European Journal of Clinical Nutrition最新文献

Objectives: This study aimed to define handgrip strength (HGS) cutoff points to predict 1-year mortality in adult patients with liver cirrhosis.

Methods: This is an analysis of cohort databases from four reference centers in Brazil. Inpatients or outpatients with cirrhosis and aged ≥18 years were included. The best cutoff values of HGS (highest value from three attempts with the non-dominant hand) for predicting 1-year mortality, stratified by sex and age, were established based on the sensitivity and specificity analyses. Adjusted Cox regression models were used to test the predictive value of low HGS.

Results: The study included 724 patients with cirrhosis, with a median age of 57.0 years (IQR: 50.0-63.0), 66.4% (n = 481) male. Most patients had alcoholic cirrhosis (n = 281; 38.8%), 400 (55.3%) were classified as Child-Pugh B or C, and 134 (18.5%) patients died after 1-year. The HGS cutoffs were ≤33 kgf and ≤12 kgf for men and women aged <60 years, respectively, and ≤22 kgf and ≤10 kgf for older men and women, respectively (sensitivity: 70.9%; specificity: 61.2%). Low HGS was associated with a 2.5-fold increase in the risk of 1-year mortality.

Conclusion: These cutoff points could be used to identify patients with a higher mortality risk.

Background: Surveys based on capillary blood show that anaemia is rampant in India, but capillary blood haemoglobin (Hb) may not accurately reflect venous blood Hb concentrations. Further, iron deficiency (ID) is thought to be the main cause of anaemia, there are no venous blood-based surveys to confirm this.

Methods: A community-based (urban, slum and rural) cross-sectional, venous blood survey was conducted in eight Indian states to estimate anaemia and ID prevalences from Hb and inflammation-corrected plasma ferritin concentrations in adolescents, adults, and elderly.

Results: The prevalence of anaemia was 44%, 41% and 45% in adolescent girls, adult and elderly women respectively, compared to 24%, 21% and 37% in adolescent boys, adult, and elderly men. The overall prevalence varied widely, ranging from 12% in Meghalaya to 70% in Assam. Mild anaemia prevalence was predominant at about half of overall anaemia prevalence. ID-associated anaemia (IDA) prevalence was less than a third of the overall anaemia prevalence, and varied among age and sex groups, approaching 45% only in adolescent girls. IDA prevalence was even lower in the mild anaemia group. Thus, the major proportion of anaemia in all groups was associated with 'other' causes.

Conclusions: Anaemia prevalence, when measured by venous blood Hb, was substantially lower than earlier capillary blood-based estimates and was predominantly of the mild variety. The prevalence of IDA was also much lower than anticipated; therefore, the aetiological role of ID appears not to be predominant. These results have policy implications for anaemia prevention and correction at the population level.

Background/objectives: Myosteatosis has been associated with sarcopenia, and increased mortality risk in patients on hemodialysis. We aimed to explore the associations between myosteatosis, as assessed by computed tomography (CT), with demographic parameters, body composition metrics, muscle strength, metabolic parameters and mortality in patients with chronic kidney disease (CKD).

Subjects/methods: We enrolled 216 patients (age 60.3 ± 10.6 years, 63% men) with CKD stages 3-5. Abdominal CT scans at the third lumbar vertebra (L3) were used to assess body composition. Abdominal obesity was determined by abdominal adipose tissue (AT), sarcopenia by low skeletal muscle area (SMA) and low handgrip strength. Myosteatosis was evaluated by two parameters using CT scans at L3: mean muscle attenuation and percentage of intermuscular adipose tissue (%IMAT) within SMA. We evaluated the correlation between parameters of myosteatosis with demographic, clinical and metabolic variables. To determine independent predictors of myosteatosis, a multiple linear regression model was fitted. Mortality risk was evaluated with Cox-regression analysis.

Results: Both parameters of myosteatosis were independently associated with age, metabolic syndrome, abdominal AT and SMA in the multiple linear regression analysis (adjusted R² for multiple linear regression: muscle attenuation model 0.535, P < 0.001; %IMAT model 0.462, P < 0.001). Moreover, higher %IMAT and lower attenuation were associated with a higher mortality risk.

Conclusion: In patients with CKD, increased myosteatosis, as assessed by abdominal CT, was associated with old age, adiposity, metabolic dysfunction, and higher mortality risk.

Background/objectives: Studies suggest that greater maternal adherence to the Dietary Approaches to Stop Hypertension (DASH) diet reduces the risk of both maternal and fetal adverse health outcomes. The study aimed to evaluate the relationship between adherence to the DASH diet during pregnancy and the classification of birth weight according to gestational age.

Subjects/methods: Secondary analysis of a prospective cohort of 601 mother and child pairs who attended primary healthcare in a Brazilian municipality. Dietary intake was estimated based on 24 h recall and a Food Frequency Questionnaire. Data on gestational duration, birth weight, and newborn sex were obtained from the Live Birth Information System. The relationship between adherence to the DASH diet and birth weight categories was investigated using logistic regression models adjusted for confounding factors.

Results: In total, 10.3% of newborns were classified as small for gestational age (SGA), and 13.3% as large for gestational age (LGA). There was low adherence to the healthy components of the DASH diet. However, it was observed that pregnant women classified in the third tertile of the DASH diet score had a lower chance of having LGA newborns [OR 0.51 (95% CI 0.28; 0.94), p = 0.03]. There was no association between adherence to the DASH diet and SGA newborns [OR 0.87 (95% CI 0.42; 1.84), p = 0.65].

Conclusion: Despite the low adherence to the DASH diet between Brazilian pregnant women, higher adherence scores in its components had a lower chance of having LGA newborns.

Background: Oropharyngeal squamous cell carcinoma (OPSCC) of human papillomavirus (HPV)-positive status is increasing relative to HPV-negative disease. Nutritional features of OPSCC patients according to HPV status is unclear.

Subjects/methods: Canadian and Spanish patients with OPSCC were assessed for body mass index (BMI), weight loss grade (WLG), and computed tomography-defined skeletal muscle index (SMI). Chi-square, t-test, Mann-Whitney-U, Kruskal-Wallis tests were conducted to compare HPV positive and negative groups. Overall survival (OS) was assessed by univariable Kaplan-Meier and Cox proportional hazard methods.

Results: No differences in BMI, WLG, SMI, and adipose tissue index between the 308 (Canada) and 134 (Spain) patients according to HPV status; hence cohorts were pooled (n = 442). HPV-positive patients (n = 317) were overweight/obese (72.8%), had WLG of 0/1 (59.6%) and high SMI (83.4%) while HPV-negative patients were normal/underweight (61.5%), had high WLG 3/4 (50.8%), and moderate/severe SMI depletion (46.9%) (p < 0.003). These overall differences notwithstanding, there was crossover i.e. 35% of HPV-positive patients had high WLG and/or moderate/severe muscle depletion and 29% of HPV-negative patients had minimal weight loss and high SMI. HPV-negative patients had a higher risk of mortality (HR 3.78, 95% CI 2.70-5.29, P < 0.001) and this difference was retained after multivariable adjustment for WLG, SMI, age, disease stage, and planned treatment (HR 3.30, 95% CI 2.17-5.02, P < 0.001).

Conclusion: Nutrition features of patients with OPSCC did not differ between Canada and Spain. Distinctive nutrition features exist in patients according to HPV status. The high heterogeneity of individual nutritional profiles invites an individualized approach to nutrition care.

Background: Breastfeeding and human milk are the normative standards for infant feeding and nutrition.

Objectives: We aimed to examine the association of breastfeeding practices during the first year of life with subsequent infant respiratory tract infections (RTIs).

Methods: The study was a secondary analysis embedded in the Tongji Maternal and Child Health Cohort study. Information on infant breastfeeding was collected at 3, 6, and 12 months of age. Pediatrician-diagnosed infant RTIs and hospitalization for RTIs during 12-24 months were obtained at 24 months postpartum. Robust log-Poisson regression models were applied to explore the association of breastfeeding practices with RTIs risk and hospitalization due to RTIs.

Results: Among the 5242 infants studied, 13.1% (n = 435) of infants received full breastfeeding for six months and continued breastfeeding for at least one year (F6-L). When compared with infants in the F6-L group, those who were formula fed (FF) had a higher risk of RTIs, including upper RTIS and lower RTIS, the adjusted RRs (95%CIs) were 1.34 (1.17, 1.53), 1.31 (1.12, 1.52), 1.59 (1.10, 2.31), respectively. When compared with infants in the F6-L group, the adjusted RRs (95%CIs) for hospitalization from RTIs was 1.88 (1.20, 2.95) for the FF group.

Conclusion: Full breastfeeding for six months and continued breastfeeding for at least one year was associated with a lower risk of subsequent infant RTIs and hospitalization from RTIs.

Nutraceuticals, with their potential health benefits, are increasingly being used to manage a variety of health conditions. The global market for nutraceuticals, valued at USD 540 billion in 2022, is projected to reach USD 1025 billion by 2030. This paper delves into the beneficial impacts of emerging nutraceuticals on a spectrum of medical disorders, drawing from credible sources from the National Library of Medicine. We have scrutinized studies on the application of nutraceuticals in treating conditions like sleep disorders, migraines, oxidative stress, mental health issues, pain disorders, obesity, gastrointestinal disorders, and even COVID-19. Our analysis indicates that nutraceuticals hold promise for addressing various health issues. However, this paper also sheds light on the health risks associated with nutraceuticals. Despite their widespread use, the safety and efficacy of nutraceuticals are still uncertain due to the lack of stringent regulations, unlike pharmaceutical drugs. This raises concerns about potential health risks and misleading claims. Research indicates that some supplements can cause adverse effects and interact with medications. Therefore, to ensure safe usage, it is imperative to implement stricter regulations, enhance reporting systems, and boost consumer awareness.

Introduction: The finger-ring test (FRT) offers a simple method to screen older adults at increased risk of sarcopenia.

Objective: To investigate the association between the FRT and lean soft tissue mass estimated by dual-energy X-ray absorptiometry (DXA), and to further elucidate the FRT as an indicator of muscle mass, while accounting for potential confounders, in a community-dwelling population.

Materials and methods: Within this cross-sectional study 430 community-dwelling individuals aged 18 to 79 (286 women (66.5%) and 144 men (33.5%)) were enrolled. Data regarding FRT and anthropometric measurements were collected. Whole-body composition was estimated using DXA. Binary and ordinal logistic regressions were performed.

Results: The frequency of smaller calf, just fits, and bigger calf was 17.7%, 33.7%, and 48.6%, respectively. Regardless of sex, higher appendicular lean soft tissue mass adjusted for height squared was observed for higher FRT categories (p < 0.001). For the ordinal logistic regression model, each unity of increment in appendicular lean soft tissue mass adjusted for height squared (kg/m²) was associated with a higher probability of being allocated to higher finger-ring test categories, in both genders. A higher cumulative adjusted odds ratio was found for women (7.53; 95% confidence interval: 4.58-12.38) than for men (2.99; 2.00-4.48).

Conclusion: By demonstrating an association between the appendicular lean soft tissue mass estimated by DXA and the FRT, these results strengthen the utility of this simple self-test as an indicator of muscle mass, which can be used in the primary prevention of muscle mass decline and its recovery.