Kelsey M. Mangano

Background: Dietary and lifestyle inflammation scores (DIS/LIS) were created to assess their contributions to systemic inflammation; however, there is little understanding of their validity in Hispanic adults. Objective: This study aims to utilize DIS and LIS in the Boston Puerto Rican Health Study (BPRHS), as previously published, and create cohort-adapted scores. Adapted scores were validated in The Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends (PROSPECT). Methods: This cross-sectional analysis assessed diet from a food-frequency questionnaire, self-reported lifestyle information, and inflammation from fasted blood. Published food and lifestyle groups were used to create DIS-1 and LIS-1. Cohort-adapted food and lifestyle groups were used to create DIS-2 and LIS-2 in the BPRHS ( n = 854). Factor analysis was used to create DIS-3. The associations among DIS-1, LIS-1, DIS-3, and a biomarker score (continuous and dichotomized) were tested in BPRHS using multivariable linear and logistic regression. The associations among DIS-2, LIS-2, DIS-3, and inflammation (continuous concentration and higher versus lower hsCRP) were tested in PROSPECT ( n = 835) using multivariable linear and logistic regression. Results: In BPRHS, DIS-1 showed a 1.07 (95% CI: 1.01, 1.15) times greater odds of a high inflammation BMS with each 1-unit increase in the DIS-1 and a 2.86 (95% CI: 2.14, 3.56) times greater odds of a high BMS with each 1-unit increase in the LIS-1. In PROSPECT, LIS-1 showed a 2.91 (95% CI: 2.33, 3.67) times greater odds of high hsCRP with each 1-unit increase in LIS-1; results were similar in linear analyses. DIS-3 was characterized by three factors. In BPRHS, high (quintile 5) vs. low (quintile 1) adherence to factor 1 (healthy diet) showed a 0.57 (95% CI: 0.35, 0.92) times lower odds of high BMS. DIS-3 was not associated with high hsCRP in PROSPECT. Conclusion: Predetermined lifestyle inflammation scores were associated with inflammation in this population, but dietary inflammation scores were inconsistent in their association with inflammation. Cohort-specific adaptation did not improve the scores’ association with inflammatory status. Further work is needed to understand the role of diet in the development of inflammation in these populations of Hispanic adults.

Background: Magnesium’s (Mg) role in brain aging is under-studied. We examined associations of dietary and serum Mg with MRI and cognitive measures in a cohort with >10 y follow-up. Methods: Adults from the Boston Puerto Rican Health Study who underwent MRI (n = 218 with serum Mg, n = 198 with Mg intake) and cognitive testing (n = 1049 with serum Mg, n = 1363 with Mg intake) were included. Hypomagnesemia was defined as serum Mg <0.75 mmol/L, and adequate Mg intake as ≥ the Estimated Average Requirement (males: 350 mg/d, females: 265 mg/d). Multivariable linear regression and linear mixed-effects models were used to estimate associations of Mg with brain age gap (z-score), volumes (% of total intracranial volume), and cognitive scores (z-score). Effect modification by diabetes, hypertension, dyslipidemia, calcium: Mg intake ratio, or ApoE4 was evaluated. Results: In the full sample, hypomagnesemia was not associated with brain MRI measures, but with global cognitive function [β (95% CI) = −0.058 (−0.11, −0.0020)], in fully adjusted models. Adequate Mg intake was associated with volumes of total gray matter [β (95% CI) = 2.83 (0.56, 5.11)], white matter [β (95% CI) = 1.54 (0.22, 2.86)], and multiple subregions, but not cognition. In participants with diabetes, hypomagnesemia was associated with lower volumes of multiple brain regions, which were not observed in participants without diabetes (pinteraction < .05). Limited or no interaction was detected for other potential modifiers, despite some variation in association direction or magnitude across subgroups. Conclusions: Diabetes modified Mg’s association with brain volumes. Mg merits more attention among people with diabetes for preventing neurodegeneration.

Dairy foods have been shown to improve BMD, a measure of bone quantity, yet there is little understanding of their influence on measures of bone quality. The aim of this study was to examine associations of dairy intakes with two measures of bone quality: bone material strength index (BMSi) and spinal trabecular bone score (TBS), and the potential mediating role of inflammation, among adults from the Boston Puerto Rican Osteoporosis Study. This cross-sectional analysis included dietary intake assessed with a culturally tailored food frequency questionnaire. Dairy food groups were calculated as total dairy (milk, yogurt, and cheese), milk, cheese, yogurt, desserts, non-fat, and fat-containing dairy. Bone material strength index (n = 138) was measured using micro indentation with the Osteoprobe, and TBS (n = 412) was calculated from DXA scans. Multivariable linear regression estimated the association of dairy food intakes with each bone measure. Mediation analysis evaluated direct and indirect (via inflammatory cytokines) associations between dairy intake and BMSi and TBS. Participants were 77.4% female with mean age 70.5 ± 6.9 yr. Higher intakes of total dairy (β = 1.79, p = .04) and milk (β = 1.74, p = .06) were associated with BMSi. Higher intake of fat-containing dairy (β = .018, p = .04) was positively associated with TBS, while higher intake of non-fat dairy (β = −.042, p = .02) was inversely associated with TBS. Inflammatory cytokines were not identified as mediators of these associations. Dairy food intakes were associated with measures of bone quality; however, the foods that predicted BMSi and TBS differed. Bone material strength index was influenced by total dairy and milk, while TBS was influenced by dairy fat content. Future studies should examine the impact of dairy matrix components on immune and inflammatory pathways.

Extensive use of per- and polyfluoroalkyl substances (PFAS) has resulted in their ubiquitous presence in human blood. PFAS exposures have been associated with multiple adverse human health effects. Biomonitoring studies have focused on long-chain PFASs, but these are being replaced by short-chain PFASs or with alternate PFAS chemistries (or replacement chemistries such as GenX), resulting in changes in human exposures with time. Here, we take advantage of serum samples collected as part of a clinical trial testing the efficacy of a dietary fiber intervention to reduce serum cholesterol to investigate exposure to PFASs in Canadian participants. Serum samples were collected from 72 participants (adult males with elevated cholesterol) in 2019–2020 at baseline and after 4 weeks of the intervention and were analyzed for 17 PFASs. The highest geometric mean serum concentrations of PFAS measured at baseline corresponded to PFOSA (7.1 ng/ml), PFOS (4.2, ng/ml), PFOA (1.8 ng/ml) and PFHxS (1.3 ng/ml). Four long-chain PFASs (PFOA, PFOS, PFOSA and PFHxS) and two short-chain PFASs (PFBA, PFHxA) were detected in 100% of participants. GenX was detected in 71% of participants. Analyses of associations between serum-PFAS concentrations and biomarkers of adverse health outcomes showed the PFBA, PFHxA, PFDA and PFOSA were associated with higher serum gamma-glutamyl transferase concentrations but not with measures of serum-total or low-density lipoprotein cholesterol. Comparison of PFAS concentrations at baseline and after a 4-week follow-up showed that the total PFAS detected decreased in both the control and cholesterol intervention groups. However, the suite of long-chain PFASs of concern identified by the United States National Academies of Sciences, Engineering, and Medicine, significantly decreased only in the cholesterol intervention group. This observation suggests that a sustained dietary fiber intervention may reduce long-chain PFAS body burden, but future intervention studies need to control for PFAS exposure sources and extend the dietary supplement intake beyond 4 weeks. Overall, the results show that exposures to short-chain and replacement chemistry PFASs are common in this Canadian population.

Extensive use of per- and polyfluoroalkyl substances (PFAS) has resulted in their ubiquitous presence in human blood. PFAS exposures have been associated with multiple adverse human health effects including increased risk of liver damage, elevated serum lipids, impaired vaccine response, adverse birth outcomes and cancer. Biomonitoring studies have focused on measuring long-chain PFAS, but these are being replaced by shorter chain PFAS and PFAS with alternative structures, resulting in incomplete understanding of human exposures. Here, we take advantage of serum samples collected as part of a clinical trial testing the efficacy of a dietary fiber intervention to reduce serum cholesterol to investigate exposure to legacy and replacement PFAS chemicals in Canadian participants. Serum samples were collected from 72 participants in 2019-2020 at baseline and after 4 weeks of the intervention and were analyzed for 17 PFAS species. The highest geometric mean concentrations of PFAS measured at baseline corresponded to PFOSA (7.1 ng/ml), PFOS (4.2, ng/ml), PFOA (1.8 ng/ml) and PFHxS (1.3 ng/ml). Short chain PFAS including PFBuA, PFHxS and/or PFHpA were detected in 100% of participants and GenX was detected in 70% of participants. Analyses of associations between PFAS serum concentrations and biomarkers of adverse health outcomes showed the PFBuA, PFHxA, PFDA and PFOSA were associated with higher serum gamma-glutamyl transferase concentrations but not with measures of serum total or low-density lipoprotein cholesterol. Comparison of PFAS concentrations at baseline and after a 4-week follow-up showed that total PFAS concentrations decreased in both the control and cholesterol intervention groups. However, the suite of PFAS of concern identified by the United States National Academies of Sciences, Engineering, and Medicine, significantly decreased only in the cholesterol intervention group. This observation suggests that a dietary fiber intervention may reduce PFAS body burden, but future intervention studies need to control for PFAS exposure sources and extend beyond 4 weeks. Overall, the results show that exposures to short-chain and alternative PFAS are common in this Canadian population.

Background: Caribbean Latino adults are at high risk for osteoporosis yet remain underrepresented in bone research. This increased risk is attributed to genetics, diet, and lifestyle known to drive inflammation and microbial dysbiosis.Objective: The primary objective of this study was to determine whether consuming 5 oz of yogurt daily for 8wks improves bone turnover markers (BTMs) among Caribbean Latino adults > 50 years; and secondarily to determine the impact on the gut microbiota and markers of intestinal integrity and inflammation.Methods: Following a 4wk baseline period, participants were randomized to an 8wk whole fat yogurt intervention (n = 10) daily, containing onlyStreptococcus thermophilusandLactobacillus bulgaricus,or to an untreated control group that did not consume yogurt (n = 10). Blood and stool samples collected at week-0 and week-8 were used to assess BTMs, inflammation, intestinal integrity biomarkers, and gut microbiota composition, short chain fatty acids (SCFAs), respectively. Data were evaluated for normality and statistical analyses were performed.Results: Participants were 55% women, with a mean age of 70 ± 9 years, BMI 30 ± 6 kg/m², and serum C-reactive protein 4.8 ± 3.6 mg/L, indicating chronic low-grade inflammation. Following 8wks of yogurt intake, absolute change in BTMs did not differ significantly between groups (P = 0.06–0.78). Secondarily, absolute change in markers of inflammation, intestinal integrity, and fecal SCFAs did not differ significantly between groups (Prange 0.13–1.00). Yogurt intake for 8wks was significantly associated with microbial compositional changes of rare taxa (P = 0.048); however, no significant alpha diversity changes were observed.Conclusions: In this study, daily yogurt did not improve BTMs, inflammation, intestinal integrity, nor SCFAs. However, yogurt did influence beta diversity, or the abundance of rare taxa within the gut microbiota of the yogurt group, compared to controls. Additional research to identify dietary approaches to reduce osteoporosis risk among Caribbean Latino adults is needed.Trial registration: This study is registered to ClinicalTrials.gov, NCT05350579 (28/04/2022).

Purpose of Review The purpose of this review is to summarize the scientific evidence published in the past 5 years examining the epidemiology of bone health as it relates to the gut microbiome, across race and ethnicity groups. Recent Findings The link between the gut microbiome and bone health is well established and is supported by numerous biological mechanisms. However, human study research in this field is dominated by studies of older adults residing in Asian countries. A limited number of epidemiological and randomized controlled trials have been conducted with individuals in other countries; however, they are marked by their racial and ethnic homogeneity, use varied measures of the gut microbiome, and different interventions (where applicable), making comparisons across race and ethnic groups difficult. Summary As the global prevalence of osteoporosis increases, the need for lifestyle interventions is critical. Existing data suggest that racial and ethnic differences in gut microbiome exist. Studies examining the relation between bone health and gut microbial structure and function across diverse racial and ethnic groups are needed to determine appropriate microbiome-based interventions.