While the traditional Japanese diet has been suggested to increase blood pressure due to its high sodium content, whether the contemporary Japanese diet is associated with blood pressure remains elusive. We developed a traditional Japanese diet score (nine items: white rice, miso soup, soy products, vegetables, mushrooms, seaweeds, fish, salty food, and green tea) and a modified version by substituting white rice with whole-grain rice, reverse scoring for salty food and adding fruits, raw vegetables, and dairy foods using data from 12,213 employees from Japanese companies. Hypertension was defined as a blood pressure of 140/90 mmHg or more or the use of antihypertensive drugs. A multilevel Poisson regression model with a robust variance estimator was used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) while adjusting for covariates. The adjusted PRs (95%CIs) of hypertension for the lowest through highest quartiles of the traditional Japanese diet score were 1.00 (reference), 0.94 (0.88–1.02), 0.98 (0.90–1.06), and 0.96 (0.90–1.02), respectively (P for trend=0.29), while those for the modified Japanese diet score were 1.00 (reference), 0.96 (0.94–0.99), 0.95 (0.85–1.05), and 0.94 (0.87–1.01), respectively (P for trend=0.10). In this cross-sectional study, close adherence to the traditional Japanese diet was not associated with the prevalence of hypertension, whereas there was a suggestion of an inverse association between the modified Japanese diet and the prevalence of hypertension.

Inflammation and infections such as malaria affect concentrations of many micronutrient biomarkers, and hence estimates of nutritional status. We aimed to assess the relationship between malaria infection and micronutrient biomarker concentrations in pre-school children (PSC), school-age children (SAC) and women of reproductive age (WRA) in Malawi, and to examine the potential role of malaria immunity on the relationship between malaria and micronutrient biomarkers. Data from the 2015/2016 Malawi micronutrient survey were used. The associations between current or recent malaria infection, detected by rapid diagnostic test, and concentration of serum ferritin, soluble transferrin receptor (sTfR), zinc, serum folate, red blood cell (RBC) folate and vitamin B12, were estimated using multivariable linear regression. Factors related to malaria immunity including age, altitude and presence of hemoglobinopathies were examined as effect modifiers. Serum ferritin, sTfR and zinc were adjusted for inflammation using the BRINDA method. Malaria infection was associated with 68% (95% CI 51, 86), 28% (18,40) and 34% (13,45) greater inflammation-adjusted ferritin in PSC, SAC and WRA respectively (p<0.001 for each). In PSC, the positive association was stronger in younger children, in high altitude, and in children who were not carriers of the sickle cell trait. In PSC and SAC, sTfR was elevated (+ 25% (16, 29) and + 15% (9,22) respectively, p<0.001). Serum folate and RBC folate were elevated in WRA with malaria (+ 18% (3,35) and + 11% (1,23), p=0.01 and p=0.003 respectively). Malaria affects the interpretation of micronutrient biomarker concentrations and examining factors related to malaria immunity may be informative.

Thyroid disorders are increasingly prevalent globally and are considered metabolic-lifestyle diseases. While medications can manage thyroid dysfunction, they are usually lifelong, costly, and not always practical. Intermittent fasting (IF), a highly adaptable dietary regimen, has been shown to influence lifestyle, gut microbiome, and circadian rhythms. Our study hypothesized that IF, combined with vitamin supplementation, could reduce the risk of thyroid disorders due to their antioxidant effects. In this study, experimental animals were divided into five groups: Euthyroid, hypothyroidism control, IF + vitamin E, vitamin E, and IF. Hypothyroidism was induced using propylthiouracil (PTU) over 24 days, and IF and vitamin E (66 mg/ml) were administered based on the experimental group. The hypothyroid animals exhibited increased anxiety, weight gain, lipid peroxidation, and a significant reduction in thyroid hormone levels, locomotor activity, and antioxidant levels—clear signs of thyroid dysfunction’s impact on metabolism and overall health. Our proposed therapies IF and vitamin E effectively mitigated thyroid damage. Drawing inspiration from ancient Ayurveda and modern healthcare strategies, these cost-effective and practical regimens offer a promising solution to managing thyroid disorders globally.

Triceps skinfold thickness (TSF) is a surrogate marker of subcutaneous fat. Evidence is limited about the association of sex-specific TSF with the risk of all-cause mortality among maintenance hemodialysis (MHD) patients. We aimed to investigate the longitudinal relationship of TSF with all-cause mortality among MHD patients. A multicenter prospective cohort study was performed in 1034 patients undergoing MHD. The primary outcome was all-cause mortality. Multivariable Cox proportional hazards models were used to evaluate the association of TSF with the risk of mortality. The mean (standard deviation) age of the study population was 54.1 (15.1) years. 599 (57.9%) of the participants were male. The median (interquartile range) of TSF was 9.7 (6.3–13.3 mm) in males and 12.7 (10.0–18.0 mm) in females. Over a median follow up of 4.4 years (interquartile range, 2.4-7.9 years), there were 548 (53.0%) deaths. When TSF was assessed as sex-specific quartiles, compared with those in quartile 1, the adjusted HRs (95%CIs) of all-cause mortality in quartile 2, quartile 3 and quartile 4 were 0.93 (0.73, 1.19), 0.75 (0.58, 0.97) and 0.69 (0.52, 0.92), respectively (P for trend =0.005). Moreover, when analyzed by sex, increased TSF (≥9.7 mm for males and ≥18mm for females) was significantly associated with a reduced risk of all-cause mortality (quartile 3-4 vs. quartile 1-2; HR, 0.70; 95%CI: 0.55, 0.90 in males; quartile 4 vs. Quartile 1-3; HR, 0.69; 95%CI: 0.48, 1.00 in females). In conclusion, high TSF was significantly associated with lower risk of all-cause mortality in MHD patients.

Irritable bowel syndrome (IBS) is a common gut-brain interaction disorder. The etiology of IBS is not entirely elucidated, however, among the risk factors, dietary factors are regarded as crucial. Previous studies have primarily investigated the association of single nutrients and food groups with odds of IBS, rather than diet quality, which considers the interaction of food groups in odds of disease. Thus, the current study sought to investigate the association of dietary quality index-international (DQI-I) and odds of IBS in Iranian adults. In this case-control study, dietary intakes of 100 IBS cases and 310 healthy controls were examined using a validated Dish-based Semi-quantitative Food Frequency Questionnaire (DS-FFQ). DQI-I score was then calculated based and categorized into tertiles. The Persian version of the Rome IV questionnaire was utilized to assess IBS. Multivariable logistic regression was used to assess the association of DQI-I score and the odds of IBS. After controlling for potential confounders, no significant association was shown between DQI-I scores and IBS odds among whole and gender-stratified groups. Although DQI-I represents a healthy diet, the results of the current case-control study demonstrated that, a higher DQI-I score was not associated with reduced odds of IBS in fully adjusted regression models. Considering inherent limitations as well as the scarce evidence regarding the association between DQI-I and odds of IBS, further large-scale, prospective studies are required to confirm our findings.

This study aims to illustrate a process approach for the calculation of minimum dietary diversity (MDD) indicators for interpretation of dietary diversity (DD) scores and to validate the MDD indicator as a proxy for adequate micronutrient intake using an existing dataset for 2 to younger than 10-year-old South African children. The DD scores were derived from nine food groups, adjusted from the 10 food groups for women of reproductive age (MDD-W) by combining pulses, nuts and seeds. Three reference methods were used to inspect micronutrient adequacy, namely the mean adequacy ratio (MAR) and the mean probability of adequacy (MPA) using a single 24-hour recall, and the MPA derived from usual intake using more than one 24-hour recall in a sub-sample. Adequacy threshold levels and candidate MDD indicators were inspected and validated using several performance criteria. Results show that the mean and median DD scores were 3.6 and 3.1 respectively. The resulting MDD indicators varied between 3 and 4 out of 9 food groups favouring the identification of children with adequate and inadequate intake respectively, depending on the method used and the age group. Our results and those from others furthermore support a simplified method or ‘rule of thumb’ for the determination of an MDD indicator to establish the integer values below and above the median of the DD scores. We conclude that finding a valid MDD indicator can be done using different methodologies and that results underscore the potential of a simplified method for determining an MDD indicator.

Little is known about the association between iodine nutrition status and bone health. The present study aimed to explore the connection between iodine nutrition status, bone metabolism parameters, and bone disease (osteopenia and osteoporosis). A cross-sectional survey was conducted involving 391, 395, and 421 adults from iodine fortification areas (IFA), iodine adequate areas (IAA), and iodine excess areas (IEA) of China. Iodine nutrition status, bone metabolism parameters and BMD were measured. Our results showed that, in IEA, the urine iodine concentrations (UIC) and serum iodine concentrations (SIC) were significantly higher than in IAA. BMD and Ca2+ levels were significantly different under different iodine nutrition levels and the BMD were negatively correlated with UIC and SIC. Univariate linear regression showed that gender, age, BMI, menopausal status, smoking status, alcohol consumption, UIC, SIC, free thyroxine, TSH, and alkaline phosphatase were associated with BMD. The prevalence of osteopenia was significantly increased in IEA, UIC ≥ 300µg/L and SIC > 90µg/L groups. UIC ≥ 300µg/L and SIC > 90µg/L were risk factors for BMD T value < -1.0 SD. In conclusion, excess iodine can not only lead to changes in bone metabolism parameters and BMD, but is also a risk factor for osteopenia and osteoporosis.

This study aims to investigate the relationship between serum folate levels and the risk of psoriasis by integrating observational study with Mendelian Randomization (MR) analysis.We firstly conducted an observational study using data from the National Health and Nutrition Examination Survey (NHANES). Subsequently, genetic instruments were selected for two-sample MR analyses to investigate the causal relationship between serum folate levels and the risk of psoriasis. The observational study showed no significant association between serum folate levels and psoriasis. In the fully adjusted model: serum folate as a continuous variable (OR = 0.99, 95% CI: 0.98 to 1.00, P = 0.071); serum folate quartiles Q4 vs Q1 (OR = 0.83, 95% CI: 0.58 to 1.19, P = 0.309). The MR analysis revealed that higher genetically predicted serum folate levels from Icelandic and Danish populations was significantly associated with a reduced risk of psoriasis (OR = 0.63, 95% CI, 0.45 to 0.88, P = 0.005). Similarly, higher genetically predicted serum folate levels from South Asian populations were also significantly associated with a lower risk of psoriasis (OR = 0.84, 95% CI, 0.72 to 0.98, P = 0.025). Integrating observational study with MR analysis suggests that serum folate levels are protective factors against psoriasis, indicating that higher serum folate levels may help prevent the onset of the disease.

(Poly)phenols are plant-derived food bioactives abundantly present in human diet. They exert positive effects on various aspects of human health, and in particular in reducing the risk of chronic non-communicable diseases. Dietary (poly)phenols have been reported to improve vascular function, blood lipids, insulin sensitivity, and to decrease systemic inflammation. Evidence also suggests that (poly)phenols may exert protective effects on DNA, by reducing the extent of its damage. In recent years, advanced analytical methods, including transcriptomics, metabolomics, proteomics, and metagenomics, have been employed to unravel the complex impact of (poly)phenols in health and disease. Advances in bioinformatics enable an integrated multi-omics approach to data analysis, opening avenues for discovering new, previously unknown molecular mechanisms of action. Innovative solutions and automation of the Comet assay offer new opportunities for more in-depth analysis of the impact of (poly)phenols on DNA damage and its inclusion in integrative bioinformatic models. Such an approach has the potential to uncover new multi-level interactions and to reveal previously unknown factors underlying inter-individual variabilities in health-promoting effects of (poly)phenols. This review provides an insight into the application of the Comet assay in human intervention studies using (poly)phenol-rich dietary sources. Recent advancements in the Comet assay technology, and the prospects for more extensive use of this method in future human intervention studies with (poly)phenols could contribute to the development of personalized dietary recommendations for these plant-derived food bioactives.

Selenium is particularly necessary in infants because of their rapid physical growth period in addition to being indispensable for neurodevelopment. Severe deficiency can lead to cardiomyopathy, hypothyroidism and faltering growth. However, selenium can be toxic at high doses. In the pediatric age group, plasma/serum and erythrocyte selenium levels seem to increase with age, except in the first year of life. Understanding the variability in selenium status during this period can help to identify infants at risk of deficiency and develop strategies for controlling and preventing its consequences. This review aimed to identify the extent and characteristics of the variability of selenium status during the first year of life. A search was conducted across five databases to find articles published until July 30, 2024, with no limitations on the language or date of publication. Articles were screened, data were extracted independently by two reviewers, and any disagreement was resolved by a third reviewer. A total of 22 studies comprising 1288 participants were included in this review, 21 of which assessed plasma/serum selenium and 12 assessed erythrocyte selenium. In the first four months of age, serum/plasma selenium decreased, remained stable, or increased depending on feeding, with an increase in supplemented formula-fed infants and breastfed infants of supplemented mothers. Erythrocyte selenium levels showed a declining trend, except in infants fed supplemented formula or breastfed by supplemented mothers. Variability of serum/plasma and erythrocyte selenium levels in the first year was associated with maternal selenium intake/supplementation and the selenium content of the infant’s diet.

Dietary intervention is a key strategy for preventing and managing chronic kidney disease (CKD). However, evidence on specific foods’ effects on CKD is limited. This study aims to clarify the impact of various foods on CKD risk. We used two-sample Mendelian randomization (TSMR) to analyze the causal relationships between the intake of 18 foods (e.g., cheese, processed meat, poultry, beef, non-oily fish) and CKD risk, as well as eGFRcr and eGFRcys levels. The inverse variance weighting (IVW) method, weighted median method, MR-Egger regression, simple mode and weighted mode were employed. Sensitivity analysis included Cochran’s Q test and the Egger intercept test. Frequent alcohol intake was linked to higher CKD risk (P=0.007, 0.048). Protective factors included cheese (OR=0.71, [95%CI: 0.53, 0.94], P=0.017), tea (OR=0.66, [95%CI: 0.43, 1.00], P=0.048) and dried fruit (OR=0.78, [95%CI: 0.63, 0.98], P=0.033). Oily fish (β=0.051, [95%CI: 0.001, 0.102], p=0.046) and dried fruit (β=0.082, [95%CI: 0.016, 0.149], p=0.014) were associated with elevated eGFRcys. Salad/raw vegetables (β=0.024, [95%CI: 0.003, 0.045], p=0.028) and dried fruit (β=0.013, [95%CI: 0.001, 0.031], p=0.014) were linked to higher eGFRcr, while cereal intake (β=-0.021, [95%CI: -0.033, -0.010], p<0.001) was associated with lower eGFRcr. These findings provide insights for optimizing dietary strategies for CKD patients.

High-fat food intake is associated with atopic dermatitis (AD), but the role of habitual dietary habits related to the frequency of high-fat food intake remains unclear. To address this, we developed a frequency-based dietary index, Diet Quality based on Dietary Fat Score, to assess high-fat food intake and examined its association with AD in 13,561 young Chinese adults (mean age = 22.51 years, SD ± 5.90) from Singapore and Malaysia. Using an investigator-administered questionnaire aligned with the validated International Study of Asthma and Allergy in Childhood protocol, we conducted multivariable logistic regression adjusting for demographics, body mass index, genetic predisposition, and lifestyle factors, with false discovery rate correction for multiple comparisons. Frequent high-fat food intake was associated with higher odds of AD presentation (Adjusted Odds Ratios [AOR]: 1.525; 95% Confidence Intervals [CI]: 1.314-1.772; adjusted p < 0.001). The association remained significant regardless of total fat intake (AOR: 1.445; 95% CI: 1.054-1.801; adjusted p < 0.001) and among individuals with high fruit and vegetable intake (Adjusted Odds Ratios [AOR]: 1.489; 95% Confidence Intervals [CI]: 1.191-1.860; adjusted p < 0.001) or low energy intake (AOR: 1.399; 95% CI: 1.054-1.857; adjusted p < 0.05). No synergistic effects were observed between dietary factors. These findings highlight that frequent intake of high-fat foods is independently associated with AD, emphasizing the importance of dietary moderation in AD risk management.

Fine particulate matter (PM2.5) is a known risk factor for heart failure (HF), while plant-based dietary patterns may help reduce HF risk. This study examined the combined impact of PM2.5 exposure and a plant-based diet on HF incidence. A total of 190,092 participants from the UK Biobank were included in this study. HF cases were identified through linkage to the UK National Health Services register, with follow-up lasting until October 2022 in England, August 2022 in Scotland, and May 2022 in Wales. Annual mean PM2.5 concentration was obtained using a land use regression model, while the healthful plant-based diet index (hPDI) was calculated using the Oxford WebQ tool based on two or more 24-hour dietary assessments of 17 major food groups. Cox proportional hazard models assessed the associations of PM2.5 and hPDI with HF risk, and interactions were evaluated on additive and multiplicative scales. During a median of 13.4-year follow-up, 4,351 HF cases were recorded. Participants in the highest PM2.5 tertile had a 23% increased HF risk (HR: 1.23, 95% CI: 1.14–1.32) compared to those in the lowest tertile. Moderate or high hPDI was associated with reduced HF risk relative to low hPDI. The lowest HF risk was observed in individuals with high hPDI and low PM2.5 exposure, underscoring the protective role of a plant-based diet, particularly in areas with lower PM2.5 levels. A healthy plant-based diet may mitigate HF risk, especially in populations exposed to lower PM2.5 levels.

Research on the association between the Chinese visceral adiposity index (CVAI) and hyperuricemia (HUA) is scarce, and whether the association differs by sex is unclear. This research aimed to explore sex-specific associations between CVAI and HUA and to compare CVAI’s predictive performance with other adiposity indices using data from 22,171 adults (30–79 years) in the China Multi-Ethnic Cohort (CMEC) study (Chongqing region). The prevalence of HUA was 20.9% in men and 9.7% in women. Multivariable logistic regression analyses were utilized to assess the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). After multivariable adjustment, CVAI was associated with HUA in men (OR Q4 vs. Q1 = 3.31, 95% CI 2.73, 4.03) and women (OR Q4 vs. Q1 = 7.20, 95% CI 5.12, 10.12). Moreover, Significant interactions were observed between BMI and CVAI on HUA in both sexes (all Pinteraction <0.001), with the strongest associations in those with BMI <24.0 kg/m2. The ORs (95% CI) across different BMI groups (<24.0, 24.0–27.9, ≥28.0 kg/m²) were 1.87 (1.63, 2.13), 1.65 (1.48, 1.85), and 1.30 (1.14, 1.49) for men, and 2.76 (2.18, 3.51), 2.46 (1.98, 3.07), and 1.87 (1.47, 2.39) for women, respectively. Additionally, CVAI showed satisfactory predictive performance for HUA in women, with the largest area under the receiver operating characteristic curve (AUROC) of 0.735, but not in men (0.660). These findings suggest a close association between CVAI and HUA, particularly pronounced in those with BMI <24.0 kg/m², and a stronger association in women than in men.

Despite previous observational studies suggesting that malnutrition could be involved in venous thromboembolism (VTE), definitive causality still lacks in high-quality research evidence. This study aims to explore the genetic causal association between malnutrition and VTE. The study was performed using summary statistics from genome-wide association studies (GWAS) for VTE (cases =23,367; controls =430,366). Single nucleotide polymorphism (SNP) associated with exposure was selected based on quality control steps. The primary analysis employed the Inverse-variance weighted (IVW) method, with additional support from MR-Egger, weighted median, and weighted mode approaches. MR-Egger, leave-one-SNP-out analysis and MR-PRESSO was used for sensitivity analysis. Cochran’s Q test was used to assess heterogeneity between instrumental variables (IVs). IVW suggested that overweight have a positive genetic casual effect on VTE (OR=1.1344, 95% CI= 1.056-1.2186, p<0.001). No genetic casual effect of malnutrition (IVW: OR=0.9983, 95% CI= 0.9593-1.0388, p=0.9333) was found on VTE. Cochran’s Q test suggests no possible heterogeneity in both related exposures. The results of the MR-Egger regression suggest that the analysis is not affected by horizontal pleiotropy. The results of the MR-PRESSO suggest that there are no outliers. The results revealed a statistical genetical association where overweight correlate with an increased risk of VTE. Meanwhile, no genetical causal link was observed between malnutrition and VTE. Further research is warranted to deepen our understanding of these associations.

Inflammation and oxidative stress contribute to the progression of chronic diseases, and the volume of research in this area is rapidly expanding. Various dietary indices have been developed to determine the overall inflammatory or oxidative stress potential of a diet; however, few have been validated in cardiometabolic disease populations. This review aimed to explore the association between dietary indices and biomarkers of inflammation and oxidative stress in adults with cardiometabolic conditions. Four databases were systematically searched for literature in any language (Embase, CINAHL, CENTRAL, and MEDLINE) with 12,177 deduplicated records identified. Seventeen studies of adults with metabolic syndrome, cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease or chronic kidney disease were included. Fourteen studies were observational studies, one study was a clinical trial, and one was a randomised controlled trial. Four dietary indices were reported on with most studies (n=11) reporting on the dietary inflammatory index. The most reported biomarker was C-reactive protein. The findings were narratively synthesised. Results were inconclusive due to the heterogeneity of dietary indices and their use, disease states, and biomarkers reported. Only one study reporting on the dietary inflammatory index assessed all 45 parameters. Observational studies, particularly retrospective designs (n=7) are subject to recall and selection biases, potentially presenting overestimated results. Further research is required to determine the relationship between dietary indices and biomarkers of inflammation and oxidative stress in cardiometabolic disease populations. Future research should be rigorous, prospective, assess the full range of index parameters, and examine biomarkers the tool was developed for.

This study elucidated the impacts of coenzyme Q10 (COQ10) supplementation in a high-fat diet on growth, lipid metabolism, and mitochondrial function in spotted seabass (Lateolabrax maculatus). Totally five diets were formulated: a diet with normal fat content (11% lipid, NFD), a high-fat diet (17% lipid, HFD), and three additional diets by supplementing 5, 20 or 80 mg/kg of COQ10 to the HFD. After an 8-week culture period, samples were collected and analyzed. The results demonstrated that COQ10 inclusion prevented the HFD-induced deterioration of growth performance and feed utilization. COQ10 alleviated the deposition of saturated fatty acids following HFD intake and promoted the assimilation of n-3 and n-6 polyunsaturated fatty acids. Moreover, COQ10 administration inhibited the surge in serum transaminase activity and reduced hepatic lipid content following HFD ingestion, which was consistent with the results of oil red O staining. In addition, HFD feeding led to reduced hepatic citrate synthase and succinate dehydrogenase activities, and decreased ATP content. Notably, COQ10 administration improved these indices, and up-regulated the expression of mitochondrial biogenesis-related genes (pgc-1α, pgc-1β, nrf-1, tfam) and autophagy-related genes (pink1, mul1, atg5). In summary, supplementing 20-80 mg/kg of COQ10 in the HFD promoted growth performance, alleviated hepatic fat accumulation, and enhanced liver mitochondrial function in spotted seabass.

Evidence of an association between metabolic syndrome (MetS) and irritable bowel syndrome (IBS) is emerging but is still inconclusive. The current cross-sectional study was conducted to explore the relationship between the two syndromes in a sample of Lebanese adults (n=221; mean age: 43.36 years; 62.9% females), recruited from a large urban university and its neighboring community. MetS was diagnosed based on the International Diabetes Federation criteria, and IBS was assessed using the Birmingham IBS scale. Logistic regression analyses were performed taking MetS and its components as dependent variables, and IBS and its subscales as independent variables. Covariates included sociodemographic, dietary, and lifestyle variables. MetS was positively associated with Visual Analogue Scale (VAS)-IBS (total scale (Beta=4.59, p=0.029) and VAS-Diarrhea subscale (Beta=4.96, p=0.008). Elevated blood pressure (Beta=5.02, p=0.007), elevated fasting blood sugar (Beta=4.19, p=0.033), and elevated waist circumference (Beta=5.38, p=0.010) were positively associated with VAS- Diarrhea subscale. MetS and IBS were found to be positively associated in a sample of the Lebanese adult population. We suggest that it might be of value to screen for either condition if one of the syndromes exists. Future longitudinal studies are essential to establish a causal relationship between the two syndromes to further understand the commonality related to pathogenesis and explore potential underlying mechanisms.

The sulfur microbial diet (SMD), a dietary pattern associated with 43 sulfur-metabolizing bacteria, may influence gut microbiota composition and contribute to aging process through gut-produced hydrogen sulfide (H2S). We aimed to explore the association between SMD and biological age acceleration, using the cross-sectional study included 71,579 individuals from the UK Biobank. The SMD score was calculated by multiplying β-coefficients by corresponding serving sizes and summing them, based on dietary data collected using the Oxford WebQ, a 24-hour dietary assessment tool. Biological age (BA) was assessed using Klemerae-Doubal (KDM) and PhenoAge methods. The difference between BA and chronological age refers to the age acceleration (AgeAccel), termed “KDMAccel” and “PhenoAgeAccel”. Generalized linear regression was performed. Mediation analyses were used to investigate underlying mediators including body mass index (BMI) and serum aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio. Following adjustment for multiple variables, a positive association was observed between consuming a dietary pattern with a higher SMD score and both KDMAccel (βQ4vsQ1 = 0.35, 95%CI = 0.27 to 0.44, P<0.001) and PhenoAgeAccel (βQ4vsQ1 = 0.32, 95%CI = 0.23 to 0.41, P<0.001). Each 1-standard deviation increase in SMD score was positively associated with the acceleration of biological age by 7.90% for KDMAccel (P<0.001) and 7.80% for PhenoAgeAccel (P<0.001). BMI and AST/ALT mediated the association. The stratified analysis revealed stronger accelerated aging impacts in males and smokers. Our study indicated a higher SMD score is associated with elevated markers of biological aging, supporting the potential utility of gut microbiota-targeted dietary interventions in attenuating the aging process.

Dietary guidelines often combine plant and animal protein intake recommendations, yet some evidence suggests they may have distinct associations with diet quality and obesity. This study aimed to examine relationships between animal and plant protein intake, based on different protein classification approaches, and diet quality and obesity. Plant and animal protein contents of foods reported by 7637 adult participants aged ≥19 years during the 2011-12 Australian National Nutrition and Physical Activity Survey were estimated using Australian food composition databases. Usual animal, plant, and total protein intakes were estimated using Multiple Source Method. Diet quality was assessed using the 2013-Dietary Guidelines Index (DGI), and obesity measures included BMI and waist circumference (WC). Sex-stratified multiple linear and logistic regressions were performed and adjusted for potential confounders. Plant and animal protein intakes were positively associated with DGI scores [Plant protein: men, β=0.74(95%CI: 0.64, 0.85); women, β=0.78(0.67, 0.89); Animal protein: men, β=0.15(0.12, 0.18); women, β=0.26(0.22, 0.29)]. These associations were consistent when examining high-quality plant protein (i.e., high-protein-containing plant-based foods with comparable nutritional values to animal proteins) and non-dairy animal protein intakes. Plant protein intake was inversely associated with BMI and WC in men but not women. Animal protein intake was positively associated with BMI in men and women and WC in men only [β=0.04(0.02, 0.07)]. Plant protein intake was inversely associated with obesity [OR=0.97(0.96, 0.99)] and central obesity [OR=0.97(0.95, 0.98)] among men only. Further studies are needed to examine the influence of different animal protein sources by accounting for energy intake and sex-specific associations.