BACKGROUND & AIMS: Biological age (BA) is the hypothetical underlying age of an organism and has been proposed as a more powerful predictor of health than chronological age (CA). The difference between BA and CA (Deltaage) reflects the rate of biological aging, with lower values indicating slowed-down aging. We sought to compare the relationship of four a priori-defined dietary patterns, including a traditional Mediterranean diet (MD) and three non-Mediterranean diets, with biological aging (Deltaage) among Italian adults. We also examined distinctive nutritional traits of these diets as potential mediators of such associations.
METHODS: Cross-sectional analysis on a sub-cohort of 4510 subjects (aged >/=35 y; 52.0% women) from the Moli-sani Study (enrolment, 2005-2010). Food intake was recorded by a 188-item semi-quantitative food-frequency questionnaire. A Mediterranean diet score (MDS) was used as exposure and compared with non-Mediterranean dietary patterns, i.e. DASH (Dietary Approaches to Stop Hypertension), Palaeolithic and the Nordic diets. A Deep Neural Network based on 36 blood biomarkers was used to compute BA and the resulting Deltaage (BA-CA), which was tested as outcome in multivariable linear regressions adjusted for clinical factors, lifestyles and sociodemographic factors.
RESULTS: In a multivariable-adjusted model, 1 standard deviation increase in the MDS was inversely associated with Deltaage (beta = -0.23; 95%CI -0.40, -0.07), and similar findings were observed with the DASH diet (beta = -0.17; 95%CI -0.33, -0.01). High dietary polyphenol content explained 29.8% (p = 0.04) and 65.8% (p = 0.02) of these associations, respectively, while other nutritional factors analysed (e.g. dietary fibre) were unlikely to be on the pathway. No significant associations were found with either the Palaeolithic or the Nordic diets.
CONCLUSIONS: Increasing adherence to either the traditional MD or the DASH diet was associated with delayed biological aging, possibly through their high polyphenol content.
Evidence on the impact of diet, alcohol, body-mass index (BMI), and physical activity on mortality due to cancer and other cancer-related outcomes is still scarce. Herein, we reviewed the contribution of the European Prospective Investigation into Cancer and Nutrition (EPIC) study to the current state of the art on the role of these factors in cancer mortality. We identified 45 studies using a rapid systematic review methodology.
Dietary factors associated with reduced cancer mortality included raw vegetable intake; dietary fiber intake; the Mediterranean diet; other dietary scores; other diet patterns including low meat eaters, vegetarians/vegans, or fish eaters; dietary intake (or biomarkers) of some vitamins (e.g., vitamin D, vitamin K2, or Vitamin C); and intake of lignans. Physical activity and following healthy lifestyle recommendations also reduced cancer mortality risk.
In contrast, dietary factors associated with higher cancer mortality risk included poor diet quality, consumption of alcohol and soft drinks including juice, and, to a lesser extent, intake of some fatty acids. Excess weight and obesity also increased the risk of cancer mortality. The EPIC study holds valuable information on diet and lifestyle factors and offers a unique opportunity to identify key diet-related factors for cancer mortality prevention.
This review aims at summarizing updated evidence on cardiovascular disease (CVD) risk associated with consumption of specific food items to substantiate dietary strategies for atherosclerosis prevention. A systematic search on PubMed was performed to identify meta-analyses of cohort studies and RCTs with CVD outcomes. The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods-whole grains, fruits, vegetables, legumes, and nuts-are linked with reduced atherosclerosis risk. The same applies for the replacement of butter and other animal/tropical fats with olive oil and other unsaturated-fat-rich oil. Although the literature reviewed overall endorses scientific society dietary recommendations, some relevant novelties emerge. With regard to meat, new evidence differentiates processed and red meat-both associated with increased CVD risk-from poultry, showing a neutral relationship with CVD for moderate intakes. Moreover, the preferential use of low-fat dairies in the healthy population is not supported by recent data, since both full-fat and low-fat dairies, in moderate amounts and in the context of a balanced diet, are not associated with increased CVD risk; furthermore, small quantities of cheese and regular yogurt consumption are even linked with a protective effect. Among other animal protein sources, moderate fish consumption is also supported by the latest evidence, although there might be sustainability concerns. New data endorse the replacement of most high glycemic index (GI) foods with both whole grain and low GI cereal foods. As for beverages, low consumption not only of alcohol, but also of coffee and tea is associated with a reduced atherosclerosis risk while soft drinks show a direct relationship with CVD risk. This review provides evidence-based support for promoting appropriate food choices for atherosclerosis prevention in the general population.
We assessed, for the first time, to what extent the composition of the gut microbiome might explain the cross-sectional association of habitual flavonoid and flavonoid-rich food intake with systolic and diastolic blood pressure (BP) in a community-based sample (N=904) from Northern Germany. Gut microbiome composition was sequenced from 16S ribosomal RNA genes. Higher total flavonoid intakes and specifically the polymer subclass were associated with lower systolic BP (SBP; β T3-T1: −2.9% [95% CI, −5.1 to −0.7], P=0.01 and −3.7% [95% CI, −5.4 to −1.0], P=0.01). In food-based analyses, a higher intake of berries (SBP, β Q4-Q1: −2.9% [95% CI, −5.2 to −0.6], P=0.01; pulse pressure, −5.5% [95% CI, −9.6 to −1.2], P=0.01) and red wine (SBP, β Q4-Q1: −2.6% [95% CI, −4.8 to −0.3], P=0.03; pulse pressure, −6.1% [95% CI, −10.1 to −2.0], P<0.01) were associated with lower SBP and pulse pressure. There were no associations with diastolic BP. In food-based analyses, higher intakes of anthocyanin-rich berries and red wine were associated with higher alpha diversity (β Q4-Q1: 0.03 [95% CI, 0.0–0.1], P=0.04 and 0.1 [95% CI, 0.03–0.1], P<0.01). Higher intakes of berries and apples/pears were associated with a lower abundance of Parabacteroides (β Q4-Q1: −0.2 [95% CI, −0.4 to −0.1], P<0.01, Q=0.07 and −0.3 [95% CI, −0.4 to −0.1], P< 0.01, Q=0.04). Structural equation modeling of these novel data suggests that microbial factors explained 15.2% to the association between flavonoid-rich foods and clinically relevant lower SBP. Further research should focus on interindividual variability in the gut microbiome in mediating the cardiovascular effects of flavonoid-rich foods.