Frank B Hu’s research while affiliated with Joslin Diabetes Center and other places

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Publications (904)


Joint analysis between adolescent and adulthood beverage intake in relation to type 2 diabetes (T2D) risk. Low, medium and high intakes of beverage in adolescence and adulthood were cross-classified into a single categorical variable and evaluated for risk of T2D with low intake in adolescence and adulthood used as the reference category in a multivariable model. The multi variable model was adjusted for age, family history of diabetes (yes, no), adolescent covariates: BMI at age 18 (< 18.5, 18.5 to < 22.5, 22.5 to < 25.0, 25.0 to < 30.0, or ≥ 30.0 kg/m²), total energy intake (quintiles, kcal/day), cigarette smoking (none, 1 to 4, 5 to 14, or ≥ 15 cigarettes/day), physical activity [quintiles, metabolic equivalents (Mets)/week], alcohol intake (continuous, grams/day), alternate healthy eating index without sugar-sweetened beverage and alcohol (quintiles), and mutually adjusted for coffee intake (never, < 1/wk, 1/wk to < 1/day, or ≥ 1/day), tea intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day 1/day to < 2/day, or ≥ 2/day), regular soda intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, or ≥ 1/day), diet soda intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, or ≥ 1/day), fruit juice intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, or ≥ 1/day), milk intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, 1/day to < 2/day, or ≥ 2/day), and, adulthood covariates: total energy intake (quintiles, kcal/day), cigarette smoking (never smoker, past smoker, current smoker: 1–14 cigarettes/day, or current smoker: ≥15 cigarettes/day), physical activity (quintiles, Mets/week), oral contraceptive use (never, past, or current), postmenopausal hormone use (never, past, or current), history of hypertension (yes, no), history of hypercholesterolemia (yes, no), aspirin use (yes, no), alcohol intake (0, 0.1 to 4.9, 5.0 to 14.9, 15.0 to 29.9, or ≥ 30 g/day), alternate healthy eating index without sugar-sweetened beverage and alcohol (quintiles), and mutually adjusted for total coffee intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, 1/day to < 2/day, 2/day to < 3/day, 3/day to < 4/day, or ≥ 4/day), tea intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, 1/day to < 2/day, or ≥ 2/day), regular soda intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, or ≥ 1/day), diet soda intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, 1/day to < 2/day, 2/day to < 3/day, or ≥ 3/day), fruit juice intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, or ≥ 1/day), milk intake (never, < 1/wk, 1/wk to < 4/wk, 4/wk to < 1/day, 1/day to < 2/day, or ≥ 2/day), and punch intake (never, < 1/wk, 1/wk to < 4/wk, or ≥ 4/wk). Median adolescent beverage intake (servings/wk): coffee (low: 0.0, medium: 0.5, high: 7.0); tea (low: 0.0, medium: 1.0, high: 7.5); regular soda (low: 0.5, medium: 3.0, high: 7.0); diet soda (low: 0.0, medium: 1.0, high: 7.5); fruit juice (low: 0.5, medium: 3.5, high: 8.0); and, milk (low: 0.0, medium: 3.0, high: 17.5). Median adulthood beverage intake (servings/wk): coffee (low: 1.5, medium: 17.5, high: 27.8); tea (low: 0.2, medium: 3.3, high: 12.3); regular soda (low: 0.0, medium: 1.0, high: 7.2); diet soda (low: 0.2, medium: 7.5, high: 19.7); fruit juice (low: 0.5, medium: 2.5, high: 7.3); and, milk (low: 0.5, medium: 3.7, high: 12.3). P-interaction was assessed by multiplying median values of low, medium and high adolescent and adulthood intake categories. Ref: reference
Influence of consuming coffee and other beverages in adolescence on risk of type 2 diabetes in adulthood
  • Article
  • Publisher preview available

November 2024

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57 Reads

European Journal of Epidemiology

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Lu Zhu

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Background Dietary strategies for type 2 diabetes (T2DM) prevention have mainly focused on solid foods and nutrients. Emanating evidence suggests that beverage consumption in adulthood may also influence T2DM development, whereas the role of beverages during adolescence remains unknow. Objective To examine adolescent beverages consumption, and their changes from adolescence to adulthood in relation to T2DM risk in adulthood. Methods This prospective cohort study, conducted within the Nurses’ Health Study II (NHS II), enrolled 41,317 women who completed a food-frequency questionnaire (FFQ) regarding their diet in high school and had no diabetes, cardiovascular disease, or cancer at baseline (1997). Beverage consumption including coffee, tea, regular or diet soda, fruit juice or milk, was assessed using the FFQ. Cox proportional hazards models were utilized to estimate hazard ratios (HRs) for the association between beverage consumption in adolescence and risk of incident type 2 diabetes (T2DM) in adulthood, adjusting for potential confounders. Results During 725,650 person-years of follow-up, 2,844 participants developed T2DM. After adjustment for demographic, lifestyle and dietary risk factors, comparing ≥ 1 serving/day with non-consumers, adolescent coffee [HR, 0.86 (95% confidence interval: 0.75 to 0.98); P-trend = 0.02)] and orange juice [HR, 0.83 (0.71 to 0.96); P-trend = 0.0008)] consumption was associated with lower T2DM risk, whereas, regular soda [HR, 1.37 (1.20 to 1.57); P-trend < 0.0001)] and iced tea [HR, 1.41 (1.21 to 1.65); P-trend < 0.0001)] intake was associated with higher T2DM risk. Increased coffee intake from adolescence to adulthood in 1991 was associated with a lower T2DM risk [HR, 0.70 (0.61 to 0.80); P-trend < 0.0001), comparing ≥ + 3 servings/day with no change], whereas the opposite was observed for increased regular soda [HR, 1.20 (1.06 to 1.35); P-trend = 0.004), comparing ≥ + 1 or more servings/week with no change)] and diet soda consumption [HR, 1.59 (1.41 to 1.80); P-trend = 0.0002), comparing ≥ + 2 servings/day with no change]. Conclusion Adolescent consumption of coffee or orange juice intake was associated with a lower risk of T2DM, whereas the opposite was observed for intake of regular soda or iced tea. In addition, increased coffee intake was associated with a lower diabetes risk, whereas the opposite was observed for regular or diet soda intake. These data highlight a potentially important role of beverage intake at early life in the etiology of diabetes during adulthood.

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Microbiome-based correction for random errors in nutrient profiles derived from self-reported dietary assessments

October 2024

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48 Reads

Since dietary intake is challenging to directly measure in large-scale cohort studies, we often rely on self-reported instruments (e.g., food frequency questionnaires, 24-hour recalls, and diet records) developed in nutritional epidemiology. Those self-reported instruments are prone to measurement errors, which can lead to inaccuracies in the calculation of nutrient profiles. Currently, few computational methods exist to address this problem. In the present study, we introduce a deep-learning approach—Microbiome-based nutrient profile corrector (METRIC), which leverages gut microbial compositions to correct random errors in self-reported dietary assessments using 24-hour recalls or diet records. We demonstrate the excellent performance of METRIC in minimizing the simulated random errors, particularly for nutrients metabolized by gut bacteria in both synthetic and three real-world datasets. Additionally, we find that METRIC can still correct the random errors well even without including gut microbial compositions. Further research is warranted to examine the utility of METRIC to correct actual measurement errors in self-reported dietary assessment instruments.


GAmAge and GEAA. The correlation between GAmAge and GEAA across OWO group at age period birth to 1y
Child’s GAmAge across OWO groups in selected age periods. Left: results of the multinomial regression with NW as the reference group. Models adjusted for GEAA in days, maternal smoking, delivery method, and child sex. Results presented for the GAmAge and gestational age predictors. N = 831. Right: box plots for GAmAge across OWO groups for age periods birth to 1y, birth to 6y, and birth to 14y. GAmAge, gestational methylation age; GEAA, gestational age; NW, normal weight; OWO, overweight or obese; y, years. *Denotes significant difference at p < 0.05 level
Newborn DNA methylation age differentiates long-term weight trajectories: the Boston Birth Cohort

September 2024

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23 Reads

BMC Medicine

Background Gestational age (GEAA) estimated by newborn DNA methylation (GAmAge) is associated with maternal prenatal exposures and immediate birth outcomes. However, the association of GAmAge with long-term overweight or obesity (OWO) trajectories is yet to be determined. Methods GAmAge was calculated for 831 children from a US predominantly urban, low-income, multi-ethnic birth cohort based on cord blood DNA methylation profile using Illumina EPIC array. Repeated anthropometric measurements aligned with pediatric primary care schedule allowed us to calculate body-mass-index percentiles (BMIPCT) at specific age and to define long-term weight trajectories from birth to 18 years. Results GAmAge was associated with BMIPCT trajectories, defined by 4 groups: stable (consistent OWO: “early OWO”; constant normal weight: “NW”) or non-stable (OWO by year 1 of follow-up: “late OWO”; OWO by year 6 of follow-up: “NW to very late OWO”). GAmAge differentiated between the group with consistently normal BMIPCT pattern and the non-stable groups with late and very late OWO development. Such differentiation was observed in the age periods of birth to 1year, 3years, 6years, 10years, and 14years (p < 0.05 for all). The findings persisted after adjusting for GEAA, maternal smoking, delivery method, and child’s sex in multivariate models. Birth weight was a mediator for the GAmAge effect on OWO status for specific groups at multiple age periods. Conclusions GAmAge is associated with BMIPCT trajectories from birth to age 18 years, independent of GEAA and birth weight. If further confirmed, GAmAge may serve as an early biomarker for predicting BMI trajectory to inform early risk assessment and prevention of OWO. Trial registration ClinicalTrials.gov (NCT03228875).






Understanding the genetic complexity of puberty timing across the allele frequency spectrum

July 2024

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190 Reads

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6 Citations

Nature Genetics

Pubertal timing varies considerably and is associated with later health outcomes. We performed multi-ancestry genetic analyses on ~800,000 women, identifying 1,080 signals for age at menarche. Collectively, these explained 11% of trait variance in an independent sample. Women at the top and bottom 1% of polygenic risk exhibited ~11 and ~14-fold higher risks of delayed and precocious puberty, respectively. We identified several genes harboring rare loss-of-function variants in ~200,000 women, including variants in ZNF483, which abolished the impact of polygenic risk. Variant-to-gene mapping approaches and mouse gonadotropin-releasing hormone neuron RNA sequencing implicated 665 genes, including an uncharacterized G-protein-coupled receptor, GPR83, which amplified the signaling of MC3R, a key nutritional sensor. Shared signals with menopause timing at genes involved in DNA damage response suggest that the ovarian reserve might signal centrally to trigger puberty. We also highlight body size-dependent and independent mechanisms that potentially link reproductive timing to later life disease.



Sedentary Behaviors, Light-Intensity Physical Activity, and Healthy Aging

June 2024

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49 Reads

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3 Citations

JAMA Network Open

Importance Sleep duration and moderate-to-vigorous physical activity (MVPA) are associated with healthy aging, but the associations of sedentary behaviors and light-intensity physical activity (LPA) with healthy aging are still unclear. Objective To examine the independent association of sedentary behaviors and LPA with healthy aging, and to estimate the theoretical association of replacing sedentary behavior with LPA, MVPA, or sleep with healthy aging. Design, Setting, and Participants In this cohort study using data from the Nurses’ Health Study, participants aged 50 years or older and free of major chronic diseases in 1992 were prospectively followed up for 20 years. Data were analyzed from January to May 2022. Exposures Three measures for sedentary behaviors (hours watching television, sitting at work, and other sitting at home) and 2 measures for LPA (hours of standing or walking around at home [LPA-Home] and at work [LPA-Work]). Main Outcomes and Measures Healthy aging was defined as survival to at least age 70 years with maintenance of 4 health domains (ie, no major chronic diseases and no impairment in subjective memory, physical function, or mental health). The isotemporal substitution model was used to evaluate the potential impact on healthy aging of replacing 1 hour of 1 behavior with equivalent duration of another. Results Among 45 176 participants (mean [SD] age, 59.2 [6.0] years), 3873 (8.6%) women achieved healthy aging. After adjustment for covariates including MVPA, each increment of 2 hours per day in sitting watching television was associated with a 12% (95% CI, 7%-17%) reduction in the odds of healthy aging. In contrast, each increase of 2 hours per day in LPA-Work was associated with a 6% (95% CI, 3%-9%) increase in the odds of healthy aging. Replacing 1 hour of sitting watching television with LPA-Home (OR, 1.08; 95% CI, 1.05-1.12), LPA-Work (OR, 1.10; 95% CI, 1.07-1.14), or MVPA (OR, 1.28; 95% CI, 1.23-1.34) was associated with increased odds of healthy aging. Among participants who slept 7 hours per day or less, replacing television time with sleep was also associated with increased odds of healthy aging. Conclusions and Relevance In this cohort study, longer television watching time decreased odds of healthy aging, whereas LPA and MVPA increased odds of healthy aging and replacing sitting watching television with LPA or MVPA, or with sleep in those who slept 7 hours per day or less, was associated with increased odds of healthy aging, providing evidence for rearranging 24-hour behavior to promote overall health.


Citations (55)


... There has been evidence to support that meat intake increases the risk of GDM [62,63]. A recent meta-analysis of individual participant data from 31 cohorts in 20 countries indicated that higher consumption of meat was associated with an increased risk of developing T2D. ...

Reference:

Pre-Pregnancy Provegetarian Food Pattern and the Risk of Developing Gestational Diabetes Mellitus: The Seguimiento Universidad de Navarra (SUN) Cohort Study
Meat consumption and incident type 2 diabetes: an individual-participant federated meta-analysis of 1·97 million adults with 100 000 incident cases from 31 cohorts in 20 countries
  • Citing Article
  • September 2024

... As the global population ages, perspectives on aging are shifting from simply prolonging life to enhancing the quality of life in later years. This shift reflects a growing recognition of "healthy aging," which emphasizes maintaining physical, mental, and social well-being as individuals age, rather than merely focusing on the absence of disease (10,11). Historically, aging has been viewed through a biomedical lens, where the focus has primarily been on the physiological deterioration that comes with advancing years. ...

Sedentary Behaviors, Light-Intensity Physical Activity, and Healthy Aging
  • Citing Article
  • June 2024

JAMA Network Open

... It could also indirectly contribute to lower mortality by enhancing other health outcomes, such as health-related quality of life and physical function [37]. Another cohort study suggested that a higher post-diagnostic intake of total ultra-processed foods in colorectal cancer survivors was associated with increased cancer-specific mortality [38]. The cumulative intake of ultra-processed foods may promote tumor proliferation and metastasis, potentially due to their high glycemic load and inflammatory potential [38,39]. ...

Ultra-processed food consumption and mortality among patients with stages I-III colorectal cancer: a prospective cohort study

EClinicalMedicine

... Additionally, autologous fecal transplantation was effective in weight loss among consumers of a high-polyphenol Green Mediterranean Diet (67). An interesting finding was the inverse association between the Green Mediterranean diet and biological aging in the group with increased polyphenol intake (68). ...

The effect of polyphenols on DNA methylation-assessed biological age attenuation: the DIRECT PLUS randomized controlled trial

BMC Medicine

... Tools coming from natural language processing 12 and machine learning 13 have revolutionized our ability to analyze and interpret the complexities of recipe composition and preparation methods 14 . Applications range from extracting the list of ingredients from meal images 15,16 , to examining nutrient concentration in food 17 , predicting food processing levels 18 and investigating the impact of certain diets on health 19,20 . ...

Nutritional redundancy in the human diet and its application in phenotype association studies

... Consequently, more plant-based and less animal-based foods are increasingly embedded in dietary guidelines across the globe (James-Martin et al., 2022), with notable examples in the United Kingdom (DEFRA, 2022) and Germany (Springmann, 2023). However, societal challenges persist, such as engaging consumers in sustainable healthy food consumption (Biesbroek et al., 2023). This is particularly true for the tourism domain, often characterized by hedonism and liminality. ...

Toward healthy and sustainable diets for the 21st century: Importance of sociocultural and economic considerations

Proceedings of the National Academy of Sciences

... Considering a slightly lower CC for men, the possibility cannot be denied that they forgot to declare beverages. Recently, a reduction in total water content and mortality risk has been reported [41,42]. These intakes need to be evaluated in the future. ...

Beverage consumption and mortality among adults with type 2 diabetes: prospective cohort study

The BMJ

... In addition, several lysophosphatidylcholines (LysoPC) and cholesterol esters have been linked to AF in many recent studies. 69,77,78,80,81 LysoPC species are antiatherogenic, have anti-inflammatory responses, and reduce metabolic syndrome progression, 82 and the concentrations of these metabolites have been lower in AF patients than in controls. 81,82 There is also evidence on the connection between other inflammatory biomarkers and AF. ...

Plasma lipidome and risk of atrial fibrillation: results from the PREDIMED trial

Journal of Physiology and Biochemistry

... However, associations between parents and newborns were not addressed in these twin studies. Hu et al., recently found that there are high correlations between mothers and newborns in whole blood DNAm on both autosomes and chromosome X 25 . ...

Sex differences in the intergenerational link between maternal and neonatal whole blood DNA methylation: a genome-wide analysis in 2 birth cohorts

Clinical Epigenetics

... Low nutrition literacy may stem from inadequate access to nutritional education, misinformation, or a lack of understanding regarding the specific dietary needs of cancer survivors [22,32,33]. Addressing this gap through targeted educational interventions, such as nutrition counseling and workshops tailored to breast cancer survivors, could significantly improve their nutritional knowledge and empower them to make healthier food choices, thereby achieving the prevention of chronic diseases through optimal dietary patterns [34]. ...

Optimal dietary patterns for prevention of chronic disease

Nature Medicine