Pub Date : 2024-10-19DOI: 10.1016/j.clnesp.2024.09.032
Saeedeh Talebi , Peyman Eshraghi
Phenylketonuria (PKU) is a genetic metabolic disease resulting from a deficiency in the enzyme phenylalanine hydroxylase. This defect prevents the conversion of phenylalanine to tyrosine, and as a result, the level of phenylalanine in the body increases abnormally. The accumulation of this amino acid may cause brain damage and grows development in these patients.
The primary approach to treating the disease involves dietary management that restricts protein and phenylalanine intake, often alongside Tetrahydrobiopterin (BH4) supplementation. Medical foods specifically formulated for these patients are utilized to supply the necessary energy, protein, and tyrosine. Other treatment options, including the use of large neutral amino acids (LNAAs) and the enzyme Phenylalanine ammonia lyase (PAL), can be utilized to manage symptoms in adult patients. Advancements in gene therapy aimed at correcting defective genes in patients may help restore phenylalanine metabolism, though further research in this area is necessary. Effective personal management of phenylketonuria necessitates enhanced knowledge and collaboration among healthcare professionals to achieve optimal treatment outcomes for patients. This article emphasis the nutritional management of individuals with phenylketonuria across various stages of their lives.
{"title":"Nutrition in phenylketonuria","authors":"Saeedeh Talebi , Peyman Eshraghi","doi":"10.1016/j.clnesp.2024.09.032","DOIUrl":"10.1016/j.clnesp.2024.09.032","url":null,"abstract":"<div><div>Phenylketonuria (PKU) is a genetic metabolic disease resulting from a deficiency in the enzyme phenylalanine hydroxylase. This defect prevents the conversion of phenylalanine to tyrosine, and as a result, the level of phenylalanine in the body increases abnormally. The accumulation of this amino acid may cause brain damage and grows development in these patients.</div><div>The primary approach to treating the disease involves dietary management that restricts protein and phenylalanine intake, often alongside Tetrahydrobiopterin (BH4) supplementation. Medical foods specifically formulated for these patients are utilized to supply the necessary energy, protein, and tyrosine. Other treatment options, including the use of large neutral amino acids (LNAAs) and the enzyme Phenylalanine ammonia lyase (PAL), can be utilized to manage symptoms in adult patients. Advancements in gene therapy aimed at correcting defective genes in patients may help restore phenylalanine metabolism, though further research in this area is necessary. Effective personal management of phenylketonuria necessitates enhanced knowledge and collaboration among healthcare professionals to achieve optimal treatment outcomes for patients. This article emphasis the nutritional management of individuals with phenylketonuria across various stages of their lives.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Poor oral status during stroke recovery can cause malnutrition, which can markedly affect activities of daily living and prevent patients from being discharged home. Therefore, prompt evaluation and treatment of oral disorders immediately after stroke is essential. This study aimed to examine the impact of poor oral status on the post-stroke recovery of independence in activities of daily living and home discharge.
Methods
This single-center retrospective observational study included 137 patients with acute stroke, divided into two groups based on their Oral Assessment Guide (OAG) scores: the normal OAG group (score = 8) and the impaired OAG group (scores ≥9). Propensity-score matching was performed to minimize confounding variables. The χ2 test and odds ratios were used to compare the percentage of independence and home discharges between the two groups.
Results
The normal and impaired OAG groups exhibited no difference in neurological severity or nutritional intake after matching. The percentage of patients achieving independence in activities of daily living in the normal OAG group (86.8 %) was significantly higher than that in the impaired OAG group (65.8 %) (p = 0.03, odds ratio [OR] 0.29, 95 % confidence interval [CI] 0.09–0.92). Conversely, no significant difference in the percentage of patients discharged home was found (p = 0.15, OR 0.49, 95%CI 0.19–1.29).
Conclusions
This study found that poor oral status after stroke onset was an independent factor affecting independence in activities of daily living at discharge, irrespective of neurological severity and dietary intake.
{"title":"Poor oral status at stroke onset negatively affects activities of daily living at discharge: A propensity-score analysis","authors":"Takuma Mogamiya , Yuki Ohshima , Hiromasa Takashima , Shinya Matsushima , Takuma Watanabe , Misako Mori , Yuta Hagiwara , Hidetaka Onodera","doi":"10.1016/j.clnesp.2024.10.147","DOIUrl":"10.1016/j.clnesp.2024.10.147","url":null,"abstract":"<div><h3>Background & aims</h3><div>Poor oral status during stroke recovery can cause malnutrition, which can markedly affect activities of daily living and prevent patients from being discharged home. Therefore, prompt evaluation and treatment of oral disorders immediately after stroke is essential. This study aimed to examine the impact of poor oral status on the post-stroke recovery of independence in activities of daily living and home discharge.</div></div><div><h3>Methods</h3><div>This single-center retrospective observational study included 137 patients with acute stroke, divided into two groups based on their Oral Assessment Guide (OAG) scores: the normal OAG group (score = 8) and the impaired OAG group (scores ≥9). Propensity-score matching was performed to minimize confounding variables. The χ2 test and odds ratios were used to compare the percentage of independence and home discharges between the two groups.</div></div><div><h3>Results</h3><div>The normal and impaired OAG groups exhibited no difference in neurological severity or nutritional intake after matching. The percentage of patients achieving independence in activities of daily living in the normal OAG group (86.8 %) was significantly higher than that in the impaired OAG group (65.8 %) (p = 0.03, odds ratio [OR] 0.29, 95 % confidence interval [CI] 0.09–0.92). Conversely, no significant difference in the percentage of patients discharged home was found (p = 0.15, OR 0.49, 95%CI 0.19–1.29).</div></div><div><h3>Conclusions</h3><div>This study found that poor oral status after stroke onset was an independent factor affecting independence in activities of daily living at discharge, irrespective of neurological severity and dietary intake.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.clnesp.2024.10.149
Saba Aljasir , Noura M.S. Eid , Emanuela V. Volpi , Ihab Tewfik
Genetic testing is increasingly used in clinical practice to provide personalized information and recommendations about health risks and lifestyle habits at a relatively low cost. Research on the effectiveness of nutrigenomics-guided lifestyle interventions is growing. A scoping review approach was adopted to identify pertinent published studies on nutrigenomics-guided intervention programmes from 2007 to 2023. The review shows that despite the growing interest in nutrigenomics-guided lifestyle interventions, there are still few empirically supported studies, primarily based on developed countries. Furthermore, the findings on the impact of personalised genetic advice are mixed, leaving the field unclear. Existing studies have some empirical strength, contributing to further understanding of the relationship between food and gene expression. However, some limitations that affect the robustness of findings exist, such as a small sample size, insufficient monitoring of the data collection process, and a short follow-up period. Future research needs to address reliability concerns and provide more robust practical evidence.
{"title":"Nutrigenomics-guided lifestyle intervention programmes: A critical scoping review with directions for future research","authors":"Saba Aljasir , Noura M.S. Eid , Emanuela V. Volpi , Ihab Tewfik","doi":"10.1016/j.clnesp.2024.10.149","DOIUrl":"10.1016/j.clnesp.2024.10.149","url":null,"abstract":"<div><div>Genetic testing is increasingly used in clinical practice to provide personalized information and recommendations about health risks and lifestyle habits at a relatively low cost. Research on the effectiveness of nutrigenomics-guided lifestyle interventions is growing. A scoping review approach was adopted to identify pertinent published studies on nutrigenomics-guided intervention programmes from 2007 to 2023. The review shows that despite the growing interest in nutrigenomics-guided lifestyle interventions, there are still few empirically supported studies, primarily based on developed countries. Furthermore, the findings on the impact of personalised genetic advice are mixed, leaving the field unclear. Existing studies have some empirical strength, contributing to further understanding of the relationship between food and gene expression. However, some limitations that affect the robustness of findings exist, such as a small sample size, insufficient monitoring of the data collection process, and a short follow-up period. Future research needs to address reliability concerns and provide more robust practical evidence.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.clnesp.2024.10.148
Bruna Lima Chechin Catussi , Edson Guimarães Lo Turco , Dirceu Mendes Pereira , Rafael Matheus Nunes Teixeira , Bárbara Prestes Castro , Irineu Francisco Delfino Massaia
Precision nutrition, an expanding field at the intersection of nutrition science and personalized medicine, is rapidly evolving with metabolomics integration. Metabolomics, facilitated by advanced technologies like mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy, facilitates comprehensive profiling of metabolites across diverse biological samples. From the perspective of health care systems, precision nutrition gains relevance due to the substantial impact of prevalent non-communicable diseases (NCDs) on societal well-being, which is directly linked with dietary habits and eating behavior. Furthermore, biomarker products derived from metabolomics have been utilized in Europe, the USA, and Brazil to understand metabolic dysregulations and tailor diets accordingly. Despite its burgeoning status, metabolomics holds great potential in revolutionizing nutritional science, particularly with the integration of artificial intelligence and machine learning, offering novel insights into personalized dietary interventions and disease prediction. This narrative review emphasizes the transformative impact of metabolomics in precision and delineates avenues for future research and application, paving the way for a more tailored and practical approach to nutrition management.
{"title":"Metabolomics: Unveiling biological matrices in precision nutrition and health","authors":"Bruna Lima Chechin Catussi , Edson Guimarães Lo Turco , Dirceu Mendes Pereira , Rafael Matheus Nunes Teixeira , Bárbara Prestes Castro , Irineu Francisco Delfino Massaia","doi":"10.1016/j.clnesp.2024.10.148","DOIUrl":"10.1016/j.clnesp.2024.10.148","url":null,"abstract":"<div><div>Precision nutrition, an expanding field at the intersection of nutrition science and personalized medicine, is rapidly evolving with metabolomics integration. Metabolomics, facilitated by advanced technologies like mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy, facilitates comprehensive profiling of metabolites across diverse biological samples. From the perspective of health care systems, precision nutrition gains relevance due to the substantial impact of prevalent non-communicable diseases (NCDs) on societal well-being, which is directly linked with dietary habits and eating behavior. Furthermore, biomarker products derived from metabolomics have been utilized in Europe, the USA, and Brazil to understand metabolic dysregulations and tailor diets accordingly. Despite its burgeoning status, metabolomics holds great potential in revolutionizing nutritional science, particularly with the integration of artificial intelligence and machine learning, offering novel insights into personalized dietary interventions and disease prediction. This narrative review emphasizes the transformative impact of metabolomics in precision and delineates avenues for future research and application, paving the way for a more tailored and practical approach to nutrition management.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 10.1016/j.clnesp.2024.09.033
Judwin Ndzo , Sudheer K. Vuyyuru , Thomas Trimble , Kaung Yan , Grazziela Figueredo , Gordon W. Moran
Background & aims
Incidence of obesity and Crohn's disease (CD) is increasing globally. Therefore, understanding any associations between adiposity and disease phenotype is crucial. We aimed explore the relationship between nutritional status measured by body mass index (BMI) and phenotypes of CD using a large national recallable data set.
Methods
Using National Institute for Health and Care Research-IBD Bioresource data base, we retrospectively assessed the relationship between BMI and stenosing CD by logistic regression. BMI was the primary variable of interest; CD behaviour was the dependent variable; stenosing CD was the primary outcome. Confounders were adjusted for in a multivariate model.
Results
8797 patients diagnosed between 1942 and 2020 were included. Mean overall BMI was 26.3 kg/m2 (SD5.5). 52.7 % had a BMI ≥25 kg/m2 (mean 30.2 kg/m2, SD 4.5). Majority had inflammatory CD (62.9 %) followed by stenosing (25.1 %) and penetrating CD (12 %). Stenosing and penetrating phenotypes were more common in the <25 kg/m2 BMI group (50.7 %, 50.3 % respectively) p < 0.001. Colonic disease location was more common (27.8 % vs 24.3 %, p = 0.001) in patients with high BMI. On univariate analysis, stenosing disease was positively associated with ileal disease location, disease duration, previous surgery, use of infliximab, ustekinumab, vedolizumab, adalimumab and azathioprine but negatively associated with BMI (OR 0.98, 95%CI [0.968–0.99]). On multivariate analyses, BMI remained negatively associated with stenosing CD (OR 0.98, 95%CI [0.97–0.99]); ileal disease location (OR 3.69, 95%CI [3.22–4.24]), adalimumab (OR 1.47, 95%CI [1.30–1.66]), ustekinumab usage (OR 1.51, 95%CI [1.14–2.01] and azathioprine (OR 1.35, 95%CI [1.19–1.53]).
Conclusions
After multivariate analyses, BMI, ileal disease location and biologic use was negatively associated with a stenosing disease phenotype. This might reflect a change in eating behaviour due to persistent postprandial symptoms related to stenosing disease. Large longitudinal studies are needed to investigate any possible temporal relationship between the obesogenic state and intestinal fibrosis.
{"title":"Association between nutritional status assessed by body mass index and Crohn's disease phenotype: A Nation-wide analysis","authors":"Judwin Ndzo , Sudheer K. Vuyyuru , Thomas Trimble , Kaung Yan , Grazziela Figueredo , Gordon W. Moran","doi":"10.1016/j.clnesp.2024.09.033","DOIUrl":"10.1016/j.clnesp.2024.09.033","url":null,"abstract":"<div><h3>Background & aims</h3><div>Incidence of obesity and Crohn's disease (CD) is increasing globally. Therefore, understanding any associations between adiposity and disease phenotype is crucial. We aimed explore the relationship between nutritional status measured by body mass index (BMI) and phenotypes of CD using a large national recallable data set.</div></div><div><h3>Methods</h3><div>Using National Institute for Health and Care Research-IBD Bioresource data base, we retrospectively assessed the relationship between BMI and stenosing CD by logistic regression. BMI was the primary variable of interest; CD behaviour was the dependent variable; stenosing CD was the primary outcome. Confounders were adjusted for in a multivariate model.</div></div><div><h3>Results</h3><div>8797 patients diagnosed between 1942 and 2020 were included. Mean overall BMI was 26.3 kg/m<sup>2</sup> (SD5.5). 52.7 % had a BMI ≥25 kg/m<sup>2</sup> (mean 30.2 kg/m<sup>2</sup>, SD 4.5). Majority had inflammatory CD (62.9 %) followed by stenosing (25.1 %) and penetrating CD (12 %). Stenosing and penetrating phenotypes were more common in the <25 kg/m<sup>2</sup> BMI group (50.7 %, 50.3 % respectively) p < 0.001. Colonic disease location was more common (27.8 % vs 24.3 %, p = 0.001) in patients with high BMI. On univariate analysis, stenosing disease was positively associated with ileal disease location, disease duration, previous surgery, use of infliximab, ustekinumab, vedolizumab, adalimumab and azathioprine but negatively associated with BMI (OR 0.98, 95%CI [0.968–0.99]). On multivariate analyses, BMI remained negatively associated with stenosing CD (OR 0.98, 95%CI [0.97–0.99]); ileal disease location (OR 3.69, 95%CI [3.22–4.24]), adalimumab (OR 1.47, 95%CI [1.30–1.66]), ustekinumab usage (OR 1.51, 95%CI [1.14–2.01] and azathioprine (OR 1.35, 95%CI [1.19–1.53]).</div></div><div><h3>Conclusions</h3><div>After multivariate analyses, BMI, ileal disease location and biologic use was negatively associated with a stenosing disease phenotype. This might reflect a change in eating behaviour due to persistent postprandial symptoms related to stenosing disease. Large longitudinal studies are needed to investigate any possible temporal relationship between the obesogenic state and intestinal fibrosis.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.clnesp.2024.10.145
Peipei Wang , Junjian Chen , Zhipeng Li , Husheng Xiong , Ziying Lei , Dabiao Chen , Ying Zhang , Zhiliang Gao , Zhishuo Mo
Background & aim
Functional cure for chronic hepatitis B (CHB) patients can be achieved using nucleos(t)ide analogues (NAs) and pegylated interferon alpha (Peg-IFNα) combination treatment. However, the role of vitamin D in functional cure remains unclear. We aimed to investigate the association between vitamin D levels and functional cure in CHB patients.
Methods
A retrospective study was conducted to detect changes in serum 25-hydroxyvitamin D (25(OH)D) levels in 526 CHB patients. Furthermore, an intervention study was conducted on 90 CHB patients with baseline vitamin D insufficiency, and 45 patients were randomly assigned to the control group receiving NAs/Peg-IFNα treatment, whereas the remaining patients were categorized into the vitamin D group (VD group) receiving NAs/Peg-IFNα treatment combined with vitamin D supplementation at 800 IU/day.
Results
A retrospective study revealed a progressive elevation in serum 25(OH)D levels throughout the duration of treatment. The cured group displayed significantly higher serum 25(OH)D levels than the uncured group (P = 0.046) at the end of treatment, and the changes in serum 25(OH)D (Δ25(OH)D) levels between the two groups were found to be significantly different (P < 0.0001). In the intervention study, the VD group tended to have an increased functional cure rate (48.0 %) compared with the control group (34.3 %) in the binary logistic regression equation analysis (P = 0.09). Notably, a linear mixed-effects model in the longitudinal analysis indicated a significant impact of serum 25(OH)D levels on treatment outcomes (P = 0.017).
Conclusions
Serum 25(OH)D and Δ25(OH)D were both positively associated with functional cure in this retrospective study, and vitamin D supplementation may be helpful for functional cure in CHB patients.
Registration number of clinical trial
ChiCTR1800020108.
背景和目的：使用核苷（t）ide 类似物（NAs）和聚乙二醇干扰素α（Peg-IFNα）联合治疗可实现慢性乙型肝炎（CHB）患者的功能性治愈。然而，维生素 D 在功能性治愈中的作用仍不清楚。我们旨在研究维生素 D 水平与慢性阻塞性肺病患者功能性治愈之间的关系：方法：我们进行了一项回顾性研究，以检测 526 名慢性阻塞性肺病患者血清 25- 羟维生素 D（25(OH)D）水平的变化。此外，还对 90 名维生素 D 基线不足的慢性阻塞性肺病患者进行了干预研究，其中 45 名患者被随机分配到接受 NAs/Peg-IFNα 治疗的对照组，而其余患者则被分为维生素 D 组（VD 组），在接受 NAs/Peg-IFNα 治疗的同时每天补充 800 IU 的维生素 D：一项回顾性研究显示，在整个治疗过程中，血清 25(OH)D 水平逐渐升高。治疗结束时，治愈组的血清 25（OH）D 水平明显高于未治愈组（P = 0.046），两组间血清 25（OH）D（Δ25（OH）D）水平的变化有显著差异（P < 0.0001）。在干预研究中，与对照组（34.3%）相比，在二元逻辑回归方程分析中，VD 组的功能治愈率（48.0%）有增加的趋势（P = 0.09）。值得注意的是，纵向分析中的线性混合效应模型显示，血清25（OH）D水平对治疗结果有显著影响（P = 0.017）：结论：在这项回顾性研究中，血清25（OH）D和Δ25（OH）D均与功能性治愈呈正相关，补充维生素D可能有助于CHB患者的功能性治愈：临床试验注册号：ChiCTR1800020108。
{"title":"Association of vitamin D with functional cure in chronic hepatitis B: Insights from a retrospective cohort study and an intervention study","authors":"Peipei Wang , Junjian Chen , Zhipeng Li , Husheng Xiong , Ziying Lei , Dabiao Chen , Ying Zhang , Zhiliang Gao , Zhishuo Mo","doi":"10.1016/j.clnesp.2024.10.145","DOIUrl":"10.1016/j.clnesp.2024.10.145","url":null,"abstract":"<div><h3>Background & aim</h3><div>Functional cure for chronic hepatitis B (CHB) patients can be achieved using nucleos(t)ide analogues (NAs) and pegylated interferon alpha (Peg-IFNα) combination treatment. However, the role of vitamin D in functional cure remains unclear. We aimed to investigate the association between vitamin D levels and functional cure in CHB patients.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted to detect changes in serum 25-hydroxyvitamin D (25(OH)D) levels in 526 CHB patients. Furthermore, an intervention study was conducted on 90 CHB patients with baseline vitamin D insufficiency, and 45 patients were randomly assigned to the control group receiving NAs/Peg-IFNα treatment, whereas the remaining patients were categorized into the vitamin D group (VD group) receiving NAs/Peg-IFNα treatment combined with vitamin D supplementation at 800 IU/day.</div></div><div><h3>Results</h3><div>A retrospective study revealed a progressive elevation in serum 25(OH)D levels throughout the duration of treatment. The cured group displayed significantly higher serum 25(OH)D levels than the uncured group (<em>P</em> = 0.046) at the end of treatment, and the changes in serum 25(OH)D (Δ25(OH)D) levels between the two groups were found to be significantly different (<em>P</em> < 0.0001). In the intervention study, the VD group tended to have an increased functional cure rate (48.0 %) compared with the control group (34.3 %) in the binary logistic regression equation analysis (<em>P</em> = 0.09). Notably, a linear mixed-effects model in the longitudinal analysis indicated a significant impact of serum 25(OH)D levels on treatment outcomes (<em>P</em> = 0.017).</div></div><div><h3>Conclusions</h3><div>Serum 25(OH)D and Δ25(OH)D were both positively associated with functional cure in this retrospective study, and vitamin D supplementation may be helpful for functional cure in CHB patients.</div></div><div><h3>Registration number of clinical trial</h3><div>ChiCTR1800020108.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.clnesp.2024.10.146
Mojgan Rajati , Fatemeh Rajati , Maryam Chegeni , Roumina Rasulehvandi , Mohsen Rezaei , Maryam Ganjabi , Mohsen Kazeminia
Background
Preeclampsia is a type of hypertension disorder characterized by symptoms of damage to other organs. The effect of omega-3 supplementation and fish oil on preeclampsia has been studied several times over the years. Therefore, due to the importance of the subject and the inconsistency of the results of the studies, the present research aimed to estimate the effect of omega-3 supplementation and fish oil on preeclampsia by systematic review and meta-analysis.
Methods
The present systematic review and meta-analysis was performed according to PRISMA guidelines from 1990 to February 2022. A systematic literature review was conducted in MagIran, SID, PubMed, Embase, Scopus, Web of Science (WoS) databases and Google Scholar motor engine using related MeSH/Emtree terms, which were combined with free text word. The heterogeneity of the studies was addressed using I2 index and publication bias was assessed using Egger's regression intercept.
Results
The initial systematic literature search retrieved 12095 studies, of which 16 articles with a sample size of 8004 subjects in the intervention group and 8233 in the control group were finally included in the meta-analysis after excluding irrelevant studies. As a result of combining primary studies, the risk ratio of the frequency of total preeclampsia (mild and severe) was obtained (RR: 0.63; 95 % CI, 0.41–0.95, P = 0.027) in the intervention group compared to the control group and risk ratio of the frequency of severe preeclampsia was calculated (RR: 0.45; 95 % CI, 0.24–0.83, P = 0.011) in the intervention group compared to the control group.
Conclusion
Based on the results of the present study, the consumption of omega-3 supplementation and fish oil significantly reduces the risk of developing preeclampsia. Therefore, it seems that omega-3 supplementation and fish oil can be considered in preventing preeclampsia.
{"title":"The effect of Omega-3 supplementation and fish oil on preeclampsia: A systematic review and meta-analysis","authors":"Mojgan Rajati , Fatemeh Rajati , Maryam Chegeni , Roumina Rasulehvandi , Mohsen Rezaei , Maryam Ganjabi , Mohsen Kazeminia","doi":"10.1016/j.clnesp.2024.10.146","DOIUrl":"10.1016/j.clnesp.2024.10.146","url":null,"abstract":"<div><h3>Background</h3><div>Preeclampsia is a type of hypertension disorder characterized by symptoms of damage to other organs. The effect of omega-3 supplementation and fish oil on preeclampsia has been studied several times over the years. Therefore, due to the importance of the subject and the inconsistency of the results of the studies, the present research aimed to estimate the effect of omega-3 supplementation and fish oil on preeclampsia by systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>The present systematic review and meta-analysis was performed according to PRISMA guidelines from 1990 to February 2022. A systematic literature review was conducted in MagIran, SID, PubMed, Embase, Scopus, Web of Science (WoS) databases and Google Scholar motor engine using related MeSH/Emtree terms, which were combined with free text word. The heterogeneity of the studies was addressed using <em>I</em><sup>2</sup> index and publication bias was assessed using Egger's regression intercept.</div></div><div><h3>Results</h3><div>The initial systematic literature search retrieved 12095 studies, of which 16 articles with a sample size of 8004 subjects in the intervention group and 8233 in the control group were finally included in the meta-analysis after excluding irrelevant studies. As a result of combining primary studies, the risk ratio of the frequency of total preeclampsia (mild and severe) was obtained (RR: 0.63; 95 % CI, 0.41–0.95, <em>P</em> = 0.027) in the intervention group compared to the control group and risk ratio of the frequency of severe preeclampsia was calculated (RR: 0.45; 95 % CI, 0.24–0.83, <em>P</em> = 0.011) in the intervention group compared to the control group.</div></div><div><h3>Conclusion</h3><div>Based on the results of the present study, the consumption of omega-3 supplementation and fish oil significantly reduces the risk of developing preeclampsia. Therefore, it seems that omega-3 supplementation and fish oil can be considered in preventing preeclampsia.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.clnesp.2024.10.150
Ísis Gois , Débora C.K. Lichtenecker , Nathália Beserra , Emily Rocha Cordeiro , Isadora Gonçalves Almeida , Isabela Borges da Silveira , João Guimarães Ferreira , Felipe Behrends Rodrigues , Charlles Heldan de Moura Castro , Guiomar Nascimento Gomes , Magnus R. Dias-da-Silva
Background & aims
Gender-affirming hormone therapy (GAHT) is essential for transgender individuals seeking body modifications. For transfeminine people assigned male at birth, GAHT typically involves a combination of antiandrogens and estrogens. Despite its importance, the scientific literature presents inconsistencies regarding the effects of these hormones on nutritional status, body composition, and biochemical markers. This study aims to evaluate the impact of estradiol enanthate and dihydroxyprogesterone acetophenide (E2EN/DHPA) hormonal treatment, in conjunction with resistive physical exercise, on body composition and metabolic profiles.
Methods
Twenty-eight male rats were divided into three groups: MO (control group, n = 8), receiving sesame oil vehicle; MH (n = 11), receiving E2EN/DHPA; and MEH (n = 9), receiving E2EN/DHPA along with physical exercise. The hormonal treatment was administered every ten days for two months, while the exercise regimen involved stair climbing with progressively increasing weights, performed five times weekly for seven weeks. Evaluated parameters included body mass index (BMI), body composition (fat and lean mass), bone mineral density (BMD), and lipid profile (triglycerides, HDL-C, LDL-C).
Results
The rats that received E2EN/DHPA showed significant changes in body composition and BMI, regardless of exercise. The MH group had increased body fat, while both the MH and MEH groups had decreased bone area and mineral content. However, BMD remained the same across all groups. Elevated triglyceride levels were observed, and the MEH group also had reduced LDL-C levels. HDL-C levels did not show significant variation.
Conclusion
The study's findings show similarities to changes seen in transfeminine individuals undergoing GAHT with estrogen and antiandrogens. These changes include decreased muscle mass, increased body fat, preserved bone mineral density, and elevated triglycerides. The study also found that resistance exercise positively impacted lipid profiles, particularly in reducing LDL-C. These results highlight the need for further research and comparative trials on hormone therapy regimens.
{"title":"Evaluating changes in body composition, bone mass, and metabolic profile in an animal model undergoing transfeminine hormone therapy and physical exercise","authors":"Ísis Gois , Débora C.K. Lichtenecker , Nathália Beserra , Emily Rocha Cordeiro , Isadora Gonçalves Almeida , Isabela Borges da Silveira , João Guimarães Ferreira , Felipe Behrends Rodrigues , Charlles Heldan de Moura Castro , Guiomar Nascimento Gomes , Magnus R. Dias-da-Silva","doi":"10.1016/j.clnesp.2024.10.150","DOIUrl":"10.1016/j.clnesp.2024.10.150","url":null,"abstract":"<div><h3>Background & aims</h3><div>Gender-affirming hormone therapy (GAHT) is essential for transgender individuals seeking body modifications. For transfeminine people assigned male at birth, GAHT typically involves a combination of antiandrogens and estrogens. Despite its importance, the scientific literature presents inconsistencies regarding the effects of these hormones on nutritional status, body composition, and biochemical markers. This study aims to evaluate the impact of estradiol enanthate and dihydroxyprogesterone acetophenide (E2EN/DHPA) hormonal treatment, in conjunction with resistive physical exercise, on body composition and metabolic profiles.</div></div><div><h3>Methods</h3><div>Twenty-eight male rats were divided into three groups: MO (control group, n = 8), receiving sesame oil vehicle; MH (n = 11), receiving E2EN/DHPA; and MEH (n = 9), receiving E2EN/DHPA along with physical exercise. The hormonal treatment was administered every ten days for two months, while the exercise regimen involved stair climbing with progressively increasing weights, performed five times weekly for seven weeks. Evaluated parameters included body mass index (BMI), body composition (fat and lean mass), bone mineral density (BMD), and lipid profile (triglycerides, HDL-C, LDL-C).</div></div><div><h3>Results</h3><div>The rats that received E2EN/DHPA showed significant changes in body composition and BMI, regardless of exercise. The MH group had increased body fat, while both the MH and MEH groups had decreased bone area and mineral content. However, BMD remained the same across all groups. Elevated triglyceride levels were observed, and the MEH group also had reduced LDL-C levels. HDL-C levels did not show significant variation.</div></div><div><h3>Conclusion</h3><div>The study's findings show similarities to changes seen in transfeminine individuals undergoing GAHT with estrogen and antiandrogens. These changes include decreased muscle mass, increased body fat, preserved bone mineral density, and elevated triglycerides. The study also found that resistance exercise positively impacted lipid profiles, particularly in reducing LDL-C. These results highlight the need for further research and comparative trials on hormone therapy regimens.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 10.1016/j.clnesp.2024.09.029
Sara-Pier Paquet , Etienne Pronovost , David Simonyan , Georges Caouette , Célia Matte-Gagné , François Olivier , Julie Bartholomew , Alyssa Morin , Ibrahim Mohamed , Isabelle Marc , Mireille Guillot
Background & aims
Docosahexaenoic acid (DHA) is the most abundant omega-3 fatty acid in the brain and is accumulated by the fetal brain during the last trimester of pregnancy. Our objective was to determine whether high-dose DHA supplementation during the neonatal period, vs. placebo, improves behavioral functioning at 5 years in children born very preterm.
Methods
This is a follow-up at 5 years corrected age of a subset of children who participated in a multicenter randomized controlled trial. The participants received a high-dose DHA supplementation, or a placebo, through maternal breastmilk until 36 weeks’ postmenstrual age. Primary outcome was child behavioral functioning, assessed by the Total Difficulties Score from the Strengths and Difficulties Questionnaire (SDQ). Secondary outcomes included behavioral scores from the SDQ, executive functions assessment and global developmental performance. Neurodevelopmental outcomes were assessed through interviews with parents. Mean differences between DHA and placebo groups were estimated using mixed linear models. Subgroup analyses were conducted for sex and gestational age (GA) at birth.
Results
Among 177 eligible children, 132 (74.6 %) completed neurodevelopmental assessment at 5 years (DHA, N = 64, placebo, N = 68). Total Difficulties Score did not differ between the DHA and placebo groups (mean differences, −0.9 [95 % confidence interval, −2.7 to 0.8], P = 0.30), nor any of the secondary outcomes. There was no significant interaction between treatment groups and sex, nor GA, for the primary outcome. However, significant interactions between treatment groups and sex or GA were found for some secondary outcomes.
Conclusions
In very preterm infants, high-dose DHA supplementation did not improve behavioral functioning at 5 years.
背景与目的：二十二碳六烯酸（DHA）是大脑中含量最丰富的欧米伽-3 脂肪酸，胎儿大脑在怀孕的最后三个月就会积累这种脂肪酸。我们的目的是确定在新生儿期补充高剂量 DHA 与补充安慰剂相比，是否能改善极早产儿 5 岁时的行为功能：这是对参加多中心随机对照试验的儿童进行的 5 岁随访。参加者在月经后 36 周之前一直通过母乳摄入高剂量 DHA 或安慰剂。主要结果是儿童的行为功能，通过优势与困难问卷（SDQ）中的困难总分进行评估。次要结果包括 SDQ 的行为得分、执行功能评估和总体发育表现。神经发育结果通过与家长的访谈进行评估。采用混合线性模型估算了DHA组和安慰剂组之间的平均差异。根据出生时的性别和胎龄（GA）进行了分组分析：在 177 名符合条件的儿童中，132 名（74.6%）在 5 岁时完成了神经发育评估（DHA，64 人；安慰剂，68 人）。DHA组和安慰剂组的总困难评分没有差异（平均差异为-0.9 [95%置信区间为-2.7至0.8]，P=0.30），任何次要结果也没有差异。在主要结果方面，治疗组与性别和 GA 之间没有明显的交互作用。然而，在一些次要结果中，治疗组与性别或性别差异之间存在明显的交互作用：结论：对于早产儿，补充高剂量的 DHA 并不能改善其 5 岁时的行为功能：临床试验注册：ClinicalTrials.gov，NCT02371460，https://clinicaltrials.gov/study/NCT02371460。
{"title":"Maternal high-dose docosahexaenoic acid supplementation and neurodevelopment at 5 Years of preterm children","authors":"Sara-Pier Paquet , Etienne Pronovost , David Simonyan , Georges Caouette , Célia Matte-Gagné , François Olivier , Julie Bartholomew , Alyssa Morin , Ibrahim Mohamed , Isabelle Marc , Mireille Guillot","doi":"10.1016/j.clnesp.2024.09.029","DOIUrl":"10.1016/j.clnesp.2024.09.029","url":null,"abstract":"<div><h3>Background & aims</h3><div>Docosahexaenoic acid (DHA) is the most abundant omega-3 fatty acid in the brain and is accumulated by the fetal brain during the last trimester of pregnancy. Our objective was to determine whether high-dose DHA supplementation during the neonatal period, vs. placebo, improves behavioral functioning at 5 years in children born very preterm.</div></div><div><h3>Methods</h3><div>This is a follow-up at 5 years corrected age of a subset of children who participated in a multicenter randomized controlled trial. The participants received a high-dose DHA supplementation, or a placebo, through maternal breastmilk until 36 weeks’ postmenstrual age. Primary outcome was child behavioral functioning, assessed by the Total Difficulties Score from the Strengths and Difficulties Questionnaire (SDQ). Secondary outcomes included behavioral scores from the SDQ, executive functions assessment and global developmental performance. Neurodevelopmental outcomes were assessed through interviews with parents. Mean differences between DHA and placebo groups were estimated using mixed linear models. Subgroup analyses were conducted for sex and gestational age (GA) at birth.</div></div><div><h3>Results</h3><div>Among 177 eligible children, 132 (74.6 %) completed neurodevelopmental assessment at 5 years (DHA, N = 64, placebo, N = 68). Total Difficulties Score did not differ between the DHA and placebo groups (mean differences, −0.9 [95 % confidence interval, −2.7 to 0.8], P = 0.30), nor any of the secondary outcomes. There was no significant interaction between treatment groups and sex, nor GA, for the primary outcome. However, significant interactions between treatment groups and sex or GA were found for some secondary outcomes.</div></div><div><h3>Conclusions</h3><div>In very preterm infants, high-dose DHA supplementation did not improve behavioral functioning at 5 years.</div></div><div><h3>Clinical trial registration</h3><div>ClinicalTrials.gov, NCT02371460, <span><span>https://clinicaltrials.gov/study/NCT02371460</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 10.1016/j.clnesp.2024.10.004
Sunmin Park, Da Sol Kim, Suna Kang
Background and aim: Carbonated sugar-sweetened beverages (CSSB) intake has been increasingly linked to metabolic diseases. To investigate the association between CSSB intake and metabolic syndrome (MetS) risk, and the interaction between genetic predisposition to CSSB intake and dietary patterns.
Methods: We examined a hospital-based cohort of 57,940 participants, categorized into low-CSSB (n = 52,848) and high-CSSB (n = 5092) groups based on a 50 ml daily consumption cutoff. A genome-wide association study (GWAS) identified single-nucleotide polymorphisms (SNPs) associated with CSSB intake, and SNP-SNP/SNP-environment interactions were explored. Using XGBoost and deep neural network (DNN) approaches, we developed prediction models for CSSB intake.
Results: The low- and high-CSSB groups daily consumed an average of 0.56 and 8.91 g sugar from the soda, respectively. The high-CSSB group had unhealthy dietary habits and a lower intake of carotenoids, folate, vitamins C and D, calcium, flavonoids, and phenols than the low-CSSB group, consistent with the results of the prediction models. A polygenic risk score (PRS) based on 6 selected SNPs, linked to genes involved in obesity, diabetes, and nervous system disorders, showed the strongest association with CSSB intake and insulin resistance. Notably, carbohydrate, fat, and Western-style diet (WSD) intake interacted with the PRS, with lower carbohydrate and higher fat and WSD intakes associated with a stronger PRS-sugar intake relationship. The prediction models by XGboost and DNN mainly included dietary factors to explain CSSB intake.
Conclusions: A significant interplay between genetic predisposition and poor dietary habits, particularly increased CSSB intake associated with WSD, contributed to MetS risk. It suggested that personalized dietary interventions based on genetic profiles could mitigate MetS risk, especially in populations transitioning to Westernized diets.
{"title":"Gene-diet interactions in carbonated sugar-sweetened beverage consumption and metabolic syndrome risk: A machine learning analysis in a large hospital-based cohort.","authors":"Sunmin Park, Da Sol Kim, Suna Kang","doi":"10.1016/j.clnesp.2024.10.004","DOIUrl":"10.1016/j.clnesp.2024.10.004","url":null,"abstract":"<p><strong>Background and aim: </strong>Carbonated sugar-sweetened beverages (CSSB) intake has been increasingly linked to metabolic diseases. To investigate the association between CSSB intake and metabolic syndrome (MetS) risk, and the interaction between genetic predisposition to CSSB intake and dietary patterns.</p><p><strong>Methods: </strong>We examined a hospital-based cohort of 57,940 participants, categorized into low-CSSB (n = 52,848) and high-CSSB (n = 5092) groups based on a 50 ml daily consumption cutoff. A genome-wide association study (GWAS) identified single-nucleotide polymorphisms (SNPs) associated with CSSB intake, and SNP-SNP/SNP-environment interactions were explored. Using XGBoost and deep neural network (DNN) approaches, we developed prediction models for CSSB intake.</p><p><strong>Results: </strong>The low- and high-CSSB groups daily consumed an average of 0.56 and 8.91 g sugar from the soda, respectively. The high-CSSB group had unhealthy dietary habits and a lower intake of carotenoids, folate, vitamins C and D, calcium, flavonoids, and phenols than the low-CSSB group, consistent with the results of the prediction models. A polygenic risk score (PRS) based on 6 selected SNPs, linked to genes involved in obesity, diabetes, and nervous system disorders, showed the strongest association with CSSB intake and insulin resistance. Notably, carbohydrate, fat, and Western-style diet (WSD) intake interacted with the PRS, with lower carbohydrate and higher fat and WSD intakes associated with a stronger PRS-sugar intake relationship. The prediction models by XGboost and DNN mainly included dietary factors to explain CSSB intake.</p><p><strong>Conclusions: </strong>A significant interplay between genetic predisposition and poor dietary habits, particularly increased CSSB intake associated with WSD, contributed to MetS risk. It suggested that personalized dietary interventions based on genetic profiles could mitigate MetS risk, especially in populations transitioning to Westernized diets.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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