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Higher serum 25-hydroxyvitamin D [25(OH)D] has been associated with a lower risk of breast cancer in epidemiologic studies. Vitamin D binds receptors on breast epithelium to regulate cell cycle, promote differentiation, protect against cellular DNA damage, regulate cytokines, activate immune cells, and suppress inflammation. The current analysis investigated the relationship between serum 25(OH)D and breast cancer across a wide range of 25(OH)D concentrations in women aged 55 and older.

The composition of gut microbiota is emerging as a risk factor for obesity, with studies reporting lower levels of Bifidobacterium and higher levels of Firmicutes in obese subjects than in lean subjects. Higher levels of the lipopolysaccharide (LPS)-binding protein have been detected in overweight and obese individuals, suggesting that intestinal permeability, subclinical endotoxemia, and low-grade inflammation mechanistically link changes in the gut microbiome to changes in metabolism and body weight.

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and occurs on a continuum from simple steatosis to steatohepatitis (NASH) and cirrhosis. The pathophysiology of NAFLD is thought to begin with insulin resistance and progress because of oxidative stress and inflammation. In the absence of pharmaceutical treatments for NAFLD, the mainstay approach to therapy is dietary modification, exercise, and weight loss. In addition, antioxidant supplementation has been explored as a therapeutic option in NAFLD. 

Studies suggest that the intestinal microbiota influence depression, anxiety, and stress. The bidirectional communication of the gut-brain axis is thought to link the microbiome to mood, and the microbiome is known to be affected by diet. A review of studies related to diet, the microbiome, and mood was published in 2018 in Nutritional Neuroscience

More than 1 in 5 patients with chronic heart failure (CHF) also experience depression, which is associated with mortality rates that are 2 to 3 times higher than those of non-depressed patients. The SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial showed that improvement in depression correlated with reduced cardiovascular events in patients with CHF. A post-hoc analysis of this trial found that 80% of the patients with both CHF and depression had low plasma omega-3 levels.

Obesity-related chronic inflammation is marked by elevated levels of high-sensitivity C-reactive protein (hs-CRP) and pro-inflammatory cytokines. These mediators adversely affect endothelial function by raising levels of endothelial-derived compounds, like plasminogen activator inhibitor 1 (PAI-1). Higher PAI-1 is correlated with other markers of endothelial dysfunction, such as increased intima media thickness and arterial stiffness index.

Non-alcoholic fatty liver disease (NAFLD), defined as hepatic steatosis resulting from no secondary cause, ranges from simple steatosis to nonalcoholic steatohepatitis (NASH) with the potential to progress to cirrhosis or hepatocellular carcinoma. Medical management of NAFLD relies on diet, exercise, and weight loss, with no approved pharmacologic interventions. Omega-3 polyunsaturated fatty acids have been extensively investigated to supplement dietary interventions for NAFLD.

The main strategies to prevent metabolic diseases are lifestyle and dietary interventions, including an emphasis on low-glycemic or low-glycemic-load meals. Meals with a high glycemic load produce a higher blood glucose response and adverse metabolic consequences, including high insulin levels, reactive hypoglycemia, and eventual insulin resistance.

Age-related cognitive decline, defined as non-pathological yet meaningful decreases in memory and mental abilities, can develop with advancing age in any person. Epidemiological studies suggest that better nutritional habits are associated with lower rates of cognitive decline, and polyphenols in fruits and vegetables have specifically been associated with better cognitive function in older adults.

Osteoporosis-related fractures affect as many as half of all women and a quarter of all men over the age of 50. Bisphosphonate medications have been shown to reduce fracture risk, but their use is limited by fears of side effects and a recommended duration of use no longer than 3-5 years. Safer options that can be taken for more extended periods of time are needed to reduce bone loss and fracture risk in older adults.

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