Michael D. Wirth

Background: Chrononutrition emphasizes alignment of meal timing with circadian rhythms, as misalignment of eating and sleep behaviors may adversely affect health. Aim: We examined the relationship between timing of dietary macronutrients and sleep quality. Methods: This post hoc analysis used data from the Sistas Inspiring Sistas through Activity and Support randomized trial. Participants completed the Pittsburgh Sleep Quality Index and a 24-h dietary recall at baseline ( n = 251), 3 months ( n = 159), and 12 months ( n = 127). Meal-timing metrics included clock times for meals and the percentage of daily macronutrient intake consumed after 5 p.m. Linear mixed-effects models adjusted for relevant covariates. Summary: Later breakfast timing was associated with poorer sleep quality at 12 months ( β = 0.64, p = 0.02). No significant associations were observed for lunch or dinner timing, or macronutrient intake after 5 p.m. Later breakfast timing may be associated with lower sleep quality. Further studies should explore meal timing and composition in diverse populations.

Background/Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. Sleep duration, diet, and obesity have each been identified as modifiable risk factors linked to CRC. However, their joint effect on CRC incidence is underexplored. This study investigated the association between sleep duration and CRC incidence and explored the joint effects of sleep duration, a pro-inflammatory diet, and obesity on CRC incidence in the Multiethnic Cohort (MEC). Methods: This prospective cohort study analyzed 193,027 participants from Hawaii and California enrolled in the MEC between 1993 and 1996. Sleep duration was self-reported and categorized as short (≤6 h), normal (7–8 h), or long (≥9 h). Diet was self-reported via FFQ and inflammatory potential was assessed using the energy-adjusted Dietary Inflammatory Index (E-DII). CRC cases were identified via cancer registries. Cox proportional hazards models estimated the hazard ratios (HRs) for CRC risk. Results: After 23.8 years of follow-up, 5825 CRC cases were identified. A pro-inflammatory diet combined with suboptimal sleep increased CRC risk by 12% (short sleep duration, aHR: 1.12; 95% CI: 1.02–1.24) and 22% (long sleep duration, aHR: 1.22, 95% CI: 1.05–1.43). Furthermore, long sleep duration was associated with a 10% increase in CRC risk (aHR: 1.10; 95% CI: 1.01–1.22) compared with normal sleep, while short sleep showed no significant association overall. Obese individuals with short or long sleep had significantly higher CRC risk (short sleep aHR: 1.35; 95% CI: 1.21–1.51; long sleep aHR: 1.36; 95% CI: 1.14–1.64) compared with non-obese individuals with corresponding sleep durations. Conclusions: Long sleep duration and a combination of suboptimal sleep duration and a pro-inflammatory dietary pattern or obesity amplifies the risk.

To assess the associations between serum and dietary polyunsaturated fatty acids (PUFAs), as well as the inflammatory potential of diet measured by the Children’s Dietary Inflammatory Index (C-DII^TM), and recurrent respiratory infections (RRIs) in children. We enrolled 44 children aged 3–16 years with RRIs and 44 healthy controls. Dietary intake was assessed using a 7-day food record from which PUFA intake and C-DII^TM were calculated. Serum PUFA levels were determined using gas–liquid chromatography–mass spectrometry. The dietary assessment showed a significantly lower fiber intake in children with RRIs. The RRI group had a higher inflammatory potential in the diet than healthy controls. Children with RRIs have higher serum levels of linoleic, arachidonic, and eicosapentaenoic acids than healthy subjects. A pro-inflammatory diet was positively associated with serum n-6 PUFA levels in both the groups. A high inflammatory potential of diet, body mass index over 75 percentile, and short breastfeeding duration were identified as risk factors for RRIs. The inflammatory potential of diet is strongly associated with RRIs in children and related to their PUFA status. Promoting breastfeeding and healthy dietary habits during childhood are crucial for implementing effective preventive management strategies.

To assess the associations between serum and dietary polyunsaturated fatty acids (PUFAs), as well as the inflammatory potential of diet measured by the Children’s Dietary Inflammatory Index (C-DIITM), and recurrent respiratory infections (RRIs) in children. We enrolled 44 children aged 3-16 years with RRIs and 44 healthy controls. Dietary intake was assessed using a 7-day food record from which PUFAs intake and C-DIITM were calculated. Serum PUFAs levels were determined using gas-liquid chromatography-mass spectrometry. The dietary assessment showed a significantly lower fiber intake in children with RRIs. The RRI group had a higher inflammatory potential in the diet than healthy controls. Children with RRIs have higher serum levels of linoleic, arachidonic, and eicosapentaenoic acids than healthy subjects. A pro-inflammatory diet was positively associated with serum n-6 PUFAs levels in both the groups. A high inflammatory potential of diet, body mass index over 75 percentile, and short breastfeeding duration were identified as risk factors for RRIs. The inflammatory potential of diet is strongly associated with RRIs in children and related to their PUFAs status. Promoting breastfeeding and healthy dietary habits during childhood are crucial for implementing effective preventive management strategies.

Introduction: Physician assistants (PAs) are subject to high levels of burnout, depressive symptoms, and anxiety, which can negatively impact quality of care and patient outcomes. Learning how to handle stress in the classroom may increase success and engagement in PA programs. The goal of this study was to characterize burnout, depressive symptoms, and anxiety in current PA students and examine the relationship between these factors and work engagement. Methods: This cross-sectional study surveyed PA students ( n = 42) via convenience sampling from eighteen different PA programs across North and South Carolina in October, 2021. Questionnaires included the Utrecht Work Engagement Scale (UWES-17), the Patient Health Questionnaire (PHQ-2), the General Anxiety Disorder scale (GAD-7), and the COVID-19 Anxiety Scale (CIAS). Adjusted linear regression was used to assess associations between the GAD-7, PHQ-2, and CIAS and the three subscales of the UWES-17 (vigor, dedication, and absorption). Results: Students were primarily female (79%), white (79%), second-year students (62%), and had an average body mass index of 21.0 ± 3.9 kg/m². A one-unit increase in the GAD-7 was associated with a decrease in the vigor (β = −0.94, SE = 0.19, p < .01) and dedication (β = −0.42, SE = 0.15, p = .01) subscales. A one-unit increase in the PHQ-2 was associated with a decrease in the vigor subscale (β = −2.94, SE = 0.60, p < .01). Conclusions: Recognizing warning signs of declining mental health early among PA school students may be key to increasing resilience, enthusiasm, and concentration, which may enhance school/work engagement. More work is needed to elucidate potential intervention targets to increase school/work engagement in PA students.

This study analyzed the overall quality of the diet using predefined indices, including the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII^®), to explore their association with the risk of bladder cancer in the Multiethnic Cohort Study. Data were taken from 186,979 African American, Japanese American, Latino, Native Hawaiian, and non-Hispanic White participants aged 45–75 years, with 1152 incident cases of invasive bladder cancer during a mean follow-up period of 19.2 ± 6.6 years. Cox models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) with comprehensive adjustment for smoking. Comparing the highest vs. lowest diet quality score quintile, HRs (95% CIs) in men was 1.08 (0.86–1.36) for HEI-2015, 1.05 (0.84–1.30) for AHEI-2010, 1.01 (0.80–1.27) for aMED, 1.13 (0.90–1.41) for DASH, and 0.96 (0.76–1.21) for DII^®, whereas the corresponding HRs for women were 0.75 (0.53–1.07), 0.64 (0.45–0.92), 0.60 (0.40–0.88), 0.66 (0.46–0.95), and 0.63 (0.43–0.90) with all p values for trend <0.05. The inverse association found in women did not vary by smoking status or race and ethnicity. Our findings suggest that adopting high-quality diets may reduce the risk of invasive bladder cancer among women in a multiethnic population.