European Journal of Clinical Nutrition最新文献

Objective: To explore gender disparities in thyroid dysfunction within the elderly population.

Methods: This cross-sectional study was conducted among elderly individuals residing in Longxi County (Dingxi City, Gansu Province), Yuncheng County (Heze City, Shandong Province), and Tianjin, China. Urine and blood samples were collected, and thyroid volume was measured using thyroid ultrasonography to evaluate iodine nutritional status and thyroid function in the elderly.

Results: A total of 3397 elderly individuals were included in the study, comprising 1433 men and 1964 women. The median urinary iodine concentration (UIC) was 253.27  (interquartile range: 126.50-492.66) μg/L. The study revealed that the prevalence of thyroid nodules, goiter, positive thyroid antibodies, and thyroid dysfunction was significantly higher in women than in men (P < 0.05). With the increase in iodine nutrition levels, an upward trend in the prevalence of thyroid dysfunction is observed across both men and women elderly populations (P < 0.001). Logistic regression analysis demonstrated that elderly women had a significantly higher risk of thyroid nodules (OR: 1.79, 95% CI: 1.56-2.06), goiter (OR: 10.67, 95% CI: 5.18-22.01), positive thyroid antibodies (OR: 2.31, 95% CI: 1.90-2.81), and thyroid dysfunction (OR: 1.79, 95% CI: 1.51-2.09) compared with men.

Conclusions: Our findings highlight a significant sexual dimorphism in thyroid health among the elderly. Women consistently exhibited a higher risk of thyroid dysfunction, nodules, and autoimmunity compared to men, with this disparity remaining evident across all levels of iodine nutrition.

Background and objective: Hypertension is influenced by both genetic and dietary factors. Understanding gene-diet interactions across populations is key to precision prevention.

Objectives: To identify genetic variants associated with hypertension in KoGES and UK Biobank (UKBB), and evaluate their interactions with nutrient intake.

Subjects/methods: Genome-wide association analyses were conducted for hypertension (HTN: SBP ≥ 140 mmHg, DBP ≥ 90 mmHg or taking hypotensive medication) in KoGES (Non-HTN, n = 39,387; HTN, n = 13,727) and replicated in UKBB (Non-HTN, n = 334,785; HTN, n = 132,140). Genetic risk scores (GRS) were constructed from seven common SNPs. Genetic variant or GRS-diet interactions were analyzed via logistic regression.

Results: Common SNPs in genes such as FGF5, CYP17A1, CNNM2, AS3MT, ATP2B1, BORCS7-ASMT, NT5C2, and RGL3 were significantly linked to hypertension in both cohorts (P < 5 × 10⁻⁸). In KoGES, the associated genes were enriched in lipid metabolism pathways. In UKBB, vascular signaling pathways, including AKT1, MAPK, and TGF-β signaling, were predominant based on the selected genetic variants. Despite common variants, distinct biological mechanisms were implicated in Koreans and Caucasians. The GRS of the 6-SNP model, including FGF5, CYP17A1, CNNM2, ATP2B1, BORCS7-ASMT, and RGL3, was associated with hypertension risk. However, this effect was attenuated with high tea and coffee intake only in the low-GRS individuals in both cohorts (P < 0.05). The RGL3 rs167479 variant showed significant interactions with vitamins C, D, B12, and flavonoids in KoGES (P = 0.02-0.002).

Conclusions: Common genetic variants contribute to hypertension across populations but act through divergent molecular pathways. Targeted nutrient intake appears to mitigate genetic risk, underscoring the promise of gene-informed dietary strategies for hypertension prevention.

Background: Previous almond intervention studies involving relatively healthy populations did not demonstrate improvements in cognitive performance. However, a long-term study with participants at risk of cognitive decline, such as those with prediabetes, may be necessary. Potential changes in cognitive performance could be related to changes in brain vascular function.

Methods: A randomized, single-blinded, controlled crossover trial including 43 overweight/obese men and women with prediabetes. Participants were assigned to a 5-month almond (50 g/day) intervention and a 5-month control period, separated by a 2-month washout. Cognitive performance (psychomotor speed, executive function and memory) was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB) at the beginning and at the end of each period. Cerebral blood flow (CBF), a marker of brain vascular function, was measured using the non-invasive magnetic resonance imaging (MRI) perfusion method, pseudo-continuous Arterial Spin Labeling (pCASL) at the end of each study period. Data were analyzed using linear mixed models.

Results: Participants had a median age (interquartile range [IQR]) of 66 years (IQR: 59-69 years), and their median BMI was 28.3 kg/m² (IQR: 26.7-33.1 kg/m²). Thirty-four prediabetic adults (22 men and 12 women) completed the study. No significant intervention effects were observed on any cognitive performance outcomes (n = 33). Compared to the control period, long-term almond consumption also had no significant impact on whole-brain or regional CBF (n = 26).

Conclusion: In line with earlier observations in relatively healthy populations, long-term almond consumption (50 g/day) did not enhance cognitive performance in overweight/obese individuals with prediabetes. Moreover, brain vascular function was unaffected.

Background/objective: Hypercholesterolemia is a well-known risk factor for cardiovascular disease. This clinical trial evaluated the effects of TOTUM-070, a polyphenol-rich blend of plant extracts, on lipid metabolism in individuals with moderate hypercholesterolemia.

Subjects/methods: This was a 6-month, multicenter, randomized, double-blind, placebo-controlled trial. Individuals not receiving lipid-lowering treatment and with fasting low-density lipoprotein cholesterol (LDL-C) between 1.3 and 1.9 g/L received TOTUM-070 (5 g/day) or placebo. The primary outcome was the change in fasting LDL-C. Secondary endpoints included safety, changes in the lipid profile, anthropometric measurements, and gut microbiome composition.

Results: A total of 120 subjects (mean age:53.1 ± 10.3 years; BMI: 25.9 ± 3.7 kg.m²; 69.2% women; baseline LDL-C: 1.44 ± 0.23 g/L) were included and randomized. TOTUM-070 was well tolerated. After 6 months, fasting LDL-C was reduced in the TOTUM-070 group compared with the placebo group (Mean estimate: 1.31 ± 0.03 [1.25 ; 1.37] vs 1.41 ± 0.03 [1.35 ; 1.47], p = 0.0041). Compared with placebo, TOTUM-070 also reduced total cholesterol (p < 0.01), non-high-density lipoprotein cholesterol (non-HDL-C) (p < 0.001), triglycerides (p < 0.05), apolipoprotein (apo)B100 (p < 0.01), the apoB100/apoA1 ratio (p < 0.01), oxidized LDL (p < 0.05), and body weight (-1.4 kg; p < 0.001). Furthermore, a decrease in the abundance of Dorea in fecal samples was observed in the TOTUM-070 group.

Conclusions: This clinical trial showed that supplementation with TOTUM-070 significantly lowers LDL-C and improves other lipid parameters in subjects with moderate hypercholesterolemia. As a polyphenol-rich plant-based blend, TOTUM-070 represents a promising non-pharmacological strategy that could complement lifestyle modifications for the management of early-stage hypercholesterolemia.

Background: Moderate-to-late preterm (MLP) infants (i.e., <37 weeks' gestation) are at risk for suboptimal neonatal nutrition and growth. We compared anthropometry and body composition at 24 months corrected age (CA; i.e., after term equivalent age (TEA)) between MLP infants fed either an isocaloric, protein- and mineral-enriched post-discharge formula (PDF) or standard term formula (STF) between TEA and 6 months CA.

Methods: After enrollment (≤7 d postpartum), MLP infants received PDF if (fortified) mother's own milk was insufficient. At TEA, those receiving >25% of intake as formula were randomized to either continue the same PDF or switch to STF until 6 months CA. At 24 months CA, anthropometry was assessed and air-displacement plethysmography was used to estimate body composition.

Results: From the original study (n = 157), only 64 infants had anthropometry assessed and 34 infants had body composition estimated at 24 months CA. At the follow-up visit, PDF-fed infants had slightly larger head circumference compared to STF-fed infants (49.0 ± 1.5 and 48.3 ± 1.5 cm, p < 0.05). Despite similar total body weight at 24 months CA, PDF-fed infants had lower fat mass and higher fat-free mass compared to STF-fed infants (fat mass: 2392 ± 923 and 3615 ± 1359 g; fat-free mass: 10461 ± 1030 and 10108 ± 1700 g; respectively, p < 0.05).

Conclusions: Providing MLP infants with PDF for 6 months after TEA was associated with lower fat mass and higher fat-free mass, with similar bodyweights at 24 months CA compared to those fed STF. Our findings should be interpreted cautiously, due to high loss-to-follow-up.

Background/objectives: The maternal immune system requires careful regulation during pregnancy to prevent complications such as preeclampsia and prematurity. Inflammatory immune states may be linked to maternal diet throughout pregnancy. Although gestational changes in cytokines are well-documented, the association with the inflammatory potential of diet has not been robustly explored. This study investigates the associations between maternal dietary inflammatory potential, measured by energy adjusted dietary inflammatory index (E-DII) in late pregnancy (28-32 weeks' gestation).

Subjects/methods: E-DII was calculated using 6-month food frequency questionnaires completed by pregnant mothers at 28-32 weeks' gestation. Serum cytokine levels from maternal blood samples were measured using Cobas® and ProteinSimple ELLA immunoassay, while PBMC derived cytokine levels were assessed using BioLegend LEGENDplex™.

Results: The study included 68 pregnant women, with a mean age (SD) at recruitment of 33.01(4.6) years and median BMI (IQR) of 24.95 (21.87, 27.57) kg/m². There was a positive association between E-DII and serum C3 complement protein in late pregnancy [β =0.057, p = 0.043]. A positive association between maternal E-DII and late pregnancy serum IL-17 levels was also observed [β = 0.156, p = 0.011]. A more pro-inflammatory diet in late pregnancy indicated by higher E-DII scores was associated with lower IL-10 secretion from PBMCs stimulated with anti-CD3/28/2 [β = -0.232, p = 0.049].

Conclusions: Diet may hold potential to promote optimal maternal inflammatory states. These data may inform nutritional guidelines to reduce pregnancy related complications, especially for mothers with higher background metabolic risk, such as those living with obesity.

Objective: We investigated the association of obesity phenotypes with MetS and components scores, subclinical inflammation, anti- and oxidative markers in children.

Subjects/methods: This is a cross-sectional study with 364 children (8 and 9-year-olds) in Viçosa, Minas Gerais, Brazil. Children were classified as: 1."normal-weight lean" (NWL) when they had normal-weight by BMI and adequate fat percentage assessed by DXA; 2. "normal-weight obesity" (NWO) for those with normal-weight and excess fat; and 3. "excess weight" for those with overweight/obesity and excess fat. The score for the MetS and its components was estimated, and the inflammatory and oxidative stress markers were measured. Multiple linear regression was used.

Results: Of thirteen cardiometabolic risk factors investigated, five were positively associated with the NWO, compared to NWL. Moreover, eleven cardiometabolic risk factors were associated with excess weight, compared to NWL. When the two phenotypes of excess body fat were contrasted, we found eight cardiometabolic risk factors associated with excess weight, compared to NWO.

Conclusion: An intermediate cardiometabolic risk was observed in children with the NWO phenotype when comparing the status of NWL to excess weight. This study reinforces the importance of investigating cardiometabolic risk in early ages, independent of BMI.

This study aimed to quantify the associations between adherence to three dietary patterns-the Dietary Approaches to Stop Hypertension (DASH), Mediterranean diet (MED), and Alternative Healthy Eating Index (AHEI)-and the risk of heart failure (HF) through a dose-response meta-analysis. Prospective cohort studies evaluating the associations between these dietary patterns and HF incidence were systematically identified from the PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Random-effects models were used to pool effect estimates. Generalized least squares regression and restricted cubic spline models were applied to explore potential dose-response relationships between dietary adherence and HF risk. Eleven independent cohorts (n = 450,451; ≥18,877 HF events) were included in the final analysis. Combined across patterns, the highest adherence group had a 25% lower risk of HF than the lowest adherence group did (hazard ratio [HR] 0.75; 95% confidence interval [CI]: 0.67-0.84; P < 0.001). Subgroup analyses revealed significant inverse associations for the DASH (HR 0.81; 95% CI: 0.67-0.98; P = 0.034), MED (HR 0.74; 95% CI: 0.64-0.87; P < 0.001), and AHEI (HR 0.75; 95% CI: 0.63-0.89; P < 0.001) patterns, with no significant differences across patterns (P = 0.860). Dose-response analyses revealed linear associations between adherence to each dietary pattern and HF risk. High adherence to DASH, MED, and AHEI is associated with lower HF risk, with similar effects among the different dietary patterns and linear dose-response relationships. PROSPERO registration: CRD420251024001.

Objectives: Intermittent fasting (IF) has gained attention for weight management and metabolic health, but detailed trials comparing its efficacy to calorie restriction (CR) in type 2 diabetes mellitus (T2D) are limited. Our aim was to compare the impact of CR diet with or without 12-hour overnight IF regimen on weight loss, glycemic control, and reduction of medication use in T2D.

Methods: This was a 3-month, single-center randomized clinical trial. Participants (N = 99), 21-60 years with T2D, were randomly assigned to Group 1 (12-hour IF + CR, N = 48) or Group 2 (CR alone, N = 51). Anthropometric evaluations included weight, height, waist and hip circumference, and BMI. Body composition analysis was performed, and biochemical analysis included HbA1c, FBG, and fasting insulin levels to calculate the HOMA-IR. Physical activity was assessed using the Global Physical Activity Questionnaire.

Results: Both groups experienced significant weight loss after 12 weeks. The IF + CR group showed a more pronounced weight reduction (-6.51%) compared to the CR group (-4.41%) (P < 0.001) and significant improvements in HbA1c levels, with a reduction to 6.51% compared to 6.86% in the CR group (P = 0.035). The absolute reduction in HbA1c showed a significantly greater median decrease in the IF + CR group [-0.50 (IQR - 0.60 to -0.35)] compared with the CR group [-0.20 (IQR - 0.40 to -0.10)] (P = 0.002). IF + CR demonstrated significant reductions in waist circumference (-4.64%) and hip circumference (-3.12%) compared to the CR (-2.70% and -0.86%, respectively) (P < 0.05). Furthermore, IF + CR showed greater reductions in body fat mass (-9.39%) compared to the CR (-5.32%) (P < 0.001). Physical activity levels were comparable, with average MET of 100 and sedentary hours of 15.7 ( ± 3) for IF + CR and 16.2 ( ± 2.3) for CR, (P = 0.134).

Conclusions: A 12-hour intermittent fasting (IF) regimen combined with calorie restriction (CR) demonstrated superior efficacy in promoting weight loss and improving glycemic control in patients with type 2 diabetes (T2D) compared to CR alone. Integrating IF into clinical nutrition guidelines could offer a practical and effective approach to diabetes management.

Clinical trial registration: The study was registered at the Pan African Clinical Trial Registry (PACTR202411524439559).