Publications by authors named "Tingjing Zhang"

39 Publications

Edible mushroom consumption and incident hyperuricemia: results from the TCLSIH cohort study.

Food Funct 2021 Oct 4;12(19):9178-9187. Epub 2021 Oct 4.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

: Basic studies have found that xanthine oxidase inhibitors extracted from mushrooms have inhibitory effects on hyperuricemia. However, the association between mushroom consumption and hyperuricemia is unknown in humans. : We therefore designed a large-scale cohort study to examine whether mushroom consumption is a protective factor for developing hyperuricemia in adults. : This prospective cohort study investigated 19 830 participants (mean age: 39.4 years; and 9906 [50.0%] men) who were free of hyperuricemia, cardiovascular disease, and cancer at the baseline. Mushroom consumption was measured at the baseline using a validated food frequency questionnaire. Hyperuricemia is defined as serum uric acid levels >420 μmol L in men and >350 μmol L in women. Cox proportional hazards regression models were used to examine the association of mushroom consumption with incident hyperuricemia. Restricted cubic spline regression was used to estimate the dose-response relationship between mushroom consumption and risk of hyperuricemia. : A total of 4260 first incident cases of hyperuricemia occurred during 61 421 person-years of follow-up (median follow-up of 4.2 years). After adjusting for demographic characteristics, lifestyle factors, dietary intake, and inflammatory markers, the multivariable hazard ratios (95% confidence intervals) for incident hyperuricemia were 1.00(reference) for <1.76 g per 1000 kcal per day, 0.93(0.86, 1.01) for 1.76-2.84 g per 1000 kcal per day, 0.93(0.85, 1.01) for 2.85-5.52 g per 1000 kcal per day, and 0.88 (0.80, 0.96) for >5.52 g per 1000 kcal per day, respectively ( for trend = 0.007). : This population-based prospective cohort study has firstly demonstrated that higher mushroom consumption is significantly associated with lower incidence of hyperuricemia among general adults.
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http://dx.doi.org/10.1039/d1fo00650aDOI Listing
October 2021

Dietary patterns and sarcopenia in elderly adults: the TCLSIH study.

Br J Nutr 2021 Sep 27:1-26. Epub 2021 Sep 27.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Sarcopenia is a core contributor to several health consequences, including falls, fractures, physical limitations, and disability. The pathophysiological processes of sarcopenia may be counteracted with the proper diet, delaying sarcopenia onset. Dietary pattern analysis is a whole diet approach used to investigate the relationship between diet and sarcopenia. Here we aimed to investigate this relationship in an elderly Chinese population. A cross-sectional study with 2,423 participants aged more than 60 years was performed. Sarcopenia was defined based on the guidelines of the Asian Working Group for Sarcopenia, composed of low muscle mass plus low grip strength and/or low gait speed. Dietary data were collected using a food-frequency questionnaire that included questions on 100 food items along with their specified serving sizes. Three dietary patterns were derived by factor analysis: sweet pattern; vegetable pattern; animal food pattern. The prevalence of sarcopenia was 16.1%. The higher vegetable pattern score and animal food pattern score were related to lower prevalence of sarcopenia (Ptrend =0.006 and Ptrend <0.001, respectively); the multivariate-adjusted odds ratio (95% confidence interval) of the prevalence of sarcopenia in the highest versus lowest quartiles were 0.54 (0.34, 0.86) and 0.50 (0.33, 0.74), separately. The sweet pattern score was not significantly related to the prevalence of sarcopenia. The present study showed that vegetable pattern and animal food pattern were related to a lower prevalence of sarcopenia in Chinese older adults. Further studies are required to clarify these findings.
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http://dx.doi.org/10.1017/S0007114521003871DOI Listing
September 2021

Dietary patterns and risk of non-alcoholic fatty liver disease in adults: A prospective cohort study.

Clin Nutr 2021 Oct 4;40(10):5373-5382. Epub 2021 Sep 4.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Background And Aims: Prospective cohort studies linking dietary patterns and non-alcoholic fatty liver disease (NAFLD) are limited, especially in Asian populations. This study aimed to prospectively investigate the association between dietary patterns and risk of NAFLD in a general Chinese adult population.

Methods: This study included a total of 17,360 participants free from NAFLD at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated 100-item food frequency questionnaire. NAFLD was diagnosed by abdominal ultrasound after excluding other causes related to chronic liver disease. Cox proportional regression models were used to assess the association between dietary patterns and risk of NAFLD.

Results: During a median follow-up of 4.2 years, 4034 NAFLD cases were documented. Three main dietary patterns were extracted: sugar rich dietary pattern, vegetable rich dietary pattern, and animal food dietary pattern. After adjusting for age, sex, body mass index, smoking, alcohol, education, occupation, income, physical activity, total energy intake, personal and family history of disease, depressive symptoms, dietary supplement use, inflammation markers, and each other dietary pattern score, comparing the highest with the lowest quartiles of dietary pattern scores, the multivariable hazard ratios (95% confidence interval) of NAFLD were 1.11 (1.01, 1.23) for sugar rich dietary pattern, 0.96 (0.86, 1.07) for vegetable rich dietary pattern, and 1.22 (1.10, 1.36) for animal food dietary pattern. Further adjustment for waist circumference instead of body mass index provided similar results.

Conclusion: Dietary patterns rich in animal foods or sugar were associated with a higher risk of NAFLD among Chinese adults, whereas a vegetable rich dietary pattern was not associated.
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http://dx.doi.org/10.1016/j.clnu.2021.08.021DOI Listing
October 2021

Dietary fiber intake and risk of prediabetes in China: results from the TCLSIH Cohort Study.

Br J Nutr 2021 Sep 21:1-20. Epub 2021 Sep 21.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

High dietary fiber intake has been associated with a lower risk of diabetes, but the association of dietary fiber with prediabetes is only speculative, especially in China, where the supportive data from prospective studies is lacking. This study aimed to examine the association between dietary fiber intake and risk of incident prediabetes among Chinese adults. We performed a prospective analysis in 18,085 participants of the TCLSIH cohort study who were free of diabetes, prediabetes, cancer, and cardiovascular disease at baseline. Dietary data were collected using a validated 100-item food frequency questionnaire. Prediabetes was defined based on the American Diabetes Association diagnostic criteria. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 63,175 person-years of follow-up, 4,139 cases of incident prediabetes occurred. The multivariable HRs (95% CIs) of prediabetes for the highest versus lowest quartiles were 0.85 (0.75, 0.98) (P for trend =0.02) for total dietary fiber, 0.84 (0.74, 0.95) (P for trend <0.01) for soluble fiber, and 1.05 (0.93, 1.19) (P for trend =0.38) for insoluble fiber. Fiber from fruits, but not from cereals, beans, and vegetables was inversely associated with prediabetes. Our results indicate that intakes of total dietary fiber, soluble fiber, and fiber derived from fruit sources were associated with a lower risk of prediabetes.
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http://dx.doi.org/10.1017/S0007114521003779DOI Listing
September 2021

Ultra-processed food consumption and the risk of non-alcoholic fatty liver disease in the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study.

Int J Epidemiol 2021 Sep 16. Epub 2021 Sep 16.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Growing evidence supports a link between ultra-processed food consumption and human health outcomes. However, the association between ultra-processed food consumption and non-alcoholic fatty liver disease (NAFLD) is not known. We aimed to explore the association between ultra-processed food consumption and risk of NAFLD.

Methods: The prospective study included 16 168 participants aged 18-90 years from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Information on ultra-processed food consumption was collected at baseline using a validated food frequency questionnaire. NAFLD was defined as the presence of sonographic fatty liver in the absence of significant alcohol intake (≥210 g/week for men and ≥140 g/week for women, respectively) and other liver diseases. Multivariable Cox proportional hazards models were used to examine the association between ultra-processed food consumption and risk of NAFLD.

Results: During 56 935 person-years of follow-up, we documented 3752 incident NAFLD cases. After adjusting for age, sex, body mass index, smoking, alcohol drinking, education, occupation, income, physical activity, total energy intake, personal and family history of disease and overall diet quality, the multivariable hazard ratios (95% confidence interval) of NAFLD across increasing quartiles of ultra-processed food consumption were 1.00 (reference), 0.99 (0.90, 1.08), 1.13 (1.03, 1.25) and 1.18 (1.07, 1.30), respectively (P for trend <0.0001). The hazard ratio (95% confidence interval) per one standard deviation increase in ultra-processed food consumption, equivalent to a 62.7 g/1000 kcal per day, was 1.06 (1.03, 1.09), P = 0.0001.

Conclusions: Our study indicates that higher ultra-processed food consumption is associated with a higher risk of NAFLD. This finding suggests that ultra-processed food, which is widely consumed worldwide, might be a modifiable dietary target to reduce the risk of NAFLD.
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http://dx.doi.org/10.1093/ije/dyab174DOI Listing
September 2021

Association between dietary onion intake and subclinical hypothyroidism in adults: a population-based study from an iodine-replete area.

Endocrine 2021 Jul 31. Epub 2021 Jul 31.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Purpose: The protective effect of onion against thyroid hypofunction has been reported in animal studies. However, in humans, the association between onion consumption and subclinical hypothyroidism (SCH) are unclear. The study sought to explore the association between habitual onion intake and SCH among adult population from an iodine-replete area.

Methods: A cross-sectional study (6515 men and 5290 women) was performed in Tianjin, China. Frequency of onion consumption was assessed using a valid self-administered food frequency questionnaire. Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were determined by chemiluminescence immunoassay. SCH was diagnosed with TSH > 4.78 mIU/L. Multiple logistic regression was used to evaluate the association of onion intake with SCH.

Results: The prevalence of SCH was 2.56% in men and 7.18% in women, respectively. In women, the fully adjusted odds ratios [95% confidence interval (CI)] of having SCH across increasing frequency of onion intake were 1.00 (reference) for <1 time/week, 0.99 (0.73, 1.34) for 1-3 times/week, 0.74 (0.53, 1.03) for 4-6 times/week, and 0.67 (0.47, 0.97) for ≥7 times/week (P for trend <0.01). However, we observed no significant association between onion intake and SCH in men. Stratified analyses suggested a potential effect modification by age: the odds ratios (95% CI) across extreme quartiles was 0.37 (0.17, 0.80) in <40 women and 1.11 (0.51, 2.47) in >60 women.

Conclusions: Frequent consumption of onion is inversely associated with SCH in adult women from an iodine-replete area. Further studies are needed to explore the casual relationship. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.
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http://dx.doi.org/10.1007/s12020-021-02790-2DOI Listing
July 2021

Handgrip strength as a predictor of incident hypertension in the middle-aged and older population: The TCLSIH cohort study.

Maturitas 2021 Aug 11;150:7-13. Epub 2021 Jun 11.

Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Objectives: The independent role of muscular strength in the prevention of chronic disease is increasingly being recognized. However, no cohort study has assessed the relationship between handgrip strength and the incidence of hypertension among the middle-aged and older population. The aim of this prospective cohort study was to investigate whether handgrip strength is related to incident hypertension among people aged 40 years and over.

Study Design: This prospective cohort study (n = 8,480) was performed between 2013 and 2019 as part of the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study, Tianjin, China.

Main Outcome Measures: Participants without baseline hypertension were followed up for ~6 years (median 4.0 years). Hypertension was defined according to the JNC7 criteria. Handgrip strength was measured using a hydraulic handheld dynamometer. Adjusted Cox proportional hazards regression models were used to assess the relationships between weight-adjusted handgrip strength and the risk of incident hypertension.

Results: The incidence rate of hypertension per 1000 person-years was 70. The fully adjusted hazards ratios (95% confidence interval) of the incidence of hypertension for increasing quartiles of weight-adjusted handgrip strength were: 1.00(reference), 0.84 (0.75-0.95), 0.78 (0.69-0.88), and 0.66 (0.58-0.75) (P for trend<0.0001). Moreover, the adjusted hazards ratio (95% confidence interval) of incident hypertension for per unit increase in weight-adjusted handgrip strength was 0.17 (0.10-0.27) (P<0.0001). Similar results were observed in males and females.

Conclusions: The present cohort study is the first to find that high weight-adjusted handgrip strength, but not absolute handgrip strength, is significantly and independently related to low risk of incident hypertension among the middle-aged and older population.
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http://dx.doi.org/10.1016/j.maturitas.2021.06.002DOI Listing
August 2021

Association of Appendicular Skeletal Muscle to Trunk Fat Ratio with Type 2 Diabetes Mellitus in Older Adults.

Gerontology 2021 Jun 30:1-8. Epub 2021 Jun 30.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Introduction: Mounting evidence has demonstrated that skeletal muscle and visceral adiposity play crucial roles in glucose metabolism. The purpose of this study was to investigate whether the appendicular skeletal muscle mass index (ASMI) to trunk fat mass (TFM) ratio (ASMI/TFM) is a more specific and identifiable factor for type 2 diabetes mellitus (T2DM) in older adults than conventional anthropometric measures.

Methods: This cross-sectional study included 1,370 older adults from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort. ASMI and TFM were measured by using a bioelectrical impedance analyzer, and T2DM was defined with the criteria of the American Diabetes Association. Odds ratios (ORs) were evaluated using multivariable logistic analysis.

Results: The prevalence of T2DM is 20.0% in this study. The multivariable-adjusted ORs (95% confidence interval) of T2DM for increasing categories of ASMI/TFM, BMI, and waist circumference (WC) were 1.00 (reference), 0.70 (0.49, 1.02), 0.61 (0.42, 0.89), and 0.45 (0.30, 0.67; p for trend <0.0001); 1.00 (reference), 1.15 (0.83, 1.60), and 1.37 (0.94, 2.01; p for trend = 0.10); and 1.00 (reference) and 1.78 (1.19, 2.74; p < 0.01), respectively.

Conclusions: Higher ASMI/TFM was associated with a lower prevalence of T2DM in this study of older adults. The T2DM predictive value of ASMI/TFM may be stronger than BMI and WC in this population.
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http://dx.doi.org/10.1159/000516076DOI Listing
June 2021

Association between consumption of ultra-processed foods and hyperuricemia: TCLSIH prospective cohort study.

Nutr Metab Cardiovasc Dis 2021 06 7;31(7):1993-2003. Epub 2021 May 7.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Background And Aims: Emerging evidence suggests that consumption of ultra-processed foods (UPF) plays a role in the development of chronic diseases, but evidence of their influence on hyperuricemia is limited. We therefore designed a cohort study to examine whether UPF consumption increase the risk of hyperuricemia in adults.

Methods And Results: This was a prospective study (n = 18,444) performed in Tianjin, China from 2013 to 2019. Participants that were aged 18 years and over and with no history of hyperuricemia, were followed up for 1-6 years (median follow-up duration = 4.2 years). UPF consumption was assessed by a validated semi-quantitative food frequency questionnaire. Hyperuricemia was defined as serum uric acid levels ≥7.0 mg/dL in males and ≥ 6 mg/dL in females. Multivariable Cox proportional hazards regression models were used to assess the association between UPF consumption and the risk of hyperuricemia. Restricted cubic spline regression was used to estimate the dose-response association between UPF consumption and risk of hyperuricemia. During follow-up period, the incidence of hyperuricemia was 20.3% in general population (27.7% in males and 13.2% in females). In the final multivariate models, the hazard ratios (95% confidence interval) for hyperuricemia across energy adjusted UPF consumption quartiles were 1.00 (reference), 1.04 (0.94, 1.14), 1.11 (1.01, 1.23), 1.16 (1.05, 1.28) (p for trend = 0.02) in general population.

Conclusions: This population-based prospective cohort study suggests that increased consumption of UPF is independently associated the risk of hyperuricemia.
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http://dx.doi.org/10.1016/j.numecd.2021.04.001DOI Listing
June 2021

Saltwater fish but not freshwater fish consumption is positively related to handgrip strength: The TCLSIH Cohort Study.

Nutr Res 2021 06 25;90:46-54. Epub 2021 Apr 25.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China. Electronic address:

Fish contain many important nutrients and are primarily known for high n-3 polyunsaturated fatty acids (n-3 PUFA) content. Studies have shown that supplementation of fish oil-derived n-3 PUFA improves muscle mass and strength. Here, we hypothesized that fish consumption might improve muscle strength. To test this hypothesis, we performed this cross-sectional study (n = 29,084) in Tianjin, China. The frequency of fish consumption was assessed using a valid self-administered food frequency questionnaire. Handgrip strength (HGS) was used as the indicator of muscle strength, and was measured using a handheld digital dynamometer. Analysis of covariance was used to examine the relationship between fish consumption and HGS. In men, after adjusted potential confounding factors, the least square means (95% confidence intervals) of HGS across saltwater fish consumption categories were 41.5 (41.1, 43.7) kg for <1 time/week, 44.6 (43.2, 45.8) kg for 1 time/week, and 44.7 (43.3, 46.1) kg for ≥2 to 3 times/week (P for trend <0.001). In men, the least square means (95% confidence intervals) of HGS across the ascending quartiles of dietary n-3 PUFA intake were 43.6 (43.2, 44.4) kg, 43.7 (43.2, 44.6) kg, 44.4 (43.0, 45.8) kg, and 44.6 (43.1, 46.0) kg (P for trend <0.01). The results showed that saltwater fish consumption was positively related to HGS in men, but not in women, suggesting that saltwater fish contain nutrients that may be used to improve HGS.
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http://dx.doi.org/10.1016/j.nutres.2021.04.002DOI Listing
June 2021

Consumption of Preserved Egg Is Associated with Modestly Increased Risk of Nonalcoholic Fatty Liver Disease in Chinese Adults.

J Nutr 2021 Sep;151(9):2741-2748

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Although preserved egg is a traditional Chinese delicacy widely consumed in China and Southeast Asian countries, whether habitual preserved egg consumption is associated with nonalcoholic fatty liver disease (NAFLD) remains unknown.

Objectives: This study aimed to examine the association between preserved egg consumption and risk of NAFLD in a cohort of Chinese adults.

Methods: This prospective cohort study included 15,883 participants aged 19-88 y (58% women) from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study who were free of liver diseases, cancer, and cardiovascular disease at baseline. Preserved egg consumption was assessed using an FFQ at baseline. NAFLD was diagnosed by transabdominal sonography during an annual health examination. Multivariable Cox proportional hazards regression models were used to calculate HRs and 95% CIs across categories of preserved egg consumption.

Results: During 56,002 person-years of follow-up, 3683 first incident cases of NAFLD were recorded. After adjustment for sociodemographic characteristics, lifestyle risk factors, total energy intake, egg intake, and eating patterns, the multivariable HRs (95% CIs) of incident NAFLD according to categories of preserved egg consumption were 1.00 (reference) for never, 1.05 (0.98, 1.14) for <1 time/wk, 1.09 (0.96, 1.24) for 1 time/wk, and 1.26 (1.09, 1.46) for ≥2 times/wk (P-trend < 0.01). The results were robust to a series of sensitivity analyses.

Conclusions: Habitual preserved egg consumption is associated with a modestly higher risk of NAFLD among the Chinese adult population. The mechanism underlying this association warrants further research.This trial was registered at www.umin.ac.jp/ctr/ as UMIN000027174.
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http://dx.doi.org/10.1093/jn/nxab163DOI Listing
September 2021

The consumption of wholegrain is related to depressive symptoms among Chinese adults: a cross-sectional study.

Eur J Clin Nutr 2021 Apr 30. Epub 2021 Apr 30.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Wholegrains contribute a range of beneficial nutrients, such as dietary fiber and several minerals and vitamins, that are beneficial to depressive symptoms. However, there are a few studies aimed at exploring whether a wholegrain diet is related to depressive symptoms. We conducted this study to investigate the relationship between wholegrains consumption and depressive symptoms.

Methods: This cross-sectional study included a total of 24,776 (mean age: 39.9 years, age range: 18.1-91.3 years; males, 54.1%) inhabitants living in Tianjin, China. Wholegrains consumption was assessed using a valid self-administered food frequency questionnaire. Depressive symptoms were evaluated using the Chinese version of Zung Self-Rating Depression Scale (SDS) and the cutoff point was set at 45. Multiple logistic regression analysis was used to estimate the relationship between wholegrains consumption and depressive symptoms.

Results: The prevalence of depressive symptoms was 19.1% and 22.4% in males and females, respectively. After adjustments for potential confounding factors, the odds ratios (95% confidence intervals) of depressive symptoms across wholegrains consumption were 0.77 (0.65-0.91) for <1 time/week, 0.73 (0.62-0.86) for 1 time/week and 0.68 (0.59-0.79) for ≥2 time/week in males compared with the control group (almost never). In females, the odds ratios (95% confidence intervals) were 0.86 (0.71-1.04) for <1 time/week, 0.94 (0.78-1.13) for 1 time/week, and 0.76 (0.65-0.91) for ≥2 time/week. Similar results were observed when we use other cut-offs (SDS ≥ 40 and 50) to define depressive symptoms.

Conclusion: This study first demonstrated that the higher consumption of wholegrains might have effects on the prevention and improvement of depressive symptoms. Prospective or intervention studies are needed to confirm these findings.
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http://dx.doi.org/10.1038/s41430-021-00917-2DOI Listing
April 2021

Light-To-Moderate Raw Garlic Consumption Frequency Is Inversely Associated With Thickened Carotid Intima-Media Thickness: A Population-Based Study.

Front Nutr 2021 31;8:648821. Epub 2021 Mar 31.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Previous animal and clinical studies have reported beneficial effects of garlic preparations on carotid intima-media thickness (cIMT). However, no epidemiological study has yet investigated the association between dietary raw garlic consumption and cIMT in the general population. The objective of this study was investigating the association between dietary raw garlic consumption and thickened cIMT in Chinese adults. This cross-sectional study used data from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. A total of 4,329 general adults from 2015 to 2017 were included in this study. Frequency of consumption of raw garlic was summarized as four categories for analysis: < 1 time/week, 1 time/week, 2-3 times/week, ≥4 times/week with a validated food frequency questionnaire. The thickened cIMT was defined as common carotid artery IMT ≥ 1.0 mm or a carotid bifurcation IMT ≥ 1.2 mm by ultrasonography. Multivariable logistic regression analysis was used to examine the association between frequency of raw garlic consumption and thickened cIMT. The prevalence of thickened cIMT is 22.9% among these participants. The adjusted odds ratios (95% confidence intervals) associated with the different frequencies were 1.00 (reference) for < 1 time/week, 0.74 (0.59, 0.94) for 1 time/week, 0.71 (0.55, 0.92) for 2-3 times/week, and 0.94 (0.71, 1.25) for ≥ 4 times/week. Light-to-moderate raw garlic consumption was inversely associated with thickened cIMT, whereas greater raw garlic consumption (i.e., ≥4 times/week) was not associated with thickened cIMT. Future longitudinal studies should be conducted to test these findings.
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http://dx.doi.org/10.3389/fnut.2021.648821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044311PMC
March 2021

Does a high intake of green leafy vegetables protect from NAFLD? Evidence from a large population study.

Nutr Metab Cardiovasc Dis 2021 06 2;31(6):1691-1701. Epub 2021 Feb 2.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Background And Aims: Results of in vitro and in vivo studies showed that green leafy vegetables (GLV) could attenuate liver steatosis. However, little is known regarding the association between GLV intake and nonalcoholic fatty liver disease (NAFLD) in human. We examined the association of GLV intake with NAFLD in a large-scale adult population.

Methods And Results: This cross-sectional study investigated 26,891 adults in China who participated in health examinations from 2013 to 2017. Newly diagnosed NAFLD was detected by liver ultrasonography. Dietary intake was assessed by using a validated and standardized food frequency questionnaire. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) across categories of GLV intake. After adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the OR (95% CI) for comparing the highest vs. lowest GLV intake categories (≥7 times/week vs. almost never) was 0.72 (0.59, 0.90) (P < 0.0001). In addition, a linear inverse association was demonstrated between GLV intake and NAFLD in women (P for trend = 0.04), but ORs for any intake category did not reach significance. Stratified analyses suggested a potential effect modification by obesity status; the ORs (95% CIs) for comparing the highest vs. lowest GLV intake categories was 0.72 (0.54, 0.97) in normal/overweight individuals and 1.04 (0.65, 1.65) in obese individuals (P-interaction < 0.0001).

Conclusion: This large population-based study shows that high GLV intake is inversely associated with NAFLD, particularly in women and non-obese participants.
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http://dx.doi.org/10.1016/j.numecd.2021.01.009DOI Listing
June 2021

Higher plain water intake is related to lower newly diagnosed nonalcoholic fatty liver disease risk: a population-based study.

Eur J Clin Nutr 2021 Apr 9. Epub 2021 Apr 9.

Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.

Background/objectives: High plain water intake (PWI) lowered body weight, reduced total energy intake, and increased fat oxidation and energy consumption. Because such factors are closely linked to metabolic disorders, which are the main risk factors for nonalcoholic fatty liver disease (NAFLD) onset, it was speculated that higher PWI was associated with a lower risk of NAFLD. However, no prior human studies have examined such relationship. Therefore, the purpose of this study was to evaluate the relationship between PWI and newly diagnosed NAFLD in a large-scale adult population.

Subjects/methods: A total of 16,434 participants from 2010 to 2019 in Tianjin, China, were included in this cross-sectional study. PWI was assessed by using a validated self-administered food frequency questionnaire, and it was categorized into three subgroups for analysis: ≤3 cups/day, 4-7 cups/day, and >7 cups/day. NAFLD was diagnosed by abdominal ultrasound. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the relationship between PWI and NAFLD.

Results: Among 16,434 participants, 20.5% (3,364) had newly diagnosed NAFLD. After controlling for demographic characteristics, lifestyle risk factors, and dietary intake, the adjusted ORs (95% CIs) for having NAFLD across PWI categories were 1.00 (reference) for ≤3 cups/day, 0.84 (0.72, 0.97) for 4-7 cups/day, and 0.77 (0.63, 0.94) for >7 cups/day in males and 1.00 (reference) for ≤3 cups/day, 1.02 (0.81, 1.27) for 4-7 cups/day, and 1.08 (0.78, 1.49) for >7 cups/day in females, respectively.

Conclusions: This study is the first to show that higher PWI is independently related to lower newly diagnosed NAFLD among males, but not females. Further studies are needed to explore the causal relationship.
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http://dx.doi.org/10.1038/s41430-021-00891-9DOI Listing
April 2021

Consumption of chilies and sweet peppers is associated with lower risk of sarcopenia in older adults.

Aging (Albany NY) 2021 03 26;13(6):9135-9142. Epub 2021 Mar 26.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Sarcopenia is an aging-related loss of muscle mass and function, which induces numerous adverse outcomes. Capsaicin and capsiate, separately extracted from chilies and sweet peppers, have the potential to induce muscle hypertrophy via activation of transient receptor potential vanilloid 1. The present study aimed to investigate whether chili and sweet pepper consumption are related to sarcopenia in the elderly general population.

Methods: A cross-sectional study with 2,451 participants was performed. Dietary chili and sweet pepper consumption were assessed using a validated self-administered food frequency questionnaire. Sarcopenia was defined according to the consensus of the Asian Working Group for Sarcopenia. Logistic regressions were performed to measure the effect of chili and sweet pepper consumption on sarcopenia.

Results: The prevalence of sarcopenia was 16.1%. After adjustment for potential confounding variables, the odds ratios (95% confidence intervals) for sarcopenia across chili and sweet pepper consumption categories were 1.00 (reference) for almost never, 0.73 (0.55, 0.97) and 0.73 (0.56, 0.96) for ≤1 time/week, 0.60 (0.39, 0.90) and 0.66 (0.45, 0.95) for ≥2-3 times/week (both for trend <0.01), respectively.

Conclusion: The present study showed that higher consumption of chilies and sweet peppers was related to a lower risk of sarcopenia in older adults.
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http://dx.doi.org/10.18632/aging.104168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034967PMC
March 2021

Relationship between seaweeds consumption and hyperuricaemia in general adults: a Population-based study from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study.

Br J Nutr 2021 Mar 15:1-8. Epub 2021 Mar 15.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin300070, People's Republic of China.

Seaweeds have numerous biologically active ingredients, such as polysaccharides, polyphenols and carotenoids, that are beneficial to human health. Although these benefits might be related to the synthesis, secretion or reabsorption of uric acid, no studies have explored the relationship between seaweeds consumption and hyperuricaemia (HUA) in the general population. The aim of this study was to investigate whether seaweeds consumption is related to HUA in a large-scale adult population. A cross-sectional study was conducted with 32 365 adults (17 328 men and 15 037 women) in Tianjin, People's Republic of China. Frequency of seaweeds consumption was assessed by a validated self-administered FFQ. HUA was defined as serum uric acid levels >420 μmol/L in men and >350 μmol/L in women. The association between seaweeds consumption and HUA was assessed by multiple logistic regression analysis. Restricted cubic spline functions were used for non-linearity tests. The prevalence of HUA in men and women was 21·17 % and 5·93 %, respectively. After adjustments for potential confounding factors, the OR (95 % CI) for HUA across seaweed consumption (g/1000 kcal per d) were 1·00 (reference) for level 1, 0·91 (95 % CI 0·81, 1·02) for level 2; 0·90 (95 % CI 0·81, 1·01) for level 3; 0·86 (95 % CI 0·78, 0·97) for level 4 in men and 0·90 (95 % CI 0·73, 1·10) for level 2; 0·82 (95 % CI 0·67, 1·00) for level 3; 0·84 (95 % CI 0·68, 1·03) for level 4 in women, respectively. A negative correlation between seaweeds consumption and HUA in males but not in females was observed. Further studies are needed to explore the causal relationship.
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http://dx.doi.org/10.1017/S0007114521000891DOI Listing
March 2021

Soft drink consumption and risk of nonalcoholic fatty liver disease: results from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study.

Am J Clin Nutr 2021 05;113(5):1265-1274

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Epidemiological evidence for the association of soft drink consumption with nonalcoholic fatty liver disease (NAFLD) is inconsistent, and such association has not been prospectively examined in the general adult population.

Objectives: We aimed to investigate the prospective association between soft drink consumption and the risk of NAFLD in a Chinese adult population.

Methods: This prospective cohort study investigated 14,845 participants [mean age: 39.3 y; 6203 (41.8%) men] who were free of liver disease, cardiovascular disease, and cancer at baseline. Soft drink consumption (mainly sugar-containing carbonated beverages) was measured at baseline using a validated FFQ. NAFLD was diagnosed based on abdominal ultrasound without significant alcohol consumption and other causes of liver disease. Hepatic steatosis index (HSI) was calculated based on sex, BMI, and blood transaminase levels. Cox proportional hazards regression models were used to examine the association of soft drink consumption with incident NAFLD.

Results: A total of 2888 first-incident cases of NAFLD occurred during 42,048 person-years of follow-up (median follow-up: 4.2 y). After adjusting for demographic characteristics, lifestyle factors, dietary intake, and inflammatory markers, the multivariable HRs (95% CIs) for incident NAFLD were 1.00 (reference) for <1 serving/wk, 1.18 (1.03, 1.34) for 1 serving/wk, 1.23 (1.08, 1.40) for 2-3 servings/wk, and 1.47 (1.25, 1.73) for ≥4 servings/wk, respectively (P for trend < 0.0001). Further sensitivity analysis showed that the corresponding multivariable HRs (95% CIs) for incident HSI-defined NAFLD were 1.00 (reference), 0.96 (0.70, 1.31), 1.16 (0.83, 1.62), and 1.59 (1.07, 2.37), respectively (P for trend < 0.0001).

Conclusions: The results from our prospective study indicate that soft drink consumption is associated with an increased risk of NAFLD in Chinese adults. This study was registered at UMIN Clinical Trials Registry as UMIN000027174.
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http://dx.doi.org/10.1093/ajcn/nqaa380DOI Listing
May 2021

High-normal thyroid function predicts incident non-alcoholic fatty liver disease among middle-aged and elderly euthyroid subjects.

J Gerontol A Biol Sci Med Sci 2021 Feb 3. Epub 2021 Feb 3.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Thyroid hormones (THs) influence hepatic lipid homeostasis through multiple pathways, suggesting that THs may predict the risk of non-alcoholic fatty liver disease (NAFLD). However, prospective studies on the association between THs levels and incident NAFLD in euthyroid subjects are limited. This prospective cohort study aimed to explore whether THs were associated with the development of NAFLD in middle-aged and elderly euthyroid subjects.

Methods: A total of 6,462 subjects without baseline NAFLD were included in the cohort study (~6-year follow-up period, median: 4.2 years). Chemiluminescence immunoassay was used to measure serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH), and NAFLD was diagnosed by abdominal ultrasonography. Multivariable Cox proportional hazards regression models were used to assess the association between baseline THs, TSH, and the risk of NAFLD.

Results: During the follow-up period, 1,675 subjects developed NAFLD. The incidence rate of NAFLD was 85.0 per 1000 person-years. Compared with the lowest FT3, FT4, and TSH quartiles, the multivariable-adjusted hazard ratios (95% confidence interval) of incident NAFLD for highest quartiles were 1.30 (1.12, 1.51), 1.07 (0.93, 1.23), 0.82 (0.71, 0.95) (P <0.001, =0.56, =0.01, respectively), respectively.

Conclusions: In middle-aged and elderly euthyroid subjects, high-normal FT3 and low-normal TSH are independently associated with a higher incidence of NAFLD.
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http://dx.doi.org/10.1093/gerona/glab037DOI Listing
February 2021

Predictive Value of Thyroid Hormones for Incident Hyperuricemia in Euthyroid Subjects: The Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study.

Endocr Pract 2021 Apr 30;27(4):291-297. Epub 2021 Jan 30.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Objective: Thyroid hormones (THs) play an important role in both serum uric acid (SUA) excretion and purine nucleotide metabolism. Past research mainly focused on the relationships between thyroid dysfunction and hyperuricemia. Although most subjects at risk for hyperuricemia are euthyroid, few studies have investigated the predictive values of THs on incident hyperuricemia in euthyroid adults. This study aimed to examine how free triiodothyronine, thyroxine, and thyroid-stimulating hormone are related to incident hyperuricemia in euthyroid subjects.

Methods: Participants without baseline hyperuricemia were recruited from Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study and followed up for ∼6 years. Thyroid function was determined by chemiluminescence immunoassay methods. Hyperuricemia was defined as SUA ≥416.5 μmol/L for males and ≥357.0 μmol/L for females. Thyroid function and SUA were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationship between thyroid function and hyperuricemia.

Results: The incidence rates of hyperuricemia were 109 and 50 per 1000 person-years in males and females, respectively. In males, compared with the lowest quartile, the multivariable-adjusted hazards ratios for hyperuricemia in the highest quartiles of triiodothyronine, thyroxine, and thyroid-stimulating hormone were 0.57 (0.50-0.66), 0.63 (0.54-0.73), and 1.03 (0.90-1.19) (P for trend < .0001, < .0001, and .51), respectively. However, no statistically significant correlations between thyroid function and incident hyperuricemia in females were found.

Conclusion: This cohort study is the first to demonstrate that higher THs are related to lower risk of incident hyperuricemia in a male population with euthyroid status.
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http://dx.doi.org/10.1016/j.eprac.2020.10.009DOI Listing
April 2021

The association between longitudinal trends of thyroid hormones levels and incident hypertension in a euthyroid population.

J Hum Hypertens 2021 Jan 18. Epub 2021 Jan 18.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Thyroid hormones, including free triiodothyronine (FT3), free thyroxine (FT4), have well-recognized effects on the cardiovascular system. However, the evidence is lacking regarding the relationship between repeated FT3, FT4, and thyroid-stimulating hormone (TSH) measurements and incident hypertension. The aim of this cohort study was to examine how longitudinal trends of serum FT3, FT4, and TSH levels are related to the development of hypertension in a euthyroid population. A prospective study (n = 5926) was performed in Tianjin, China. Participants without a history of hypertension were followed up for ~4 years (median: 3 years). Hypertension was defined according to the criteria of JNC7. FT3, FT4, and TSH were determined by chemiluminescence immunoassay methods. FT3, FT4, TSH, and blood pressure were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationships between baseline, means, and annual changes in FT3, FT4, TSH, and hypertension. The incidence rate of hypertension per 1000 person-years was 73. Compared with the lowest quartile, the multivariable-adjusted hazards ratios (95% confidence interval) for hypertension in the highest quartiles of changes in FT3, FT4, and TSH were 1.51 (1.23-1.84), 2.04 (1.67-2.48), and 1.20 (0.99-1.45), respectively. Similar relationships were observed between the means of FT3, FT4, TSH, and hypertension. However, we found no correlations between baseline FT3, FT4, TSH, and incident hypertension. The present study is the first to demonstrate that the annual changes and means, but not baseline FT3 and FT4 values are independently related to the risk of incident hypertension in the euthyroid general population.
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http://dx.doi.org/10.1038/s41371-020-00474-4DOI Listing
January 2021

Effects of wheat flour particle size on physicochemical properties and quality of noodles.

J Food Sci 2020 Dec 5;85(12):4209-4214. Epub 2020 Nov 5.

Henan Food Crop Collaborative Innovation Center, Zhengzhou, 450001, China.

The effect of particle size on the physicochemical and noodle quality of wheat flours was investigated. Granular wheat flour was ground by adjusting the distance between the rolls (0.02, 0.04, 0.06, 0.08, and 0.1 mm) of the flour mill to obtain wheat flour in five different particle sizes. The results showed that milling intensity significantly reduced the particle size and increased the damaged starch content and sedimentation value, but there were no significant differences in protein or ash contents. The reduction of wheat flour particle size significantly decreased the peak viscosity, trough viscosity, final viscosity, breakdown, and setback of the blends, while there were no significant differences in pasting temperature. Stress relaxation characteristics indicated that as the particle size of wheat flour decreased, dough hardness increased. The noodles made from wheat flour with a smaller particle size had a higher water absorption rate and cooking loss rate. Textural profile analysis parameters showed that as the particle size of wheat flour decreased, the hardness, chewiness, recovery, and adhesiveness of noodles showed increasing trends, and there was no significant difference in elasticity. In summary, it is found that the quality of the noodles made by sample C (D : 78.47 µm) is better.
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http://dx.doi.org/10.1111/1750-3841.15479DOI Listing
December 2020

The relationship between dietary patterns and grip strength in the general population: the TCLSIH cohort study.

Eur J Nutr 2021 Aug 1;60(5):2409-2421. Epub 2020 Nov 1.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.

Purpose: Previous studies have shown that many nutrients play an essential role in maintaining skeletal muscle strength. Hand grip strength (HGS) is frequently used as an objective and reliable method to evaluate overall body muscle strength and physical function. Some studies have demonstrated that some specific single nutrients such as PUFA, fiber, vitamin C, fruits and vegetables are associated with muscle strength. However, few studies have explored the relationship between dietary patterns and HGS in the adult population. The aim of this study was to investigate how dietary patterns are related to HGS in a large-scale Chinese population.

Methods: A cross-sectional study (n = 35,175) was performed in Tianjin, China. Adherence to dietary patterns was measured by a valid self-administered food frequency questionnaire with 81 food items. Principal-components analysis was used to derive three major dietary patterns: "sweet", "healthy" and "animal food". HGS was measured using a handheld digital dynamometer. Analysis of covariance and multiple logistic regression were employed to explore the relationship between dietary patterns and HGS.

Results: After adjustment for potential confounders, the means (95% confidence interval) of HGS for increasing quartile of dietary patterns were as follows: "sweet", 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.48-0.51) (P value = 0.07); "healthy" 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51) (P value < 0.0001); "animal food" 0.51(0.50-0.52), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.49 (0.48-0.51) (P value < 0.0001), respectively.

Conclusions: The present study demonstrated a slight improvement between healthy dietary pattern and HGS across the quartiles. On the contrary, this study also showed higher adherence to the animal food dietary pattern (i.e., higher quartile) had lower grip strength. A long-term prospective study or randomized trials are required to clarify this association.
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http://dx.doi.org/10.1007/s00394-020-02385-zDOI Listing
August 2021

Complex Dietary Topologies in Non-alcoholic Fatty Liver Disease: A Network Science Analysis.

Front Nutr 2020 29;7:579086. Epub 2020 Sep 29.

Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.

Previous studies have explored the associations between nutrition (food groups, nutrients, and dietary patterns) and the prevalence of non-alcoholic fatty liver disease. However, it remains unclear whether how foods are consumed together is associated with non-alcoholic fatty liver disease. The present study aims to construct dietary networks from network science and to explore the associations between complex dietary networks and non-alcoholic fatty liver disease. The present case-control study generated 2,043 multivariate matched controls for 2,043 newly diagnosed non-alcoholic fatty liver disease cases. Mutual information, which represents both linear and non-linear dependencies among food groups, was used to construct the network topologies. The dietary topologies in the studied case and control groups were different despite the fact that only few food groups show differences in absolute intake. The dietary structure of the case group focused on two major components with more cohesion among food groups, while contrarily the control group had one major component with higher diversity of food groups. The dietary topology of the case group showed equality in connections among beneficial and detrimental food groups, whereas the control group focused more on healthier food choices. This study suggests how foods are consumed, besides the absolute intake, could be an important determinant of the occurrence of non-alcoholic fatty liver disease. A diverse diet that focuses on whole grain, tubers, and vegetables could yield beneficial effects regarding non-alcoholic fatty liver disease. Network science could offer a complementary tool in nutritional epidemiology.
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http://dx.doi.org/10.3389/fnut.2020.579086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557363PMC
September 2020

Soy Food Intake Is Inversely Associated with Newly Diagnosed Nonalcoholic Fatty Liver Disease in the TCLSIH Cohort Study.

J Nutr 2020 12;150(12):3280-3287

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Animal studies have shown that soy protein and isoflavones can increase antioxidant capacity and improve insulin resistance, and thus ameliorate nonalcoholic fatty liver disease (NAFLD). However, only limited epidemiological studies have examined the association of soy food intake with NAFLD.

Objectives: We investigated the association between soy food intake and NAFLD in a Chinese cohort.

Methods: A total of 24,622 participants aged 20-90 y were included in the study. Diet information was collected using a validated 100-item FFQ. NAFLD was defined as having fatty liver diagnosed by ultrasonography and excluding men and women who consumed >210 g alcohol/wk and >140 g/wk, respectively. Logistic regression analysis was used to assess the association of soy food intake with NAFLD.

Results: After adjustment for potential confounders, and taking those with <1 time/wk soy food intake as the reference group, the ORs for NAFLD across soy food intake frequency were 0.94 (95% CI: 0.83, 1.07) for 1 time/wk, 0.88 (95% CI: 0.78, 0.99) for 2-3 times/wk, and 0.75 (95% CI: 0.65, 0.87) for ≥4 times/wk (P-trend <0.0001). The results were similar when participants were categorized by the energy-adjusted soy food intake (grams per 1000 kilocalories) quartiles (OR = 0.80; 95% CI: 0.71, 0.91; comparing extreme quartiles).

Conclusions: Higher soy food intake was associated with a lower prevalence of NAFLD in Chinese adults. Further prospective studies and randomized clinical trials are necessary to confirm if soy food intake is inversely related to the risk of NAFLD.
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http://dx.doi.org/10.1093/jn/nxaa297DOI Listing
December 2020

Grip strength and depressive symptoms in a large-scale adult population: The TCLSIH cohort study.

J Affect Disord 2021 01 14;279:222-228. Epub 2020 Aug 14.

Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.

Background: Previous studies suggest that muscle-derived cytokines (myokines) are linked with brain function. Although muscle strength measured by handgrip strength is a prognostic indicator of functional decline, epidemiological studies directly examining the association between grip strength and mental health remain scarce. The aim of this study is to clarify the association between grip strength and depressive symptoms in the general adult population.

Methods: This is a cross-sectional study of 24,109 Chinese adults (41. 5  ± 11.9 years; 46.0% females). Grip strength was measured by dynamometer and the greatest force was normalized to body weight (NGS, kg/kg). Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Models of logistic regression were conducted to assess the association between NGS and depressive symptoms, with adjustment for established confounding factors.

Results: Of the 24,109 participants, the prevalence of depressive symptoms (SDS ≥45) was 16.8% (males 15.7%, females 18.0%). After adjusting for multiple confounding factors, the odds ratios and 95% confidence interval for depressive symptoms in the quartiles of NGS were 1.00, 0.96 (0.84-1.10), 0.91 (0.79-1.05), and 0.91 (0.78-1.07) (P = 0.03) in males; 1.00, 0.92 (0.80-1.06), 0.90 (0.77-1.04), and 0.80 (0.69-0.94) (P = 0.0002) in females, respectively.

Limitations: This cross-sectional study cannot determine causality.

Conclusions: Grip strength was inversely associated with depressive symptoms, with stronger association observed among females than males.  Further prospective studies or randomized trials are required to clarify these findings.
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http://dx.doi.org/10.1016/j.jad.2020.08.023DOI Listing
January 2021

Association between consumption of edible seaweeds and newly diagnosed non-alcohol fatty liver disease: The TCLSIH Cohort Study.

Liver Int 2021 02;41(2):311-320

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background & Aims: Seaweeds are rich sources of anti-oxidants and anti-inflammatory properties, which are beneficial to non-alcoholic fatty liver disease (NAFLD). However, whether seaweed consumption is associated with NAFLD is unknown. We investigated the association of seaweed consumption with newly diagnosed NAFLD in a large-scale adult population.

Methods: This cross-sectional study involved 24 572 participants aged over 18 years. NAFLD was diagnosed by results of liver ultrasonography and alcohol intake. Dietary information was assessed using a validated and standardized 100-item food frequency questionnaire. Multivariate logistic analysis was used to evaluate the association between seaweed consumption and NAFLD.

Results: The prevalence of newly diagnosed NAFLD was 20.1%. After adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the multivariable adjusted odds ratios (95% confidence intervals) of newly diagnosed NAFLD across seaweed consumption were 1.00 (reference) for almost never, 1.03 (0.93, 1.15) for <1 time/wk, 1.01 (0.90, 1.13) for 1 time/wk, and 0.84 (0.73, 0.96) for >1 times/wk (P for trend < .001). Stratified analyses suggested a potential effect modification by obesity status; the odds ratios (95% confidence intervals) across extreme quartiles was 0.77 (0.66, 0.91) in non-obese participants and 1.02 (0.79, 1.33) in obese participants (P for interaction < .001).

Conclusion: Seaweed consumption is negatively associated with NAFLD, especially in non-obese participants.
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http://dx.doi.org/10.1111/liv.14655DOI Listing
February 2021

Association between eating speed and newly diagnosed nonalcoholic fatty liver disease among the general population.

Nutr Res 2020 08 25;80:78-88. Epub 2020 Jun 25.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Fast eating speed is a risk factor for obesity, which is also closely related to nonalcoholic fatty liver disease (NAFLD), suggesting that fast eating speed may contribute to the development of NAFLD. But the extent to which obesity may mediate the association between eating speed and NAFLD is uncertain. We hypothesized that obesity plays a mediating role in the association between eating speed and prevalence of NAFLD in the general population. A cross-sectional study (n = 23,611) was conducted in a general population sample from Tianjin, China. We measured anthropometrics and biochemical variables. The self-reported eating speed per meal was recorded and classified into 4 categories: slow, medium, relatively fast, and very fast. NAFLD was diagnosed by liver ultrasonography. Multiple logistic regression analysis was used to assess the associations between the eating speed and the prevalence of NAFLD, as well as the mediation effects of obesity on the association between eating speed and NAFLD. The prevalence of newly diagnosed NAFLD was 19.0%. After adjusting for potentially confounding factors, the odds ratios (95% confidence interval) of NAFLD across categories of eating speed were 1.00 (reference), 1.39 (1.18-1.64), 1.71 (1.45-2.01), and 2.04 (1.70-2.46). All these significant odds ratios were attenuated to be nonsignificant by adjustment for body mass index and/or waist circumference. This is the first study to demonstrate that eating speed is not independently associated with increased risk of NAFLD.
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http://dx.doi.org/10.1016/j.nutres.2020.06.012DOI Listing
August 2020

Sugar-containing carbonated beverages consumption is associated with hyperuricemia in general adults: A cross-sectional study.

Nutr Metab Cardiovasc Dis 2020 09 2;30(10):1645-1652. Epub 2020 Jun 2.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Background And Aims: Research evidence supports a positive link between sugar-containing soft beverages and hyperuricemia. However, data thus far are mostly from Caucasian populations. And in sugar-containing soft beverages overall, sugar-containing carbonated beverages are purchased most often. Therefore, we investigated whether the high consumption of sugar-containing carbonated beverages was associated with the prevalence of hyperuricemia among adults in China.

Methods And Results: A cross-sectional study was conducted with 25,507 adults (13,013 men and 12,494 women) in Tianjin, China. Sugar-containing carbonated beverages intake was assessed by a validated semi-quantitative food frequency questionnaire. Hyperuricemia was defined as serum uric acid levels ≥7.0 mg/dL in men and ≥ 6 mg/dL in women. The association between carbonated beverages consumption and hyperuricemia was assessed by multiple logistic regression analysis. The prevalence of hyperuricemia in men and women was 23.4% and 8.2%, respectively. After adjustments for potential confounding factors, the odds ratios (95% confidence interval) for hyperuricemia across sugar-containing carbonated beverages consumption were 1.00 (reference) for almost never, 1.18 (1.05, 1.32) for <1-3 cups/week, 1.49 (1.25, 1.77) for ≥4 cups/week in men (P for trend < 0.005) and 1.11 (0.91, 1.34) for <1-3 cups/week (P for trend = 0.27), 1.70 (1.23, 2.31) for ≥4 cups/week in women (P for trend < 0.001), respectively.

Conclusions: This cross-sectional survey demonstrated that increased consumption of sugar-containing carbonated beverages is associated with hyperuricemia among adults in China. Restricted sugar-containing carbonated beverages intake might be beneficial to the prevention of hyperuricemia in the general population.
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http://dx.doi.org/10.1016/j.numecd.2020.05.022DOI Listing
September 2020

Ultrafine grinding of wheat flour: Effect of flour/starch granule profiles and particle size distribution on falling number and pasting properties.

Food Sci Nutr 2020 Jun 1;8(6):2581-2587. Epub 2020 May 1.

School of Food Science and Technology Henan University of Technology Zhengzhou China.

In the present paper, the properties of different ultrafine flour samples, including particle size distribution, damaged starch content, falling number, and pasting properties, were examined. The results indicated that the particle size decreased significantly after jet milling, as the rotation speed and grinding time increased, and the damaged starch content significantly increased as the size of the flour/starch decreased; this is in contrast to the significant decrease in falling number. Significant differences in pasting temperature were observed between straight-grade flour (68.6°C) and five ultrafine flour samples (from 86.3 to 87.9°C). We also observed significant increases in peak viscosity, trough, breakdown viscosity, final viscosity, and setback as the flour particle size decreased from 43.07 µm to 25.81 µm (D). The same parameters significantly decreased as the flour particle size decreased from 25.81 µm to 10.15 µm (D). Correlation analysis identified a significant negative correlation between flour particle size (D) and damaged starch content and pasting temperature, while a significant positive correlation was found with the falling number values. The results of this work may have an important impact on the quality of processed foods.
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http://dx.doi.org/10.1002/fsn3.1431DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300039PMC
June 2020
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