IntroductionOverweight and obesity are increasing global challenges associated with severe health risks. Lifestyle factors like easy access to high-caloric foods and a decrease in physical activity contribute to weight gain. The increase in fat mass (FM) and decrease in lean body mass (LBM) are supported by age-related changes in body composition by the age of 30. Two dietary strategies, the volumetrics diet (VD) and time-restricted eating (TRE), have shown promise in achieving sustainable loss of body weight (BW) and FM without requiring food group exclusions or portion reductions. This study aimed to compare the impact of VD and TRE on body composition parameters and their adherence rate in middle-aged normal-weight to overweight physically active people over 12 weeks.MethodsIn this randomized controlled trial, 37 physically active participants were allocated to either VD or TRE (VD: n = 21, age: 39.48 ± 8.83 years, body mass index (BMI): 25,38 ± 4.37 kg/m2; TRE: n = 16, age: 42.06 ± 8.47, BMI: 26.38 ± 2.81 kg/m2). Participants followed their assigned dietary strategy for 12 weeks while documenting their daily food intake using the FDDB app. Adherence to the diets was self-reported weekly. The VD group consumed meals with an energy density ≤ 1.5 kcal/g and the TRE group restricted calorie intake to an 8-hour window (11:30 AM–7:30 PM). Measurements of BW, FM, LBM, BMI, waist circumference (WC) and hip circumference (HC) were taken at baseline (T0) and after 4 (T1), 8 (T2) and 12 weeks (T3). Statistical analysis included linear mixed-effect models to compare time, group and interaction effects on body composition.ResultsBoth VD and TRE groups showed significant reductions in BW (p = 0.0002; d = 0.61), absolute FM (p < 0.0001; d = 0.85), relative FM (p < 0.0001; d = 0.84), BMI (p = 0.0001; d = 0.60), WC (p < 0.0001; d = 0.92), HC (p = 0.003; d = 0.51) and WHR (p < 0.0001; d = 0.90) after 12 weeks. No significant differences were observed between groups or in interaction effects for these parameters. Both groups maintained LBM throughout the intervention. Adherence rates were significantly higher in TRE (5.78 ± 1.13 days/week) compared to VD (5.29 ± 1.49 days/week; p = 0.0002). Adherence declined over time in both groups but not significantly. Dietary analysis showed no significant differences in energy and macronutrient intake.ConclusionVD led to the same results as TRE but with a significantly lower adherence rate in the 12-week intervention period. Both dietary approaches reduced BW and FM and maintained LBM in middle-aged, physically active individuals without changing physical activity levels. Therefore, VD and TRE may counteract age-related body composition changes as long-term measures. Further studies with larger samples and a longer study duration are needed to confirm these findings.Registration numberDRKS00033809.

BackgroundOlder adults spend the majority of their day engaging in sedentary behavior, which increases risk of mortality by 22%. Despite the well-established health benefits of physical activity, a large portion of older adults remain sedentary. Recent evidence suggests that inflammation contributes to lack of motivation, which is a critical barrier to overcoming sedentary behavior in older adults. Given that inflammation is highly modifiable by diet, an anti-inflammatory dietary strategy may be a viable way to improve inflammation-driven lack of motivation and ultimately increase physical activity in sedentary older adults. However, interventions targeting such a pathway are scarce. We propose a study intervention protocol, which aims to determine the feasibility and preliminary efficacy of daily supplementation of freeze-dried blueberries. Supplementation with blueberries provides 2 anti-inflammatory nutrients (fiber and anthocyanins) to theoretically reduce inflammation-driven lack of motivation and thereby enhance physical activity in older adults with sedentary behavior and mild depressive symptoms.MethodsThe current study is planned as a single-site, randomized, double-blind, parallel pilot study in 40 older adults with sedentary behavior and mild depressive symptoms. Individuals with depressive symptoms often lack motivation and have increased levels of inflammatory cytokines, representing an ideal population for an anti-inflammatory dietary intervention to improve motivation. Participants will be randomized to consume either 48 g of freeze-dried blueberry powder (~ 600 mg of anthocyanins and ~ 8 g of fiber) or a nutritionally matched placebo powder (without any known amounts of anthocyanins and fiber) each day for a total of 12 weeks.DiscussionIdentification of a dietary intervention to target the inflammatory pathways may offer a novel and feasible approach to increase motivation and engagement of physical activity in older adults. If feasible and effective, such a strategy would help avoid the plethora of health consequences associated with sedentary behavior and physical inactivity.Trial registrationThe current study is approved by the Advarra IRB (#Pro00064749) and registered at Clinicaltrials.gov (Identifier: NCT05735587).

BackgroundMalnutrition continues to have large and negative impacts on millions of people. Lack of nutrition education and access to accurate information can be large barriers to healthy eating.MethodsIn this paper, we causally tested if providing participants with consumption tracking information accompanied by tailored messaging that referenced internationally recognized dietary guidelines improved their consumption patterns. To do so, we developed a smartphone application that participants used to record their consumption and that of their children. Those self-recorded data were then used to provide the participants with tailored feedback by comparing their recorded consumption against recommended consumption patterns. The causal impacts of the tailored feedback were estimated using a regression discontinuity estimation strategy and validated using alternative empirical strategies and a parallel dataset collected from the same participants by Community Health Volunteers.ResultsWe found that the informational and feedback treatments improved consumption patterns of the caregivers and their children. Specifically, once caregivers began receiving tracking information and tailored feedback on their children’s diet, their children’s likelihood of meeting the minimum dietary threshold increased by at least 23 percentage points. An analogous, although smaller and less precisely estimated, effect on the caregivers’ consumption was caused by providing them with tracking and feedback information on their own consumption. To verify these findings, we tested for the same effects using a parallel dataset collected by Community Health Volunteers from the same participants at the same period. The results of these analysis remained consistent with those estimated from self-recorded data but showed smaller effect sizes. Tests for persistence of the effects found no loss in impacts over the remaining months of the project.ConclusionsThese findings show that improving access to information on recommended consumption and providing easy methods for tracking own performance against those recommendations can improve consumption patterns while also demonstrating that low-cost, light-touch approaches can be effective for collecting related data and delivering such services.Trial registrationPan African Clinical Trial Registry ACTR202407500217236. Retrospectively registered on July 15 2024.

BackgroundDietary protein plays a crucial role in the growth and development of children and adolescents. However, recent evidence has shown inconsistent findings regarding the impact of dietary protein sources on health outcomes. This study aimed to investigate the association between total, animal, and plant protein intake and the odds of metabolic dysfunction-associated fatty liver disease (MAFLD) in overweight and obese children and adolescents.MethodsThis cross-sectional study included 505 participants (52.9% males) aged 6–18 years, with a body mass index (BMI)-for-age z-score ≥ 1 based on WHO standards. MAFLD diagnosis followed established consensus definitions. Dietary intake of total, animal, and plant protein was assessed using a validated 147-item food frequency questionnaire. Adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for MAFLD across protein intake and subtype quartiles.ResultsThe participants had a mean age of 10.0 ± 2.3 years and a mean BMI-for-age z-score of 2.70 ± 1.01. Higher animal protein intake was significantly associated with an increased likelihood of MAFLD (highest vs. lowest quartile OR: 2.31; 95% CI: 1.01–5.30). Conversely, higher plant protein intake was significantly associated with reduced odds of MAFLD (highest vs. lowest quartile OR:0.48;95% CI:0.23–0.96). No significant relationship was found between total protein intake and MAFLD odds.ConclusionsOur findings highlight the significance of dietary protein source in the odds of MAFLD among overweight and obese children and adolescents. Further studies are warranted to confirm these findings and explore the underlying mechanisms.

BackgroundDietary fat and fatty acid intakes impact the occurrence and development of several cancers. However, the evidence regarding fat and fatty acid intake and ovarian cancer (OC) survival is limited.MethodsThe Ovarian Cancer Follow-Up Study (OOPS), a prospective cohort study, analyzed data collected from 703 OC patients. Deaths were ascertained via medical records and active follow-up. Dietary intake was derived from a validated food frequency questionnaire. Cox proportional hazard models were used to calculate hazard ratio (HR) and 95% confidence interval (CI) for association evaluation. Furthermore, several subgroup and sensitivity analyses were also performed.ResultsA total of 130 patients died during a median follow-up of 37.17 (interquartile: 24.73–50.17) months. Relative to the lowest tertile of intake, patients with the highest tertile of total fat (HR = 1.87, 95% CI = 1.01–3.49), total fatty acid (HR = 2.20, 95% CI = 1.27–3.80), total saturated fatty acid (SFA) (HR = 2.02, 95% CI = 1.22–3.34), shorter-chain SFA (HR = 1.59, 95% CI = 1.03–2.47), long-chain SFA (HR = 1.69, 95% CI = 1.03–2.77), total monounsaturated fatty acid (MUFA) (HR = 1.77, 95% CI = 1.02–3.05), and animal-based MUFA (HR = 2.05, 95% CI = 1.17–3.58) intake had higher all-cause mortality risk. In contrast, individuals in the highest tertile of egg fat (HR = 0.57, 95% CI = 0.35–0.92) and fruit and vegetable fat (HR = 0.48, 95% CI = 0.31–0.75) intake exhibited a reduced risk of all-cause mortality. Additionally, significant positive associations with all-cause mortality were identified for the consumption of several common fatty acids, including capric acid (HR = 1.92, 95% CI = 1.23–3.00), myristic acid (HR = 1.86, 95% CI = 1.15–3.02), palmitic acid (HR = 1.72, 95% CI = 1.07–2.76), stearic acid (HR = 1.93, 95% CI = 1.12–3.31), and oleic acid (HR = 1.96, 95% CI = 1.13–3.40), when comparing the highest to the lowest tertile of intake.ConclusionsWe identified a linkage of higher intake of total fats, total fatty acids, SFAs, shorter-chain SFAs, long-chain SFAs, total MUFAs, and animal-based MUFAs with increased all-cause mortality of OC patients. Conversely, consumption of egg fats and fruit and vegetable fats demonstrated inverse associations with all-cause mortality.

BackgroundThe use of nonfood prebiotics, probiotics, and synbiotics has approximately tripled in the last 20 years. It is necessary to examine the associations of these substances with all-cause and cause-specific mortality in a large prospective cohort.MethodsThis study included 53,333 adults from the National Health and Nutrition Examination Survey 1999–2018. All participants answered questions on the use of dietary supplements and medications, including prebiotics, probiotics, and synbiotics. Death outcomes were determined by linkage to National Death Index records through 31 December 2019. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for mortality from all causes, heart diseases, cancer, and other causes.ResultsDuring a mean follow-up of 10.6 years, 9117 deaths were documented, including 2364 heart disease deaths, 1964 cancer deaths, and 4700 other causes deaths. Compared to nonusers, nonfood prebiotic, probiotic, and synbiotic users had a 59% (HR 0.41, 95% CI 0.30 to 0.56), 56% (HR 0.44, 95% CI 0.26 to 0.74), 49% (HR 0.51, 95% CI 0.31 to 0.83), and 64% (HR 0.36, 95% CI 0.23 to 0.59) for lower risk of all-cause, cancer, heart disease, and other causes mortality, respectively. Moreover, the inverse association of the use of prebiotics, probiotics, and synbiotics with mortality was stronger in female participants and participants without hypertension.ConclusionThe use of nonfood prebiotics, probiotics, and synbiotics is significantly associated with lower all-cause mortality, as well as deaths from heart disease, cancer, and other causes.

BackgroundThis study aimed to investigate the association between tea and coffee consumption and the 15-year incidence of cardiovascular events and mortality among the Iranian population.MethodsThe present study Data were obtained from the Isfahan Cohort Study (ICS), a prospective cohort study of ≥ 35-year-old healthy adults in central Iran from 2001 to 2017. This study was conducted using baseline data on tea and/or coffee consumption per day/week from ICS to identify the occurrence of any new cardiovascular events, including acute myocardial infarction (AMI), unstable angina (UA), stroke, cardiovascular disease (CVD), sudden cardiac death (SCD), cardiovascular mortality, and all-cause mortality.Results5248 participants with complete data were included in the study. After full adjustments, compared to participants with the lowest tea intake, the risk of AMI was significantly higher for participants with the highest tea intake (hazard ratio (HR) = 1.83; 95% confidence interval (CI): 1.10, 3.07; p for trend = 0.060). Also, moderate-tea drinking was associated with a 66% increased risk of AMI compared to the lowest-tea drinking (HR = 1.66; 95%CI: 1.03, 2.70). No significant association was observed between tea consumption and other CVD events or all-cause mortality. Moreover, after full adjustment, no significant association was observed between tea intake above the median and cardiovascular events or all-cause mortality or between coffee consumption and study outcomes.ConclusionsHigh tea consumption significantly increases the risk of AMI; however, high tea and coffee consumption had no significant association with other cardiovascular events. Future research is needed, especially in Iran and the Middle East, to clarify and evaluate more factors related to the complex nature of tea and coffee consumption and cardiovascular events.

BackgroundCarotenoids have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. The data for the effect of dietary specific carotenoids on biological aging is limited. Our study aims to examine the association between dietary carotenoid intake levels and biological aging.MethodsThis cross-sectional study was performed among 27,338 adults from NHANES 1999–2018. Dietary intake was assessed through two 24-hour dietary recall interviews. Biological aging indices included allostatic load (AL), homeostatic dysregulation (HD), Klemera-Doubal method (KDM), and phenoAge (PA). Multiple linear regression, weighted quantile sum (WQS) regression and quantile g-computation (QG-comp) were used to explore the associations of single carotenoid and mixed carotenoids with biological aging.ResultsAssociations between dietary carotenoid intake levels and biological aging indices were significant among adults across the United States. Multiple linear regression showed that most carotenoids were significantly negatively correlated with AL (β = -0.017 - -0.011), HD (β = -0.045 - -0.032), KDM (β = -0.984 - -0.471), and PA (β = -0.975 - -0.539). Subgroup analysis indicated that male, older individuals, smokers, alcohol drinkers, and less physically active individuals are particularly sensitive populations. Meanwhile, WQS regression and QG-comp analyses consistently indicated a negative association between mixed carotenoids exposure and four biological aging indices, highlighting that lutein/zeaxanthin and β-carotene were responsible for the outcomes.ConclusionsIncreased dietary intakes of various carotenoids were associated with lower biological aging indices, which was possibly and mainly driven by lutein/zeaxanthin and β-carotene.

ObjectiveThe objective of this study was to investigate the association between sarcopenia and liver fibrosis in patients aged 18–59 years with metabolic dysfunction-associated steatotic liver disease (MASLD) and to assess the potential of sarcopenia as a risk factor for the progression of liver fibrosis.MethodsThe study included 821 patients with MASLD in the US cohort and 3,405 patients with MASLD in the Chinese cohort. Liver controlled attenuation parameters (CAP) and liver stiffness measurements (LSM) were assessed by vibration-controlled transient elastography (VCTE) to evaluate the extent of hepatic steatosis and fibrosis. Sarcopenia was assessed by measuring appendicular skeletal muscle mass (ASM) and calculating ASMI. To analyze the relationship between sarcopenia, ASMI, and liver fibrosis, logistic regression models, multivariate-adjusted models, and restricted cubic spline (RCS) models were employed, with stratification and interaction analyses.ResultsThe results demonstrated that patients with sarcopenia exhibited a markedly elevated risk of significant liver fibrosis, advanced liver fibrosis, and cirrhosis compared to those without sarcopenia in both cohorts. After adjusting for confounding variables, sarcopenia was identified as an independent risk factor for the progression of liver fibrosis in patients with MASLD. A significant negative correlation was observed between ASMI and the severity of liver fibrosis, with a progressive reduction in the risk of liver fibrosis associated with increasing ASMI. Additionally, a non-linear feature was evident in some liver fibrosis indicators. Subgroup analysis further corroborated the finding that the harmful effect of sarcopenia on liver fibrosis was consistent across all identified subgroups.ConclusionSarcopenia may be associated with the progression of liver fibrosis in patients with MASLD. Monitoring ASMI may assist in identifying individuals at an elevated risk of liver fibrosis in MASLD patients.

BackgroundGallstone disease (GSD) is a prevalent gastrointestinal disorder, few studies have examined the combined effects of dietary and lifestyle factors on GSD. This study aims to investigate the relationship between oxidative balance score (OBS) and GSD, and explores the potential mediating role of oxidative stress.MethodsCross-sectional data from 6,196 participants in the NHANES 2017–2020 were analyzed. OBS, encompassing 16 dietary and 4 lifestyle factors, was assessed alongside GSD prevalence. Weighted multivariate logistic regression, restricted cubic spline (RCS) analysis were used to explore the relationship between OBS and GSD and mediation analysis was used to test the indirect effect of oxidative stress indicators. Subgroup analysis and sensitivity analysis were used to determine the stability of results.ResultsA higher OBS was significantly associated with a reduced risk of GSD (OR: 0.701, 95% CI: 0.492–0.999, P < 0.05). RCS analysis revealed a linear association between OBS and GSD risk. Mediation analysis indicated significant mediating effects of albumin and uric acid, with a combined mediation proportion of 19.540% (P < 0.05). Subgroup analysis revealed differences and interrelationships based on education level, providing additional insights into the relationship between OBS and GSD and sensitivity analysis confirmed the stability of these associations.ConclusionsA higher OBS is associated with a reduced risk of GSD, especially among higher education levels groups, and albumin, uric acid may act as mediators of this association. These findings underscore the potential role of oxidative stress in GSD and the significance of maintaining a healthy diet and lifestyle to decrease GSD risk.