European Journal of Clinical Nutrition最新文献

Background/objective: Since muscle strength is modifiable and handgrip strength is a reliable biomarker for strength and mortality, exploring its association with mortality in individuals with severe obesity could help identify protective thresholds. We aimed to examine the dose-response association between handgrip strength and mortality in adults with severe obesity.

Subjects/methods: We retrieved data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Handgrip strength was measured in participants with a body mass index (BMI) higher than 40 kg/m². We used time-varying Cox proportional hazards regression to assess the association between handgrip strength and all-cause mortality risk. To account for potential non-linearity, we employed restricted cubic splines. We examined a total of 2229 adults (67.9% women; BMI of 43.8 kg/m²).

Results: We found an association between handgrip strength and mortality, showing a minimal and optimal dose for a reduced risk with 31 kg (HR 0.97, 95% CI, 0.96-0.99) and 36 kg (HR 0.90, 95% CI, 0.81-0.99), respectively. Additional sex-stratified analysis showed that lower than median levels of handgrip strength were gradually associated with increased risk in both men and women.

Conclusions: The association between handgrip strength and all-cause mortality in European adults with severe obesity highlights practical thresholds for risk reduction, with 31 kg as the minimum and 36 kg as the optimal strength level. In both men and women, handgrip strength below the median was linked to a gradual increase in mortality risk, emphasizing the importance of maintaining adequate muscle strength to improve health outcomes.

This scoping review aimed to assess the repeatability and accuracy of Digital Anthropometry by Mobile Application (DAM) compared to reference methods for estimating anthropometric dimensions, body volume (BV), and body composition. A comprehensive search was conducted on December 8th, 2024, without restrictions on language, time, sex, ethnicity, age, or health condition. We found 14 different DAMs across the 23 included studies. Reference methods for each estimated variable were: (a) Body circumferences-tape measure; (b) body mass-calibrated scale; (c) body length-stadiometer; (d) BV-Underwater Weighing; (e) percentage of body fat-Dual energy x-ray absorptiometry (DXA), BOD POD, 3, 4, and 5-compartment models; (f) fat mass and fat-free mass-DXA, 3 and 4-compartment models; (g) appendicular Lean Mass-DXA. DAMs demonstrated high repeatability and accuracy at a mean level in most studies. However, their accuracy is lower at individual-level analysis and for tracking changes over time. Estimated BV showed high accuracy compared to UWW (SEE = 0.68; MD = 0.04 to 0.1; LoA = 2.86), including the BV-derived DAMs integrated into alternative multi-compartment models compared to reference methods. As relatively new methods, DAMs offer numerous possibilities and areas for exploration in future studies. However, caution is advised due to their potentially low or unknown accuracy at the individual level.

Background: Adequate fruit and vegetable intake is important for preventing chronic disease. The transition from adolescence to early adulthood involves changes in their social and environmental context, lifestyle and behaviours that may determine lifelong dietary patterns. Differences that emerge between populations over this age range may lead to long-term health inequalities. This study examined the trajectories of fruit and vegetable intake among young adults in the United Kingdom (UK) and Australia.

Methods: We analysed data from young adults aged 16-30 years from the UK Household Longitudinal Study (UKHLS; n = 2751) and the Household, Income and Labour Dynamics in Australia Survey (HILDA; n = 6255). Hybrid mixed-effect regression models were fitted to assess intake trajectories of fruit and vegetables, exploring differences by sex and socioeconomic position.

Results: Fruit intake decreased and vegetable intake increased with age in both countries. Fruit intake trajectories differed by sex in both cohorts, while vegetable intake trajectories differed by sex in Australia only. Parental education was a predictor of fruit and vegetable intake trajectories in both cohorts, with differences between groups with high and low parental education narrowing with age in Australia for fruit intake.

Conclusions: The differing trajectories emphasise the importance of understanding contextual influences to effectively tailor public health strategies. Our study highlights early adulthood as a critical period for developing dietary patterns that could influence long-term health outcomes, with differences between groups emerging quickly. Addressing these inequalities is essential when developing policies aimed at improving diet among young adults and reducing the prevalence of chronic disease.

Background: Diet is pivotal in preventing and managing cardiometabolic diseases. Our study aimed to describe the prevalence of poor diet quality and perceiving a poor diet as healthy and to determine individual-level factors associated with these groups.

Methods: This cross-sectional study analyzed seven 2-year cycles of National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018, which included non-pregnant adults between 20 and 85 years old, who completed a one-day 24-h dietary recall and dietary interview. Diet quality was measured using the American Heart Association (AHA) primary diet score, and perceived diet quality was based on NHANES questionnaire response.

Results: Among 31,644 adults, the prevalence of poor diet quality was 47%. Male sex and smoking were associated with a higher risk of poor diet quality, while older age, higher levels of education, increased income, diabetes mellitus diagnosis, and increased vigorous activity levels were associated with a lower risk of poor diet quality. Among adults with poor diet quality (n = 14,952), 23% perceived their diet as healthy. In multivariable analysis, older age, higher education, and vigorous activity level were associated with a higher risk of perceiving a poor diet as healthy.

Conclusions: Nearly half of US adults had poor diet quality based on AHA guidelines for cardiovascular health, yet nearly a quarter of them perceived their diet as healthy. This gap underscores the need for focused educational efforts and interventions in both healthcare and public health settings to dispel diet-related misperceptions and motivate the adoption of a healthier diet to address cardiometabolic health.

Background: Finland's national vitamin D fortification policy has significantly improved the population's vitamin D sufficiency. This study investigates the association between serum vitamin D concentration and muscle health, considering the impact of menopause and aging in Finnish cohorts.

Methods: The study comprised two cohorts: 237 middle-aged women (aged 47-55 years) from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study and its follow-up, and 908 older adults (aged 75, 80, and 85 years) from the Active Aging (AGNES) study. Vitamin D concentration was assessed through serum 25-hydroxyvitamin D (25(OH)D) concentrations, alongside measurements of muscle mass and function.

Results: High concentrations of 25(OH)D were observed across both cohorts, aligning with Finland's fortification efforts. Furthermore, no significant correlations were found between 25(OH)D concentrations and indicators of muscle mass or function in either age group. Notably, middle-aged women in menopausal transition exhibited a slight increase in 25(OH)D concentrations, yet this did not translate into improved muscle outcomes. Similarly, older adults demonstrated sufficient 25(OH)D concentrations without a corresponding enhancement in muscle health.

Conclusions: The findings indicate that, within the context of Finland's vitamin D fortification program, serum 25(OH)D sufficiency does not directly correlate with better muscle mass or function among middle-aged and older Finnish populations. These results suggest a need for a broader approach to sarcopenia prevention, incorporating factors beyond vitamin D sufficiency. Further research is warranted to explore the multifactorial nature of muscle health during aging and the menopausal transition, to develop targeted interventions for sarcopenia prevention.

Background: Most people with anorexia nervosa (pAN) have digestive symptoms, which affect tolerance to nutritional treatment. Oligomeric oral nutritional supplements may be better absorbed and tolerated than polymeric ones. Our aim was to compare an oligomeric versus a polymeric nutritional supplement in pAN in terms of worsening of digestive symptoms after ingestion (primary objective) and in terms of sensory perception of the supplement (secondary objective).

Methods: A randomised, crossover, double-blind, controlled clinical trial was conducted. Inclusion criteria were: male or female aged 12-50 years with anorexia nervosa treated at the Eating Disorders Unit of the Hospital Regional Universitario de Málaga, Spain. Participants were randomised to first receive one container of the oligomeric or polymeric supplement. A digestive symptom questionnaire was administered, which they completed again after taking the supplement, together with a questionnaire for sensory evaluation of the supplement. One week later, they received a container of the other type of supplement, and the process was repeated. Analysis was performed on a per protocol basis.

Results: Ten people were randomised to the oligomeric-polymeric sequence and 12 to the polymeric-oligomeric sequence, of whom 9 and 11, respectively, finally received the intervention and were analysed. There were no statistically significant differences in digestive symptoms between the two supplements. The oligomeric one scored lower on taste and higher on acidity. The median (interquartile range) for oligomeric and polymeric were respectively: taste 6.5 (4), 8(3), p 0.03; acidity 0 (1), 0 (0), p 0.01.

Conclusions: In pAN, there is no difference in the worsening of digestive symptoms after ingestion of oligomeric versus polymeric supplements. Polymerics are perceived as having better taste and less acidity.

Trial registration: The trial is registered at ClinicalTrials.gov, number NCT05184738.

Background: Children with stunting are at risk of infections. We assessed the effect of lipid-based nutrient supplement (LNS) on morbidity in children with stunting.

Methods: This was a secondary analysis of a randomized, 2×2 factorial trial among 12-59 months-old, stunted children in Uganda. Children were randomized to LNS containing milk or soy protein and whey permeate or maltodextrin, or no supplementation, for 12 weeks. The outcomes were caregiver-reported morbidity after 2, 4, 8 and 12 weeks, serum C-reactive protein (S-CRP), α₁-acid glycoprotein (S-AGP), and phase-angle (PhA) by bioimpedance.

Results: Of 750 children, mean (SD) age was 32.0 (11.7) months, 55% (n = 412) were male. LNS increased diarrhoea prevalence (18.1% vs 7.3%, P = 0.001) during the first two weeks, but not thereafter. There was no effect of LNS on cough or fever. LNS resulted in greater decline in S-AGP (-0.10 g/L, 95% CI: -0.17, -0.03, P = 0.003) but not S-CRP (25%, 95% CI: -11, 74, P = 0.193), and greater increase in PhA (0.10 degrees, 95% CI: 0.01, 0.18, P = 0.030), explained by greater fat-free mass. Milk compared to soy protein in LNS resulted in higher PhA (0.10 degrees, 95% CI: 0.02, 0.17, P = 0.013), not explained by fat-free mass.

Conclusion: LNS supplementation in children with stunting had no effect on morbidity but resulted in a small reduction in sub-acute systemic inflammation. The possible effect of LNS supplementation on inflammation in stunted children requires further evaluation. ( www.isrctn.com : ISRCTN13093195).

Background and objective: Iron deficiency is prevalent among geriatric hospitalized patients, often coinciding with inflammation. This study aimed to determine a critical C-reactive protein (CRP) threshold for sufficient intestinal iron absorption using standardized tests.

Subjects/methods: This retrospective, cross-sectional study was conducted in a geriatric acute care unit. Serum iron and CRP levels were measured before breakfast and two- and four-hours after ingestion of two iron capsules. Intestinal iron absorption was calculated by subtracting baseline values from those obtained after the test, with an increase of 100 ug/dl indicating sufficient absorption. Patients were categorized into six CRP groups: ≤0.50, 0.51-2.50, 2.51-5.0, 5.1-7.50, 7.51-10.0, and ≥10.1 mg/dl.

Results: The study included 59 participants (73% females, age range 71-99). Iron absorption was highest in groups with lower CRP levels ≤0.50 to 2.5 mg/dl) and declined significantly as CRP increased, particularly beyond 5 mg/dl. The most significant decline was noted in patients with CRP ≥ 10.1 mg/dl. A negative correlation between inflammation, as measured by CRP, and iron absorption was found. As CRP levels escalate, there is a significant reduction in the increase of serum iron levels after 2 h. A regression analysis showed that only elevated CRP levels significantly reduced serum iron increments post-iron supplementation (P = 0.004), while other factors such as age, sex, body mass index, frailty, weight loss, hemoglobin and nutritional status had no significant impact.

Conclusion: A CRP level above 5 mg/dl is indicative of significantly impaired intestinal iron absorption in older patients, underscoring the critical influence of inflammation on iron metabolism.