Clinical nutrition最新文献_第7页

Suboptimal dietary patterns are associated with accelerated biological aging in young adulthood: A study with twins 次优饮食模式与青年期生物衰老加速有关：一项对双胞胎的研究。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.018

Suvi Ravi , Anna Kankaanpää , Leonie H. Bogl , Aino Heikkinen , Kirsi H. Pietiläinen , Jaakko Kaprio , Miina Ollikainen , Elina Sillanpää

Background & aims

Suboptimal diets increase morbidity and mortality risk. Epigenetic clocks are algorithms that can assess health and lifespan, even at a young age, before clinical manifestations of diseases. We investigated the association between dietary patterns and biological aging in young adult twins.

Methods

The data were drawn from the population-based FinnTwin12 study and consisted of twins aged 21–25 years (n = 826). Food and beverage intakes were assessed using a food frequency questionnaire. Biological aging was estimated using the epigenetic clocks GrimAge and DunedinPACE. Latent class analysis was used to identify dietary patterns. The association between dietary patterns and biological aging was assessed using linear regression modeling at the individual level, followed by within–twin pair analyses to account for genetic liabilities and shared familial confounders.

Results

Six dietary patterns were identified: 1) High fast food, low fruits and vegetables (F&V), 2) Plant-based, 3) Health-conscious, 4) Western with infrequent fish, 5) Western with regular fish, and 6) Balanced average. At the individual level, GrimAge acceleration was slower in the Plant-based, Health-conscious, and Balanced-average patterns compared to the High fast food, low F&V, and faster in the Western with infrequent fish pattern compared to the Balanced average, regardless of sex, nonalcoholic energy intake, smoking, and alcohol consumption. After further adjustment for BMI and sports participation, the strengths of the associations modestly decreased; however, the difference between the Balanced-average and High fast food, low F&V patterns remained significant. The pace of aging (DunedinPACE) was slower in the Plant-based pattern compared to the High fast food, low F&V and the Western with infrequent fish patterns after adjustment for sex, nonalcoholic energy intake, smoking, and alcohol. The effect sizes were attenuated and reached a non-significant level when BMI and sports participation were added to the model. Most of the associations were replicated in the within-pair analyses among all twin pairs and among dizygotic twin pairs, but the effect sizes tended to be smaller among monozygotic twin pairs. This suggests that genetics, but not a shared environment, may partially explain the observed associations between diet and biological aging.

Conclusion

Diets high in fast food, processed red meat, and sugar-sweetened beverages and low in fruits and vegetables are associated with accelerated biological aging in young adulthood. The clustering effect of lifestyle factors and genetic confounders should be considered when interpreting the findings.

背景与目的：次优饮食增加发病率和死亡率风险。表观遗传时钟是一种算法，可以评估健康和寿命，甚至在年轻时，在疾病的临床表现之前。我们调查了年轻成年双胞胎饮食模式和生物衰老之间的关系。方法：数据来自基于人群的FinnTwin12研究，包括21-25岁的双胞胎（n = 826）。食物和饮料的摄入量通过食物频率问卷进行评估。使用表观遗传时钟GrimAge和DunedinPACE来估计生物衰老。潜在分类分析用于确定饮食模式。饮食模式与生物衰老之间的关系采用个体水平的线性回归模型进行评估，随后进行双胞胎内分析，以解释遗传责任和共同的家族混杂因素。结果：确定了6种饮食模式：1)高快餐，低水果和蔬菜（F&V）， 2)植物性饮食，3)健康意识，4)不常吃鱼的西方饮食，5)经常吃鱼的西方饮食，6)均衡的平均饮食。在个体水平上，与高快餐、低F&V模式相比，植物性、健康意识和平衡平均模式的GrimAge加速速度较慢，而与平衡平均模式相比，无论性别、非酒精能量摄入、吸烟和饮酒如何，很少吃鱼的西方模式的GrimAge加速速度较快。在进一步调整BMI和运动参与后，这些关联的强度略有下降；然而，平衡平均和高快餐，低餐饮模式之间的差异仍然显著。在调整了性别、非酒精性能量摄入、吸烟和酒精之后，与高快餐、低F&V和不经常吃鱼的西方模式相比，以植物为基础的模式的衰老速度（DunedinPACE）要慢。在模型中加入BMI和运动参与后，效应量减弱并达到非显著水平。大多数关联在所有双胞胎和异卵双胞胎的对内分析中得到了重复，但在同卵双胞胎中效应大小往往较小。这表明基因，而不是共同的环境，可能部分解释了观察到的饮食和生物衰老之间的联系。结论：多吃快餐、加工红肉和含糖饮料，少吃水果和蔬菜与青年期生物衰老加速有关。在解释研究结果时，应考虑生活方式因素和遗传混杂因素的聚类效应。

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引用次数: 0

The interaction between the Circadian Locomotor Output Cycles Kaput and Melanocortin-4-receptor gene variants on obesity and parameters related to obesity 生理运动输出周期Kaput和黑素皮质素-4受体基因变异与肥胖及肥胖相关参数的相互作用

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.021

Sara Rahati , Mostafa Qorbani , Anoosh Naghavi , Hamideh Pishva

Introduction

Obesity is a multifactorial disease caused by an interaction between genetic, environmental and behavioral factors. Polymorphisms of the two genes Circadian Locomotor Output Cycles Kaput (CLOCK) rs1801260 and Melanocortin-4-receptor (MC4R) rs17782313, are associated with obesity. Knowledge is limited on the interaction between CLOCK, MC4R and obesity. The aim was to explore the interactions between the CLOCK and MC4R gene variants on markers related to obesity.

Methods

There were 423 subjects with information on two genetic variants of two genes (CLOCK and MC4R). Their interaction was evaluated with: chronotype, sleeping duration, emotional eating, food timing, stress, dietary intake, appetite, physical activity (assessed by questionnaires), anthropometric measures of obesity (assessed by physical measurements), and also hormonal factors (assessed by ELISA). Generalized Linear Models were applied.

Results

Our results revealed that significant differences were observed between the genotypes of CLOCK rs1801260 for weight, Body Mass Index (BMI), Glucagon-like peptide-1 (GLP-1), cortisol, energy, fat, sleep duration, chronotype, appetite, depression, stress, emotional eating, physical activity, breakfast, lunch, and dinner time (p˂0.05). Also, significant differences were observed between the genotypes of MC4R rs17782313 for weight, BMI, Waist Circumference (WC), Waist to Hip Ratio (WHR), ghrelin, energy, carbohydrate, fat, appetite, depression, stress, breakfast time, and emotional eating (p˂0.05). Our findings also showed significant interactions between the CLOCK (CC)∗MC4R (CT) genotypes for higher appetite, stress and CLOCK (CT)∗ MC4R (CC) genotypes for higher fat and energy intake and CLOCK (CC)∗MC4R (CC) genotypes for higher weight, BMI, energy and fat intake, appetite, emotional eating, stress, ghrelin, cortisol and lower sleep duration and GLP-1 (p˂ 0.05).

Conclusion

Due to the non-significance of the interaction in CLOCK (CT)∗ MC4R (CT) genotypes, it seems that the presence of a healthy arm in the CLOCK and MC4R polymorphism is necessary for the proper function of the genes. Thus, these results highlight that gene variants and their interaction should be considered in obesity assessment.

肥胖症是一种多因素疾病，是遗传、环境和行为因素相互作用的结果。昼夜运动输出周期Kaput (Circadian Locomotor Output Cycles Kaput， CLOCK) rs1801260和黑素皮质素-4受体（melanocortin -4 receptor, MC4R） rs17782313基因多态性与肥胖有关。目前对CLOCK、MC4R与肥胖之间的相互作用了解有限。目的是探索CLOCK和MC4R基因变异在肥胖相关标记上的相互作用。方法：423例被试具有CLOCK和MC4R两种基因变异信息。他们的相互作用被评估为：睡眠类型、睡眠时间、情绪化饮食、进食时间、压力、饮食摄入、食欲、身体活动（通过问卷评估）、肥胖的人体测量（通过身体测量评估）以及激素因素（通过ELISA评估）。采用广义线性模型。结果：我们的研究结果显示，CLOCK rs1801260基因型在体重、体重指数（BMI）、胰高血糖素样肽-1 （GLP-1）、皮质醇、能量、脂肪、睡眠时间、睡眠类型、食欲、抑郁、压力、情绪性饮食、身体活动、早餐、午餐和晚餐时间等方面存在显著差异（p小于0.05）。此外，MC4R rs17782313基因型在体重、BMI、腰围（WC）、腰臀比（WHR）、胃饥饿素、能量、碳水化合物、脂肪、食欲、抑郁、压力、早餐时间和情绪性饮食方面也存在显著差异（p小于0.05）。我们的研究结果还表明，高食欲、高压力的CLOCK (CC)∗MC4R （CT）基因型与高脂肪和高能量摄入的CLOCK (CT)∗MC4R （CC）基因型与高体重、BMI、能量和脂肪摄入、食欲、情绪性进食、压力、胃饥饿素、皮质醇和较短睡眠时间与GLP-1之间存在显著的相互作用（p小于0.05）。结论：由于CLOCK (CT)∗MC4R （CT）基因型的相互作用不显著，因此CLOCK和MC4R多态性中存在健康臂似乎是基因正常功能所必需的。因此，这些结果强调在肥胖评估中应考虑基因变异及其相互作用。

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引用次数: 0

Brown adipose tissue is associated with reduced weight loss and risk of cancer cachexia: A retrospective cohort study

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.028

Grigorios Panagiotou , Demsina Babazadeh , Dario F. Mazza , Soheila Azghadi , Joseph M. Cawood , Aaron S. Rosenberg , Fumiaki Imamura , Nita G. Forouhi , Abhijit J. Chaudhari , Yasser G. Abdelhafez , Ramsey D. Badawi , Maria Chondronikola

Background & aims

Brown adipose tissue (BAT) has been mainly investigated as a potential target against cardiometabolic disease, but it has also been linked to cancer-related outcomes. Although preclinical data support that BAT and the thermogenic adipocytes in white adipose tissue may play an adverse role in the pathogenesis of cancer cachexia, results from studies in patients have reported inconsistent results. The purpose of this study was to examine the interrelationship between presence of detectable BAT, changes in body weight, and cachexia in patients with cancer. We hypothesized that evidence of BAT at cancer diagnosis would be associated with greater weight loss and risk of cancer cachexia up to a year after cancer diagnosis.

Methods

We conducted a retrospective cohort study in treatment-naïve patients with detectable BAT (BAT+, n = 57) and without evidence of BAT (BAT-, n = 73) on 2-deoxy-2-[¹⁸F]fluoro-d-glucose positron emission tomography-computed tomography (¹⁸F-FDG-PET-CT) imaging performed for cancer staging (2004–2020). Patients’ clinical, demographic, and anthropometric characteristics were extracted from their electronic medical record for up to a year after diagnosis. The two groups were a priori matched for demographic, anthropometric, and disease-related characteristics at diagnosis, as well as for season and outdoor temperature on the day of the PET-CT scan. Cancer cachexia was defined as weight loss greater than 5 % or 2 % if body mass index was lower than 20 kg/m². Poisson regression models were fitted to estimate the relative risk (RR) for developing cancer cachexia over the 1-year follow-up among BAT+ compared to BAT- patients.

Results

The BAT+ group experienced a lower magnitude of weight loss compared with the BAT- group during the 1-year follow-up (p = 0.014 for interaction between BAT status and time). The risk for cancer cachexia was 44 % lower in the BAT+ than the BAT- group, adjusted for age, sex, outdoor temperature on the day of the ¹⁸F-FDG-PET-CT imaging, cancer site and stage (RR: 0.56, 95 % CI: 0.32 to 0.97).

Conclusion

Contrary to our original hypothesis, evidence of BAT assessed by ¹⁸F-FDG-PET-CT imaging at cancer diagnosis was associated with greater body weight maintenance and lower risk for developing cancer cachexia up to one year after diagnosis. Larger, prospective studies and mechanistic experiments are needed to expand and identify the causal factors of our observations.

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引用次数: 0

Adiposity and inflammation markers explain mostly part of the plasma zonulin variation in Brazilian adults with overweight/obesity: A cross-sectional analysis from Brazilian nuts study 肥胖和炎症标志物解释了巴西超重/肥胖成年人血浆带蛋白变化的大部分原因：巴西坚果研究的横断面分析。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.017

Madalena Geralda Cupertino Ribeiro , Ana Claudia Pelissari Kravchychyn , Josefina Bressan , Helen Hermana Miranda Hermsdorff

Objective

This study evaluated intestinal permeability according to plasma zonulin and its association with adiposity, inflammation, cardiometabolic risk, liver function, and intestinal health markers in adults with overweight/obesity.

Methodology

This study is a cross-sectional analysis using baseline data from the Brazilian Nut Study, which involved 123 participants (93 women, age 33.2 ± 8.58 years, BMI 33.9 ± 4.30kg/m2). Subjects were divided into quartiles according to plasma zonulin, assessed by Elisa. Cytokines were assessed by flow cytometry; anthropometric measurements were collected by standard procedure and body composition was assessed by DXA. SCFA analysis was performed by high-performance liquid chromatography, and fecal pH, by a pH meter. Linear regression models were performed (α<5 %).

Results

Participants included in the last quartile of plasma zonulin had higher values of body fat (%), pro-inflammatory cytokines (CRP, IL-1). According to the multivariate regression model, each one-unit increased in body fat, CRP, IL-12p70, IL-6 and IL-8 resulted correspondingly in an increment of 0.42, 0.14, 0.192, 0.250 and 0.312 ng/ml in plasma zonulin, respectively. Conversely, a one-unit decreased in IL-10 led to an increase of 0.40 ng/ml in plasma zonulin.

Conclusion

Intestinal permeability assessed by plasma zonulin is associated with adiposity, subclinical inflammation and reduced serum HDL levels adults with overweight/obesity, while adiposity and inflammation markers are independent factors for plasma zonulin variation.

目的：本研究评估了超重/肥胖成人血浆zonulin的肠通透性及其与肥胖、炎症、心脏代谢风险、肝功能和肠道健康指标的关系。方法：本研究采用巴西坚果研究基线数据的横断面分析，涉及123名参与者（93名女性，年龄33.2±8.58岁，BMI 33.9±4.30kg/m2）。根据血浆zonulin水平将受试者分为四分位数，采用Elisa法进行评估。流式细胞术检测细胞因子；采用标准程序采集人体测量数据，采用DXA评估体成分。SCFA分析采用高效液相色谱法，粪便pH测定采用pH计。采用线性回归模型(α结果：血浆zonulin最后四分位数的参与者体脂（%）、促炎细胞因子（CRP、IL-1）值较高。根据多元回归模型，体脂、CRP、IL-12p70、IL-6、IL-8每增加1个单位，血浆带蛋白分别增加0.42、0.14、0.192、0.250、0.312 ng/ml。相反，IL-10降低1个单位导致血浆带蛋白升高0.40 ng/ml。结论：血浆zonulin评估肠道通透性与肥胖、亚临床炎症和血清HDL水平降低有关，而肥胖和炎症标志物是血浆zonulin变化的独立因素。

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引用次数: 0

Vitamin D deficiency may accelerate cognitive decline in female apolipoprotein E ε4 non-carriers 维生素D缺乏可能加速女性载脂蛋白E ε4非携带者的认知能力下降。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.029

Jiwon Kim , Eunjeong Ji , Jong Bin Bae , Ji Won Han , Tae Hui Kim , Kyung Phil Kwak , Bong Jo Kim , Shin Gyeom Kim , Jeong Lan Kim , Seok Woo Moon , Joon Hyuk Park , Seung-Ho Ryu , Jong Chul Youn , Dong Young Lee , Dong Woo Lee , Seok Bum Lee , Jung Jae Lee , Jin Hyeong Jhoo , Junghan Song , Kyunghoon Lee , Ki Woong Kim

Background & aims

The impact of vitamin D deficiency (VDD) on cognition remains controversial. Evidences suggest that variability based on apolipoprotein E (APOE) ε4 status and gender, given APOE ε4's influence on vitamin D metabolism and women's heightened vitamin D sensitivity. We investigated the interplay between APOE ε4, gender, and VDD in cognitive decline among older adults.

Methods

In a population-based cohort of 1547 cognitively normal Koreans aged ≥60 years, Mini Mental State Examination (MMSE) changes were tracked biennially (2010–2020). VDD was defined as serum 25-hydroxyvitamin D < 10 ng/mL. Linear mixed models analyzed VDD effects, with subgroup analyses for APOE ε4 status and gender.

Results

VDD was present in 21.3 % at baseline and was linked to faster MMSE decline (estimate = −0.054, 95 % CI [-0.091, −0.017], p = 0.004), particularly in APOE ε4 non-carriers (estimate = −0.070, 95 % CI [-0.112, −0.029], p = 0.001). A gender-based analysis revealed that this effect was significant only in female non-carriers (estimate = −0.097, 95 % CI [-0.156, −0.038], p = 0.001). Conversely, male non-carriers demonstrated an absence of a statistically significant association (estimate = −0.017, 95 % CI [-0.076, 0.041], p = 0.562).

Conclusions

VDD accelerates cognitive decline in cognitively normal APOE ε4 non-carriers, particularly women, underscoring the importance of tailored prevention strategies.

背景与目的：维生素D缺乏症（VDD）对认知的影响仍存在争议。有证据表明，由于载脂蛋白E (APOE) ε4对维生素D代谢的影响以及女性维生素D敏感性的提高，这种变异基于载脂蛋白E (APOE) ε4状态和性别。我们研究了APOE ε4、性别和VDD在老年人认知能力下降中的相互作用。方法：在1547名年龄≥60岁认知正常的韩国人群为基础的队列中，每两年（2010-2020）追踪一次迷你精神状态检查（MMSE）的变化。结果：基线时VDD发生率为21.3%，与MMSE下降速度加快有关（估计= -0.054,95% CI [-0.091, -0.017], p = 0.004），特别是APOE ε4非携带者（估计= -0.070,95% CI [-0.112, -0.029], p = 0.001）。基于性别的分析显示，这种影响仅在女性非携带者中显著（估计= -0.097,95% CI [-0.156, -0.038], p = 0.001）。相反，男性非携带者显示没有统计学上显著的关联（估计= -0.017,95% CI [-0.076, 0.041], p = 0.562）。结论：VDD加速认知正常APOE ε4非携带者的认知能力下降，特别是女性，强调了量身定制预防策略的重要性。

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引用次数: 0

Disease modifies the dependency of percentiles of the phase angle distribution on age, sex, height and weight in hospitalized patients 疾病改变了相位角分布百分位数对住院患者年龄、性别、身高和体重的依赖性。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.024

Mathias Plauth , Peter Bauer , Melanie Viertel , Michael Reich , Michael Hiesmayr

Background & aims

Phase angle (PhA) is viewed as a holistic indicator of quantity and quality of cellularity and hydration status and has emerged as a significant predictor of patient outcome in clinical medicine. We sought to analyze the impact of hospitalization as a surrogate for disease on the distribution of PhA and its dependency on influence variables age, sex, height and weight without any assumption as to the form of PhA-distribution.

Methods

First PhA measurements obtained from 2418 women (median age 75 IQR[63; 82]) and 2541 men (median age 70 IQR[60; 79]) hospitalized in a Community General Hospital were analyzed. Multivariable quantile regression was applied for estimating percentiles P1 – P95 using parsimonious models including a dichotomous factor for sex and cubic polynomials for age (model A) and height and weight (model B) using only linear interaction terms between the four variables sex, age, height, and weight.

Results

The association of PhA was strongest with age (women r = −0.48; men r = −0.47). In each age class average PhA values of hospitalized patients were below those reported for healthy individuals. In contrast to percentiles above the median showing a monotonous decrease with age as reported from healthy individuals the lower percentiles of patients showed a marked dip-and-plateau deformation. This deformation was associated with a change in the distribution span of PhA between P1 and P95 which was narrower at young age, expanded markedly due to a persisting fraction of patients with low PhA over the age range from 50 to 80 years and became narrower again at higher age due to the decreasing fraction of patients with high PhA. These distribution patterns were the same, irrespective of using either model A or model B. Furthermore, bootstrapping confirmed the estimated form of the percentile curves.

Conclusions

Disease modifies the PhA distribution pattern resulting not only in lower PhA in patients than in healthy individuals but also in a dip-and-plateau deformation of lower PhA percentile curves for the association with age. The dip-and-plateau pattern and the narrowing of the span between P1 and P95 with older age suggest that there is a low threshold value for PhA, below which life is impossible.

Clinical trial registry

DRKS00025307, https://www.drks.de/DRKS00025307.

背景与目的：相位角（PhA）被认为是细胞质量和水合状态的整体指标，在临床医学中已成为患者预后的重要预测指标。我们试图分析住院作为疾病替代对PhA分布的影响，以及其对影响变量年龄、性别、身高和体重的依赖关系，而不假设PhA分布的形式。方法：首次PhA测量来自2418名女性(中位年龄75 IQR[63；[82])和2541名男性(中位年龄70 IQR[60；[79])在某社区综合医院住院。多变量分位数回归应用于估计P1 - P95百分位数，使用简约模型，包括性别的二分因子和年龄（模型a）的三次多项式，以及身高和体重（模型B），仅使用四个变量性别、年龄、身高和体重之间的线性相互作用项。结果：PhA与年龄的相关性最强(女性r = -0.48；男性r = -0.47)。在每个年龄组中，住院患者的平均PhA值低于健康个体的报告值。与健康个体报告的中位数以上的百分位数随年龄单调下降相反，患者的较低百分位数表现出明显的下降和平台变形。这种变形与P1和P95之间PhA分布范围的变化有关，该分布范围在年轻时变窄，由于50至80岁年龄组中低PhA患者的持续比例而显着扩大，并且由于高PhA患者比例的减少而在较高年龄时再次变窄。无论使用模型A还是模型b，这些分布模式都是相同的。此外，自举证实了百分位曲线的估计形式。结论：疾病改变了PhA分布模式，不仅导致患者的PhA低于健康人，而且还导致PhA低百分位曲线与年龄相关的倾斜和平台变形。随着年龄的增长，P1和P95之间的跨度逐渐缩小，表明PhA存在一个较低的阈值，低于这个阈值就不可能有生命。临床试验注册：DRKS00025307， https://www.drks.de/DRKS00025307。

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引用次数: 0

The effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial 6个月饮食咨询对心血管疾病患者饮食质量和心血管风险的影响：一项随机对照试验

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2024.12.020

Iris van Damme , Eva R. van Veldhuisen , Auke J.C.F. Verkaar , Remy H.H. Bemelmans , Marcel M.C. Hovens , Frank L.J. Visseren , Charlotte Koopal , Renate M. Winkels , Johanna M. Geleijnse

Background & aims

A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.

Methods

In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.

Results

DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: −4.1 %; 5.3 %), blood pressure (−2 mmHg, 95%CI: −7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (−0.7 kg, 95%CI: −2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: −1.20; 2.62) or depressive symptoms and optimism scores between groups.

Conclusions

Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.

Clinical trial registration

This trial was registered at www.clinicaltrials.gov/study/NCT05071092.

背景与目的：健康的饮食可以改善心血管疾病（CVD）的危险因素。然而，饮食咨询尚未在心血管疾病患者的医疗保健中广泛实施。我们评估了以改善饮食质量为重点的营养师的饮食咨询如何影响心血管疾病患者的心血管风险概况。方法：在这项为期6个月的试验中，124例CVD患者（68.1±9.5岁，72%为男性）被随机分配到营养师咨询组（n = 63）或常规护理组（n = 61）。采用10年心血管风险综合预测评分，包括血压和低密度脂蛋白胆固醇（LDL-C）的变化，评估两组间心血管风险概况的差异。次要结局包括荷兰健康饮食指数-2015 （DHD15-index）、个体危险因素（LDL-C、血压、体重和高敏c反应蛋白[hs-CRP]）以及抑郁症状和乐观评分评估的健康饮食依从性。结果：基线dhd15指数为103±18（满分160），与常规护理组相比，饮食咨询组的dhd15指数增加了5.7点(95%置信区间（CI）： 1.3；10.1)。多因素分析显示，10年心血管风险评分随时间的变化无统计学意义(0.6%,95%CI: - 4.1%；5.3%)，血压(-2 mmHg, 95%CI: -7；4)、LDL-C (0.0 mmol/l, 95%CI: 0.2；0.2)，体重(-0.7 kg, 95%CI: -2.9；1.5), hs-CRP (0.71 mg/dl, 95%CI: -1.20；2.62)或抑郁症状和乐观得分。结论：对CVD患者进行6个月的饮食咨询只略微改善了已确诊CVD患者对健康饮食的坚持，并没有导致心血管风险概况或抑郁症状和乐观评分的实质性改善。临床试验注册：该试验在www.Clinicaltrials: gov/study/NCT05071092注册。

{"title":"The effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial","authors":"Iris van Damme , Eva R. van Veldhuisen , Auke J.C.F. Verkaar , Remy H.H. Bemelmans , Marcel M.C. Hovens , Frank L.J. Visseren , Charlotte Koopal , Renate M. Winkels , Johanna M. Geleijnse","doi":"10.1016/j.clnu.2024.12.020","DOIUrl":"10.1016/j.clnu.2024.12.020","url":null,"abstract":"<div><h3>Background & aims</h3><div>A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.</div></div><div><h3>Methods</h3><div>In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.</div></div><div><h3>Results</h3><div>DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: −4.1 %; 5.3 %), blood pressure (−2 mmHg, 95%CI: −7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (−0.7 kg, 95%CI: −2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: −1.20; 2.62) or depressive symptoms and optimism scores between groups.</div></div><div><h3>Conclusions</h3><div>Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.</div></div><div><h3>Clinical trial registration</h3><div>This trial was registered at <span><span>www.clinicaltrials.gov/study/NCT05071092</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"45 ","pages":"Pages 101-110"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969341","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}

引用次数: 0

Digital dietary interventions for healthy adolescents: A systematic review of behavior change techniques, engagement strategies, and adherence 健康青少年的数字饮食干预：行为改变技术、参与策略和依从性的系统回顾。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2025.01.012

Geiziane Leite Rodrigues Melo , Rafaela Espírito Santo , Eugeni Mas Clavel , Marina Bosque Prous , Karsten Koehler , Josep Vidal-Alaball , Judith van der Waerden , Inese Gobiņa , José Francisco López-Gil , Rodrigo Lima , Cesar Agostinis-Sobrinho

Background

Adolescence is a crucial phase for developing healthy eating habits with lifelong health implications. Digital interventions, such as smartphone apps and web platforms, have emerged as promising strategies to promote healthy eating habits among adolescents by using behavior change techniques (BCTs). This study aims to systematically review internet-based dietary interventions targeting adolescents, focusing on the analysis of BCTs employed, their delivery modes, and their impact on adolescents' adherence and engagement.

Methods

PubMed, Scopus, and Web of Science databases were used up to July 2024. Eligible studies included randomized clinical trials involving adolescents aged 12 to 18. The interventions analyzed involved smartphone apps and web platforms promoting changes in eating habits, with results focusing on adherence and techniques used.

Results

The initial search identified 5399 articles, of which 16 studies were included in the final analysis. The studies involved a total of 31,971 participants (range: 29–7890), with 40.29 % being female (n = 12,881), aged 12–18 years. The duration of interventions ranged from two weeks up to 12 months, with follow-ups of up to 24 months. Interventions that utilized BCTs such as goal setting (n = 14), feedback on behavior (n = 14), social support (n = 14), prompts/cues (n = 13), and self-monitoring (n = 12), were the most effective in promoting adherence and engagement. Digital dietary interventions that incorporated personalized feedback (n = 9) and gamification (n = 1) showed adherence rates between 63 % and 85.5 %, with notable improvements in dietary habits, such as increased fruit and vegetable consumption and reduced intake of sugar-sweetened beverages. However, the intervention using gamification involved only 36 participants, and its effects require further investigation due to the limited sample size.

Conclusion

Digital interventions show potential for promoting healthy dietary behaviors among adolescents, yet mixed outcomes underscore the challenges of maintaining adherence and long-term engagement. Techniques such as self-monitoring, goal setting, and social support can enhance engagement and effectiveness, particularly when combined with gamified features. The trial protocol is registered on PROSPERO (CRD42024564261).

背景：青春期是养成健康饮食习惯的关键阶段，对一生的健康都有影响。通过使用行为改变技术（bct），智能手机应用程序和网络平台等数字干预措施已成为促进青少年健康饮食习惯的有希望的策略。本研究旨在系统回顾针对青少年的基于互联网的饮食干预措施，重点分析采用的bct、其提供模式及其对青少年依从性和参与度的影响。方法：截止到2024年7月，使用PubMed、Scopus和Web of Science数据库。符合条件的研究包括涉及12至18岁青少年的随机临床试验。分析的干预措施包括促进饮食习惯改变的智能手机应用程序和网络平台，结果集中在坚持和使用的技术上。结果：最初检索到5399篇文章，其中16篇研究被纳入最终分析。这些研究共涉及31971名参与者（范围：29-7890），其中40.29%为女性（n = 12881），年龄在12-18岁。干预的持续时间从两周到12个月不等，随访时间长达24个月。利用btc的干预措施，如目标设定（n = 14）、行为反馈（n = 14）、社会支持（n = 14）、提示/线索（n = 13）和自我监控（n = 12），在促进依从性和参与度方面最有效。结合个性化反馈（n = 9）和游戏化（n = 1）的数字饮食干预显示，依从率在63%至85.5%之间，饮食习惯得到显著改善，例如增加水果和蔬菜的摄入量，减少含糖饮料的摄入量。然而，使用游戏化的干预仅涉及36名参与者，由于样本量有限，其效果需要进一步调查。结论：数字干预显示了促进青少年健康饮食行为的潜力，但好坏参半的结果突显了保持坚持和长期参与的挑战。自我监控、目标设定和社会支持等技术可以提高用户粘性和有效性，特别是在与游戏化功能相结合时。该试验方案在PROSPERO （CRD42024564261）上注册。

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引用次数: 0

Effects of Ramadan intermittent fasting on hormones regulating appetite in healthy individuals: A systematic review and meta-analysis

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2025.01.005

Deema M. Alogaiel , Abdulaziz Alsuwaylihi , May S. Alotaibi , Ian A. Macdonald , Dileep N. Lobo

Background and aims

This systematic review and meta-analysis aimed to examine the effect of Ramadan intermittent fasting on appetite-regulating hormones including leptin, ghrelin, insulin, gastrin, glucagon-like peptide-1, peptide YY, and cholecystokinin.

Methods

We searched the MEDLINE, Embase, Cochrane Library, CINAHL, Google Scholar, and Web of Science databases to identify relevant research on appetite-regulating hormones during Ramadan intermittent fasting, published until the end of March 2024.

Results

Data from 16 eligible studies comprising 664 participants (341, 51.4 % male) with a mean ± standard deviation age of 33.9 ± 10.8 years were included. The meta-analysis included 12 studies with complete leptin data, showing no significant effect of Ramadan intermittent fasting on leptin concentrations (standardised mean difference – SMD = −0.11 μg/mL, 95 % CI: −0.36 to 0.14). Analysis of three studies with complete ghrelin data demonstrated a significant increase in ghrelin concentrations following Ramadan intermittent fasting (SMD = 0.31 pg/mL, 95 % CI: 0.03 to 0.60). Six studies examining insulin concentrations pre- and post-fasting revealed no significant effect on insulin concentrations (SMD = −0.24 μU/mL, 95 % CI: −0.54 to 0.02). Similarly, analysis of three studies with complete gastrin data showed no significant effect of intermittent fasting on gastrin concentrations (SMD = 0.23 pg/mL, 95 % CI: −0.71 to 0.99).

Conclusion

Ramadan intermittent fasting significantly increases ghrelin concentrations while showing no significant effects on leptin, insulin, and gastrin. While ghrelin findings were consistent across studies, the high heterogeneity in leptin studies suggests further research to better understand the effects of Ramadan intermittent fasting on appetite-regulating hormones.

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引用次数: 0

Corrigendum to “Dietary patterns, inflammatory biomarkers and cognition in older adults: An analysis of three population-based cohorts” [Clin Nutr 10 (43) (2024) 2336-2343] “老年人的饮食模式、炎症生物标志物和认知：一项基于三个人群的队列分析”的更正[临床营养学10(43)(2024)2336-2343]。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.clnu.2025.01.013

Natalia Ortega , Leona Schütte , Tosca O.E. de Crom , Trudy Voortman , Olivia I. Okereke , Marco Vinceti , Armin von Gunten , Pedro Marques-Vidal , Nicolas Rodondi , Arnaud Chiolero , Patricia O. Chocano-Bedoya

引用次数: 0