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    Meal Timing of Subtypes of Macronutrients Consumption With Cardiovascular Diseases: NHANES, 2003 to 2016. Hou Wanying,Gao Jian,Jiang Wenbo,Wei Wei,Wu Huanyu,Zhang Yuntao,Sun Changhao,Li Ying,Han Tianshu The Journal of clinical endocrinology and metabolism CONTEXT:Emerging evidence suggests that not only the quantity but also the quality and food sources of macronutrients plays an important role in CVD. However, limited studies have examined the association of meal timing of different quality of macronutrients with CVD risk. OBJECTIVE:This study aimed to examine the association of subtypes of macronutrient consumption at dinner vs breakfast with cardiovascular diseases (CVD). METHODS:A total of 27 911 participants from the National Health and Nutrition Examination Survey (2003-2016) were included. The differences of subtypes of macronutrients at dinner vs breakfast (Δratio) were categorized into quintiles. Multiple logistic regression models and isocaloric substitution effects of subtypes were performed. RESULTS:After adjustment of a variety of covariates, participants in the highest quintile of the Δratio of low-quality carbohydrates had a higher risk of angina (odds ratio [OR] = 1.63; 95% CI, 1.16-2.29) (Pfor trend = .007) and heart attack (OR = 1.47; 95% CI, 1.13-1.93) (Pfor trend = .068) compared with the lowest quintile. The highest quintile of the Δratio of animal protein had a higher risk of coronary heart disease (OR = 1.44; 95% CI, 1.06-1.95) (Pfor trend = .014) and angina (OR = 1.44; 95% CI, 1.01-2.07) (Pfor trend = .047). For the Δratio of unsaturated fatty acid (USFA), the highest quintile of the Δratio of USFA was related to lower stroke risk (OR = 0.76; 95% CI, 0.58-0.99) (Pfor trend = .049). Isocaloric substitution of low-quality carbohydrates/animal protein by high-quality carbohydrates/plant protein at dinner reduced CVD risk by around 10%. CONCLUSION:This study indicated that overconsumption of low-quality carbohydrates and animal protein at dinner rather than breakfast was significantly associated with higher CVD risk and USFA consumption at dinner related to lower CVD risk among US adults. Substitution of low-quality carbohydrates or animal protein by high-quality carbohydrates or plant protein at dinner could reduce CVD risk. 10.1210/clinem/dgab288
    Prevalence of NAFLD, MAFLD and associated advanced fibrosis in the contemporary United States population. Ciardullo Stefano,Perseghin Gianluca Liver international : official journal of the International Association for the Study of the Liver Data are limited on the epidemiological implications of the recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD). We therefore performed a cross-sectional study of adults recruited in the 2017-2018 National Health and Nutrition Examination Survey, a representative sample of the general US population. The prevalence of NAFLD and MAFLD based on controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) obtained through vibration-controlled transient elastography (VCTE) were 37.1% (95% CI 34.0-40.4) and 39.1% (95% CI 36.3-42.1), respectively, with higher rates among Hispanic individuals. Agreement between the two definitions was high (Cohen's κ 0.92). Patients with NAFLD and MAFLD also showed similar risk of advanced liver fibrosis (7.5% and 7.4% respectively). Our results suggest that the recent change in diagnostic criteria did not affect the prevalence of the condition in the general United States population. 10.1111/liv.14828
    Are the different MAFLD subtypes based on the inclusion criteria correlated with all-cause mortality? Chen Xu,Chen Shen,Pang Juan,Tang Yi,Ling Wenhua Journal of hepatology 10.1016/j.jhep.2021.06.013
    Skipping breakfast is associated with an increased long-term cardiovascular mortality in metabolic dysfunction-associated fatty liver disease (MAFLD) but not MAFLD-free individuals. Xie Jiarong,Huang Hangkai,Chen Yishu,Xu Lei,Xu Chengfu Alimentary pharmacology & therapeutics BACKGROUND:Balancing calorie control to prevent cardiovascular diseases (CVDs) by skipping breakfast while guarding against its potential risks is a challenge. AIMS:To explore the association between skipping breakfast and cardiovascular mortality in individuals with metabolic dysfunction-associated fatty liver disease (MAFLD). METHODS:A total of 9926 individuals (including 3004 MAFLD participants) aged 20 years or older were enrolled in the Third National Health and Nutrition Examination Survey and followed for up to 27 years. All participants were classified according to the frequency of breakfast consumption (every day, some days, rarely and never). Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. RESULTS:During the 212 239 person-years of follow-up, we documented a total of 2595 deaths including 603 deaths from CVDs. Of these, 1039 deaths including 253 deaths from CVDs were recorded in MAFLD individuals. MAFLD individuals showed higher cardiovascular mortality than MAFLD-free controls (P < 0.001). Furthermore, skipping breakfast was independently associated with high cardiovascular mortality risk (adjusted HR: 2.850, 95% CI: 1.490-5.452; P = 0.002), and a high cerebrovascular disease mortality risk (adjusted HR: 5.570, 95% CI: 1.814-17.099; P = 0.003) in participants with MAFLD. However, skipping breakfast was not associated with cardiovascular mortality in MAFLD-free individuals (adjusted HR: 1.526, 95% CI: 0.701-3.326; P = 0.280). CONCLUSIONS:In this US population-based study, skipping breakfast was associated with a high risk of cardiovascular mortality in MAFLD but not MAFLD-free individuals. 10.1111/apt.16727