There has been substantial research undertaken on the role of a health-promoting diet in depression. Yet, the evidence of the relationship between the Nordic diet and the risk of depression is scarce. This cross-sectional study aimed to assess whether a healthy Nordic diet is associated with depressive symptoms. In total, 2603 men aged 42–60 years from the Kuopio Ischaemic Heart Disease Risk Factor Study were included. Diet quality was evaluated with a healthy Nordic diet score derived from the 4-day food diaries and depressive symptoms with the self-reported Human Population Laboratory (HPL) depression scale. Quade ANCOVA was used to examine the mean values of HPL scores in quartiles of a healthy Nordic diet score. Participants’ mean age was 53 years and BMI 26·8 kg/m2; 31·7 % were current smokers, and 86·9 % were married or living as a couple. The mean healthy Nordic diet score was 12·8 (sd 4·0, range 2–25), and the mean HPL depression score was 1·9 (sd 2·1, range 0–13). The findings suggested that lower adherence to a healthy Nordic diet was associated with higher HPL depression scores after adjusting for age, examination year, daily energy intake, leisure-time physical activity, adulthood socio-economic status, smoking and marital status (extreme quartile difference: 0·33 points, 95 % CI 0·10, 0·56, P for trend across the quartiles = 0·003). The results support the hypothesis that a lower-quality diet increases the odds of having depressive symptoms. However, prospective studies are needed to confirm the association.

Understanding the interplay between adiposity and histopathological features of colorectal tumours is crucial for advancing strategies in disease management. We conducted a retrospective cohort study over an 8-year period (2007–2015), including patients who underwent surgical resection for colorectal cancer (CRC). Body composition was assessed via computed tomography (CT) at the level of the third lumbar vertebra, with visceral adipose tissue (VATd) and subcutaneous adipose tissue (SATd) radiodensities stratified into tertiles. Systemic inflammatory status was evaluated using the neutrophil-to-lymphocyte ratio (NLR). Logistic regression was employed to analyse the relationship between variables, using OR with 95 % CI. The Cox proportional hazards model assessed hazard ratios (HR) with 95 % CI. A total of 231 patients were included (48·9 % men, 51·1 % women), with 93·6 % in CRC stages II and III. Multivariate analyses demonstrated that CRC stages II and III (OR = 5·15, 95 % CI: 1·60, 16·62; OR = 5·16, 95 % CI: 1·59, 16·77) and low VATd (1st and 2nd tertiles; OR = 2·43, 95 % CI: 1·30, 4·53) were associated with the presence of desmoplasia. In the multivariate Cox analyses, only stage III disease (HR = 4·77, 95 % CI: 1·09, 20·89) and moderate to accentuated fibrous stroma (HR = 1·90, 95 % CI: 1·03, 3·46) were identified as predictors of reduced overall survival. These findings suggest that increased visceral adiposity may contribute to the development of a desmoplastic tumour microenvironment. Moreover, the presence of moderate to accentuated fibrous stroma is significantly associated with poorer long-term survival in patients with CRC.

My research on dietary protein and the regulation of proteostasis in muscle and the whole body during growth and adult maintenance is reviewed. Growth control involves both permissive and regulatory roles of protein acting with genetic determinants and functional demand, to mediate substrate flow into metabolic consumption, energy storage and growth. In 1995 a Protein-Stat hierarchical model for control of the fat-free mass was proposed and is updated here with special emphasis on the skeletal muscle mass. Control is exerted in large part through a central aminostatic appetite mechanism sensing changes in free amino-acid patterns in response to the balance between their supply in relation to their demand. This acts primarily to maintain skeletal muscle mass at a level set by the linear dimensions of the organism, which in turn is controlled by genetic programming and mediated by the developmental hormones acting together with an appropriate anabolic drive deriving from dietary protein. This, together with other important nutrients like zinc, calcium and vitamin D, provides the regulatory stimulus for growth and protein deposition in all tissues. The applicability of this model to childhood growth and development will be described as well as the maintenance of the adult phenotypic muscle mass within populations with protein intakes varying over a wide range, work which resulted in an adaptive metabolic demand model for protein and amino acid requirements and values for apparent adult protein and lysine requirements. Finally current understanding of aminostatic mechanisms of amino-acid sensing in the brain will be reviewed.

Epidemiological studies have reported an association between the planetary health diet (PHD), diet-related greenhouse gas emissions (GHGEs), and mortality. However, data from individuals from non-Western countries was limited. Therefore, we aimed to examine this association among Japanese individuals using a cross-sectional ecological study of all 47 prefectures in Japan. Prefecture-level data were obtained from government surveys. The dietary amount was estimated based on the weight of food purchased (211 items) from the 2021–2023 Family Income and Expenditure Survey. Adherence to PHD was scored using the EAT-Lancet index (range, 0 [worst] to 42 [best]) and categorised into four groups: ≤ 24 (n = 14, low), 25 (n = 17, medium-low), 26 (n = 10, medium-high), and 27 points (n = 6, high). Diet-related GHGEs were estimated using previously developed GHGE tables for each food item. Mortality data were obtained using the 2022 Vital Statistics. Mortality rate ratio (RR) was calculated using a multivariate Poisson regression model. After adjusting for confounders, compared to the prefecture in the medium-low group of adherence score, those in the low and high groups were associated with a higher mortality RR for all-cause (low group: RR = 1.03 [95% CI (confidence interval) = 1.01–1.05]; high group: RR = 1.03 [95% CI = 1.00–1.07]) and pneumonia. Moreover, although a higher adherence score was inversely associated with GHGE, it was linked to an increased mortality risk from heart disease and stroke. Our findings indicate a reverse J-shaped association between adherence to PHD and mortality.

Epidemiologic evidence on the association between dietary choline, betaine and mortality risk remains limited, particularly among non-Western populations. We examined the association of dietary choline and betaine with all-cause mortality in Chinese adults using data from the China Health and Nutrition Survey 1991–2015. We included 9027 men and 8828 women without CVD and cancer at baseline. Dietary intake was assessed using 3-day 24-hour dietary recalls and household food inventories. Death was ascertained through household surveys in each wave. Time-dependent Cox proportional hazards regression models estimated multivariable-adjusted hazard ratios (HRs) and 95 % CIs. During a median follow-up of 9·1 years, 891 men and 687 women were deceased. Higher total choline intake was associated with lower all-cause mortality in both men (HRQ5 v. Q1 = 0·58 (95 % CI: 0·45, 0·74)) and women (HRQ5 v. Q1 = 0·59 (95 % CI: 0·44, 0·78)). The dose–response curve were reverse J-shaped in men and L-shaped in women (both P-nonlinear ≤ 0·005). Similarly, fat-soluble choline intake was inversely associated with mortality in both men (HRQ5 v. Q1 = 0·59 (95 % CI: 0·46, 0·75)) and women (HRQ5 v. Q1 = 0·53 (95 % CI: 0·40, 0·70)), showing reverse J-shaped patterns (both P-nonlinear < 0·001). A J-shaped association between water-soluble choline and mortality was observed in women (P-nonlinear < 0·001), but a null association was found in men. Betaine intake was not associated with all-cause mortality in either sex. Our findings suggest that adequate choline intake is linked to reduced all-cause mortality in Chinese adults with predominantly plant-based diets.

The RDA for dietary protein is likely insufficient for individuals with cystic fibrosis (CF). This study sought to characterise protein intake and diet quality in adults with cystic fibrosis (awCF), before and after elexacaftor/tezacaftor/ivacaftor (ETI) therapy, compared with healthy controls. Dietary intake was assessed by diet diary in awCF at baseline (BL, n 40) and at follow-up > 3 months post ETI therapy (follow-up (FUP), n 40) and in age-matched healthy controls (CON, n 80) free from known disease at a single time point. Protein intake dose and daily distribution, protein quality, protein source and overall diet quality were calculated for each participant. Both CON (1·39 (sd 0·47) g·kg–1·day–1) and CF (BL: 1·44 (sd 0·52) g·kg–1·day–1, FUP: 1·12 (sd 0·32) g·kg–1·day–1) had a higher mean daily protein intake than the protein RDA of 0·75g·kg–1·day–1. There was a significant reduction in daily protein intake in the CF group at FUP (P = 0·0003, d = 0·73), with levels below the alternative suggested dietary intake of ≥ 1·2 g·kg–1·day–1. There were no sex differences or noticeable effects on protein quality or source following the commencement of ETI therapy when compared with CON (all P > 0·05), although overall diet quality decreased between time points (P = 0·027, d = 0·57). The observed reduction in daily protein intake in the present cohort emphasises the importance of ensuring appropriate dietary protein intake to promote healthy ageing in adults with CF. More research is needed to evidence base dietary protein requirements in this at-risk population.

Diet quality has been linked to socio-economic status. However, evidence within rural and regional populations is lacking. This cross-sectional study examined the relationship between diet quality and socio-economic position in adults living in rural and regional areas of Australia. The Australian Recommended Food Score (ARFS; range 0–73) measured diet quality (total and subscale scores). Area-level socio-economic position was determined by postcode-linked socio-economic index for areas (SEIFA), Index of Relative Social Advantage and Disadvantage scores, stratified into quintiles. The mean total ARFS (34·7; sd = 9·1; n 836) was classified as ‘getting there’. Findings showed significantly lower mean total ARFS between SEIFA quintile 1 (1 = lowest; mean total ARFS = 30·4; sd = 10·2; categorised as ‘needs work’) compared with all other SEIFA quintiles (F (44 831) = 8·44, P ≤ 0·001). Linear regression, adjusting for age, sex, income, education, employment status and household composition demonstrated significantly lower overall diet quality for SEIFA quintile 1 compared with SEIFA quintile 3 (B = –3·9; 95 % CI (–6·2, −1·5); P < 0·001) and lower subscale scores for vegetables (B = –1·6; 95 % CI (–2·7, −0·6); P = 0·003), fruit (B = –0·9; 95 % CI (–1·6, −0·1); P = 0·018) and grains (B = –0·6; 95 % CI (–1·3, −0·0); P = 0·050). After adjusting for individual confounders of diet quality, results indicate that lower area-level socio-economic position remained associated with poorer diet quality in this sample of rural and regional Australian adults. This suggests that broader social and environmental factors unique to these areas may impact diet quality and amplify individual barriers to achieving a healthy diet.

Legume lectins represent a broad class of environmental toxicants that bind to cell surface glycoproteins. Raw red kidney beans (RRKB), a widely consumed common source of dietary protein, are rich in the lectin phytohemagglutinin (PHA). Consumption of improperly cooked (which may require overnight presoaking and boiling at least at 100°C for 45 min) red kidney beans causes severe gastrointestinal symptoms. Since the relationship between lectin toxicity and the cellular chaperone machinery remains unknown, the study aimed to determine the effects of heat-denatured PHA on epithelial barrier function and heat shock protein 70 (HSP70) expression and its function as a molecular chaperone in PHA-treated Caco-2 cells and animals. Twelve male Sprague-Dawley rats were randomised to an ad libitum diet of either standard rat chow or chow containing 26% crude red kidney beans. We measured HSP70 and heat shock factor 1 gene expressions in the small intestine and HSP70 protein expression in Caco-2 cells. In Caco-2 cells, luciferase activity was measured to investigate protein folding. Fluorescein-5-isothiocyanate (FITC)-labelled lectin was used to study its intracellular uptake by Caco-2 cells. PHA lectin reduced transepithelial electrical resistance in Caco-2 cells. FITC-labelled PHA entered Caco-2 cells within 3 h of treatment. PHA treatment significantly reduced HSP70 levels and luciferase activity in Caco-2 cells, which was prevented by HSP70 overexpression. In rats fed RRKB chow consisting of legume lectins, we found reduced levels of HSP70 and heat shock factor 1. These observations suggest that lectins counter the protective function of HSP70 on intestinal barrier function.

Sessile serrated lesions (SSL) are recognised precursors to colorectal cancer. Little is known about risk factors for SSL due to their relatively recent clinical recognition as a cancer precursor and routine documentation of cases. Lifestyle and diet-related information were collected using validated questionnaires in a colonoscopy-based case–control study in Australia (257 SSL cases, 239 conventional adenoma (CA) cases, 180 polyp-free controls). A posteriori dietary patterns were derived from self-reported dietary intake in the past 12 months using principal component analysis. Multivariable-adjusted OR and 95 % CI were used to examine associations between lifestyle factors and dietary patterns on risk of SSL and CA v. polyp-free controls and SSL v. CA using logistic regression modelling. Use of anti-inflammatory medications was associated with reduced SSL risk (OR = 0·61; 95 % CI 0·38, 1·00), while current smoking was associated with increased SSL risk (OR = 1·96; 95 % CI 1·09, 3·53). Unlike CA, SSL risk was not increased by hormone replacement therapy use and current alcohol consumption but was increased by taller height. Higher adherence to a dietary pattern featuring processed meats, ready-made convenience foods and high-energy drinks was associated with increased SSL risk (OR = 2·13; 95 % CI 1·13, 4·00; Ptrend = 0·03) and CA (OR = 2·60; 95 % CI 1·32, 5·09; Ptrend = 0·005). Compared with CA, a dietary pattern featuring wholegrains, low-fat dairy products, nuts, seeds and oily fish was associated with reduced SSL risk (OR = 0·60; 95 % CI 0·36, 0·98; Ptrend = 0·04). This study supports a healthy diet as primary prevention for both SSL and CA and reinforces smoking as a risk factor for SSL.

Vitamin A deficiency (VAD) poses significant health risks and is prevalent in children and adolescents in India. This study aimed to determine the effect of seasonal variation and availability of vitamin A-rich (VA-rich) foods on serum retinol in adolescents. Data on serum retinol levels from adolescents (n 2297, mean age 14 years) from the Comprehensive National Nutrition Survey (2016–2018) in India were analysed, with VAD defined as serum retinol < 0·7 µmol/L. Five states were selected based on a comparable under-five mortality rate and the seasonal spread of the data collection period. Dietary data from adolescents and children ≤ 4 years old were used to assess VA-rich food consumption. A linear mixed model framework was employed to analyse the relationship between serum retinol, month of the year and VA-rich food consumption, with a priori ranking to control for multiple hypothesis testing. Consumption of VA-rich foods, particularly fruits and vegetables/roots and tubers, showed seasonal patterns, with higher consumption during summer and monsoon months. Significant associations were found between serum retinol concentrations and age, month of sampling, consumption of VA-rich foods and fish. VAD prevalence was lowest in August, coinciding with higher consumption of VA-rich fruits and foods. Findings highlight the importance of considering seasonality in assessing VAD prevalence and careful interpretation of survey findings. Intentional design, analysis and reporting of surveys to capture seasonal variation is crucial for accurate assessment and interpretation of VAD prevalence, including during monitoring and evaluation of programmes, and to ensure that public health strategies are appropriately informed.