Frontiers in Nutrition最新文献

Depression is a leading global mental health burden, and diet has emerged as a modifiable risk factor. This narrative review summarizes evidence about the association between plant-based dietary patterns and depression. It focuses particularly on diet quality and potential mechanisms. We examined plant-based diets-defined by the Plant-Based Diet Index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI)-and plant-forward dietary patterns such as the Mediterranean, DASH, and MIND diets in relation to depressive symptoms or diagnosed depression. In diverse populations, greater adherence to healthful plant-based dietary patterns that emphasize minimally processed plant foods typically correlates with reduced depressive symptoms, better mental health, and improved quality of life. Conversely, diets that are high in ultra-processed, energy-dense plant foods are associated with a higher risk of depression. Proposed mechanisms include reduced systemic inflammation, beneficial modulation of the gut microbiota and the microbiota-gut-brain axis, and improved intake of key nutrients and phytochemicals involved in monoamine neurotransmission, neurotrophic signaling, and oxidative stress defense. In general, the influence of plant-based diets on depression seems to be more closely related to diet quality and nutrient adequacy rather than merely the elimination of animal foods.

The extraction process for crude polysaccharides from Ceratocarpus arenarius L. was optimized using response surface methodology (RSM). A major polysaccharide fraction with high purity, designated CAP, was isolated from the crude polysaccharides using DEAE-650 M and Sephadex G-75 column chromatography. Its structure was comprehensively characterized using FT-IR, partial acid hydrolysis, peroxide oxidation, Smith degradation, methylation analysis, and NMR analysis. Subsequently, carboxymethylated (CAP-C), acetylated (CAP-A), sulfated (CAP-S), and phosphorylated (CAP-P) derivatives of CAP were prepared. Their structures were characterized using techniques, including HPSEC, GC, UV, FT-IR, Congo red assay, SEM, XRD, and thermal stability analysis. The results of the RSM optimization indicated that the optimal extraction conditions were as follows: time 43 min, ultrasonic power 310 W, liquid-solid ratio 21:1 mL/g, temperature 62 °C. The crude polysaccharide yield obtained under these conditions was 19.09 ± 0.12%. CAP is primarily composed of pyranose rings linked by α-glycosidic bonds. Its backbone primarily consists of →3)-Xylp-(1→, →3)-Galp-(1→, Galp-(1→, and →2,4)-Galp-(1→ glycosidic bonds, while the terminal residues of the side chains are mainly T-Xylp and T-Rhap. Structural modification significantly altered the monosaccharide molar ratio, molecular weight, viscosity, solubility, surface morphology, crystalline characteristics, and thermodynamic properties of CAP and its derivatives. Anti-inflammatory activity studies revealed that different modification methods differentially enhanced the polysaccharide bioactivity. However, all derivatives could effectively suppress LPS-induced inflammatory responses by regulating the production of nitric oxide (NO), prostaglandin E2 (PGE₂), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α). These findings suggest that CAP and its derivatives have potential applications in the functional food and pharmaceutical industries.

Purpose: Fermented foods are widely consumed, contribute important bioactive compounds and microbial metabolites to the diet, and play an important role in global nutrition. This meta-analysis evaluated evidence from prospective cohort studies on the association between fermented food and non-alcoholic beverage consumption and the risk of all-cause and cause-specific mortality in healthy adults.

Methods: A systematic search of three databases identified 50 cohort studies, including more than three million participants, examining associations between fermented food intake and all-cause, cardiovascular disease (CVD), and cancer mortality. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses using the DerSimonian and Laird method, were conducted on fully adjusted risk estimates comparing highest vs. lowest intake categories.

Results: Higher consumption of chocolate, cheese, and fermented milks (including yogurt) was associated with lower all-cause and CVD mortality. Fermented milk consumption also showed a protective association with cancer mortality. Miso and bread consumption showed no significant associations with mortality.

Conclusion: This is the first meta-analysis to comprehensively evaluate the association between fermented food intake and mortality. Findings support a protective role for specific fermented foods consumption, i.e., milks, cheese, and chocolate, against all-cause and CVD mortality, with additional evidence of a protective effect of fermented milk on overall cancer mortality. These associations may underline the role of bioactive peptides, polyphenols, and microbial metabolites that modulate the gut microbiota, improve vascular function, and reduce the risk of certain chronic diseases.

Systematic review registration: https://osf.io/vg7f6, identifier: vg7f6.

Background: Post-stroke epilepsy (PSE) is a severe complication characterized by significant heterogeneity. Traditional anatomical models often fail to identify patients with high metabolic risk but minor structural injury. Based on the concept that systemic metabolic and nutritional disturbances exacerbate neuronal excitability, we proposed a "Two-Hit" hypothesis: an acute immune-inflammatory hit combined with a hypoxia-metabolic hit acts upon nutritionally compromised brain tissue to drive epileptogenesis. This study aims to evaluate the synergistic value of the Immuno-Nutritional Index (C-reactive protein to Albumin Ratio, CAR) and Hypoxia-Nutritional Index (Lactate to Albumin Ratio, LAR) in predicting PSE.

Methods: We conducted a multi-center retrospective cohort study involving 21,459 acute ischemic stroke patients. CAR and LAR were calculated from admission biomarkers to quantify immuno-nutritional and hypoxia-metabolic status. Restricted cubic splines (RCS) were used to model non-linear dose-response relationships. A "Two-Hit" multivariate prediction model was constructed, and its incremental value over baseline clinical features was assessed using the Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI). A web-based risk calculator was developed for clinical translation.

Results: During a one-year follow-up, 936 patients (4.36%) developed PSE. CAR exhibited a J-shaped relationship with epilepsy risk, reflecting an inflammatory threshold, while LAR showed a bell-shaped association, indicating a "metabolic hyper-excitatory state". A significant synergistic effect was observed: patients with concurrent elevations in both indices ("Double High") had a 13.5% incidence rate compared to 2.4% in the "Double Low" group. The "Two-Hit" model achieved an AUC of 0.888, significantly outperforming single-marker and baseline models (NRI 0.820, p < 0.001). Importantly, these nutritional indices maintained predictive value even in patients with minor stroke severity (NIHSS < 4).

Conclusion: The CAR and LAR are potent synergistic predictors of PSE, supporting a "Two-Hit" mechanism involving immuno-metabolic disturbances. The developed web-based calculator serves as a valuable preliminary screening tool to identify metabolically high-risk patients. While the model demonstrates robust internal validity, external validation is warranted before widespread clinical adoption. These findings also suggest that optimizing immuno-nutritional management may act as a novel neuroprotective strategy.

Background: With South Korea transitioning into a super-aged society in 2024, nutritional vulnerability among the elderly is a growing concern, particularly in Seoul with its large elderly population. This study aimed to identify nutritionally vulnerable elderly individuals in Seoul and examine associated sociodemographic and dietary characteristics using the Nutrition Quotient for the Elderly (NQ-E).

Methods: This study analyzed data on 720 elderly individuals aged 65 years or older from the raw data of the Seoul Food Survey 2024. Based on their scores calculated using NQ-E, respondents were categorized into high, medium, and low grades. In this study, individuals in the low grade were defined as the nutritionally vulnerable group, while those in the medium and high grades were classified as the non-vulnerable group to facilitate analysis of group-specific characteristics. Sociodemographic and dietary characteristics of the two groups were compared. Logistic regression was conducted to identify these characteristics associated with nutritional vulnerability.

Results: A total of 19.0% of respondents were classified as nutritionally vulnerable. Logistic regression analysis revealed, among the total elderly population, men were more likely to be nutritionally vulnerable than women (OR = 2.88, 95% CI: 1.29-6.44). Those with middle school graduation or less had higher odds of nutritional vulnerability compared to those with high school graduation or higher (OR = 3.42, 95% CI: 1.52-7.70). Higher food literacy was associated with lower odds of nutritional vulnerability across all groups: total elderly population (OR = 0.90, 95% CI: 0.87-0.93), elderly men (OR = 0.91, 95% CI: 0.86-0.96), and elderly women (OR = 0.88, 95% CI: 0.83-0.93). Among elderly men, those with lower educational level (middle school graduation or less) were more likely to be nutritionally vulnerable (OR = 8.63, 95% CI: 2.63-28.26), and those living alone were more likely to be nutritionally vulnerable compared to those living with others (OR = 3.42, 95% CI: 1.14-10.27).

Discussion: These findings underscore the importance of implementing targeted interventions to reduce nutritional vulnerability among older adults in Seoul, particularly elderly men living alone. Future research and policy efforts should focus on food literacy as a potential approach to address nutritional vulnerability among the elderly.

Vitamin K, a fat-soluble micronutrient traditionally recognized for its role in blood coagulation, has increasingly been implicated as a micronutrient with emerging roles in skeletal muscle health. Experimental and clinical evidence now suggests that vitamin K influences skeletal muscle through both γ-carboxylation-dependent pathways-mediated by osteocalcin, matrix Gla protein (MGP), and growth arrest-specific 6 (Gas6)-and through non-carboxylation mechanisms, including anti-inflammatory, antioxidant, mitochondrial-regulatory, and ferroptosis-suppressing effects. Observational studies associate higher vitamin K intake and status with greater muscle strength, higher muscle mass, and better physical performance among older adults. However, findings from randomized controlled trials (RCTs) remain inconclusive, possibly due to differences in vitamin K isoforms, dosage, intervention duration, and study populations. Beyond age-related sarcopenia, vitamin K may also play a potentially protective role in muscle dysfunction associated with chronic diseases, including dialysis-related cramps and metabolic disorders. This review synthesizes recent mechanistic insights and clinical evidence, highlighting vitamin K as a biologically plausible contributor that is supported primarily by observational and mechanistic evidence for the prevention and management of sarcopenia and other muscle-related disorders, though its role remains incompletely validated.

Childhood stunting is a condition resulting from chronic malnutrition affecting millions globally, with lasting consequences for growth, cognition, and productivity. This review explores the molecular mechanisms underlying stunting, focusing on evidence obtained from systems biology to uncover biochemical pathways and potential biomarkers for early detection and targeted interventions. Key findings highlight the role of disrupted pathways such as the mechanistic target of rapamycin (mTOR) signaling, the tryptophan-kynurenine pathway, one-carbon metabolism, and chronic inflammation associated with environmental enteric dysfunction and dysbiosis of the gut microbiome. These insights emphasize the multifactorial nature of stunting, influenced by nutrition, infections, socioeconomic and maternal factors. Integrating systems biology to support public health strategies may provide avenues for precision nutrition-driven interventions that address specific deficiencies and systemic biochemical disturbances.

Background: Sepsis is a life-threatening condition often complicated by organ dysfunction and is associated with a high mortality rate. The dysregulation of immune response, inflammation, and nutritional status are critical factors contributing to its pathogenesis. This study aimed to develop a nomogram that integrates prognostic immune-inflammatory-nutritional indicators with other clinical information to predict 28-day mortality in sepsis patients with acute respiratory distress syndrome (ARDS).

Methods: Clinical data from 635 adult sepsis patients with ARDS were obtained from Shaanxi Provincial People's Hospital and randomly divided into a training set (n = 477) and a validation set (n = 158). To identify predictors of 28-day mortality in sepsis patients with ARDS, univariate analysis, and least absolute shrinkage and selection operator (LASSO) regression were utilized. Subsequently, a multivariate logistic regression model was constructed to identify independent predictors. A nomogram was then developed by integrating the selected indicators. The model's performance was assessed with respect to discrimination, calibration, and clinical utility through the use of the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA).

Results: The independent predictors utilized for the construction of the nomogram included the albumin-alkaline phosphatase ratio (AAPR), albumin-bilirubin grade (ALBI), neutrophil-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and lactate-albumin ratio (LAR). Notably, the nomogram exhibited superior predictive performance, with an AUC of 0.873 in the training set and 0.837 in the validation set, as compared to the SOFA score, which showed an AUC of 0.689 in the training set and 0.684 in the validation set, for predicting 28-day mortality in sepsis patients with ARDS. The calibration plots demonstrated excellent consistency. DCA confirmed the model's clinical utility, showing a positive net benefit across a wide range of clinically relevant threshold probabilities (approximately 10% to 70%), which supports its potential to guide clinical decision-making.

Conclusion: We have successfully developed and validated a robust nomogram that integrates seven readily accessible immune-inflammatory-nutritional indicators. This model serves as an individualized and precise tool for predicting the 28-day mortality risk in sepsis patients with acute respiratory distress syndrome (ARDS), thereby potentially enhancing early risk stratification and informing clinical decision-making.

Background: Plant-based diets have been demonstrated to be associated with lower risk of several chronic diseases. However, a comprehensive assessment of plant-based diet quality and its association with heart failure (HF) is limited. This study aimed to investigate whether healthful and unhealthful plant-based dietary patterns are associated with overall HF risk among middle-aged and older adults in the United Kingdom.

Methods: We included a total of 190,092 UK Biobank participants without HF at baseline. Three plant-based diet indices were calculated using 24-h dietary recalls based on 17 food groups: the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Multivariable Cox regression models were applied to assess the association between these indices and incident HF.

Results: Over a median follow-up of 13.04 years, 4,351 cases of new-onset HF were recorded. Compared to the lowest tertile, the multivariable-adjusted hazard ratios (HRs) with 95% confidence interval (CI) for HF in the highest tertile were 0.94 (0.88-1.02) for overall PDI, 0.84 (0.78-0.91) for hPDI, and 1.11 (1.03-1.19) for uPDI.

Conclusion: A higher intake of healthful plant-based diets was associated with a lower risk of HF, while follow unhealthful plant-based diet was linked to a higher overall HF risk. Adhering to a high-quality diet primarily based on healthy plant-based foods may be helpful prevent HF.

Objective: To examine meteorological factors associated with maternal vitamins D, A, and E and their associations with delivery and neonatal outcomes in central China.

Methods: In this retrospective cross-sectional analysis of 10,824 third-trimester women who delivered at 37 weeks or later in Wuhan (2020-2023), serum vitamin levels were measured by high-performance liquid chromatography. Daily temperature, humidity, precipitation, and wind speed were matched to individual blood collection dates. Multivariable logistic regression and restricted cubic spline models were used to evaluate associations with fetal distress, meconium-stained amniotic fluid, premature rupture of membranes (PROM), low birth weight, and macrosomia.

Results: Vitamin D deficiency (30.2%), vitamin A deficiency (5.5%), and vitamin E excess (41.8%) were common. Each 1 °C increase in ambient temperature was associated with lower odds of vitamin D deficiency (aOR 0.970, p < 0.001) and vitamin A deficiency (aOR 0.976, p = 0.008), with significant temperature-humidity and temperature-wind interactions (p < 0.001). Vitamin A deficiency was associated with higher odds of PROM (aOR 1.76, 95% CI 1.44-2.14), whereas low or moderate vitamin D and A levels were associated with lower odds of fetal distress and meconium staining (aOR approximately 0.85, p < 0.05). Vitamin A deficiency was associated with markedly higher odds of macrosomia (aOR 3.14), and vitamin E excess was associated with a 60% increase in odds (aOR 1.60). Restricted cubic spline models revealed U-shaped associations between vitamin A and low birth weight, and between vitamin D and macrosomia.

Conclusion: Ambient temperature emerged as the primary meteorological factor associated with maternal vitamin status. Both deficiency and excess were associated with adverse delivery and neonatal outcomes, supporting the need for population-specific optimization beyond deficiency prevention.