Pub Date : 2024-09-30DOI: 10.1016/j.clnesp.2024.09.024
Tara Conway, Karin Seidler, Michelle Barrow
<div><h3>Background and aims</h3><div>Growing evidence suggests nutritional intervention may influence the development and progression of Alzheimer's Disease (AD). Choline, an essential dietary nutrient plays a critical role in neurological development and brain function, however, its effects on AD in humans is unclear. The research aims to investigate mechanistic links between dietary choline intake and cognitive functioning, focusing on the role of phosphatidylcholine (PC) in neuroplasticity and its interaction with amyloid beta (Aβ) peptides in neuron membranes. Additionally, human evidence on the potential benefits of PC interventions on AD, cognition, and proposed mechanisms are evaluated.</div></div><div><h3>Methods</h3><div>A reproducible systematic literature search was performed using a three-tranche strategy, consisting of a review, mechanism, and intervention search. Using PubMed as the main database, 1254 titles and abstracts were screened, 149 papers were read in full and 65 peer-reviewed papers were accepted, critically appraised, and analysed in a narrative review.</div></div><div><h3>Results</h3><div>Predominantly preclinical evidence demonstrated that PC enhances neuroplasticity, a key biological substrate for cognition, by activating intracellular neuronal signalling pathways or through neuron membrane function.</div><div>Molecular dynamic simulation methods provided a mechanistic understanding of the interconnection between neuronal PC content and the potential behaviour and trajectory of Aβ peptide aggregation. The results indicate that the neuronal membrane composition of PC is critical to inhibiting Aβ aggregation and neuronal damage, protecting the neuron from Aβ toxicity. This might provide a foundation for optimising cellular PC which may prove beneficial in the treatment or prevention of neurodegenerative disease.</div><div>Altered PC metabolism in AD was evidenced in observational studies; however, whether this relationship represents a cause or consequence of AD remains to be determined. Human intervention studies did not produce conclusive evidence supporting its effectiveness in enhancing cognitive function. This lack of consistency primarily stems from methodological constraints within the conducted studies. Human observational research provided the most compelling evidence linking a higher dietary PC intake to a reduced risk of dementia and significant improvements in cognitive testing.</div></div><div><h3>Conclusion</h3><div>Despite the lack of randomised control trials (RCTs) assessing the efficacy of lecithin/PC to improve cognition in AD patients, there exists promising evidence supporting its neuroprotective and neurotrophic role.</div><div>This review establishes an evidence-based framework through chains of mechanistic evidence, that may provide potential strategies for enhanced neuroprotection and reduced neurodegeneration caused by AD. Considering the escalating global burden of AD and the current shortcom
背景和目的：越来越多的证据表明，营养干预可能会影响阿尔茨海默病（AD）的发生和发展。胆碱是一种必需的膳食营养素，在神经系统发育和大脑功能中起着至关重要的作用，但它对人类阿兹海默症的影响尚不清楚。这项研究旨在调查膳食胆碱摄入量与认知功能之间的机理联系，重点研究磷脂酰胆碱（PC）在神经可塑性中的作用及其与神经元膜中β淀粉样蛋白（Aβ）肽的相互作用。此外，还评估了有关PC干预对AD、认知和拟议机制的潜在益处的人类证据：方法：采用回顾、机制和干预搜索三管齐下的策略进行了可重复的系统性文献检索。以PubMed为主要数据库，筛选了1254篇标题和摘要，全文阅读了149篇论文，接受了65篇经同行评审的论文，并对其进行了严格评估和叙事性综述分析：主要临床前证据表明，多氯化萘可通过激活细胞内神经元信号通路或神经元膜功能来增强神经可塑性，而神经可塑性是认知的关键生物基质。分子动态模拟方法从机理上理解了神经元 PC 含量与 Aβ 肽聚集的潜在行为和轨迹之间的相互联系。研究结果表明，神经元膜的 PC 成分对于抑制 Aβ 聚集和神经元损伤、保护神经元免受 Aβ 毒性损伤至关重要。这可能为优化细胞 PC 提供了基础，从而可能被证明有益于治疗或预防神经退行性疾病。观察性研究证明，多糖代谢改变会导致注意力缺失症；然而，这种关系是注意力缺失症的原因还是结果仍有待确定。人体干预研究并没有提供确凿证据证明 PC 能有效增强认知功能。这种一致性的缺乏主要源于所进行研究的方法限制。人体观察研究提供了最有说服力的证据，证明膳食中摄入更多的 PC 与降低痴呆症风险和显著改善认知测试有关：尽管缺乏随机对照试验（RCT）来评估卵磷脂/PC 对改善注意力缺失症患者认知能力的功效，但仍有证据表明卵磷脂/PC 具有保护神经和营养神经的作用。本综述通过机理证据链建立了一个循证框架，可为加强神经保护和减少注意力缺失症引起的神经变性提供潜在策略。考虑到注意力缺失症给全球带来的日益沉重的负担以及目前有效治疗方法的不足，本综述以及在现有研究中发现的局限性和差距提出了宝贵的见解，强调了对 PC 与注意力缺失症之间的关系进行更全面研究的紧迫性。
{"title":"Unlocking choline's potential in Alzheimer's disease: A narrative review exploring the neuroprotective and neurotrophic role of phosphatidylcholine and assessing its impact on memory and learning","authors":"Tara Conway, Karin Seidler, Michelle Barrow","doi":"10.1016/j.clnesp.2024.09.024","DOIUrl":"10.1016/j.clnesp.2024.09.024","url":null,"abstract":"<div><h3>Background and aims</h3><div>Growing evidence suggests nutritional intervention may influence the development and progression of Alzheimer's Disease (AD). Choline, an essential dietary nutrient plays a critical role in neurological development and brain function, however, its effects on AD in humans is unclear. The research aims to investigate mechanistic links between dietary choline intake and cognitive functioning, focusing on the role of phosphatidylcholine (PC) in neuroplasticity and its interaction with amyloid beta (Aβ) peptides in neuron membranes. Additionally, human evidence on the potential benefits of PC interventions on AD, cognition, and proposed mechanisms are evaluated.</div></div><div><h3>Methods</h3><div>A reproducible systematic literature search was performed using a three-tranche strategy, consisting of a review, mechanism, and intervention search. Using PubMed as the main database, 1254 titles and abstracts were screened, 149 papers were read in full and 65 peer-reviewed papers were accepted, critically appraised, and analysed in a narrative review.</div></div><div><h3>Results</h3><div>Predominantly preclinical evidence demonstrated that PC enhances neuroplasticity, a key biological substrate for cognition, by activating intracellular neuronal signalling pathways or through neuron membrane function.</div><div>Molecular dynamic simulation methods provided a mechanistic understanding of the interconnection between neuronal PC content and the potential behaviour and trajectory of Aβ peptide aggregation. The results indicate that the neuronal membrane composition of PC is critical to inhibiting Aβ aggregation and neuronal damage, protecting the neuron from Aβ toxicity. This might provide a foundation for optimising cellular PC which may prove beneficial in the treatment or prevention of neurodegenerative disease.</div><div>Altered PC metabolism in AD was evidenced in observational studies; however, whether this relationship represents a cause or consequence of AD remains to be determined. Human intervention studies did not produce conclusive evidence supporting its effectiveness in enhancing cognitive function. This lack of consistency primarily stems from methodological constraints within the conducted studies. Human observational research provided the most compelling evidence linking a higher dietary PC intake to a reduced risk of dementia and significant improvements in cognitive testing.</div></div><div><h3>Conclusion</h3><div>Despite the lack of randomised control trials (RCTs) assessing the efficacy of lecithin/PC to improve cognition in AD patients, there exists promising evidence supporting its neuroprotective and neurotrophic role.</div><div>This review establishes an evidence-based framework through chains of mechanistic evidence, that may provide potential strategies for enhanced neuroprotection and reduced neurodegeneration caused by AD. Considering the escalating global burden of AD and the current shortcom","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 177-195"},"PeriodicalIF":2.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364660","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 : 2024-09-30DOI: 10.1016/j.clnesp.2024.09.025
F. Campa, A. Paoli, L.B. Sardinha
{"title":"Letter to the editor: “Variations in bioelectrical impedance devices impact raw measures comparisons and subsequent prediction of body composition using recommended estimation equations”","authors":"F. Campa, A. Paoli, L.B. Sardinha","doi":"10.1016/j.clnesp.2024.09.025","DOIUrl":"10.1016/j.clnesp.2024.09.025","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 156-157"},"PeriodicalIF":2.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364659","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}
{"title":"Commentary on: “Association between objectively measured protein intake and muscle status, health-related quality of life, and mortality in hemodialysis patients”","authors":"Bing-Hau Lee, Kuo-Shen Chou, Chih-Kuan Lai, Chih-Chung Shiao","doi":"10.1016/j.clnesp.2024.09.026","DOIUrl":"10.1016/j.clnesp.2024.09.026","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 158-159"},"PeriodicalIF":2.9,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364658","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 : 2024-09-28DOI: 10.1016/j.clnesp.2024.09.020
Yashar Vaziri
Recent studies have explored the impact of lifestyle, particularly diet, on cognitive decline and Alzheimer's disease (AD) risk. The Mediterranean diet has emerged as a potential safeguard, with observational studies indicating it might help defend against cognitive disorders. High adherence is linked with lower cognitive impairment risk, while low adherence elevates the risk for AD. Though these studies suggest connections between the Mediterranean diet and reduced cognitive decline or AD, they do not establish causality. Potential mechanisms might involve vascular factors, glucose/lipid metabolism, and anti-inflammatory effects. Specific Mediterranean diet components like vegetables, fruits, legumes, cereals, fish, and monounsaturated fats might contribute to cognitive benefits. Large-scale randomized controlled trials are needed to ascertain the diet's influence on AD and cognitive health. Currently, the Mediterranean diet cannot be definitively named as a preventive strategy for AD due to insufficient evidence. More research is essential to identify key ingredients and processes that might have preventive effects on AD. In summary, while the Mediterranean diet shows promise against cognitive decline and AD, further research is needed.
{"title":"The Mediterranean Diet: A powerful defense against Alzheimer disease–A comprehensive review","authors":"Yashar Vaziri","doi":"10.1016/j.clnesp.2024.09.020","DOIUrl":"10.1016/j.clnesp.2024.09.020","url":null,"abstract":"<div><div>Recent studies have explored the impact of lifestyle, particularly diet, on cognitive decline and Alzheimer's disease (AD) risk. The Mediterranean diet has emerged as a potential safeguard, with observational studies indicating it might help defend against cognitive disorders. High adherence is linked with lower cognitive impairment risk, while low adherence elevates the risk for AD. Though these studies suggest connections between the Mediterranean diet and reduced cognitive decline or AD, they do not establish causality. Potential mechanisms might involve vascular factors, glucose/lipid metabolism, and anti-inflammatory effects. Specific Mediterranean diet components like vegetables, fruits, legumes, cereals, fish, and monounsaturated fats might contribute to cognitive benefits. Large-scale randomized controlled trials are needed to ascertain the diet's influence on AD and cognitive health. Currently, the Mediterranean diet cannot be definitively named as a preventive strategy for AD due to insufficient evidence. More research is essential to identify key ingredients and processes that might have preventive effects on AD. In summary, while the Mediterranean diet shows promise against cognitive decline and AD, further research is needed.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 160-167"},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342826","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 : 2024-09-28DOI: 10.1016/j.clnesp.2024.09.021
João Valentini Neto , Amália Almeida Bastos , Marcelo Macedo Rogero , Regina Mara Fisberg , Sandra Maria Lima Ribeiro
Background & aims
Common mental disorders (CMD) are more prevalent in women, as well as noncommunicable diseases. Diet and physical activity are lifestyle modifiable factors that might help on managing these conditions.
Methods
This study aimed to investigate the association between lifestyle aspects (diet and physical activity) and common mental disorders in women aged 40+ years. Methods: This is a cross-sectional, population-based study (2015 ISA-Nutrition) with a representative sample of São Paulo-SP-Brazil urban residents. The present study was conducted with data from 467 women aged 40+ years old. Common Mental Disorders (dependent variable) were investigated by the Self-Reporting Questionnaire-20 (SRQ-20); the independent variables of interest were: the inflammatory potential of the diet was evaluated by dietary inflammatory index (DII), and physical activity level (evaluated by IPAQ) adopting the leisure dimension of physical activity. We considered as adjusting variables the presence of self-reported Noncommunicable Diseases (NCD), the age intervals (defined as 40–45, 46–50, 51–55, 56–60, 61+ years old), schooling (according to years of formal education), Body Mass Index (BMI); and ethnicity (self-declared skin color). Simple and multi-adjusted logistic regression models were performed to investigate the associations.
Conclusions
The main findings indicate that the prevalence of CMD was 32.2 %, and the frequency of having one or more NCD was 67.2 %. In the final regression model, CMD was associated with the highest tertile of the DII (OR = 2.215; p = 0.003) and having three, and four or more NCD (OR = 6.735; p < 0.001, and OR = 3.874; p = 0.033, respectively). Altogether, our results indicate that dietary inflammatory characteristics, and physical activity, along with NCD, are associated with CMD, in women aged 40+ years old, in different dimensions.
{"title":"Lifestyle aspects are associated with common mental disorders in women over 40 years older in a population-based study","authors":"João Valentini Neto , Amália Almeida Bastos , Marcelo Macedo Rogero , Regina Mara Fisberg , Sandra Maria Lima Ribeiro","doi":"10.1016/j.clnesp.2024.09.021","DOIUrl":"10.1016/j.clnesp.2024.09.021","url":null,"abstract":"<div><h3>Background & aims</h3><div>Common mental disorders (CMD) are more prevalent in women, as well as noncommunicable diseases. Diet and physical activity are lifestyle modifiable factors that might help on managing these conditions.</div></div><div><h3>Methods</h3><div>This study aimed to investigate the association between lifestyle aspects (diet and physical activity) and common mental disorders in women aged 40+ years. Methods: This is a cross-sectional, population-based study (2015 ISA-Nutrition) with a representative sample of São Paulo-SP-Brazil urban residents. The present study was conducted with data from 467 women aged 40+ years old. Common Mental Disorders (dependent variable) were investigated by the Self-Reporting Questionnaire-20 (SRQ-20); the independent variables of interest were: the inflammatory potential of the diet was evaluated by dietary inflammatory index (DII), and physical activity level (evaluated by IPAQ) adopting the leisure dimension of physical activity. We considered as adjusting variables the presence of self-reported Noncommunicable Diseases (NCD), the age intervals (defined as 40–45, 46–50, 51–55, 56–60, 61+ years old), schooling (according to years of formal education), Body Mass Index (BMI); and ethnicity (self-declared skin color). Simple and multi-adjusted logistic regression models were performed to investigate the associations.</div></div><div><h3>Conclusions</h3><div>The main findings indicate that the prevalence of CMD was 32.2 %, and the frequency of having one or more NCD was 67.2 %. In the final regression model, CMD was associated with the highest tertile of the DII (OR = 2.215; p = 0.003) and having three, and four or more NCD (OR = 6.735; p < 0.001, and OR = 3.874; p = 0.033, respectively). Altogether, our results indicate that dietary inflammatory characteristics, and physical activity, along with NCD, are associated with CMD, in women aged 40+ years old, in different dimensions.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 149-155"},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342824","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 : 2024-09-28DOI: 10.1016/j.clnesp.2024.09.023
Salvatore Sotgia , Arduino A. Mangoni , Stefano Zoroddu , Biagio Di Lorenzo , Angelo Zinellu , Ciriaco Carru , Mark McEvoy
Background
Ergothioneine (ERT) and asymmetric dimethyl-l-arginine (ADMA) have been associated with cognitive decline and dementia in older adults, but their interplay with psychological distress remains unexplored. This study aimed to measure the serum concentrations of ERT and ADMA in a representative sample of older community-dwelling adults and to determine their association with psychological distress.
Methods
Data on clinical, lifestyle, demographic characteristics, and serum concentrations of ERT and ADMA were collected from a population-based sample of older Australian adults (mean age 65.5 ± 7.5 years) from the Hunter Community Study. Psychological distress was assessed using the self-reported Kessler Psychological Distress Scale (K10).
Results
In individuals with psychological distress, serum ERT concentrations decreased by 24 %, while ADMA concentrations increased by 6 %. In adjusted analysis, accounting for age and sex, only ERT remained independently associated with psychological distress. For each unit increase in ERT, the odds of experiencing psychological distress decreased by approximately 68 %.
Conclusion
The trend of decreasing serum ERT concentrations observed in older adults with increasing psychological distress suggests a potential link between this compound and mental health. Given the dietary origin of ERT, its integration offers therapeutic opportunities that warrant investigation in intervention studies.
{"title":"Higher scores of the Kessler Psychological Distress Scale (K10) are associated with lower serum ergothioneine and higher serum asymmetric dimethyl-l-arginine concentrations in a cohort of middle-aged and older adults","authors":"Salvatore Sotgia , Arduino A. Mangoni , Stefano Zoroddu , Biagio Di Lorenzo , Angelo Zinellu , Ciriaco Carru , Mark McEvoy","doi":"10.1016/j.clnesp.2024.09.023","DOIUrl":"10.1016/j.clnesp.2024.09.023","url":null,"abstract":"<div><h3>Background</h3><div>Ergothioneine (ERT) and asymmetric dimethyl-<span>l</span>-arginine (ADMA) have been associated with cognitive decline and dementia in older adults, but their interplay with psychological distress remains unexplored. This study aimed to measure the serum concentrations of ERT and ADMA in a representative sample of older community-dwelling adults and to determine their association with psychological distress.</div></div><div><h3>Methods</h3><div>Data on clinical, lifestyle, demographic characteristics, and serum concentrations of ERT and ADMA were collected from a population-based sample of older Australian adults (mean age 65.5 ± 7.5 years) from the Hunter Community Study. Psychological distress was assessed using the self-reported Kessler Psychological Distress Scale (K10).</div></div><div><h3>Results</h3><div>In individuals with psychological distress, serum ERT concentrations decreased by 24 %, while ADMA concentrations increased by 6 %. In adjusted analysis, accounting for age and sex, only ERT remained independently associated with psychological distress. For each unit increase in ERT, the odds of experiencing psychological distress decreased by approximately 68 %.</div></div><div><h3>Conclusion</h3><div>The trend of decreasing serum ERT concentrations observed in older adults with increasing psychological distress suggests a potential link between this compound and mental health. Given the dietary origin of ERT, its integration offers therapeutic opportunities that warrant investigation in intervention studies.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 107-113"},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342822","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}
Disturbed glycemia and the resulting type 2 diabetes (T2D) are significant health concerns. Various approaches have been examined to improve glycemic control in patients with T2D. Modification of gut microbiome via administering probiotics has been extensively studied. The present study aims to sum up the existing literature which investigated the effect of probiotics on glycemic indices in individuals with T2D in the format of randomized controlled trials (RCTs).
Methods
Online medical databases (PubMed, Scopus, and Web of Science) were searched from inception to January 2024. Eligible studies were included using pre-defined inclusion and exclusion criteria. Outcome variables included fasting blood sugar (FBS), insulin, hemoglobin A1c (HbA1c), and homeostatic model of insulin resistance (HOMA-IR). Weighted mean differences (WMDs) were estimated. Subgroup and dose-response analyses were conducted. P-values <0.05 were considered as statistically significant.
Results
Out of 5636 records retrieved by the initial search, thirty-two RCTs were included in the final analyses. Supplementation with probiotics was observed to significantly improve indices of glycemic control; including FBS (WMD: −13.27 mg/dl; 95 % CI: −18.31, −8.22), HbA1c (WMD: −0.44 %; 95 % CI: −0.59, −0.28), insulin (WMD: −1.33 μIU/ml; 95 % CI: −2.57, −0.08), and HOMA-IR (WMD: −0.95; 95 % CI: −1.71, −0.18). Dose-response analysis revealed that increased duration of intervention results in a larger reduction only in FBS.
Conclusion
Supplementation with probiotics seems to improve indices of glycemic control. Nonetheless, taken into account the notable heterogeneity (with regard to dosage, duration, and the species/strains used) between the included studies and low quality of evidence, caution must be considered, especially when long-term clinical implications are intended.
{"title":"Effects of probiotics supplementation on glycemic profile in adults with type 2 diabetes mellitus: A grade-assessed systematic review and dose–response meta-analysis of randomized controlled trials","authors":"Najmeh Hejazi , Hamid Ghalandari , Raha Rahmanian , Fatemeh Haghpanah , Maede Makhtoomi , Amirhossein Asadi , Moein Askarpour","doi":"10.1016/j.clnesp.2024.09.014","DOIUrl":"10.1016/j.clnesp.2024.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Disturbed glycemia and the resulting type 2 diabetes (T2D) are significant health concerns. Various approaches have been examined to improve glycemic control in patients with T2D. Modification of gut microbiome via administering probiotics has been extensively studied. The present study aims to sum up the existing literature which investigated the effect of probiotics on glycemic indices in individuals with T2D in the format of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>Online medical databases (PubMed, Scopus, and Web of Science) were searched from inception to January 2024. Eligible studies were included using pre-defined inclusion and exclusion criteria. Outcome variables included fasting blood sugar (FBS), insulin, hemoglobin A1c (HbA1c), and homeostatic model of insulin resistance (HOMA-IR). Weighted mean differences (WMDs) were estimated. Subgroup and dose-response analyses were conducted. P-values <0.05 were considered as statistically significant.</div></div><div><h3>Results</h3><div>Out of 5636 records retrieved by the initial search, thirty-two RCTs were included in the final analyses. Supplementation with probiotics was observed to significantly improve indices of glycemic control; including FBS (WMD: −13.27 mg/dl; 95 % CI: −18.31, −8.22), HbA1c (WMD: −0.44 %; 95 % CI: −0.59, −0.28), insulin (WMD: −1.33 μIU/ml; 95 % CI: −2.57, −0.08), and HOMA-IR (WMD: −0.95; 95 % CI: −1.71, −0.18). Dose-response analysis revealed that increased duration of intervention results in a larger reduction only in FBS.</div></div><div><h3>Conclusion</h3><div>Supplementation with probiotics seems to improve indices of glycemic control. Nonetheless, taken into account the notable heterogeneity (with regard to dosage, duration, and the species/strains used) between the included studies and low quality of evidence, caution must be considered, especially when long-term clinical implications are intended.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 133-143"},"PeriodicalIF":2.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342820","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 : 2024-09-27DOI: 10.1016/j.clnesp.2024.09.018
Guohua Zhu , Tingting Zhu , Ruhe Jiang , Xin Lu , Yan Du
Background
Hydatidiform mole (HM), a subset of gestational trophoblastic disease, is considered precancerous and exhibits geographical variation. The incidence of HM is linked to nutritional factors. This study aimed to investigate the causal relationship between nutrients and HM using a bidirectional two-sample Mendelian randomization (MR) approach.
Methods
We utilized publicly available genome-wide association study data to assess the causal associations between levels of specific vitamins (retinol, vitamins B12, B6, C, D, E, folate, and carotene) and minerals (iron, calcium, and magnesium) with HM. The MR analysis was conducted and reported following the STROBE-MR guidelines, employing MR Egger and inverse variance weighted (IVW) methods to estimate associations, with MR-PRESSO for pleiotropy testing.
Results
The study revealed vitamin B6 as a significant protective factor against HM (MR-Egger OR: 0.094, 95 % CI: 0.011–0.0778, P < 0.05; IVW OR: 0.365, 95 % CI: 0.142–0.936, P < 0.05). Folate and magnesium showed suggestive associations with HM, whereas most other nutrients did not exhibit a causal relationship. MR-PRESSO analysis supported the absence of horizontal pleiotropy of vitamin B6. Besides, reverse MR analysis did not reveal a significant causal association between HM and serum nutrient levels, suggesting that differences of nutrients in HM patients may not be directly attributed to the mole.
Conclusion
This MR study provides evidence that vitamin B6 may protect against HM, and suggests potential roles for folate and magnesium in HM development, while highlighting the need for further research to confirm these findings.
{"title":"The causal relationship between hydatidiform mole and nutrients: A two-sample Mendelian randomization study","authors":"Guohua Zhu , Tingting Zhu , Ruhe Jiang , Xin Lu , Yan Du","doi":"10.1016/j.clnesp.2024.09.018","DOIUrl":"10.1016/j.clnesp.2024.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Hydatidiform mole (HM), a subset of gestational trophoblastic disease, is considered precancerous and exhibits geographical variation. The incidence of HM is linked to nutritional factors. This study aimed to investigate the causal relationship between nutrients and HM using a bidirectional two-sample Mendelian randomization (MR) approach.</div></div><div><h3>Methods</h3><div>We utilized publicly available genome-wide association study data to assess the causal associations between levels of specific vitamins (retinol, vitamins B12, B6, C, D, E, folate, and carotene) and minerals (iron, calcium, and magnesium) with HM. The MR analysis was conducted and reported following the STROBE-MR guidelines, employing MR Egger and inverse variance weighted (IVW) methods to estimate associations, with MR-PRESSO for pleiotropy testing.</div></div><div><h3>Results</h3><div>The study revealed vitamin B6 as a significant protective factor against HM (MR-Egger OR: 0.094, 95 % CI: 0.011–0.0778, P < 0.05; IVW OR: 0.365, 95 % CI: 0.142–0.936, P < 0.05). Folate and magnesium showed suggestive associations with HM, whereas most other nutrients did not exhibit a causal relationship. MR-PRESSO analysis supported the absence of horizontal pleiotropy of vitamin B6. Besides, reverse MR analysis did not reveal a significant causal association between HM and serum nutrient levels, suggesting that differences of nutrients in HM patients may not be directly attributed to the mole.</div></div><div><h3>Conclusion</h3><div>This MR study provides evidence that vitamin B6 may protect against HM, and suggests potential roles for folate and magnesium in HM development, while highlighting the need for further research to confirm these findings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 100-106"},"PeriodicalIF":2.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342825","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 : 2024-09-27DOI: 10.1016/j.clnesp.2024.09.019
Indar Kumar Sharawat , Prateek Kumar Panda , Surbhi Choudhary , Pranita Pradhan , Vivek Singh Malik , Meenu Singh
Introduction
Several randomized controlled trials (RCT) have been conducted in the past to determine the optimum dose of iron supplementation during pregnancy, but there is a lack of consensus among different guidelines regarding the appropriate dosage of iron for prophylaxis during pregnancy.
Methods
Relevant electronic databases were searched to identify publications describing RCTs comparing different daily dosages of iron supplementation during pregnancy. Meta-analysis for various efficacy and safety outcomes such as changes in blood hemoglobin, serum ferritin, serum iron, and serum transferrin saturation, as well as the frequency of adverse effects, was performed using random and fixed effect models suitably depending on the degree of heterogeneity. Two groups were compared: those receiving 60 mg elemental iron or less and those receiving more than 60 mg elemental iron per day. Additionally, the efficacy of those receiving 30 mg elemental iron per day and those receiving 60 mg elemental iron per day were also compared.
Results
A to total of 15 RCTs comprising 2726 participants were included in the meta-analysis. Change in blood hemoglobin levels was comparable between the ≤60 mg/day and >60 mg/day group (pooled estimate for mean difference, 0.01 [-0.11, 0.09], p = 0.86, I2 = 96 %), but serum ferritin, iron level, and serum transferrin saturation change were higher in the >60 mg group (p < 0.0001, 0.008, and 0.02, respectively). Change in blood hemoglobin level was better in the 60 mg/day group compared to the 30 mg/day group (pooled estimate for mean difference, −0.11 [-0.21, 0.00], p = 0.04, I2 = 90 %), as well as changes in serum ferritin and serum transferrin saturations (p = 0.004 and 0.0004, respectively).
Conclusion
Daily supplementation of 60 mg elemental iron is more efficacious than daily supplementation of 30 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate), and daily supplementation of ≤60 mg elemental iron is equally efficacious compared to daily supplementation of >60 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate).
{"title":"Efficacy of different doses of daily prophylactic iron supplementation in pregnant women: A systematic review and meta-analysis","authors":"Indar Kumar Sharawat , Prateek Kumar Panda , Surbhi Choudhary , Pranita Pradhan , Vivek Singh Malik , Meenu Singh","doi":"10.1016/j.clnesp.2024.09.019","DOIUrl":"10.1016/j.clnesp.2024.09.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Several randomized controlled trials (RCT) have been conducted in the past to determine the optimum dose of iron supplementation during pregnancy, but there is a lack of consensus among different guidelines regarding the appropriate dosage of iron for prophylaxis during pregnancy.</div></div><div><h3>Methods</h3><div>Relevant electronic databases were searched to identify publications describing RCTs comparing different daily dosages of iron supplementation during pregnancy. Meta-analysis for various efficacy and safety outcomes such as changes in blood hemoglobin, serum ferritin, serum iron, and serum transferrin saturation, as well as the frequency of adverse effects, was performed using random and fixed effect models suitably depending on the degree of heterogeneity. Two groups were compared: those receiving 60 mg elemental iron or less and those receiving more than 60 mg elemental iron per day. Additionally, the efficacy of those receiving 30 mg elemental iron per day and those receiving 60 mg elemental iron per day were also compared.</div></div><div><h3>Results</h3><div>A to total of 15 RCTs comprising 2726 participants were included in the meta-analysis. Change in blood hemoglobin levels was comparable between the ≤60 mg/day and >60 mg/day group (pooled estimate for mean difference, 0.01 [-0.11, 0.09], p = 0.86, I<sup>2</sup> = 96 %), but serum ferritin, iron level, and serum transferrin saturation change were higher in the >60 mg group (p < 0.0001, 0.008, and 0.02, respectively). Change in blood hemoglobin level was better in the 60 mg/day group compared to the 30 mg/day group (pooled estimate for mean difference, −0.11 [-0.21, 0.00], p = 0.04, I<sup>2</sup> = 90 %), as well as changes in serum ferritin and serum transferrin saturations (p = 0.004 and 0.0004, respectively).</div></div><div><h3>Conclusion</h3><div>Daily supplementation of 60 mg elemental iron is more efficacious than daily supplementation of 30 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate), and daily supplementation of ≤60 mg elemental iron is equally efficacious compared to daily supplementation of >60 mg elemental iron for the prophylaxis of anemia in pregnant women (certainty of evidence-moderate).</div></div><div><h3>Proespero registration no</h3><div>CRD42023455485.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 122-132"},"PeriodicalIF":2.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342821","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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