Shufang Xia

Patients with lung cancer are at increased risk of developing cancer-related cognitive impairment (CRCI), and oxidative stress may contribute to its development. We conducted an assessor-blinded randomized controlled trial to evaluate whether a 12-week antioxidant-focused dietary intervention improved cognitive function, oxidative stress biomarkers, and quality of life (QoL) in lung cancer patients with CRCI. One hundred participants were randomized to standard dietary counseling or an antioxidant-focused dietary intervention. Continuous outcomes were assessed at baseline and week 12 and analyzed using linear mixed-effects models under the intention-to-treat principle. The mean age was 66.10 ± 5.39 years, and 78.0% of participants were male. Ninety-one participants completed the week-12 assessment. Participants receiving the intervention demonstrated greater increases in Montreal Cognitive Assessment scores (β = 2.626; 95% CI: 0.825, 4.427; p = 0.005), dietary oxidative balance score (β = 2.292; 95% CI: 0.656, 3.928; p = 0.006), and physical and mental QoL component scores than those in the control group (p < 0.05). In the complete-case analysis (n = 91), the proportion meeting CRCI criteria was lower in the intervention group (60.0% vs. 93.5%; p < 0.001). Biomarker analyses showed increases in glutathione and superoxide dismutase and a reduction in malondialdehyde in the intervention group (p < 0.05). The intervention demonstrated a large effect on cognitive function (Cohen’s d = 0.84), supporting antioxidant-focused dietary intervention as a promising supportive-care strategy for managing CRCI in lung cancer patients.

Background: Cydonia oblonga Mill. is rich in flavonoid compounds and shows potential for application in functional foods. This study investigated the therapeutic potential of hydroethanolic extract of Cydonia oblonga Mill. fruit (HECO) in alleviating lipopolysaccharide (LPS)-induced depression-like behaviors in mice. Methods: Mice were treated with HECO (600 mg/kg, p.o.) for 21 consecutive days. From day 14 to day 21, depression-like behavior was induced by LPS (2.0 mg/kg injected i.p.). Behavioral parameters and biochemical markers were then assessed. Gut microbiota composition was analyzed by 16S rRNA gene sequencing, and serum metabolites were profiled through untargeted metabolomics. Results: HECO improved LPS-induced behavioral alterations, including increased locomotor activity in the open-field test and decreased immobility time in the forced swimming test and tail suspension test, and reduced serum IL-6 levels in LPS-treated mice. Furthermore, HECO markedly upregulated the expression of occludin and ZO-1 in the hippocampus and inhibited neuroinflammation by suppressing activation of the TLR4/MyD88/NF-κB signaling pathway. HECO significantly increased the relative abundance of Deferribacterota in LPS-induced mice. A total of 262 differential metabolites were identified between the LPS and HECO groups, with the top potential biomarkers predominantly categorized into lipids, flavonoid-containing phenylpropanoids, organic acids, and peptides. Conclusions: HECO improved depression-like behavior in LPS-induced mice, potentially through modulation of gut microbiota and serum metabolites, attenuation of systemic inflammation, and inhibition of the TLR4/MyD88/NF-κB signaling pathway in the hippocampus.

Background: Depressive symptoms (DepS) are prevalent among breast cancer patients and are associated with poor treatment outcomes and prognosis. Oxidative stress has been implicated in the pathophysiology of depression, and dietary antioxidants may be associated with oxidative balance. This study aimed to evaluate the association between the composite dietary antioxidant index (CDAI) and DepS, and to explore the statistical relationships between CDAI, oxidative stress biomarkers, and DepS. Methods: In this cross-sectional study, 302 breast cancer patients were enrolled, of whom 113 provided blood samples for the assessment of plasma oxidative stress biomarkers. Dietary intake was assessed using 3-day 24 h dietary recalls. The CDAI was calculated based on the intake of six dietary antioxidants, including vitamins A, C, and E, zinc, selenium, and manganese. DepS were defined as a score of ≥8 on the Hospital Anxiety and Depression Scale—Depression subscale (HADS–D). Results: A total of 102 patients (33.77%) exhibited DepS, and these patients had significantly lower CDAI scores and reduced plasma levels of superoxide dismutase (SOD) and glutathione (GSH), compared with those without DepS (all p < 0.05). CDAI and dietary zinc intake were non-linearly associated with DepS (p for non-linearity p < 0.001). CDAI scores were positively associated with SOD and GSH levels (both p < 0.001), while SOD and GSH were inversely associated with DepS (SOD: β = −0.610; GSH: β = −0.900; both p < 0.001). In exploratory mediation analysis, GSH and SOD statistically accounted for part of the association between CDAI and DepS (ACME = −0.192 and −0.228, respectively; all p < 0.01). Conclusions: Higher dietary antioxidant intake, as reflected by CDAI, is associated with lower DepS in breast cancer patients, and oxidative stress biomarkers may be statistically involved in this association.

Background and objective: Unhealthy dietary patterns are recognized risk factors for obesity by promoting chronic low-grade inflammation. This meta-analysis aimed to examine whether higher DII scores are associated with overweight/obesity in adults. Methods: PubMed, Embase, ScienceDirect, Cochrane Library, and Web of Science databases were searched up to April 16, 2025. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were pooled for the highest versus lowest DII. Results: A total of 22 studies were included, comprising 19 cross-sectional studies and three prospective cohort studies. Meta-analysis of the cross-sectional studies indicated a small but significant positive association between DII and BMI (Cohen’s d = 0.17; 95% CI: 0.09, 0.25), with significant heterogeneity (Q test, p < 0.001; I ² = 85.7%). After excluding one study identified by leave-one-out sensitivity analysis, the pooled effect size increased slightly and heterogeneity significantly decreased (Cohen’s d = 0.20; 95% CI: 0.17, 0.23; Q test, p = 0.032; I ² = 42.0%). Meta-regression analysis indicated that publication year and WHO regions partially explained heterogeneity ( p = 0.016; p = 0.004), whereas subgroup analyses revealed only publication year as statistically significant ( p = 0.040). Cohort studies generally suggested a positive association between DII and BMI (RR = 1.59, 95% CI: 0.72, 3.50; β = 0.41, 95% CI: 0.21, 0.61; HR = 1.32, 95% CI: 1.08, 1.60). Conclusion: Higher DII is associated with overweight/obesity. Further studies are needed to clarify the temporal relationship and underlying biological mechanisms linking dietary inflammatory potential with overweight/obesity. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251049098 , Identifier: CRD420251049098.

Background: Cancer-related fatigue (CRF) is a prevalent, persistent, and multidimensional symptom in breast cancer patients, negatively affecting physical function and quality of life (QoL). Dietary interventions have emerged as safe and cost-effective strategies to alleviate CRF. Methods: This assessor-blinded, randomized controlled trial evaluated the effects of a 12-week dietary quality-based nutrition education program on CRF in breast cancer patients. A total of 128 participants were randomly assigned to the intervention, which received nutrition education based on the Chinese Healthy Eating Index (CHEI), or the control group, which received standard care. Outcomes, including CRF (Revised Piper Fatigue Scale), dietary quality (CHEI), body mass index (BMI), self-management efficacy (Strategies Used by People to Promote Health, SUPPH) and QoL (Functional Assessment of Cancer Therapy-Breast, FACT-B) were assessed at baseline and post-intervention. Results: Of the 128 participants, 111 (86.7%) completed follow-up. Linear mixed-effects models demonstrated a significant group × time interaction for total RPFS scores. After adjusting for age, BMI, cancer stage, pain, anxiety, and depression, the intervention group showed a significantly larger reduction in RPFS scores (β = −1.426, 95% CI: −1.959~−0.893, p < 0.001, Cohen’s d = −0.97). In addition, after adjusting for the same covariates, significant improvements were observed in CHEI (β = 4.799, 95% CI: 1.383~8.215, p = 0.006, Cohen’s d = 0.75), SUPPH scores (β = 16.657, 95% CI: 12.557~20.758, p < 0.001, Cohen’s d = 1.65) and FACT-B scores (β = 12.688, 95% CI: 9.250~16.125, p < 0.001, Cohen’s d = 1.16) in the intervention group, all showing meaningful changes compared with the control group. Conclusions: Dietary quality-based nutrition education significantly alleviated CRF and improved other health-related outcomes in breast cancer patients, suggesting that nutrition education may be an effective strategy for managing CRF and supporting recovery during breast cancer treatment.

Background: Sleep disturbance (SD) is very common in breast cancer (BC) patients, resulting in poor therapeutic efficacy and prognosis. Diet may be associated with SD through systemic inflammation. This study aimed to evaluate the association between the energy-adjusted Dietary Inflammatory Index (E-DII) and SD, as well as the potential mediating role of inflammatory biomarkers in patients with BC. Methods: In this cross-sectional study, 302 BC patients were recruited, from whom 103 blood samples were obtained for the determination of plasma inflammatory biomarkers. Dietary intake was evaluated using 3-day, 24 h dietary recalls, while SD was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: SD was observed in 91 (30.13%) patients, who exhibited significantly higher E-DII scores, C-reactive protein (CRP), interleukins (IL-1β, IL-6, and IL-10), and tumor necrosis factor-α (TNF-α) levels compared to non-SD participants (p < 0.05). After adjusting for covariates, for every 1-point elevation in E-DII, the risk of SD increased by 23.0% (OR = 1.23; 95% CI: 1.04, 1.44; p = 0.014). Among the E-DII components, only vitamin C showed an inverse correlation with SD (OR = 0.99; 95% CI: 0.99, 1.00; p = 0.015). Mediation analysis showed that IL-1β, IL-10, IL-6, TNF-α, and CRP statistically mediated the association between E-DII and SD (all p < 0.05). The sensitivity parameters ρ were 0.3, 0.5, 0.4, 0.4, and 0.4, respectively. Conclusions: A diet with pro-inflammatory potential was correlated with SD among BC patients, which might be mediated by circulating IL-1β, IL-10, IL-6, TNF-α, and CRP.

Higher net endogenous acid production scores and lower protein and potassium intakes were significantly associated with increased risk of frailty.

Background: While substantial evidence links single lifestyle factors to mental health, research on how multiple co-occurring healthy lifestyle behaviors relate to mental health, particularly among college students, remains limited. This study aimed to identify distinct profiles of healthy lifestyle behaviors and examine their associations with mental health among college students. Method: This cross-sectional study included 1340 college students (mean age = 19.4 years; SD = 1.2). Self-reported data were collected on diet, sleep, physical activity (PA), screen time, and sedentary behavior. Mental health was assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Latent profile analysis was used to identify groups with similar lifestyle characteristics. Multiple linear regression was applied to examine associations between lifestyle profiles and mental health. Result: Three lifestyle profiles were identified: “Active Engagement” (n = 520, 38.8%), “Moderate Engagement” (n = 478, 35.7%), and “Negative Engagement” (n = 342, 25.5%). These groups showed significant differences in anxiety, depression and stress levels (p < 0.001). Monthly family income and sex predicted profile membership. Compared with the “Active Engagement” group, the “Moderate Engagement” and “Negative Engagement” groups showed a higher risk of mental health problems. Conclusions: Our findings suggest that interventions specifically targeting the active lifestyle pattern (characterized by the higher PA, low sedentary behavior and screen time) may be particularly effective for improving mental health in college students, moving beyond simply promoting single health behaviors.