Pub Date : 2025-07-22DOI: 10.1038/s41430-025-01649-3
Anna Winkvist, Ciara Mangan, Ingegerd Johansson, Annemarie E. Bennett
High dietary diversity is recognized as a crucial element of diet quality because this ensures abundant nutrients. A diverse diet may also provide health benefits beyond nutritional adequacy. Few studies have evaluated associations with lipid profile. The aim of this study was to investigate the association between dietary diversity and metabolic health and common measures of diet quality in a large population-based sample. This was a cross-sectional analysis within the Västerbotten Intervention Programme (VIP). Participants filled out an extensive health questionnaire including a 66-item semi-quantitative food frequency questionnaire (FFQ). The FFQ was used to create dietary diversity scores (DDS) for 5 major and 13 minor food groups. Associations between DDS and concurrent fasting lipid profile and measured body mass index (BMI) were explored with multivariable linear regression. Correlation analyses were used to explore the relationship between DDS and diet quality. The mean age of participants was 51 ± 8.3 years, with females comprising 50.8% of the study population (n = 82,171). Higher DDS was associated with decreased total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides (all p < 0.01). DDS had no significant association with BMI. DDS had a positive correlation with the Relative Mediterranean Diet Score, the Healthy Nordic Food Index and the Healthy Diet Score, and a negative correlation with the Dietary Inflammatory Index (all p < 0.001). The results add to the body of research showing metabolic health benefits of dietary diversity. More consistent methods of measuring dietary diversity should be developed, with careful consideration given to the healthfulness of foods included in the definition.
{"title":"Dietary diversity and metabolic health among people in Västerbotten, Sweden","authors":"Anna Winkvist, Ciara Mangan, Ingegerd Johansson, Annemarie E. Bennett","doi":"10.1038/s41430-025-01649-3","DOIUrl":"10.1038/s41430-025-01649-3","url":null,"abstract":"High dietary diversity is recognized as a crucial element of diet quality because this ensures abundant nutrients. A diverse diet may also provide health benefits beyond nutritional adequacy. Few studies have evaluated associations with lipid profile. The aim of this study was to investigate the association between dietary diversity and metabolic health and common measures of diet quality in a large population-based sample. This was a cross-sectional analysis within the Västerbotten Intervention Programme (VIP). Participants filled out an extensive health questionnaire including a 66-item semi-quantitative food frequency questionnaire (FFQ). The FFQ was used to create dietary diversity scores (DDS) for 5 major and 13 minor food groups. Associations between DDS and concurrent fasting lipid profile and measured body mass index (BMI) were explored with multivariable linear regression. Correlation analyses were used to explore the relationship between DDS and diet quality. The mean age of participants was 51 ± 8.3 years, with females comprising 50.8% of the study population (n = 82,171). Higher DDS was associated with decreased total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides (all p < 0.01). DDS had no significant association with BMI. DDS had a positive correlation with the Relative Mediterranean Diet Score, the Healthy Nordic Food Index and the Healthy Diet Score, and a negative correlation with the Dietary Inflammatory Index (all p < 0.001). The results add to the body of research showing metabolic health benefits of dietary diversity. More consistent methods of measuring dietary diversity should be developed, with careful consideration given to the healthfulness of foods included in the definition.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1046-1052"},"PeriodicalIF":3.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01649-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-21DOI: 10.1038/s41430-025-01646-6
Mette Bohl, Søren Gregersen, Zhihang Li, Andreas Blennow, Kim H. Hebelstrup, Kjeld Hermansen
Genetically modified (GMO) high-amylose barley lowers postprandial glucose. Since certain EU countries do not allow GMO barley, we therefore assessed if high-amylose barley made from traditional breeding (Lean Baking Barley, LBB) lowers postprandial glucose compared to bread made from regular barley (RB) or wheat (WF) in individuals with or without type 2 diabetes (T2D). In a randomised crossover design, 38 participants (18 T2D and 20 non-T2D) consumed 160 g of bread made from 100% LBB, RB, or WF. Postprandial metabolic responses, appetite and bread perception were measured. A mixed model ANOVA was used for analysis. LBB bread reduced 4 h postprandial glucose measured as incremental area under the curve (iAUC) by 41% and 39% vs. WF and RB bread in T2D and by 28% and 32% in non-T2D (all, P < 0.05). In T2D, LBB reduced postprandial insulin (iAUC) by 52% and 38% vs. WF and RB, and by 60% vs. WF in non-T2D (all, P < 0.05). Postprandial GIP (iAUC) was lower after LBB in both groups vs. RB and WF (P < 0.05). GLP-1 (iAUC) and FFA (tAUC) were lower after LBB vs. WF in non-T2D (P < 0.05), but not in T2D. Appetite scores were similar for all breads. Overall liking was higher for WF but did not differ between barley types. LBB breads reduce postprandial glucose and insulin compared to RB and WF bread in individuals irrespective of T2D. LBB may have potential as a functional food in prevention and management of T2D. ClinicalTrails.gov registration: NCT04702672.
{"title":"High-amylose barley bread improves postprandial glycemia compared to regular barley and wheat bread in subjects with or without type 2 diabetes","authors":"Mette Bohl, Søren Gregersen, Zhihang Li, Andreas Blennow, Kim H. Hebelstrup, Kjeld Hermansen","doi":"10.1038/s41430-025-01646-6","DOIUrl":"10.1038/s41430-025-01646-6","url":null,"abstract":"Genetically modified (GMO) high-amylose barley lowers postprandial glucose. Since certain EU countries do not allow GMO barley, we therefore assessed if high-amylose barley made from traditional breeding (Lean Baking Barley, LBB) lowers postprandial glucose compared to bread made from regular barley (RB) or wheat (WF) in individuals with or without type 2 diabetes (T2D). In a randomised crossover design, 38 participants (18 T2D and 20 non-T2D) consumed 160 g of bread made from 100% LBB, RB, or WF. Postprandial metabolic responses, appetite and bread perception were measured. A mixed model ANOVA was used for analysis. LBB bread reduced 4 h postprandial glucose measured as incremental area under the curve (iAUC) by 41% and 39% vs. WF and RB bread in T2D and by 28% and 32% in non-T2D (all, P < 0.05). In T2D, LBB reduced postprandial insulin (iAUC) by 52% and 38% vs. WF and RB, and by 60% vs. WF in non-T2D (all, P < 0.05). Postprandial GIP (iAUC) was lower after LBB in both groups vs. RB and WF (P < 0.05). GLP-1 (iAUC) and FFA (tAUC) were lower after LBB vs. WF in non-T2D (P < 0.05), but not in T2D. Appetite scores were similar for all breads. Overall liking was higher for WF but did not differ between barley types. LBB breads reduce postprandial glucose and insulin compared to RB and WF bread in individuals irrespective of T2D. LBB may have potential as a functional food in prevention and management of T2D. ClinicalTrails.gov registration: NCT04702672.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1000-1006"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01646-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-21DOI: 10.1038/s41430-025-01637-7
Tingwen Wang, Jiaqing Huang, Zhou Shang, Mai Deng, JiaDun Su, Xuanyu Duan, Derui Kong
The incidence of malnutrition in patients undergoing abdominal surgery exceeds 50%, and postoperative nutritional support is crucial for improving patient outcomes. While Enhanced Recovery After Surgery (ERAS) protocols highlight early nutrition support, their impact on different nutritional strategies remains unclear. This study assessed the effects and safety of enteral nutrition (EN), early-supplemental parenteral nutrition (E-SPN), late-supplemental parenteral nutrition (L-SPN), and total parenteral nutrition (TPN) through network meta-analysis. Three databases were searched to obtain randomized controlled trials involving four interventions for postoperative nutritional supportive therapy in abdominal surgical patients. We used The Cochrane Handbook tool (2.0) to assess the risk bias of included studies. The primary outcome was the occurrence of postoperative adverse events. Network meta-analysis was performed using STATA 14. A total of 48 studies involving 6277 patients were included. Network meta-analysis showed that compared with other nutritional therapy E-SPN was likely more effective than other modalities in terms of reduction of postoperative adverse events (OR = 3.02, 95% CI: 1.81–5.02), infectious adverse events (OR = 3.12, 95% CI: 1.59–6.15), non-infectious adverse events (OR = 2.47, 95% CI: 1.14–5.34), shortening the resumption of exhaust time (SMD = 0.98, 95% CI: 0.59–1.36), and improvement of serum albumin (SMD = −2.74, 95% CI: −4.98–0.50). The final surface under the cumulative ranking curve value indicated that E-SPN achieved the best effect in those outcomes. The obtained results support using E-SPN in patients undergoing abdominal surgery, which might reduce adverse events, shorten recovery time, and improve patient outcomes. However, since serum albumin is primarily an inflammatory marker rather than a direct indicator of nutritional status, its role in evaluating SPN benefits should be interpreted with caution. Further research is needed to assess SPN’s effectiveness in patients undergoing surgery according to an ERAS protocol.
{"title":"Efficacy and safety of nutrition therapy for patients undergoing abdominal surgery: a systematic review and network meta-analysis","authors":"Tingwen Wang, Jiaqing Huang, Zhou Shang, Mai Deng, JiaDun Su, Xuanyu Duan, Derui Kong","doi":"10.1038/s41430-025-01637-7","DOIUrl":"10.1038/s41430-025-01637-7","url":null,"abstract":"The incidence of malnutrition in patients undergoing abdominal surgery exceeds 50%, and postoperative nutritional support is crucial for improving patient outcomes. While Enhanced Recovery After Surgery (ERAS) protocols highlight early nutrition support, their impact on different nutritional strategies remains unclear. This study assessed the effects and safety of enteral nutrition (EN), early-supplemental parenteral nutrition (E-SPN), late-supplemental parenteral nutrition (L-SPN), and total parenteral nutrition (TPN) through network meta-analysis. Three databases were searched to obtain randomized controlled trials involving four interventions for postoperative nutritional supportive therapy in abdominal surgical patients. We used The Cochrane Handbook tool (2.0) to assess the risk bias of included studies. The primary outcome was the occurrence of postoperative adverse events. Network meta-analysis was performed using STATA 14. A total of 48 studies involving 6277 patients were included. Network meta-analysis showed that compared with other nutritional therapy E-SPN was likely more effective than other modalities in terms of reduction of postoperative adverse events (OR = 3.02, 95% CI: 1.81–5.02), infectious adverse events (OR = 3.12, 95% CI: 1.59–6.15), non-infectious adverse events (OR = 2.47, 95% CI: 1.14–5.34), shortening the resumption of exhaust time (SMD = 0.98, 95% CI: 0.59–1.36), and improvement of serum albumin (SMD = −2.74, 95% CI: −4.98–0.50). The final surface under the cumulative ranking curve value indicated that E-SPN achieved the best effect in those outcomes. The obtained results support using E-SPN in patients undergoing abdominal surgery, which might reduce adverse events, shorten recovery time, and improve patient outcomes. However, since serum albumin is primarily an inflammatory marker rather than a direct indicator of nutritional status, its role in evaluating SPN benefits should be interpreted with caution. Further research is needed to assess SPN’s effectiveness in patients undergoing surgery according to an ERAS protocol.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 11","pages":"1078-1086"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-19DOI: 10.1038/s41430-025-01638-6
Maren Wolf, Mónica Mazariegos, Oscar Cordón, Karla Mesarina, Maria Elena D. Jefferds, O. Yaw Addo, Mireya Palmieri
This paper defines the double burden of malnutrition as occurring when over- and undernutrition coexist within a household. It is most common in countries undergoing the nutrition transition where cheap and accessible food is often of poor quality. This brief narrative review examines four cycles of reports from the Epidemiological Health and Nutrition Surveillance System (SIVESNU, Spanish acronym) in Guatemala between 2015–2018/19, examining the following indicators: overall double burden of stunting among children aged ≤59 months and overweight or obesity among women aged 15–49 years in the same household, and individual stunting, overweight, and obesity by indigenous/non-indigenous ethnicity. The review also incorporates double burden prevalence in Guatemala from the literature since 1995. In 1995, the double burden prevalence was 13.4%, and negligible change occurred from 2000 to 2018/19 (18.2% and 17.6%, respectively). Individual level prevalences for stunting, overweight, and obesity were notable, with large disparities in stunting prevalence by ethnicity.
{"title":"Double burden of malnutrition in Guatemala: co-existence of childhood stunting and overweight and obesity within the household","authors":"Maren Wolf, Mónica Mazariegos, Oscar Cordón, Karla Mesarina, Maria Elena D. Jefferds, O. Yaw Addo, Mireya Palmieri","doi":"10.1038/s41430-025-01638-6","DOIUrl":"10.1038/s41430-025-01638-6","url":null,"abstract":"This paper defines the double burden of malnutrition as occurring when over- and undernutrition coexist within a household. It is most common in countries undergoing the nutrition transition where cheap and accessible food is often of poor quality. This brief narrative review examines four cycles of reports from the Epidemiological Health and Nutrition Surveillance System (SIVESNU, Spanish acronym) in Guatemala between 2015–2018/19, examining the following indicators: overall double burden of stunting among children aged ≤59 months and overweight or obesity among women aged 15–49 years in the same household, and individual stunting, overweight, and obesity by indigenous/non-indigenous ethnicity. The review also incorporates double burden prevalence in Guatemala from the literature since 1995. In 1995, the double burden prevalence was 13.4%, and negligible change occurred from 2000 to 2018/19 (18.2% and 17.6%, respectively). Individual level prevalences for stunting, overweight, and obesity were notable, with large disparities in stunting prevalence by ethnicity.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1066-1068"},"PeriodicalIF":3.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-11DOI: 10.1038/s41430-025-01640-y
Chanita Unhapipatpong, Katherine J. P. Schwenger, David Armstrong, Barbara Bielawska, Brian Jurewitsch, J. D. McHattie, Donald R. Duerksen, Yidan Lu, Dane Christina Daoud, Anabelle Cloutier, Matreyi Raman, Leah Gramlich, George Ou, Johane P. Allard
Home parenteral nutrition (HPN) is indicated for patients with intestinal failure, but its use in cancer patients requires careful consideration due to the unique challenges and complexities involved. This prospective cohort study analyzed data from cancer patients receiving HPN, recorded in the Canadian HPN Registry from 2003 to 2022. Patients were divided into two groups: those with gastrointestinal or gynecologic cancer and a propensity score-matched cohort of non-cancer patients. The objective was to assess survival rates by performance status and prescription decade in both groups. Secondary objectives were to compare complications between the groups. A total of 400 HPN patients were enrolled: 200 cancer patients (128 gastrointestinal, 72 gynecologic) and 200 matched non-cancer patients. Median age (interquartile range) was 58 (16) years for cancer and 56 (19) for non-cancer groups, with 71.5% and 66.5% female, respectively. Median survival was 1.71 years (95% confidence interval (CI), 0.81–2.61) for gastrointestinal cancer, 0.99 years (95% CI, 0.36–1.6) for gynecologic cancer, and 3.89 years (95% CI, 2.72–5.06) for non-cancer patients (p-value < 0.001). Survival showed no improvement over two decades. Patients with Karnofsky Performance Scale (KPS) ≤ 50 had shorter survival. Catheter complications and HPN-related hospitalizations were similar, but HPN-related liver disease was more common in non-cancer patients (16.5% vs. 9%, p-value = 0.025). Survival for patients with gastrointestinal and gynecologic cancer and co-existing intestinal failure has not improved over the past two decades, with poorer outcomes observed in those with low KPS. Complication rates were similar in both groups.
背景：家庭肠外营养（HPN）适用于肠衰竭患者，但由于其独特的挑战和复杂性，在癌症患者中的应用需要仔细考虑。方法：这项前瞻性队列研究分析了2003年至2022年加拿大HPN登记处记录的接受HPN治疗的癌症患者的数据。患者被分为两组：胃肠道或妇科癌症患者和倾向评分匹配的非癌症患者。目的是评估两组患者的表现状态和处方年限的生存率。次要目的是比较两组之间的并发症。结果：共纳入400例HPN患者：200例肿瘤患者（128例胃肠道患者，72例妇科患者）和200例匹配的非肿瘤患者。癌症组的中位年龄（四分位数范围）为58（16）岁，非癌症组为56（19）岁，分别为71.5%和66.5%的女性。胃肠道肿瘤患者的中位生存期为1.71年（95%可信区间（CI） 0.81-2.61），妇科肿瘤患者的中位生存期为0.99年（95% CI, 0.36-1.6），非癌症患者的中位生存期为3.89年（95% CI, 2.72-5.06） (p值结论：胃肠道和妇科肿瘤合并肠道衰竭患者的生存期在过去20年没有改善，低KPS患者的预后更差。两组的并发症发生率相似。图形摘要：在BioRender中创建。Unhapipatpong， C. (2025) https://BioRender.com/l25d998。
{"title":"Comparative clinical outcomes of home parenteral nutrition in adults with gastrointestinal or gynecologic cancers versus non-cancer patients: a prospective cohort study using propensity score matching from the Canadian HPN registry","authors":"Chanita Unhapipatpong, Katherine J. P. Schwenger, David Armstrong, Barbara Bielawska, Brian Jurewitsch, J. D. McHattie, Donald R. Duerksen, Yidan Lu, Dane Christina Daoud, Anabelle Cloutier, Matreyi Raman, Leah Gramlich, George Ou, Johane P. Allard","doi":"10.1038/s41430-025-01640-y","DOIUrl":"10.1038/s41430-025-01640-y","url":null,"abstract":"Home parenteral nutrition (HPN) is indicated for patients with intestinal failure, but its use in cancer patients requires careful consideration due to the unique challenges and complexities involved. This prospective cohort study analyzed data from cancer patients receiving HPN, recorded in the Canadian HPN Registry from 2003 to 2022. Patients were divided into two groups: those with gastrointestinal or gynecologic cancer and a propensity score-matched cohort of non-cancer patients. The objective was to assess survival rates by performance status and prescription decade in both groups. Secondary objectives were to compare complications between the groups. A total of 400 HPN patients were enrolled: 200 cancer patients (128 gastrointestinal, 72 gynecologic) and 200 matched non-cancer patients. Median age (interquartile range) was 58 (16) years for cancer and 56 (19) for non-cancer groups, with 71.5% and 66.5% female, respectively. Median survival was 1.71 years (95% confidence interval (CI), 0.81–2.61) for gastrointestinal cancer, 0.99 years (95% CI, 0.36–1.6) for gynecologic cancer, and 3.89 years (95% CI, 2.72–5.06) for non-cancer patients (p-value < 0.001). Survival showed no improvement over two decades. Patients with Karnofsky Performance Scale (KPS) ≤ 50 had shorter survival. Catheter complications and HPN-related hospitalizations were similar, but HPN-related liver disease was more common in non-cancer patients (16.5% vs. 9%, p-value = 0.025). Survival for patients with gastrointestinal and gynecologic cancer and co-existing intestinal failure has not improved over the past two decades, with poorer outcomes observed in those with low KPS. Complication rates were similar in both groups.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1036-1045"},"PeriodicalIF":3.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Self-reported abdominal symptoms after consuming gluten-containing cereals in individuals without celiac disease (CeD) are common. The long-term outcomes of these individuals are unknown. Seventy-six adults experiencing symptoms from gluten-containing cereals underwent exclusion of CeD and wheat allergy in 1995–1997 and were thus advised to revert to a normal gluten-containing diet. These individuals were invited to a comprehensive health examination, including measurement of CeD antibodies and symptoms and assessment of quality of life using the Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being Index (PGWB). Healthy individuals (n = 160) and untreated CeD patients (n = 128) served as controls. Altogether, 28 individuals participated, half of whom were still avoiding gluten-containing cereals. None had acquired a diagnosis of any gastrointestinal disease, and all had negative CeD serology. The entire study group presented with significantly higher GSRS total (participants 2.8, 95% confidence interval 2.5–3.1 vs. controls 1.8, 1.7–1.9; p < 0.001) and other sub-scores than healthy controls, and higher total (vs. patients 2.5, 2.3–2.6; p = 0.041) and constipation scores than untreated CeD patients. Additionally, the group had worse PGWB total (participants 92.1, 84.9–99.4 vs. controls 105.3, 102.5–108.7; p = 0.002) and anxiety, self-control, general health, and vitality sub-cores than healthy controls, as well as self-control, general health, and vitality scores than untreated CeD patients. Twelve participants fulfilled the criteria for irritable bowel syndrome. None of the participants had developed CeD or been diagnosed with gastrointestinal disease for 25 years. They reported more gastrointestinal symptoms and a poorer quality of life, even when compared to untreated CeD patients.
{"title":"Long-term health outcomes of people without celiac disease avoiding gluten consumption: a 25-year prospective cohort study","authors":"Eeva Salmela, Kurppa Kalle, Katri Lindfors, Päivi Saavalainen, Heini Huhtala, Katri Kaukinen, Juha Taavela","doi":"10.1038/s41430-025-01641-x","DOIUrl":"10.1038/s41430-025-01641-x","url":null,"abstract":"Self-reported abdominal symptoms after consuming gluten-containing cereals in individuals without celiac disease (CeD) are common. The long-term outcomes of these individuals are unknown. Seventy-six adults experiencing symptoms from gluten-containing cereals underwent exclusion of CeD and wheat allergy in 1995–1997 and were thus advised to revert to a normal gluten-containing diet. These individuals were invited to a comprehensive health examination, including measurement of CeD antibodies and symptoms and assessment of quality of life using the Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being Index (PGWB). Healthy individuals (n = 160) and untreated CeD patients (n = 128) served as controls. Altogether, 28 individuals participated, half of whom were still avoiding gluten-containing cereals. None had acquired a diagnosis of any gastrointestinal disease, and all had negative CeD serology. The entire study group presented with significantly higher GSRS total (participants 2.8, 95% confidence interval 2.5–3.1 vs. controls 1.8, 1.7–1.9; p < 0.001) and other sub-scores than healthy controls, and higher total (vs. patients 2.5, 2.3–2.6; p = 0.041) and constipation scores than untreated CeD patients. Additionally, the group had worse PGWB total (participants 92.1, 84.9–99.4 vs. controls 105.3, 102.5–108.7; p = 0.002) and anxiety, self-control, general health, and vitality sub-cores than healthy controls, as well as self-control, general health, and vitality scores than untreated CeD patients. Twelve participants fulfilled the criteria for irritable bowel syndrome. None of the participants had developed CeD or been diagnosed with gastrointestinal disease for 25 years. They reported more gastrointestinal symptoms and a poorer quality of life, even when compared to untreated CeD patients.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1053-1059"},"PeriodicalIF":3.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01641-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The interplay between beverage consumption patterns and critical aspects of health, such as quality of life (QoL) and sleep disorders, has been increasingly recognized. This study is essential as it explores how the Healthy Beverage Index (HBI) and Healthy Beverage Score (HBS) relate to sleep disorders and QoL in a diverse adult population, highlighting their impact on various health aspects. A cross-sectional analysis was conducted using data from the Shiraz University of Medical Sciences Employees Health Cohort Study (SUMS EHCS), encompassing 3380 participants aged 20–65. Data collection included a 119-item Food Frequency Questionnaire (FFQ) and comprehensive anthropometric, lifestyle, and health-related assessments. HBI and HBS were computed to evaluate beverage consumption patterns, and their associations with sleep quality and QoL were analyzed using logistic regression models. Higher HBI scores were significantly associated with 16% improved QoL (OR: 1.16, 95% CI: 1.02–1.29, p = 0.034) and a 17% reduced risk of sleep disorders (OR = 0.83, 95% CI: 0.69–0.99, p = 0.039). However, HBS did not significantly correlate with QoL or sleep quality. As indicated by higher HBI scores, the findings emphasize that promoting healthier beverage choices could enhance sleep quality and overall life satisfaction.
背景/目的：饮料消费模式与健康的关键方面之间的相互作用，如生活质量（QoL）和睡眠障碍，已经越来越被认识到。这项研究是至关重要的，因为它探讨了健康饮料指数（HBI）和健康饮料评分（HBS）与不同成人人群中睡眠障碍和生活质量的关系，突出了它们对各个健康方面的影响。对象/方法：采用设拉子医科大学员工健康队列研究（sum EHCS）的数据进行横断面分析，包括3380名年龄在20-65岁之间的参与者。数据收集包括119项食物频率问卷（FFQ）和综合人体测量、生活方式和健康相关评估。计算HBI和HBS来评估饮料消费模式，并使用逻辑回归模型分析其与睡眠质量和生活质量的关系。结果：较高的HBI评分与16%的生活质量改善（OR: 1.16, 95% CI: 1.02-1.29, p = 0.034）和17%的睡眠障碍风险降低（OR = 0.83, 95% CI: 0.69-0.99, p = 0.039）显著相关。然而，HBS与生活质量或睡眠质量没有显著相关。结论：正如较高的HBI分数所表明的那样，研究结果强调了促进健康饮料的选择可以提高睡眠质量和整体生活满意度。
{"title":"Association between beverage quality with sleep disorders and quality of life: a cross-sectional study","authors":"Kimia Leilami, Seyedhassan Sadrian, Zahra Ghazimoradi, Zahra Rezaei, Atefeh Torabi Ardekani, Morteza Zare, Seyed Jalil Masoumi","doi":"10.1038/s41430-025-01624-y","DOIUrl":"10.1038/s41430-025-01624-y","url":null,"abstract":"The interplay between beverage consumption patterns and critical aspects of health, such as quality of life (QoL) and sleep disorders, has been increasingly recognized. This study is essential as it explores how the Healthy Beverage Index (HBI) and Healthy Beverage Score (HBS) relate to sleep disorders and QoL in a diverse adult population, highlighting their impact on various health aspects. A cross-sectional analysis was conducted using data from the Shiraz University of Medical Sciences Employees Health Cohort Study (SUMS EHCS), encompassing 3380 participants aged 20–65. Data collection included a 119-item Food Frequency Questionnaire (FFQ) and comprehensive anthropometric, lifestyle, and health-related assessments. HBI and HBS were computed to evaluate beverage consumption patterns, and their associations with sleep quality and QoL were analyzed using logistic regression models. Higher HBI scores were significantly associated with 16% improved QoL (OR: 1.16, 95% CI: 1.02–1.29, p = 0.034) and a 17% reduced risk of sleep disorders (OR = 0.83, 95% CI: 0.69–0.99, p = 0.039). However, HBS did not significantly correlate with QoL or sleep quality. As indicated by higher HBI scores, the findings emphasize that promoting healthier beverage choices could enhance sleep quality and overall life satisfaction.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"972-979"},"PeriodicalIF":3.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-19DOI: 10.1038/s41430-025-01636-8
Melanie Haas, Beate Brandl, Klaus Neuhaus, Susanne Wudy, Karin Kleigrewe, Hans Hauner, Thomas Skurk
The gut-microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been linked to cardiovascular disease (CVD) risk, while dietary fiber is associated with reduced CVD risk and improved gut health. Considering these associations, we conducted a randomized, double-blind, pilot study to investigate the influence of fiber supplementation on intestinal TMAO formation after beef consumption. 13 volunteers underwent a two-week dietary fiber and placebo intervention. We assessed the effect of fiber supplementation on the gut microbiota and gene abundance of the enzyme cutC, a key enzyme for microbial TMA formation, a precursor for TMAO. We measured the TMAO response following beef consumption after the two-week intervention. We also examined the role of hepatic enzyme FMO3 on TMAO plasma levels. Although overall TMAO production did not change between the dietary fiber and placebo group (p-value = 0.26, 95% CI), subgroup analysis revealed that fiber supplementation attenuated TMAO formation following beef intake in participants with lower habitual meat consumption ( <3 times/week, p-value = 0.029, 95% CI). Furthermore, fiber intervention significantly downregulated microbial cutC gene abundance (p = 0.034, 95% CI), suggesting a mechanism by which fiber might reduce plasma TMAO levels. While dietary fiber intervention did not alter TMAO production across all participants, it showed a potential effect in individuals with lower habitual meat intake. The observed downregulation of cutC gene abundance suggests a mechanism for the beneficial impact of fiber on TMAO formation. These findings support the role of a high-fiber, low-meat diet as a promising strategy to mitigate TMAO-related CVD risk.
背景/目的：肠道微生物依赖的代谢物三甲胺- n -氧化物（TMAO）与心血管疾病（CVD）风险有关，而膳食纤维与降低CVD风险和改善肠道健康有关。考虑到这些关联，我们进行了一项随机、双盲、试点研究，以调查纤维补充对牛肉食用后肠道氧化三甲胺形成的影响。受试者/方法：13名志愿者接受了为期两周的膳食纤维和安慰剂干预。我们评估了纤维补充对肠道微生物群和酶cutC基因丰度的影响，酶cutC是微生物TMA形成的关键酶，是TMAO的前体。在两周的干预后，我们测量了食用牛肉后的氧化三甲胺反应。我们还研究了肝酶FMO3对TMAO血浆水平的作用。结果：虽然膳食纤维组和安慰剂组的氧化三甲胺总生成没有变化（p值= 0.26,95% CI），但亚组分析显示，在习惯肉类消费量较低的参与者中，膳食纤维补充可以减少牛肉摄入后氧化三甲胺的形成(结论：这些发现支持高纤维、低肉饮食作为一种有希望的策略来减轻氧化三甲胺相关心血管疾病风险的作用。MEATMARK研究的图形摘要。创建与BioRender.com。哈斯，M. (2025) https://BioRender.com/x12v771。
{"title":"Effect of dietary fiber on trimethylamine-N-oxide production after beef consumption and on gut microbiota: MEATMARK – a randomized cross-over study","authors":"Melanie Haas, Beate Brandl, Klaus Neuhaus, Susanne Wudy, Karin Kleigrewe, Hans Hauner, Thomas Skurk","doi":"10.1038/s41430-025-01636-8","DOIUrl":"10.1038/s41430-025-01636-8","url":null,"abstract":"The gut-microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been linked to cardiovascular disease (CVD) risk, while dietary fiber is associated with reduced CVD risk and improved gut health. Considering these associations, we conducted a randomized, double-blind, pilot study to investigate the influence of fiber supplementation on intestinal TMAO formation after beef consumption. 13 volunteers underwent a two-week dietary fiber and placebo intervention. We assessed the effect of fiber supplementation on the gut microbiota and gene abundance of the enzyme cutC, a key enzyme for microbial TMA formation, a precursor for TMAO. We measured the TMAO response following beef consumption after the two-week intervention. We also examined the role of hepatic enzyme FMO3 on TMAO plasma levels. Although overall TMAO production did not change between the dietary fiber and placebo group (p-value = 0.26, 95% CI), subgroup analysis revealed that fiber supplementation attenuated TMAO formation following beef intake in participants with lower habitual meat consumption ( <3 times/week, p-value = 0.029, 95% CI). Furthermore, fiber intervention significantly downregulated microbial cutC gene abundance (p = 0.034, 95% CI), suggesting a mechanism by which fiber might reduce plasma TMAO levels. While dietary fiber intervention did not alter TMAO production across all participants, it showed a potential effect in individuals with lower habitual meat intake. The observed downregulation of cutC gene abundance suggests a mechanism for the beneficial impact of fiber on TMAO formation. These findings support the role of a high-fiber, low-meat diet as a promising strategy to mitigate TMAO-related CVD risk.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"980-990"},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41430-025-01636-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-14DOI: 10.1038/s41430-025-01623-z
Zhi Wang, Ling Yang, Bowen Du, Hualin Wang, Caifang Xu, Qianchuo Wang, Zhuoyan Li, Zhikang Xu, Hui Wang, Kun Sun, Jian Wang
Breast milk is an important source of nutrition for infant development. But few studies have investigated the relationship between breastfeeding duration and children’s cardiac structure and function. To assess the association of the duration of breastfeeding in infancy with cardiac structures and functions in 4-year-old children. The study analyzed data from 891 mother-offspring pairs in the Shanghai Birth Cohort (SBC) with complete 4-year follow-up and breastfeeding questionnaires. It excluded children with congenital heart defects or missing echocardiography data at age 4. Breastfeeding duration, including exclusive and mixed feeding, was categorized into three groups (<6months, 6-12months, >12months) based on questionnaires at 3 days, 24 days, 6, 12, and 24 months. Echocardiographic data were measured following 2010 American Society of Echocardiography recommendations. The results showed that: compared to 4-year-old children who were breastfed for less than 6 months, those breastfed for more than 6 months had bigger left atrial and ventricular volume, including increased left atrial diastolic volume [LAVd (β: 2.09, 95% CI: 1.35, 2.83)], left atrial systolic volume [LAVs (β: 0.92, 95% CI: 0.53, 1.3)], left ventricular diastolic volume [LVEDV (β: 2.00, 95% CI: 0.36, 3.62)] and systolic volume [LVESV (β: 0.87, 95% CI: 0.17, 1.57)]. Children breastfed over 12 months showed similar cardiac structural changes as those breastfed 6-12 months. These findings were more pronounced in girls and low birthweight children. Four-year-old children who were breastfed for six months or more had increased left heart volume, and this association was influenced by gender and birthweight.
{"title":"Association of breastfeeding duration with cardiac structure and function in 4 years old","authors":"Zhi Wang, Ling Yang, Bowen Du, Hualin Wang, Caifang Xu, Qianchuo Wang, Zhuoyan Li, Zhikang Xu, Hui Wang, Kun Sun, Jian Wang","doi":"10.1038/s41430-025-01623-z","DOIUrl":"10.1038/s41430-025-01623-z","url":null,"abstract":"Breast milk is an important source of nutrition for infant development. But few studies have investigated the relationship between breastfeeding duration and children’s cardiac structure and function. To assess the association of the duration of breastfeeding in infancy with cardiac structures and functions in 4-year-old children. The study analyzed data from 891 mother-offspring pairs in the Shanghai Birth Cohort (SBC) with complete 4-year follow-up and breastfeeding questionnaires. It excluded children with congenital heart defects or missing echocardiography data at age 4. Breastfeeding duration, including exclusive and mixed feeding, was categorized into three groups (<6months, 6-12months, >12months) based on questionnaires at 3 days, 24 days, 6, 12, and 24 months. Echocardiographic data were measured following 2010 American Society of Echocardiography recommendations. The results showed that: compared to 4-year-old children who were breastfed for less than 6 months, those breastfed for more than 6 months had bigger left atrial and ventricular volume, including increased left atrial diastolic volume [LAVd (β: 2.09, 95% CI: 1.35, 2.83)], left atrial systolic volume [LAVs (β: 0.92, 95% CI: 0.53, 1.3)], left ventricular diastolic volume [LVEDV (β: 2.00, 95% CI: 0.36, 3.62)] and systolic volume [LVESV (β: 0.87, 95% CI: 0.17, 1.57)]. Children breastfed over 12 months showed similar cardiac structural changes as those breastfed 6-12 months. These findings were more pronounced in girls and low birthweight children. Four-year-old children who were breastfed for six months or more had increased left heart volume, and this association was influenced by gender and birthweight.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 10","pages":"1-7"},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-12DOI: 10.1038/s41430-025-01635-9
Melissa Antunes, Leandro dos Santos, Luís Alberto Gobbo, Analiza M. Silva, Paolo M. Cunha, Witalo Kassiano, Letícia T. Cyrino, Hellen C. G. Nabuco, Ricardo J. Rodrigues, Luís B. Sardinha, Edilson S. Cyrino
Bioelectrical impedance vector analysis (BIVA) and phase angle (PhA) are important for monitoring hydration, muscle function, and quality of life in older adults. Resistance training (RT) can counteract aging’s adverse effects on cellular integrity and function. This study compared the effects of RT volume reduction on BIVA and PhA in physically independent older women. Sixty-seven participants (>60 years) underwent a 20-week standardized whole-body RT program (eight exercises, three sets each, 8–12 repetitions, three non-consecutive days per week in the morning). They were then randomly assigned to one of the three eight-week training conditions following the training model described above: reduced volume to one set (RV1, n = 22), two sets (RV2, n = 24), or maintained volume (MV, n = 21). Bioimpedance spectroscopy measured total body water (TBW), intracellular (ICW), and extracellular (ECW) water, BIVA, and PhA based on resistance (R), impedance (Z), reactance (Xc), and height (H). All groups showed significant increases in TBW, ICW, and ECW during the volume reduction phase (P < 0.05). R, R/H, Z, and Z/H decreased across all groups, with significant changes from the pre-conditioning phase in the RV1 and RV2 groups (P < 0.05). Xc and Xc/H increased during the pre-conditioning phase across all groups and returned to baseline during the volume reduction phase (P < 0.05). PhA increased during the pre-conditioning and was maintained during the volume reduction phase (RV1 = +0.33°, RV2 = +0.50°, MV = +0.47°; P < 0.05). These results suggest that reducing RT volume by up to one-third can still improve PhA, BIVA, and hydration status in older women.
背景：生物电阻抗矢量分析（BIVA）和相位角（PhA）对于监测老年人的水合作用、肌肉功能和生活质量很重要。抗阻训练（RT）可以抵消衰老对细胞完整性和功能的不利影响。目的：比较RT减容对身体独立老年妇女BIVA和PhA的影响。67名参与者（60岁）接受了为期20周的标准化全身RT计划（8项运动，每组3组，重复8-12次，每周3天非连续的早晨）。然后，他们被随机分配到上述训练模型所描述的三种为期八周的训练条件之一：将体积减少到一组（RV1, n = 22），两组（RV2, n = 24）或保持体积（MV, n = 21）。生物阻抗光谱根据电阻(R)、阻抗(Z)、电抗（Xc）和高度(H)测量全身水分（TBW）、细胞内（ICW）和细胞外（ECW）水分、BIVA和PhA。所有组在减容期TBW、ICW和ECW均显著增加(P结果：R、R/H、Z和Z/H在所有组中均下降，RV1和RV2组的预适应期变化显著(P结论：这些结果表明，将RV1体积减少三分之一仍可改善老年妇女的PhA、BIVA和水合状态。
{"title":"Bioelectrical impedance vector analysis and phase angle in response to resistance training volume reduction in older women","authors":"Melissa Antunes, Leandro dos Santos, Luís Alberto Gobbo, Analiza M. Silva, Paolo M. Cunha, Witalo Kassiano, Letícia T. Cyrino, Hellen C. G. Nabuco, Ricardo J. Rodrigues, Luís B. Sardinha, Edilson S. Cyrino","doi":"10.1038/s41430-025-01635-9","DOIUrl":"10.1038/s41430-025-01635-9","url":null,"abstract":"Bioelectrical impedance vector analysis (BIVA) and phase angle (PhA) are important for monitoring hydration, muscle function, and quality of life in older adults. Resistance training (RT) can counteract aging’s adverse effects on cellular integrity and function. This study compared the effects of RT volume reduction on BIVA and PhA in physically independent older women. Sixty-seven participants (>60 years) underwent a 20-week standardized whole-body RT program (eight exercises, three sets each, 8–12 repetitions, three non-consecutive days per week in the morning). They were then randomly assigned to one of the three eight-week training conditions following the training model described above: reduced volume to one set (RV1, n = 22), two sets (RV2, n = 24), or maintained volume (MV, n = 21). Bioimpedance spectroscopy measured total body water (TBW), intracellular (ICW), and extracellular (ECW) water, BIVA, and PhA based on resistance (R), impedance (Z), reactance (Xc), and height (H). All groups showed significant increases in TBW, ICW, and ECW during the volume reduction phase (P < 0.05). R, R/H, Z, and Z/H decreased across all groups, with significant changes from the pre-conditioning phase in the RV1 and RV2 groups (P < 0.05). Xc and Xc/H increased during the pre-conditioning phase across all groups and returned to baseline during the volume reduction phase (P < 0.05). PhA increased during the pre-conditioning and was maintained during the volume reduction phase (RV1 = +0.33°, RV2 = +0.50°, MV = +0.47°; P < 0.05). These results suggest that reducing RT volume by up to one-third can still improve PhA, BIVA, and hydration status in older women.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 12","pages":"1167-1173"},"PeriodicalIF":3.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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