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Purpose: The available evidence regarding the role of fruit and vegetable consumption in the development of colorectal polyps remains inconclusive, and there is a lack of data on different histopathologic features of polyps. We aimed to evaluate the associations of fruit and vegetable consumption with the prevalence of colorectal polyps and its subtypes in a high-risk population in China., Methods: We included 6783 Chinese participants aged 40-80 years who were at high risk of colorectal cancer (CRC) in the Lanxi Pre-colorectal Cancer Cohort (LP3C). Dietary information was obtained through a validated food-frequency questionnaire (FFQ), and colonoscopy screening was used to detect colorectal polyps. Dose-response associations of fruit and vegetable intake with the prevalence of polyps were calculated using multivariate-adjusted regression models, which was reported as odds ratios (ORs) with 95% confidence intervals (CIs)., Results: 2064 cases of colorectal polyps were ascertained in the LP3C during 2018-2019. Upon multivariable adjustments, including the diet quality, fruit consumption was inversely associated with the prevalence of polyps (P trend = 0.02). Participants in the highest tertile of fruit intake had a 25% lower risk (OR: 0.75; 95% CI 0.62‒0.92) compared to non-consumers, while vegetable consumption had no significant association with polyp prevalence (P trend = 0.86). In terms of colorectal histopathology and multiplicity, higher fruit intake was correlated with 24, 23, and 33% lower prevalence of small polyps (OR: 0.76; 95% CI 0.62‒0.94; P trend = 0.05), single polyp (OR: 0.77; 95% CI 0.62‒0.96; P trend = 0.04), and distal colon polyps (OR: 0.67; 95% CI 0.51‒0.87; P trend = 0.003), respectively., Conclusions: Fresh fruit is suggested as a protective factor to prevent colorectal polyps in individuals at high risk of CRC, and should be underscored in dietary recommendations, particularly for high-risk populations., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Background & Aims: Accumulating evidence has linked distinct associations of red/processed and white meat consumption with chronic diseases and longevity among the general population. However, the associations of meat consumption and changes with mortality among hypertensive patients remain unknown. We aimed to assess the associations of red and white meat consumption with all-cause mortality among hypertensive patients in China., Methods: We followed 8095 hypertensive patients from the China Health and Nutrition Survey between 1991 and 2015. In each survey year, 3-day 24-h dietary records were used to collect dietary data. Cumulative averages of dietary meat intake after the diagnosis of hypertension were calculated. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality., Results: Overall 927 deaths were documented among these hypertensive patients during an average of 11.4 years of follow-up. Red meat consumption was positively associated with all-cause mortality after multivariable adjustment [HR (95% CI) comparing the highest versus lowest quartile: 1.29 (1.05-1.57), P trend = 0.02]. White meat intake was associated with lower all-cause mortality [HR (95% CI) comparing the highest tertile with non-consumers: 0.77 (0.63-0.94), P trend = 0.002]. Increasing red meat consumption from before to after hypertension diagnosis was significantly associated with higher all-cause mortality [HR (95% CI): 1.55 (1.05-2.28), P trend = 0.04]. Theoretically replacing 1 ounce/day of red meat with the equivalent amount of white meat or eggs was associated with 5% and 10% lower all-cause mortality, respectively., Conclusions: High consumption of red meat, especially after hypertension diagnosis, is associated with higher mortality among hypertensive patients. Our findings suggest replacing red meat consumption with healthy alternative foods for long-term survival among hypertensive patients., Competing Interests: Conflicts of interest The authors declare that they have no competing interests., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Whether consumption of egg and cholesterol is detrimental to cardiovascular health and longevity is highly debated. Data from large-scale cohort studies are scarce. This study aimed to examine the associations of egg and cholesterol intakes with mortality from all causes, cardiovascular disease (CVD), and other causes in a US population., Methods and Findings: Overall, 521,120 participants (aged 50-71 years, mean age = 62.2 years, 41.2% women, and 91.8% non-Hispanic white) were recruited from 6 states and 2 additional cities in the US between 1995 and 1996 and prospectively followed up until the end of 2011. Intakes of whole eggs, egg whites/substitutes, and cholesterol were assessed by a validated food frequency questionnaire. Cause-specific hazard models considering competing risks were used, with the lowest quintile of energy-adjusted intake (per 2,000 kcal per day) as the reference. There were 129,328 deaths including 38,747 deaths from CVD during a median follow-up of 16 years. Whole egg and cholesterol intakes were both positively associated with all-cause, CVD, and cancer mortality. In multivariable-adjusted models, the hazard ratios (95% confidence intervals) associated with each intake of an additional half of a whole egg per day were 1.07 (1.06-1.08) for all-cause mortality, 1.07 (1.06-1.09) for CVD mortality, and 1.07 (1.06-1.09) for cancer mortality. Each intake of an additional 300 mg of dietary cholesterol per day was associated with 19%, 16%, and 24% higher all-cause, CVD, and cancer mortality, respectively. Mediation models estimated that cholesterol intake contributed to 63.2% (95% CI 49.6%-75.0%), 62.3% (95% CI 39.5%-80.7%), and 49.6% (95% CI 31.9%-67.4%) of all-cause, CVD, and cancer mortality associated with whole egg consumption, respectively. Egg white/substitute consumers had lower all-cause mortality and mortality from stroke, cancer, respiratory disease, and Alzheimer disease compared with non-consumers. Hypothetically, replacing half a whole egg with equivalent amounts of egg whites/substitutes, poultry, fish, dairy products, or nuts/legumes was related to lower all-cause, CVD, cancer, and respiratory disease mortality. Study limitations include its observational nature, reliance on participant self-report, and residual confounding despite extensive adjustment for acknowledged dietary and lifestyle risk factors., Conclusions: In this study, intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality. The increased mortality associated with egg consumption was largely influenced by cholesterol intake. Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival., Trial Registration: ClinicalTrials.gov NCT00340015., Competing Interests: The authors have declared that no competing interests exist.

Background & Aims: Evidence linking individual cooking oil consumption with total mortality is limited in China. The aim of this study was to examine the associations of intakes of plant-sourced and animal-sourced cooking oils with total mortality in a Chinese nationwide cohort., Methods: We analyzed data from 14,305 adults aged ≥20 y at entry in the China Health and Nutrition Survey (CHNS). The 3-day 24-h dietary records were used to collect dietary information. Cox proportional hazards regression models were established to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause death., Results: Overall 1006 deaths were documented during a median of 14 years (199,091 person-years) of follow-up. Multivariate-adjusted HRs (95% CIs) of total mortality via comparing the highest tertile of cooking oil consumption with no consumption were 0.86 (0.70-1.06) for lard, 0.59 (0.47-0.74) for peanut oil, 0.71 (0.54-0.93) for soybean oil, 0.76 (0.61-0.94) for canola oil, 0.71 (0.50-0.99) for salad oil, and 0.59 (0.44-0.79) for other plant cooking oils. Replacing animal cooking oils with 1 tablespoon/d of total plant cooking oils or other plant cooking oils was related to 4% or 17% lower total mortality, respectively, while consumption of peanut oil or salad oil in replacement of animal cooking oils had a marginal inverse association with total mortality., Conclusions: Intakes of plant-sourced cooking oils, including peanut oil, soybean oil, canola oil, salad oil, and other plant cooking oils and substituting plant cooking oils for animal cooking oils were associated with lower total mortality among general Chinese population (NCT03259321)., Competing Interests: Conflicts of interest The authors declare that they have no competing interests., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background & Aims: Evidence linking egg and dietary cholesterol consumption with human health and longevity is highly debated. Data from non-Western populations are sparse. We aim to prospectively assess the egg and cholesterol consumption in relation to mortality in a nationwide Chinese cohort., Methods: We followed 18,914 adults aged ≥20 y from China Health and Nutrition Survey (CHNS) between 1991 and 2015. In each survey year, 3-day 24-hr dietary records were used to collect dietary data. Cumulative averages of egg and cholesterol intakes were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model., Results: Overall 1,429 deaths were reported after a median follow-up of 15 years. Egg consumption was significantly associated with lower total mortality (P-trend<0.001). Multivariable-adjusted HRs (95% CIs) were 0.69 (0.59-0.81) for 1-3 eggs/wk, 0.68 (0.59-0.79) for 3-7 eggs/wk, 0.78 (0.66-0.93) for 1-2 eggs/d, and 0.64 (0.52-0.78) for ≥2 eggs/d compared with ≤1 egg/wk. Although total dietary cholesterol was not related to mortality, intake of cholesterol from eggs was inversely associated with total mortality (P-trend = 0.001) while intake of cholesterol from non-egg sources was positively related to total mortality (P-trend = 0.01). Substituting 50 g/d egg for equivalent amounts of dairy products, nuts/legumes, or red meat was associated with 9%, 7%, or 8% lower total mortality, respectively., Conclusions: Egg consumption is associated with lower total mortality among the Chinese population. Consuming cholesterol from non-egg sources may be detrimental to longevity. Habitual consumption of eggs should continue to be recommended in the Chinese dietary guidelines while excess intake of cholesterol from non-egg sources may be discouraged., Clinical Trial Registry: This trial was registered at clinicaltrials.gov (NCT04104308)., Competing Interests: Conflicts of interest The authors declare that they have no competing interests., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background & Aims: Government has popularized potatoes as the staple food in China. Potatoes as a potassium-rich food show high glycemic responses after consumption. Whether potato consumption is prospectively linked with the risk of hypertension remains unclear in oriental populations. In this study, we aimed to investigate the association of potato consumption with the risk of hypertension among Chinese people., Methods: A total of 11,763 adults (≥20 years old) who were free of hypertension at baseline were enrolled from China Health and Nutrition Survey (CHNS) Cohort study in 1989-2011. Participants were excluded if they were <20 years old, identified to be pregnant, and previously diagnosed with hypertension, cancers, infarction, apoplexy and diabetes at baseline. Cox proportional hazards regression models were used to estimate the associations after adjusting for potential confounders., Results: During average 11.3 years of follow-up, 4033 incident cases of hypertension were ascertained. People who consumed more amounts of total potatoes, stir-fried potatoes, and non stir-fried potatoes had higher risk of hypertension (P for trend = 0.1225, 0.2168 and 0.0456, respectively). Multivariable hazard ratios (HRs) for increased consumption of total potatoes were 1.402 (95% confidence interval [CI], 1.270-1.548), 1.198 (95% CI, 1.014-1.415), and 1.120 (95% CI, 0.929-1.349) compared with non-consumers. However, the participants with higher intake of potato consumption were inclined to have lower risk of hypertension when excluding the non-consumers of total potatoes or stir-fried potatoes (P for trend = 0.0271 and 0.0001). In addition, a positive association of sweet potatoes intake with hypertension risk was only found in urban residents (P for trend = 0.0239)., Conclusions: Our results showed that potato consumption was prospectively associated with hypertension in Chinese population. As the urbanization process continues along with the transition to Western-style diets, more consideration should be taken before the formulation of potato popularization is promoted in China., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background & Aims: Polyunsaturated fatty acids (PUFA) have been reported to exert pleiotropic protective effects against various chronic diseases. However, epidemiologic evidence linking specific PUFA intake to mortality has been limited and contradictory. We aim to assess the associations between specific dietary PUFA and mortality among adults in China and America, respectively., Methods: Participants from China Health and Nutrition Survey (CHNS, n = 14,117) and National Health and Nutrition Examination Survey [NHANES (n = 36,032)] were prospectively followed up through the year 2011. Cox regression models were used to investigate hypothesized associations., Results: A total of 1007 and 4826 deaths accrued over a median of 14 and 9.1 years of follow-up in CHNS and NHANES, respectively. Dietary marine omega-3 PUFA was robustly associated with a reduced all-cause mortality [Hazard ratio (HR) comparing extreme categories: 0.74, 95% CI: 0.61-0.89; P < 0.001 for trend] in CHNS. Nevertheless, this inverse relationship was not observed in NHANES. The overall mortality was positively associated with the intake of α-linolenic acid (ALA) (HR comparing extreme quartiles: 1.23, 95% CI: 1.01-1.50; P = 0.054 for trend) in CHNS, whereas weak inverse associations of ALA (P = 0.035 for trend) and LA (P = 0.027 for trend) with all-cause mortality were found in NHANES. Increased dietary intake of arachidonic acid was consistently linked with reduced all-cause mortality both in NHANES and CHNS. Importantly, consuming PUFA at an omega-6/omega-3 ratio of 6-10 was associated with a lower risk of death in CHNS., Conclusions: Intakes of different specific PUFA show distinct associations with mortality and these relationships also vary between Chinese and US populations. These findings suggest maintaining an omega-6/omega-3 balance diet for overall health promotion outcomes (NCT03155659)., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Scope: Whether dietary fish consumption is linked to mortality remains unclear. We aim to investigate the association of fish consumption with mortality in Chinese and US nationwide populations., Methods and Results: We utilize data from China Health and Nutrition Survey (CHNS, n = 14 117) and National Health and Nutrition Examination Survey (NHANES, n = 33 221) including NHANES III conducted in 1988-1994 and continuous NHANES 1999-2010. Cox proportional hazards regression is used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 14 and 9.8 years for CHNS and NHANES, 1007 and 5209 deaths are documented, respectively. Among Chinese adults, increased fish intake is significantly associated with decreased total mortality. The multivariable-adjusted HRs (95% CIs) across increasing categories of fish intake are 0.45 (0.36-0.56), 0.72 (0.60-0.86), and 0.70 (0.59-0.85) (p trend < 0.0001). However, fish intake is not associated with total mortality among US adults (p trend = 0.21). We only detected a borderline inverse association between fish intake and stroke mortality (p trend = 0.05), whereas a positive association with diabetes mortality in the third category of fish intake in NHANES., Conclusion: In these two nationwide cohort studies, fish consumption is associated with a reduced risk of total mortality for Chinese but not US populations., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: The intake of fish and polyunsaturated fatty acids (PUFAs) may benefit cognitive function. However, optimal intake recommendations for protection are unknown., Objective: We systematically investigated associations between fish and PUFA intake and mild-to-severe cognitive impairment risk., Design: Studies that reported risk estimates for mild cognitive impairment (MCI), cognitive decline, dementia, Alzheimer disease (AD), or Parkinson disease (PD) from fish, total PUFAs, total n-3 (ω-3) PUFAs, or at least one n-3 PUFA were included. Study characteristics and outcomes were extracted. The pooled RR was estimated with the use of a random-effects model meta-analysis. A dose-response analysis was conducted with the use of the 2-stage generalized least-squares trend program., Results: We included 21 studies (181,580 participants) with 4438 cases identified during follow-up periods (2.1-21 y). A 1-serving/wk increment of dietary fish was associated with lower risks of dementia (RR: 0.95; 95% CI: 0.90, 0.99; P = 0.042, I(2) = 63.4%) and AD (RR: 0.93; 95% CI: 0.90, 0.95; P = 0.003, I(2) = 74.8%). Pooled RRs of MCI and PD were 0.71 (95% CI: 0.59, 0.82; P = 0.733, I(2) = 0%) and 0.90 (95% CI: 0.80, 0.99; P = 0.221, I(2) = 33.7%), respectively, for an 8-g/d increment of PUFA intake. As an important source of marine n-3 PUFAs, a 0.1-g/d increment of dietary docosahexaenoic acid (DHA) intake was associated with lower risks of dementia (RR: 0.86; 95% CI: 0.76, 0.96; P < 0.001, I(2) = 92.7%) and AD (RR: 0.63; 95% CI: 0.51, 0.76; P < 0.001, I(2) = 94.5%). Significant curvilinear relations between fish consumption and risk of AD and between total PUFAs and risk of MCI (both P-nonlinearity < 0.001) were observed., Conclusions: Fishery products are recommended as dietary sources and are associated with lower risk of cognitive impairment. Marine-derived DHA was associated with lower risk of dementia and AD but without a linear dose-response relation., (© 2016 American Society for Nutrition.)

Purpose: Previous evidence indicated anti-ageing potential of docosahexaenoic acid (DHA), but the underlying mechanism remains unclear. We investigated protective effect of DHA on telomere attrition and lipid disturbance in male mice with premature ageing caused by telomerase deficiency. Methods: Wild-type (WT) and fourth-generation telomerase-deficient (G4 Terc−/−, Terc knockout, KO) male mice (C57BL/6, 2 months old) were fed control diet (WT-C and KO-C groups) or DHA-enriched diet containing 0.80% DHA by weight (WT-DHA and KO-DHA groups) for 10 months. The ageing phenotypes and metabolic level [carbon dioxide emission, oxygen consumption, and respiratory exchange ratio (RER)] were assessed at the end of the experiment. Telomere length in various tissues and the hepatic gene and protein expression for regulating lipid synthesis and lipolysis were measured. Data were tested using one- or two-factor ANOVA. Results: In KO male mice, DHA prevented weight loss, corrected high RER, and reduced fat loss. Telomere shortening was reduced by 22.3%, 25.5%, and 13.5% in heart, liver, and testes of the KO-DHA group compared with those in the KO-C group. The KO-DHA group exhibited higher gene transcription involved in glycerol-3-phosphate pathway [glycerol-3-phosphate acyltransferase (Gpat)], lower gene expression of β-oxidation [carnitine palmitoyltransferase 1a (Cpt1a)], and upregulation of proteins in lipid synthesis [mammalian target of rapamycin complex 1 (mTORC1) and sterol responsive element binding protein 1 (SREBP1)] in liver than the KO-C group. Conclusion: Long-term DHA intervention attenuates telomere attrition and promotes lipid synthesis via the tuberous sclerosis complex 2 (TSC2)-mTORC1-SREBP1 pathway in KO male mice. [ABSTRACT FROM AUTHOR]

Objective: To assess the interactions between diet quality and genetic predisposition to incident type 2 diabetes (T2D).Research Design and Methods: Between 2006 and 2010, 357,419 participants with genetic and complete dietary data from the UK Biobank were enrolled and prospectively followed up to 2017. The genetic risk score (GRS) was calculated on the basis of 424 variants associated with T2D risk, and a higher GRS indicates a higher genetic predisposition to T2D. The adherence to a healthy diet was assessed by a diet quality score comprising 10 important dietary components, with a higher score representing a higher overall diet quality.Results: There were 5,663 incident T2D cases documented during an average of 8.1 years of follow-up. A significant negative interaction was observed between the GRS and the diet quality score. After adjusting for major risk factors, per SD increment in the GRS and the diet quality score was associated with a 54% higher and a 9% lower risk of T2D, respectively. A simultaneous increment of 1 SD in both the diet quality score and GRS was additionally associated with a 3% lower T2D risk due to the antagonistic interaction. In categorical analyses, a sharp reduction of 23% in T2D risk associated with a 1-SD increment in the diet quality score was detected among participants in the extremely high GRS group (GRS >95%). We also observed a strong negative interaction between the GRS and the diet quality score on the blood HbA1c level at baseline (P < 0.001).Conclusions: The adherence to a healthy diet was associated with more reductions in blood HbA1c levels and subsequent T2D risk among individuals with a higher genetic risk. Our findings support tailoring dietary recommendations to an individual's genetic makeup for T2D prevention. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that the relations between intakes of individual fatty acids and risk of type 2 diabetes (T2D) vary. However, associations between intakes of different cooking oils as sources of fatty acids and incident T2D remain largely unknown.Objectives: We aimed to evaluate relations between intakes of individual cooking oils and incident T2D in a nationwide Chinese cohort.Methods: Overall 15,022 Chinese adults aged ≥20 y from the China Health and Nutrition Survey (CHNS) without self-reported T2D at entry in the 1997, 2000, 2004, 2006, or 2009 rounds were followed up until 2011. Consumption of various cooking oils/fats including lard, peanut oil, soybean oil, canola oil, sesame oil, and refined blended plant oil was assessed using 3-d 24-h records in each survey and the cumulative mean intake was calculated. Multivariable-adjusted Cox proportional hazards regression models were constructed to estimate the HRs of T2D.Results: A total of 1014 cases were recorded after a median follow-up of 14 y. The intakes of animal and plant cooking oils/fats were both associated with higher T2D risk. Compared with nonconsumers, multivariable-adjusted HRs and 95% CIs for the highest tertiles were 1.31 (1.03, 1.67) for lard, 1.36 (1.10, 1.66) for peanut oil, 1.14 (0.91, 1.43) for soybean oil, 1.11 (0.87, 1.43) for canola oil, 1.02 (0.79, 1.32) for sesame oil, and 1.42 (1.12, 1.82) for refined blended plant oil. Substituting 1 tablespoon/d (8 g · 2000 kcal-1 · d-1) of soybean oil for the sum of lard, peanut oil, refined blended plant oil, and other plant oils was associated with a 3% (HR: 0.97; 95% CI: 0.95, 0.99) lower risk of T2D.Conclusions: Intakes of lard, peanut oil, and refined blended plant oil but not soybean oil, canola oil, and sesame oil are associated with higher T2D risk. Reducing the consumption of cooking oils in general may be protective against T2D among the Chinese population.This trial was registered at clinicaltrials.gov as NCT03259321. [ABSTRACT FROM AUTHOR]

Liver cirrhosis is a leading cause of death in Hispanics and Hispanics who live in South Texas have the highest incidence of liver cancer in the United States. We aimed at determining the prevalence and associated risk factors of cirrhosis in this population. Clinical and demographic variables were extracted for 2466 participants in the community-based Cameron County Hispanic Cohort in South Texas. Aspartate transaminase to Platelet Ratio Index (APRI) was used to predict cirrhosis in Cameron County Hispanic Cohort. The prevalence of cirrhosis using APRI≥2 was 0.94%, which is nearly 4-fold higher than the national prevalence. Using APRI≥1, the overall prevalence of cirrhosis/advanced fibrosis was 3.54%. In both analyses, highest prevalence was observed in males, specifically in the 25–34 age group. Risk factors independently associated with APRI≥2 and APRI≥1 included hepatitis C, diabetes and central obesity with a remarkable population attributable fraction of 52.5% and 65.3% from central obesity, respectively. Excess alcohol consumption was also independently associated with APRI≥2. The presence of patatin-like phospholipase domain-containing-3 gene variants was independently associated with APRI≥1 in participants >50 years old. Males with both central obesity and excess alcohol consumption presented with cirrhosis/advanced fibrosis at a young age. Alarmingly high prevalence of cirrhosis and advanced fibrosis was identified in Hispanics in South Texas, affecting young males in particular. Central obesity was identified as the major risk factor. Public health efforts are urgently needed to increase awareness and diagnosis of advanced liver fibrosis in Hispanics. [ABSTRACT FROM AUTHOR]