First-Borns Carry a Higher Metabolic Risk in Early Adulthood: Evidence from a Prospective Cohort Study

Background: Birth order has been associated with early growth variability and subsequent increased adiposity, but the consequent effects of increased fat mass on metabolic risk during adulthood have not been assessed. We aimed to quantify the metabolic risk in young adulthood of being first-born relative to those born second or subsequently.Methodology and Principal Findings: Body composition and metabolic risk were assessed in 2,249 men, aged 17-19 years, from a birth cohort in southern Brazil. Metabolic risk was assessed using a composite z-score integrating standardized measurements of blood pressure, total cholesterol, high density lipoprotein, triglycerides and fat mass. First-borns had lower birth weight z-score (Delta = -0.25, 95%CI -0.35, -0.15, p<0.001) but showed greater weight gain during infancy (change in weight z-score from birth to 20 months: Delta = 0.39, 95%CI 0.28-0.50, P<0.0001) and had greater mean height (Delta = 1.2 cm, 95%CI: 0.7-1.6, p<0.0001) and weight (Delta = 0.34 kg, 95%CI: 0.13-0.55, p<0.002) at 43 months. This greater weight and height tracked into early adulthood, with first-borns being significantly taller, heavier and with significantly higher fat mass than later-borns. The metabolic risk z-score was significantly higher in first-borns.Conclusions/Significance: First-born status is associated with significantly elevated adiposity and metabolic risk in young adult men in Brazil. Our results, linking cardiovascular risk with life history variables, suggest that metabolic risk may be associated with the worldwide trend to smaller family size and it may interact with changes in behavioural or environmental risk factors

Carrot intake is consistently negatively associated with cancer incidence: A systematic review and meta-analysis of prospective observational studies

\ua9 2023 The Author(s). Published with license by Taylor &amp; Francis Group, LLC. Carrots are main dietary sources of several potential anti-cancer compounds, including polyacetylenes, while β-carotene has shown no benefits in controlled cancer trials. Accordingly, associations between carrot intake and cancer incidence were quantified, where necessary using α-carotene as a non-causal biomarker of carrot consumption, by searching for studies published before June 2022 reporting risk estimates for relationships of cancer incidence with carrot intake or α-carotene intake or α-carotene plasma concentration, supplemented with hand searches of included studies and reviews. Meta-analyses comparing highest and lowest reported intakes in prospective studies using a random-effects model estimated summary relative risks (RRs) with 95% confidence intervals (CIs), separately for carrot intake or α-carotene plasma concentration, and the corresponding dose-responses. Of 198 observational studies, in 50 prospective studies with 52000 cases recording carrot intake, the cancer-risk was substantially reduced (RR 0.90, 95% CI 0.87–0.94, p ˂ 0\ub700004). In 30 prospective studies with 9331 cases reporting plasma α-carotene levels, summary RR was 0.80 (0.72–0.89, p ˂ 0\ub700006). For both exposure types, inter-study heterogeneity was moderate, interaction with cancer types insignificant, and the dose-response significant (p ˂ 0\ub701). In conclusion, carrot consumption is robustly associated with decreased cancer-risk; carrot consumption should be encouraged, and the causal mechanisms further investigated

Association between worldwide dietary and lifestyle patterns with total cholesterol concentrations and DALYs for infectious and cardiovascular diseases: An ecological analysis

Global dietary and lifestyle trends are primary risk factors for communicable and non-communicable diseases. An ecological analysis was conducted to examine the association of global dietary and lifestyle patterns with total cholesterol concentrations. This study also investigated whether total cholesterol modified the association between dietary and lifestyle habits with disability-adjusted-life-years-lost (DALYs) for infectious and cardiovascular diseases (CVDs). Country-specific mean total cholesterol concentrations and DALYs for infectious and CVDs were obtained. Data were then matched to country-specific food and energy availability for consumption and information on obesity, physical inactivity, urbanization, gross domestic product (GDP), life expectancy and smoking. Stepwise multiple regression models were developed to identify significant predictors of total cholesterol concentrations and DALYs for infectious and CVDs. Life expectancy and egg and meat consumption were significantly associated with cholesterol concentrations. DALYs for infectious diseases were associated with smoking, life expectancy and per capita GDP. Smoking was the only predictor of DALYs for CVDs. The improvement of socio-demographic conditions and economic growth is likely to reduce the burden of communicable diseases in developing countries. A concurring increase in non-communicable diseases is expected, and these results have, yet again, identified smoking as a primary risk factor for CVDs

Association of the body adiposity index (BAI) with metabolic risk factors in young and older overweight and obese women.

PURPOSE: Body adiposity index (BAI) is a novel index for the assessment of percentage fat mass (FM%). We tested the association between BAI and metabolic outcomes in overweight and obese women of different ages. METHODS: 260 young women (24.7 ± 5.3 years, 31.0 ± 5.0 kg/m(2)) and 328 older women (66.9 ± 4.6 years, 34.8 ± 4.7 kg/m(2)) were recruited. BAI was calculated using hip circumference and height. Bioimpedance analysis was used to measure FM%. Metabolic risk was assessed using a composite z score integrating standardised measurements of fasting glucose, total cholesterol, liver enzymes and triglycerides. RESULTS: The association between BAI and FM% was modest in both young (r = 0.56, p < 0.001) and older (r = 0.49, p < 0.001) groups. BAI was directly associated with metabolic risk in young women (r = 0.29, p < 0.001), whereas it showed a weak, inverse association in the older group (r = -0.14, p = 0.01). CONCLUSIONS: BAI validity needs to be re-assessed in older individuals for better definition of its predictive accuracy

Dietary nitrate supplementation enhances short but not longer duration running time-trial performance

Purpose This study evaluated the effects of dietary nitrate (NO3-) supplementation on physiological functioning and exercise performance in trained runners/ triathletes conducting short and longer distance treadmill running time-trials (TT). Method Eight trained male runners or triathletes completed four exercise performance tests comprising a 10 minute warm up followed by either a 1500 m or 10,000 m treadmill TT. Exercise performance tests were preceded 3 hours before the exercise by supplementation with either 140 ml concentrated nitrate-rich (~ 12.5 mmol nitrate) (BRJ) or nitrate-deplete (~ 0.01 mmol nitrate) (PLA) beetroot juice. Results BRJ supplementation significantly elevated plasma [NO2-] (P 0.05). However, post-exercise blood [lactate] was significantly greater in BRJ following the 1500 m TT (6.6 ± 1.2 vs. 6.1 ± 1.5 mM; P 0.05). Performance in the 1500 m TT was significantly faster in BRJ versus PLA (319.6 ± 36.2 vs. 325.7 ± 38.8 s; P 0.05). Conclusion Acute BRJ supplementation significantly enhanced 1500 m but not 10,000 m TT performance. These findings suggest that BRJ might be ergogenic during shorter-distance TTs which allow for a high work rate, but not during longer-distance TTs, completed at a lower work rate

What are the risk factors for malnutrition in older-aged institutionalized adults?

Malnutrition is common in older adults and is associated with functional impairment, reduced quality of life, and increased morbidity and mortality. The aim of this study was to explore the association between health (including depression), physical functioning, disability and cognitive decline, and risk of malnutrition. Participants were recruited from nursing homes in Italy and completed a detailed multidimensional geriatric evaluation. All the data analyses were completed using Stata Version 15.1. The study included 246 participants with an age range of 50 to 102 (80.4 ± 10.5). The sample was characterised by a high degree of cognitive and functional impairment, disability, and poor health and nutritional status (according to Mini Nutritional Assessment (MNA), 38.2% were at risk for malnutrition and 19.5% were malnourished). Using a stepwise linear regression model, age (B = −0.043, SE = 0.016, p = 0.010), depression (B = −0.133, SE = 0.052, p = 0.011), disability (B = 0.517, SE = 0.068, p &lt; 0.001), and physical performance (B = −0.191, SE = 0.095, p = 0.045) remained significantly associated with the malnutrition risk in the final model (adjusted R-squared = 0.298). The logistic regression model incorporating age, depression, disability, and physical performance was found to have high discriminative accuracy (AUC = 0.747; 95%CI: 0.686 to 0.808) for predicting the risk of malnutrition. The results of the study confirm the need to assess nutritional status and to investigate the presence of risk factors associated with malnutrition in order to achieve effective prevention and plan a better intervention strategy

Dietary nitrate and population health: a narrative review of the translational potential of existing laboratory studies

BACKGROUND: Dietary inorganic nitrate (NO(3)(−)) is a polyatomic ion, which is present in large quantities in green leafy vegetables and beetroot, and has attracted considerable attention in recent years as a potential health-promoting dietary compound. Numerous small, well-controlled laboratory studies have reported beneficial health effects of inorganic NO(3)(−) consumption on blood pressure, endothelial function, cerebrovascular blood flow, cognitive function, and exercise performance. Translating the findings from small laboratory studies into ‘real-world’ applications requires careful consideration. MAIN BODY: This article provides a brief overview of the existing empirical evidence basis for the purported health-promoting effects of dietary NO(3)(−) consumption. Key areas for future research are then proposed to evaluate whether promising findings observed in small animal and human laboratory studies can effectively translate into clinically relevant improvements in population health. These proposals include: 1) conducting large-scale, longer duration trials with hard clinical endpoints (e.g. cardiovascular disease incidence); 2) exploring the feasibility and acceptability of different strategies to facilitate a prolonged increase in dietary NO(3)(−) intake; 3) exploitation of existing cohort studies to explore associations between NO(3)(−) intake and health outcomes, a research approach allowing larger samples sizes and longer duration follow up than is feasible in randomised controlled trials; 4) identifying factors which might account for individual differences in the response to inorganic NO(3)(−) (e.g. sex, genetics, habitual diet) and could assist with targeted/personalised nutritional interventions; 5) exploring the influence of oral health and medication on the therapeutic potential of NO(3)(−) supplementation; and 6) examining potential risk of adverse events with long term high- NO(3)(−) diets. CONCLUSION: The salutary effects of dietary NO(3)(−) are well established in small, well-controlled laboratory studies. Much less is known about the feasibility and efficacy of long-term dietary NO(3)(−) enrichment for promoting health, and the factors which might explain the variable responsiveness to dietary NO(3)(−) supplementation between individuals. Future research focussing on the translation of laboratory data will provide valuable insight into the potential applications of dietary NO(3)(−) supplementation to improve population health