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Type 1 resistant starch (RS1) was prepared by high-pressure homogenization of corn starch (CS) embedded with 0.1%, 0.3%, 0.5%, and 0.7% konjac glucomannan (KGM), followed by heat-moisture treatment (HMT) at 30% moisture content and 110 °C for 6 h. After embedding KGM and applying HMT, the gelatinization temperature of CS increased by 8.09 °C, and the resistant starch content of cooked CS increased from 8.46% to 28.05%. The addition of KGM enhanced the adhesiveness and hardness of CS while reducing its elasticity and chewiness. Rheological analysis revealed that KGM addition increased both the storage and loss moduli of CS, and the crystallinity of KGM-embedded CS decreased to 18.58%. Moreover, short-chain fatty acid production and the abundance of beneficial bacteria, including Lachnospiraceae, Prevotellaceae, Anaerostipes, and Weissella, were higher in the RS1 group compared to the high-amylose maize starch and fructooligosaccharide groups. In the in vivo digestibility experiment, the peak blood glucose level in the RS1 group (7.08 mmol/L) was significantly lower than that in the CS group (8.57 mmol/L). These findings highlight the potential of KGM-embedded CS-derived RS1 in improving postprandial blood glucose levels in individuals with type 2 diabetes and obesity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Background and aims. Undernutrition coexists with tuberculosis and is associated with adverse treatment outcomes. Nutrition packages have been incorporated into tuberculosis patient care in some regions but there are little data on its effectiveness. The aim of this study is to evaluate the effect of a nutrition package on the treatment response and nutritional status of tuberculosis patients. Methods. We conducted a double-blinded placebo-controlled randomized trial in 360 pulmonary tuberculosis patients with concurrent diabetes or prediabetes. The participants were randomly assigned to receive a daily nutrition package (112 kcal, 9 g protein, and micronutrients) or a daily placebo package (112 kcal, 3 g protein, and no micronutrients) during tuberculosis treatment. The intervention lasted for six months. All participants received standard pulmonary tuberculosis treatment. The clinical symptoms, sputum smear, chest computed tomography, and nutritional status were monitored during the intervention. Results. The nutrition package improved the expectoration (intervention vs. placebo: 34.1% vs. 48.3% in week 1, 27.8% vs. 45.0% in week 2, 25.9% vs. 38.6% in week 3, 25.6% vs. 35.4% in month 1, 15.3% vs. 22.9% in month 2) and chest pain (2.3% vs. 9.0% in week 3, 3.6% vs. 8.3% in month 1, 4.3% vs. 10.0% in month 2, 1.8% vs. 6.4% in month 4). The nutrition package also increased hemoglobin, albumin, and lymphocyte counts. The nutrition package did not influence the sputum smear conversion in the whole population [hazard ratio (95% CI): 1.031 (0.685, 1.550), P = 0.885], but accelerated the conversion in patients without cavity [2.583 (1.180, 5.656), P = 0.018]. Conclusions. The nutrition package improved the clinical symptoms ( e.g. chest pain and expectoration) and alleviated undernutrition ( e.g. anemia and hypoproteinemia) among tuberculosis patients. The study was registered at the China Clinical Trial Registry Center (no. ChiCTR1900022294; https://www.chictr.org.cn).

To instruct the production of millet porridge, the effect of cooking methods on flavor and texture of millet porridge was investigated. A total of 91 volatiles were detected and most volatile compounds decreased with cooking time, e.g. alcohols. The esters as major volatiles had a high content in electric rice cooker (IC). Multiple chemometric results indicated that volatiles from different cooking methods were distinguished respectively. Texture analysis indicated that the hardness of millet porridge prepared in IC had a more dominant decrease trend than electromagnetic oven and the electric pressure cooker before 40 min. In conclusion, different cooking methods had a more significant influence on the volatiles than cooking time, while the texture is opposite. The comprehensive sensory score reached its peak in IC-30 min. The comprehensive sensory scores of IC and EC decreased with the prolongation of cooking time. This study helps to improve the sensory attributes of millet porridge., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background and Purpose: Nutrition is associated with tuberculosis drug-induced liver injury (TBLI). How dietary patterns relate to tuberculosis drug-induced liver injury is still unknown. The objective of this study is to explore the relation between dietary patterns and the risk of tuberculosis drug-induced liver injury., Methods: This cohort study was conducted at two hospitals in Shandong Province, China, between 2011 and 2013. A total of 605 tuberculosis patients were included in the final analysis. The blood aspartate aminotransferase or alanine aminotransferase level was monitored through the 6-month tuberculosis treatment. The semi-quantitative food frequency questionnaires were used to survey dietary intake in the second month of the tuberculosis treatment. The China Healthy Diet Index (CHDI), which was previously validated in the Chinese population, was used as an a priori dietary pattern. A posteriori dietary patterns were extracted by principal component analysis (PCA)., Results: The CHDI was negatively associated with the risk of liver injury [adjusted odds ratio (aOR) per standard deviation (SD) (95% CI): 0.61 (0.40-0.94)] and liver dysfunction [aOR per SD (95% CI): 0.47 (0.35-0.64)] in the multivariate logistic model. A positive association between "Organ meat, poultry, and vegetable oil" dietary pattern scores (extracted by PCA) and the risk of liver injury [aOR (95% CI): 3.02 (1.42-6.41)] and liver dysfunction [aOR (95% CI): 1.83 (1.09-3.05)] was observed., Conclusion: In conclusion, a high CHDI score was a protective factor for tuberculosis drug-induced liver injury, while the "Organ meat, poultry, and vegetable oil" dietary pattern, which was rich in organ meat, poultry, and vegetable oil and low in vegetables, was an independent risk factor for tuberculosis drug-induced liver injury., 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 Wang, Zhou, Zhao, Xiong, Liu, Zhao and Ma.)

The effects of the structure and digestibility of konjac glucomannan (KGM)-recrystallized resistant starch complex (KRS3) on the glycemic response and short-term satiety in mice were investigated. KRS3 samples were prepared by recrystallized debranched starch (RS3) at 50 °C, and then combined with KGM. The RS3 and KRS3 samples displayed an A-type pattern and maintained peak temperature values above 110 °C. With an increase in KGM, the swelling power and apparent viscosity of KRS3 increased. The results of in vitro and in vivo digestion revealed that KRS3 with a resistant starch content ranging from 69.4 % to 78.8 % could effectively maintain postprandial blood glucose levels. KRS3, particularly with 0.5 % KGM, slowed gastric emptying of mice from 82.7 % to 36.6 % and intestinal propulsion rate from 60.9 % to 35.3 %, resulting in strong satiety. RS3 combined with KGM could serve as a new approach to develop RS3 based foods with low glycemic responses and high-satiety., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Malnutrition is related to impaired oral health and function that causes poor dietary intake, declining the general health of older adults. The role of dietary intake in the association between oral function and nutritional status of Chinese older adults (aged 75 and above) was examined in this cross-sectional study., Methods: Through the randomized cluster sampling method, 267 older adults living in rural areas of Qingdao, Shandong (aged 81.4 ± 4.3, 75-94 years) were chosen as the primary research participants. A Mini Nutritional Assessment - Short Form was used to determine nutritional status, and Food Frequency Questionnaire and 24-hour Food Intake Recall were used to assess dietary intake. The oral function was evaluated by analyzing the teeth, oral problems, bite force, tongue pressure, lip sealing pressure, chewing function questionnaire, whole saliva flow rate, 10-Item Eating Assessment Tool, and water swallow test., Results: Based on the MNA-SF score, it was divided into a well-nourished group and a malnutrition group, with the malnutrition group comprising 40.6% of participants. The participants in the malnutrition group showed a higher rate of xerostomia, lower bite force, tongue pressure, and lip sealing pressure, and higher Chewing Function Questionnaire and 10-Item Eating Assessment Tool scores. Furthermore, their plant fat, iron, cereals and potatoes, vegetables, fruits, and seafood intake were relatively low. The regression model indicated that exercise frequency, stroke, chewing and swallowing function, intake of vegetables and fruits were risk factors for nutritional status of older adults., Conclusion: Malnutrition was relatively common among the Chinese older adults aged 75 and above, and it was significantly correlated with exercise frequency, stroke, chewing and swallowing function, and intake of vegetables and fruits. Therefore, nutrition management should be carried out under the understanding and guidance of the oral function and dietary intake of the older adults., (© 2024. The Author(s).)

To investigate the optimal processing of maize porridge, the volatile compounds and texture under different cooking methods and time have been studied. A total of 51 volatile compounds were identified in maize porridge. Notably, the major volatiles, aldehydes and esters exhibited a relatively high content in electric pressure cooker (EPC), and esters tend to significantly increase after cooking. Among aldehydes, nonanal and hexanal played a great role in flavor due to their relatively high content. Volatile compounds of maize porridge in different cooking methods could be clearly distinguished by multiple chemometrics. Furthermore, texture analysis revealed that almost all the indicators in the EPC can reach the lowest value at 60 min. To summarize, different cooking methods had a more significant influence on the volatile compounds and texture compared to time. This study helps to improve the sensory attributes of maize porridge, and thus contributes to healthier and more sustainable production., Competing Interests: This is a manuscript prepared by Kaixuan Chen et al. entitled “Effect of Cooking Methods on Volatile Compounds and Texture Properties in Maize Porridge” It is submitted to be considered for publication as an “article” in “Food Chemistry: X". Neither the full paper nor any part of its content has been published or has been submitted to any other journal for publication consideration. All the authors listed have approved the manuscript that is enclosed. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: A healthy, well-balanced diet plays an essential role in respiratory diseases. Since micronutrient deficiency is relatively common in patients with chronic obstructive pulmonary disease (COPD), micronutrient supplementation might have the beneficial health effects in those patients. This systematic review and meta-analysis aimed to demonstrate the impact of micronutrient supplementation on the lung function of patients with COPD., Methods: The PubMed, Cochrane Library, and Web of Science databases were searched from their corresponding creation until February 2024. Search terms included 'chronic obstructive pulmonary disease', 'COPD', 'micronutrients', 'dietary supplements', 'vitamins', 'minerals', and 'randomized controlled trials'. Meta-analysis was performed to evaluate the effects of micronutrient supplementation alone or complex on lung function in patients with COPD., Results: A total of 43 RCTs fulfilled the inclusion criteria of this study. Meta-analysis revealed that vitamin D supplementation could significantly improve FEV1% (WMD differences between baseline and post-intervention (de) : 6.39, 95% CI: 4.59, 8.18, p < 0.01; WMD post-intervention indicators (af) : 7.55, 95% CI: 5.86, 9.24, p < 0.01) and FEV1/FVC% (WMD de : 6.88, 95%CI: 2.11, 11.65, WMD af : 7.64, 95% CI: 3.18, 12.10, p < 0.001), decrease the odds of acute exacerbations, and improve the level of T-cell subsets, including CD3 + %, CD4 + %, CD8 + %, and CD4 + /CD8 + % (all p < 0.01). The effects of compound nutrients intervention were effective in improving FEV1% (WMD de : 8.38, 95%CI: 1.89, 14.87, WMD af : 7.07, 95%CI: -0.34, 14.48) and FEV1/FVC% (WMD de : 7.58, 95% CI: 4.86, 10.29, WMD af : 6.00, 95% CI: 3.19, 8.81). However, vitamin C and vitamin E supplementation alone had no significant effects on lung function ( p > 0.05)., Conclusions: Micronutrient supplementation, such as vitamin D alone and compound nutrients, has improved effect on the lung function of patients with COPD. Therefore, proper supplementation with micronutrients would be beneficial to stabilize the condition and restore ventilation function for COPD patients.

The hypoglycemic effects of two recrystallized resistant starches, A-type (ARS) and B-type (BRS), were investigated in type 2 diabetic mice. Mice were treated with low-, medium-, or high-dose ARS, high-dose BRS, or high-dose ARS combined with BRS (ABRS). After 10 weeks of continuous intervention, the medium-dose ARS group showed a significant reduction in fasting blood glucose, area under the curve of glucose, triglyceride (P < 0.01), and low-density lipoprotein (P < 0.05) levels compared to the model group and an increase in high-density lipoprotein levels (P < 0.01). The peptide YY and glucagon-like peptide-1 levels in the high-dose ARS, BRS, and ABRS groups and the butyric acid yield in the medium-dose ARS and BRS groups were significantly increased (P < 0.01) compared to those in the model group. Medium- and high-dose ARS intervention efficiently increased the relative abundance of beneficial Bacteroidetes, Lactobacillus, Lachnospiraceae&#95;NK4A136&#95;group, and Faecalibaculum, and lowered the ratio of Firmicutes to Bacteroidetes. Overall, ARS exhibited greater advantages than BRS in lowering blood sugar levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property. We understand that the Corresponding Author is the sole contact for the Editorial process (including Editorial Manager and direct communications with the office). He is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs. We confirm that we have provided a current, correct email address which is accessible by the Corresponding Author and which has been configured to accept email from rrchang08@qdu.edu.cn., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Objectives: Macronutrients play a vital role in liver dysfunction and affect tuberculosis treatment and prognosis. However, macronutrients intake was inadequate for most tuberculosis patients. This study aimed to clarify the associations between macronutrients intake or energy percentages and liver dys-function in tuberculosis patients., Methods and Study Design: In this cross-sectional study, 2581 active tu-berculosis patients aged ≥18 years were included from local tuberculosis clinics in Linyi, China. Macronutrients intake and energy percentages were assessed by 24-hour dietary recalls. The concentration of alanine transferase (ALT) or aspartate transaminase (AST) greater than 40 U/L was defined as liver dysfunction. A restricted cubic spline (RCS) was applied to determine the dose-response relationships., Results: Liver dysfunction was assessed for 14.6% (377 patients) of tuberculosis patients. Higher protein (Q2-Q4 in model 1 and 2) or fat intake and fat-to-energy percentages and lower carbohydrate-to-energy percentages (Q4 in model 1) were associated with a decreased incidence of liver dysfunction (p-trend < 0.05). Among those who were male, normal BMI, or consumed energy <1636 kcal/d, inverse associations between protein or fat intake and the risks of liver dysfunction in models were suggested (p-trend < 0.05). Moreover, J-shaped curves in RCS were evident in liver dysfunction tuberculosis patients with protein or fat intake (p-nonlinearity < 0.05). Conclu-sions: Significant linear associations between macronutrients intake or energy percentages and liver dysfunction prevalence were found only in male, normal BMI, or less energy intake patients. The shapes of liver dysfunction-morbidity differed significantly by macronutrients intake or energy percentage., Competing Interests: The authors declare no conflict of interest

Purpose: The objective of this study is to explore the neural correlates of pain sensitization in patients with chronic low back pain (cLBP). While the association between cLBP and pain sensitization has been widely reported, the underlying brain mechanism responsible for this relationship requires further investigation., Methods: Our study included 56 cLBP patients and 56 healthy controls (HC). Functional magnetic resonance imaging data were obtained, and the voxel-wise amplitude of low-frequency fluctuation (ALFF) was calculated to identify brain alterations in cLBP patients compared to HC groups. Pearson correlation coefficients were computed to explore the association between clinical data and brain alterations. Furthermore, mediation analyses were performed to investigate the path association between brain alterations and pain-related behaviors., Results: Our findings revealed that patients with cLBP exhibited higher sensitivity, attention, and catastrophizing tendencies towards pain compared to HC. Furthermore, cLBP patients displayed significantly higher ALFF in various brain regions within the "pain matrix" and the default mode network when compared to HC. The altered precuneus ALFF was positively correlated with pain intensity (R = 0.51, P<0.001) and was negatively correlated with pain sensitivity (R = -0.43, P<0.001) in cLBP patients. Importantly, the effect of altered precuneus ALFF on pain intensity was mediated by pain threshold in these patients., Conclusion: Our study suggests that altered neural activity in the precuneus may contribute to pain hypersensitivity, which further exacerbating pain in cLBP patients., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Sodium intake from pre-packaged foods is increasing in China and is well above the WHO recommendation of 5 g per day. The purpose of this study is to analyze the sodium content of pre-packaged foods collected by the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (NINH, China CDC) in 20 provinces of China from 2017 to 2022. The proportion of pre-packaged foods that meet or exceed the low-sodium, medium-sodium, and high-sodium classifications were analyzed. The proportion of pre-packaged foods that meet and do not meet the WHO global sodium benchmarks and the difference in sodium content between these foods was also calculated. High-sodium foods include sauces, dips, and dressings (3896 mg/100 g), convenience foods (1578 mg/100 g), processed fish products (1470 mg/100 g), processed meat products (1323 mg/100 g), processed poultry products (1240 mg/100 g), snack foods (750 mg/100 g), processed egg products (741 mg/100 g), and fine dried noodles (602 mg/100 g). A large number of pre-packaged foods currently collected in China have a sodium content above sodium benchmarks. This study provided data to support the assessment of sodium intake from pre-packaged foods in the Chinese population and the implementation of comprehensive salt reduction strategies.

Insufficient protein intake and cognitive decline are common in older adults; however, there have been few studies on low protein risk screening and complex nutrient interventions for elderly individuals in rural communities. This study aimed to evaluate the effect of dietary multinutrient soy flour (MNSF) on body composition and cognitive function in elderly individuals who are at risk of protein deficiency in a randomized, double-blind, placebo-controlled clinical trial. Nutritional interventions were given to those found to have low protein levels using bioelectrical impedance analysis (BIA). Among 733 older adults screened, 62 participants were included and randomly assigned into two groups, one taking soy flour and the other taking MNSF for 12 weeks. A previous cross-sectional survey found that 35.1% of the elderly people with an average age of 71.61 ± 5.94 years had an inadequate body protein mass proportion. After the intervention, the MNSF group demonstrated a significant improvement in protein mass, muscle mass, mineral levels, skeletal muscle mass, and fat-free mass compared with baseline (all P < 0.05), as well as a better upward trend compared with the soy flour group ( P = 0.08; P = 0.07; P = 0.05; P = 0.08; P = 0.07). Regarding the mini-mental state examination (MMSE) scores, the MNSF group showed a significant decrease after 12 weeks ( P < 0.05), which were significantly different compared with the soy flour group ( P < 0.05). In the future, the application of MNSF as a food-based supplement to improve nutrition and delay cognitive decline in older adults at the risk of protein deficiency may be considered.

Condiments are a significant source of sodium in the diets of Chinese residents. This study aimed to analyze the nutrient content of China's major condiments and to provide support for setting the reference intake for condiments in order to take measures on salt reduction in China. Nutrition data for condiments were collected from the Database on Nutrition Labelling of Prepackaged Foods China in 2017-2022, and by online access to food composition databases from France, the UK, Belgium, and Japan. The analyses include 1510 condiments in China and 1565 related condiments in four countries, of which the descriptive indicators were examined such as median, IQR, and range. Cross-comparisons were made in terms of the difference between the content levels in five countries and the "WHO global sodium benchmarks". The results show that among the 15 types of condiments in China, sesame/peanut butter-based products have a relatively high content of energy, fat, and protein, namely, 2580 kJ/100 g, 50 g/100 g, and 22.2 g/100 g, respectively. In addition to salt, chicken extract/chicken powder, bouillon cubes, and soy sauce are also high in sodium. Furthermore, there were significant differences in the contents of energy and core nutrients across different products when benchmarking with similar condiments in the five countries ( p < 0.001). The sodium content and fat content of some condiments are excessively high. Therefore, enhancing residents' consumption awareness and reducing the amount of condiments is of great significance for reducing China's per capita salt intake and promoting good health.

Background: Dietary advanced glycation end products (AGEs) might exert adverse effects on cognition. The associations between dietary AGEs and long-term risk of dementia are yet to be assessed in large population studies. We aimed to explore whether elevated dietary AGEs intake is associated with increased risk of dementia, and whether this association might be affected by genetic risk., Methods: A prospective cohort study, which included a total of 93,830 participants (aged≥ 50 years) free from dementia at baseline of the UK Biobank study (2006-2010) and had at least two 24-h dietary assessments and were followed up until 2021. Dietary AGEs, including Nε-(1-Carboxyethyl)-l-lysine (CEL), Nε-(carboxymethyl) lysine (CML), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were estimated via averaged data from the multiple 24-h food assessments according to the ultra-performance LC-tandem MS based dAGEs database. Incidence of all-cause dementia was ascertained through hospital inpatient and mortality records. Multivariable Cox regression models were utilized to estimate hazards ratios (HRs) and 95% confidence interval (CI) of dementia risk associated with dietary AGEs., Results: During a median follow-up of 11.9 years, 728 participants developed dementia. In multivariable adjusted model, when comparing the highest with the lowest tertile of intake level, HRs (95% CI) of dementia were 1.43 (1.16, 1.76) for total AGEs Z score, 1.53 (1.25, 1.89) for CEL, 1.27 (1.03, 1.56) for CML and 1.24 (1.02, 1.52) for MG-H1 (all P trend<0.01). There was no significant interaction between dietary AGEs intake, genetic risk and APOE ε4 carrier status for dementia., Conclusions: Higher intakes of dietary AGEs including CEL, CML and MG-H1 were associated with a higher risk of dementia, independent from genetic risk, highlighting the significance of dietary AGEs restriction for dementia prevention., Competing Interests: Conflict of Interest The authors declare no conflicts of interest., (Copyright © 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Hyperlipidemia is one of the metabolic disorders posing great threat to human health. Our previous studies have shown that the nutritional properties of peanut meal after fermentation are markedly improved, and can effectively improve hyperlipidemia caused by high-fat diet in mice. In this study, in order to facilitate the further utilization of peanut meal, the effect of peanut polypeptide (PP) from peanut meal mixed fermentation on lipid metabolism in mice fed with high-fat diet (HFD) and its possible mechanism were investigated. Fifty male C57BL/6J mice were randomly divided into five groups: normal control group (N), high-fat model group (M), PP low-dose group (PL), PP high-dose group (PH), and atorvastatin positive control group (Y)., Results: The results show that PP supplementation can effectively reduce the body weight of mice, decrease the serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and leptin levels (P < 0.05), increase the high-density lipoprotein cholesterol (HDL-C) levels (P < 0.05), up-regulate the expression levels of ileal tight junction proteins ZO-1 and occludin (P < 0.05), reduce the hepatocyte injury and lipid accumulation caused by high-fat diet and increase the species richness of intestinal flora., Conclusion: PP can significantly improve hyperlipidemia and regulate intestinal flora disorders caused by hyperlipidemia. The possible mechanism may be related to the reduction of serum leptin levels and up-regulating the expression levels of the ileal tight junction proteins ZO-1 and occludin. This study provides evidence for its regulatory role in lipid metabolism and intestinal function, and provides a research basis for the potential nutritional benefits of underutilized food by-products. © 2023 Society of Chemical Industry., (© 2023 Society of Chemical Industry.)

The gut-liver axis may provide a new perspective for treating anti-tuberculosis drug-induced liver injury (ATDILI). Herein, the protective effect of Lactobacillus casei (Lc) was investigated by modulating gut microflora (GM) and the toll like receptor 4 (TLR4)-nuclear factor (NF)-κB-myeloiddifferentiationfactor 88 (MyD88) pathway. C57BL/6J mice were given three levels of Lc intragastrically for 2 h before administering isoniazid and rifampicin for 8 weeks. Blood, liver, and colon tissues, as well as cecal contents, were collected for biochemical and histological examination, as well as Western blot, quantitative real time polymerase chain reaction (qRT-PCR), and 16S rRNA analyses. Lc intervention decreased alkaline phosphatase (ALP), superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA), and tumor necrosis factor (TNF)-α levels ( p < 0.05), recovered hepatic lobules, and reduced hepatocyte necrosis to alleviate liver injury induced by anti-tuberculosis drugs. Moreover, Lc also increased the abundance of Lactobacillus and Desulfovibrio and decreased Bilophila abundance, while enhancing zona occludens (ZO)-1 and claudin-1 protein expression compared with the model group ( p < 0.05). Furthermore, Lc pretreatment reduced the lipopolysaccharide (LPS) level and downregulated NF-κB and MyD88 protein expression ( p < 0.05), thus restraining pathway activation. Spearman correlation analysis indicated that Lactobacillus and Desulfovibrio were positively correlated with ZO-1 or occludin protein expression and negatively correlated with pathway protein expression. Desulfovibrio had significant negative relationships with alanine aminotransferase (ALT) and LPS levels. In contrast, Bilophila had negative associations with ZO-1, occludin, and claudin-1 protein expressions and positive correlations with LPS and pathway proteins. The results prove that Lactobacillus casei can enhance the intestinal barrier and change the composition of the gut microflora. Moreover, Lactobacillus casei may also inhibit TLR4-NF-κB-MyD88 pathway activation and alleviate ATDILI.

Chronic alcohol intake can affect both liver and intestinal barrier function. The goal of this investigation was to evaluate the function and mechanism of lutein administration on the chronic ethanol-induced liver and intestinal barrier damage in rats. During the 14-week experimental cycle, seventy rats were randomly divided into seven groups, with 10 rats in each group: a normal control group (Co), a control group of lutein interventions (24 mg/kg/day), an ethanol model group (Et, 8-12 mL/kg/day of 56% (v/v) ethanol), three intervention groups with lutein (12, 24 and 48 mg/kg/day) and a positive control group (DG). The results showed that liver index, ALT, AST and TG levels were increased, and SOD and GSH-Px levels were reduced in the Et group. Furthermore, alcohol intake over a long time increased the level of pro-inflammatory cytokines TNF-α and IL-1β, disrupted the intestinal barrier, and stimulated the release of LPS, causing further liver injury. In contrast, lutein interventions prevented alcohol-induced alterations in liver tissue, oxidative stress and inflammation. In addition, the protein expression of Claudin-1 and Occludin in ileal tissues was upregulated by lutein intervention. In conclusion, lutein can improve chronic alcoholic liver injury and intestinal barrier dysfunction in rats.

Ulcerative colitis (UC) is a chronic recurrent inflammatory illness of the gastrointestinal system. The purpose of this study was to explore the alleviating effect of vitamin K2 (VK2) on UC, as well as its mechanism. C57BL/6J mice were given 3% DSS for seven days to establish UC, and they then received VK2 (15, 30, or 60 mg/kg·bw) and 5-aminosalicylic acid (100 mg/kg·bw) for two weeks. We recorded the clinical signs, body weights, colon lengths, and histological changes during the experiment. We detected the inflammatory factor expressions using enzyme-linked immunosorbent assay (ELISA) kits, and we detected the tight junction proteins using Western blotting. We analyzed the intestinal microbiota alterations and short-chain fatty acids (SCFAs) using 16S rRNA sequencing and targeted metabolomics. According to the results, VK2 restored the colon lengths, improved the colonic histopathology, reduced the levels of proinflammatory cytokines (such as IL-1β, TNF-α, and IL-6), and boosted the level of the immunosuppressive cytokine IL-10 in the colon tissues of the colitis mice. Moreover, VK2 promoted the expression of mucin and tight junction proteins (such as occludin and zonula occludens-1) in order to preserve the intestinal mucosal barrier function and prevent UC in mice. Additionally, after the VK2 intervention, the SCFAs and SCFA-producing genera, such as Eubacterium&#95;ruminantium&#95;group and Faecalibaculum , were elevated in the colon. In conclusion, VK2 alleviated the DSS-induced colitis in the mice, perhaps by boosting the dominant intestinal microflora, such as Faecalibaculum , by reducing intestinal microflora dysbiosis, and by modulating the expression of SCFAs, inflammatory factors, and intestinal barrier proteins.

Scope: Gastrointestinal side effects are frequently observed in patients receiving medical radiation therapy. As Lacticaseibacillus casei ATCC334 potentially affects microbial ecosystem, the study hypothesizes that it may improve radiation-induced intestinal injury in rats by modulating the "gut microbiota-metabolite-barrier axis.", Methods and Results: Rats are fed one of three or no doses of L. casei ATCC334 for 7 days and then expose to a single dose of 9 Gy X-ray total abdominal irradiation. Supplementation with L. casei ATCC334 promote the proliferation of intestinal stem cells (ISCs), increase the expression of tight junction proteins, reduce intestinal permeability, and protect intestinal barrier integrity. Moreover, 16S rRNA sequencing show that medium and high doses of L. casei ATCC334 inhibit the growth of Escherichia/Shigella and favor Akkermansia proliferation. L. casei ATCC334 intervention reprogram the metabolic profile and inhibit putrescine production but promote alpha-linolenic acid (ALA) production. Notably, a decrease in putrescine and an increase in ALA are significantly correlated with the proliferation of ISCs and enhanced intestinal barrier function following L. casei ATCC334 intervention., Conclusion: These results highlight that medium and high doses of L. casei ATCC334 alleviate radiation-induced intestinal damage by enhancing the mucosal barrier and remodeling the gut microbiota structure and metabolic activity., (© 2022 Wiley-VCH GmbH.)

Background and Objectives: Malnutrition is associated with pulmonary tuberculosis (PTB). The aim of this study is to investigate the association between persistent malnutrition and the effect of PTB treatment., Methods and Study Design: A total of 915 PTB patients were included. Baseline demographic information, anthropometry, and nutritional indicators were measured. The treatment effect was assessed by combinations of clinical manifestations, sputum smear, chest computerized tomography, gastrointestinal symptoms, and the indexes of liver function. Persistent malnutrition was considered when one or more indicators of malnutrition were lower than the reference standards in two tests on admission and after one month of treatment. Clinical symptom score (TB score) was used to assess the clinical manifestations. The generalized estimating equation (GEE) was used to assess the associations., Results: In GEE analyses, patients with underweight had a higher incidence of TB score >3 (OR=2.95; 95% CI, 2.28-3.82) and lung cavitation (OR=1.36; 95% CI, 1.05-1.76). Hypoproteinemia was associated with a higher risk of TB score >3 (OR=2.73; 95% CI, 2.08-3.59) and sputum positive (OR=2.69; 95% CI, 2.08-3.49). Anemia was associated with a higher risk of TB score >3 (OR=1.73; 95% CI, 1.33-2.26), lung cavitation (OR=1.39; 95% CI, 1.19-1.63), and sputum positive (OR=2.23; 95% CI, 1.72-2.88). Lymphocytopenia was associated with a higher risk of gastrointestinal adverse reactions (OR=1.47; 95% CI, 1.17-1.83)., Conclusions: Persistent malnutrition within one month of treatment can adversely affect anti-tuberculosis treatment. Nutritional status during anti-tuberculosis treatment should be continuously monitored.

Objective: The purpose of this study was to compare and evaluate the diet quality of tuberculosis patients and healthy adults by using the China Healthy Diet Index (CHDI) and to provide guidance for the diet of tuberculosis patients in the future., Methods: A case-control study of 1241 patients and 1241 healthy individuals matchedfor sex and age. The CHDI was used to score the overall diet quality of patients in the casegroup and the control group., Results: The CHDI score of tuberculosis patients was 61.61 and that of healthy controls was 63.97. After adjustment for confounders, participants with >80 on CHDI were 73.5% less likely to develop tuberculosis than participants with <51 (OR: 0.265, 95% CI: 0.086, 0.813, p < 0.05). In the original model, the CHDI scores in the highest range were inversely associated with tuberculosis risk compared with the lowest range (OR: 0.687, 95% CI: 0.420,1.122, p < 0.001). After adjusting for confounders, the CHDI score was significantly associated with a reduced risk of tuberculosis (OR: 0.265, 95% CI: 0.086, 0.813, p < 0.001). After adjusting for confounders, a high-quality diet was positively correlated with anti-tuberculosis treatment outcomes (OR:0.957, 95% CI: 0.918,0.998, p = 0.039)., Conclusion: Compared with healthy adults, tuberculosis patients have poor diet quality with unreasonable diet structure. The insufficient intake of whole grains, vegetables, beans, aquatic products, meat and eggs and the excessive intake of pure energy food and solid fat suggests that the dietary structure of tuberculosis patients was unreasonable. This study provides an idea of the diet structure of tuberculosis patients., (© 2021 The British Dietetic Association Ltd.)

Excessive fructose intake from desserts and beverages may influence bone development among adolescents. The gut microbiota (GM) and energy metabolism play important roles in bone development. In this study, 40 female adolescent rats were randomly assigned to the control group, the fructose group with two concentrations, and the glucose group as the positive control group. After 10 weeks, serum glucose and lipids were detected by means of an automatic analyzer, and the bone microstructure was analyzed by Micro-CT. Then, the GM was determined via 16S rRNA sequencing analysis, and energy metabolism was detected by measuring serum carbohydrate metabolites. At last, bone metabolism markers were measured via ELISA kits. The results showed that excessive fructose intake could increase body weight and influence the glucolipid metabolism of female adolescent rats. Meanwhile, the bone microstructures were impaired with excessive fructose intake. Mechanistically, excessive fructose intake shifted the GM of rats with the decrease of Lachnospiraceae, Ruminococcaceae , and increase of Allobaculum, Lachnospiraceae. Energy metabolism analysis suggested that most metabolites of fructose did not enter the tricarboxylic acid cycle to provide energy for the body's development. Furthermore, serum bone metabolism markers showed that excessive fructose intake could decrease both bone formation and resorption. Our results suggested that excessive fructose intake could inhibit skeletal development in adolescents. One potential mechanism might be that it affected the intestinal microbiota homeostasis in the juvenile body, thus changing the energy metabolism level, and ultimately affecting the bone metabolic balance., 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 Gao, Tian, Tian, Ma, Xu, Liu, Cai, Zhong, Zhang and Ma.)

Lutein was shown to provide health benefits for a few diseases. The dose-response relation of oral lutein intake in humans has rarely been reported. The objective is to investigate the dose-response relation between oral lutein intake and plasma lutein concentration in humans. Forty subjects were recruited from Qingdao University, China in 2014. The subjects were randomly divided into four groups: (1-3) consuming 10, 20, or 40 mg lutein by one, two, or four capsules of lutein A, respectively; (4) consuming 20 mg lutein by two capsules of lutein B (containing 280 mg n-3 fatty acid). After a single oral dose, plasma lutein concentrations were measured at 9-time points. The raise of plasma lutein concentration by a 40 mg dose was significantly higher than by a 10 or 20 mg dose. Plasma lutein concentrations were not significantly different between taking 20 mg lutein A and 20 mg lutein B. A dose-response relation was demonstrated between oral lutein administration and plasma lutein concentration. The dose-response relation was more pronounced among men. The current work provides a scientific basis for recommending a dietary intake level of lutein. Future work should validate the results in other ethnic and age groups., 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 Xiong, Zhao, Hu, Ma and Ma.)

Chronic excessive alcohol intake may lead to male reproductive damage. Lutein is a carotenoid compound with antioxidant activity. The purpose of this study was to observe the effect of lutein supplementation on male reproductive damage caused by excessive alcohol intake. In this study, an animal model of excessive drinking (12 mL/(kg.bw.d)) for 12 weeks was established and supplemented with different doses of lutein (12, 24, 48 mg/(kg.bw.d)). The results showed that the body weight, sperm quality, sex hormones (FSH, testosterone), and antioxidant markers (GSH-Px) decreased significantly, while MDA and inflammatory factors (IL-6, TNF-α) increased significantly in the alcohol model group when compared to the normal control group. After 12 weeks of high-dose lutein supplementation with 48mg/(kg.bw.d), the spermatogenic ability, testosterone level, and the activity of marker enzymes reflecting testicular injury were improved. In addition, high-dose lutein supplementation downregulated the NF-κB and the pro-apoptosis biomarkers (Bax, Cytc and caspase-3), whereas it upregulated the expression of Nrf2/HO-1 and the anti-apoptotic molecule Bcl-2. These findings were fully supported by analyzing the testicular histopathology and by measuring germ cell apoptosis. In conclusion, lutein protects against reproductive injury induced by excessive alcohol through its antioxidant, anti-inflammatory, and anti-apoptotic properties.

The adverse effects of anti-tuberculosis (TB) drugs in the intestines were related to alteration of the intestinal microbiota. However, there was less information about microbial metabolism on the adverse reactions. This study aimed to explore whether Lactobacillus casei could regulate gut microbiota or short-chain fatty acids (SCFAs) disorders to protect intestinal adverse reactions induced by isoniazid (H) and rifampicin (R). Male Wistar rats were given low and high doses of Lactobacillus casei two hours before daily administration of anti-TB drugs. After 42 days, colon tissue and blood were collected for analysis. The feces at two-week and six-week were collected to analyze the microbial composition and the content of SCFAs in colon contents was determined. Supplementation of Lactobacillus casei increased the proportion of intestinal goblet cells induced by H and R (p < 0.05). In addition, HR also reduced the level of mucin-2 (p < 0.05), and supplementation of Lactobacillus casei restored. After two weeks of HR intervention, a decrease in OTUs, diversity index, the abundance of Bacteroides, Akkermansia, and Blautia, and an increase of the abundance of Lacetospiraceae NK4A136 group and Rumencoccus UCG-005, were observed compared with the control group (p all < 0.05). These indices in Lactobacillus casei intervention groups were similar to the HR group. Six-week intervention resulted in a dramatic reduction of Lacetospiraceae NK4A136 group, butyric acid, valeric acid and hexanoic acid, while an increase of Bacteroides and Blautia (p all < 0.05). Pretreatment with Lactobacillus casei significantly increased the content of hexanoic acid compared with HR group (p < 0.05). Lactobacillus casei might prevent intestinal injury induced by anti-tuberculosis drugs by regulating gut microbiota and SCFAs metabolism.

Food is an important factor affecting the treatment of patients with early gastric cancer (EGC). We have established a hospital cohort to guide dietary patterns and observe the health status of patients with EGC after endoscopic submucosal dissection (ESD) after dietary modification. A total of 273 patients with EGC who underwent ESD were recruited to the cohort. They were given dietary instruction and education through a dietary manual and were followed up for 12 months. If the dietary pattern changed to the "traditional food" pattern (high consumption of vegetables, wheat products, and red meat) after the nutritional guidance, subjects were defined as the improvement diet group. Dietary patterns focused on "alcohol and fish" (drink a lot of wine and beer and eating freshwater and marine fish) or "coarse cereals" (mainly whole grains, beans and poultry) were the main ones in the unimproved diet group. The nutritional status, gastric mucosa, and gastrointestinal symptoms of the two groups of patients before and after the dietary instruction were compared. Compared with the unimproved diet group, the endoscopic performance score and the symptom score in the improved diet group were decreased by an average of 1.31 and 1.90, respectively. Except for lymphocyte count ( P = 0.227), total protein ( P < 0.000), albumin ( P = 0.003), globulin ( P = 0.014), red blood cell count ( P < 0.000), and hemoglobin ( P < 0.000) values were improved to varying degrees. After changing the diet, the intake of wheat products and vegetables in the improved diet group increased by 15.58 and 17.52%, respectively, while the intake of alcohol, fish, and pickled products was reduced by 43.36, 36.43, and 31.41%, respectively. After 1 year of dietary adjustment, the nutritional status, gastric mucosa, and gastrointestinal symptoms of patients with EGC after ESD eating the "traditional food" diet were all improved., 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 Zhang, Liu, Ma, Xu, Wang, Wang, Cao, Ma and Gao.)

Background and Objectives: Energy provided by macronutrients plays a key role in healthy aging. This study therefore explored the association between macronutrients and cognitive function in elderly populations in rural areas of Qingdao, China., Methods and Study Design: This study included 1,504 participants over the age of 65 recruited from Licha Town, Qingdao City, China. Dietary intake was measured using the Food Frequency Questionnaire, and cognitive function was assessed using the Mini-Mental State Examination. Logistic regression models were used to evaluate the association between dietary macronutrient intake and cognitive function. In addition, restricted cubic bars were applied to determine the dose-response relationship between macronutrient ratios and cognitive performance., Results: A total of 877 adults over the age of 65 were included. After adjusting the weighted multiple variables, significant positive associations were revealed between protein and moderate carbohydrate intake and cognitive ability, but a negative association between fat intake and cognitive performance was identified. After calculating the daily energy supply ratio, similar associations were revealed between fat and protein intake and cognitive function. Furthermore, the ratio of proteins to carbohydrates had a U-shaped relationship with cognitive function (pnonlinearity=0.674), whereas the ratio of proteins to fats was L-shaped with lower cognitive function (pnonlinearity<0.001). Compared with the lowest quartile of the ratio of protein to fat intake, the weighted adjusted OR (95% CI) of the highest quartile was 0.509 (0.314, 0.827) for low cognitive performance., Conclusions: With an adequate carbohydrate supply, appropriately increasing dietary protein intake and reducing fat intake might benefit the cognitive function of elders in rural areas.

Background and Objectives: The aim is to investigate the association between nutritional status and clinical picture of pulmonary tuberculosis (PTB)., Methods and Study Design: A total of 613 pulmonary tuberculosis patients in Weifang city, Shandong province, China were included. Clinical and nutritional history, anthropometry, nutritionally relevant indicators including serum total protein and albumin, hemoglobin and lymphocyte count were measured. Adjustments were made for confounders in multivariable logistic models where tuberculosis activity (clinical symptoms and signs, sputum-smear tests or chest computerized tomography (CT)) was the dependent variable., Results: Hypoalbuminemia (OR=2.61; 95% CI, 1.69-4.03), anemia (OR=1.62; 95% CI, 1.04-2.51) and lymphocytopenia (OR=1.92; 95% CI, 1.21-3.05) were associated with a higher TB score (a clinical severity measure for pulmonary tuberculosis based on typical signs and symptoms); hypoalbuminemia (OR=1.75; 95% CI, 1.08-2.84) and anemia (OR=1.87; 95% CI, 1.14-3.08) were associated with a positive sputum smear; anemia (OR=3.58; 95% CI, 1.85-6.94) was associated with cavitation in CT., Conclusions: Hypoalbuminemia, anemia and lymphocytopenia were positively associated with the severity of clinical manifestation of PTB. Nutritional status may be a marker for the severity of the clinical manifestations of PTB.

Background and Objectives: It has been proven that skeletal muscle index (SMI) and muscle attenuation (MA) are correlated with outcomes in liver cirrhosis. However, whether there are sex differences in these factors re-mains unknown. We aimed to analyze the predictive ability of SMI and MA for the prognosis of cirrhotic patients of different sexes and promote computed tomography (CT) use in body composition assessment., Methods and Study Design: CT images taken at the 3rd lumbar vertebra from 223 patients were quantified for body composi-tion. A Cox regression model was used to assess associations between mortality and body composition. Time-dependent receiver operating characteristic curves were calculated to evaluate the predictive ability of SMI and MA for the 1-, 3- and 5- year mortality of cirrhotic patients., Results: The majority of patients with liver cirrhosis were male (64.6%), and there was a weak linear correlation between SMI and MA in males (r=0.33, p<0.001). In the sex stratified multivariate Cox regression analysis, SMI in males (HR=0.95; 95% CI, 0.91-0.98; p=0.002) and MA in females (HR=0.91; 95% CI, 0.87-0.96; p<0.001) were independently associated with mortality. The areas under the curve (AUCs) of SMI (AUC=0.718) and MA (AUC=0.705) were similar in the 5-year mortality predic-tion of males, while in females, MA (AUC=0.797) had a stronger predictive ability than SMI (AUC=0.541)., Conclusions: SMI in males and MA in females are independent prognostic factors for liver cirrhosis. For females, MA may be a more sensitive indicator of mortality prediction than SMI, while in males, they are equivalent.

Background and Objectives: Inflammatory cytokines and metabolic abnormalities are common in patients with tuberculosis. Observational studies have indicated that probiotics modulate inflammatory cytokines and metabolites; however, clinical evidence of the effect of probiotics on patients with tuberculosis is lacking. This study investigated the effects of Lactobacillus casei on inflammatory cytokines and metabolites during tuberculosis treatment., Methods and Study Design: A randomized controlled trial was conducted. A total of 47 inpatients were included and randomly assigned to receive standard antituberculosis therapy only (control group) or that treatment together with 1 × 1010 colony-forming units per day of Lactobacillus casei (low-dose group) or 2 × 1010 colony-forming units per day of Lactobacillus casei (high-dose group) for 4 weeks of intensive treatment during hospitalization. Plasma samples were analyzed for inflammatory cytokines and metabolomics with ELISA kits and ultrahigh performance liquid chromatography quadrupole time-of-flight mass spectrometry., Results: Daily Lactobacillus casei supplementation of up to 2 × 1010 colony-forming units significantly lowered the concentrations of tumor necrosis factor-α, interleukin-6, interleukin-10, and interleukin-12 (p=0.007, p=0.042, p=0.002, p<0.001, respectively) in patients with tuberculosis. Compared with the control and low-dose groups, the plasma metabolites of phosphatidylserine, maresin 1, phosphatidylcholine, L-saccharopine, and pyridoxamine were significantly upregulated, and N-acetylmethionine, L-tryptophan, phosphatidylethanolamine, and phenylalanine were downregulated in the high-dose group. Strong correlations were observed between metabolites and inflammatory cytokines., Conclusions: Lactobacillus casei supplementation during the intensive phase of tuberculosis treatment can significantly modulate inflammatory cytokines and metabolites. Decreased inflammatory cytokines may be related to metabolite changes.

The objective of this study is to investigate the effects of vitamin A, D and their interaction on the glycaemic control in patients with both diabetes and tuberculosis. Tuberculosis infection and its treatment induce hyperglycaemia and complicate the glycaemic control in patients with diabetes. A randomised controlled trial with a 2 × 2 factorial design was conducted in a tuberculosis-specialised hospital in Qingdao, China. A total of 279 patients who have both diabetes and tuberculosis were included in this analysis. The patients received standard anti-tuberculosis treatment alone (control group), or together with a dose of vitamin A (600 μg RAE/d) or vitamin D (10 μg/d) or a combination of vitamin A (600 μg RAE/d) and vitamin D (10 μg/d) for 2 months. The effects of the intervention on fasting plasma glucose and 2-h postprandial blood glucose were investigated by ANCOVA. The analysis was adjusted for baseline values, age, sex, smoking, drinking and antidiabetic treatment as covariates. No significant effect was observed for vitamin A and D supplementation on fasting plasma glucose, 2-h postprandial blood glucose, BMI and related blood parameters. No interaction was observed between vitamin A and D supplementation for these endpoints. Vitamin A and D supplementation showed a null effect on the glycaemic control for patients with concurrent diabetes and tuberculosis. Future work should evaluate the effect of vitamin A and D supplementation on insulin-related indices for these patients and investigate the effect of vitamin D receptor genotypes.

Shellfish, including various species of mollusks (e.g., clams, oysters, and mussels) and crustaceans (e.g., shrimp and crab), have been a cornerstone of healthy dietary recommendations. However, beyond providing basic nutrition needs, their health-promoting effects have been suggested to include inflammation reduction and prevention of various chronic non-communicable diseases. Currently, studies on the association between shellfish consumption and health outcomes have reported conflicting results. The present comprehensive review summarized the latest studies on shellfish consumption and synthesized the available evidence on the potential health benefits or risks of shellfish consumption. The findings demonstrated that shellfish consumption may increase the risk of hyperuricemia and gout but may not increase the risk of type 2 diabetes, cardiovascular diseases, and thyroid cancer. Adequate evidence is lacking on the association between shellfish consumption and the risk of colorectal cancer, pancreatic cancer, oral cancer, endometriosis, hip fracture, cognitive function, wheeze, eczema and food allergy. Raw shellfish consumption may cause gastroenteritis and other diseases infected by bacteria or viruses. This review thus provides consumers and other relevant stakeholders with the latest evidence-based information on the potential benefits and risks of shellfish consumption.

Background and Objectives: Poor nutritional status is a common finding in pulmonary tuberculosis (TB) patients with and without type 2 diabetes mellitus (T2DM), thiamin (VB-1) and riboflavin (VB-2) are coenzymes important for the activation of many enzymes involved in improving nutritional status. We aimed to investigate enzymatic activities and the associations between VB-1 and VB-2, and their relations to nutritional status in TB and TB+T2DM patients., Methods and Study Design: This was a cross-sectional study that prospectively enrolled TB 40 patients with or without T2DM respectively from the Chest Hospital of Qingdao and 76 healthy controls with similar age and gender distributions were recruited from the medical center of the affiliated hospital of Qingdao Medical College. The erythrocyte transketolase activation coefficient (ETKac, for VB-1 deficiency), the glutathione reductase activation coefficient (EGRac, for VB-2 deficiency), and metabolic enzyme activities were analyzed., Results: VB-1 and VB-2 deficiency rates were higher, and enzyme activities were lower in TB and TB+T2DM relative to control group. ETKac and EGRac were negatively correlated with enzyme activities, either with body mass index (BMI), while enzyme activities were positively associated with BMI., Conclusions: VB-1 and VB-2 concentrations were lower in TB patients with or without T2DM relative to controls, with concomitant reductions in the activity levels of key metabolic enzymes. Significant correlations were observed between VB-1 and VB-2 concentrations and the activity of these metabolic enzymes, they all correlated with nutrition status. VB-1 and VB-2 concentrations may thus impact metabolic enzyme activity and thereby influence nutritional status.

Our previous studies have shown that the nutritional properties of peanut meal after fermentation are markedly improved. In this study, in order to facilitate the further utilization of peanut meal, we investigated the effects of its fermentation extract by Bacillus natto (FE) on cognitive ability, antioxidant activity of brain, and protein expression of hippocampus of aging rats induced by D-galactose. Seventy-two female SD rats aged 4-5 months were randomly divided into six groups: normal control group (N), aging model group (M), FE low-dose group (FL), FE medium-dose group (FM), FE high-dose group (FH) and vitamin E positive control group (Y). Morris water maze (MWM) test was performed to evaluate their effects on learning and memory ability in aging rats. SOD activity and malondialdehyde (MDA) content of brain, HE staining and the expression of γ-aminobutyric acid receptor 1 (GABABR1) and N-methyl-D-aspartic acid 2B receptor (NMDAR2B) in the hippocampus of rats were measured. The results show that FE supplementation can effectively alleviate the decrease of thymus index induced by aging, decrease the escape latency of MWM by 66.06%, brain MDA by 28.04%, hippocampus GABABR1 expression by 7.98%, and increase brain SOD by 63.54% in aging model rats. This study provides evidence for its anti-aging effects and is a research basis for potential nutritional benefits of underutilized food by-products.

Helicobacter pylori-induced oxidative stress plays an important role in gastric diseases. H. pylori disturbs gut microbiota. The objective is to investigate the effects of cranberry beverages on oxidative stress biomarkers and gut microbiota in H. pylori positive subjects. 171 H. pylori positive participants were randomly assigned to one of the three groups: high-dose (HCb; 480 mL cranberry beverage), low-dose (LCb; 240 mL cranberry beverage plus 240 mL placebo) and placebo (480 mL). Subjects consumed the beverages daily for 4 weeks. Fasting blood samples were analyzed for oxidative stress biomarkers. The intestinal microbiome was analyzed by 16S rRNA sequencing. Compared with the placebo, HCb resulted in a significantly higher increase of total antioxidant capacity (mean ± SD: 1.39 ± 1.69 IU mL-1vs. 0.34 ± 1.73 IU mL-1; p < 0.001) and a higher decrease of the lipid peroxidation product malondialdehyde (-7.29 ± 10.83 nmol mg-1vs. -0.84 ± 15.66 nmol mg-1; p = 0.025). A significant dose-dependent effect on the elevation of superoxide dismutase was observed (p < 0.001). Microbiome data showed that consuming HCb and LCb led to a significant reduction of Pseudomonas (p < 0.05). In conclusion, the current research showed that consuming cranberry beverages significantly improved the antioxidant status in H. pylori positive subjects, which may be related to the reshaping of gut microbiota.

Scope: Probiotics are promising in mitigating drug-induced liver injury in animal experiments. However, the clinical evidence is absent. The objective is to investigate the effect of adjunctive Lactobacillus casei on tuberculosis-drug-induced liver injury., Methods and Results: A post hoc analysis is conducted for a previous randomized controlled trial. The trial is registered at the Chinese Clinical Trial Registry (No. ChiCTR-IOR-17013210). Four hundred twenty nine patients are allocated to receive standard tuberculosis therapy alone (control group), or together with 1 × 10 10 colony-forming units (CFU) per day (low-dose group), or 2 × 10 10 CFU per day of L. casei (high-dose group) during tuberculosis treatment. The L. casei supplementation significantly reduced the incidence of the abnormal increase of cholestasis-related liver indices including alkaline phosphatase (p = 0.024) and bilirubin (p = 0.013). Plasma lipopolysaccharide (p = 0.02), intestinal permeability biomarkers including zonula occludens-1 (p = 0.001) and intestinal fatty acid binding protein (p = 0.002) are significantly reduced. The gut microbiota composition is dramatically altered with a reduction of Bacteroidetes (p < 0.001) and a corresponding increase of Actinobacteria (p < 0.001) and Firmicutes (p = 0.003)., Conclusions: L. casei supplementation is beneficial for suppressing abnormally elevated cholestasis-related liver indices during tuberculosis treatment, which may be related to its modification on blood lipopolysaccharide, intestinal barrier function, and gut microbiota., (© 2021 Wiley-VCH GmbH.)

Previous epidemiological studies have investigated the association of fish and marine n-3 polyunsaturated fatty acids (n-3 PUFA) consumption with cardiovascular disease (CVD) mortality risk. However, the results were inconsistent. The purpose of this meta-analysis is to quantitatively evaluate the association between marine n-3 PUFA, fish and CVD mortality risk with prospective cohort studies. A systematic search was performed on PubMed, Web of Science, Embase and MEDLINE databases from the establishment of the database to May 2021. A total of 25 cohort studies were included with 2,027,512 participants and 103,734 CVD deaths. The results indicated that the fish consumption was inversely associated with the CVD mortality risk [relevant risk (RR) = 0.91; 95% confidence intervals (CI) 0.85-0.98]. The higher marine n-3 PUFA intake was associated with the reduced risk of CVD mortality (RR = 0.87; 95% CI: 0.85-0.89). Dose-response analysis suggested that the risk of CVD mortality was decreased by 4% with an increase of 20 g of fish intake (RR = 0.96; 95% CI: 0.94-0.99) or 80 milligrams of marine n-3 PUFA intake (RR = 0.96; 95% CI: 0.94-0.98) per day. The current work provides evidence that the intake of fish and marine n-3 PUFA are inversely associated with the risk of CVD mortality.

Background: Pre-eclampsia (PE) can result in severe damage to maternal and fetal health. It has been reported that gut microbiota (GM) had important roles in regulating the metabolic and inflammatory responses of the mother. However, investigations on GM in PE are rare., Objective: The objective of the present study was to investigate the changes of GM in PE and how to alter the GM composition in PE by dietary or dietary supplements., Design: We analyzed the composition changes in GM as well as the relationship between bacteria of different genera and clinical indices by amplifying the V4 region of the 16S ribosomal RNA gene in 12 PE patients and eight healthy pregnant women in East China., Results: In the PE group, the Observed Species Index was lower than that in the control group, indicating that the α-diversity of the microbiome in the PE group decreased. At phylum, family, and genus levels, the relative abundance of different bacteria in PE patients displayed substantial differences to those from healthy women. We noted a decreased abundance of bacteria of the phylum Actinobacteria ( P = 0.042), decreased abundance of bacteria of the family Bifidobacteriaceae ( P = 0.039), increased abundance of bacteria of the genus Blautia ( P = 0.026) and Ruminococcus ( P = 0.048), and decreased abundance of bacteria of the genus Bifidobacterium ( P = 0.038) . Among three enriched genera, bacteria of the genus Bifidobacterium showed a negative correlation with the systolic blood pressure (SBP), diastolic blood pressure (DBP), and dyslipidemia, which involved glucose metabolism, lipid metabolism, and the oxidative-phosphorylation pathway. The increased abundance of bacteria of the genera Blautia and Ruminococcus was positively correlated with obesity and dyslipidemia, which involved lipid metabolism, glycosyltransferases, biotin metabolism, and the oxidative-phosphorylation pathways. Moreover, women in the PE group ate more than women in the control group, so fetuses were more prone to overnutrition in the PE group., Conclusion: There is a potential for GM dysbiosis in PE patients, and they could be prone to suffer from metabolic syndrome. We speculate that alterations in the abundance of bacteria of certain genera (e.g. increased abundance of Blautia and Ruminococcus , and decreased abundance of Bifidobacterium ) were associated with PE development to some degree. Our data could help to monitor the health of pregnant women and may be helpful for preventing and assisting treatment of PE by increasing dietary fiber or probiotics supplement., Competing Interests: The authors declare no conflicts of interest. The authors have not received any funding or benefits from industry or elsewhere to conduct this study., (© 2021 Tingting Miao et al.)

The effects of resistant starch on glycaemic control are controversial. In this study, a systematic review and meta-analysis of results from nineteen randomised controlled trials (RCT) was performed to illustrate the effects of resistant starch on glycaemic control. A literature search was conducted on PubMed, Scopus and Cochrane electronic databases for related publications from inception to 6 April 2020. Key inclusion criteria were: RCT; resistant starch as intervention substances and reporting glucose- and insulin-related endpoints. Exclusion criteria were: using type I resistant starch or a mixture of resistant starch and other functional food ingredients as intervention; using substances other than digestible starch as controls. The effect of resistant starch on fasting plasma glucose was significant (effect size (ES) -0·09 (95 % CI -0·13, -0·04) mmol/l, P = 0·001) compared with digestible starch. Subgroup analyses revealed that the ES was larger when the dosage of resistant starch was more than 28 g/d (ES -0·16 (95 % CI -0·24, -0·08) mmol/l, P < 0·001) or the intervention period was more than 8 weeks (ES -0·12 (95 % CI -0·18, -0·06) mmol/l, P < 0·001). The effect on homoeostatic model assessment (HOMA)-insulin resistance (IR) was significant (ES -0·33 (95 % CI -0·51, -0·14), P = 0·001). However, the effects on other insulin-related endpoints were not significant, including fasting plasma insulin, four endpoints from the frequently sampled intravenous glucose tolerance test (insulin sensitivity index, acute insulin response, disposition index and glucose effectiveness) and HOMA-β. The current study indicated moderate effects of resistant starch on improving glycaemic control.

Objectives: Vitamins A and D provided protection from xenobiotic-induced liver injury in previous animal studies. We conducted a post hoc analysis of our previous randomized controlled trial to investigate the effects of vitamin A and D supplementation on tuberculosis-drug-induced liver injury., Methods: The trial was conducted in a hospital in Qingdao, China, from October 2012 to March, 2015. The control group received only tuberculosis treatment. The vitamin A, vitamin D, and vitamins A & D groups received, respectively, additional supplementation of 2000 IU/d vitamin A, 400 IU/d vitamin D, and a combination of 2000 IU/d vitamin A and 400 IU/d vitamin D. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, γ-glutamyltransferase, and cholinesterase were monitored throughout the treatment. Liver injury was defined as ALT or AST three times higher than the upper limit of normal, which was defined for AST, ALT, alkaline phosphatase, γ-glutamyltransferase, and cholinesterase, respectively, as 40 U/L, 40 U/L, 150 U/L, 40 U/L, and 10 500 U/L., Results: Among the 753 participants, 11% exhibited liver injury. No significant effect of vitamin A or D supplementation was observed on the incidence of liver injury or on elevated liver indices including ALT, AST, alkaline phosphatase, γ-glutamyltransferase, and cholinesterase. The interaction between vitamin A and D supplementation was not significant., Conclusions: Vitamin A and D supplementation did not protect against tuberculosis-drug-induced liver injury. Future work should evaluate the effects of higher dosages of vitamins A and D and the effects of different genotypes for vitamin A and D metabolic enzymes or receptors., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background and Objectives: Research has produced inconsistent findings on the association between dietary patterns and cognitive function. In the present study, we examined the association between dietary patterns and cognitive function among rural China's older adults and aimed to identify major dietary patterns., Methods and Study Design: This cross-sectional study included 1176 individuals aged 65-85 years. Dietary intake was assessed using a food frequency questionnaire. Factor analysis and the Chinese Dietary Balance Index were respectively employed to determine dietary patterns and assess dietary quality. Cognitive function was evaluated using the Mini-Mental State Examination, and logistic regression analysis was performed to examine the relationship between dietary patterns and cognitive decline., Results: Three main dietary patterns were identified and named on the basis of foods with high content: a "healthy dietary pattern," a "multigrain dietary pattern," and a "snack dietary pattern." With the increase in the score of the healthy dietary pattern, the Mini-Mental State Examination total score exhibited a significant downward trend (p<0.001). Moreover, we observed a prominent negative association between the healthy dietary pattern and mild cognitive impairment (4th to 1st quartile, OR=0.36; 95%CI, 0.24-0.54; p<0.001). After we adjusted for potential covariates, the negative correlation remained (4th to 1st quartile, OR=0.48; 95%CI, 0.28-0.81; p=0.006). However, no relation was observed between mild cognitive impairment and either the multigrain or snack dietary patterns., Conclusions: The healthy dietary pattern, which is based on the consumption of rice and flour, red meat, chicken, vegetables, seafood, and fruits, protects against cognitive dysfunction.

Background and Objectives: Diabetes mellitus (DM) leads to nearly 3-fold higher risk of pulmonary tuberculosis (TB), indicating an increasing challenge to public health in low-to-middle income countries. Till now, the risk factor is still uncertain. We carried out this study with the main purpose to identify the risk factors of having TB in DM patients., Methods and Study Design: A hospital-based matched case-control study was conducted in Qingdao, China from March, 2016 to January, 2018. Cases were DM patients with concurrent TB (DM-TB). Each case was matched with two controls, patients with DM only of similar age, sex and DM course. Cox regression of conditional logistic analysis was used to define the risk factors for having TB in DM, and then sensitivity analysis was carried out., Results: We identified 315 patients, including 105 cases and 210 controls. Smokers had a higher risk of having TB with a multivariable adjusted odds ratio (aOR) of 12.45 than non-smokers. Poor glycemic control (aOR=2.66), frequency of DM re-examination <1 time/year (aOR=3.39), as well as TB contact history was also independently related with higher risk, while BMI ≥24 (aOR=0.42), education level ≥ college (aOR=0.11) showed a negative association., Conclusions: Poor glycemic control, smoking, low frequency of reexamination was associated with higher risk of having TB in DM, while overweight and obesity, high education levels showed a negative association. These findings provide clues to target DM populations prone to TB, which may be of help to halt the epidemic of TB in high burden countries.

Background and Purpose: Drug-induced liver injury is challenging during tuberculosis treatment. There is no epidemiological data investigating the relation between dietary intake and the risk of drug-induced liver injury during tuberculosis treatment. The aim of this study is to investigate the association of food and nutrient intake with the incidence of tuberculosis-drug-induced liver injury. Methods: A cohort study was conducted in two city-level tuberculosis-specialized hospitals in Linyi City and Qingdao City, China from January 2011 to December 2013. The dietary intake was assessed by a 3-day 24-h food recall survey and a standard food-frequency questionnaire. The liver functions including aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were monitored throughout the 6-month tuberculosis therapy. Liver injury was defined as ALT or AST higher than two times of the upper limit of normal (ULN). Liver dysfunction was defined as ALT or AST higher than the ULN. The ULN for ALT and AST is 40 U/L. Multivariate logistic regression analyses were performed to determine the dietary factors associated with the incidence of liver injury and liver dysfunction. Results: A total of 605 patients were included in the analysis. During the treatment, 8.1% patients exhibited liver injury and 23.3% patients exhibited liver dysfunction. A lower intake of vegetables was associated with a higher risk of liver injury [OR (95% CI): 3.50 (1.52-8.08), P = 0.003) and liver dysfunction [OR (95% CI): 2.37 (1.31-4.29), P = 0.004], while a lower intake of cooking oil was associated with a lower risk of liver injury [OR (95% CI): 0.44 (0.20-0.96), P = 0.040)] and liver dysfunction [OR (95% CI): 0.51 (0.31-0.85), P = 0.009]. Conclusion: The current study indicated that the higher risks of tuberculosis-drug-induced liver injury and liver dysfunction were statistically associated with decreased vegetable intake and increased cooking oil intake., 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 © 2021 Wang, Xiong, Xu, Zhang, Zhao, Liu and Ma.)

Increased intake of vegetables and fruits has been associated with reduced risk of tuberculosis infection. Vegetables and fruits exert immunoregulatory effects; however, it is not clear whether vegetables and fruits have an adjuvant treatment effect on tuberculosis. Between 2009 and 2013, a hospital-based cohort study was conducted in Linyi, Shandong Province, China. Treatment outcome was ascertained by sputum smear and chest computerised tomography, and dietary intake was assessed by a semi-quantitative FFQ. The dietary questionnaire was conducted at the end of month 2 of treatment initiation. Participants recalled their dietary intake of the previous 2 months. A total of 2309 patients were enrolled in this study. After 6 months of treatment, 2099 patients were successfully treated and 210 were uncured. In multivariate models, higher intake of total vegetables and fruits (OR 0·70; 95 % CI 0·49, 0·99), total vegetables (OR 0·68; 95 % CI 0·48, 0·97), dark-coloured vegetables (OR 0·61; 95 % CI 0·43, 0·86) and light-coloured vegetables (OR 0·67; 95 % CI 0·48, 0·95) were associated with reduced failure rate of tuberculosis treatment. No association was found between total fruit intake and reduced failure rate of tuberculosis treatment (OR 0·98; 95 % CI 0·70, 1·37). High intake of total vegetables and fruits, especially vegetables, is associated with lower risk of failure of tuberculosis treatment in pulmonary tuberculosis patients. The results provide important information for dietary guidelines during tuberculosis treatment.

Background: Hyperlipidemia is one of the metabolic disorders that poses a great threat to human health. This study is aimed at investigating the potential hypolipidemic properties of extract from peanut meal fermented with Bacillus natto and Monascus in mice fed with a high-fat diet. Herein, 60 male C57BL/6J mice were randomly divided into six groups: four control groups, comprised of a normal group, a model (M) group, a positive control group (atorvastatin 10 mg kg -1 ), and a nonfermented peanut meal extract group (150 mg kg -1 ), and two experimental groups, comprised of a fermented peanut meal extract low-dose group (50 mg kg -1 ) and a fermented peanut meal extract high-dose group (FH, 150 mg kg -1 )., Results: Body weight (P = 0.001) and levels of serum total cholesterol (P = 0.007), triacylglycerol (P = 0.040), low-density lipoprotein cholesterol (P < 0.001), and leptin (P < 0.001) were remarkably decreased in the FH group, whereas the serum high-density lipoprotein cholesterol levels were increased (P < 0.001) by 78.3% compared with the M group. Ileum tissue stained with hematoxylin and eosin showed that the ileal villus detachments in mice were improved, and the villus height was increased by supplementation with extract from fermented peanut meal. Moreover, the expressions of intestinal ZO-1 (P = 0.003) and occludin (P = 0.013) were elevated in the FH group, compared with the M group., Conclusion: Extract of peanut meal fermented by B. natto and Monascus can effectively improve hyperlipidemia caused by a high-fat diet in mice, via regulating leptin and blood lipid levels, and protect the intestinal mucosal barrier, which provides evidence for its anti-hyperlipidemia effects and is a research basis for potential industrial development. © 2020 Society of Chemical Industry., (© 2020 Society of Chemical Industry.)

Tuberculosis remains a major global health challenge, particularly in low-to-middle income countries such as China. At the same time, the country is facing a rapidly increasing diabetes incidence over the last 10 years. Diabetes aggravates the tuberculosis epidemic which poses a serious challenge in public health. In recent years, the high prevalence of vitamin D deficiency represents a global health problem, which is also associated with the risk of diabetes, and tuberculosis. Therefore, this review aims to provide an overall and updated understanding of the epidemiology of co-occurrence of tuberculosis and diabetes in China, and to elucidate the possible role of vitamin D deficiency. In conclusion, significant aggravation of the tuberculosis epidemic due to diabetes may exist in China for a relatively long period of time to come. Further, the double burden and its implications to public health in this country may be significantly influenced by the high prevalence of vitamin D deficiency. Bidirectional screening for tuberculosis and diabetes is recommended, and extra vitamin D may benefit especially in a situation of a heavy tuberculosis burden combined with prevalent vitamin D deficiency. Longitudinal studies to verify the role of vitamin D deficiency in the double burden, and trials on the effect of vitamin D supplementation are needed in the future., Competing Interests: Conflict of interest The authors declare no conflict of interest. The study sponsor had no role in study design; writing the paper; and the decision to submit the paper for publication., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background and Objectives: Information regarding the relationship between dietary meat intake and tuberculosis treatment outcomes among patients with tuberculosis is still limited. The aim of the present study was to investigate the relationship between meat consumption and tuberculosis treatment outcomes in patients with pulmonary tuberculosis., Methods and Study Design: A pulmonary tuberculosis cohort study including 2,261 patients with pulmonary tuberculosis was conducted in Linyi, Shandong Province, China from 2009 to 2013. Dietary data were collected using a semi-quantitative food frequency questionnaire. Treatment outcomes were assessed using a combination of sputum smear microscopy and chest computerized tomography., Results: In a multiple adjusted model, the higher quartile of total meat (OR=0.59, 95% CI, 0.38-0.91) was associated with a decreased failure rate of pulmonary tuberculosis treatment. In addition, higher consumption of chicken (OR=0.62; 95% CI, 0.44-0.87) and pork (OR=0.54; 95% CI, 0.31-0.95) was associated with a lower failure rate of tuberculosis treatment., Conclusions: Increased dietary intake of total meat, pork, and chicken are associated with a decreased failure rate of pulmonary tuberculosis treatment. A higher dietary meat intake may be beneficial in pulmonary tuberculosis treatment.

Malnutrition is associated with an increased risk of pulmonary tuberculosis (PTB) treatment failure. Currently, there is no effective adjunctive nutritional therapy. The current objective is to investigate the association of dietary micronutrient intake with PTB treatment outcome.A cohort study including 1834 PTB patients was conducted in Linyi, China. The dietary micronutrient intake was assessed through a three-day 24 h dietary recall questionnaire. The treatment outcome was assessed by combinations of sputum smear and computerized tomography results. A multivariate binary regression model was used to assess the associations. The final model was adjusted for potential confounding factors. A low intake of vitamin C (adjusted OR (95% CI): 1.80 (1.07, 3.04), P trend = 0.02) and Zn (adjusted OR (95% CI): 2.52 (1.25, 5.08), P trend = 0.02) was associated with a high treatment failure rate. In addition, a low intake of vitamin C and Mn was associated with a severe tuberculosis symptom, as indicated by a high TB score. A supplementation of vitamin C and Zn may be beneficial in PTB treatment. Previous meta-analysis of randomized controlled trials (RCTs) reported a null effect of Zn supplementation on PTB treatment. The effect of vitamin C supplementation should be investigated by RCTs.

Epidemiological studies on the impact of fish consumption on coronary heart disease (CHD) incidence have shown inconsistent results. In addition, in terms of CHD mortality, although previous meta-analyses showed that fish consumption reduces the risk of CHD, six newly incorporated studies show that fish consumption has no impact on CHD. Therefore, the results still need to be verified. The purpose of this study is to quantitatively evaluate the impact of fish consumption on CHD incidence and mortality. Relevant studies were identified from PubMed, Web of Science, and Embase databases up to October 2019. The multivariate-adjusted relative risks (RRs) for the highest versus the lowest fish consumption categories and the 95% confidence intervals were computed with a random-effect model. A restricted cubic spline regression model was used to assess the dose-response relationship between fish consumption and CHD incidence and mortality. Forty prospective cohort studies were incorporated into research. Among them, 22 studies investigated the association between fish consumption and CHD incidence (28,261 cases and 918,783 participants), and the summary estimate showed that higher fish consumption was significantly associated with a lower CHD incidence [RR: 0.91, 95% CI: (0.84, 0.97); I 2 = 47.4%]. Twenty-seven studies investigated the association between fish consumption and CHD mortality (10,568 events and 1,139,553 participants), and the summary estimate showed that higher fish intake was significantly associated with a lower CHD mortality [RR: 0.85, 95% CI: (0.77, 0.94); I 2 = 51.3%]. The dose-response analysis showed that the CHD incidence and mortality were reduced by 4%, respectively, with a 20 g/day increment in fish consumption. This meta-analysis indicates that fish consumption is associated with a lower CHD incidence and mortality.