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Association of Midlife #Diet With Subsequent Risk for #Dementia
https://jamanetwork.com/journals/jama/article-abstract/2727449
Alternate Healthy Eating Index (AHEI)
Observational studies suggest that diet is linked to cognitive health. However, the duration of follow-up in many studies is not sufficient to take into account the long preclinical phase of dementia, and the evidence from interventional studies is not conclusive.
Compared with the worst AHEI tertile in 1997-1999 (incidence rate for dementia, 2.06 [95% CI, 1.62 to 2.61] per 1000 person-years), the absolute rate difference for the intermediate AHEI tertile was 0.14 (95% CI, −0.58 to 0.86) per 1000 person-years and for the best AHEI tertile was 0.14 (95% CI, −0.58 to 0.85) per 1000 person-years. Compared with the worst AHEI tertile in 2002-2004 (incidence rate for dementia, 3.12 [95% CI, 2.49 to 3.92] per 1000 person-years), the absolute rate difference for the intermediate AHEI tertile was −0.61 (95% CI, −1.56 to 0.33) per 1000 person-years and for the best AHEI tertile was −0.73 (95% CI, −1.67 to 0.22) per 1000 person-years. In the multivariable analysis, the adjusted hazard ratios (HRs) for dementia per 1-SD (10-point) AHEI increment were not significant as assessed in 1991-1993 (adjusted HR, 0.97 [95% CI, 0.87 to 1.08]), in 1997-1999 (adjusted HR, 0.97 [95% CI, 0.83 to 1.12]), or in 2002-2004 (adjusted HR, 0.87 [95% CI, 0.75 to 1.00]).
Conclusions and Relevance In this long-term prospective cohort study, diet quality assessed during midlife was not significantly associated with subsequent risk for dementia.
Association of Midlife #Diet With Subsequent Risk for #Dementia
https://jamanetwork.com/journals/jama/article-abstract/2727449
Alternate Healthy Eating Index (AHEI)
Observational studies suggest that diet is linked to cognitive health. However, the duration of follow-up in many studies is not sufficient to take into account the long preclinical phase of dementia, and the evidence from interventional studies is not conclusive.
Compared with the worst AHEI tertile in 1997-1999 (incidence rate for dementia, 2.06 [95% CI, 1.62 to 2.61] per 1000 person-years), the absolute rate difference for the intermediate AHEI tertile was 0.14 (95% CI, −0.58 to 0.86) per 1000 person-years and for the best AHEI tertile was 0.14 (95% CI, −0.58 to 0.85) per 1000 person-years. Compared with the worst AHEI tertile in 2002-2004 (incidence rate for dementia, 3.12 [95% CI, 2.49 to 3.92] per 1000 person-years), the absolute rate difference for the intermediate AHEI tertile was −0.61 (95% CI, −1.56 to 0.33) per 1000 person-years and for the best AHEI tertile was −0.73 (95% CI, −1.67 to 0.22) per 1000 person-years. In the multivariable analysis, the adjusted hazard ratios (HRs) for dementia per 1-SD (10-point) AHEI increment were not significant as assessed in 1991-1993 (adjusted HR, 0.97 [95% CI, 0.87 to 1.08]), in 1997-1999 (adjusted HR, 0.97 [95% CI, 0.83 to 1.12]), or in 2002-2004 (adjusted HR, 0.87 [95% CI, 0.75 to 1.00]).
Conclusions and Relevance In this long-term prospective cohort study, diet quality assessed during midlife was not significantly associated with subsequent risk for dementia.
Jamanetwork
Association of Midlife Diet With Subsequent Risk for Dementia
This Whitehall II cohort study examines whether midlife diet assessed using the Alternate Healthy Eating Index, a food frequency questionnaire, is associated with subsequent risk for dementia in UK civil servants.
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Population Impact Attributable to Modifiable Risk Factors for #Hyperuricemia
#BMI, #alcohol intake, adherence to a DASH‐style #diet, and diuretic use were all associated with serum urate levels and the presence of hyperuricemia in a dose‐response manner. The corresponding PARs of hyperuricemia cases for overweight/obesity (prevalence, 60%), non‐adherence to a DASH‐style diet (prevalence, 82%), alcohol use (prevalence, 48%), and diuretic use (prevalence, 8%) were 44% (95% CI, 41 to 48%), 9% (3% to 16%), 8% (5% to 11%), and 12% (11% to 14%), respectively, whereas the corresponding variances explained were 8.9%, 0.1%, 0.5%, and 5.0%. Our simulation study showed the variance nearing zero with exposure prevalence's nearing 100%.
Conclusion
In these nationally representative US adults, four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of hyperuricemia cases. However, the corresponding serum urate variance explained by these risk factors was very small and paradoxically masked their high prevalences, providing real‐life empirical evidence for its limitations in assessing common risk factors.
https://onlinelibrary.wiley.com/doi/abs/10.1002/art.41067
Population Impact Attributable to Modifiable Risk Factors for #Hyperuricemia
#BMI, #alcohol intake, adherence to a DASH‐style #diet, and diuretic use were all associated with serum urate levels and the presence of hyperuricemia in a dose‐response manner. The corresponding PARs of hyperuricemia cases for overweight/obesity (prevalence, 60%), non‐adherence to a DASH‐style diet (prevalence, 82%), alcohol use (prevalence, 48%), and diuretic use (prevalence, 8%) were 44% (95% CI, 41 to 48%), 9% (3% to 16%), 8% (5% to 11%), and 12% (11% to 14%), respectively, whereas the corresponding variances explained were 8.9%, 0.1%, 0.5%, and 5.0%. Our simulation study showed the variance nearing zero with exposure prevalence's nearing 100%.
Conclusion
In these nationally representative US adults, four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of hyperuricemia cases. However, the corresponding serum urate variance explained by these risk factors was very small and paradoxically masked their high prevalences, providing real‐life empirical evidence for its limitations in assessing common risk factors.
https://onlinelibrary.wiley.com/doi/abs/10.1002/art.41067
Wiley Online Library
Population Impact Attributable to Modifiable Risk Factors for Hyperuricemia
Objective
To examine modifiable risk factors in relation to the presence of hyperuricemia and estimate the proportion of hyperuricemia cases that could be prevented through risk factor modification ...
To examine modifiable risk factors in relation to the presence of hyperuricemia and estimate the proportion of hyperuricemia cases that could be prevented through risk factor modification ...
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A brief #diet intervention can reduce symptoms of #depression in young adults – A randomised controlled trial
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression
No such RCTs have been performed in young adults. Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group).
..The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen’s d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen’s d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression.
The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222768
A brief #diet intervention can reduce symptoms of #depression in young adults – A randomised controlled trial
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression
No such RCTs have been performed in young adults. Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group).
..The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen’s d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen’s d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression.
The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222768
journals.plos.org
A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression. To date…
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A brief #diet intervention can reduce symptoms of #depression in young adults – A randomised controlled trial
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression.
Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group).
The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen’s d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen’s d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression. The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222768
A brief #diet intervention can reduce symptoms of #depression in young adults – A randomised controlled trial
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression.
Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group).
The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen’s d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen’s d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression. The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222768
journals.plos.org
A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression. To date…
#Diet modulates brain network stability, a biomarker for brain #aging, in young adults
https://2medical.news/2020/03/28/diet-modulates-brain-network-stability-a-biomarker-for-brain-aging-in-young-adults/
..One cohort was scanned under standard diet, overnight fasting, and ketogenic diet conditions. To isolate the impact of fuel type, an independent overnight fasted cohort was scanned before and after administration of a calorie-matched glucose and exogenous ketone ester (D-β-hydroxybutyrate) bolus. Across the life span, brain network destabilization correlated with decreased brain activity and cognitive acuity. Effects emerged at 47 y, with the most rapid …
https://2medical.news/2020/03/28/diet-modulates-brain-network-stability-a-biomarker-for-brain-aging-in-young-adults/
..One cohort was scanned under standard diet, overnight fasting, and ketogenic diet conditions. To isolate the impact of fuel type, an independent overnight fasted cohort was scanned before and after administration of a calorie-matched glucose and exogenous ketone ester (D-β-hydroxybutyrate) bolus. Across the life span, brain network destabilization correlated with decreased brain activity and cognitive acuity. Effects emerged at 47 y, with the most rapid …
Effects of #Diet versus Gastric #Bypass on Metabolic Function in Diabetes
https://2medical.news/2020/08/24/effects-of-diet-versus-gastric-bypass-on-metabolic-function-in-diabetes/
Some studies have suggested that in people with type 2 diabetes, Roux-en-Y gastric bypass has therapeutic effects on metabolic function that are independent of weight loss.. ..Weight loss was associated with increases in mean suppression of glucose production from baseline, by 7.04 μmol per kilogram of fat-free mass per minute (95% confidence interval [CI], 4.74 to 9.33) in the diet group and by 7.02 μmol …
https://2medical.news/2020/08/24/effects-of-diet-versus-gastric-bypass-on-metabolic-function-in-diabetes/
Some studies have suggested that in people with type 2 diabetes, Roux-en-Y gastric bypass has therapeutic effects on metabolic function that are independent of weight loss.. ..Weight loss was associated with increases in mean suppression of glucose production from baseline, by 7.04 μmol per kilogram of fat-free mass per minute (95% confidence interval [CI], 4.74 to 9.33) in the diet group and by 7.02 μmol …
U.S. #Diet Guidelines Sidestep Scientific Advice to Cut #Sugar and #Alcohol
https://2medical.news/2021/01/06/u-s-diet-guidelines-sidestep-scientific-advice-to-cut-sugar-and-alcohol/
..Evidence suggests that added sugars, particularly those in sweetened beverages, may contribute to obesity and weight gain, which are linked to higher rates of chronic health conditions like heart disease and Type 2 diabetes, the scientific panel noted. More than two-thirds of American adults are overweight or obese; obesity, diabetes and other related conditions also increase the risk of developing severe Covid-19 illness. The scientific …
https://2medical.news/2021/01/06/u-s-diet-guidelines-sidestep-scientific-advice-to-cut-sugar-and-alcohol/
..Evidence suggests that added sugars, particularly those in sweetened beverages, may contribute to obesity and weight gain, which are linked to higher rates of chronic health conditions like heart disease and Type 2 diabetes, the scientific panel noted. More than two-thirds of American adults are overweight or obese; obesity, diabetes and other related conditions also increase the risk of developing severe Covid-19 illness. The scientific …
#Microbiome connections with host metabolism and habitual #diet from 1,098 deeply phenotyped individuals
https://2medical.news/2021/01/22/microbiome-connections-with-host-metabolism-and-habitual-diet-from-1098-deeply-phenotyped-individuals/
The gut microbiome is shaped by diet and influences host metabolism; however, these links are complex and can be unique to each individual. We performed deep metagenomic sequencing of 1,203 gut microbiomes from 1,098 individuals enrolled in the Personalised Responses to Dietary Composition Trial (PREDICT 1) study, whose detailed long-term diet information, as well as hundreds of fasting and same-meal postprandial cardiometabolic blood marker measurements …
https://2medical.news/2021/01/22/microbiome-connections-with-host-metabolism-and-habitual-diet-from-1098-deeply-phenotyped-individuals/
The gut microbiome is shaped by diet and influences host metabolism; however, these links are complex and can be unique to each individual. We performed deep metagenomic sequencing of 1,203 gut microbiomes from 1,098 individuals enrolled in the Personalised Responses to Dietary Composition Trial (PREDICT 1) study, whose detailed long-term diet information, as well as hundreds of fasting and same-meal postprandial cardiometabolic blood marker measurements …
#Diet, Exercise, Lifestyle, and Mental #Distress among Young and Mature Men and Women: A Repeated Cross-Sectional Study
https://2medical.news/2021/03/07/diet-exercise-lifestyle-and-mental-distress-among-young-and-mature-men-and-women-a-repeated-cross-sectional-study/
Customization of mental health therapies needs to consider the differences in degree of brain maturity between young (18–29 years) and mature (30 years or older) adults as well as brain morphology among men and women. The aim of this study was to identify the significant dietary and lifestyle contributors to mental distress in these sub-populations. Independent repeated cross-sectional sampling was performed for over a 5-year …
https://2medical.news/2021/03/07/diet-exercise-lifestyle-and-mental-distress-among-young-and-mature-men-and-women-a-repeated-cross-sectional-study/
Customization of mental health therapies needs to consider the differences in degree of brain maturity between young (18–29 years) and mature (30 years or older) adults as well as brain morphology among men and women. The aim of this study was to identify the significant dietary and lifestyle contributors to mental distress in these sub-populations. Independent repeated cross-sectional sampling was performed for over a 5-year …
The gut #mycobiome of healthy mice is shaped by the environment and correlates with metabolic outcomes in response to #diet
https://2medical.news/2021/03/12/the-gut-mycobiome-of-healthy-mice-is-shaped-by-the-environment-and-correlates-with-metabolic-outcomes-in-response-to-diet/
As an active interface between the host and their diet, the gut microbiota influences host metabolic adaptation; however, the contributions of fungi have been overlooked. Here, we investigate whether variations in gut mycobiome abundance and composition correlate with key features of host metabolism. We obtained animals from four commercial sources in parallel to test if differing starting mycobiomes can shape host adaptation in response to …
https://2medical.news/2021/03/12/the-gut-mycobiome-of-healthy-mice-is-shaped-by-the-environment-and-correlates-with-metabolic-outcomes-in-response-to-diet/
As an active interface between the host and their diet, the gut microbiota influences host metabolic adaptation; however, the contributions of fungi have been overlooked. Here, we investigate whether variations in gut mycobiome abundance and composition correlate with key features of host metabolism. We obtained animals from four commercial sources in parallel to test if differing starting mycobiomes can shape host adaptation in response to …
Western-style #diet impedes colonization and clearance of #Citrobacter rodentium
https://2medical.news/2021/05/06/western-style-diet-impedes-colonization-and-clearance-of-citrobacter-rodentium/
https://2medical.news/2021/05/06/western-style-diet-impedes-colonization-and-clearance-of-citrobacter-rodentium/
2Medical.News
Western-style #diet impedes colonization and clearance of #Citrobacter rodentium
Western-style diet (WSD), which is high in fat and low in fiber, lacks nutrients to support gut microbiota. Consequently, WSD reduces microbiota density and promotes microbiota encroachment, potent…
Indices of #Diet Quality and Risk of Lung #Cancer in the Women’s Health Initiative Observational Study
https://2medical.news/2021/05/23/indices-of-diet-quality-and-risk-of-lung-cancer-in-the-womens-health-initiative-observational-study/
https://2medical.news/2021/05/23/indices-of-diet-quality-and-risk-of-lung-cancer-in-the-womens-health-initiative-observational-study/
2Medical.News
Indices of #Diet Quality and Risk of Lung #Cancer in the Women’s Health Initiative Observational Study
Prospective evidence on associations between diet quality indices and lung cancer risk is limited, particularly among older women. ObjectivesWe investigated associations between 4 diet quality indi…
Ultra-processed #foods consumption and #diet quality of European children, adolescents and adults: results from the I.Family study
https://2medical.news/2021/08/05/ultra-processed-foods-consumption-and-diet-quality-of-european-children-adolescents-and-adults-results-from-the-i-family-study/
https://2medical.news/2021/08/05/ultra-processed-foods-consumption-and-diet-quality-of-european-children-adolescents-and-adults-results-from-the-i-family-study/
2Medical.News
Ultra-processed #foods consumption and #diet quality of European children, adolescents and adults: results from the I.Family study
Energy intake from Ultra Processed Foods (UPFs) represents almost half of the daily energy intake within our study population, and this trend decrease progressively with age with no differences by …
#Diet-induced #fasting ghrelin elevation reflects the recovery of #insulin sensitivity and visceral adiposity regression
https://2medical.news/2021/10/20/diet-induced-fasting-ghrelin-elevation-reflects-the-recovery-of-insulin-sensitivity-and-visceral-adiposity-regression/
https://2medical.news/2021/10/20/diet-induced-fasting-ghrelin-elevation-reflects-the-recovery-of-insulin-sensitivity-and-visceral-adiposity-regression/
2Medical.News
#Diet-induced #fasting ghrelin elevation reflects the recovery of #insulin sensitivity and visceral adiposity regression
Lower fasting-ghrelin-levels (FGL) are associated with obesity and metabolic syndrome. We aimed to explore the dynamics of FGL during weight-loss and its metabolic and adiposity-related manifestati…
#Prebiotic #diet changes neural correlates of #food decision-making in #overweight adults: a randomised controlled within-subject cross-over trial
https://2medical.news/2023/10/25/prebiotic-diet-changes-neural-correlates-of-food-decision-making-in-overweight-adults-a-randomised-controlled-within-subject-cross-over-trial/
https://2medical.news/2023/10/25/prebiotic-diet-changes-neural-correlates-of-food-decision-making-in-overweight-adults-a-randomised-controlled-within-subject-cross-over-trial/
2Medical.News
#Prebiotic #diet changes neural correlates of #food decision-making in #overweight adults: a randomised controlled within-subject…
Objective Animal studies suggest that prebiotic, plant-derived nutrients could improve homoeostatic and hedonic brain functions through improvements in microbiome–gut–brain communication. However, …
#Fasting-mimicking #diet causes hepatic and blood markers changes indicating reduced biological #age and disease risk
https://2medical.news/2024/02/22/fasting-mimicking-diet-causes-hepatic-and-blood-markers-changes-indicating-reduced-biological-age-and-disease-risk/
https://2medical.news/2024/02/22/fasting-mimicking-diet-causes-hepatic-and-blood-markers-changes-indicating-reduced-biological-age-and-disease-risk/
2Medical.News
#Fasting-mimicking #diet causes hepatic and blood markers changes indicating reduced biological #age and disease risk
In mice, periodic cycles of a fasting mimicking diet (FMD) protect normal cells while killing damaged cells including cancer and autoimmune cells, reduce inflammation, promote multi-system regenera…
#Diet, Pace of Biological #Aging, and Risk of #Dementia in the Framingham Heart Study
https://2medical.news/2024/03/25/diet-pace-of-biological-aging-and-risk-of-dementia-in-the-framingham-heart-study/
https://2medical.news/2024/03/25/diet-pace-of-biological-aging-and-risk-of-dementia-in-the-framingham-heart-study/
2Medical.News
#Diet, Pace of Biological #Aging, and Risk of #Dementia in the Framingham Heart Study
AbstractObjectivePeople who eat healthier diets are less likely to develop dementia, but the biological mechanism of this protection is not well understood. We tested the hypothesis that healthy di…
One #Avocado per Day as Part of Usual Intake Improves #Diet Quality: Exploratory Results from a Randomized Controlled Trial
https://2medical.news/2024/04/01/one-avocado-per-day-as-part-of-usual-intake-improves-diet-quality-exploratory-results-from-a-randomized-controlled-trial/
https://2medical.news/2024/04/01/one-avocado-per-day-as-part-of-usual-intake-improves-diet-quality-exploratory-results-from-a-randomized-controlled-trial/
2Medical.News
One #Avocado per Day as Part of Usual Intake Improves #Diet Quality: Exploratory Results from a Randomized Controlled Trial
Few clinical trials have evaluated diet quality change as a predictor of intervention effectiveness.ObjectivesThe aim of this study was to examine changes in the Healthy Eating Index (HEI)-2015 aft…
The microbiome-driven impact of western #diet in the development of noncommunicable chronic disorders
https://2medical.news/2024/05/24/the-microbiome-driven-impact-of-western-diet-in-the-development-of-noncommunicable-chronic-disorders/
https://2medical.news/2024/05/24/the-microbiome-driven-impact-of-western-diet-in-the-development-of-noncommunicable-chronic-disorders/
2Medical.News
The microbiome-driven impact of western #diet in the development of noncommunicable chronic disorders
Noncommunicable chronic disorders (NCDs) are multifactorial disorders that share a state of chronic, low-grade inflammation together with an imbalance of gut microbiota. NCDs are becoming increasin…
#Mediterranean #Diet Adherence and Risk of All-Cause #Mortality in #Women
https://2medical.news/2024/06/03/mediterranean-diet-adherence-and-risk-of-all-cause-mortality-in-women/
https://2medical.news/2024/06/03/mediterranean-diet-adherence-and-risk-of-all-cause-mortality-in-women/
2Medical.News
#Mediterranean #Diet Adherence and Risk of All-Cause #Mortality in #Women
Key PointsQuestion Is adherence to the Mediterranean diet associated with lower mortality in a US female population, and if so, what are possible biological mechanisms? Findings In this cohort st…