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Edited by
Richard Pinder, Imperial College of Science, Technology and Medicine, London,Christopher-James Harvey, Imperial College of Science, Technology and Medicine, London,Ellen Fallows, British Society of Lifestyle Medicine
Health inequalities refer to unfair and avoidable differences in health across populations, influenced by factors such as socio-economic status and societal inequality. These disparities are evident in various health and social outcomes, including child mortality, obesity, and life expectancy. Lifestyle Medicine, which focuses on individual behaviours, acknowledges the need for multi-level action to address health inequalities effectively. Strategies to improve health equity must consider individual circumstances, providing support according to specific needs. For instance, addressing food insecurity, promoting physical activity, and ensuring good quality sleep are Public Health targets that can benefit both individuals and society. Interventions must be tailored to overcome barriers such as cost, availability of resources, and safe environments for positive health behaviours. Ultimately, tackling lifestyle-related health inequality requires a collaborative effort between Lifestyle Medicine and Public Health, aiming for upstream changes to social determinants and advocating for a more equal society
Although B vitamins have been shown to play beneficial roles in bone health, the effects of vitamin B1 in humans are still unclear. This study aimed to investigate the effects of vitamin B1 supplementation on middle-aged and older adults. This single-armed trial study included community-dwelling adults in Japan and used a pre- and post-test design. The participants were given 28.0 mg of vitamin B1 supplementation per day for 1 month in addition to their daily usual diet. The effect of this treatment on bone turnover markers and metabolism was evaluated at baseline and after 1 month. Forty-two participants were enrolled (mean age, 58.6 ± 10.4 years; 36 women). The vitamin B1 levels in whole blood increased significantly from baseline after vitamin B1 supplementation. The level of serum tartrate-resistant acid phosphatase 5b (TRACP 5b), a bone resorption marker, reduced significantly (378 ± 135 vs. 335 ± 120 mU/dL, p < 0.001), while the level of N-terminal propeptide of type I procollagen (P1NP), a marker specific to bone formation, did not change. Moreover, the serum phosphorus and parathyroid hormone (PTH) concentrations did not change, whereas the corrected serum calcium concentrations increased and vitamin D concentrations decreased. The serum TRACP 5b levels decreased after vitamin B1 supplementation in the middle-aged and older adults. Further definitive trials are needed to determine the efficacy of vitamin B1 in improving bone health.
The objective was to evaluate the influence of supplementation of L-arginine at 10g/kg on the performance of lactating sows and their litters by evaluating the milk amino acid composition, serum hormone levels, mammary tissue redox status indicators, mammary tissue histomorphology, and the expression of genes related to mammary gland metabolism. The study was conducted in the municipality of Oliveira, Minas Gerais, Brazil, in 2019. A total of 24 sows were selected. A completely randomized design was used in a 2 × 3 factorial arrangement, with two diets (control and 10g L-arginine/kg) and three mammary gland positions (thoracic, abdominal and inguinal), totaling six treatment groups. Each dietary treatment consisted of 12 replicates, with each replicate equivalent to one experimental unit, which was considered a sow and its litter. Females that were fed a diet supplemented with L-arginine had lower feed intake and greater weight loss. Piglets from sows that received L-arginine supplementation presented reduced weaning weight variation. L-arginine supplementation did not affect the amino acid composition of the milk, the plasma hormone levels of the sows, the oxidative stress parameters of redox, or breast tissue morphology. However, it may modulate the expression of genes important for mammary gland metabolism, such as the COX1 and SLC27A4. Piglets that suckled teats in the thoracic and abdominal positions had higher mean weights at 14 and 23 days, as well as greater daily weight gains. L-arginine supplementation to sows improves litter quality by increasing weaning weight uniformity; piglets that occupy the thoracic and abdominal positions perform better.
Schizophrenia is a chronic condition that requires long-term management. Quality of life is an important outcome measure for individuals diagnosed with schizophrenia; it can be tracked over time allowing evaluation of whether interventions lead to sustainable improvements. Nutrition and dietary interventions are an underutilized treatment for tackling the metabolic consequences of mental illness, which is now recognized as having increased importance in the management of schizophrenia. This study examines the impact of nutrition and dietary interventions on quality of life outcomes for those with schizophrenia.
Methods:
A systematic review of the literature was conducted, assessing the impact of nutritional interventions on quality of life outcomes in individuals with a diagnosis of schizophrenia.
Results:
A total of 982 articles were screened, of which nine articles met the inclusion criteria. Quality of life measures varied across studies, which made comparison across studies challenging. Previous studies had relatively small sample sizes and did not have long follow-up durations. Some of the studies found that dietary interventions such as counselling, weight management programs, food diaries and nutritional education improved quality of life, whereas others did not detect any effect.
Conclusions:
The review provides preliminary evidence that nutrition and dietary interventions may benefit quality of life among individuals with schizophrenia. There were however substantial limitations in studies highlighting the need for further research. The paper also highlights the need to standardize assessment tools for future quality-of-life research.
Australian children fall short of national dietary guidelines with only 63 % consuming adequate fruit and 10 % enough vegetables. Before school care operates as part of Out of School Hours Care (OSHC) services and provides opportunities to address poor dietary habits in children. The aim of this study was to describe the food and beverages provided in before school care and to explore how service-level factors influence food provision.
Design:
A cross-sectional study was conducted in OSHC services. Services had their before school care visited twice between March and June 2021. Direct observation was used to capture food and beverage provision and child and staff behaviour during breakfast. Interviews with staff collected information on service characteristics. Foods were categorised using the Australian Dietary Guidelines, and frequencies were calculated. Fisher’s exact test was used to compare food provision with service characteristics.
Setting:
The before school care of OSHC services in New South Wales, Australia.
Participants:
Twenty-five OSHC services.
Results:
Fruit was provided on 22 % (n 11) of days and vegetables on 12 % (n 6). Services with nutrition policies containing specific language on food provision (i.e. measurable) were more likely to provide fruit compared with those with policies using non-specific language (P= 0·027). Services that reported receiving training in healthy eating provided more vegetables than those who had not received training (P= 0·037).
Conclusions:
Before school care can be supported to improve food provision through staff professional development and advocating to regulatory bodies for increased specificity requirements in the nutrition policies of service providers.
Malnutrition is a relevant prognostic factor in cardiovascular disease. However, it has not been studied in adults with CHD and Fontan circulation.
Methods:
Retrospective, single-centre cohort study including all consecutive adults with Fontan circulation. Objectives: 1. To evaluate the prevalence of malnutrition, defined according to Controlling Nutritional Status score, which includes albumin, lymphocytes, and cholesterol and 2. To assess its utility as a prognostic marker.
Results:
We included 93 patients (55.9% male) with a mean age of 32.7 ± 8.3 years. After a median follow-up of 5.5 years (interquartile range 2.2 – 10.6), 14 patients met the combined primary outcome of death or heart transplant (15.1%). Moderate or severe malnutrition (Controlling Nutritional Status score ≥ 5) was detected in 18.3%. Overweight was found in 21.5% of patients, obesity in 4.3%, and low weight in 8.6%, with no significant differences in malnutrition parameters across weight categories. Patients with malnutrition had worse functional capacity (58.8% in New York Heart Association—NYHA-class III–IV, vs. 33.3% in patients without malnutrition, p = 0.05).
In univariate analysis, malnutrition was associated with a worse prognosis (death or heart transplant) with a hazard ratio of 3.7 (95% confidence interval 1.3 to 10.7, p = 0.01). In the adjusted model including cyanosis, functional class, and protein-losing enteropathy, malnutrition did not reach statistical significance (p = 0.81).
Conclusion:
Malnutrition as defined by Controlling Nutritional Status score is common in adults with Fontan circulation and represents a strong prognostic marker. Controlling Nutritional Status scale could be used in Fontan patients as a simple tool to identify a high-risk population.
Since the 1980s, research has linked environmental factors to adult-onset diseases. The DOHaD theory suggests that exposures during development can permanently affect organ function, predisposing individuals to adult diseases. Studies indicate that protein restriction or a high-fat diet (HFD) during this phase impacts adult metabolism since programmed dysfunctions may depend on changes established during puberty, such as the reproductive system. However, there are no studies on the impact of low-protein (LP) or HFD on male testicles during this phase. For this, Male Wistar rats were categorized into three dietary groups: LP (isocaloric low-protein pelletized); HFD; and Control (balanced commercial) until PND 60. This study was approved by the CEUA-UEM. On postnatal day 61, the animals were euthanized for histopathological, sperm count, and oxidative stress assessments in the testis and epididymis. Statistical analyses were conducted following established ethical principles in animal research. The research revealed significant alterations in daily sperm production and transit through the epididymis. Sperm morphology was affected in the experimental groups. Mitochondrial activity increased in the HFD group. Testicular and epididymal histopathology, seminiferous tubule diameter, and germinal epithelium height, as well as the number of Sertoli and Leydig cells, remained unchanged. Stereological analysis revealed tissue remodeling in the epididymis, particularly in the LP group. LP group showed an increase in lipid peroxidation in the oxidative damage test. In conclusion, low-protein and HFD during peripubertal age did not affect postnatal testicular development in rats. However, they impacted sperm quality, potentially affecting fertility and male reproductive system development.
This study aims to identify fathers’ profiles integrating food parenting practices (FPP) and physical activity parenting practices (PAPP).
Design:
We analysed cross-sectional data. The fathers completed the reduced FPP and PAPP item banks and socio-demographic and family dynamics (co-parenting and household responsibility) questionnaires. We identified fathers’ profiles via latent profile analysis. We explored the influence of social determinants, child characteristics and family dynamics on fathers’ profiles using multinomial logistic regression.
Setting:
Online survey in the USA.
Participants:
Fathers of 5–11-year-old children.
Results:
We analysed data from 606 fathers (age = 38 ± 8·0; Hispanic = 37·5 %). Most fathers self-identified as White (57·9 %) or Black/African American (17·7 %), overweight (41·1 %) or obese (34·8 %); attended college (70 %); earned > $47 000 (62·7 %); worked 40 hrs/week (63·4 %) and were biological fathers (90·1 %). Most children (boys = 55·5 %) were 5–8 years old (65·2 %). We identified five fathers’ profiles combining FPP and PAPP: (1) Engaged Supporter Father (n 94 (15·5 %)); (2) Leveled Father (n 160 (26·4 %)); (3) Autonomy-Focused Father (n 117 (19·3 %)); (4) Uninvolved Father (n 113 (18·6 %)) and (5) Control-Focused Father (n 122 (20·1 %)). We observed significant associations with race, ethnicity, child characteristics, co-parenting and household responsibility but not with education level, annual income or employment status. We observed significant pairwise differences between profiles in co-parenting and household responsibility, with the Engaged Supporter Father presenting higher scores in both measures.
Conclusions:
Understanding how fathers’ FPP and PAPP interact can enhance assessments for a comprehensive understanding of fathers’ influences on children’s health. Recognising the characteristics and differences among fathers’ profiles may enable tailored interventions, potentially improving children’s health trajectories.
In China, low levels of early childhood development (ECD) in rural areas may inhibit economic development as the nation attempts to transition from a middle-income manufacturing-based economy to a high-income innovation economy. This paper surveys the recent literature on ECD among children ages 0-3 years in rural China, including rates of developmental delays, causes of delays, and implications for the future of China's economy. Recent studies have found high rates of developmental delays among young children in rural China and point to poor nutrition and psychosocial stimulation as the primary causes. This review highlights the need for large-scale ECD interventions in rural China to raise human capital and support future economic growth.
Acquired chylothorax is an established complication of CHD surgery, affecting 2–9% of patients. CHD places a child at risk for failure to thrive, with subsequent chylothorax imposing additional risk.
Objective:
We conducted a retrospective chart review to ascertain quantitative markers of nutrition and growth in children affected by chylothorax following CHD surgery between 2018 and 2022 compared to controls.
Methods:
We utilised electronic medical record system, EPIC, at Children’s Hospital, New Orleans, targeting subjects < 18 years old who underwent CHD surgery between 2018 and 2022 and developed a subsequent chylothorax. Study subjects were identified using the 10th revision of the International Classification of Diseases codes (ICD-10 codes: J94.0, I89.8, and J90.0). Each chylothorax case (n = 20) was matched by procedure type and age to a control with no chylothorax (n = 20). Data were recorded in REDCap and analysed using SPSS.
Results:
After removal of outliers, we analysed 19 total matched pairs. There was no statistical difference in growth velocity (p = 0.12), weight change (operation to discharge) (p = 0.95), weight change (admission to discharge) (p = 0.35), Z-score change (operation to discharge) (p = 0.90), Z-score change (admission to discharge) (p = 0.21), serum protein (p = 0.88), or serum albumin (p = 0.82). Among cases, linear regression demonstrated no significant association between maximum chylous output and growth velocity (p = 0.91), weight change (operation to discharge) (p = 0.15), or weight change (admission to discharge) (p = 0.98).
Conclusions:
We did not observe statistically significant markers of growth or nutrition in children with chylothorax post-CHD surgery compared to those without chylothorax. Multisite data collection and analysis is required to better ascertain clinical impact and guide clinical practice.
The objective of this scoping review is to identify the cultural factors that influence the acceptance of food aid by those affected by disasters.
Methods
A literature review was conducted on articles published in Web of Science, Scopus, PubMed, Cochrane, and ScienceDirect databases until March 30, 2023, using keywords determined within the scope of the subject. This study follows the PICOS (participation, intervention, comparison, outcomes, study desings) and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Twelve articles that met the inclusion criteria were included in the findings.
Results
The study comprised 12 articles, of which 3 were cross-sectional, 5 were qualitative, 1 was descriptive, and 3 were mixed method studies. Thematic analysis identified 7 themes that emerged from the cultural factors/codes affecting nutrition activities in disasters: local and traditional food, socio-economic status, faith/religion, traditional practices and habits, cultural food beliefs and taboos, food sharing, and social organization.
Conclusions
A considerable body of research indicates that the selection of local and traditional foods is a key cultural factor influencing the efficacy of nutrition interventions and food assistance programs in the aftermath of disasters. It is therefore essential to take into account the identified cultural factors in order to ensure that the nutrition intervention is both accurate and efficient, and to enhance the acceptance of the population.
Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between diet quality indices and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n 257). A 147-item FFQ evaluated adherence to the Mediterranean diet score, the Dietary Approaches to Stop Hypertension score and the Plant-based Diet Index (PDI), including its original (oPDI), healthy (hPDI) and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol overconsumption, energy intake and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to Dietary Approaches to Stop Hypertension (OR = 3·75; 95 % CI 1·313, 10·700; P = 0·01) and hPDI (OR = 4·04; 95 % CI 1·251, 13·064; P = 0·02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0·25; 95 % CI 0·085, 0·716; P = 0·01). With further adjustment for BMI, a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3·46; 95 % CI 1·029, 11·656; P = 0·05). Dietary interventions and assessment should be introduced in the care pathway for psoriasis management.
Poor weight gain in infants with single ventricle cardiac physiology between stage 1 and stage 2 palliative surgeries is associated with worse outcomes. The growth of infants with single ventricle physiology, enrolled in home monitoring programmes in the United Kingdom, has not been widely described.
Aim:
To explore the growth of infants with single ventricle physiology supported by a home monitoring programme, at a tertiary centre in the South of England.
Methods:
A retrospective review of two cohorts, comparing weight gain amongst infants with single ventricle physiology, before and following the implementation of a home monitoring programme. Inclusion was dependent on a diagnosis compatible with single ventricle physiology during the interstage.
Results:
Enrolment into a home monitoring programme (cohort 2) was associated with 55% more infants being discharged home during the interstage period (p < 0.05). Interstage mortality did not differ between cohorts. There were no differences in interstage growth velocity between cohorts (cohort 1 23.98 ± 11.7 g/day and cohort 2 23.82 ± 8.3 g/day); however, infants in cohort 2 experienced less growth deceleration early in life, and achieved catch-up growth at 12-23 months. Interstage nasogastric feeding, regardless of the cohort, was associated with worse growth outcomes.
Conclusion:
A home monitoring programme for infants with single ventricle physiology provides the opportunity for infants to be safely discharged home to their families and cared for at home during the interstage. Infants in the home monitoring programme experienced better growth, achieving weight restoration at 12–23 months.
Psychosocial stimulation is one of the recommended interventions in the management of hospitalised children with severe acute malnutrition (SAM). However, there is currently limited scientific evidence supporting the effectiveness of the intervention. The study aimed to examine the effects of psychosocial stimulation on the development, nutrition, and treatment outcomes of hospitalised SAM children. A cluster-randomised controlled trial was conducted among health facilities that provide inpatient care for children with SAM in Silti Zone, Ethiopia. Fifty-eight children enrolled in the intervention facilities were provided stimulation intervention during their inpatient care and for 6 months after discharge. Sixty-eight children enrolled from control health facilities received routine inpatient care without stimulation and were followed for six months. Health education was provided to all caregivers on child health-related topics. Child development and nutrition outcomes were assessed four times using Denver II-Jimma and anthropometric measurements while the length of hospitalisation was used to measure treatment outcome. Children in the intervention group showed significantly better scores in Personal Social (p=0.001, effect size=0.77), Fine Motor (p=0.001, effect size=1.87), and Gross Motor (p=0.001, effect size=0.78) developmental domains from baseline to end line. Language domain however showed a significant difference only after discharge and intervention children scored better at six months (p<0.001, effect size=0.59). The intervention significantly improved treatment outcomes (p=0.010), but no significant changes in nutritional outcomes were documented. The findings highlighted the benefits of the intervention and the need to promote these interventions in health facilities within resource-limited settings.
Poor diets and food insecurity during adolescence can have long-lasting effects, and Métis youth may be at higher risk. This study, as part of the Food and Nutrition Security for Manitoba Youth study, examines dietary intakes, food behaviours and health indicators of Métis compared with non-Métis youth.
Design:
This observational cross-sectional study involved a cohort of adolescents who completed a self-administered web-based survey on demographics, dietary intake (24-h recall), food behaviours, food security and select health indicators.
Setting:
Manitoba, Canada
Participants:
Participants included 1587 Manitoba grade nine students, with 135 (8·5 %) self-identifying as Métis, a distinct Indigenous nation living in Canada.
Results:
Median intake of sugar was significantly higher in Métis (89·2 g) compared with non-Métis (76·3 g) participants. Percent energy intake of saturated fat was also significantly higher in Métis (12·4 %) than non-Métis (11·6 %) participants. Median intakes of grain products and meat and alternatives servings were significantly lower among Métis than non-Métis (6·0 v. 7·0 and 1·8 v. 2·0, respectively) participants. Intake of other foods was significantly higher in Métis (4·0) than non-Métis (3·0). Significantly more Métis participants were food insecure (33·1 %) compared with non-Métis participants (19·1 %). Significantly more Métis participants ate family dinners and breakfast less often than non-Métis participants and had lower self-reported health. Significantly more Métis participants had a BMI classified as obese compared with non-Métis participants (12·6 % v. 7·1 %).
Conclusions:
The dietary intakes observed in this study, both among Métis and non-Métis youth, are concerning. Many have dietary patterns that put them at risk for developing health issues in the future.
To examine power and governance arrangements in food and nutrition policy formulation and agenda-setting in South Africa
Design:
Analysis of the policy implementation environment and in-depth interviews were conducted focussing on: existing policy content and priorities across food system sectors; institutional structures for cross-sectoral and external stakeholder engagement; exercise of power in relation to food system policies; and opportunities to strengthen action on nutrition.
Setting:
South Africa
Participants:
Interviews were conducted with 48 key stakeholders involved in the food and nutrition policy sphere: government sectors relevant to food systems (n=21), the private sector (n=4), academia (n=10), NGOs (n=11) and farmers (n=2).
Results:
This study found that there are power dynamics involved in shaping the planning agenda that is inadvertently generating a food system that undermines the right to food. The concept of nutrition governance remains poorly defined and applied in different ways and usually based on a relatively narrow interpretation – therefore limiting policy coherence and coordination. South Africa has strong legal institutions and practices, and social policies that support public provisioning of food, but a non-interventionist approach to the food system.
Conclusions:
The right to food and nutrition, as outlined in the South African Constitution, has not yet been effectively utilized to establish a robust normative and legal basis for tackling the dual challenges of food insecurity and malnutrition. Currently, the governance of the food system is grappling with substantial obstacles, balancing the influence of powerful stakeholders who uphold the status quo against its responsibilities for food justice.
Religious and cultural health and food practices are informed and influenced by religious texts and beliefs. These beliefs and practices can impact dietary and food choices, which in turn can impact health. The Mediterranean dietary pattern, including regional variations of countries in Europe, North Africa, and the Middle East, is particularly aligned with Qur’anic guidance. The healthful dietary practices and health benefits conferred by specific foods mentioned in the Qur’an include and guide to components emphasized in the Mediterranean diet (MedDiet). This chapter examines Qur’anic guidance on food, nutrition, and dietary practices and, in particular, how this guidance relates to the traditional MedDiet. This information can be used to tailor acceptable and healthful dietary patterns for those in diverse Muslim communities. In addition, the health benefits of the traditional dietary patterns of Mediterranean countries, including the Middle East and North Africa, can and have been widely adopted globally for health interventions.
In Islam, the act of eating is considered a form of worship and adoration when performed as prescribed by Allah and Prophet Muhammad (PBUH). This chapter explores the recommendations related to eating and dietary practices as indicated in the Holy Qu’ran and Prophetic guidance. These recommendations emphasize promoting balanced, clean, nutritious, varied, and diverse food choices in addition to appropriate eating etiquettes. Comparing these Islamic recommendations with contemporary scientific findings from peer-reviewed studies lends itself towards how these recommendations could contribute to the overall quality of eating and well-being of Muslim communities. This chapter highlights how these conducts are valuable and could be congruently applied through faith-based health education programs to promote public health within the Islamic context.
The COVID-19 pandemic has presented multifaceted challenges globally, impacting adolescent health. Among these, food security and nutrition are intertwined closely with mental health outcomes. In Indonesia, with its diverse socio-economic landscape, these interconnections may have been exacerbated by the pandemic. This study investigated the relationship between food security, nutrition and adolescent mental health in Indonesia during COVID-19. Longitudinal data were collected from 511 adolescent boys and girls in 2021–2022 in Gunungkidul district, Yogyakarta. Food security was measured using the Household Food Insecurity Access Scale (HFIAS), and the validated Kessler-10 Psychological Distress Scale (K10) was used to measure adolescent depression. Multivariate linear regression and linear mixed-effects regression were employed to explore associations between these variables, while adjusting for sex, age, pubertal status and household income. Overall, food insecurity score was positively associated with depressive symptoms (β: 0·72, 95 % CI 0·52, 0·92), while BMI z-score was inversely associated (β: −0·31, 95 % CI 0·68, −0·03). We found an increase in strength of association between food insecurity and depressive symptoms over time (moderately food-insecure: β: 1·36 (95 % CI −0·10, 2·83) to 4·63 (95 % CI 2·17, 7·09); severely food-insecure: β: 1·89 (95 % CI 0·36, 3·41) to 3·30 (95 % CI 1·50, 5·10). Enhancing food access, improving nutritional status and providing mental health support are crucial components of adolescent health.
Although dietary factors have been examined as potential risk factors for liver cancer, the evidence is still inconclusive. Using a diet-wide association analysis, our research evaluated the associations of 126 foods and nutrients on the risk of liver cancer in a Chinese population. We obtained the diet consumption of 72,680 women in the Shanghai Women’s Health Study using baseline dietary questionnaires. The association between each food and nutrient and liver cancer risk was quantified by Cox regression model. A false discovery rate of 0.05 was used to determine the foods and nutrients which need to be verified. Totally 256 incident liver cancer cases were identified in 1,267,391 person-years during the follow-up duration. At the statistical significance level (P ≤ 0.05), higher intakes of cooked wheaten foods, pear, grape and copper were inversely associated with liver cancer risk, while spinach, leafy vegetables, eggplant and carrots showed the positive associations. After considering multiple comparisons, no dietary variable was associated with liver cancer risk. Similar findings were seen in the stratification, secondary and sensitivity analyses. Our findings observed no significant association between dietary factors and liver cancer risk after considering multiple comparisons in Chinese women. More evidence is needed to explore the associations between diet and female liver cancer occurrence.