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High BMI is an important risk factor for female colon and rectal, ovarian and uterine cancers. Current comprehensive studies on its effects on these cancers are limited. This paper aims to explore regional and age differences in the impact of high BMI on these cancers and the commonalities among the three by using the Global Burden of Disease 2021. Deaths, disability-adjusted life years and their age-standardised rates for these cancers were retrieved from 1990 to 2021, and burden trends were assessed using the estimated annual percentage change and percentage changes. The study also analysed the correlation between age-standardised rate and socio-demographic index across twenty-one regions and projected future disease burden trends using the Bayesian Age-Period-Cohort model. Results showed that the global burden of female colon and rectal cancer declined since 1990 but remained at the highest level among the three cancers in 2021. At the same time, these three cancers had high burdens in high-income areas. Since 1990, ovarian and uterine cancer burdens attributable to high BMI increased, and all three burdens grew fastest in low-middle-income regions and among younger people. The burden of all three is projected to continue increasing through 2050. This study confirms that high BMI’s impact on these cancers is regional and age-specific, with long-term effects. Therefore, subsequent public health interventions should adopt more targeted obesity prevention and control strategies based on national and regional situations to effectively mitigate the adverse effects of high BMI on these cancers.
Age is the main risk factor for many neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease and frontotemporal dementia. Despite our limited understanding of cellular mechanisms of ageing-associated neuronal loss, an increasing number of studies demonstrate that oxidative stress and inflammation are key drivers. Epidemiological studies indicate that diet during middle adulthood can influence the risk of developing neurodegenerative diseases later in life, so it is important to investigate dietary interventions to combat oxidative stress and inflammation. In this study, we hypothesised that treatment with fucoxanthin, a marine carotenoid with strong antioxidant properties, prevents ageing-associated oxidative stress that is known to be related to natural brain ageing. Treatment with fucoxanthin protected rat primary hippocampal neurons against oxidative stress and ageing in vitro. In our in vivo study, middle-aged male Sprague-Dawley rats were gavaged with fucoxanthin (1 mg/kg, 5 d/week, n 6) or vehicle (n 6) for 4 weeks. After supplementation was completed, brain samples were harvested and subjected to quantitative and bioinformatic analyses. Fucoxanthin was detected and shown to decrease lipid peroxidation in the brains of the animals supplemented with fucoxanthin. Microarray analysis showed that treatment with fucoxanthin changed 5602 genes. Together, our results suggest that treatment with fucoxanthin prevents ageing-associated oxidative stress and is capable of regulating genes that potentially ameliorate age-related changes to the brain.
This review comprehensively examines the current evidence on the dietary management of chronic constipation, and the dietary recommendations presented in clinical guidelines for chronic constipation. Several randomised controlled trials (RCT) have investigated the effect of dietary supplements, foods and drinks in chronic constipation. Systematic reviews and meta-analyses of these RCTs have demonstrated that psyllium supplements, specific probiotic supplements, magnesium oxide supplements, kiwifruits, prunes, rye bread and high mineral water content may be effective in the management of constipation. However, despite the plethora of evidence, current clinical guidelines only offer a limited number of dietary recommendations. The most commonly recommended dietary strategy in clinical guidelines is dietary fibre, followed by senna supplements and psyllium supplements. The least commonly recommended dietary strategies are magnesium oxide, Chinese herbal supplements, prunes and high mineral-content water. Several evidence-based dietary strategies are omitted by current clinical guidelines (e.g. kiwifruits), while some strategies that are recommended are not always supported by evidence (e.g. insoluble fibre supplement). Dietary recommendations in clinical guidelines can also be ambiguous, lacking outcome-specific recommendations and information for appropriate implementation. Future RCTs are needed to assess currently under-investigated dietary approaches that are nevertheless commonly recommended, and future clinical guidelines should include dietary recommendations supported by available evidence.
This study examines the influence of fish oil on brain amyloidogenesis in hyperglycaemic Alzheimer’s disease animal models, emphasising the potential of omega-3 fatty acids in fish oil to prevent the development of Alzheimer’s disease. Thirty males of Wistar rats were divided into five groups: 1) control rats (NS); 2) rats supplemented with 3 g/kg of fish oil (NS+FO3); 3) rats injected via intraperitoneal (i.p) with Streptozotocin-Lipopolysaccharide (STZ-LPS); 4) rats injected with STZ-LPS (i.p) and supplemented with 1 g/kg of fish oil (STZ-LPS+FO1), and 5) rats injected with STZ-LPS (i.p) and supplemented with 3 g/kg of fish oil (STZ-LPS+FO3). The cerebral brain was extracted for examination, and the αβ precursor protein (APP) level was measured using an immunoassay kit, while αβ 42 expression was evaluated using immunohistochemistry staining. Brain amyloidosis-related genes were quantified using real-time Polymerase Chain Reaction (PCR). The results revealed that fish oil supplementation significantly increased APP levels and reduced αβ 42 accumulations in STZ-LPS rats. Moreover, the Apolipoprotein E, ε4 isoform (ApoE-4) and Beta-site APP-cleaving enzyme 1 (Bace-1) genes were downregulated while the Low-density lipoprotein receptor-related protein 1 (Lrp-1) gene was upregulated in STZ-LPS rats treated with fish oil, thereby elucidating the impact of fish oil on diminishing αβ buildup in the brain. Therefore, this study contributes to a growing body of evidence supporting dietary interventions as adjunctive strategies for the prevention or delay of Alzheimer’s disease progression in metabolic dysfunction.
A Palaeolithic diet is an efficacious dietary approach for glycaemic control in type 2 diabetes. Causal mechanisms are body weight loss and glucometabolic effects from differences in included food groups, macronutrient composition, fibre content, and glycaemic load. The aim was to test the hypothesis that characteristic food group differences between a Palaeolithic and a diabetes diet would cause an effect on glycaemic control when weight was kept stable and diets were matched for macronutrient composition, fibre content and glycaemic load. Adult participants with type 2 diabetes and increased waist circumference were instructed to follow two diets, with or without the food groups cereal grain, dairy products, and legumes, during two periods of 4 weeks separated by a 6-week washout period in a random-order crossover design. The Palaeolithic diet included fruit, vegetables, tubers, fish, shellfish, lean meat, nuts, eggs and olive oil, and excluded cereal grains, dairy products and legumes. The diabetes diet included fruit, vegetables, fish, shellfish, lean meat, nuts, eggs, olive oil, and substantial amounts of whole grains, low-fat dairy products and legumes. Dietary energy content was adjusted throughout the study to maintain stable body weight. There were no differences between diets on HbA1c or fructosamine among the 14 participants. Body weight was kept stable, and the two diets were successfully matched for macronutrient composition and glycaemic load but not for fibre content. Characteristic food group differences and the accompanying differences in fibre content between a Palaeolithic and a diabetes diet do not cause an effect on glycaemic control.
We aimed to analyse the effects of nutrition-sensitive agriculture (NSA) interventions on nutrition, examine the pathways within a project cycle and explore the pathways 3 years after the end of the funding period.
Design:
We employed a sequential mixed-methods design using (1) secondary quantitative data and (2) primary qualitative data. The quantitative data were analysed using the Mann–Whitney test, independent sample t test and binary logistic regression. The qualitative data were analysed thematically.
Setting:
This research used the case of the Integrated Agriculture and Health Based Interventions project.
Participants:
The quantitative data comprised 4825 households. The qualitative data included forty-six participants (twenty-eight beneficiaries and eighteen implementers) from two focus group discussions (n 15) and thirty-one semi-structured interviews.
Results:
NSA interventions reduced child underweight and improved household and women’s dietary diversity scores, breastfeeding practices, handwashing and access to Fe–folic acid during pregnancy. Pregnant and lactating women’s minimum dietary diversity increased, while children’s minimum dietary diversity reduced. Key pathways to nutrition during project implementation were food production, nutrition-related knowledge and strengthening local institutions. Sustainability of knowledge was mostly evident, followed by food production, while the strengthening of local institutions was less evident.
Conclusions:
Key pathways to outcomes during the project implementation were food production, nutrition-related knowledge and strengthening local institutions, as these were the main focus of the project. Income and women’s empowerment pathways could be more effective if intentionally integrated. We reiterate the need to enhance children’s dietary diversity, strengthen income–expenditure and women empowerment pathways, sustain livestock production and strengthen local institutions.
This study aimed to assess the relationship between selected parameters of nutritional status and the occurrence of frailty syndrome in older adults by analysing clinical and socio-demographic factors. Methods: The study included 150 community-dwelling participants aged > 60 years who were qualified in the medical centre. The following research tools were used: activity of daily living, instrumental activities of daily living, survey of health, aging, and retirement in Europe, geriatric depression scale, mini mental state examination (MMSE), anthropometric measurements, mini nutritional assessment (MNA), body composition measurements, and biochemical blood tests. Results: The study included 150 people over 60 years of age (mean age 76.2/SD 4.9), including 104 women and 46 men. Participants in the frail group were significantly older (KW-H: P < 0.001) and had a higher level of depression (P = 0.008), whereas on the MMSE scale, they achieved a lower result (P < 0.001) than those in the non-frail and pre-frail groups. People in the frail group had significantly lower levels of nutritional status (P < 0.001) according to the MNA scale, assessment of basic activities in everyday life (P = 0.005), complex activities of everyday life (P < 0.001), hand grip strength of the right hand (P = 0.038) and left hand (P = 0.028), and energy drop (P < 0.001). They were also characterised by difficulties walking (P < 0.001), less frequent physical activity (P < 0.001), loss of appetite (P < 0.001), and weight loss more often (P < 0.05). Conclusion: Advanced age, a greater number of diseases, worse functional and mental performance, and differences in nutritional status and body composition were observed in people with frailty syndrome.
Parkinson’s disease (PD) is the fastest-growing neurological condition in the world, affecting 11·8 million people worldwide in 2021. Due to the globally expanding and ageing population, as well as growing industrialisation, this number is likely to increase. Given the absence of disease-modifying pharmacological therapies, this review aimed to examine the effect of dietary interventions on PD progression, motor symptoms, non-motor symptoms, specifically those affecting the gastrointestinal (GI) tract, and severity. To do so, this review synthesised the current evidence from randomised controlled trials (RCTs) on dietary patterns, individual foods and beverages, and nutritional supplements including nutrients, bioactive compounds, and biotics.
Results from the included RCTs failed to demonstrate conclusive evidence for the use of a dietary intervention as a therapy for improving PD progression, symptoms and severity. However, this is likely a reflection of the current scarcity of RCTs in the literature, rather than an outright demonstration of the ineffectiveness of such dietary approaches. In contrast, several trials have demonstrated a beneficial effect of biotic supplementation in managing GI symptoms, particularly constipation syndrome, which may be a promising avenue for improving GI-related issues that affect up to 80 % of PD patients. In conclusion, further RCTs are required to decipher the role that diet may play in mitigating PD progression and severity and improving overall patient care by reducing both motor and non-motor symptoms.
To assess the association between dietary consumption patterns of antioxidant and pro-oxidant nutrients with prostate cancer (PC) and its histological differentiation, we analysed data from 394 histologically confirmed incident cases of PC and 793 age-matched population controls (±5 years), residents of Mexico City. Cases were classified by Gleason score into well-differentiated, moderately differentiated and poorly differentiated categories. Dietary nutrient intake over the 3 years preceding diagnosis for cases and before the interview for controls was estimated using a semi-quantitative FFQ. Using energy-adjusted residuals and a k-means approach, we identified three consumption patterns: (1) pro-oxidant, (2) moderate antioxidants/low pro-oxidants and (3) high antioxidants and pro-oxidants. Associations were evaluated using independent unconditional logistic regression models; stratified models were analysed based on smoking status. Although proportions differed, the main food contributors to the moderate antioxidants/low pro-oxidants and high antioxidants and pro-oxidants patterns included green vegetables, maize tortillas, seeds and fruits. Compared with the pro-oxidant pattern, the moderate antioxidants/low pro-oxidants (OR: 0·71; 95 % CI 0·53, 0·97) and high antioxidants and pro-oxidants (OR: 0·70; 95 % CI 0·50, 0·99) patterns were associated with lower odds of having PC. These associations were mainly observed with well-differentiated PC and among ever-smokers. Diets with a higher antioxidant content were associated with a reduced likelihood of PC. Further validation of these findings through prospective studies is needed.
To examine differences in fruit and vegetable intake and food insecurity between Black African and Caribbean and South Asian (Indian, Pakistani and Bangladeshi) ethnic minority groups with a White British/Irish reference population in the UK. This study was part of the TANGERINE project (nuTritional heAlth aNd aGeing in oldER ethnIc miNoritiEs).
Design:
Longitudinal analysis using multilevel logistic regression from Understanding Society and a cross-sectional comparison with UK Biobank.
Setting:
Understanding Society waves 2 (2010–2012), 5 (2013–2015), 7 (2015–2017), 9 (2017–2019) 11 (2019–2021) and 13 (2021–2023). UK Biobank baseline data (2006–2010).
Participants:
Understanding Society: adults aged 16 years and above (approximately 44 000 households). UK Biobank: participants aged 37–73 years (n = 502 412).
Results:
At wave 2, African, Caribbean, Pakistani and Bangladeshi participants in Understanding Society had lower odds of daily vegetable intake than White British/Irish participants, with Pakistanis showing the lowest intake. These disparities persisted after adjusting for socio-economic position (SEP) at individual and area levels, particularly for Caribbean and Pakistani groups. Indians consistently had higher odds of vegetable intake. Ethnic differences in fruit intake were smaller and largely attenuated by SEP adjustment. Food insecurity was more prevalent in all ethnic minority groups (except Indians) and associated with lower vegetable and fruit intake, though SEP explains more of the ethnic difference.
Conclusions:
Ethnic differences in fruit and vegetable intake are at least partially explained by SEP, with persistent vegetable consumption disparities after adjustment. Culturally tailored interventions addressing affordability, accessibility and SEP disparities are needed to improve dietary behaviours among minority ethnic groups.
This paper explored international experts’ views on what influences the development and implementation of local government (LG) planning policy to support healthy food retail environments; and 2) whether a rapid group model building (RGMB) approach can successfully be applied to capture valuable insights.
Design:
Adaptation of methods from community-based system dynamics in the form of RGMB.
Setting:
In person, facilitated workshop at the World Public Health Nutrition Congress (WPHNC) June 2024, London, England.
Participants:
WPHNC delegates.
Results:
Sixty-six participants contributed to the RGMB. Factors identified that influence the development and implementation of LG planning to support healthy food retail environments centred around community, evidence, policy, political leadership/priorities and capitalism. Feedback loops identified in the causal loop diagram showed the potential influence of policies to support healthy food retail environments on public health outcomes. Research evidence and data were key factors in supporting community demand for healthy food policies and raising the profile of health as a priority, which, in turn, could support funding to support healthy food environments. Political will and corporate influence in the system were shown to be highly influential.
Conclusions:
International experts identified that data is urgently needed to support demand for healthy food policies and political will to address key nutrition issues. The influence of corporate interests was viewed as highly influential over the current system across the world. RGMB workshop activities and processes described in this paper can be used successfully to capture expert insights into complex problems using interactive technologies.
With the re-emerging homelessness issue in Hong Kong, given its least affordable housing, securing food to meet the basic physiological needs is of priority concern for the homeless. This study aims to examine the situation and determinants of food insecurity among the homeless in Hong Kong.
Design:
Cross-sectional survey on food insecurity level, socio-demographic characteristics, homeless experiences and health status and behaviours.
Setting:
360 community hot spots of homeless people identified by NGO and experienced social workers in different districts of Hong Kong in 2021.
Participants:
711 individuals experiencing homelessness.
Results:
The observed prevalence of low, medium and high food insecurity levels was 37·4 %, 20·4 % and 42·2 %, respectively. Results from multivariable ordinal logistic regression showed that older, female, non-Chinese and non-married respondents were inversely associated with food insecurity, whereas having sufficient savings for more proper housing was the primary determinant among socio-economic indicators. In addition to reasons for homelessness, risk factors of food insecurity included living in guesthouses/hotels and difficulties due to government measures on homeless control. Except for disability, both self-rated physical and mental health statuses showed dose–response relationships with food insecurity level.
Conclusions:
The substantial individual variations in socio-demographic statuses, homeless experiences and health deficits shaped the differential risks of food insecurity within the homeless community in Hong Kong. Targeted homeless programmes should go beyond the conventionally vulnerable groups but consider the multifaceted nature of homeless experiences in relation to food access and integrate health assessments to holistically support the homeless.
To assess the nutritional quality of foods and beverages (F&B) advertised to adolescents and analyse marketing techniques and persuasive appeals used by celebrities and influencers on Instagram.
Design:
A content analysis study was conducted using the WHO’s CLICK Monitoring Framework and Nutrient Profile Model.
Setting:
Instagram, a popular social media platform among adolescents with frequent F&B advertisements by celebrities and influencers.
Participants:
The top forty-eight Instagram accounts of celebrities and influencers posting F&B advertisements were selected based on follower count and engagement metrics. Nutrient profiling of advertised F&B (n 344) and content analysis of posts featuring F&B (n 326) between January 2021 and May 2023 were performed. Data collected included characteristics of celebrities and influencers, marketing techniques, online engagement and persuasive appeals in the posts.
Results:
Carbonated beverages and flavored waters (28·5 %), energy drinks (20·6 %) and ready-made foods (15·4 %) were most frequently advertised, with the majority (89·2 %) of products not permitted for advertisement to adolescents, according to WHO. Common marketing techniques included tagging brand (96·9 %) and using brand logo (94·2 %). The most frequently used persuasive appeals were taste (20·9 %), energy (10·7 %), link to sports events (10·7 %), new product (9·5 %) and fun (7·4 %).
Conclusion:
Most F&B advertised on Instagram by celebrities and influencers are prohibited from being advertised to adolescents by the WHO. This highlights the need for stricter regulation of user-generated content and for users and parents to be better educated about persuasive techniques used on social media to make them less vulnerable to the influence of marketing.
To explore the development of the Nutrition Society of Australia’s (NSA) mentoring program for Registered Nutritionists and evaluate the experience of the nutrition professionals participating in the mentoring program.
Design:
Case study evaluation utilising a focus group, individual semi-structured interviews, open-ended survey responses and document analysis, via an interpretivist lens.
Setting:
Australia
Participants:
Three members of the NSA’s inaugural Mentoring Program Committee participated in a focus group. Eleven program mentees and ten mentors from three consecutive cohorts of the NSA mentoring program for Registered Nutritionists (paired in 2021–2022) agreed to participate.
Results:
Data were analysed from survey responses, document analysis, in addition to focus group and in-depth interviews with twelve program participants. Mentoring was seen as a pathway beyond tertiary training to negotiate challenges associated with career development; mentors were seen as facilitators of growth through ‘real world’ skill-set acquisition. Successful partnerships were facilitated by program flexibility and the perception of professional compatibility. Participation in the NSA’s mentoring program was perceived to value-add to society membership, strengthening the society and professional practice, promoting networking within the nutrition community and public health field.
Conclusions:
Mentoring programs may provide access to diverse skillsets required in a non-vocational profession, promoting greater confidence and a stronger professional identity. These skills are essential for fostering a resilient nutrition workforce that can help combat the burden of non-communicable disease.
To estimate the potential health benefits from the reduction in consumption of salt and sugar following the introduction of a proposed tax on salt and sugar in the United Kingdom (UK).
Design:
Epidemiological modelling study. Life table modelling was used to estimate the expected population health benefits from the reduction in consumption of salt and sugar for four scenarios, each reflecting different manufacturer and consumer responses the proposed tax. Relative risks for twenty-four disease–risk pairs were applied, exploring different pathways between salt and sugar consumption, and mortality and morbidity.
Setting:
UK.
Participants:
Population of the UK.
Results:
The results show that life expectancy in the UK could be increased by 1·7 (0·3–3·6) to 4·9 (1·0–9·4) months, depending on the degree of industry and consumer response to the tax. The tax could also lead to up to nearly 2 (0·4–3·6) million fewer cases of preventable chronic diseases and an increase of as much as 3·5 (0·8–6·4) million years of life gained. The largest health benefits would accrue from reduced mortality and morbidity from CVD.
Conclusions:
Significant benefits to population health could be expected from extending the current tax on sugar-sweetened beverages to other sugary foods and from adding a tax on foods high in salt. The proposed dietary changes are likely to be insufficient to reach national public health targets; hence, additional measures to reduce the burden of chronic disease in the UK will be equally critical to consider.