In this study, nine isonitrogenous experimental diets containing graded level of carbohydrates (40 g/kg, 80 g/kg and 120 g/kg) and crude lipid (80 g/kg, 120 g/kg, and 160 g/kg) were formulated in a two-factor (3×3) orthogonal design. 945 mandarin fish with similar body weight were randomly assigned into 27 tanks and the experiment diets were fed to triplicate tanks twice daily for 10 weeks. Results showed that different dietary treatments did not significantly affect survival rate and growth performance of mandarin fish. However, high dietary lipid and carbohydrate level significantly decreased the protein content of whole body and muscle of cultured fish. The lipid content of whole body, liver and muscle all significantly increased with increasing levels of dietary lipid, while only liver lipid level was significantly affected by dietary carbohydrate level. Hepatic glycogen content increased significantly with increasing dietary carbohydrate level. As to liver antioxidant capacity, malondialdehyde content increased significantly with increasing dietary lipid or carbohydrate content and catalase activity showed an opposite trend. Superoxide dismutase activity increased significantly with increasing levels of dietary lipid but decreased first and then increased with increasing dietary carbohydrate level. Additionally, the increase of both dietary lipid and carbohydrate levels resulted in a significant reduction in muscle hardness. Muscle chewiness, gumminess and shear force were only affected by dietary lipid levels and decreased significantly with increasing dietary lipid levels. In conclusion, considering all the results, the appropriate dietary lipids and carbohydrates level for mandarin fish were 120 g/kg and 80 g/kg, respectively.

Ultra-processed foods (UPF), defined using the Nova classification system, are associated with increased chronic disease risk. More recently, evidence suggests the UPF subgroup of whole-grain breads and cereals is in fact linked with reduced chronic disease risk. This study aimed to explore associations of cardiometabolic risk measures with Nova UPF intake versus when foods with ≥25% or ≥50% whole grain are excluded from the definition. We considered dietary data from the Australian National Nutrition and Physical Activity Survey (NNPAS) 2011-12. Impacts on associations of UPF intake (quintiles) and cardiometabolic risk measures were analysed using regression models. The median proportion of UPF intake from high whole-grain foods was zero for all quintiles. Participants in the highest Nova UPF intake quintile had significantly higher weight (78.1kg [0.6]), BMI (27.2kg/m2 [0.2]), waist circumference (92.7cm [0.5]), and weight-to-height ratio (0.55 [0.003]) compared to the lowest quintile (p<0.05). Associations were the same when foods with ≥25% and ≥50% whole grain were excluded. Adjusted R-squared values remained similar across all approaches for all outcomes. In Australia, high whole-grain foods considered UPF may not significantly contribute to deleterious cardiometabolic risk associations. Until conclusive evidence on Nova UPF is available, prioritisation should be given to the nutrient density of high whole-grain foods and their potential contribution to improving whole-grain intakes and healthful dietary patterns in Australia.

Reduced exposure to sweet taste has been proposed to reduce sweet food preferences and intakes, but the evidence to support these associations is limited. This randomised controlled trial investigated the effects of a whole-diet sweet taste intervention for 6 days, on subsequent pleasantness, desire for, and sweet food intakes. Participants (n 104) were randomised to increase (n 40), decrease (n 43), or make no change to (n 21) their consumption of sweet-tasting foods and beverages for six consecutive days. Pleasantness, desire to eat, sweet taste intensity and sweet food intakes were assessed on days 0 and 7. One-hundred-and-two (98%) participants completed the study, and self-reported adherence with the dietary interventions was moderate-good (M=66-72/100mm), with instructions to decrease sweet food consumption reported as more difficult than the other diets (smallest (t(81)=2.45, p=.02, Mdiff=14/100mm, SE=2mm). In intention-to-treat analyses, participants in the decrease sweet food consumption group reported higher sweet taste intensity perceptions at day 7 compared to day 0 (F(2,101)=4.10, p=.02, Mdiff=6/100mm, SE=2mm). No effects were found for pleasantness (F(2,101)=2.04, p=.14), desire to eat (F(2,101)=1.49, p=.23) or any of the measures of sweet food intake (largest F(2,101)=2.53, p=.09). These results were confirmed in regression analyses which took self-reported adherence to the diets into account. Our findings suggest that exposure to sweet taste does not affect pleasantness, desire for, or intakes of, sweet-tasting foods and beverages. Public health recommendations to limit the consumption of sweet-tasting foods and beverages to reduce sweet food preferences may require revision.

Although the energy stored in the lean tissue (LT) and adipose tissue (AT) is well known, the energy required to synthesize these tissues is obscure. Theoretically, the energy at the point at which ΔLT/Δ body weight (BW) reaches 100% on a regression line, which indicates the relationship between ΔLT/ΔBW and the energy required for BW gain, is considered to be the energy expended to synthesize LT. Therefore, we investigated this relationship in rats. Rats were fed diets with different ratios of protein, fat, and carbohydrates because their ΔLT/ΔBW values were expected to be different. Six-week-old male Sprague-Dawley rats had ad libitum access to normal (N, n = 6), high-fat (HF, n = 7), or high-protein (HP, n = 8) diets for 4 weeks. The ΔLT/ΔBW was 0.77 in the N group, 0.70 in the HF, and 0.87 in the HP groups, respectively. The average energy required to gain BW was 8.8 kJ/g in the N group, 7.0 kJ/g in the HF group, and 11.3 kJ/g in the HP group. We observed a positive correlation between ΔLT/ΔBW and energy required for BW gain. The regression line demonstrated that the energy expended to synthesize LT was 13.9 kJ/g and AT was -7.9 kJ/g. Therefore, combined with the energy stored in LT, the energy required to accumulate LT is approximately 19 kJ/g, whereas the energy to accumulate AT could not be elucidated.

The extent of de-novo biosynthesis of non-essential fatty acids (FAs) and the endogenous biosynthesis of long chain polyunsaturated FAs in human fetuses remains largely unknown. We used natural variations in the 13C:12C (δ 13C) of plasma phospholipids of the woman at delivery and of cord blood to infer fetal biosynthesis of FAs. We studied 39 mother-fetus pairs with uncomplicated pregnancies and term delivery. Eighteen women were supplemented with docosahexaenoic acid (DHA), from pregnancy week 20 until delivery, sourced from an algae (n=13) or fish oil (n=5), each with slightly different 13C content. Twenty-one women did not receive DHA supplementation. We measured the δ 13C value of selected phospholipid FAs (C16:0, C18:0, C18:1n-9, C18:2n-6, C20:4n-6, and C22:6n-3), in maternal and cord plasma samples at delivery using isotope ratio mass spectrometry.

We found significant linear correlations for δ 13C values of FAs between mothers and their fetuses (C16:0, r=0.8535; C18:0, r=0.9099; C18:1n-9, r=0.8079; C18:2n-6, r=0.9466; C20:4n-6, r=0.9257; and C22:6n-3, r=0.9706). Women supplemented with algal DHA had significantly lower DHA δ 13C values in their plasma phospholipids than those supplemented with fish DHA or those who did not receive DHA supplementation (p<0.001).

There was no significant difference in δ 13C values of FAs between women at delivery and their fetuses.

These findings strongly suggest that the human fetus is highly dependent on the placental transport of maternal plasma FAs, particularly DHA. The limited fetal biosynthesis of major FAs emphasizes the crucial role of maternal nutrition and placental well-being in fetal development.

We investigated the hypotheses that broilers and pigs have distinct starch digestion capacities, and that different cereals could trigger diet-species interactions. Ten replicates of 2 broilers (14-d-old) or 1 pig (50-d-old) each were distributed into a 3x2 randomized factorial design with 3 pelleted diets (maize, barley, or oat-based) and the 2 species. Nutritional composition was equal for both species. Diets were fed for 10 days, then pancreas and organs from the stomach region and small intestine were collected with contents. It was observed that both species were similarly efficient at digesting starch, but differed on some digestive aspects. Broilers had higher ileal digestibility coefficients (P < 0.001) of DM (0.69) and crude protein (0.75) than pigs (0.66 and 0.67), presented a higher volume of particles <0.1 mm in duodenal digesta (P < 0.001), and had a lower gizzard pH (3.68) than pig stomach (4.48; P < 0.05). Conversely, pigs had lower ileal viscosity (1.44 v. 2.77 cP; P < 0.05) and higher pancreatic lipase activity (27 v. 5.9 U/g of pancreas; P < 0.05) compared to broilers. In the jejunum, oat led to higher starch digestibility (0.96; P < 0.05) than maize and barley regardless of species. In the ileum, starch digestibility was higher for broilers fed oats (0.99) than broilers fed barley (0.94; P < 0.05), establishing that oats provided, in general, a superior starch availability. The results imply that starch utilization capacity is more related to its dietary source than to the species to which it is fed.

Tryptophan (Trp) is an essential amino acid acting as a key nutrition factor regulating animal growth and development. But how Trp modulates food intake in pigs is still not well known. Here, we investigated the effect of dietary supplementation of Trp with different levels on food intake of growing pigs. The data showed that dietary Trp supplementation with the standardized ileal digestibility (SID) Trp to Lysine (Lys) ratio at both 0.18 and 0.20 significantly increased the food intake by activating the expression of orexigenic gene agouti-related peptide (AgRP) and inhibiting the expression of anorexigenic gene pro-opiomelanocortin (POMC), cocaine- and amphetamine-regulated transcript (CART) and melanocortin receptor 4 (MC4R) in the hypothalamus. Meanwhile, the level of anorexigenic hormones appetite-regulating peptide YY (PYY) in the duodenum and serum, and Leptin receptor in the duodenum were also significantly decreased. Importantly, both the kynurenine and serotonin metabolic pathways were activated upon dietary Trp supplementation to downregulate MC4R expression in the hypothalamus. Further mechanistic studies revealed that the reduced MC4R expression activated the hypothalamic AMP-activated protein kinase (AMPK) pathway, which in turn inhibited the mTOR /S6K1 activity to stimulate food intake. Together, our study unravels the orexigenic effect of dietary Trp supplementation in pigs and expands its potential application in developing nutrition intervention strategy in pig production.

The aim of this study was to analyze the validity and reliability of the Turkish version of the Renal Inpatient Nutrition Screening Tool (Renal iNUT) for hemodialysis patients.

The Renal Inpatient Nutrition Screening Tool (Renal iNUT) and the Malnutrition Universal Screening Tool (MUST) were used in adult hemodialysis patients at two different centers to identify malnutrition. The Subjective Global Assessment (SGA), regarded as the gold standard for nutritional status assessment, was utilized for comparison. Structural validity was assessed using biochemical values and anthropometric measurements, while reliability was assessed using repeated the Renal iNUT assessment. Of the 260 patients admitted, 42.3% were malnourished (SGA score was B or C). According to the Renal iNUT, 59.6% of the patients were at increased risk for malnutrition (score ≥1) and 3.8% required referral to a dietitian (score ≥2). According to the MUST, 13.1% the of patients were at increased risk for malnutrition and 8.5% required referral to a dietician. The Renal iNUT was found to be more sensitive in detecting increased risk of malnutrition in hemodialysis patients compared with the MUST (59.6% versus 13.1%). According to the SGA, the sensitivity of the Renal iNUT is higher compared to the MUST (89% and 45%, respectively). Kappa-assessed reliability of the Renal iNUT was 0.48 (95% CI, 0.58-0.9) and a moderate concordance was observed. The Renal iNUT is a valid and reliable nutritional screening tool for evaluating hemodialysis patients to determine their nutritional status. The use of the Renal iNUT by dieticians will contribute to the identification of malnutrition and its treatment.

The effect of diminished ovarian reserves after undergoing hysterectomies with bilateral salpingectomies is one of the health concerns among reproductive-age women with benign gynecologic diseases. Coenzyme Q10 (CoQ10), an antioxidant, is crucial in mitochondrial energy production, improving oocyte quality and quantity. This study compares the benefit of a 14-day preoperative (CoQ10) versus placebo on ovarian reserve by measuring anti-mullerian hormone (AMH) in women undergoing hysterectomy with bilateral salpingectomy. A double-blinded, randomised, placebo-controlled trial was conducted. Forty-four women with benign gynecologic diseases were randomised to receive either oral CoQ10 300 mg per day or placebo for 14 days before undergoing hysterectomy with bilateral salpingectomy. Serum AMH levels were collected for analysis before taking CoQ10 and 6 weeks postoperatively in each group. The baseline demographic, clinical characteristics, and baseline AMH levels were comparable between the groups (1.47(0.45,2.49) vs.1.29 (0.47,2.11), p=0.763). The serum AMH levels after the surgery were significantly decreased from pre-operative levels (median 0.99 (0.37,1.63) vs 1.34 (0.57,2.30)), p= 0.001. However, there was no significant difference in the AMH change between the CoQ10 group and the placebo group (AMH per cent change -28.2% (64.09, -4.81) vs -20.07% (-61.51, -2.92)), p= 0.99, respectively. Age, gynecologic disease, operative time, and blood loss were not significantly associated with the AMH change. There were no significant side effects or adverse operative outcomes among coQ10 users. In conclusion, Hysterectomy with bilateral salpingectomy led to a significantly decreased AMH level. However, pretreatment with CoQ10 for two weeks was ineffective in protecting an ovarian reserve.

Prior observational studies have reported the potential protective effect of omega-3 fatty acids on the prognosis of acute pancreatitis. However, the causal impact of omega-3 fatty acids on acute pancreatitis is unclear. We aimed to investigate further the association of omega-3 fatty acids with acute pancreatitis. We performed a meta-analysis and Mendelian randomization (MR) to explore the association between omega-3 fatty acids and the prognosis of acute pancreatitis from clinical observation and genetics perspectives, respectively. 9 randomized controlled trials were included in this study. The result meta-analysis showed that complementary therapy of omega-3 fatty acids significantly decreased mortality (RR: 0.30; 95% CI 0.14 to 0.65, P＜0.05) and infectious complications in acute pancreatitis (RR: 0.45; 95% CI 0.27 to 0.77, P＜0.05). Compared to the control groups, the hospital stays (MD: -1.02; 95% CI -1.85 to -0.20, P＜0.05) in acute pancreatitis patients with omega-3 fatty acids treatment were statistically reduced. However, the ICU stay (MD: -0.49; 95% CI -1.29 to -0.31, P＞0.05) between control groups and acute pancreatitis patients with omega-3 fatty acids treatment was insignificant. Utilizing genetic susceptibility analysis in the Mendelian randomization (MR) approach, the MR showed omega-3 fatty acids have a significant causal effect on the acute pancreatitis risk (OR, 0.887; 95% CI, 0.797-0.986, P = 0.027, fixed-effect; OR, 0.887; 95% CI, 0.792-0.993, P = 0.037, random-effect). Omega-3 fatty acids complementary therapy may improve the prognosis of acute pancreatitis. Furthermore, genetically predicted serum levels of omega-3 fatty acids can significantly lower acute pancreatitis risk.

Rheumatoid arthritis (RA) is a prevalent autoimmune disease, and there is growing evidence suggesting a potential correlation between dietary factors and the pathogenesis of this condition. In order to investigate the causal relationship between diet and RA, we conducted a two-sample Mendelian randomization (MR) analysis to examine the causal associations between 22 dietary factors and RA. Summary data from genome-wide association studies (GWAS) of RA were obtained from large GWAS meta-analyses. GWAS summary data for 22 dietary factors were obtained from UK Biobank (UKB). Random-effects inverse variance weighted (IVW) was used as the primary method for assessing causality, and analyses of heterogeneity and horizontal pleiotropy were performed to ensure the accuracy of the results. Research indicates a negative genetic causal relationship between cereal intake (OR = 0.64, 95% CI: 0.41 - 0.99, P = 0.048) and oily fish intake (OR = 0.70, 95% CI: 0.52 - 0.95, P = 0.020) with the risk of RA. Other dietary factors were not causally related to RA. Sensitivity analysis shows that our results are reliable. This study provides genetic evidence suggesting that cereal intake and oily fish intake are protective factors for RA, indicating that RA patients and individuals at high risk should make appropriate dietary adjustments.

We investigated associations between ‘healthy dietary pattern’ scores, at ages 36, 43, 53 and 60-64 years, and body composition at age 60-64 among participants from the MRC National Survey of Health and Development (NSHD). Principal component analyses of dietary data (food diaries) at age 60-64 were used to calculate diet scores (healthy dietary pattern scores) at each age. Higher scores indicated healthier diets (higher consumption of fruit, vegetables and wholegrain bread). Linear regression was used to investigate associations between diet scores at each age and height-adjusted dual-energy x-ray absorptiometry-measured fat and lean mass measures at age 60-64. Analyses, adjusting for sex and other potential confounders (age, smoking history, physical activity and occupational class), were implemented among 692 men and women. At age 43, 53 and 60-64, higher diet scores were associated with lower fat mass index (FMI) and android: gynoid fat mass ratio; for example, in fully-adjusted analyses, a standard deviation (SD) increase in diet score at age 60-64 was associated with a difference in mean FMI of -0.18 SD (95% CI: -0.25, -0.10). In conditional analyses, higher diet scores at ages 43, 53 and 60-64 (than expected from diet scores at younger ages) were associated with lower FMI and android: gynoid fat mass ratio in fully-adjusted analyses. Diet scores at age 36 had weaker associations with the outcomes considered. No associations regarding appendicular lean mass index were robust after full adjustment. This suggests that improvements in diet through adulthood are linked to beneficial effects on adiposity in older age.

Dietitians working at evacuation shelters conduct weighed food records (WFRs) for multiple days for dietary assessment. Because the menus in evacuation shelters do not change much from day to day, this study examined whether one- and two-day WFRs are sufficient for dietary assessment at shelters and identified dietary components that can influence the number of assessment days. Overall, 26 WFRs were collected from 10 shelters in Kumamoto Prefecture, and the amounts of energy; protein; vitamins B1, B2 and C and salt were calculated. Correlation analysis and paired sample tests were conducted to examine significant differences between ‘one- and two-consecutive- or nonconsecutive-day WFRs’ and ‘three-consecutive-day WFRs’, which were set as the standard in this study. Additionally, the coefficients of variation (CV) for the categories by meal and dish were calculated to examine the variables that affected the large variations. As a result, one-day WFRs had significant positive correlations with the standard; thus, it could be used for the triage of shelters requiring nutrition assistance as a substitute for three-day WFRs. Two-consecutive-day and nonconsecutive-day WFRs showed a stronger correlation with the standard compared with the one-day WFRs. For energy and nutrients and dish categories, ready-to-eat foods had larger CV than boxed meals or foods from hot meal services. Whenever the meals included ready-to-eat foods, a two-nonconsecutive-day WFR is recommended considering large between-day variations. Salty soup or beverages affected the variation of some nutrients. Our result would help municipalities to consider the number of WFRs during emergency.

The scientific literature indicates that chokeberry is widely used as a supplement to support the maintenance of the body’s homeostasis by reducing inflammation and oxidative stress. In recent years, positive effects of chokeberry on intestinal parameters have also been observed. Oxidative stress, inflammation, and according to recent reports, also the gut microbiome are closely related to the overall well-being and health of the population. This study, therefore, attempts to summarize all the health benefits of black chokeberry supplementation. This study was registered in PROSPERO (International Prospective Register of Systematic Reviews) under registration number CRD42023395969. Additionally, the systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Electronic databases were searched in Web of Science, Pubmed, Scopus, and EBSCO using the following combination of the words “chokeberry or aronia” and “inflammation or oxidative stress or microbiota or microbiome or permeability or gut.” Ultimately, 57 studies were summarized in the review. Data analysis showed that black chokeberry has a positive effect on the reduction of inflammation, oxidative stress, and intestinal microflora, but the size of the changes varies and depends on many variables. Therefore, the researchers concluded that the compounds found in black chokeberry play a pivotal role in maintaining the overall balance within the system. This is a crucial consideration given the tendency for disturbances in organismal homeostasis to accompany disease processes and various disorders. However, further research is necessary to elucidate the mechanisms and optimize its use fully.

The aim of this randomized, controlled trial was to investigate effects of breakfast high or low in protein on body composition and cardiometabolic markers in young women with overweight. In total, 56 women aged 18-30 years consumed a breakfast containing either high-protein (HP, 34 g protein, n= 26) or low-protein (LP, 6 g protein, n=30) for 12 weeks. Measurements of body composition by DXA, waist circumference, glucose tolerance, and fasting glucose, insulin, and lipid profile were performed before and after this period. The primary outcome was fat mass. Satiety and hunger were evaluated by self-reported VAS-scores. Dietary intake was estimated by 4-day dietary records, and calcium intake was estimated by food frequency questionnaires. At baseline, relative daily protein intake was 15.2±2.8 E%, which increased to 19.3±3.4 E% in HP but was unchanged in LP (P<0.001 between groups). HP reported higher satiety compared to LP (P=0.02). Yet, no group differences were observed in changes in energy intake, body composition, blood lipid profile, or measures of glucose tolerance (all P>0.10). However, bone mineral content tended to increase in HP (P=0.05) and decrease in LP (P=0.07, interaction effect: P=0.01). Conclusively, a high versus low content of protein in breakfast increased satiety but did not affect body composition or cardiometabolic markers in young women with overweight. This study adds to the sparse evidence on effects of breakfast with different macro-nutrient compositions on health parameters in women with overweight. Registered at clinicaltrials.gov: NCT04518605.

Childhood and puberty can affect metabolism, leading to tissue injury and malfunction later in life. The consumption of high-processed foods rich in salt and sugar is increasing in middle- and high-income countries, especially among young people. It is necessary to evaluate the effects of high salt and sugar levels in the youth on most injured organs during metabolic challenges. We aimed to investigate whether high salt/sucrose intake affects whole-body development and leads to end-organ injury. Weaned Male Wistar rats were divided into two groups: a control group fed a standard diet (CO) and tap water, and an experimental group (SS) fed a standard diet and a beverage containing 1.8% NaCl and 20% sucrose instead of tap water. The animals were treated for 60 days, starting after weaning at 21 days of age, after which the animals were subjected to glucose and insulin tolerance tests, urine collection, and heart rate monitoring, and euthanized for sample collection at 81 days of age. SS showed reduced body weight gain and increased food intake of sodium/sucrose solution. Interestingly, high salt/sucrose intake led to increased body adiposity, liver lipid inclusion, heart rate, and renal dysfunction. SS exhibits increased levels of peroxisome proliferator-activated receptor alpha to counterbalance the hypertrophy of brown adipose tissue. Our findings reveal that the SS rat model exhibits non-obvious obesity with end-organ damage and preserved brown adipose tissue function. This model closely parallels human conditions with normal BMI but elevated visceral adiposity, providing a relevant tool for studying atypical metabolic disorders.

Emerging evidence has shown a strong correlation between serum triacylglycerol (TAG) levels, the inflammatory response, and Parkinson’s disease (PD) onset. However, the causal relationship between TAG levels and PD has not been well-established. We aimed to investigate the relationship between serum TAG levels and risk of PD and explore the potential mediating role of circulating immune cells and inflammatory proteins. We utilised genotype data from the GeneRISK cohort, and summary data from genome wide association studies investigating PD, circulating immune cells, inflammatory proteins, and plasma lipidomes. Using Mendelian randomization (MR) and multivariate MR (MVMR) analysis, we further adjusted for phosphatidylcholine (17:0_18:1) and triacylglycerol (58:7). Our results suggested a robust causal link between higher serum TAG (51:4) levels and a decreased risk of PD, with one standard deviation genetically instrumented higher serum TAG (51:4) level leading to a 21 percent [95% CI, 0.66 – 0.96] reduction in the risk of PD (p = 0.015). Additionally, the results of the mediation analysis suggested a possible role for mediation through circulating immune cells (including IgD-CD38-B cells and resting CD4 regulatory T cells), but not circulating inflammatory proteins, in the causal relationship between the plasma lipidomes and PD. Our study confirms a causal relationship between higher serum TAG (51:4) levels and a lower risk of PD and clarifies a possible role for mediation through circulating immune cells, but not inflammatory proteins. These findings indicate that serum triacylglycerol (51:4) regulates immunity to effectively lower the risk of PD.

Choline and its derivative betaine are important methyl donors, components of cell membrane phospholipids, or precursors of the neurotransmitter acetylcholine and the gut microbial metabolite trimethylamine-N-oxide. We aimed to investigate trends in dietary intake and food sources of total choline, individual choline forms, and betaine in Chinese adults using data from the China Health and Nutrition Survey (CHNS) 1991-2011. The sample was drawn from urban and rural communities in 12 provinces or autonomous regions with a multistage, random cluster design. Dietary intake was estimated using three consecutive 24-hour dietary recalls in combination with a household food inventory. Linear mixed-effect models were constructed to calculate adjusted mean intake values and 95% confidence intervals (CIs) using R version 4.2.2. A total of 11,188 men and 12,279 women aged 18 years or older were included. Between 1991 and 2011, total choline intake increased from 219.3 (95% CI: 215.1-223.4) mg/d to 269.0 (95% CI: 265.6-272.5) mg/d in men and from 195.6 (95% CI: 191.8-199.4) mg/d to 240.4 (95% CI: 237.4-243.5) mg/d in women (both P-trends <0.001). Phosphatidylcholine was the major form of dietary choline and its contribution to total choline increased from 46.9% in 1991 to 58.8% in 2011. Cereals were the primary food source of total choline before 2000 while eggs had ranked at the top since 2004. Dietary betaine intake was relatively steady over time with a range of 134.0-151.5 mg/d in men (P-trend <0.001) and 111.7-125.3 mg/d in women (P-trend >0.05). In conclusion, Chinese adults experienced a significant increase in dietary intake of choline, particularly phosphatidylcholine during 1991-2011 and animal-derived foods have replaced plant-based foods as the main food sources of choline. Betaine intake remained relatively stable over time. Future efforts should address the health effects of these changes.

This study aimed to explore the combined association between the dietary antioxidant quality score (DAQS) and leisure-time physical activity on sleep patterns in cancer survivors. Data of cancer survivors were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007-2014 in this cross-sectional study. Weighted multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of DAQS and leisure-time physical activity on sleep patterns. The combined association was also assessed in subgroups of participants based on age, and use of painkillers and antidepressants. Among the eligible participants, 1,133 had unhealthy sleep patterns. After adjusting for covariates, compared to low DAQS level combined with leisure-time physical activity level <600 MET·min/week, high DAQS level combined with leisure-time physical activity ≥600 MET·min/week was associated with lower odds of unhealthy sleep patterns (OR=0.41, 95%CI: 0.23-0.72). Additionally, the association of high DAQS level combined with high leisure-time physical activity with low odds of unhealthy sleep patterns was also significant in <65 years old (OR=0.30, 95%CI: 0.13-0.70), non-painkiller (OR=0.39, 95%CI: 0.22-0.71), non-antidepressant (OR=0.49, 95%CI: 0.26-0.91) and antidepressant (OR=0.11, 95%CI: 0.02-0.50) subgroups. DAQS and leisure-time physical activity had a combined association on sleep patterns in cancer survivors. However, the causal associations of dietary nutrient intake and physical activity with sleep patterns in cancer survivors needs further clarification.