UNASSIGNED: The aim of this study was to analyse whether the association between adherence to the Mediterranean diet and health-related quality of life (HRQoL) is mediated by physical fitness components (i.e., cardiorespiratory fitness, lower-limb strength, upper-limb strength and motor competence) in adolescents.
UNASSIGNED: This is a cross-sectional study including mediation analyses. This study involved 181 adolescents (86 girls) aged 15.8 ± 0.3 years recruited from secondary schools and sport clubs located in Castellon (Spain). Adherence to the Mediterranean diet was evaluated using the KIDMED questionnaire. HRQoL was assessed with the KIDSCREEN-10 questionnaire. Cardiorespiratory fitness was assessed using the 20-m shuttle run test. Lower-limb strength was assessed through the standing broad jump test. Upper-limb strength was evaluated using a handgrip dynamometer. Motor competence was assessed using the 4 × 10 m shuttle run test. Mediation analyses were performed for each physical fitness component in order to assess its mediating effect on the association between adherence to the Mediterranean diet and HRQoL. Indirect effects (IE) with confidence intervals (CI) not including zero were interpreted as statistically significant.
UNASSIGNED: Cardiorespiratory fitness and lower-limb strength had a mediating effect on the positive association between adherence to the Mediterranean diet and HRQoL (IE = 0.11, 95 % CI = 0.01; 0.27 and IE = 0.07, 95 % CI = 0.01; 0.19). Upper-limb strength and motor competence did not act as mediators in the association between adherence to the Mediterranean diet and HRQoL (IE = 0.00, 95 % CI = -0.04; 0.07 and IE = 0.01, 95 % CI = -0.03; 0.07, respectively).
UNASSIGNED: Our findings showed that the positive association of adherence to the Mediterranean diet on adolescents\' HRQoL was mediated by physical fitness. Educational and public health strategies aiming to improve Spanish adolescents\' HRQoL should focus on diet and physical fitness.

Chronic kidney disease (CKD) is a heterogeneous disorder that affects the kidney structure and function. This study investigated the effect of the interaction between genetic factors and dietary pattern on kidney dysfunction in Korean adults.
Baseline data were obtained from the Ansan and Ansung Study of the Korean Genome and Epidemiology Study involving 8230 participants aged 40-69 years. Kidney dysfunction was defined as an estimated glomerular filtration rate < 90 mL/minute/1.73 m2. Genomic DNAs genotyped on the Affymetrix® Genome-Wide Human SNP array 5.0 were isolated from peripheral blood. A genome-wide association study using a generalized linear model was performed on 1,590,162 single-nucleotide polymorphisms (SNPs). To select significant SNPs, the threshold criterion was set at P-value < 5 × 10-8. Linkage disequilibrium clumping was performed based on the R2 value, and 94 SNPs had a significant effect. Participants were divided into two groups based on their generic risk score (GRS): the low-GR group had GRS > 0, while the high-GR group had GRS ≤ 0.
Three distinct dietary patterns were extracted, namely, the \"prudent pattern,\" \"flour-based and animal food pattern,\" and \"white rice pattern,\" to analyze the effect of dietary pattern on kidney function. In the \"flour-based and animal food pattern,\" higher pattern scores were associated with a higher prevalence of kidney dysfunction in both the low and high GR groups (P for trend < 0.0001 in the low-, high-GR groups of model 1; 0.0050 and 0.0065 in the low-, high-GR groups of model 2, respectively).
The results highlight a significant association between the \'flour-based and animal food pattern\' and higher kidney dysfunction prevalence in individuals with both low and high GR. These findings suggest that personalized nutritional interventions based on GR profiles may become the basis for presenting GR-based individual dietary patterns for kidney dysfunction.

OBJECTIVE: Limited research exists on the association between dietary patterns (DP) and COPD risk or health-related outcomes. We reviewed existing literature to identify DP as a potential factor influencing COPD development and associated health outcomes in diagnosed individuals.
METHODS: We followed the Joanna Briggs Institute methodology for this scoping review, conducting searches on PubMed, Scopus, Embase, and Web of Science to identify studies meeting our inclusion criteria (P, population - adults from the general population with or without COPD diagnosis; C, concept - DP; C, context - any setting). Two reviewers screened titles and abstracts, confirmed eligibility through full-text examination, extracted data using Redcap®, and assessed bias risk with the Newcastle Ottawa Scale.
RESULTS: We analyzed 24 studies with sample sizes ranging from 121 to 421,426 individuals aged 20 to 75. Eighty-three percent investigated the role of DP in the COPD etiology, while 16.7 % examined health-related COPD outcomes. Food frequency questionnaires predominated (75 %) in exploring 23 distinct DP. Sixty-seven percent employed a priori-defined DP, focusing on the Mediterranean Diet (MedDiet) and Healthy Eating Index (HEI), while 33.3 % utilized a posteriori-defined DP, mainly represented by the Prudent and Traditional DP. Sixty percent of the studies reported significant associations between DP and COPD risk/odds. However, studies examining DP and COPD patient outcomes produced varied results.
CONCLUSIONS: Most studies focused on assessing COPD risk using a priori-defined DP, particularly emphasizing the Med Diet and HEI. Overall, the studies found that healthy DPs are associated with reduced risk of COPD and improved outcomes in diagnosed patients.

BACKGROUND: Food intakes 1-2 years following bariatric surgery depend more on patients than the surgery\'s gastrointestinal tract changes. This study aimed to determine the major dietary patterns of patients after the first two years of sleeve gastrectomy and to investigate their associations with total weight loss (TWL) and the proportion of TWL as fat mass (FM) and fat-free mass (FFM) loss.
METHODS: This cross-sectional study included 146 patients undergoing sleeve gastrectomy 2-4 years after surgery. Dietary patterns were determined using principal component analysis based on the 19 food groups. The percentage of FM loss relative to TWL (%FML) and FFM loss relative to TWL (%FFML) were calculated. A suboptimal clinical response was defined as a TWL of less than 25%. High FM loss and excessive FFM loss were defined based on the highest tertiles. Linear and logistic regression models were used to derive unstandardized (B) coefficients and odds ratios (OR), with dietary pattern scores serving as both a continuous and a binary variable (higher vs. lower adherence groups based on median).
RESULTS: Two predominant dietary patterns were retained. Each 1-unit increase in the first dietary pattern score characterized by high intakes of fast foods, soft drinks, processed meats, sugar confectionary, salty snacks, grains, and organ meats was associated with higher %FFML (B = 1.99; 95% confidence interval (CI) 0.34, 3.66), lower %FML (B = - 1.84; 95% CI - 3.49, - 0.20), and higher odds of excessive FFM loss (OR = 1.84; 95% CI 1.09, 3.11). Participants with higher adherence to the first dietary pattern had lower %TWL, and greater odds of suboptimal clinical response and excessive FFM loss than those with lower adherence. Each 1-unit increase in score for the second dietary pattern characterized by a high intake of fruits, dairy, vegetables, legumes, eggs, nuts, red meats, poultry, and fish was associated with lower odds of suboptimal clinical response (OR = 0.51; 95% CI 0.31, 0.86).
CONCLUSIONS: Patients should be encouraged to modify their diet by reducing the consumption of ultra-processed foods and increasing their intake of high-quality protein sources, fruits, and vegetables to achieve the best postoperative outcome.

Diet play an important role in the development of cancer. A lot of research has been done on the role of individual nutrients or phytochemicals and cancer risk. Both harmful and beneficial associations of this nutrient have been observed with cancer. However, there is an interaction of individual dietary constituents to influence disease risk. On the other hand, examining the diet as a whole as is done in dietary patterns research may produce more accurate estimates and data that can be more easily translated into dietary recommendations. Dietary patterns and cancer research are becoming increasingly common in the epidemiology literature, and novel dietary patterns are being generated at a rapid pace. However, major issues remain over whether one general \"healthy\" dietary pattern can be suggested for cancer prevention or whether several diets should be advocated for different forms of cancer protection. It is challenging to study typical human diet in animal model that is appropriate for cancer prevention. Some dietary patterns, such as the ketogenic diet or macronutrient composition alteration, have been investigated more extensively in animal models than in humans in terms of cancer prevention, and bigger human observational studies are now needed to advise dietary guidelines. The question of whether to adapt nutritional guidelines to population subgroups based on susceptibility factors (for example, family history, sex, age, other lifestyle factors or comorbidities, metabolomics signatures, or microbiota-based profiles) is still open and will be crucial in moving the field forward.

We assessed the effects of consuming a U.S.-style healthy dietary pattern (HDP) with lean, unprocessed beef (BEEF) compared to a U.S.-style HDP without meat (vegetarian, VEG) on short-term changes in cardiometabolic disease (CMD) risk factors in adults classified as overweight or obese. Forty-one adults (22 females, 19 males; age 39.9 ± 8.0 y; BMI 29.6 ± 3.3 kg/m2; mean ± SD) completed two 5-week controlled feeding periods (randomized, crossover, controlled trial). For the BEEF HDP, two 3-oz (168-g) servings/d of lean, unprocessed beef were predominately substituted for some starchy vegetables and refined grains in the VEG HDP. Baseline and post-intervention measurements were fasting CMD risk factors, with serum low-density lipoprotein (LDL), total cholesterol (TC), and total apolipoprotein B as primary outcomes. VEG reduced LDL, insulin, and glucose compared to BEEF. Reductions did not differ between VEG vs. BEEF for TC, high-density lipoprotein (HDL), apolipoprotein A1, small, dense LDL IV, buoyant HDL2b, TC-to-HDL ratio, and systolic blood pressure. Total apolipoprotein B and all other CMD risk factors measured were not influenced by HDP type nor changed over time. Adopting a U.S.-style HDP that is either vegetarian or omnivorous with beef improved multiple cardiometabolic disease risk factors among adults classified as overweight or obese.

Neurodevelopmental disorders (NDDs), of which Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are two of the most common, are described as a group of conditions that begin in the developmental period and lead to deficits that impair functioning [...].

OBJECTIVE: This study aims to identify the association between adherence to healthy eating, using the Lebanese Mediterranean Diet Scale (LMDS), and cardiovascular risk factors in the Lebanese population.
METHODS: A cross-sectional study using a multistage cluster sample was conducted in Lebanon. Sociodemographic characteristics were collected through structured interviews and self-administered questionnaires. The LMDS assessed dietary habits. The associations between diabetes, dyslipidemia, and cardiovascular disease were investigated using stratification analysis.
RESULTS: The study included 2048 people (mean age: 41.54 ± 17.09 years). Higher adherence to the Mediterranean diet was associated with older age (Beta = 0.175, p < 0.001), being female (Beta = 0.085, p = 0.001), being married (Beta = 0.054, p = 0.047), participating in regular physical activity (Beta = 0.142, p < 0.001), and having cardiovascular disease (Beta = 0.115, p < 0.001) and diabetes (Beta = 0.055, p = 0.043). Adherence was, however, negatively associated with being a smoker (Beta = -0.083, p = 0.002), a previous smoker (Beta = -0.059, p = 0.026), and having higher distress levels (Beta = -0.079, p = 0.002). Stratification analysis by diabetes, dyslipidemia, and cardiovascular disease (CVD) consistently demonstrated these associations.
CONCLUSIONS: These findings suggest that demographic and health factors influence the Lebanese population\'s adherence to the Mediterranean diet. Older age, female gender, married status, physical activity, CVD, and diabetes were all found to be associated with adherence to the Mediterranean diet in the Lebanese population. In contrast, smoking and distress were inversely associated with it.

Objectives　Deficiency of zinc, an essential trace element in the body, adversely affects taste, wound healing, and immunity. This study aimed to identify the dietary patterns of male and female workers using factor analysis and clarify the relationship between dietary patterns and zinc intake.Methods　The participants were 395 municipal employees (193 men and 202 women) in Northern Kyushu aged 19-71 years. To obtain the dietary intake data, participants were asked to complete a lifestyle and health questionnaire and brief self-administered dietary history questionnaire. Zn intake was evaluated per 1,000 kcal (mg/1,000 kcal). The values were adjusted for energy using the density method, and multiple regression analysis was performed.Results　Three dietary patterns were identified for each participant. Among men, \"main and side dish type pattern\" characterized by higher intakes of potatoes, legumes, vegetables, seafood, meat, and low for cereals, \"snack type pattern\" characterized by higher intakes of sweets and coffee, and \"Mediterranean diet pattern\" characterized by higher intakes of bread, pasta, fruits, eggs, and milk, and low for miso soup and rice were identified. For women, a \"vegetarian diet type pattern\" characterized by higher intakes of beans, vegetables, mushrooms, and seaweed, \"main and side dish type pattern\" characterized by low intake of rice, and \"dinner-time drinking pattern\" characterized by higher intakes of alcoholic beverages were identified. Zinc intake was positively associated with the \"main and side dish type pattern\" and \"Mediterranean diet pattern\" in men and \"vegetarian diet\" and \"main and side dish type pattern\" in women. Additionally, zinc intake was negatively associated with the \"dinner-time drinking pattern\" among women.Conclusion　Despite adjusting for age, BMI, marriage, occupation, smoking habits, and exercise habits, the \"main and side dish type pattern\" and \"Mediterranean diet pattern\" were positively correlated with zinc intake in men and the \"vegetarian diet\" and \"main and side dish type pattern\" in women. The data suggest awareness of the dietary patterns that are conducive to ensuring zinc intake.

OBJECTIVE: Urban-rural inequities in health and mortality exist in Korea, a highly centralized developed country. The potential impact of multiple health-related lifestyle behaviors on mortality and difference between urban and rural areas is not fully understood. This study aimed to investigate the effect of high-risk health behaviors on all-cause mortality among residents living in urban and rural in Korea.
METHODS: Cross-sectional analyses were conducted on 8,298 adults aged 40 yrs and older from the Korea National Health and Nutrition Examination Survey 2013-2015. High-risk behaviors were defined as having poor diet quality, current smoking, high-risk drinking, or insufficient physical activity. Mortality status was linked to the Cause of Death data followed up to December 31, 2019. The associations between all-cause mortality and high-risk behaviors were evaluated using Cox proportional hazard regression models adjusted for age, sex, education, income, and survey year. Population attributable fractions (PAFs) were calculated, and effect modification analysis was conducted. Participants were stratified by residential area (urban or rural).
RESULTS: During the follow-up (median: 5.4 yrs), 313 deaths occurred. A higher proportion of rural residents than urban residents engaged in multiple high-risk behaviors (28.9% vs. 22.6%; P < 0.0001). As individual factors, a greater risk of mortality was associated with poor diet quality, current smoking, and inadequate physical activity, and these tendencies persisted in rural residents, especially for diet quality. Multiple high-risk behaviors were positively associated with a higher risk of mortality in Koreans living in urban and rural areas. PAF (95% confidence interval) was 18.5% (7.35-27.9%) and 29.8% (16.1-40.2%) in urban and rural residents, respectively. No additive or multiplicative effect of the region was observed.
CONCLUSIONS: The higher prevalence of multiple high-risk lifestyle behaviors in rural residents may explain the higher mortality in rural areas compared to urban areas. Comprehensive public health policies to improve health-related behaviors in rural populations may be needed.