European Journal of Clinical Nutrition最新文献

Background: Inflammatory Bowel Disease (IBD) involves genetic and environmental factors, but the relationship between disease activity, adiposity, and diet remains unclear.

Objective: To investigate the association between endoscopic/radiological activity of IBD, body adiposity, and the Dietary Inflammatory Index with or without adjustment for energy density (E-DII or DII).

Method: An observational, cross-sectional study was carried out. Endoscopic activity was defined by an endoscopic Mayo score >2, Crohn's Disease Endoscopic Index of Severity (CDEIS) > 5, and/or the presence of a deep ulcer in any intestinal segment. Body adiposity was estimated using the body mass index, waist circumference, and waist-hip ratio (WHR). The DII and E-DII scores were calculated from a validated quantitative food frequency questionnaire. According to the DII and E-DII, the patients were divided into three groups: the first with the least pro-inflammatory diet and the third with a predominantly pro-inflammatory diet.

Results: Of the 62 patients, 58.1% (n = 36) were in remission (RD) and 41.9% (n = 26) had active disease (AD). The proportion of patients with overweight/obesity was 69.4% (n = 25) in the RD group and 50.0% (n = 13) in the AD group. Patients in remission exhibited significantly higher WHR (p < 0.05) and a greater frequency of central obesity (p < 0.01). A predominantly pro-inflammatory diet was common across both groups; 58.3% (n = 21) of RD patients and 50.0% (n = 13) of AD patients were in the highest DII tertile. Similar results were found for the E-DII.

Conclusions: Among patients with IBD, pro-inflammatory dietary patterns and excess adiposity are highly prevalent. Despite greater central adiposity in patients in remission, no significant associations were found between DII or EDII scores and endoscopic and radiological markers of disease activity.

Aim: Methylmalonic acidemia (MMA), propionic acidemia (PA), and maple syrup urine disease (MSUD) are rare monogenic disorders that are described as intoxication-type inborn errors of metabolism (IEMs). They usually present in early life, and long-term management requires strict dietary protein restriction, which may significantly alter gut microbiota composition. Despite growing interest in microbiome research, limited data exist on gut microbiota in these disorders, and no study is available for MMA and MSUD. We aimed to describe the gut microbiota compositions in children with MMA, PA, and MSUD.

Method: A total of eight patients (Five MMA, one PA, and two MSUD), and 11age-matched healthy controls were enrolled. All patients were following a medically supervised, protein-restricted diet. Fecal sample was collected from each participant, and gut microbiota composition was evaluated with 16S rRNA sequencing.

Results: Patients with MMA, PA, and MSUD exhibited significantly altered gut microbiota composition compared to healthy controls. Alpha diversity analysis revealed reduced microbial richness in patients, with significantly lower Chao1 and observed OTU indices (p < 0.05). Beta diversity metrics demonstrated distinct clustering between groups, indicating significantly different microbial community structures. Higher relative abundances of opportunistic or dysbiotic taxa have been seen in patient group, while controls were enriched in beneficial taxa like Faecalibacterium prausnitzii, Ruminococcus, and Lactobacillus. LEfSe analysis identified 17 taxa enriched in patients-including members of Proteobacteria, Sphingobacteriia, and Streptococcus anginosus-and 6 taxa enriched in controls, notably Faecalibacterium prausnitzi.

Discussion: This is the first descriptive study of the gut microbiota composition of MMA, PA, and MSUD patients. These findings indicate an association between long-term dietary management and altered microbiota composition, although causality cannot be inferred due to the cross-sectional study design. The observed alterations suggest that the gut microbiota may represent a novel therapeutic target in the management of IEMs.

Objective: To examine the associations between BMI trajectories and changes in fat-free mass index (FFMI) and fat mass index (FMI), assessed via bioelectrical impedance analysis (BIA) and skinfold thickness (ST).

Methods: The study included 4708 European children with BIA data and 3627 with ST data, aged 2-9.9 years at baseline, participating in two waves of the IDEFICS (IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants))/I.Family (I. Family (Determinants of eating behavior in European children, adolescents, and their parents)) studies (w0: 2007/08; w2: 2013/14). Children were classified into three BMI trajectory groups: retained normal weight (RNW), remained overweight/obese (ROO), and excessive weight gain (EWG). Analyses of covariance evaluated differences in BMI z-score changes, FFMI, and FMI across groups. Mixed-effects linear regression assessed associations between BMI z-score changes and FFMI/FMI over time.

Results: BMI z-score changes were more strongly associated with FMI (β = 1.16-1.70 in boys; 1.17-1.62 in girls, p < 0.05) than with FFMI, for both BIA and ST. In ROO and EWG groups, associations with FMI were consistently stronger, except among girls <6 years in the ROO group (BIA). In the RNW group, boys >6 years showed stronger associations with FFMI.

Conclusions: Associations between BMI changes and FFMI/FMI vary by BMI trajectory and body composition method. BIA showed closer alignment with BMI changes than ST. These findings suggest that BMI alone may not adequately capture changes in specific body compartments. While convenient, BMI should be interpreted with caution, especially when fat or fat-free mass plays a differential role in disease risk or health outcomes.

A recent animal study suggested that olive oil or other oleic acid-enriched food sources promote adiposity. In contrast, human evidence indicates neutral or protective effects on weight gain. Reconciling these divergent findings is crucial for understanding the role of olive oil, specifically oleic acid, in metabolism. In this Perspective, we contrast the animal study with evidence in humans, emphasizing the context in which each body of research was generated. We also highlight key limitations for translating results from controlled animal experiments to humans. Olive oil, beyond being a traditional culinary fat, serves as a major dietary source of monounsaturated fatty acids in Mediterranean-style diets, where its consumption has been consistently linked to favorable metabolic profiles. Our Perspective emphasizes the need for comprehensive metabolic phenotyping in mice, which can facilitate translation to humans.

Background: Adolescence is a key developmental stage marked by physiological and behavioural changes. Eating behaviour, modifiable and sex-dependent, may be altered and linked to future health issues. This cross-sectional study aims to assess whether eating behaviours and body composition are associated in an adolescent sample.

Methods: Participants aged 12.5-17.5 years were recruited from 10 European cities, with valid data on age, sex, socio-demographic status, body composition and physical activity and who had also completed the specific eating behaviour questionnaire "Eating Behaviour and Weight Problems Inventory for Children". Different linear regression models were adjusted for relevant confounders, and ANCOVA models were performed.

Results: Eating Behaviours related to weight concerns, dietary restraint, emotional eating, fear of weight gain, healthy nutrition and figure dissatisfaction were strongly positively associated with higher Body Mass Index (BMI), Fat Mass Index (FMI) and Waist Circumference (WC), especially in males (betas resulting from the association between these behavioural subscales and body composition in males, ranged from 0.174 to 0.974 for BMI, 0.172 to 0.930 for FMI, and 0.128 to 0.889 for WC). The strongest association was detected in the weight concerns subscale for both males and females.

Conclusion: Eating behaviours across all domains are significantly linked to body composition, with variations depending on the specific behavioural domain and the adolescent's sex. These findings are critical for identifying specific behavioural patterns that contribute to obesity and related health issues, providing new insights for more targeted prevention strategies during this crucial stage of development.

Background/objectives: This study assessed whether adherence to the Lebanese Mediterranean diet (LMeD) is associated with a lower risk of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) among a national sample of pregnant women in Lebanon.

Methods: For this longitudinal study, 618 women were recruited in trimester 1. The main outcomes were IGT and GDM. Independent variables included adherence to the LMeD, maternal anthropometry, clinical and biochemical variables collected at 3 trimesters. Hierarchical multiple logistic regression was used to test associations of independent predictors with IGT and GDM.

Results: The diagnosis of GDM was 5.6%, whereas IGT was more prevalent, and increased from 17% to 24% from T1 to T3, but neither GDM nor IGT risk was associated with adherence to LMeD. A higher consumption of legumes and burghol increased IGT risk in trimester 1 whereas vegetables lowered IGT risk in trimester 3. Family history of diabetes, high gestational weight gain (GWG) and elevated Mean Arterial Pressure (eMAP) were associated with increased GDM risk.

Conclusion: Findings underscore the importance of early screening for family history of diabetes, excessive gestational weight gain (GWG), stress, and elevated mean arterial pressure (MAP) to target to identify women at risk of IGT and GDM. Trimester-specific dietary strategies, such as reducing overconsumption of burghul and legumes in early pregnancy and promoting vegetable intake later, may help improve maternal glycemia.

Background/objectives: Food addiction (FA) is characterized by the presence of dependence symptoms associated with the consumption of calorie-rich, sugary, and fatty foods, typical of ultra-processed foods. The growing prevalence of childhood obesity has been linked to the increased consumption of ultra-processed foods. This study aimed to analyze the direct and indirect associations between FA symptoms, food consumption, and body mass index for age (BMI-for-age) in children from 7 to 10 years of age from a Brazilian low-income region.

Subjects/methods: A cross-sectional study was conducted, including 259 children of both genders, enrolled in public schools in the municipality of Vitória de Santo Antão, Pernambuco, Brazil. The Yale Food Addiction Scale for Children (YFAS-C) was used to assess FA symptoms. A food frequency questionnaire assessed food consumption, and the BMI-for-age was used to evaluate nutritional status. Structural equation analysis was employed for data analysis. The measurement model incorporated the seven FA symptoms from the YFAS-C, yielding favorable fit indices.

Results: FA symptoms had an inverse direct effect on the consumption of in natura and minimally processed foods (β = -10.878; SE = 4.919; p = 0.027), while exhibiting a positive direct impact on the consumption of ultra-processed foods (β = 10.025; SE = 4.898; p = 0.001). The relationship between FA symptoms and BMI-for-age was not mediated by the consumption of ultra-processed foods (β = -0.054; SE = 0.081; p = 0.041).

Conclusion: FA symptoms are associated with an increase in ultra-processed food consumption and a decrease in healthy food consumption among children from low-income families.

Limited studies have explored the longitudinal alterations of fat-free mass (FFM), fat mass (FM), and phase angle (PhA) in the motor neuron disease (MND) population. This pilot longitudinal study investigated body composition changes via bioimpedance analysis (BIA) at time of diagnosis and gastrostomy. Nineteen patients (n = 11, 57.9% females) were included. Statistically significant reductions in FFM [median (IQR) 43.0 (17.8) kg to 42.1 (16.7) kg, p < 0.001] and PhA [4.6 (2.0)° to 4.5 (2.1)°, p = 0.012] were found. FFM (p = 0.007, 95% CI 0.505, 1.32) and FM (p = 0.024, 95% CI 0.160, 1.249) were significant predictors of weight change, with FFM accounting for 72% of the change. Larger longitudinal studies are needed to explore the clinical benefit associated with reducing pre-gastrostomy FFM loss in the MND population. In the interim, clinicians should consider monitoring body composition and implementing interventions aimed at preserving body weight and composition, particularly FFM, prior to gastrostomy placement.

The Enhanced Recovery After Surgery (ERAS) program emphasizes early oral feeding (EOF) as a key component for faster patient recovery. ERAS guidelines recommend resuming oral feeding within 24 h after surgery, but without specification on diet progression, portion sizes, and macronutrient targets. This scoping review aims to analyze existing postoperative oral feeding protocols (OFPs) across various abdominal surgical procedures. A literature search was conducted via PubMed and Scopus. Articles were assessed for eligibility based on prespecified inclusion criteria. The data were synthesized, and the results were reported and discussed thematically. Sixty-eight articles were included (24 for esophageal and/or gastric surgery, 16 for hepatobiliary or pancreatic, 22 for colorectal, 6 for urologic or gynecologic surgery). Our review found that in many studies oral feeding started much later than recommended by the ERAS guidelines. For colorectal surgery, although a low-residue diet is preferred over clear liquids, only few studies prescribed a solid diet immediately postoperatively. Similarly, for gastric and upper GI surgery, where early oral feeding is encouraged, most studies started with liquids and progressed slowly. In gynecologic and urologic surgeries, although early feeding is safe and recommended, alternative approaches were found. This review analyzed dietary protocols within ERAS pathways and identified significant inconsistencies and non-adherence to the ERAS recommendations. A major issue was the lack of standardized terminology and detailed descriptions of diet composition (energy, nutrients, food types, meal frequency) across studies.