Pub Date : 2024-06-26DOI: 10.1038/s41430-024-01468-y
Yuanyuan Li, Qing Xiao, LiangKai Chen, Guang Li, Benchao Li, Tingting Li, Yan Deng, Fengping Li, Bo Yang, Shuang Rong
To investigate the association of serum saturated fatty acids (SFAs) and prevalent mild cognitive impairment (MCI) among middle-aged and elderly Chinese. A total of 607 Chinese adults aged at least 45 years were included in the baseline survey of The Lifestyle and Healthy Aging of Chinese Square Dancer Study. Serum concentrations of individual SFAs including 6 even-chain SFAs (C14:0, C16:0, C18:0, C20:0, C22:0, and C24:0) and 4 odd-chain SFAs (C15:0, C17:0, C21:0, and C23:0), were quantified by Gas chromatography system with a mass spectrometer. According to Petersen’s criteria, prevalent MCI was diagnosed by neurologists through uniformed neuropsychological tests, including trail-making test-part B (TMT-B), auditory verbal learning test (AVLT), digit symbol substitution test (DSST), and verbal fluency test (VFT). The median age was 62 years with an interquartile range of 57.0 to 67.0 years, and 86 (14.17%) participants were living with MCI. Higher levels of either even-chain or odd-chain individual SFAs were associated with the higher odds of MCI, and their odds ratios (ORs) and 95% confidence intervals (95%CIs) were 2.054 (1.012 to 4.171) for C14:0, 2.246 (1.061 to 4.755) for C16:0, 2.789 (1.321 to 5.886) for C18:0, and 2.329 (1.136 to 4.778) for C15:0, and 2.761 (1.310 to 5.820) for C17:0, respectively. The serum concentration of SFAs was positively related to the odds of MCI in middle-aged and elderly adults. Determining the link between SFAs profiles and MCI may inform a better understanding of the potential role of saturated fat intake on cognitive function.
{"title":"Association of the serum levels of saturated fatty acids and mild cognitive impairment: a cross-sectional study","authors":"Yuanyuan Li, Qing Xiao, LiangKai Chen, Guang Li, Benchao Li, Tingting Li, Yan Deng, Fengping Li, Bo Yang, Shuang Rong","doi":"10.1038/s41430-024-01468-y","DOIUrl":"10.1038/s41430-024-01468-y","url":null,"abstract":"To investigate the association of serum saturated fatty acids (SFAs) and prevalent mild cognitive impairment (MCI) among middle-aged and elderly Chinese. A total of 607 Chinese adults aged at least 45 years were included in the baseline survey of The Lifestyle and Healthy Aging of Chinese Square Dancer Study. Serum concentrations of individual SFAs including 6 even-chain SFAs (C14:0, C16:0, C18:0, C20:0, C22:0, and C24:0) and 4 odd-chain SFAs (C15:0, C17:0, C21:0, and C23:0), were quantified by Gas chromatography system with a mass spectrometer. According to Petersen’s criteria, prevalent MCI was diagnosed by neurologists through uniformed neuropsychological tests, including trail-making test-part B (TMT-B), auditory verbal learning test (AVLT), digit symbol substitution test (DSST), and verbal fluency test (VFT). The median age was 62 years with an interquartile range of 57.0 to 67.0 years, and 86 (14.17%) participants were living with MCI. Higher levels of either even-chain or odd-chain individual SFAs were associated with the higher odds of MCI, and their odds ratios (ORs) and 95% confidence intervals (95%CIs) were 2.054 (1.012 to 4.171) for C14:0, 2.246 (1.061 to 4.755) for C16:0, 2.789 (1.321 to 5.886) for C18:0, and 2.329 (1.136 to 4.778) for C15:0, and 2.761 (1.310 to 5.820) for C17:0, respectively. The serum concentration of SFAs was positively related to the odds of MCI in middle-aged and elderly adults. Determining the link between SFAs profiles and MCI may inform a better understanding of the potential role of saturated fat intake on cognitive function.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"748-756"},"PeriodicalIF":3.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456066","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 : 2024-06-26DOI: 10.1038/s41430-024-01467-z
Amrita Vijay, Ana M. Valdes
{"title":"Retraction Note: Role of the gut microbiome in chronic diseases: a narrative review","authors":"Amrita Vijay, Ana M. Valdes","doi":"10.1038/s41430-024-01467-z","DOIUrl":"10.1038/s41430-024-01467-z","url":null,"abstract":"","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 8","pages":"736-736"},"PeriodicalIF":3.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456067","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 : 2024-06-22DOI: 10.1038/s41430-024-01465-1
Juliana Omena, Vanessa Monteiro Voll, Flávia Fioruci Bezerra, Bernardo Ferreira Braz, Ricardo Erthal Santelli, Carmen Marino Donangelo, Gustavo Federico Jauregui, Andrea Soares Ribeiro, Cláudia dos Santos Cople Rodrigues, Marta Citelli
Sickle cell anemia (SCA) is marked by hypoxia, inflammation, and secondary iron overload (IO), which potentially modulate hepcidin, the pivotal hormone governing iron homeostasis. The aim was to evaluate the iron incorporation in red blood cells (RBC) in SCA pediatric patients, considering the presence or absence of IO. SCA children (n = 12; SCAtotal) ingested an oral stable iron isotope (57Fe) and iron incorporation in RBC was measured after 14 days. Patients with ≥1000 ng/mL serum ferritin were considered to present IO (SCAio+; n = 4) while the others were classified as being without IO (SCAio−; n = 8). Liver iron concentration (LIC) was determined by Magnetic Resonance Imaging (MRI) T2* method. The SCAio+ group had lower iron incorporation (mean ± SD: 0.166 ± 0.04 mg; 3.33 ± 0.757%) than SCAio− patients (0.746 ± 0.303 mg; 14.9 ± 6.05%) (p = 0.024). Hepcidin was not different between groups. Iron incorporation was inversely associated with serum ferritin level (SCAtotal group: r = −0.775, p = 0.041; SCAio− group: r = −0.982; p = 0.018) and sickle hemoglobin (HbS) presented positive correlation with iron incorporation (r = 0.991; p = 0.009) in SCAio− group. LIC was positively associated with ferritin (SCAtotal: r = 0.921; p = 0.026) and C reactive protein (SCAio+: r = 0.999; p = 0.020). SCAio+ group had lower iron incorporation in RBC than SCAio− group, suggesting that they may not need to reduce their intake of iron-rich food, as usually recommended. Conversely, a high percentage of HbS may indirectly exacerbate hypoxia and seems to increase iron incorporation in RBC. This trial was registered at www.ensaiosclinicos.gov.br . Identifier RBR-4b7v8pt.
{"title":"Iron incorporation in red blood cells of pediatric sickle cell anemia: a stable isotope pilot investigation","authors":"Juliana Omena, Vanessa Monteiro Voll, Flávia Fioruci Bezerra, Bernardo Ferreira Braz, Ricardo Erthal Santelli, Carmen Marino Donangelo, Gustavo Federico Jauregui, Andrea Soares Ribeiro, Cláudia dos Santos Cople Rodrigues, Marta Citelli","doi":"10.1038/s41430-024-01465-1","DOIUrl":"10.1038/s41430-024-01465-1","url":null,"abstract":"Sickle cell anemia (SCA) is marked by hypoxia, inflammation, and secondary iron overload (IO), which potentially modulate hepcidin, the pivotal hormone governing iron homeostasis. The aim was to evaluate the iron incorporation in red blood cells (RBC) in SCA pediatric patients, considering the presence or absence of IO. SCA children (n = 12; SCAtotal) ingested an oral stable iron isotope (57Fe) and iron incorporation in RBC was measured after 14 days. Patients with ≥1000 ng/mL serum ferritin were considered to present IO (SCAio+; n = 4) while the others were classified as being without IO (SCAio−; n = 8). Liver iron concentration (LIC) was determined by Magnetic Resonance Imaging (MRI) T2* method. The SCAio+ group had lower iron incorporation (mean ± SD: 0.166 ± 0.04 mg; 3.33 ± 0.757%) than SCAio− patients (0.746 ± 0.303 mg; 14.9 ± 6.05%) (p = 0.024). Hepcidin was not different between groups. Iron incorporation was inversely associated with serum ferritin level (SCAtotal group: r = −0.775, p = 0.041; SCAio− group: r = −0.982; p = 0.018) and sickle hemoglobin (HbS) presented positive correlation with iron incorporation (r = 0.991; p = 0.009) in SCAio− group. LIC was positively associated with ferritin (SCAtotal: r = 0.921; p = 0.026) and C reactive protein (SCAio+: r = 0.999; p = 0.020). SCAio+ group had lower iron incorporation in RBC than SCAio− group, suggesting that they may not need to reduce their intake of iron-rich food, as usually recommended. Conversely, a high percentage of HbS may indirectly exacerbate hypoxia and seems to increase iron incorporation in RBC. This trial was registered at www.ensaiosclinicos.gov.br . Identifier RBR-4b7v8pt.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"801-807"},"PeriodicalIF":3.6,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01465-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440327","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 : 2024-06-19DOI: 10.1038/s41430-024-01463-3
Kyunghwa Lee, In-Ae Song, Sunghee Lee, Keonhee Kim, Tak Kyu Oh
The South Korean government implemented a multidisciplinary nutritional support team (NST) system to focus on the proper evaluation and supply of nutritional status in hospitalized patients who are at a higher risk of malnutrition. This nationwide population-based cohort study included patients diagnosed with sepsis who were admitted to hospitals from 2016 to 2020. The NST should consist of four professional personnel (physicians, full-time nurses, full-time pharmacists, and full-time clinical dietitians). The NST group included patients with sepsis admitted to a hospital with an NST system, whereas the non-NST group included patients with sepsis admitted to a hospital without an NST system. A total of 323,841 patients with sepsis were included in the final analysis, and 120,274 (37.1%) admitted to a hospital with an NST system were included in the NST group. In the multivariable Cox regression analysis, the NST group showed a 15% lower 90-day mortality than the non-NST group (hazard ratio [HR]:0.85, 95% confidence interval [CI]:0.83, 0.86; P < 0.001). The NST group shows 11% lower 1-year all-cause mortality than the non-NST group (HR:0.89, 95% CI:0.87, 0.90; P < 0.001). In subgroup analyses, a more evident association of the NST group with lower 90-day mortality was shown in the intensive care unit admission group and age ≥65 years old group. Multidisciplinary NST intervention is associated with improved survival outcomes in patients with sepsis. Moreover, this association was more evident in patients with sepsis aged ≥65 years old who were admitted to the ICU.
{"title":"Multidisciplinary nutritional support team and survival outcomes in patients with sepsis: a nationwide population-based cohort study in South Korea","authors":"Kyunghwa Lee, In-Ae Song, Sunghee Lee, Keonhee Kim, Tak Kyu Oh","doi":"10.1038/s41430-024-01463-3","DOIUrl":"10.1038/s41430-024-01463-3","url":null,"abstract":"The South Korean government implemented a multidisciplinary nutritional support team (NST) system to focus on the proper evaluation and supply of nutritional status in hospitalized patients who are at a higher risk of malnutrition. This nationwide population-based cohort study included patients diagnosed with sepsis who were admitted to hospitals from 2016 to 2020. The NST should consist of four professional personnel (physicians, full-time nurses, full-time pharmacists, and full-time clinical dietitians). The NST group included patients with sepsis admitted to a hospital with an NST system, whereas the non-NST group included patients with sepsis admitted to a hospital without an NST system. A total of 323,841 patients with sepsis were included in the final analysis, and 120,274 (37.1%) admitted to a hospital with an NST system were included in the NST group. In the multivariable Cox regression analysis, the NST group showed a 15% lower 90-day mortality than the non-NST group (hazard ratio [HR]:0.85, 95% confidence interval [CI]:0.83, 0.86; P < 0.001). The NST group shows 11% lower 1-year all-cause mortality than the non-NST group (HR:0.89, 95% CI:0.87, 0.90; P < 0.001). In subgroup analyses, a more evident association of the NST group with lower 90-day mortality was shown in the intensive care unit admission group and age ≥65 years old group. Multidisciplinary NST intervention is associated with improved survival outcomes in patients with sepsis. Moreover, this association was more evident in patients with sepsis aged ≥65 years old who were admitted to the ICU.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"765-771"},"PeriodicalIF":3.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426530","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 : 2024-06-18DOI: 10.1038/s41430-024-01460-6
Arne Astrup
Scientists were chasing an incretin hormone, and when GLP-1 was finally discovered, we found that it had a pronounced satiety effect, slowed down gastric emptying, and actually reduced postprandial insulin response. These mechanisms are the basis for the highly efficacious GLP-1 analogues that today offer safe and effective treatment in millions of people living with obesity. Moreover, the combined GLP-1 mechanisms of weight loss and delayed carbohydrate absorption may also be the key drivers of remission of type 2 diabetes and reduced cardiovascular events found by GLP-1 analogues.
{"title":"Reflections on the discovery GLP-1 as a satiety hormone: Implications for obesity therapy and future directions","authors":"Arne Astrup","doi":"10.1038/s41430-024-01460-6","DOIUrl":"10.1038/s41430-024-01460-6","url":null,"abstract":"Scientists were chasing an incretin hormone, and when GLP-1 was finally discovered, we found that it had a pronounced satiety effect, slowed down gastric emptying, and actually reduced postprandial insulin response. These mechanisms are the basis for the highly efficacious GLP-1 analogues that today offer safe and effective treatment in millions of people living with obesity. Moreover, the combined GLP-1 mechanisms of weight loss and delayed carbohydrate absorption may also be the key drivers of remission of type 2 diabetes and reduced cardiovascular events found by GLP-1 analogues.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 7","pages":"551-556"},"PeriodicalIF":3.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01460-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418445","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 : 2024-06-17DOI: 10.1038/s41430-024-01462-4
David Hakimian, Elizabeth Wall, Jean Herlitz, Edward Scott Lozano, Edwin McDonald, Carol Semrad, Dejan Micic
Intestinal failure-associated liver disease (IFALD) is a complication of long-term PN use, attributed to the use of ω-6 injectable lipid emulsions (ILE). Fish oil (FO) ILE have been successful in reversing liver injury in neonates. Evidence for pure FO ILE use in adult patients is limited. Case series of the use of FO lipid emulsions in adults with IFALD from the University of Chicago PN registry. Analysis of medical charts and PN formulations was performed. Three cases of IFALD treated with FO ILE were identified. The first case was a 30-year-old man with short bowel syndrome (SBS), hyperbilirubinemia, and biopsy-proven IFALD. Following a change from a soy lipid emulsion to FO lipid emulsion, his liver tests rapidly improved and remained stable over 202 weeks of use. The second case was a 76-year-old woman with intestinal failure (IF) due to a frozen bowel. A change from a soy ILE to a composite lipid and later to a pure FO ILE did not result in improvement in her liver tests. The third case was a 28-year-old man with SBS and biopsy-proven IFALD. Change to a composite ILE and subsequently FO lipid emulsion resulted in a gradual improvement in liver tests. No clinical essential fatty acid (EFA) deficiencies were identified during treatment. FO ILE may be effective in the treatment of adult patients with cholestatic IFALD. Use is safe with no EFA deficiencies detected in up to 4 years of use.
背景：肠功能衰竭相关性肝病（IFALD）是长期使用 PN 的一种并发症，归因于ω-6 注射用脂质乳剂（ILE）的使用。鱼油 ILE 成功逆转了新生儿的肝损伤。在成年患者中使用纯鱼油 ILE 的证据有限：方法：芝加哥大学新生儿营养登记处对患有 IFALD 的成人患者使用 FO 脂质乳剂的病例系列。对病历和 PN 配方进行了分析：结果：发现了三例使用FO ILE治疗的IFALD病例。第一个病例是一名 30 岁的男性，患有短肠综合征 (SBS)、高胆红素血症和活组织检查证实的 IFALD。在从大豆脂质乳剂换成膳食纤维脂质乳剂后，他的肝脏检查迅速得到改善，并在使用 202 周后保持稳定。第二个病例是一名 76 岁的妇女，因肠冻死而导致肠功能衰竭（IF）。从大豆 ILE 到复合脂质，再到后来的纯 FO ILE，她的肝脏测试结果都没有改善。第三个病例是一名 28 岁的男性，患有 SBS 和活组织检查证实的 IFALD。改用复合 ILE 后，又改用 FO 脂质乳剂，结果肝脏测试逐渐得到改善。治疗期间未发现临床必需脂肪酸（EFA）缺乏症：结论：FO ILE 可有效治疗患有胆汁淤积性 IFALD 的成年患者。结论：FO ILE 可有效治疗患有胆汁淤积性 IFALD 的成年患者，而且使用安全，在长达 4 年的使用过程中未发现 EFA 缺乏症。
{"title":"Parenteral fish oil lipid emulsion use in adults: a case series and review from an intestinal failure referral center","authors":"David Hakimian, Elizabeth Wall, Jean Herlitz, Edward Scott Lozano, Edwin McDonald, Carol Semrad, Dejan Micic","doi":"10.1038/s41430-024-01462-4","DOIUrl":"10.1038/s41430-024-01462-4","url":null,"abstract":"Intestinal failure-associated liver disease (IFALD) is a complication of long-term PN use, attributed to the use of ω-6 injectable lipid emulsions (ILE). Fish oil (FO) ILE have been successful in reversing liver injury in neonates. Evidence for pure FO ILE use in adult patients is limited. Case series of the use of FO lipid emulsions in adults with IFALD from the University of Chicago PN registry. Analysis of medical charts and PN formulations was performed. Three cases of IFALD treated with FO ILE were identified. The first case was a 30-year-old man with short bowel syndrome (SBS), hyperbilirubinemia, and biopsy-proven IFALD. Following a change from a soy lipid emulsion to FO lipid emulsion, his liver tests rapidly improved and remained stable over 202 weeks of use. The second case was a 76-year-old woman with intestinal failure (IF) due to a frozen bowel. A change from a soy ILE to a composite lipid and later to a pure FO ILE did not result in improvement in her liver tests. The third case was a 28-year-old man with SBS and biopsy-proven IFALD. Change to a composite ILE and subsequently FO lipid emulsion resulted in a gradual improvement in liver tests. No clinical essential fatty acid (EFA) deficiencies were identified during treatment. FO ILE may be effective in the treatment of adult patients with cholestatic IFALD. Use is safe with no EFA deficiencies detected in up to 4 years of use.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"796-800"},"PeriodicalIF":3.6,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01462-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418444","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 : 2024-06-12DOI: 10.1038/s41430-024-01458-0
Findlay Crystal, Robert Fulai, Patrick Kaonga, Andrew Davenport
Haemodialysis (HD) patients are reported to be at greater risk of malnourishment, and at risk of increased morbidity and mortality. However, most studies report from economically advanced countries. We therefore assessed the nutritional status and diet among HD patients attending a public university hospital in a sub-Saharan African country. We performed nutritional assessments in HD patients attending the largest dialysis centre, in the country, collecting demographic and clinical data, dietary intake, along with anthropometric and bioimpedance body composition measurements in May 2022. Malnutrition was classified according to subjective global assessment score (SGA). Additional assessments of protein energy wasting (PEW), clinical frailty, and sarcopenia were made. All 97 HD patients were recruited, mean age 44.7 ± 12.2 years, with 55 (56.7%) males. Malnutrition was present in 43.8%, PEW 20.6%, frailty 17.6% and sarcopenia 4.1%. On multivariable logistic regression higher serum albumin (adjusted odds ratio (AOR) 0.89, 95% confidence intervals (CI) 0.85-0.95, p < 0.001), creatinine (AOR 0.99, 95%CI 0.98–0.99, p < 0.001), greater mid upper arm circumference (AOR 0.89, 95%CI 0.83–0.95, p = 0.001), body cell mass (BCM) (AOR 0.79, 95%CI 0.67–0.95, p = 0.013) and employment (AOR 0.45, 95%CI 0.23–0.87, p = 0.017), were are all protective against malnourishment. Almost 75% had reduced dietary protein intake. Despite a younger, less co-morbid patient population, malnutrition is common in this resource poor setting. The staple diet is based on maize, a low protein foodstuff. Employment improved finances and potentially allows better nutrition. Further studies are required to determine whether additional dietary protein can reduce the prevalence of malnutrition in this population.
背景：据报道，血液透析（HD）患者营养不良的风险更大，发病率和死亡率也有可能增加。然而，大多数研究报告都来自经济发达的国家。因此，我们对撒哈拉以南非洲国家公立大学医院的血液透析患者的营养状况和饮食进行了评估：我们于 2022 年 5 月对在该国最大的透析中心就诊的 HD 患者进行了营养评估，收集了人口统计学和临床数据、饮食摄入量以及人体测量和生物阻抗身体成分测量结果。营养不良根据主观总体评估得分（SGA）进行分类。此外，还对蛋白质能量消耗（PEW）、临床虚弱和肌肉疏松症进行了评估：共招募了 97 名 HD 患者，平均年龄为（44.7 ± 12.2）岁，其中 55 名（56.7%）为男性。43.8%的患者存在营养不良，20.6%的患者存在PEW，17.6%的患者存在虚弱，4.1%的患者存在肌肉疏松症。在多变量逻辑回归中，血清白蛋白较高（调整后的几率比（AOR）为 0.89，95% 置信区间（CI）为 0.85-0.95，P 结论：尽管患者年龄较小、合并疾病较少，但他们的血清白蛋白却较高：尽管患者年龄较小、合并疾病较少，但在这种资源贫乏的环境中，营养不良仍很常见。主食以玉米为主，这是一种低蛋白食品。就业改善了经济状况，并有可能改善营养状况。还需要进一步研究，以确定额外的膳食蛋白质是否能降低该人群营养不良的发生率。
{"title":"Malnutrition, protein energy wasting and sarcopenia in patients attending a haemodialysis centre in sub-Saharan Africa","authors":"Findlay Crystal, Robert Fulai, Patrick Kaonga, Andrew Davenport","doi":"10.1038/s41430-024-01458-0","DOIUrl":"10.1038/s41430-024-01458-0","url":null,"abstract":"Haemodialysis (HD) patients are reported to be at greater risk of malnourishment, and at risk of increased morbidity and mortality. However, most studies report from economically advanced countries. We therefore assessed the nutritional status and diet among HD patients attending a public university hospital in a sub-Saharan African country. We performed nutritional assessments in HD patients attending the largest dialysis centre, in the country, collecting demographic and clinical data, dietary intake, along with anthropometric and bioimpedance body composition measurements in May 2022. Malnutrition was classified according to subjective global assessment score (SGA). Additional assessments of protein energy wasting (PEW), clinical frailty, and sarcopenia were made. All 97 HD patients were recruited, mean age 44.7 ± 12.2 years, with 55 (56.7%) males. Malnutrition was present in 43.8%, PEW 20.6%, frailty 17.6% and sarcopenia 4.1%. On multivariable logistic regression higher serum albumin (adjusted odds ratio (AOR) 0.89, 95% confidence intervals (CI) 0.85-0.95, p < 0.001), creatinine (AOR 0.99, 95%CI 0.98–0.99, p < 0.001), greater mid upper arm circumference (AOR 0.89, 95%CI 0.83–0.95, p = 0.001), body cell mass (BCM) (AOR 0.79, 95%CI 0.67–0.95, p = 0.013) and employment (AOR 0.45, 95%CI 0.23–0.87, p = 0.017), were are all protective against malnourishment. Almost 75% had reduced dietary protein intake. Despite a younger, less co-morbid patient population, malnutrition is common in this resource poor setting. The staple diet is based on maize, a low protein foodstuff. Employment improved finances and potentially allows better nutrition. Further studies are required to determine whether additional dietary protein can reduce the prevalence of malnutrition in this population.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"818-822"},"PeriodicalIF":3.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01458-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310363","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 : 2024-06-12DOI: 10.1038/s41430-024-01461-5
Shuhao Lin, Sofia Cienfuegos, Mark Ezpeleta, Vasiliki Pavlou, Mary-Claire Runchey, Krista A. Varady
This study examined the effects of time restricted eating (TRE) on sex hormones in males and females, versus daily calorie restriction (CR). Adults with obesity (n = 90) were randomized to 1 of 3 groups for 12-months: 8-h TRE (eating only between 12:00 to 8:00 pm, with no calorie counting); CR (25% energy restriction daily); or control. Body weight decreased (P < 0.01) in the TRE and CR groups, relative to controls, in males, premenopausal females, and postmenopausal females, by month 12. Total testosterone, dehydroepiandrosterone (DHEA), and sex hormone binding globulin (SHBG) levels did not change over time, or between groups, in males, premenopausal females, and postmenopausal females. Estradiol, estrone, and progesterone were only measured in postmenopausal females, and remained unchanged. These findings suggest that TRE produces significant weight loss but does not impact circulating sex hormone levels in males and females with obesity over 12 months, relative to CR and controls.
{"title":"Effect of time restricted eating versus daily calorie restriction on sex hormones in males and females with obesity","authors":"Shuhao Lin, Sofia Cienfuegos, Mark Ezpeleta, Vasiliki Pavlou, Mary-Claire Runchey, Krista A. Varady","doi":"10.1038/s41430-024-01461-5","DOIUrl":"10.1038/s41430-024-01461-5","url":null,"abstract":"This study examined the effects of time restricted eating (TRE) on sex hormones in males and females, versus daily calorie restriction (CR). Adults with obesity (n = 90) were randomized to 1 of 3 groups for 12-months: 8-h TRE (eating only between 12:00 to 8:00 pm, with no calorie counting); CR (25% energy restriction daily); or control. Body weight decreased (P < 0.01) in the TRE and CR groups, relative to controls, in males, premenopausal females, and postmenopausal females, by month 12. Total testosterone, dehydroepiandrosterone (DHEA), and sex hormone binding globulin (SHBG) levels did not change over time, or between groups, in males, premenopausal females, and postmenopausal females. Estradiol, estrone, and progesterone were only measured in postmenopausal females, and remained unchanged. These findings suggest that TRE produces significant weight loss but does not impact circulating sex hormone levels in males and females with obesity over 12 months, relative to CR and controls.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"814-817"},"PeriodicalIF":3.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310361","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 : 2024-06-12DOI: 10.1038/s41430-024-01457-1
Darel Wee Kiat Toh, Shalini Ponnalagu, Stefan Gerardus Camps, Joseph Lim, Melvin Xu Nian Koh, Christiani Jeyakumar Henry
Acute glycemic responses offer important insights into glucose homeostasis although the repeatability of these measurements particularly in Asian populations remains unclear. This research aimed to critically investigate the inconsistencies of the postprandial glycemic profile within individuals, and identify potential variables predicting greater inconsistencies. This was a secondary analysis of three randomized controlled trials which fed subjects with glucose (and other carbohydrate-rich foods), and measured postprandial blood glucose at regular intervals. Intra-individual rank-order consistency in the glycemic profile between acute glucose treatments was evaluated and compared against demographic, anthropometric and cardio-metabolic health related indicators to delineate potential confounding variables. Correlations between the incremental area under curve at 120 min (iAUC120 min) for glucose and the carbohydrate-rich foods were further explored. Rank-order consistency was identified to be moderate, with intra-individual inconsistencies marginally lower than inter-individual inconsistencies. Notably, greater inconsistencies within individuals were directly correlated with BMI and fat-mass index (P < 0.01) albeit non-significant for age, ethnicity, and other cardio-metabolic health-related risk indicators. Across the trials, there were positive monotonic correlations between the iAUC120 min for glucose and simple sugars (sucrose, isomaltulose), as well as different varieties of rice (jasmine white, Bapatla brown, Bapatla white; p < 0.05). However, there were a lack of associations between iAUC120 min for glucose with pastas (semolina and wholegrain penne, spaghetti) and mee pok noodles. There are inherent inconsistencies in postprandial glycemic measurements within individuals, particularly among those with higher adiposity. These confounders need to be kept in mind for appropriate and meaningful interpretations of glycemia.
{"title":"Higher adiposity predicts greater intra-individual inconsistencies in postprandial glycemic measurements—an analysis of three randomized controlled trials in Asian populations","authors":"Darel Wee Kiat Toh, Shalini Ponnalagu, Stefan Gerardus Camps, Joseph Lim, Melvin Xu Nian Koh, Christiani Jeyakumar Henry","doi":"10.1038/s41430-024-01457-1","DOIUrl":"10.1038/s41430-024-01457-1","url":null,"abstract":"Acute glycemic responses offer important insights into glucose homeostasis although the repeatability of these measurements particularly in Asian populations remains unclear. This research aimed to critically investigate the inconsistencies of the postprandial glycemic profile within individuals, and identify potential variables predicting greater inconsistencies. This was a secondary analysis of three randomized controlled trials which fed subjects with glucose (and other carbohydrate-rich foods), and measured postprandial blood glucose at regular intervals. Intra-individual rank-order consistency in the glycemic profile between acute glucose treatments was evaluated and compared against demographic, anthropometric and cardio-metabolic health related indicators to delineate potential confounding variables. Correlations between the incremental area under curve at 120 min (iAUC120 min) for glucose and the carbohydrate-rich foods were further explored. Rank-order consistency was identified to be moderate, with intra-individual inconsistencies marginally lower than inter-individual inconsistencies. Notably, greater inconsistencies within individuals were directly correlated with BMI and fat-mass index (P < 0.01) albeit non-significant for age, ethnicity, and other cardio-metabolic health-related risk indicators. Across the trials, there were positive monotonic correlations between the iAUC120 min for glucose and simple sugars (sucrose, isomaltulose), as well as different varieties of rice (jasmine white, Bapatla brown, Bapatla white; p < 0.05). However, there were a lack of associations between iAUC120 min for glucose with pastas (semolina and wholegrain penne, spaghetti) and mee pok noodles. There are inherent inconsistencies in postprandial glycemic measurements within individuals, particularly among those with higher adiposity. These confounders need to be kept in mind for appropriate and meaningful interpretations of glycemia.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 9","pages":"788-795"},"PeriodicalIF":3.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310362","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 : 2024-06-06DOI: 10.1038/s41430-024-01454-4
Vanessa Pereira, Inês Barreiros-Mota, Filipa Cortez, Inês Castela, Diana Teixeira, Conceição Calhau, Cláudia Camila Dias, André Moreira-Rosário, Marta P. Silvestre
The escalating obesity epidemic necessitates effective, sustainable weight loss (WL) and maintenance strategies. This study aimed to evaluate the effectiveness of the Weight Loss Maintenance 3 Phases Program (WLM3P) in achieving a clinically significant long-term weight loss (WL) (≥5% initial WL at 18 months) in adults with obesity compared to a standard low-carbohydrate diet (LCD). In this two-phase trial, 112 participants targeting initial WL (0–6 months) and subsequent maintenance (7–18 months) were randomly assigned to either WLM3P or LCD groups. Outcomes assessed included change in body weight (kg, %), improvements in body composition, and metabolic profile. Of 112 randomized participants, 69% (n = 77) completed the study. At 18 months, WL in the WLM3P group (n = 40) was 15.5 ± 8.3% compared to 9.6 ± 8.5% in the LCD group (n = 37) (p < 0.001). The odds ratio of achieving WL ≥ 10% and ≥15% were significantly higher in the WLM3P group. Complete-case analysis revealed significantly greater improvements in BMI, body fat mass, visceral fat area, waist circumference, waist-to-hip ratio, HDL, and triglyceride/HDL ratio in WLM3P than in LCD. No serious adverse events were reported. Both programs effectively promoted clinically relevant WL and its maintenance. However, the WLM3P program was more successful in helping participants achieve greater WL targets of ≥10% and ≥15%, along with other clinical benefits, after an 18-month intervention. NCT04192357.
{"title":"A randomized controlled trial of a weight loss maintenance program in adults with obesity: the WLM3P study","authors":"Vanessa Pereira, Inês Barreiros-Mota, Filipa Cortez, Inês Castela, Diana Teixeira, Conceição Calhau, Cláudia Camila Dias, André Moreira-Rosário, Marta P. Silvestre","doi":"10.1038/s41430-024-01454-4","DOIUrl":"10.1038/s41430-024-01454-4","url":null,"abstract":"The escalating obesity epidemic necessitates effective, sustainable weight loss (WL) and maintenance strategies. This study aimed to evaluate the effectiveness of the Weight Loss Maintenance 3 Phases Program (WLM3P) in achieving a clinically significant long-term weight loss (WL) (≥5% initial WL at 18 months) in adults with obesity compared to a standard low-carbohydrate diet (LCD). In this two-phase trial, 112 participants targeting initial WL (0–6 months) and subsequent maintenance (7–18 months) were randomly assigned to either WLM3P or LCD groups. Outcomes assessed included change in body weight (kg, %), improvements in body composition, and metabolic profile. Of 112 randomized participants, 69% (n = 77) completed the study. At 18 months, WL in the WLM3P group (n = 40) was 15.5 ± 8.3% compared to 9.6 ± 8.5% in the LCD group (n = 37) (p < 0.001). The odds ratio of achieving WL ≥ 10% and ≥15% were significantly higher in the WLM3P group. Complete-case analysis revealed significantly greater improvements in BMI, body fat mass, visceral fat area, waist circumference, waist-to-hip ratio, HDL, and triglyceride/HDL ratio in WLM3P than in LCD. No serious adverse events were reported. Both programs effectively promoted clinically relevant WL and its maintenance. However, the WLM3P program was more successful in helping participants achieve greater WL targets of ≥10% and ≥15%, along with other clinical benefits, after an 18-month intervention. NCT04192357.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"78 8","pages":"694-702"},"PeriodicalIF":3.6,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01454-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283373","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}
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