Eating out intensity, ultra-processed foods and body mass index among Albanian youth.

OBJECTIVE Ultra-processed foods (UPFs) and eating out of home (OH) are changing nutrition, particularly among youth in constrained settings. We aimed to assess the role of eating OH intensity on the associations of UPFs and unprocessed/minimally processed foods (UMPFs) with body mass index (BMI) among Albanian youth. DESIGN Cross-sectional. SETTING Albania, a south-eastern European country. PARTICIPANTS 281 youth, predominantly females. METHODS UPFs and UMPFs were defined based on NOVA, while eating OH intensity based on energy percentage from OH foods. Multivariable models tested associations of UPFs and UMPFs with BMI stratified by eating OH intensity, controlled for relevant covariates including diet quality, portion size and costs. RESULTS The respondents age ranged between 18-23 years with a female predominance(87.5%). Mean energy from UPFs and UMPFs was 846(SD:573.0) and 802.9(422.5)kcals, respectively. Among substantial at home eaters UPF intake was not associated (β=-0.07,95%CI:-0.13;0.267) with BMI, however UMPFs negatively associated with BMI (β=-0.24,95%CI:-0.43;-0.06). Among those defined as substantial out of home eaters, UPFs (β=0.24, 95%CI:0.08;0.40) and UMPFs (β=0.18,95%CI:0.04;0.33) were positively associated with BMI. CONCLUSIONS Our findings provide evidence for the hypothesis that eating OH plays an important role in the association of UPFs and UMPFs with BMI in youth. While causality cannot be established due to cross-sectional design, to the best of our knowledge, we provide the first assessment of UPFs and UMPFs intake in a south-eastern European setting, while highlighting the need for establishing and integrating youth nutrition into national nutritional surveillance systems for key dietary risk factors in Albania

Methodological utility of chemerin as a novel biomarker of immunity and metabolism

Chemerin is a recently discovered adipokine with inflammatory and metabolic actions relevant for chronic disease development. However, evidence from human research on the role of chemerin in chronic disease risk is still lacking. We assessed the reliability of plasma chemerin concentrations measured on two occasions over a 4-month period in 207 apparently healthy participants. In addition, we explored the cross-sectional associations between chemerin and inflammatory biomarkers using Spearman partial correlation and multivariable linear regression analyses. Intra-individual reproducibility of chemerin measurements was assessed by calculating intraclass correlation coefficients (ICCs) and exploration of Bland–Altman plots. Reliability analyses revealed good reproducibility of chemerin measurements (ICC: 0.72 (95%-CI 0.65, 0.78)). Visual inspection of Bland–Altman plots confirmed that the two time point measurements had a high level of agreement. In correlation analyses, chemerin was positively correlated with adiposity measures (body mass index and waist circumference). In addition, independent of adiposity measures, chemerin was correlated with the biomarkers C-reactive protein, fatty acid-binding protein 4 and progranulin (Rho-s ranging from 0.23 to 0.37). In multivariable linear regression analysis, a combination of correlated factors including body mass index, waist circumference, C-reactive protein, progranulin and fatty acid- binding protein-4 explained 28.0% of chemerin concentrations. These findings demonstrate methodological utility of chemerin concentrations in population- based research setting. Human studies are highly warranted in order to provide further insights into the role of chemerin as a biomarker linking immunity and metabolism in relation to chronic disease risk

Diet and BMI Correlate with Metabolite Patterns Associated with Aggressive Prostate Cancer

Three metabolite patterns have previously shown prospective inverse associations with the risk of aggressive prostate cancer within the European Prospective Investigation into Cancer and Nutrition (EPIC). Here, we investigated dietary and lifestyle correlates of these three prostate cancer-related metabolite patterns, which included: 64 phosphatidylcholines and three hydroxysphingomyelins (Pattern 1), acylcarnitines C18:1 and C18:2, glutamate, ornithine, and taurine (Pattern 2), and 8 lysophosphatidylcholines (Pattern 3). In a two-stage cross-sectional discovery (n = 2524) and validation (n = 518) design containing 3042 men free of cancer in EPIC, we estimated the associations of 24 dietary and lifestyle variables with each pattern and the contributing individual metabolites. Associations statistically significant after both correction for multiple testing (False Discovery Rate = 0.05) in the discovery set and at p < 0.05 in the validation set were considered robust. Intakes of alcohol, total fish products, and its subsets total fish and lean fish were positively associated with Pattern 1. Body mass index (BMI) was positively associated with Pattern 2, which appeared to be driven by a strong positive BMI-glutamate association. Finally, both BMI and fatty fish were inversely associated with Pattern 3. In conclusion, these results indicate associations of fish and its subtypes, alcohol, and BMI with metabolite patterns that are inversely associated with risk of aggressive prostate cancer

Anti-cancer therapy is associated with long-term epigenomic changes in childhood cancer survivors

Childhood cancer survivors (CCS) exhibit significantly increased chronic diseases and premature death. Abnormalities in DNA methylation are associated with development of chronic diseases and reduced life expectancy. We investigated the hypothesis that anti-cancer treatments are associated with long-term DNA methylation changes that could be key drivers of adverse late health effects. Genome-wide DNA methylation was assessed using MethylationEPIC arrays in paired samples (before/after therapy) from 32 childhood cancer patients. Separately, methylation was determined in 32 samples from different adult CCS (mean 22-years post-diagnosis) and compared with cancer-free controls (n = 284). Widespread DNA methylation changes were identified post-treatment in childhood cancer patients, including 146 differentially methylated regions (DMRs), which were consistently altered in the 32 post-treatment samples. Analysis of adult CCS identified matching methylation changes at 107/146 of the DMRs, suggesting potential long-term retention of post-therapy changes. Adult survivors also exhibited epigenetic age acceleration, independent of DMR methylation. Furthermore, altered methylation at the DUSP6 DMR was significantly associated with early mortality, suggesting altered methylation may be prognostic for some late adverse health effects in CCS. These novel methylation changes could serve as biomarkers for assessing normal cell toxicity in ongoing treatments and predicting long-term health outcomes in CCS. [Abstract copyright: © 2022. The Author(s).

Eating out intensity, ultra-processed foods and BMI among Albanian youth

Abstract Objective: Ultra-processed foods (UPF) and eating out of home (OH) are changing nutrition, particularly among youth in constrained settings. We aimed to assess the role of eating OH intensity on the associations of UPF and unprocessed or minimally processed foods (UMPF) with BMI among Albanian youth. Design: Cross-sectional. Setting: Albania, a south-eastern European country. Participants: 281 youth, predominantly females. Methods: UPF and UMPF were defined based on NOVA, while eating OH intensity based on energy percentage from OH foods. Multivariable models tested associations of UPF and UMPF with BMI stratified by eating OH intensity, controlled for relevant covariates including diet quality, portion size and costs. Results: The respondents age ranged between 18 and 23 years with a female predominance (87·5 %). Mean energy from UPF and UMPF was 846 (sd: 573·0) and 802·9 (422·5) kcals, respectively. Among substantial at home eaters UPF intake was not associated (β = −0·07, 95 % CI (−0·13, 0·267)) with BMI; however, UMPF negatively associated with BMI (β = −0·24, 95 % CI (−0·43, −0·06)). Among those defined as substantial OH eaters, UPF (β = 0·24, 95 % CI (0·08, 0·40)) and UMPF (β = 0·18, 95 % CI (0·04, 0·33)) were positively associated with BMI. Conclusions: Our findings provide evidence for the hypothesis that eating OH plays an important role in the association of UPF and UMPF with BMI in youth. While causality cannot be established due to cross-sectional design, to the best of our knowledge, we provide the first assessment of UPF and UMPF intake in a south-eastern European setting, while highlighting the need for establishing and integrating youth nutrition into national nutritional surveillance systems for key dietary risk factors in Albania

Advanced glycation end-products, measured as skin autofluorescence, associate with vascular stiffness in diabetic, pre-diabetic and normoglycemic individuals: a cross-sectional study

BACKGROUND: Advanced glycation end-products are proteins that become glycated after contact with sugars and are implicated in endothelial dysfunction and arterial stiffening. We aimed to investigate the relationships between advanced glycation end-products, measured as skin autofluorescence, and vascular stiffness in various glycemic strata. METHODS: We performed a cross-sectional analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, comprising n = 3535 participants (median age 67 years, 60% women). Advanced glycation end-products were measured as skin autofluorescence with AGE-Reader™, vascular stiffness was measured as pulse wave velocity, augmentation index and ankle-brachial index with Vascular Explorer™. A subset of 1348 participants underwent an oral glucose tolerance test. Participants were sub-phenotyped into normoglycemic, prediabetes and diabetes groups. Associations between skin autofluorescence and various indices of vascular stiffness were assessed by multivariable regression analyses and were adjusted for age, sex, measures of adiposity and lifestyle, blood pressure, prevalent conditions, medication use and blood biomarkers. RESULTS: Skin autofluorescence associated with pulse wave velocity, augmentation index and ankle-brachial index, adjusted beta coefficients (95% CI) per unit skin autofluorescence increase: 0.38 (0.21; 0.55) for carotid-femoral pulse wave velocity, 0.25 (0.14; 0.37) for aortic pulse wave velocity, 1.00 (0.29; 1.70) for aortic augmentation index, 4.12 (2.24; 6.00) for brachial augmentation index and − 0.04 (− 0.05; − 0.02) for ankle-brachial index. The associations were strongest in men, younger individuals and were consistent across all glycemic strata: for carotid-femoral pulse wave velocity 0.36 (0.12; 0.60) in normoglycemic, 0.33 (− 0.01; 0.67) in prediabetes and 0.45 (0.09; 0.80) in diabetes groups; with similar estimates for aortic pulse wave velocity. Augmentation index was associated with skin autofluorescence only in normoglycemic and diabetes groups. Ankle-brachial index inversely associated with skin autofluorescence across all sex, age and glycemic strata. CONCLUSIONS: Our findings indicate that advanced glycation end-products measured as skin autofluorescence might be involved in vascular stiffening independent of age and other cardiometabolic risk factors not only in individuals with diabetes but also in normoglycemic and prediabetic conditions. Skin autofluorescence might prove as a rapid and non-invasive method for assessment of macrovascular disease progression across all glycemic strata

Plasma Lipidomic n-6 Polyunsaturated Fatty Acids and Type 2 Diabetes Risk in the EPIC-Potsdam Prospective Cohort Study

OBJECTIVE: Evidence on plasma n-6 polyunsaturated fatty acids (PUFAs) and type 2 diabetes risk is inconsistent. We examined the associations of lipid class–specific PUFA concentrations with type 2 diabetes risk. RESEARCH DESIGN AND METHODS: In the prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (nested case-cohort study: subcohort 1,084 participants, 536 participants with type 2 diabetes, median follow-up 6.5 years), we measured plasma 18:2, 20:3, and 20:4 concentrations in 12 lipid (sub)classes, likely reflecting the plasma concentrations of linoleic acid (18:2n-6), dihomo-γ-linolenic acid (20:3n-6), and arachidonic acid (20:4n-6). The Δ-5 desaturase (D5D) activity was estimated as the 20:4/20:3 ratio. Associations with diabetes were estimated with Cox proportional hazards models. RESULTS: Higher concentrations of 18:2 were inversely associated with type 2 diabetes risk, particularly in lysophosphatidylcholines (hazard ratio [HR] per 1 SD 0.53; 95% CI 0.23–1.26) and monoacylglycerols (HR 0.59; 0.38–0.92). Higher concentrations of 20:3 in phospholipid classes phosphatidylcholines (HR 1.63; 1.23–2.14), phosphatidylethanolamines (HR 1.87; 1.32–2.65), and phosphatidylinositol (HR 1.40; 1.05–1.87); free fatty acids (HR 1.44; 1.10–1.90); and cholesteryl esters (HR 1.47; 1.09–1.98) were linked to higher type 2 diabetes incidence, and these associations remained statistically significant after correction for multiple testing. Higher 20:4 concentrations were not associated with risk. The estimated D5D activity in phospholipids and cholesteryl esters was associated with lower type 2 diabetes risk. Single nucleotide polymorphisms in the D5D-encoding FADS genes explained relatively high proportions of variation of estimated D5D activity in those lipid classes. CONCLUSIONS: Plasma n-6 PUFAs were associated differently with type 2 diabetes, depending on fatty acid and the lipid class

Association of the odd-chain fatty acid content in lipid groups with type 2 diabetes risk: A targeted analysis of lipidomics data in the EPIC-Potsdam cohort

BACKGROUND: Plasma odd-chain saturated fatty acids (OCFA) are inversely associated with type 2 diabetes (T2D) risk and may serve as biomarkers for dairy fat intake. Their distribution across different lipid classes and consequences for diabetes risk remain unknown. AIM: To investigate the prospective associations of OCFA-containing lipid species with T2D risk and their dietary determinants. METHODS: Within the European Prospective Investigation into Cancer and Nutrition–Potsdam study (n = 27,548), we applied a nested case-cohort design (subcohort: n = 1,248; T2D cases: n = 820; median follow-up 6.5 years). OCFA-containing lipids included triacylglycerols, free fatty acids (FFA), cholesteryl esters (CE), phosphatidylcholines, phosphatidylethanolamines, lysophosphatidylcholines, lysophosphatidylethanolamines, monoacylglycerols, and diacylglycerols. We estimated lipid class-specific associations between OCFA-containing lipids and T2D in sex-stratified Cox proportional-hazards models. We investigated correlations between lipids and dietary intakes derived from food-frequency questionnaires. RESULTS: We observed heterogeneous integration of OCFA in different lipid classes: triacylglycerols, FFA, CE, and phosphatidylcholines contributed most to the total OCFA-plasma abundance. The relative concentration of OCFA was particularly high in monoacylglycerols, and the contribution of C15:0 versus C17:0 to the total OCFA-abundance differed across lipid classes. In women, several OCFA-containing phospholipids were inversely associated with T2D risk [phosphatidylcholine(C15:0), HR Q5 vs Q1: 0.56, 95% CI 0.32–0.97; phosphatidylcholine(C17:0), HR per SD: 0.59, 95% CI 0.48–0.71; lysophosphatidylcholine(C17:0), HR Q5 vs Q1: 0.42, 95% CI 0.23–0.76]. In men, we did not detect statistically significant inverse associations in phospholipids, and lysophosphatidylcholine(C15:0) was associated with higher T2D risk (HR Q5 vs. Q1: 1.96, 95% CI 1.06–3.63). Besides, CE(C17:0), monoacylglycerols(C15:0), and diacylglycerols(C15:0) were inversely associated with T2D risk; FFA(C17:0) was positively associated with T2D risk in women. Consumption of fat-rich dairy and fiber-rich foods were positively and red meat inversely correlated to OCFA-containing lipid plasma levels. CONCLUSIONS: OCFA-containing lipids are linked to T2D risk in a lipid class and sex-specific manner, and they are correlated with several foods

CHEMERIN AS A NOVEL BIOMARKER OF IMMUNITY AND METABOLISM: ASSESSMENT OF CROSS-SECTIONAL ASSOCIATIONS AND METHODOLOGICAL UTILITY

Introduction: The interplay of low-grade chronic inflammation and metabolism has recently gained much interest regarding its potential involvement in chronic disease development. Based on findings from mainly mechanistic studies the novel biomarker chemerin shows great potential in this regard. However, studies investigating chemerin in humans are scarce.Aim: The aim of our study was therefore to investigate chemerin in relation to adiposity and inflammation-related biomarkers. In addition, we assessed the reliability of chemerin measurements to enable future studies relying on single time-point measurements.Materials and Methods: The study comprised 207 apparently healthy participants (124 women and 83 men) which provided blood samples on two occasions over a 4-month period. Plasma chemerin concentrations were measured using sandwich ELISA.Results: At baseline, median chemerin concentration was 159 (IQR: 137 - 186) ng/mL. Age- and sex-adjusted Spearman correlation analyses revealed positive correlations of chemerin with body mass index (BMI) [Rho=0.35 (95%-CI: 0.22, 0.47)] and waist circumference [0.37 (0.24, 0.48)]. Chemerin was further correlated with C-reactive protein [0.26 (0.10, 0.41)], as well as the adipokines fatty acid-binding protein-4 [0.28 (0.12, 0.42)] and progranulin [0.23 (0.07, 0.38)], even after adjusting for body mass index. No correlation was observed with monocyte chemoattractant protein-1, omentin-1 and vaspin. In multivariable linear regression analysis, a combination of factors including body mass index, waist circumference, C-reactive protein, progranulin and fatty acid-binding protein-4 explained 28.0% of variance in chemerin concentrations. The intraclass correlation coefficient (ICC) as a measure of reliability suggested a good level of agreement of chemerin measurements over time [ICC: 0.72 (95%-CI 0.65, 0.78)].Conclusion: Overall, the results of our cross-sectional analyses highlighted the implication of chemerin as a biomarker linking immunity and metabolism. To investigate the relation of chemerin with chronic disease development, additional prospective studies are highly warranted

Plasma Industrial and Ruminant Trans Fatty Acids and Incident Type 2 Diabetes in the EPIC-Potsdam Cohort

OBJECTIVE: Although dietary intake of trans fatty acid (TFA) is a major public health concern because of the associated increase in the risk of cardiovascular events, it remains unclear whether TFAs also influence risk of type 2 diabetes (T2D) and whether industrial TFAs (iTFAs) and ruminant TFAs (rTFAs) exert the same effect on health. RESEARCH DESIGN AND METHODS: To investigate the relationship of 7 rTFAs and iTFAs, including 2 conjugated linoleic acids (CLAs), plasma phospholipid TFAs were measured in a case-cohort study nested within the European Prospective Investigation Into Cancer and Nutrition–Potsdam cohort. The analytical sample was a random subsample (n = 1,248) and incident cases of T2D (n = 801) over a median follow-up of 6.5 years. Using multivariable Cox regression models, we examined associations of TFAs with incident T2D. RESULTS: The TFA subtypes were intercorrelated with each other, with other fatty acids, and with different food sources. After controlling for other TFAs, the iTFAs (18:1n-6t, 18:1n-9t, 18:2n-6,9t) were not associated with diabetes risk. Some rTFA subtypes were inversely associated with diabetes risk: vaccenic acid (18:1n-7t; hazard ratio [HR] per SD 0.72; 95% CI 0.58–0.89) and t10c12-CLA (HR per SD 0.81; 95% CI 0.70–0.94), whereas c9t11-CLA was positively associated (HR per SD 1.39; 95% CI 1.19–1.62). Trans-palmitoleic acid (16:1n-7t) was not associated with diabetes risk when adjusting for the other TFAs (HR per SD 1.08; 95% CI 0.88–1.31). CONCLUSIONS: The TFAs’ conformation plays an essential role in their relationship to diabetes risk. rTFA subtypes may have opposing relationships to diabetes risk. Previous observations for reduced diabetes risk with higher levels of circulating trans-palmitoleic acid are likely due to confounding