Background: Greater red meat intake is associated with increased type 2 diabetes and cardiovascular disease risk (CVD). Recently, inclusion of lean red meat in a heart-healthy diet to reduce CVD risk was suggested based on short-term controlled feeding trial evidence, indicating that varying amounts of lean red meat intakes had similar effects on a lipid profile. However, the fat content of red meat may not be solely responsible for the adverse effects of red meat contributing to progression of metabolic abnormalities. Other components and mediating pathways including obesity-related inflammation and insulin resistance may be involved. We hypothesized that greater red meat intake would be associated with biomarkers of inflammation and glucose metabolism and that these potential associations would be partly explained by body mass index (BMI). Design: We analyzed data from diabetes-free female participants in the Nurses’ Health Study (n=3690). Multiple linear regression was conducted to assess the associations of total, unprocessed and processed red meat intakes (quartile categories) with plasma C-reactive protein (CRP), ferritin, adiponectin, fasting insulin, and hemoglobin A1c (HbA1c). The contribution of BMI on the associations between red meat intake and biomarkers was evaluated using publicly available SAS macro. The effect of substituting a serving of red meat with a serving of another major protein food source was estimated. Results: Greater total, unprocessed and processed red meat consumptions were associated with higher plasma CRP, ferritin, fasting insulin, and HbA1c and lower adiponectin after adjustment for demographic information (all p for trend ≤0.03). Adiponectin was not associated with any types of red meat intake when further adjusted for medical and lifestyle factors. After adjustment for BMI, most of these associations with inflammatory and glucose metabolic biomarkers were substantially attenuated and no longer significant. BMI accounted for a statistically significant proportion of associations with CRP, HbA1c, and fasting insulin (all p for contribution ≤0.02), but not with ferritin. Substituting a serving of total red meat intake with alternative protein food in a combination of poultry, fish, legumes and nuts was associated with significantly lower CRP (β±SE: -0.106±0.043), ferritin (-0.212±0.075), HbA1c (-0.052±0.015), and fasting insulin (-0.0119±0.036)(all p≤0.02 for comparing extreme quartiles). Conclusions: Greater red meat intake is associated with unfavorable plasma concentrations of inflammatory and glucose metabolic biomarkers in diabetes-free women. BMI accounts for a significant proportion of the associations with these biomarkers, except for ferritin. Substituting red meat with another protein food is associated with a healthier biomarker profile of inflammatory and glucose metabolism.

Abstract P407: Associations between Red Meat Intake and Biomarkers of Inflammation and Glucose Metabolism in Women

The aim of this study was to derive dietary patterns associated with cardio-metabolic traits and to examine whether these predict prospective changes in these traits and incidence of the metabolic syndrome (iMetS). Subjects from the Malmo Diet and Cancer Study cardiovascular cohort without cardio-metabolic disease and related drug treatments at baseline (n 4071; aged 45-67 years, 40 % men) were included. We applied reduced rank regression on thirty-eight foods to derive patterns that explain variation in response variables measured at baseline (waist circumference, TAG, HDL- and LDL-cholesterol, systolic and diastolic blood pressure, fasting glucose and insulin). Patterns were examined in relation to change in cardio-metabolic traits and iMetS in subjects who were re-examined after 16·7 years (n 2704). Two dietary patterns ('Western' and 'Drinker') were retained and explained 3·2 % of the variation in response variables. The 'Western' dietary pattern was inversely associated with HDL-cholesterol and positively with all other response variables (both at baseline and follow-up), but there was no association with LDL at follow-up. After adjustment for potential confounders, the 'Western' dietary pattern was associated with higher risk of iMetS (hazard ratio Q4 v. Q1: 1·47; 95 % CI 1·23, 1·77; P trend=1·5×10-5). The 'Drinker' dietary pattern primarily explained variation in HDL and was not associated with iMetS. In conclusion, this study supports current food-based dietary guidelines suggesting that a 'Western' dietary pattern with high intakes of sugar-sweetened beverages and red and processed meats and low intakes of wine, cheese, vegetables and high-fibre foods is associated with detrimental effects on cardio-metabolic health.

/pdf/a-western-dietary-pattern-is-prospectively-associated-with-2zekfdk7x3.pdf

A Western dietary pattern is prospectively associated with cardio-metabolic traits and incidence of the metabolic syndrome

Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutritional factors on the development and progression of this disease can be significant and is not yet well established. Calcium intake and vitamin D status are considered to be essential for bone metabolism homeostasis. However, some recent studies have questioned the usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate intake of protein, vegetables and other nutrients is also of interest, and recommendations have been established by expert consensus and clinical practice guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the effects of the main dietary patterns on bone health. Although some dietary patterns seem to have beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility.

https://www.mdpi.com/2072-6643/12/7/1986/pdf

Nutrients and Dietary Patterns Related to Osteoporosis.

The National Osteoporosis Guideline Group (NOGG) has revised the UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Accredited by NICE, this guideline is relevant for all healthcare professionals involved in osteoporosis management.The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013 and 2017. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older.Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence.Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment and intervention thresholds, management of vertebral fractures, non-pharmacological and pharmacological treatments, including duration and monitoring of anti-resorptive therapy, glucocorticoid-induced osteoporosis, and models of care for fracture prevention. Recommendations are made for training; service leads and commissioners of healthcare; and for review criteria for audit and quality improvement.The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals involved in its management. This position paper has been endorsed by the International Osteoporosis Foundation and by the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. 

/pdf/uk-clinical-guideline-for-the-prevention-and-treatment-of-13jm4c6s.pdf

UK clinical guideline for the prevention and treatment of osteoporosis

We aimed to fully review the association of empirical dietary patterns with the risk of non-communicable chronic diseases and to rate the quality of the evidence. Published meta-analyses of observational studies investigating the association of empirically derived dietary patterns with the risk of chronic diseases were identified by searching PubMed and Scopus till September 2019. Two independent reviewers extracted the information and rated the quality of the evidence by NutriGrade score. For each meta-analysis, cross-sectional and case–control studies were excluded and then summary relative risk was recalculated by using a random-effects model. Sixteen meta-analyses of prospective cohort studies, reporting eighteen SRR for healthy dietary patterns and sixteen SRR for unhealthy patterns obtained from 116 primary prospective cohort studies with 4·8 million participants, were included. There was moderate quality of evidence for the inverse association of healthy dietary patterns with the risk of type 2 diabetes (T2D), fracture and colorectal and breast cancers. There was also low-quality evidence for the inverse relation between healthy dietary patterns and the risk of all-cause and cardiovascular mortality, depression, CHD and respiratory diseases. There was moderate quality of evidence for a positive association between unhealthy dietary patterns and the risk of T2D, fracture and the metabolic syndrome. Adopting a healthy dietary pattern may reduce the risk of T2D, CHD and premature death. More research is needed for outcomes for which the quality of the evidence was rated low, such as respiratory disease, mental illness and site-specific cancers.

Healthy and unhealthy dietary patterns and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies.

Dietary Patterns in Relation to Low Bone Mineral Density and Fracture Risk: A Systematic Review and Meta-Analysis

Metabolic Syndrome (MetS) constitutes a relevant public health burden. Several studies have demonstrated the association between diet and MetS. We performed a systematic review and meta-analysis to provide an estimate of the association between dietary patterns defined through a posteriori methods and MetS. A literature search on PubMed, Web of Science, and Scopus databases, up to March 2019, was conducted to identify all eligible case-control, prospective, or cross-sectional studies involving adult subjects of both sexes. Random-effects models were used. Heterogeneity and publication bias were evaluated. Stratified analyses were conducted on study characteristics. Forty observational studies were included in the meta-analysis, which identified the “Healthy” and the “Meat/Western” dietary patterns. The “Healthy” pattern was associated with reduced MetS risk (OR = 0.85; 95% confidence interval (CI): 0.79–0.91) and significantly decreased the risk in both sexes and in Eastern countries, particularly in Asia. Adherence to the “Meat/Western” pattern increased MetS risk (OR = 1.19; 95% CI: 1.09–1.29) and the association persisted in the stratified analysis by geographic area (Asia, Europe, America) and study design. Lifestyle is linked to risk of developing MetS. The “Healthy” and “Meat/Western” patterns are significantly associated with reduced and increased MetS risk, respectively. Nutrition represents an important modifiable factor affecting MetS risk.

https://www.mdpi.com/2072-6643/11/9/2056/pdf

Dietary Patterns and Metabolic Syndrome in Adult Subjects: A Systematic Review and Meta-Analysis.

Human papillomavirus (HPV) and chlamydia trachomatis (Ct) infection lead to severe consequences for women’s health. This meta-analysis summarizes the evidence on HPV infection risk in women with chlamydia and chlamydia risk in HPV-positive women. Medline, Web of Science and Scopus were systematically searched for eligible publications until May 2018. Eligibility criteria included: assessment of HPV/Ct infection; cohort, case–control, cross-sectional study design; and reported risk estimation with its 95% CI for HPV infection in Ct-positive women and/or Ct infection in HPV-positive women. On the PRISMA guidelines, meta-analysis was performed using random effect model. Forty-eight studies met the eligibility criteria. Among women with chlamydia, the odds ratio (OR) of HPV infection is 2.12 (95% CI 1.80, 2.49) and the OR of high-risk HPV infection is 2.32 (95% CI 2.02, 2.65). The OR for chlamydia among HPV-positive women is 2.23 (95% CI 1.70, 2.92). HPV and Ct behave as reciprocal risk factors. In women diagnosed with HPV infection or chlamydia, the screening for the mutual infection could represent a preventive intervention for severe reproductive health outcomes, such as cervical cancer and infertility.

Association between human papillomavirus and chlamydia trachomatis infection risk in women: a systematic review and meta-analysis

BACKGROUND Many epidemiological studies have investigated the effect of maternal diet and prenatal multivitamin supplementation on pediatric cancer risk. Childhood brain and spinal cord tumors (CBSCT) have been attributed to different possible risk factors. METHODS We conducted a systematic review and meta-analysis on maternal folate intake before and during pregnancy and the risk of CBSCT. We systematically reviewed publications obtained by searching the Insitute for Scientific Information Web of Knowledge and PubMed literature databases. We extracted the risk estimate of the highest and the lowest reported categories of intake from each study and conducted a meta-analysis using a random-effects model. RESULTS The results of the pooled analysis of all 10 studies, 1 cohort and 9 case-control studies, indicated that maternal folate intake was inversely associated with CBSCT risk (OR 0.77; 95% CI 0.67-0.88, p < 0.001; I2 = 51.22%, p = 0.001). Separate analyses on the basis of the source of folate (folic acid supplementation, dietary folate) and in relation to the timing of exposure (before pregnancy, during pregnancy) found that folic acid supplementation was associated with an approximately 23% reduction in -CBSCT risk (OR 0.77, 95% CI 0.66-0.90, p = 0.001; I2 = 53.18%, p = 0.001) and consumption during pregnancy was associated with an approximately 20% reduction in CBSCT risk (OR 0.80, 95% CI 0.67-0.97, p = 0.020; I2 = 62.48%, p < 0·001). CONCLUSIONS Maternal consumption of folic acid is associated with a reduced risk of CBSCT. Further investigations are necessary to increase the reliability of the results and estimate the relationship between dose-response and the best outcome.

/pdf/maternal-folate-intake-and-risk-of-childhood-brain-and-4est5xjxml.pdf

Maternal Folate Intake and Risk of Childhood Brain and Spinal Cord Tumors: A Systematic Review and Meta-Analysis.

Summarize the in vivo evidences on the association between nutrition and osteoporosis fracture healing. Osteoporotic fractures constitute a considerable public health burden. The healing capacity of fractures is influenced by local factors related to the fracture and by general factors (e.g., age, sex, osteoporosis, muscular mass, smoking, alcohol, drugs, and diet). The systematic review was conducted according to PRISMA statement. From the literature search on PubMed and Web of Science, from January 2016 to October 2019, twelve studies were selected and resulted highly variable in samples, exposure, methods, outcomes, and outcome assessment. Eleven studies were conducted on laboratory animals. Only one study aimed to investigate the impact of nutritional status on fracture healing in osteoporotic patients. In this review, the role of calcium/vitamin D supplementation remained controversial, while sialoglycoprotein supplementation, phytoestrogen-rich herb extract, flavonoids, and phosphorylated peptides showed a positive effect on osteoporotic fracture healing.

Giulia Naldini

Papers

Dietary Patterns in Relation to Low Bone Mineral Density and Fracture Risk: A Systematic Review and Meta-Analysis

Dietary Patterns and Metabolic Syndrome in Adult Subjects: A Systematic Review and Meta-Analysis.

Association between human papillomavirus and chlamydia trachomatis infection risk in women: a systematic review and meta-analysis

Maternal Folate Intake and Risk of Childhood Brain and Spinal Cord Tumors: A Systematic Review and Meta-Analysis.

The Role of Diet in Osteoporotic Fracture Healing: a Systematic Review