Existing studies suggest that dietary vitamins and carotenoids might be associated with a reduced risk of age-related cataract (ARC), although a quantitative summary of these associations is lacking. The aim of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) and cohort studies of dietary vitamin and carotenoid intake and ARC risk. The MEDLINE, EMBASE, ISI Web of Science, and Cochrane Library databases were searched from inception to June 2018. The adjusted RRs and corresponding 95% CIs for the associations of interest in each study were extracted to calculate pooled estimates. Dose-response relations were assessed with the use of generalized least-squares trend estimation. We included 8 RCTs and 12 cohort studies in the meta-analysis. Most vitamins and carotenoids were significantly associated with reduced risk of ARC in the cohort studies, including vitamin A (RR: 0.81; 95% CI: 0.71, 0.92; P = 0.001), vitamin C (RR: 0.80; 95% CI: 0.72, 0.88; P < 0.001), vitamin E (RR: 0.90; 95% CI: 0.80, 1.00; P = 0.049), β-carotene (RR: 0.90; 95% CI: 0.83, 0.99; P = 0.023), and lutein or zeaxanthin (RR: 0.81; 95% CI: 0.75, 0.89; P < 0.001). In RCTs, vitamin E (RR: 0.97; 95% CI: 0.91, 1.03; P = 0.262) or β-carotene (RR: 0.99; 95% CI: 0.92, 1.07; P = 0.820) intervention did not reduce the risk of ARC significantly compared with the placebo group. Further dose-response analysis indicated that in cohort studies the risk of ARC significantly decreased by 26% for every 10-mg/d increase in lutein or zeaxanthin intake (RR: 0.74; 95% CI: 0.67, 0.80; P < 0.001), by 18% for each 500-mg/d increase in vitamin C intake (RR: 0.82; 95% CI: 0.74, 0.91; P < 0.001), by 8% for each 5-mg/d increase in β-carotene intake (RR: 0.92; 95% CI: 0.88, 0.96; P < 0.001), and by 6% for every 5 mg/d increase in vitamin A intake (RR: 0.94; 95% CI: 0.90, 0.98; P < 0.001). Higher consumption of certain vitamins and carotenoids was associated with a significant decreased risk of ARC in cohort studies, but evidence from RCTs is less clear.

Health outcomes for Indigenous Australians with diabetes in remote areas remain poor, including high rates of avoidable complications which could be reduced with better primary level care. We aimed to evaluate the effectiveness of a community-based health-worker led case management approach to the care of Indigenous adults with poorly controlled type 2 diabetes in primary care services in remote northern Australia. Two hundred and thirteen adults with poorly controlled diabetes (HbA1c > 8.5%) and significant comorbidities in 12 remote communities were randomly assigned by service cluster to receive chronic care co-ordination from a community-based health worker supported by a clinical outreach team, or to a waitlist control group which received usual care. At baseline, mean age of participants was 47.9 years, 62.4% were female, half were Aboriginal and half identified as Torres Strait Islander, 67% had less than 12 years of education, 39% were smokers, median income was $18,200 and 47% were unemployed. Mean HbA1c was 10.7% (93 mmol/mol) and BMI 32.5. At follow-up after 18 months, HbA1c reduction was significantly greater in the intervention group (−1.0% vs −0.2%, SE (diff) = 0.2, p = 0.02). There were no significant differences between the groups for blood pressure, lipid profile, BMI or renal function. Intervention group participants were more likely to receive nutrition and dental services according to scheduled care plans. Smoking rates were unchanged. A culturally safe, community level health-worker led model of diabetes care for high risk patients can be effective in improving diabetes control in remote Indigenous Australian communities where there is poor access to mainstream services. This approach can be effective in other remote settings, but requires longer term evaluation to capture accrued benefits. ANZCTR 12610000812099 , Registered 29 September 2010.

Increased prevalence of overweight and obesity, diabetes, hypertension, and other cardio metabolic risks has become a public health concern in China, a country undergoing nutrition transition. We investigated the dietary pattern during 1991–2011 and its association with these risks in a longitudinal study among adults; Adults in The China Health and Nutrition Survey were included. Three-day food consumption was collected by 24 h recall method. Anthropometric measures, blood pressure, fasting blood glucose and lipids was collected in 2009. Dietary pattern was generated using principal components analysis. The associations between dietary pattern and cardio metabolic risk were assessed with generalized linear regression adjusted for age, sex, and social economic status (SES). “Traditional” pattern loaded with rice, meat, and vegetables, and “Modern” pattern had high loadings of fast food, milk, and deep-fried food. “Traditional” pattern was inversely associated with cardio metabolic risks, with linear slopes ranging from −0.15 (95% confidence interval (CI): −0.18, −0.12) for hypertension to −0.67 (95% CI: −0.73, −0.60) for impaired glucose control. “Modern” pattern was associated positively with those factors, with slopes ranging 0.10 (95% CI: 0.04, 0.17) for high cholesterol to 0.42 (95% CI: 0.35, 0.49) for impaired glucose control. Dietary patterns were associated with cardio metabolic risk in Chinese adults.

The association between the consumption of ultra-processed food (UPF) with overweight/obesity in Chinese adults has not been investigated. This study included a cohort of 12,451 adults aged >20 years who participated at least twice in the China Nutrition and Health Survey (CNHS) during 1997–2011. Food intake at each survey was assessed using a 3-day 24-h dietary recall. Body weight (kg), height (m), and waist circumference (WC) were measured during the survey. UPF was defined by the NOVA classification. Mixed effect logistic regression analyses were used. The mean UPF consumption of the study population (baseline mean age 43.7 years) increased from 12.0 g in 1997 to 41.5 g in 2011 with the corresponding proportion of UPF in daily diet from 1.0% to 3.6%. The adjusted odds ratios (95% CI) for BMI ≥ 25 kg/m² for those with mean UPF consumption of 1–19 g/d, 20–49 g/d, and ≥50 g/d were 1.45 (1.26–1.65), 1.34 (1.15–1.57), and 1.45 (1.21–1.74), respectively (p-trend = 0.015), compared with the non-consumers. Similarly, the corresponding adjusted ORs (95% CI) for central obesity were 1.54 (1.38–1.72), 1.35 (1.19–1.54), and 1.50 (1.29–1.74). Higher long-term UPF consumption was associated with increased risk of overweight/obesity among Chinese adults.