Little is known about the longitudinal association between dietary patterns (DPs) and metabolic disorders in people living at high altitude areas, such as Tibetans. We constructed the first open cohort, with 1832 Tibetans, and collected data in 2018 and in 2022. The metabolic syndrome (MetS) prevalence was 30.1% (32.3% in men and 28.3% in women). Three different DPs were identified: modern DP (pulses, poultry, offal, and processed meat), urban DP (vegetables, refined grain, beef/mutton, and eggs), and pastoral DP (Tibetan cheese, tsamba, butter/milk tea, and desserts). Participants within the third tertile of the urban DP had a 3.42-fold (95% CI 1.65–7.10) higher risk of MetS than those with the first tertile. Modern DP was positively associated with elevated blood pressure (BP) and elevated triglycerides (TAG), while it was inversely associated with low HDL-C. The urban DP was associated with a higher risk of low HDL-C, but a lower risk of impaired fasting blood glucose (FBG). The pastoral DP was a risk factor for impaired FBG, but protective for central obesity and elevated BP. Associations of modern DP with elevated BP, and pastoral DP with low HDL-C, were modified by altitude. In conclusion, among Tibetan adults, DPs were associated with MetS and its components, and the associations were modified by altitude among Tibetans.

Intestinal bacteria are considered the “second genome” of the host, playing a crucial physiological role in assisting the host in degrading plant secondary compounds, nutrient absorption, immune regulation, and other aspects. To explore the effects of Stellera chamaejasme on the bacterial community of the gastrointestinal tract of plateau zokor, this study uses the 16S rRNA gene high-throughput sequencing technology, and the biodiversity and the community structure of gut bacteria in different gastrointestinal tract segments (the stomach and cecum) of plateau zokors. The results showed that at the phylum level, the dominant flora in the stomach and cecum of plateau zokors before and after ingesting Stellera chamaejasme were Firmicutes and Bacteroidetes. In plateau zokors that ingested Stellera chamaejasme, the relative abundance of Firmicutes in the stomach and cecum decreased, the relative abundance of Bacteroidetes increased, and the ratio of Firmicutes to Bacteroidetes decreased. After plateau zokors ingested Stellera chamaejasme, the ACE index demonstrated a significant reduction in the richness of the stomach bacterial community, while cecal bacterial community richness showed no significant change. Stellera chamaejasme exhibits significantly different effects on the bacterial communities in different segments of the gastrointestinal tract. Beta diversity analysis revealed that, after plateau zokors ingested Stellera chamaejasme, there were notable distinctions in the bacterial communities within both the stomach and cecum, alongside a marked reduction in the variability of the intestinal bacterial profiles across individuals. The results show that ingesting Stellera chamaejasme has a significant impact on the composition and structure of the gastrointestinal tract bacterial community in plateau zokors.

Objective: This study aims to assess the intervention effects of unguided digital cognitive behavioral therapy for insomnia (dCBT-I) on patients with comorbid depression and insomnia through a systematic review and meta-analysis, in order to determine its effectiveness as a treatment strategy for comorbid depression and insomnia. Methods: We conducted a systematic search across PubMed, Cochrane, Embase, ClinicalTrials.gov, and PsycINFO.databases to identify randomized controlled trials (RCTs) focusing on adults with comorbid insomnia and depressive symptoms, excluding those with severe physical illnesses or psychiatric disorders. Following the removal of duplicates, 1842 articles were screened, resulting in the inclusion of 16 RCTs in the final meta-analysis. Results: Post-treatment evaluations revealed that digital cognitive behavioral therapy for insomnia (dCBT-I) demonstrated a significant impact on insomnia (SMD = -0.94; 95% CI: -1.40 to -0.48; p < 0.001; k = 16), though substantial heterogeneity was observed (I² = 98.63%; Q = 1250.89, df = 15, p < 0.05). For depressive symptoms, dCBT-I demonstrated a moderate effect (SMD = -0.63; 95% CI: -0.81 to -0.46; p < 0.05; k = 16), with high heterogeneity (I² = 81%; Q = 78.31, df = 15, p < 0.05).Strong outcomes were observed in both the Web and APP cohorts when analyzing program carriers, with notable findings in the moderately depressed subgroup. Conclusions: This meta-analysis evaluated the efficacy of therapist-unguided digital cognitive behavioral therapy (dCBT-I) for insomnia and depression, dCBT-I demonstrated significant reductions in insomnia severity and depressive symptoms within the studied population, despite substantial heterogeneity. It also demonstrated moderate to large effects for moderate-to-severe depression, further supporting the effectiveness of unguided dCBT-I. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251044042 , identifier CRD420251044042.