Celiac disease (CD) and potential CD (pCD) are immune-mediated disorders triggered by the ingestion of gluten. In non-celiac gluten sensitivity (NCGS) neither allergic nor autoimmune mechanisms are involved. Relationships between NCGS and CD need to be further investigated.
Methods
Serum metabolomics and lipoproteomics, performed via nuclear magnetic resonance spectroscopy, were used to characterize these three gluten-related disorders. Lasso regression models were calculated to discriminate the groups of interest.
Results
Several metabolites and lipoprotein-related parameters (particularly those associated with HDL cholesterol) allowed the selective discrimination between CD (and pCD) and NCGS. This evidence pointed to possible alterations of the gut microbiota in NCGS patients. Cross-validated regression models were able to discriminate between CD and NCGS, and pCD and NCGS with AUCs of 0.90 and 0.83, respectively.
Conclusion
This pilot study suggests changes in the gut microbiota and paves the way to the elucidation of the underlying mechanisms of NCGS.
{"title":"Serum metabolomics and lipoproteomics discriminate celiac disease and non-celiac gluten sensitivity patients","authors":"Alessia Vignoli , Claudio Luchinat , Nicola Segata , Daniela Renzi , Leonardo Tenori , Antonino Salvatore Calabrò","doi":"10.1016/j.clnu.2024.12.016","DOIUrl":"10.1016/j.clnu.2024.12.016","url":null,"abstract":"<div><h3>Background&aims</h3><div>Celiac disease (CD) and potential CD (pCD) are immune-mediated disorders triggered by the ingestion of gluten. In non-celiac gluten sensitivity (NCGS) neither allergic nor autoimmune mechanisms are involved. Relationships between NCGS and CD need to be further investigated.</div></div><div><h3>Methods</h3><div>Serum metabolomics and lipoproteomics, performed via nuclear magnetic resonance spectroscopy, were used to characterize these three gluten-related disorders. Lasso regression models were calculated to discriminate the groups of interest.</div></div><div><h3>Results</h3><div>Several metabolites and lipoprotein-related parameters (particularly those associated with HDL cholesterol) allowed the selective discrimination between CD (and pCD) and NCGS. This evidence pointed to possible alterations of the gut microbiota in NCGS patients. Cross-validated regression models were able to discriminate between CD and NCGS, and pCD and NCGS with AUCs of 0.90 and 0.83, respectively.</div></div><div><h3>Conclusion</h3><div>This pilot study suggests changes in the gut microbiota and paves the way to the elucidation of the underlying mechanisms of NCGS.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 31-35"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2024.12.034
Susanna C. Larsson , Ulrika Ericson , Koen F. Dekkers , Getachew Arage , Luka Marko Rašo , Sergi Sayols-Baixeras , Ulf Hammar , Gabriel Baldanzi , Diem Nguyen , H. Bjørn Nielsen , Jacob B. Holm , Ulf Risérus , Karl Michaëlsson , Johan Sundström , J Gustav Smith , Gunnar Engström , Johan Ärnlöv , Marju Orho-Melander , Tove Fall , Shafqat Ahmad
Objective
Meat intake is suggested to affect gut microbiome composition and the risk of chronic diseases. We aimed to identify meat-associated gut microbiome features and their association with host factors.
Design
Gut microbiota species were profiled by deep shotgun metagenomics sequencing in 9669 individuals. Intake of white meat, unprocessed red meat, and processed red meat was assessed using a food frequency questionnaire. The associations of meat intake with alpha-diversity and relative abundance of gut microbiota species were tested using linear regression models with adjustment for dietary fiber intake, body mass index, and other potential confounders. Meat-associated species were further assessed for association with enrichment of microbial gene function, meat-associated plasma metabolites, and clinical biomarkers.
Results
Higher intake of processed red meat was associated with reduced alpha microbial diversity. White meat, unprocessed, and processed red meat intakes were associated with 36, 14, and 322 microbiota species, respectively. Species associated with processed red meat were enriched for bacterial pathways like amino acid degradation, while those negatively linked were enriched for pathways like homoacetogenesis. Furthermore, species positively associated with processed red meat were to a large extent associated with reduced trimethylamine N-oxide and glutamine levels but increased creatine and carnitine metabolites, fasting insulin and glucose, C-reactive protein, apolipoprotein A1, and triglyceride levels and higher blood pressure.
Conclusion
This largest to date population-based study on meat and gut microbiota suggests that meat intake, particularly processed red meat, may modify the gut microbiota composition, functional capacity, and health-related biomarkers.
{"title":"Meat intake in relation to composition and function of gut microbiota","authors":"Susanna C. Larsson , Ulrika Ericson , Koen F. Dekkers , Getachew Arage , Luka Marko Rašo , Sergi Sayols-Baixeras , Ulf Hammar , Gabriel Baldanzi , Diem Nguyen , H. Bjørn Nielsen , Jacob B. Holm , Ulf Risérus , Karl Michaëlsson , Johan Sundström , J Gustav Smith , Gunnar Engström , Johan Ärnlöv , Marju Orho-Melander , Tove Fall , Shafqat Ahmad","doi":"10.1016/j.clnu.2024.12.034","DOIUrl":"10.1016/j.clnu.2024.12.034","url":null,"abstract":"<div><h3>Objective</h3><div>Meat intake is suggested to affect gut microbiome composition and the risk of chronic diseases. We aimed to identify meat-associated gut microbiome features and their association with host factors.</div></div><div><h3>Design</h3><div>Gut microbiota species were profiled by deep shotgun metagenomics sequencing in 9669 individuals. Intake of white meat, unprocessed red meat, and processed red meat was assessed using a food frequency questionnaire. The associations of meat intake with alpha-diversity and relative abundance of gut microbiota species were tested using linear regression models with adjustment for dietary fiber intake, body mass index, and other potential confounders. Meat-associated species were further assessed for association with enrichment of microbial gene function, meat-associated plasma metabolites, and clinical biomarkers.</div></div><div><h3>Results</h3><div>Higher intake of processed red meat was associated with reduced alpha microbial diversity. White meat, unprocessed, and processed red meat intakes were associated with 36, 14, and 322 microbiota species, respectively. Species associated with processed red meat were enriched for bacterial pathways like amino acid degradation, while those negatively linked were enriched for pathways like homoacetogenesis. Furthermore, species positively associated with processed red meat were to a large extent associated with reduced trimethylamine N-oxide and glutamine levels but increased creatine and carnitine metabolites, fasting insulin and glucose, C-reactive protein, apolipoprotein A1, and triglyceride levels and higher blood pressure.</div></div><div><h3>Conclusion</h3><div>This largest to date population-based study on meat and gut microbiota suggests that meat intake, particularly processed red meat, may modify the gut microbiota composition, functional capacity, and health-related biomarkers.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 124-133"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2025.01.002
Lei Chen , Run Liu , Xin He , Jiacheng Fang , Liyin Zhou , Zhongshi Qi , Mingzhu Tao , Haicheng Yuan , Yu Zhou
Diabetic cognitive dysfunction (DCD) refers to the cognitive impairment observed in individuals with diabetes. Epidemiological studies have suggested that supplementation with n-3 polyunsaturated fatty acid (PUFA) or B vitamins may prevent the development of diabetic complications. Post hoc studies indicate a potential synergistic effect of n-3 PUFA and B vitamins in preventing cognitive impairment. However, the precise effect and underlying mechanism of this combination on DCD remain unclear. In case–control study, we compared fatty acid composition of erythrocyte membrane and serum homocysteine levels between diabetic individuals with and without DCD. We found that insufficient levels of n-3 PUFA, along with elevated serum homocysteine, significantly increase the risk of developing DCD. Treatment with a combination of fish oil, folate, and vitamin B12 improved cognitive impairment and aberrant neuronal morphology in streptozotocin-induced DCD mice. Folic acid and vitamin B12 enhanced the efficiency of exogenous docosahexaenoic acid (DHA) transportation to the brain by preventing the accumulation of homocysteine and S-adenosylhomocysteine, thereby inhibiting neuronal apoptosis in diabetic brains. Furthermore, folic acid and vitamin B12 supplementation can provide sufficient 5-methylcytosine for diabetic brains by promoting DNA methylation, while increased DHA levels maintain TET-mediated active DNA demethylation in diabetic brains through enhancing TET2 function. Overall, our study provides novel insights into molecular mechanisms underlying the synergistic preventive effects of the combined supplementation with fish oil, folic acid and vitamin B12 on DCD, suggests that combining n-3 PUFA and B vitamins could be a promising strategy for preventing DCD among individuals with diabetes.
{"title":"Synergistically effects of n-3 PUFA and B vitamins prevent diabetic cognitive dysfunction through promoting TET2-mediated active DNA demethylation","authors":"Lei Chen , Run Liu , Xin He , Jiacheng Fang , Liyin Zhou , Zhongshi Qi , Mingzhu Tao , Haicheng Yuan , Yu Zhou","doi":"10.1016/j.clnu.2025.01.002","DOIUrl":"10.1016/j.clnu.2025.01.002","url":null,"abstract":"<div><div>Diabetic cognitive dysfunction (DCD) refers to the cognitive impairment observed in individuals with diabetes. Epidemiological studies have suggested that supplementation with n-3 polyunsaturated fatty acid (PUFA) or B vitamins may prevent the development of diabetic complications. Post hoc studies indicate a potential synergistic effect of n-3 PUFA and B vitamins in preventing cognitive impairment. However, the precise effect and underlying mechanism of this combination on DCD remain unclear. In case–control study, we compared fatty acid composition of erythrocyte membrane and serum homocysteine levels between diabetic individuals with and without DCD. We found that insufficient levels of n-3 PUFA, along with elevated serum homocysteine, significantly increase the risk of developing DCD. Treatment with a combination of fish oil, folate, and vitamin B<sub>12</sub> improved cognitive impairment and aberrant neuronal morphology in streptozotocin-induced DCD mice. Folic acid and vitamin B<sub>12</sub> enhanced the efficiency of exogenous docosahexaenoic acid (DHA) transportation to the brain by preventing the accumulation of homocysteine and S-adenosylhomocysteine, thereby inhibiting neuronal apoptosis in diabetic brains. Furthermore, folic acid and vitamin B<sub>12</sub> supplementation can provide sufficient 5-methylcytosine for diabetic brains by promoting DNA methylation, while increased DHA levels maintain TET-mediated active DNA demethylation in diabetic brains through enhancing TET2 function. Overall, our study provides novel insights into molecular mechanisms underlying the synergistic preventive effects of the combined supplementation with fish oil, folic acid and vitamin B<sub>12</sub> on DCD, suggests that combining n-3 PUFA and B vitamins could be a promising strategy for preventing DCD among individuals with diabetes.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 111-123"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2024.12.023
Kristina Vingrys , James R. Hébert , Ling-Wei Chen , Sarah Crozier , Liesbeth Duijts , Nicholas C. Harvey , Vincent W.V. Jaddoe , Cecily Kelleher , Fionnuala M. McAuliffe , Kinga Polanska , Matthew Suderman , Joanna Jerzynska , Matteo Bottai , Ricardo Segurado , Catherine M. Phillips
Background & aims
Childhood adiposity and inflammation impact long-term health. However, associations between dietary inflammation and childhood adiposity are unclear. We investigated if more pro-inflammatory diets are associated with greater adiposity in early-, mid-, and late-childhood.
Methods
We pooled individual participant data (IPD) from 13,978 children in six European birth cohorts in the ALPHABET consortium: Lifeways Cross-Generation Cohort Study (Lifeways), the Randomised cOntrol trial of LOw glycaemic index diet during pregnancy study (ROLO), the Avon Longitudinal Study of Parents and Children (ALSPAC), the Southampton Women's Survey (SWS), the Polish Mother and Child Cohort (REPRO_PL), and The Generation R Study (Generation R). Dietary inflammation was determined using the Children's Dietary Inflammatory Index (C-DII™). Adiposity-related outcomes included BMI z-score (primary outcome), abdominal circumference, skinfolds, fat-mass- and fat-free-mass-indices (secondary outcomes). Two-stage random effects IPD meta-analysis (IPD-MA), with adjusted linear and logistic regression models, was conducted. Quantile regression (QR) examined C-DII associations with BMI z-score percentiles.
Results
Median, 25th and 75th percentile C-DII scores trended upwards from early 0.18 (−0.65, 1.03) to late-childhood 0.51 (−0.40, 1.49). Pooled QR revealed positive C-DII associations across BMI z-score percentiles, particularly in late-childhood unadjusted β (95 % CI) 75th (0.075 (0.046, 0.105), p < 0.001); 85th (0.077 (0.045, 0.108), p < 0.001); and 95th (0.051 (0.011, 0.091), p = 0.01). Adjusted cohort-specific QR identified contrasting associations at early-childhood (ALSPAC and SWS) and late-childhood (Generation R). Pooled adjusted IPD-MA showed C-DII associations with late-childhood obesity [OR (95 % CI) 0.89 (0.81, 0.97), p = 0.01].
Conclusions
C-DII associations across BMI z-score distribution varied by cohort, quantile, and time-point, with some potentially explained by adiposity rebound, reverse causation and questionnaire response biases, highlighting insights not evident with linear regression.
{"title":"Dietary inflammation and childhood adiposity: Analysis of individual participant data from six birth cohorts","authors":"Kristina Vingrys , James R. Hébert , Ling-Wei Chen , Sarah Crozier , Liesbeth Duijts , Nicholas C. Harvey , Vincent W.V. Jaddoe , Cecily Kelleher , Fionnuala M. McAuliffe , Kinga Polanska , Matthew Suderman , Joanna Jerzynska , Matteo Bottai , Ricardo Segurado , Catherine M. Phillips","doi":"10.1016/j.clnu.2024.12.023","DOIUrl":"10.1016/j.clnu.2024.12.023","url":null,"abstract":"<div><h3>Background & aims</h3><div>Childhood adiposity and inflammation impact long-term health. However, associations between dietary inflammation and childhood adiposity are unclear. We investigated if more pro-inflammatory diets are associated with greater adiposity in early-, mid-, and late-childhood.</div></div><div><h3>Methods</h3><div>We pooled individual participant data (IPD) from 13,978 children in six European birth cohorts in the ALPHABET consortium: Lifeways Cross-Generation Cohort Study (Lifeways), the Randomised cOntrol trial of LOw glycaemic index diet during pregnancy study (ROLO), the Avon Longitudinal Study of Parents and Children (ALSPAC), the Southampton Women's Survey (SWS), the Polish Mother and Child Cohort (REPRO_PL), and The Generation R Study (Generation R). Dietary inflammation was determined using the Children's Dietary Inflammatory Index (C-DII™). Adiposity-related outcomes included BMI z-score (primary outcome), abdominal circumference, skinfolds, fat-mass- and fat-free-mass-indices (secondary outcomes). Two-stage random effects IPD meta-analysis (IPD-MA), with adjusted linear and logistic regression models, was conducted. Quantile regression (QR) examined C-DII associations with BMI z-score percentiles.</div></div><div><h3>Results</h3><div>Median, 25th and 75th percentile C-DII scores trended upwards from early 0.18 (−0.65, 1.03) to late-childhood 0.51 (−0.40, 1.49). Pooled QR revealed positive C-DII associations across BMI z-score percentiles, particularly in late-childhood unadjusted β (95 % CI) 75th (0.075 (0.046, 0.105), p < 0.001); 85th (0.077 (0.045, 0.108), p < 0.001); and 95th (0.051 (0.011, 0.091), p = 0.01). Adjusted cohort-specific QR identified contrasting associations at early-childhood (ALSPAC and SWS) and late-childhood (Generation R). Pooled adjusted IPD-MA showed C-DII associations with late-childhood obesity [OR (95 % CI) 0.89 (0.81, 0.97), p = 0.01].</div></div><div><h3>Conclusions</h3><div>C-DII associations across BMI z-score distribution varied by cohort, quantile, and time-point, with some potentially explained by adiposity rebound, reverse causation and questionnaire response biases, highlighting insights not evident with linear regression.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 223-233"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2025.01.008
Erik Stenberg , Anna Laurenius , Anders Thorell
Introduction
Obesity may increase complexity of surgical procedures and increase the risk of perioperative complications. Weight reduction by the use of low energy diet (LED, ≤1200 kcal/day) or very low energy diet (VLED, ≤800 kcal/day) can reduce postoperative complications after bariatric surgery, but for most other types of surgery the evidence for its use remains uncertain. The aim of this systematic review was therefore to evaluate the scientific evidence in general for this routine.
Methods
The Medline, Embase, Web of Science and Cochrane databases were searched up until November 20, 2024 using the Cochrane risk of bias assessment tool for observational studies and the NIH quality assessment of controlled intervention studies for randomized trials. Operation time, surgeon's perceived difficulty, intraoperative complications, postoperative complications and relevant efficacy measures for specific procedures were considered as endpoints. A random-effects model was used to pool effect sizes for the main analyses.
Results
A total of 7053 studies were identified. After screening by title and abstract, followed by full text, 18 studies (9 RCTs and 9 observational studies) remained for the analyses including 854 patients who received the intervention and 979 controls. Preoperative LED/VLED resulted in an overall shorter operation time (standard mean difference 0.36, 95 % CI 0.14–0.59, p = 0.002), and reduced risk of postoperative complications after bariatric surgery, cholecystectomy, colorectal surgery and hernia repair (pooled RR 0.63, 95%CI 0.51–0.79, p < 0.001). Heterogeneity between studies was high for operation time but very low for complications. No difference was seen for intraoperative complications, while the data did not allow further analyses on perceived difficulty of surgery or efficacy outcomes.
Conclusion
The results support the use of LED/VLED for short-term preoperative weight reduction in patients with obesity planned for bariatric surgery and for those undergoing cholecystectomy, colorectal surgery and hernia repair. Further studies including a comparable control group are needed to evaluate its routine use for other surgical procedures.
Registration
The protocol of this study was preregistered at the International Prospective Register of Systematic Reviews, PROSPERO.
肥胖可能会增加手术过程的复杂性，增加围手术期并发症的风险。通过使用低能量饮食（LED，≤1200千卡/天）或极低能量饮食（VLED，≤800千卡/天）来减轻体重可以减少减肥手术后的术后并发症，但对于大多数其他类型的手术，其使用的证据仍不确定。因此，本系统综述的目的是对这一常规的科学证据进行总体评价。方法：使用Cochrane观察性研究偏倚风险评估工具和NIH随机试验对照干预研究质量评估工具，检索截至2024年11月20日的Medline、Embase、Web of Science和Cochrane数据库。以手术时间、术者感知难度、术中并发症、术后并发症及特定手术的相关疗效指标为终点。随机效应模型用于汇总主要分析的效应大小。结果：共纳入7053项研究。通过题目和摘要筛选，然后是全文筛选，剩下18项研究（9项随机对照试验和9项观察性研究）用于分析，包括854名接受干预的患者和979名对照组。术前LED/VLED可缩短手术时间（标准平均差0.36,95%CI 0.14-0.59, p = 0.002），降低减重手术、胆囊切除术、结直肠手术和疝修补术后并发症的风险（合并RR 0.63, 95%CI 0.51-0.79, p）。该结果支持LED/VLED用于计划进行减肥手术的肥胖患者以及接受胆囊切除术，结直肠手术和疝气修复的患者的短期术前体重减轻。需要进一步的研究，包括一个可比的对照组来评估其在其他外科手术中的常规应用。注册：本研究的方案在国际前瞻性系统评价注册系统（PROSPERO）进行了预注册。
{"title":"Intentional weight reduction before surgery – A systematic review","authors":"Erik Stenberg , Anna Laurenius , Anders Thorell","doi":"10.1016/j.clnu.2025.01.008","DOIUrl":"10.1016/j.clnu.2025.01.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity may increase complexity of surgical procedures and increase the risk of perioperative complications. Weight reduction by the use of low energy diet (LED, ≤1200 kcal/day) or very low energy diet (VLED, ≤800 kcal/day) can reduce postoperative complications after bariatric surgery, but for most other types of surgery the evidence for its use remains uncertain. The aim of this systematic review was therefore to evaluate the scientific evidence in general for this routine.</div></div><div><h3>Methods</h3><div>The Medline, Embase, Web of Science and Cochrane databases were searched up until November 20, 2024 using the Cochrane risk of bias assessment tool for observational studies and the NIH quality assessment of controlled intervention studies for randomized trials. Operation time, surgeon's perceived difficulty, intraoperative complications, postoperative complications and relevant efficacy measures for specific procedures were considered as endpoints. A random-effects model was used to pool effect sizes for the main analyses.</div></div><div><h3>Results</h3><div>A total of 7053 studies were identified. After screening by title and abstract, followed by full text, 18 studies (9 RCTs and 9 observational studies) remained for the analyses including 854 patients who received the intervention and 979 controls. Preoperative LED/VLED resulted in an overall shorter operation time (standard mean difference 0.36, 95 % CI 0.14–0.59, p = 0.002), and reduced risk of postoperative complications after bariatric surgery, cholecystectomy, colorectal surgery and hernia repair (pooled RR 0.63, 95%CI 0.51–0.79, p < 0.001). Heterogeneity between studies was high for operation time but very low for complications. No difference was seen for intraoperative complications, while the data did not allow further analyses on perceived difficulty of surgery or efficacy outcomes.</div></div><div><h3>Conclusion</h3><div>The results support the use of LED/VLED for short-term preoperative weight reduction in patients with obesity planned for bariatric surgery and for those undergoing cholecystectomy, colorectal surgery and hernia repair. Further studies including a comparable control group are needed to evaluate its routine use for other surgical procedures.</div></div><div><h3>Registration</h3><div>The protocol of this study was preregistered at the International Prospective Register of Systematic Reviews, PROSPERO.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 156-164"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2024.12.019
Fei Fang , Ji-Mei Gu , Yu-Wen Qian , Xiao-Ping Shao , Zhong-Yue Liu , Yang-Yang Ge , Guo-Chong Chen
Background
The relationships between different dietary carbohydrates and risk of chronic obstructive pulmonary disease (COPD) have been rarely assessed. This study examined the relationships of different dietary carbohydrates with incident COPD and lung function, and the potential mediating role of chronic inflammation.
Methods
A total of 205,752 UK Biobank participants were included. Dietary information was collected using up to five rounds of 24-h dietary recalls. Multivariable Cox regression models were used to assess different types of dietary carbohydrates (energy-adjusted) in association with incident COPD. In a subsample (n = 153,630), multivariate linear regression models were used to examine the cross-sectional relationships between dietary carbohydrates and lung function.
Results
Over an average follow-up period of 12.2 years, 4591 participants developed COPD. After multivariable adjustment, higher dietary fiber and non-free sugar intakes both were associated with a lower risk of COPD, whereas a higher intake of free sugar was associated with a higher risk of COPD. Dietary fiber and non-free sugar were associated with better lung function reflected by higher levels of forced vital capacity (FVC), forced expiratory volume in 1-s (FEV1), and FEV1/FVC ratio. Conversely, dietary free sugar intake was associated lower levels of these measures. The mediation analysis revealed that low-grade chronic inflammation explained 9.22 %–25.17 % of the observed relationships of different dietary carbohydrates with incident COPD and lung function measures.
Conclusions
Dietary fiber and non-free sugar intakes were associated with a lower risk of COPD and improved lung function, whereas free sugar intake showed opposite associations, partially through the regulation of chronic inflammation.
{"title":"Quantity and quality of dietary carbohydrates, low-grade inflammation, and risk of chronic obstructive pulmonary disease and lung function","authors":"Fei Fang , Ji-Mei Gu , Yu-Wen Qian , Xiao-Ping Shao , Zhong-Yue Liu , Yang-Yang Ge , Guo-Chong Chen","doi":"10.1016/j.clnu.2024.12.019","DOIUrl":"10.1016/j.clnu.2024.12.019","url":null,"abstract":"<div><h3>Background</h3><div>The relationships between different dietary carbohydrates and risk of chronic obstructive pulmonary disease (COPD) have been rarely assessed. This study examined the relationships of different dietary carbohydrates with incident COPD and lung function, and the potential mediating role of chronic inflammation.</div></div><div><h3>Methods</h3><div>A total of 205,752 UK Biobank participants were included. Dietary information was collected using up to five rounds of 24-h dietary recalls. Multivariable Cox regression models were used to assess different types of dietary carbohydrates (energy-adjusted) in association with incident COPD. In a subsample (n = 153,630), multivariate linear regression models were used to examine the cross-sectional relationships between dietary carbohydrates and lung function.</div></div><div><h3>Results</h3><div>Over an average follow-up period of 12.2 years, 4591 participants developed COPD. After multivariable adjustment, higher dietary fiber and non-free sugar intakes both were associated with a lower risk of COPD, whereas a higher intake of free sugar was associated with a higher risk of COPD. Dietary fiber and non-free sugar were associated with better lung function reflected by higher levels of forced vital capacity (FVC), forced expiratory volume in 1-s (FEV<sub>1</sub>), and FEV<sub>1</sub>/FVC ratio. Conversely, dietary free sugar intake was associated lower levels of these measures. The mediation analysis revealed that low-grade chronic inflammation explained 9.22 %–25.17 % of the observed relationships of different dietary carbohydrates with incident COPD and lung function measures.</div></div><div><h3>Conclusions</h3><div>Dietary fiber and non-free sugar intakes were associated with a lower risk of COPD and improved lung function, whereas free sugar intake showed opposite associations, partially through the regulation of chronic inflammation.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 53-60"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2024.12.031
Camila Guazzelli Marques , Marcus V.L. dos Santos Quaresma , Catarina Bortoloto França Ferracini , Filipa Bettencourt Alves Carrilho , Fernanda Patti Nakamoto , Glaice Aparecida Lucin , Ana Carolina Oumatu Magalhães , Gabriela Lima Mendes , Leonardo Azevedo Alvares , Ronaldo Vagner Thomatieli-Santos
<div><h3>Background & aims</h3><div>Obesity is a chronic disease characterized by an excess of fat mass. It is accompanied by a low-grade chronic systemic inflammation state that leads to numerous health disorders. To counteract this scenario, dietary-derived caloric restriction (CR) is the principal intervention for weight loss. Furthermore, probiotic supplementation has gained attention as a co-intervention to optimize weight loss and other health-related factors. As such, we aimed to verify the effect of CR with probiotic supplementation on the body composition, quality of life, sleep quality, anxiety, stress, and depression symptoms of adult men living with obesity.</div></div><div><h3>Methods</h3><div>The study is called the Clinical Study of Obesity and Intestinal Microbiota (ECOMI). It is a randomized, double-blind, placebo-controlled clinical trial involving two parallel groups of stable-weight adult men living with obesity. The inclusion criteria were male individuals aged 25–44 years, with body mass index (BMI) ranging from 30.0 to 39.99 kg/m<sup>2</sup>, and stable body mass over the preceding three months. Participants were randomly assigned to two groups: Caloric Restriction with Probiotic (CRPRO) and Caloric Restriction with Placebo (CRPLA). The achieved CR was 30 % of the total daily energy expenditure. Macronutrients were distributed as 50 % carbohydrates, 30 % lipids, and 20 % proteins. Probiotic supplementation was carried out using two sachets/day of 1 g, containing 1 × 10<sup>9</sup> Colony Forming Units (CFU) of each strain: <em>Lactobacillus acidophilus</em> NCFM, <em>Lactobacillus rhamnosus</em> HN001, <em>Lactobacillus paracasei</em> Lpc-37 and <em>Bifidobacterium lactis</em> HN019, totaling 8 billion CFU/day. CR and probiotic (or placebo) supplementation intervention lasted 12 weeks. Body composition and psychobiological-related parameters (e.g., sleep, anxiety, stress, and depression) were assessed at baseline and following 12 weeks of intervention. Data are presented as mean and 95 % confidence interval (CI) and mean difference (MD).</div></div><div><h3>Results</h3><div>The present study applied the per protocol analysis. Thirty-three subjects were evaluated and randomized, but only data from 25 (CRPLA n = 12 vs CRPRO n = 13) participants were included in the final analysis. We verified that CR resulted in weight loss (p < 0.001; η<sup>2</sup>ρ = 0.754) in both CRPLA (MD: −6.30 kg; p < 0.001) and CRPRO (MD: −5.97 kg; p < 0.001), without differences between groups (p = 0.823; η<sup>2</sup>ρ = 0.002). Moreover, both CRPLA (MD: −4.83 kg; p < 0.001) and CRPRO (MD: −5.20 kg; p < 0.001) decreased body fat without difference between groups (p = 0.712; η<sup>2</sup>ρ = 0.006). Regarding obesity-related problems, only the corporeality dimension (p < 0.001; η<sup>2</sup>ρ = 0.474) in both CRPLA (p = 0.028) and CRPRO (p = 0.039) improved. World Health Organization Quality of Life (WHOQoL)-related dimensions w
{"title":"Effect of caloric restriction with probiotic supplementation on body composition, quality of life, and psychobiological factors of obese men: A randomized, double-blinded placebo-controlled clinical trial","authors":"Camila Guazzelli Marques , Marcus V.L. dos Santos Quaresma , Catarina Bortoloto França Ferracini , Filipa Bettencourt Alves Carrilho , Fernanda Patti Nakamoto , Glaice Aparecida Lucin , Ana Carolina Oumatu Magalhães , Gabriela Lima Mendes , Leonardo Azevedo Alvares , Ronaldo Vagner Thomatieli-Santos","doi":"10.1016/j.clnu.2024.12.031","DOIUrl":"10.1016/j.clnu.2024.12.031","url":null,"abstract":"<div><h3>Background & aims</h3><div>Obesity is a chronic disease characterized by an excess of fat mass. It is accompanied by a low-grade chronic systemic inflammation state that leads to numerous health disorders. To counteract this scenario, dietary-derived caloric restriction (CR) is the principal intervention for weight loss. Furthermore, probiotic supplementation has gained attention as a co-intervention to optimize weight loss and other health-related factors. As such, we aimed to verify the effect of CR with probiotic supplementation on the body composition, quality of life, sleep quality, anxiety, stress, and depression symptoms of adult men living with obesity.</div></div><div><h3>Methods</h3><div>The study is called the Clinical Study of Obesity and Intestinal Microbiota (ECOMI). It is a randomized, double-blind, placebo-controlled clinical trial involving two parallel groups of stable-weight adult men living with obesity. The inclusion criteria were male individuals aged 25–44 years, with body mass index (BMI) ranging from 30.0 to 39.99 kg/m<sup>2</sup>, and stable body mass over the preceding three months. Participants were randomly assigned to two groups: Caloric Restriction with Probiotic (CRPRO) and Caloric Restriction with Placebo (CRPLA). The achieved CR was 30 % of the total daily energy expenditure. Macronutrients were distributed as 50 % carbohydrates, 30 % lipids, and 20 % proteins. Probiotic supplementation was carried out using two sachets/day of 1 g, containing 1 × 10<sup>9</sup> Colony Forming Units (CFU) of each strain: <em>Lactobacillus acidophilus</em> NCFM, <em>Lactobacillus rhamnosus</em> HN001, <em>Lactobacillus paracasei</em> Lpc-37 and <em>Bifidobacterium lactis</em> HN019, totaling 8 billion CFU/day. CR and probiotic (or placebo) supplementation intervention lasted 12 weeks. Body composition and psychobiological-related parameters (e.g., sleep, anxiety, stress, and depression) were assessed at baseline and following 12 weeks of intervention. Data are presented as mean and 95 % confidence interval (CI) and mean difference (MD).</div></div><div><h3>Results</h3><div>The present study applied the per protocol analysis. Thirty-three subjects were evaluated and randomized, but only data from 25 (CRPLA n = 12 vs CRPRO n = 13) participants were included in the final analysis. We verified that CR resulted in weight loss (p < 0.001; η<sup>2</sup>ρ = 0.754) in both CRPLA (MD: −6.30 kg; p < 0.001) and CRPRO (MD: −5.97 kg; p < 0.001), without differences between groups (p = 0.823; η<sup>2</sup>ρ = 0.002). Moreover, both CRPLA (MD: −4.83 kg; p < 0.001) and CRPRO (MD: −5.20 kg; p < 0.001) decreased body fat without difference between groups (p = 0.712; η<sup>2</sup>ρ = 0.006). Regarding obesity-related problems, only the corporeality dimension (p < 0.001; η<sup>2</sup>ρ = 0.474) in both CRPLA (p = 0.028) and CRPRO (p = 0.039) improved. World Health Organization Quality of Life (WHOQoL)-related dimensions w","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 234-249"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2024.12.022
Bohan Zhang , Ka Po Wong , Mingyue Liu , Vivian Hui , Cai Guo , Zihan Liu , Yue Liu , Qian Xiao , Jing Qin
Background and aims
Post-stroke dysphagia is highly prevalent and causes complication. While video games have demonstrated potential to increase patient engagement in rehabilitation, their efficacy in stroke patients with dysphagia remains unclear. This aim of this study was to explore the effectiveness of the artificial intelligence-based video-game (AI-VG) intervention in improving swallowing function among stroke patients with dysphagia.
Methods
A prospective, single blinded, randomized controlled trial (RCT) was conducted in a rehabilitation hospital from October 2023 to July 2024. Participants were randomly assigned to either the AI-VG system group or the usual care group. All participants received training for 30 min per session per day, five times per week for 4 weeks. The primary outcome was change in swallowing function from baseline (T0) to post-intervention (T1) and 1 month follow-up (T2). Secondary outcomes included changes in laryngeal function, oral intake function, nutritional status, and swallowing-related quality of life. The adherence, satisfaction, and acceptance of the two groups were evaluated. Changes in outcomes over time were compared using generalized estimating equation modeling.
Results
A total of 84 participants (AI-VG group = 42, age = 65.00 ± 9.70 years, 57.10 % male; usual care group = 42, age = 66.40 ± 13.10 years, 69.00 % male) were included in this study. Compared with the usual care group, the AI-VG group showed significantly improved swallowing function, with a mean group difference of 4.02 (95 % CI = from −6.16 to −1.89, P < 0.001) at T1 and 4.14 (95 % CI = from −6.16 to 2.12, P < 0.001) at T2. Oral intake function, nutritional status, and swallowing-related quality of life improved significantly (P < 0.001 for overall group × time interaction). Adherence was significantly higher in the intervention group than in the control group (median [IQR], 18.00 [17.00–20.00] vs. 16.00 [15.00–17.00], P < 0.001). The intervention group had higher levels of acceptance and satisfaction of AI-VG (103.00 [100.50–104.00] and 73.00 [72.00–74.00], respectively). No significant difference was observed in laryngeal function (P > 0.05).
Conclusions
The AI-VG intervention is an effective method for enhancing swallowing function in patients with post-stroke dysphagia. Future validation through multicenter, large-sample RCTs are warranted to confirm the findings and explore broader clinical applications.
{"title":"Effect of artificial intelligence-based video-game system on dysphagia in patients with stroke: A randomized controlled trial","authors":"Bohan Zhang , Ka Po Wong , Mingyue Liu , Vivian Hui , Cai Guo , Zihan Liu , Yue Liu , Qian Xiao , Jing Qin","doi":"10.1016/j.clnu.2024.12.022","DOIUrl":"10.1016/j.clnu.2024.12.022","url":null,"abstract":"<div><h3>Background and aims</h3><div>Post-stroke dysphagia is highly prevalent and causes complication. While video games have demonstrated potential to increase patient engagement in rehabilitation, their efficacy in stroke patients with dysphagia remains unclear. This aim of this study was to explore the effectiveness of the artificial intelligence-based video-game (AI-VG) intervention in improving swallowing function among stroke patients with dysphagia.</div></div><div><h3>Methods</h3><div>A prospective, single blinded, randomized controlled trial (RCT) was conducted in a rehabilitation hospital from October 2023 to July 2024. Participants were randomly assigned to either the AI-VG system group or the usual care group. All participants received training for 30 min per session per day, five times per week for 4 weeks. The primary outcome was change in swallowing function from baseline (T0) to post-intervention (T1) and 1 month follow-up (T2). Secondary outcomes included changes in laryngeal function, oral intake function, nutritional status, and swallowing-related quality of life. The adherence, satisfaction, and acceptance of the two groups were evaluated. Changes in outcomes over time were compared using generalized estimating equation modeling.</div></div><div><h3>Results</h3><div>A total of 84 participants (AI-VG group = 42, age = 65.00 ± 9.70 years, 57.10 % male; usual care group = 42, age = 66.40 ± 13.10 years, 69.00 % male) were included in this study. Compared with the usual care group, the AI-VG group showed significantly improved swallowing function, with a mean group difference of 4.02 (95 % CI = from −6.16 to −1.89, <em>P</em> < 0.001) at T1 and 4.14 (95 % CI = from −6.16 to 2.12, <em>P</em> < 0.001) at T2. Oral intake function, nutritional status, and swallowing-related quality of life improved significantly (<em>P</em> < 0.001 for overall group × time interaction). Adherence was significantly higher in the intervention group than in the control group (median [IQR], 18.00 [17.00–20.00] vs. 16.00 [15.00–17.00], <em>P</em> < 0.001). The intervention group had higher levels of acceptance and satisfaction of AI-VG (103.00 [100.50–104.00] and 73.00 [72.00–74.00], respectively). No significant difference was observed in laryngeal function (<em>P</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>The AI-VG intervention is an effective method for enhancing swallowing function in patients with post-stroke dysphagia. Future validation through multicenter, large-sample RCTs are warranted to confirm the findings and explore broader clinical applications.</div></div><div><h3>Clinical trial registration</h3><div>ClinicalTrials. Gov Identifier: NCT05978700, <span><span>https://clinicaltrials.gov/study/NCT05978700</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 81-90"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In older patients undergoing cardiac surgery, physical function is a critical determinant of postoperative outcomes. Beta-hydroxy−beta-methylbutyrate (HMB) supplementation has been shown to promote muscle protein anabolism and inhibit catabolism, thereby preventing muscle weakness. However, its efficacy in older patients undergoing cardiac surgery remains unknown. This study aimed to examine the effects of preoperative HMB supplementation on postoperative physical function and complications in this population.
Methods
In this single-center, open-label, randomized controlled trial, patients aged ≥65 years scheduled for cardiac surgery were randomized to receive HMB supplementation or no nutritional intervention. The HMB group received HMB 1200 mg, l-glutamine 7000 mg, and l-arginine 7000 mg, once or twice daily, for at least 2 weeks before surgery. Evaluations were performed at baseline and before and after surgery. The primary outcome was the 6-min walking distance (6MWD) before and after surgery. Secondary outcomes included the incidence of complications, muscle mass and strength, physical performance, and length of hospital stay.
Results
Forty-four patients with a mean age of 72.5 years (women, 38 %) were randomized to the HMB (n = 22) or control (n = 22) group. Compared with the control group, the HMB group demonstrated a statistically significant improvement in the 6MWD both at the pre-surgery (448.0 ± 73.5 m vs. 375.5 ± 58.8 m; P = 0.01) and post-surgery time points (428.9 ± 76.4 m vs. 304.5 ± 52.3 m; P = 0.001). Muscle strength and physical performance also showed significant improvements in the HMB group. However, no significant difference in muscle mass was observed between the groups at any time point. The HMB group had a shorter hospital length of stay compared with that of the control group (16.1 ± 3.8 days vs. 20.4 ± 7.6 days, P = 0.03), and no adverse events were observed with the intervention.
Conclusions
Preoperative HMB supplementation in older adults undergoing cardiac surgery resulted in significant improvements in postoperative exercise capacity and physical function, along with a reduction in the length of hospital stay, without affecting muscle mass.
{"title":"Effects of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on cardiac surgery: A randomized controlled trial","authors":"Masato Ogawa , Seimi Satomi-Kobayashi , Naofumi Yoshida , Kodai Komaki , Takumi Hirabayashi , Kumiko Wakida , Saori Saitoh , Takeshi Inoue , Tomoya Yamashita , Yoshitada Sakai , Michiko Takahashi , Kenji Okada , Ken-ichi Hirata","doi":"10.1016/j.clnu.2024.12.030","DOIUrl":"10.1016/j.clnu.2024.12.030","url":null,"abstract":"<div><h3>Background & aims</h3><div>In older patients undergoing cardiac surgery, physical function is a critical determinant of postoperative outcomes. Beta-hydroxy−beta-methylbutyrate (HMB) supplementation has been shown to promote muscle protein anabolism and inhibit catabolism, thereby preventing muscle weakness. However, its efficacy in older patients undergoing cardiac surgery remains unknown. This study aimed to examine the effects of preoperative HMB supplementation on postoperative physical function and complications in this population.</div></div><div><h3>Methods</h3><div>In this single-center, open-label, randomized controlled trial, patients aged ≥65 years scheduled for cardiac surgery were randomized to receive HMB supplementation or no nutritional intervention. The HMB group received HMB 1200 mg, <span>l</span>-glutamine 7000 mg, and <span>l</span>-arginine 7000 mg, once or twice daily, for at least 2 weeks before surgery. Evaluations were performed at baseline and before and after surgery. The primary outcome was the 6-min walking distance (6MWD) before and after surgery. Secondary outcomes included the incidence of complications, muscle mass and strength, physical performance, and length of hospital stay.</div></div><div><h3>Results</h3><div>Forty-four patients with a mean age of 72.5 years (women, 38 %) were randomized to the HMB (n = 22) or control (n = 22) group. Compared with the control group, the HMB group demonstrated a statistically significant improvement in the 6MWD both at the pre-surgery (448.0 ± 73.5 m vs. 375.5 ± 58.8 m; <em>P</em> = 0.01) and post-surgery time points (428.9 ± 76.4 m vs. 304.5 ± 52.3 m; <em>P</em> = 0.001). Muscle strength and physical performance also showed significant improvements in the HMB group. However, no significant difference in muscle mass was observed between the groups at any time point. The HMB group had a shorter hospital length of stay compared with that of the control group (16.1 ± 3.8 days vs. 20.4 ± 7.6 days, <em>P</em> = 0.03), and no adverse events were observed with the intervention.</div></div><div><h3>Conclusions</h3><div>Preoperative HMB supplementation in older adults undergoing cardiac surgery resulted in significant improvements in postoperative exercise capacity and physical function, along with a reduction in the length of hospital stay, without affecting muscle mass.</div></div><div><h3>Registration number of Clinical Trial</h3><div>UMIN000030490 (UMIN<span><span>https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034773</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 91-100"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clnu.2024.12.027
Menghan Wang , Kun Xu , Jiaomei Yang , Derrick A. Bennett , Huaidong Du , Xin Liu
Background & aims
Obesity directly contributes to the progression of cardiovascular disease, but little is known about the association and risk attribution of normal-weight obesity subtypes with the incidence of major vascular events (MVEs) and their subtypes.
Methods
This is a prospective cohort study based on the China Kadoorie Biobank (CKB). A total of 308,071 individuals with no prior vascular diseases or cancer were included at baseline. The incidence of MVEs and their subtypes were recorded during follow-up. Adjusted hazard ratios (HRs) for each disease were yielded by Cox regression.
Results
During a median follow-up of 10.3 years, 62,040 MVEs occurred, with the adjusted HRs (95 % confidence intervals) were 1.11 (1.09–1.13) for normal-weight general obesity (NWGO), 1.27 (1.23–1.31) for normal-weight central obesity (NWCO), and 1.30 (1.27–1.33) for normal-weight central and general obesity (NWCGO). For subtypes of MVEs, increased waist circumference (WC) was associated with excess risk of ischaemic heart disease (IHD) independent of body fat percent (BF%) levels (HR range: 1.30–1.69 in men; 1.36–1.55 in women), while the risk plateaued with rising BF% within each WC quartile. However, even in men with lower WC (≤78 cm [median]), the risks of cerebrovascular disease (CeVD), particularly ischaemic stroke (IS), were increased with higher BF% (all P < 0.01). Conversely, in women, independent dose–response associations were primarily observed between increasing WC and CeVD, with the highest risk observed for IS (HR 1.38, 1.31–1.47).
Conclusions
This study provided novel, sex-specific evidence that normal-weight obesity subtypes were associated with distinct risks of subtypes of MVEs, with elevated risks predominantly attributable to WC in women and both WC and BF% in men.
{"title":"Normal-weight obesity subtypes and 10-year risks of major vascular diseases in 0.3 million adults","authors":"Menghan Wang , Kun Xu , Jiaomei Yang , Derrick A. Bennett , Huaidong Du , Xin Liu","doi":"10.1016/j.clnu.2024.12.027","DOIUrl":"10.1016/j.clnu.2024.12.027","url":null,"abstract":"<div><h3>Background & aims</h3><div>Obesity directly contributes to the progression of cardiovascular disease, but little is known about the association and risk attribution of normal-weight obesity subtypes with the incidence of major vascular events (MVEs) and their subtypes.</div></div><div><h3>Methods</h3><div>This is a prospective cohort study based on the China Kadoorie Biobank (CKB). A total of 308,071 individuals with no prior vascular diseases or cancer were included at baseline. The incidence of MVEs and their subtypes were recorded during follow-up. Adjusted hazard ratios (HRs) for each disease were yielded by Cox regression.</div></div><div><h3>Results</h3><div>During a median follow-up of 10.3 years, 62,040 MVEs occurred, with the adjusted HRs (95 % confidence intervals) were 1.11 (1.09–1.13) for normal-weight general obesity (NWGO), 1.27 (1.23–1.31) for normal-weight central obesity (NWCO), and 1.30 (1.27–1.33) for normal-weight central and general obesity (NWCGO). For subtypes of MVEs, increased waist circumference (WC) was associated with excess risk of ischaemic heart disease (IHD) independent of body fat percent (BF%) levels (HR range: 1.30–1.69 in men; 1.36–1.55 in women), while the risk plateaued with rising BF% within each WC quartile. However, even in men with lower WC (≤78 cm [median]), the risks of cerebrovascular disease (CeVD), particularly ischaemic stroke (IS), were increased with higher BF% (all <em>P</em> < 0.01). Conversely, in women, independent dose–response associations were primarily observed between increasing WC and CeVD, with the highest risk observed for IS (HR 1.38, 1.31–1.47).</div></div><div><h3>Conclusions</h3><div>This study provided novel, sex-specific evidence that normal-weight obesity subtypes were associated with distinct risks of subtypes of MVEs, with elevated risks predominantly attributable to WC in women and both WC and BF% in men.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 36-42"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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