPDI was associated with shorter telomere length (percentage change = -3.17%, 95% CI: -5.65%, -0.62%, P trend  = 0.017; OR = 1.25, 95% CI:1.03, 1.53, P trend  = 0.014) and this inverse association was stronger in the non-Hispanic white population (P interaction  = 0.001 in both regression models)., Conclusions: A plant-based dietary pattern rich in healthy plant foods is associated with longer telomeres. However, plant-based dietary patterns rich in unhealthy plant-based foods are associated with shorter telomere lengths, especially in non-Hispanic white populations., Competing Interests: Conflict of interest All authors disclose no conflicts., (Copyright © 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

This study conducted data on 15,446 adults to explore the impact of flavonoids on weight-adjusted waist index (WWI). This was a nationwide cross-sectional study among US adults aged 20 years or older. Dietary intake of flavonoids was assessed through 24-h recall questionnaire. WWI was calculated by dividing waist circumference (WC) by the square root of weight. We utilized weighted generalized linear regression to evaluate the association between flavonoids intake and WWI, and restricted cubic splines (RCS) to explore potential non-linear relationships. Our findings indicated that individuals with lower WWI experienced a notable increase in their consumption of total flavonoids, flavanones, flavones, flavan-3-ols, and anthocyanidins intake ( β (95% CI); -0.05(-0.09, -0.01); -0.07(-0.13, 0.00); -0.07(-0.11, -0.02); -0.06(-0.11, 0.00); -0.13(-0.18, -0.08), respectively), with the exception of flavonols and isoflavones. Additionally, consumption of total flavonoids, flavonols, flavanones, isoflavones, and flavan-3-ols had a non-linear relationship with WWI (all P for non-linearity < 0.05). Furthermore, the effect of total flavonoids on WWI varied in race ( P for interaction = 0.011), gender ( P for interaction = 0.038), and poverty status ( P for interaction = 0.002). These findings suggested that increase the intake of flavonoids might prevent abdominal obesity, but further prospective studies are requested before dietary recommendation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zu, Yang, Li, Wu, Li, Fan, Wang and Zhang.)

Objective: Inflammation plays a critical role in the progression of chronic liver diseases, and diet can modulate inflammation. Whether an inflammatory dietary pattern is associated with higher risk of hepatic steatosis or fibrosis remains unclear. We aimed to investigate the associations between inflammatory dietary pattern and the odds of hepatic steatosis and fibrosis., Design: In this nationwide cross-sectional study, diet was measured using two 24-h dietary recalls. Empirical dietary inflammatory pattern (EDIP) score was derived to assess the inflammatory potential of usual diet, which has been validated to highly predict inflammation markers in the study population. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were derived from FibroScan to define steatosis and fibrosis, respectively., Setting: US National Health and Nutrition Examination Survey., Participants: 4171 participants aged ≥18 years., Results: A total of 1436 participants were diagnosed with S1 steatosis (CAP ≥ 274 dB/m), 255 with advanced fibrosis (LSM ≥ 9·7 kPa). Compared with those in the lowest tertile of EDIP-adherence scores, participants in the highest tertile had 74 % higher odds of steatosis (OR: 1·74, 95 % CI (1·26, 2·41)). Such positive association persisted among never drinkers, or participants who were free of hepatitis B and/or C. Similarly, EDIP was positively associated with CAP in multivariate linear model ( P < 0·001). We found a non-significant association of EDIP score with advanced fibrosis or LSM ( P = 0·837)., Conclusions: Our findings suggest that a diet score that is associated with inflammatory markers is associated with hepatic steatosis. Reducing or avoiding pro-inflammatory diets intake might be an attractive strategy for fatty liver disease prevention.

The association between time-restricted eating (TRE) and the risk of non-alcoholic fatty liver disease (NAFLD) is less studied. Moreover, whether the association is independent of physical exercise or diet quality or quantity is uncertain. In this nationwide cross-sectional study of 3813 participants, the timing of food intakes was recorded by 24-h recalls; NAFLD was defined through vibration-controlled transient elastography in the absence of other causes of chronic liver disease. OR and 95 % CI were estimated using logistic regression. Participants with daily eating window of ≤ 8 h had lower odds of NAFLD (OR = 0·70, 95 % CI: 0·52, 0·93), compared with those with ≥ 10 h window. Early (05.00-15.00) and late TRE (11.00-21.00) showed inverse associations with NAFLD prevalence without statistical heterogeneity ( P heterogeneity = 0·649) with OR of 0·73 (95 % CI: 0·36, 1·47) and 0·61 (95 % CI: 0·44, 0·84), respectively. Such inverse association seemed stronger in participants with lower energy intake (OR = 0·58, 95 % CI: 0·38, 0·89, P interaction = 0·020). There are no statistical differences in the TRE-NAFLD associations according to physical activity ( P interaction = 0·390) or diet quality ( P interaction = 0·110). TRE might be associated with lower likelihood of NAFLD. Such inverse association is independent of physical activity and diet quality and appears stronger in individuals consuming lower energy. Given the potential misclassification of TRE based on one- or two-day recall in the analysis, epidemiological studies with validated methods for measuring the habitual timing of dietary intake are warranted.

Purpose: Plant-based diets, particularly when rich in healthy plant foods, have been associated with a lower risk of type 2 diabetes and cardiovascular disease. However, the impact of plant-based diets that distinguish between healthy and unhealthy plant foods on cardiometabolic biomarkers remains unclear., Methods: Dietary information was collected by two 24-h recalls among 34,785 adults from a nationwide cross-sectional study. Plasma levels of insulin, C-peptide, glucose, C-reactive protein (CRP), white blood cell (WBC) count, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) were measured. Linear regression was used to evaluate the percentage difference in plasma marker concentrations by three plant-based diet indices, namely the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI)., Results: Greater hPDI-adherence scores (comparing extreme quartiles) were associated with lower levels of insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), TG/HDL-C ratio, CRP, WBC count, and TG, and higher levels of HDL-C, with the percentage differences of  - 14.55,  - 15.72,  - 11.57,  - 14.95,  - 5.26,  - 7.10, and 5.01, respectively (all P trend  ≤ 0.001). Conversely, uPDI was associated with higher levels of insulin, C-peptide, HOMA-IR, TG/HDL-C ratio, CRP, WBC count, and TG, but lower HDL-C, with the percentage differences of 13.71, 14.00, 14.10, 10.43, 3.32, 8.00, and  - 4.98 (all P trend  ≤ 0.001), respectively. Overall PDI was only associated with lower levels of CRP and WBC count (all P trend  ≤ 0.001)., Conclusion: Our findings suggest that hPDI may have positive, whereas uPDI may have negative impacts on multiple cardiometabolic risk markers, and underscore the need to consider the quality of plant foods in future PDI studies., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Whether starchy and non-starchy vegetables have distinct impacts on health remains unknown. We prospectively investigated the intake of starchy and non-starchy vegetables in relation to mortality risk in a nationwide cohort. Diet was assessed using 24-h dietary recalls. Deaths were identified via the record linkage to the National Death Index. Hazard ratios (HR) and 95 % CI were calculated using Cox regression. During a median follow-up of 7·8 years, 4904 deaths were documented among 40 074 participants aged 18 years or older. Compared to those with no consumption, participants with daily consumption of ≥ 1 serving of non-starchy vegetables had a lower risk of mortality (HR = 0·76, 95 % CI 0·66, 0·88, P trend = 0·001). Dark-green and deep-yellow vegetables (HR = 0·79, 95 % CI 0·63, 0·99, P trend = 0·023) and other non-starchy vegetables (HR = 0·80, 95 % CI 0·70, 0·92, P trend = 0·004) showed similar results. Total starchy vegetable intake exhibited a marginally weak inverse association with mortality risk (HR = 0·89, 95 % CI 0·80, 1·00, P trend = 0·048), while potatoes showed a null association (HR = 0·93, 95 % CI 0·82, 1·06, P trend = 0·186). Restricted cubic spline analysis suggested a linear dose-response relationship between vegetable intake and death risk, with a plateau at over 300 and 200 g/d for total and non-starchy vegetables, respectively. Compared with starchy vegetables, non-starchy vegetables might be more beneficial to health, although both showed a protective association with mortality risk. The risk reduction in mortality plateaued at approximately 200 g/d for non-starchy vegetables and 300 g/d for total vegetables.

Previous studies have reported inconsistent associations between low-carbohydrate diets (LCD) and plasma lipid profile. Also, there is little evidence on the role of the quality and food sources of macronutrients in LCD in cardiometabolic health. We investigated the cross-sectional associations between LCD and plasma cardiometabolic risk markers in a nationwide representative sample of the US population. Diet was measured through two 24-h recalls. Overall, healthy (emphasising unsaturated fat, plant protein and less low-quality carbohydrates) and unhealthy (emphasising saturated fat, animal protein and less high-quality carbohydrate) LCD scores were developed according to the percentage of energy as total and subtypes of carbohydrate, protein and fat. Linear regression was used to estimate the percentage difference of plasma marker concentrations by LCD scores. A total of 34 785 participants aged 18-85 years were included. After adjusting for covariates including BMI, healthy LCD was associated with lower levels of insulin, homoeostatic model assessment for insulin resistance (HOMA-IR), C-reactive protein (CRP) and TAG, and higher levels of HDL-cholesterol, with the percentage differences (comparing extreme quartile of LCD score) of -5·91, -6·16, -9·13, -9·71 and 7·60 (all P trend < 0·001), respectively. Conversely, unhealthy LCD was associated with higher levels of insulin, HOMA-IR, CRP and LDL-cholesterol (all P trend < 0·001). Our results suggest that healthy LCD may have positive, whereas unhealthy LCD may have negative impacts on CRP and metabolic and lipid profiles. These findings underscore the need to carefully consider the quality and subtypes of macronutrients in future LCD studies.

Hepatic steatosis can occur in lean individuals, while its metabolic and risk profiles remain unclear. We aimed to characterize the clinical and risk profiles of lean and non-lean steatosis. This cross-sectional study included 1610 patients with transient elastography-assessed steatosis. The metabolic and risk profiles were compared. Compared to their non-lean counterparts, lean subjects with steatosis had a lower degree of fibrosis (F0-F1: 91.9% vs. 80.9%), had a lower prevalence of diabetes (27.9% vs. 32.8%), dyslipidemia (54.7% vs. 60.2%) and hypertension (50.0% vs. 51.3%), and had higher levels of high-density lipoprotein cholesterol while lower fasting insulin and homeostatic model assessment for insulin resistance (all p < 0.05). Of the 16 potential risk factors, being Hispanic was associated with higher odds of non-lean steatosis but not with lean steatosis (odds ratio (OR): 2.07 vs. 0.93), while excessive alcohol consumption had a different trend in the ratio (OR: 1.47 vs.6.65). Higher waist-to-hip ratio (OR: 7.48 vs. 2.45), and higher waist circumference (OR: 1.14 vs. 1.07) showed a stronger positive association with lean steatosis than with non-lean steatosis (all P heterogeneity < 0.05). Although lean individuals with steatosis presented a healthier metabolic profile, both lean and non-lean steatosis had a significant proportion of metabolic derangements. In addition, the etiological heterogeneity between lean and non-lean steatosis may exist.

Epidemiological research has demonstrated that the increase in high fat consumption has promoted the morbidity of diabetes. Exposure to organophosphorus pesticides (such as chlorpyrifos) may also increase the risk of diabetes. Although chlorpyrifos is a frequently detected organophosphorus pesticide, the interaction effect between chlorpyrifos exposure and a high-fat diet on glucose metabolism is still unclear. Thus, the effects of chlorpyrifos exposure on glucose metabolism in rats eating a normal-fat diet or a high-fat diet were investigated. The results demonstrated that the glycogen content in the liver decreased and that the glucose content increased in chlorpyrifos-treated groups. Remarkably, the ATP consumption in the chlorpyrifos-treatment group was promoted in the rats eating a high-fat diet. However, chlorpyrifos treatment did not change the serum levels of insulin and glucagon. Notably, the contents of liver ALT and AST changed more significantly in the high-fat chlorpyrifos-exposed group than in the normal-fat chlorpyrifos-exposed group. Chlorpyrifos exposure caused an increase in the liver MDA level and a decrease in the enzyme activities of GSH-Px, CAT, and SOD, and the changes were more significant in the high-fat chlorpyrifos-treatment group. The results indicated that chlorpyrifos exposure led to disordered glucose metabolism in all dietary patterns as a result of antioxidant damage in the liver, in which a high-fat diet may have aggravated its toxicity.

Hyperinsulinaemia and insulin resistance have been proposed to be associated with mortality risk, and diet can modulate insulin response. However, whether dietary patterns with high insulinaemic potential are associated with mortality remains unknown. We prospectively examined the associations between hyperinsulinaemic diets and the risk of total and cause-specific mortality in a large nationally representative population. Dietary factors were assessed by 24-h recalls. Two empirical dietary indices for hyperinsulinaemia (EDIH) and insulin resistance (EDIR) were developed to identify food groups most predictive of biomarkers for hyperinsulinaemia (C-peptide and insulin) and insulin resistance (homoeostatic model assessment for insulin resistance), respectively. Deaths from date of the first dietary interview until 31 December 2015 were identified by the National Death Index. Multivariable hazard ratios (HR) and 95 % CI were calculated using Cox regression models. During a median follow-up of 7·8 years, 4904 deaths were documented among 40 074 participants. For EDIH, the multivariable-adjusted HR (comparing extreme quintiles) were 1·20 (95 % CI 1·09, 1·32, P -trend<0·001) for overall mortality and 1·41 (95 % CI 1·15, 1·74, P -trend = 0·002) for CVD mortality. Similar associations were observed for EDIR with HR of 1·18 (95 % CI 1·07, 1·29, P -trend < 0·001) for total and 1·35 (95 % CI 1·09, 1·67, P -trend = 0·005) for CVD mortality. After further adjustments for BMI and diabetes, these positive associations were somewhat attenuated. Our findings suggested that diets with higher insulinaemic potential are associated with increased risk of overall and CVD-specific mortality.

Sulforaphane (SFN) was generated by the hydrolysis of glucoraphanin under the action of myrosinase. However, due to the instability of SFN, the bioavailability of SFN was limited. Meanwhile, the gut flora obtained the ability to synthesize myrosinase and glucoraphanin, which could be converted into SFN in the intestine. However, the ability of microorganisms to synthesize myrosinase in the gut was limited. Therefore, microorganisms with myrosinase synthesis ability need to be supplemented. With the development of research, microorganisms with high levels of myrosinase synthesis could be obtained by artificial selection and gene modification. Researchers found the SFN production rate of the transformed microorganisms could be significantly improved. However, despite applying transformation technology and regulating nutrients to microorganisms, it still could not provide the best efficiency during generating SFN and could not accomplish colonization in the intestine. Due to the great effect of microencapsulation on improving the colonization ability of microorganisms, microencapsulation is currently an important way to deliver microorganisms into the gut. This article mainly analyzed the possibility of obtaining SFN-producing microorganisms through gene modification and delivering them to the gut via microencapsulation to improve the utilization rate of SFN. It could provide a theoretical basis for expanding the application scope of SFN.

Objective: This study assessed the cross-sectional associations of low-carbohydrate diets (LCDs) and low-fat diets (LFDs) with hepatic steatosis in the National Health and Nutrition Examination Survey., Methods: Diet was measured using the 24-hour recalls. Hepatic steatosis was defined by vibration-controlled transient elastography. The odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Substitution analysis was performed using the leave-one-out model., Results: Participants with higher adherence scores (comparing extreme tertiles) for an overall (OR = 0.76, 95% CI: 0.61-0.96, p trend  = 0.049) or a healthful LCD (OR = 0.61, 95% CI: 0.43-0.87, p trend  < 0.001) exhibited lower odds of steatosis. Replacing 5% of the energy from carbohydrates with total fat and protein (OR = 0.91, 95% CI: 0.83-0.99) or unsaturated fat and plant protein (OR = 0.89, 95% CI: 0.84-0.94) was associated with lower steatosis prevalence. High overall (OR = 1.65, 95% CI: 1.13-2.40, p trend  = 0.006) or unhealthful (OR = 1.41, 95% CI: 1.10-1.80, p trend  < 0.001) LFD scores were associated with increased likelihood of steatosis., Conclusions: These findings suggest that the associations between LCDs and LFDs and steatosis may depend on the quality and food sources of the macronutrients., (© 2022 The Obesity Society.)

There is little evidence for the associations of the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI) with the odds of nonalcoholic fatty liver disease (NAFLD). We present a nationwide cross-sectional study among US adults aged 18 years or older. Diet was assessed by 24-h recalls. Overall PDI, hPDI, and uPDI were constructed based on 18 food groups. NAFLD was defined based on controlled attenuation parameter derived via transient elastography (TE) in the absence of other causes of chronic liver disease. Among 3900 participants with eligible TE examination, 1686 were diagnosed with NAFLD. The overall PDI was not associated with NAFLD prevalence (comparing extreme tertiles of PDI score OR = 1.03, 95% CI 0.76, 1.38, ptrend = 0.609). However, hPDI was inversely (OR = 0.50, 95% CI 0.35, 0.72, ptrend < 0.001), while uPDI was positively associated with odds of NAFLD (OR = 1.37, 95% CI 0.93, 2.02, ptrend = 0.009) in the multivariable-adjusted models without body mass index (BMI). After further adjustment for BMI, only the association of hPDI with NAFLD remained statistically significant (OR = 0.64, 95% CI 0.46, 0.87, ptrend = 0.006). Such inverse association appeared stronger in non-Hispanic whites, but not in other racial/ethnic groups (pinteraction = 0.009). Our findings suggest that a plant-based diet rich in healthy plant foods might be associated with lower odds of NAFLD, particularly among US non-Hispanic whites. Clinical trials and cohort studies to validate our findings are needed.

Purpose: To investigate the associations between carbohydrate intake and the risk of overall and specific-cause mortality in a prospective cohort study., Methods: Diet was measured using 24 h dietary recalls. Underlying cause of death was identified through linkage to the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression., Results: During a median follow-up of 7.1 years among 35,692 participants who aged 20-85 years, a total of 3854 deaths [783 cardiovascular disease (CVD)-specific and 884 cancer-specific death] were identified. Carbohydrate intake was not associated with risk of overall mortality (multivariable-adjusted HR comparing extreme quartiles 1.03, 95% CI 0.94, 1.13, p trend  = 0.799), while higher fiber intake was associated with lower mortality risk (HR 0.86, 95% CI 0.77, 0.95, p trend  = 0.004). Replacing 5% of energy from carbohydrate with both plant fat and plant protein was associated with 13% (95% CI 8%, 17%) and 13% (95% CI 3%, 22%) lower risk of total and CVD mortality, respectively. Whereas a positive or null association was found when replacing carbohydrate with both animal fat and animal protein. Higher carbohydrate-to-fiber ratio was associated with increased risk of overall (HR 1.20, 95% CI 1.09, 1.33, p trend  < 0.001) and cancer-specific (HR 1.17, 95% CI 0.95, 1.44, p trend  = 0.031) mortality., Conclusions: Our findings suggested that high fiber diet or diet with low carbohydrate-to-fiber ratio was associated with lower long-term death risk, and provided evidence for the health benefit from dietary substitution of both plant fat and plant protein for carbohydrate., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Although antibiotic exposure in the general population has been well documented by a biomonitoring approach, epidemiologic data on the relationships between urinary antibiotic burden in the elderly with blood pressure (BP) are still lacking. The current study revealed thirty-four antibiotics in urine specimens from 990 elderly patients in Lu'an City, China, with detection frequencies ranging from 0.2 to 35.5%. Among the elderly, the prevalence of hypertension was 72.0%, and 12 antibiotics were detected in more than 10% of individuals with hypertension. The elderly with hypertension had the maximum daily exposure (5450.45 μg/kg/day) to fluoroquinolones (FQs). Multiple linear regression analyses revealed significant associations of BP and pulse pressure (PP) with exposure to specific antibiotics. The estimated β values (95% confidence interval) of associations with systolic blood pressure (SBP) in the right arm were 4.42 (1.15, 7.69) for FQs, 4.26 (0.52, 8.01) for the preferred as human antibiotics (PHAs), and 3.48 (0.20, 6.77) for the mixtures (FQs + tetracyclines [TCs] (tertile 3 vs. tertile 1)), respectively. Increased concentrations of TCs were associated with decreased diastolic BP (DBP; tertile 3: -1.75 [-3.39, -0.12]) for the right arm. Higher levels of FQs (tertile 3: 4.28 [1.02, 7.54]), PHAs (tertile 3: 4.25 [0.49, 8.01]), and FQs + TCs (tertile 3: 3.99 [0.71, 7.26]) were associated with increased SBP, and an increase in DBP for FQs (tertile 3: 1.82 [0.22, 3.42]) was shown in the left arm. Also, higher urinary concentrations of FQs (tertile 3: 3.18 [0.53, 5.82]), PHAs (tertile 3: 3.42 [0.40, 6.45]), and FQs + TCs (tertile 3: 3.06 [0.40, 5.72]) were related to increased PP, whereas a decline in PP for TCs (tertile 2: -2.93 [-5.60, -0.25]) in the right arm. And increased concentrations of penicillin V (tertile 3: 5.31 [1.53, 9.10]) and FQs + TCs (tertile 3: 2.84 [0.19, 5.49]) were related to higher PP in the left arm. By utilizing restricted cubic splines, our current study revealed a potential nonlinear dose-response association between FQ exposure and hypertension risk. In conclusion, this investigation is the first to present antibiotic exposure using a biomonitoring approach, and informs understanding of impacts of antibiotic residues, as emerging hazardous pollutants, on the hypertension risk in the elderly., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Acrylamide is formed during food heating and is neurotoxic to animals and potentially carcinogenic to humans. It is important to reduce acrylamide content during food processing. Researchers have suggested that garlic powder could reduce acrylamide content, but the key substance and acrylamide reduction pathway of garlic powder was unclear., Methods: The inhibitory effect of garlic powder on acrylamide in asparagine/glucose solution and a fried potato model system were firstly evaluated. Furthermore, the effect of allicin on the amount of produced acrylamide in the asparagine/glucose solution model system and fried potatoes was studied with kinetic analysis., Results: The freeze-dried garlic powder had a higher inhibition rate (41.0%) than oven-dried garlic powder (maximum inhibition rate was 37.3%), and allicin had a 71.3% attribution to the reduction of acrylamide content. Moreover, the inhibition rate of allicin had a nonlinear relationship with the addition level increase. The kinetic analysis indicated that garlic powder and allicin could reduce acrylamide content through the AA formation stage, but not the decomposition stage., Conclusions: Allicin was the key component of garlic powder in reducing acrylamide content during acrylamide formation stage. This research could provide a new method to reduce acrylamide content during food processing and expand the application area of garlic.

Background: Current dietary guidelines generally treat all types of vegetables the same. However, whether specific vegetables are more beneficial or deleterious for preventing chronic liver disease (CLD) remains uncertain., Methods: We investigated the associations between starchy and non-starchy vegetables and the odds of hepatic steatosis and fibrosis in a US nationwide cross-sectional study. Diet was assessed by the 24-h dietary recalls. Hepatic steatosis and fibrosis were defined based on vibration-controlled transient elastography (TE). Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs)., Results: Among 4170 participants with reliable TE test, 1436 were diagnosed with steatosis, 255 with advanced fibrosis. Increased intake of total starchy vegetables was associated with higher odds of steatosis (OR per 1-SD increment 1.11, 95% CI 1.01-1.24) and advanced fibrosis (OR = 1.39, 95% CI 1.15-1.69). Similar positive associations were observed for potatoes. Conversely, intakes of total non-starchy (OR = 0.82, 95% CI 0.71-0.95) and dark-green vegetables (OR = 0.89, 95% CI 0.82-0.97) were inversely associated with steatosis prevalence. Replacing 5% of energy from starchy vegetables (OR = 0.65, 95% CI 0.44-0.97) or potatoes (OR = 0.65, 95% CI 0.43-0.97) with equivalent energy from dark-green vegetables was associated with lower odds of steatosis., Conclusions: These findings support the recommendation to limit starchy vegetable intake and increase non-starchy vegetable intake in CLD prevention, and provide evidence for the potential health benefit from dietary substitution of non-starchy vegetables for starchy vegetables., (© 2022. Asian Pacific Association for the Study of the Liver.)

The complexation of protein and polysaccharide has shown considerable potential for the encapsulation of functional food components. In this work, propylene glycol alginate (PGA) molecules with different molecular weights (100, 500, and 2,000 kDa) were prepared through H 2 O 2 oxidation, which were further combined with β-lactoglobulin nanoparticles (β-lgNPs) to form PGA-β-lgNPs complexes for the delivery of curcumin (Cur). Results showed that the depolymerization of PGA molecule was resulted from the breakage of glycosidic bonds in the main chain, and the depolymerization rate of PGA molecule depended on the reaction time, temperature, solution pH and H 2 O 2 concentration. As the increasing molecular weight of PGA, the particle size, zeta-potential and turbidity of the complexes were obviously increased. The formation of PGA/β-lgNPs complexes was mainly driven by non-covalent interaction, including electrostatic gravitational interaction, hydrogen bonding and hydrophobic effect. Interestingly, the difference in the molecular weight of PGA also led to significantly differences in the micro-morphology of the complexes, as PGA with a high molecular weight (2,000 kDa) generated the formation of a "fruit-tree" shaped structure, whereas PGA with relatively low molecular weight (100 and 500 kDa) led to spherical particles with a "core-shell" structure. In addition, the incorporation of PGA molecules into β-lgNPs dispersion also contributed to the improvement in the encapsulation efficiency of Cur as well as physicochemical stability of β-lgNPs, and PGA with a higher molecular weight was confirmed with a better effect. Findings in the current work may help to further understand the effect of molecular weight of polysaccharide on the physical and structural properties as well as effectiveness as delivery systems of polysaccharide-protein complexes, providing for the possibility for the design and development of more efficient carriers for bioactive compounds in food system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lin, Su, Chen, Wei, Zhang, Li and Yuan.)

Inflammation is a central mechanism in metabolic disorders associated with morbidity and mortality and dietary factors can modulate inflammation. We aimed to prospectively investigate the association between an empirically developed, food-based dietary inflammatory pattern (EDIP) score and the risk of overall and cause-specific mortality, using data from the US National Health and Nutrition Examination Survey from 1999 to 2014. EDIP score was derived by entering thirty-nine predefined commonly consumed food groups into the reduced rank regression models followed by stepwise linear regression, which was most predictive of two plasma inflammation biomarkers including C-reactive protein and leucocyte count among 25 500 US adults. This score was further validated in a testing set of 9466 adults. Deaths from baseline until 31 December 2015 were identified through record linkage to the National Death Index. During a median follow-up of 7·8 years among 40 074 participants, we documented 4904 deaths. Compared with participants in the lowest quintile of EDIP score, those in the highest quintile had a higher risk of overall death (hazard ratio (HR) = 1·19, 95 % CI 1·08, 1·32, P trend = 0·002), and deaths from cancer (HR = 1·41, 95 % CI 1·14, 1·74, P trend = 0·017) and CVD (HR = 1·22, 95 % CI 0·98, 1·53, P trend = 0·211). When stratified by age, the association of EDIP with overall mortality was stronger among individuals under 65 years of age ( P interaction = 0·001). Diets with a higher inflammatory potential were associated with increased risk of overall and cancer-specific mortality. Interventions to reduce the adverse effect of pro-inflammatory diets may potentially promote health and longevity.

There is little evidence for the association between fruit juice, especially 100% fruit juice, and mortality risk. In addition, whether 100% fruit juice can be a healthy alternative to whole fruit remains uncertain. This prospective study utilized the data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. After a median follow-up of 7.8 years, 4904 deaths among 40,074 participants aged 18 years or older were documented. Compared to non-consumption, daily consumption of 250 g or more of 100% fruit juice was associated with higher overall mortality (hazard ratio (HR) = 1.30, 95% confidence interval (CI): 1.11-1.52) and mortality from heart disease (HR = 1.49, 95 CI: 1.01-2.21). A similar pattern was observed for total fruit juice, with HRs of 1.28 (95% CI: 1.09-1.49) for overall mortality and 1.48 (95% CI: 1.01-2.17) for heart disease mortality. Replacing 5% of energy from whole fruit with 100% or total fruit juice was associated with a 9% (95% CI: 2-16%) and 8% (95% CI: 1-15%) increased mortality risk, respectively. Our findings suggest that both total and 100% fruit juice could be associated with high mortality risk, and need to be validated in well-designed studies given the potential misclassification of diet and death reasons.

Purpose: Although emphasis has recently been placed on the importance of diet high in plant-based foods, the association between plant-based diet and long-term risk of overall and cause-specific mortality has been less studied. We aimed to investigate whether plant-based diet was associated with lower death risk., Methods: This prospective cohort study used data from the US National Health and Nutrition Examination Survey. Diet was assessed using 24 h dietary recalls. We created three plant-based diet indices including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Deaths from baseline until December 31, 2015, were identified. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression., Results: We documented 4904 deaths among 40,074 participants after a median follow-up of 7.8 years. Greater adherence to PDI was associated with lower risk of overall (HR comparing extreme quintiles 0.80, 95% CI 0.73, 0.89, p trend  < 0.001) and cancer-specific (HR = 0.68, 95% CI 0.55, 0.85, p trend  < 0.001) mortality. These inverse associations remained for hPDI and overall mortality with a HR of 0.86 (95% CI 0.77, 0.95, p trend  = 0.001), but not for cancer or CVD mortality. Conversely, uPDI was associated with higher risk of total (HR = 1.33, 95% CI 1.19, 1.48, p trend  < 0.001) and CVD-specific (HR = 1.42, 95% CI 1.12, 1.79, p trend  = 0.015) mortality., Conclusions: Increased intake of a plant-based diet rich in healthier plant foods is associated with lower mortality risk, whereas a plant-based diet that emphasizes less-healthy plant foods is associated with high mortality risk among US adults., (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Aims: Hyperinsulinaemia and insulin resistance play a central role in the progression of hepatic steatosis and fibrosis, and diet can modulate insulin response. We thus hypothesised that diet with higher insulinaemic potential is associated with an increased risk of these conditions., Methods: Two empirically dietary indices for hyperinsulinaemia (EDIH) and insulin resistance (EDIR) were derived to identify food groups most predictive of fasting concentrations of C-peptide and insulin and homeostatic model assessment for insulin resistance respectively. Hepatic steatosis and fibrosis were defined by controlled attenuation parameter and liver stiffness measurement using transient elastography (TE). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression., Results: Of the 4171 participants with TE examination, 1436 (age-standardised prevalence, 33.8%) were diagnosed with steatosis, 255 (5.6%) with advanced fibrosis and 101 (2.2%) with cirrhosis. The multivariable-adjusted ORs for participants comparing the highest to the lowest EDIH tertile were 1.17 (95% CI: 0.99-1.39, P trend  = .005) for steatosis, 1.74 (95% CI: 1.24-2.44, P trend  = .001) for advanced fibrosis and 2.05 (95% CI: 1.21-3.46, P trend  = .004) for cirrhosis. Similar associations were observed for EDIR with ORs of 1.32 (95% CI: 1.11-1.55, P trend  < .001) for steatosis and 1.43 (95% CI: 1.03-1.99, P trend  = .006) for advance fibrosis. These positive associations remained among never drinkers and individuals who were free of hepatitis B and/or C., Conclusions: Our findings suggest that hyperinsulinaemia and insulin resistance may partially underlie the influence of diet on hepatic steatosis and fibrosis, and highlight the importance of reducing or avoiding insulinaemic dietary pattern., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To explore associations of hyperlipidemia and its subtypes with blood lead levels in community older adults., Methods: From June to September, 2016, a rural and an urban community in Lu&apos;an City, Anhui Province were randomly selected. Older adults aged 60 years old or over in two communities were recruited to participate, receiving a questionnaire interview(including gender, age, region, education, occupation, marital status, lifestyle, and chronic medical history, etc. ), physical examinations(height, weight, and blood pressure) and laboratory tests(blood glucose, blood lipid, and blood lead levels). A total of 1080 older adults volunteered to participate, of which 1008 had completedata. Inductively coupled plasma mass spectrometry was used to measure concentrations of blood lead. The interquartile range was used to divide the distribution of lead in blood. Logistic regression model was used to examine associations of hyperlipidemia and its subtypes with blood lead levels. Restrictive cubic splineswere used to further determine potential dose-response relationships., Results: Of 1008 older adults, the mean age was(71.9±6.5) years old, 459(45.5%)were male, and 557(55.3%) were from the rural community. The prevalence of hyperlipidemia was 51.2%(n=516). The detection rate and geometric mean of blood lead were 100% and 28.08 μg/L(ranged from 7.89 to 278.33 μg/L), respectively. Univariate analysis showed that older adults in the highest quartile group of blood lead(≥75%) had higher odds of hyperlipidemia(OR=1.42, 95%CI 1.00-2.02) and two subtypes(high total serum cholesterol(OR=1.83, 95%CI 1.25-2.68)and mixed hyperlipidemia(OR=1.49, 95%CI 0.83-2.67)) compared to counterparties in the lowest quartile group(≤25%). After adjustment for gender, age, region, education, occupation, marital status, smoking, drinking, exercise conditions, diet, high blood pressure, diabetes, and body mass index, the ORs for hyperlipidemia and mixed hyperlipidemia in the highest quartile group of blood lead were 1.55(95%CI 1.02-2.36) and 2.87(95%CI 1.44-5.70). The restricted cubic spline curves showed approximate linear relationships between blood lead levels and ORs of hyperlipidemia and mixed hyperlipidemia., Conclusion: Linear associations of blood lead levels with hyperlipidemia and mixed hyperlipidemia were found in community older adults.

Background: Studies have shown that discharged Coronavirus disease 2019 (COVID-19) patients have retested positive for SARS-CoV-2 during a follow-up RT-PCR test. We sought to assess the results of continued nucleic acid testing for SARS-CoV-2 patients in COVID-19 patients after they were discharged in Lu'an, China., Methods: We conducted RT-PCR tests on sputum, throat swabs, fecal or anal swabs, and urine samples collected from 67 COVID-19 patients following discharge. Samples were collected on the 7th and 14th days following discharge. Patients testing positive on the 7th or 14th day were retested after 24 hours until they tested negative twice., Results: Seventeen (17/67, 25.4%) discharged COVID-19 patients had a positive RT-PCR retest for SARS-CoV-2. Among them, 14 (82.4%) were sputum positive, five (29.4%) were throat swab positive, seven (41.2%) were fecal or anal swab positive, one (5.9%) was urine sample positive, five (29.4%) were both sputum and throat swab positive, four (23.5%) were both sputum and fecal test positive, and one (5.9%) was positive of all four specimens. The shortest period of time between discharge and the last positive test was 7 days, the longest was 48 days, and the median was 16 days. The proportion of positive fecal or anal swab tests increased from the third week. The median Cq cut-off values after onset were 26.7 after the first week, 37.7 the second to sixth week, and 40 after the sixth week. There were no significant differences between the RT-PCR retest positive group and the unrecovered positive group., Conclusions: There was a high proportion of patients who retested positive for COVID-19. Discharge criteria have remained fairly consistent so we encourage regions affected by COVID-19 to appropriately amend their current criteria., Competing Interests: The authors declare there are no competing interests., (©2021 Lyu et al.)

Background: Experimental and epidemiological studies have linked antibiotics use to gut dysbiosis-mediated risk of chronic metabolic diseases. However, whether adiposity is linked to antibiotic exposure in elderly remains inadequately understood., Objective: To investigate the association between internal exposure of antibiotics and adiposity in elderly by using a biomonitoring method., Methods: We included 990 participants (≥60 years) from the baseline survey of the Cohort of Elderly Health and Environment Controllable Factors in Lu'an city, China, from June to September 2016. Forty-five antibiotics and two metabolites in urine were monitored through liquid chromatography-electrospray tandem mass spectrometry (HPLC-MS/MS). Creatinine-corrected urinary concentrations were used to assess antibiotic exposure levels. Body mass index (BMI), waist circumference (WC) and body fat percentage (BFP) were used as indicators of adiposity. Multiple linear regression and binary logistic regression analyses were used to analyze the association of antibiotic concentrations with obesity-related indices. Subsequently, a gender-stratified analysis was performed., Results: Of the included elderly, 50.7% were defined as having overweight/ obesity, 59.8% as having central preobesity/obesity, and 37.5% as having slightly high/high BFP. Linear regression analysis revealed that a 1-unit increase in the logarithmic transformation of norfloxacin concentrations was related with an increase of 0.29 kg/m 2 (95% CI: 0.02-0.04), 0.99 cm (95% CI：0.24-1.75), and 0.69% (95% CI：0.21-1.17) in BMI, WC, and BFP, respectively. Compared with the control group, exposure to doxycycline (tertile 2: odds ratio, 2.06 [95% CI: 1.12-3.76]) and norfloxacin (tertile 2: 2.13 [1.05-4.29]; tertile 3: 2.07 [1.03-4.17]) had BMI-based overweight/obesity risk. Additionally, ciprofloxacin (tertile 2: 2.06 [1.12-3.76]), norfloxacin (tertile 3: 2.95 [1.34-6.49]), and florfenicol (tertile 3: 1.84 [1.07-3.14]) were related to WC-based central preobesity/obesity risk. Norfloxacin (tertile 3: 2.54 [1.23-5.24]) was positively associated with a slightly high/high BFP risk. Gender-stratified analysis demonstrated an increased adiposity risk in women compared with men., Conclusions: Our research provided an evidence that exposure to specific types of antibiotics (tetracyclines and fluoroquinolones) probably from the food chain contributed to obesity in elderly. Prospective cohort studies with larger sample size are warrented to explore the causation., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

This study aimed to evaluate the association between aluminum (Al), arsenic (As), barium (Ba), cobalt (Co), manganese (Mn), selenium (Se), strontium (Sr), thallium (Tl), and vanadium (V) levels in whole blood and the cognitive ability of people over 60 years old. A total of 1217 eligible participants were enrolled in our study in Lu'an city, Anhui province, China. The inductively coupled plasma mass spectrometry (ICP-MS) was used to determine the concentration of nine trace elements in the whole blood, which reflect their exposure levels. Mini-mental State Examination (MMSE) scale was employed to screen the cognitive function of the elderly. Logistic regression was applied to assess the associations of nine whole blood trace elements with cognition. In the work, it has found that high levels of whole blood As and Se are risk factors for cognitive dysfunction. As and Se quartile were correlated with increased risk of cognitive dysfunction, and with the odds ratio (OR) of 2.06 (95% CI 1.30-3.25; p-trend = 0.002), 1.947 (95% CI 1.20-3.17; p-trend = 0.007) in the highest quartile. However, high concentration of Al, V, and Ba in whole blood were protective factors for cognitive function [OR = 0.63 (95% CI 0.40-0.98; p-trend = 0.040), 0.549 (95% CI 0.36-0.85; p-trend = 0.007), 0.460 (95% CI 0.28-0.75; p-trend = 0.002) respectively]. The study suggested that the exposure of some trace elements (As, Se) were associated with the increased risk of cognitive dysfunction; on the contrary, other elements (Al, V, Ba) could be protective factor for cognitive function. These findings need to be confirmed in additional research of a large elderly population.

BACKGROUND This population study aimed to investigate the demographic and clinical characteristics and outcome of cases of coronavirus disease 2019 in Lu'an City, China between January 22, 2020 and February 18, 2020 identified from the China Information System for Disease Control and Prevention (CISDCP). MATERIAL AND METHODS Laboratory-confirmed cases of COVID-19 reported in the CISDCP were included in this study. The distribution of cases, exposure history, clustered epidemic situation, and clinical manifestations, disease severity, and key time nodes were analyzed. Once the throat swab or sputum sample was positive for SARS-CoV-2 by real-time reverse transcriptase-polymerase chain reaction testing as confirmed cases. RESULTS There were 69 cases of COVID-19 that were confirmed between January 22 and February 18, 2020 reported. The onset time was concentrated on January 25, 2020 solstice to February 6, 2020 (71.0%), and the reporting dates were concentrated on January 31, 2020 and February 9, 2020 (69.6%). Nineteen cases (27.5%) had a history of sojourn in Hubei Province, and none of the cases reported after February 6, 2020 had a history of exposure in Hubei Province. There were 14 cluster outbreaks, and human-to-human transmission was the most common (78.6%). The most common symptoms were fever (56.5%), cough (37.7%), and self-conscious discomfort (14.5%). Besides, there were 9 severe cases (13.0%). CONCLUSIONS The epidemic prevention and control in Lu'an City has achieved phased results. Yet, new strict control measures need to be implemented to prevent a further outbreak, especially for those who will return to Lu'an City.

Hubei province in China has had the most confirmed coronavirus disease 2019 (COVID-19) cases and has reported sustained transmission of the disease. Although Lu'an city is adjacent to Hubei province, its community transmission was blocked at the early stage, and the impact of the epidemic was limited. Therefore, we summarised the overall characteristics of the entire epidemic course in Lu'an to help cities with a few imported cases better contain the epidemic. A total of 69 confirmed COVID-19 cases and 11 asymptomatic carriers were identified in Lu'an during the epidemic from 12 January to 21 February 2020. Fifty-two (65.0%) cases were male, and the median age was 40 years. On admission, 56.5% of cases had a fever as the initial symptom, and pneumonia was present in 89.9% of cases. The mean serial interval and the mean duration of hospitalisation were 6.5 days (95% CI: 4.8-8.2) and 18.2 days (95% CI: 16.8-19.5), respectively. A total of 16 clusters involving 60 cases (17 first-generation cases and 43 secondary cases) were reported during the epidemic. We observed that only 18.9% (7/37) index cases resulted in community transmission during the epidemic in Lu'an, indicating that the scale of the epidemic was limited to a low level in Lu'an city. An asymptomatic carrier caused the largest cluster, involving 13 cases. Spread of COVID-19 by asymptomatic carriers represents an enormous challenge for countries responding to the pandemic.

Previous studies have reported an association between blood lead (BPb) levels and depressive symptoms in adults. However, the relationship between BPb levels and depression remains unclear in the old population. Our purpose was to investigate the association of BPb levels with depression among the old population. Data were gathered from 994 elderly persons in the Cohort Study of Elderly Health and Environmental Controllable Factors, which was created in Anhui, China. BPb was measured by inductively coupled plasma mass spectrometry. Our subjects were divided into four groups according to BPb quartiles. Multivariate logistic regressions were used to assess the association between BPb levels and depression. The median (25th-75th) BPb level was 26.94 μg/L (20.34 μg/L-36.13 μg/L). BPb levels in participants with depression were higher than those in participants without depression. The prevalence of depression was 27.64%. After multivariate adjustment for confounding factors, participants with BPb level in the highest quartile had 2.03 times higher risk of depression compared with those in the lowest quartile. In rural areas, the risk of depression in higher BPb quartile was higher than that in the lowest quartile. These findings suggest that higher BPb level was associated with increased odds of depression in the old population. This association was obvious among older people living in rural areas.