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

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

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

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

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

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

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

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

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