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Background: Despite increasing evidence that has shown the association of ultra-processed foods (UPFs) with cancer risk, the results remain inconclusive. We, therefore, conducted the meta-analysis to clarify the association by including recently published studies. Methods: A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies from inception to January 2023. To pool data, fixed-effects or random-effects models were used where appropriate. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. Results: A total of 13 studies (4 cohort studies and 9 case-control studies) were included in the analysis, with a total of 625,738 participants. The highest UPFs consumption was associated with increased risk of colorectal cancer (OR = 1.23, 95% CI: 1.10-1.38), colon cancer (OR = 1.25, 95% CI: 1.14-1.36), and breast cancer (OR = 1.10, 95% CI: 1.00-1.20) but not rectal cancer (OR = 1.18, 95% CI: 0.97-1.43) and prostate cancer (OR = 1.03, 95% CI: 0.93-1.12). In addition, the subgroup analyses showed that a positive association between UPFs consumption and colorectal cancer was observed among men (OR = 1.31, 95% CI: 1.15-1.50), whereas no significant association was observed among women (OR = 1.10, 95% CI: 0.94-1.29). Conclusion: The present meta-analysis suggests that high UPFs consumption is associated with a significantly increased risk of certain site-specific cancers, especially the digestive tract and some hormone-related cancers. However, further rigorously designed prospective and experimental studies are needed to better understand causal pathways.
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BACKGROUND: Sarcopenia is a major public health problem. Depressive symptoms and dietary inflammatory potential play important roles in the development of sarcopenia. We aimed to disentangle the relationships between depressive symptoms, dietary inflammatory potential, and sarcopenia. METHODS: A total of 6,082 participants from the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Sarcopenia was defined according to the Foundation for the National Institutes for Health (FNIH) criteria. The Depressive symptoms were assessed using the nine-item Patient Health Questionnaire (PHQ-9). Dietary Inflammatory Index (DII) was calculated based on 24-h dietary recall interview. Two sets of mediation models were constructed separately. RESULTS: Depressive symptoms and DII were associated with sarcopenia, with odds ratios [ORs] (95% CIs) 2.54 (1.27, 5.13) and 1.17 (1.00, 1.37), respectively. DII score mediated the association of depressive symptoms with low muscle mass, explaining a total of 10.53% of the association (indirect effect = 0.004). Depressive symptoms had a significant mediating effects on the association between DII with low muscle mass, explaining a total of 12.50% of the association (indirect effect = 0.001). CONCLUSIONS: Our findings suggested that both depressive symptoms and dietary inflammatory potential had direct effects, and indirect effects on low muscle mass, handgrip strength, muscle mass, through each other. It provides important insights into integrated nutritional and psychological intervention strategies in preventing sarcopenia.
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Objective: We aimed to systematically evaluate the association between Dietary Inflammatory Index (DII) and mental health. Methods: We searched PubMed, Embase, and Web of Science from their inception to December 31, 2020. Categorical meta-analysis and dose-response meta-analysis were performed to evaluate the association between DII and mental health. Results: A total of 16 studies were included in this meta-analysis. Compared with the lowest DII category, the highest category was significantly associated with a variety of mental health outcomes, with the following pooled odds ratios (ORs) and 95% confidence intervals (95% CIs): 1.28 (1.17-1.39) for symptoms of depression, 1.27 (1.08-1.49) for symptoms of anxiety, 1.85 (1.43-2.40) for distress, and 4.27 (1.27-14.35) for schizophrenia. Furthermore, there was a linear dose-response relationship between DII and symptoms of depression in that a 1-unit increment in DII was associated with an increased risk of 6% for symptoms of depression (OR: 1.06, 95% CI: 1.03-1.19). Conclusion: The present study indicates that more pro-inflammatory diet, as estimated by the higher DII score, is associated with symptoms of mental disorder. It may be of clinical and public health significance regarding the development of novel nutritional psychiatry approaches to promote good mental health.
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OBJECTIVES: This study aimed to examine the bidirectional associations between handgrip strength and depressive symptoms in a nationally representative sample. DESIGN: Cohort study with a 4-year follow-up. SETTING AND PARTICIPANTS: A total of 13,208 participants from the China Health and Retirement Longitudinal Study were included in the analyses. METHODS: Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies-Depression Scale. Separate generalized estimating equations were used to analyze the cross-sectional and longitudinal associations between handgrip strength and depressive symptoms. Restricted cubic spline models were performed to explore the shape of the dose-response relationship. RESULTS: Decreased handgrip strength was related to subsequent increased risk of depressive symptoms, such that participants in the lowest quartile of handgrip strength were found to have an approximately 36% increased in their risk of depressive symptoms compared with those in the highest quartile [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.17, 1.58]. There was a linear dose-response relationship between handgrip strength and risk of depressive symptoms (Pnonlinearity = .25), in that a 5-unit increment in handgrip strength may lead to an 11% decrease in the risk of depressive symptoms (OR 0.89, 95% CI 0.85, 0.92). Conversely, depressive symptoms were prospectively associated with subsequent decreased handgrip strength (ß = -0.84, 95% CI -1.13, -0.55). An approximatively L-shaped dose-response pattern was found for the association between depressive symptoms level and handgrip strength (Pnonlinearity = .02). CONCLUSIONS AND IMPLICATIONS: The present study identified bidirectional associations between handgrip strength and depressive symptoms, and the associations were found to have a dose-response pattern. It provides important insights into integrated mental and physical health intervention strategies that simultaneously promote handgrip strength and depressive symptoms.
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Depression , Hand Strength , Cohort Studies , Cross-Sectional Studies , Depression/epidemiology , Humans , Longitudinal StudiesABSTRACT
BACKGROUND: Postoperative pancreatic fistula associated with mortality and morbidity remains an intractable problem after pancreaticoduodenectomy. To date it still carries a notable incidence of roughly 10% to 30% in large series in spite of numerous pharmacological and technical methods that have been proposed to achieve a leakproof pancreatic remnant. METHODS: In order to perform a safe anastomosis to pancreatic remnant with less sophisticated sutures and shorter operative duration, a fast and simple technique of end-to-end invaginated pancreaticojejunostomy with three overlapping U-sutures was devised in our institution. RESULTS: Between April 2011 and July 2013, end-to-end invaginated pancreaticojejunostomy with three overlapping U-sutures technique was used in 23 consecutive cases that underwent pancreaticoduodenectomy in our institute. The median operative time for pancreaticojejunostomy was 12 min. The incidence of pancreatic fistula was 8.7% (n = 2) and both cases were grade A fistula with no clinical impact or delayed hospital discharge. Neither relaparotomy nor postoperative mortality was observed. CONCLUSIONS: The technique of using three overlapping U-sutures in an end-to-end invaginated pancreaticojejunostomy represents a simple management of pancreaticoenteric anastomosis with reliability and applicability, and provides an alternative choice for pancreaticojejunostomy to senior pancreatic surgeons as well as those without experience.
