Frontiers in Nutrition最新文献

Introduction: Micronutrients have significant functional implications for the human immune response, and the quality of food is a major factor affecting the severity and mortality caused by HIV in individuals undergoing antiretroviral therapy. A decrease in CD4 lymphocyte count and an increase in CD8 lymphocyte count are the hallmarks of HIV infection, which causes the CD4/CD8 ratio to invert from a normal value of >1.6 to <1.0. In this study, we tried to analyze whether the nutritional status of HIV-positive patients has an impact on the CD4/CD8 ratio inversion by utilizing a machine learning (ML) algorithm.

Methods: In this study, 55 confirmed HIV-positive patients who had not started their anti-retroviral therapy were included after obtaining their informed, written consent. Moreover, 55 age-and sex-matched relatives and caregivers of the patients who tested negative in the screening were enrolled as controls. All individual patient data points were analyzed for model development with an 80-20 train-test split. Four trace elements, zinc (Zn), phosphate (P), magnesium (Mg), and calcium (Ca), were utilized by implementing a random forest classifier. The target of the study was the inverted CD4/CD8 ratio.

Results: The data of 110 participants were included in the analysis. The algorithm thus generated had a sensitivity of 80% and a specificity of 83%, with a likelihood ratio (LR+) of 4.8 and LR-of 0.24. The utilization of the ML algorithm adds to the limited evidence that currently exists regarding the role of micronutrients, especially trace elements, in the causation of immune risk. Our inherent strength lies in the fact that this study is one of the first studies to utilize an ML-based decision tree algorithm to classify immune risk in HIV patients.

Conclusion: Our study uniquely corroborated the nutritional data to the immune risk in treatment-naïve HIV patients through the utilization of a decision tree ML algorithm. This could subsequently be an important classification and prognostic tool in the hands of clinicians.

Objective: In addition to recent discussions of low-carbohydrate, high-fat diets (LCHF) from a performance perspective, there is a paucity of knowledge regarding influence of the combined effect of an exercise and nutritional intervention, which varies in carbohydrate (CHO) intake and glycemic indices, on blood lipid levels in recreationally active men.

Methods: A total of 65 male runners (VO₂ peak = 55 ± 8 mL·min^-1·kg^-1) completed a 10-week ad libitum nutritional regimen (LOW-GI: ≥ 65% low GI CHO per day, n = 24; HIGH-GI: ≥ 65% high GI CHO per day, n = 20; LCHF: ≤ 50 g CHO daily, n = 21) with a concurrent prescribed endurance training intervention. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined before and after the intervention. Additionally, 24-h dietary recalls were completed twice weekly.

Results: Following the intervention, TC was significantly higher in LCHF (196 ± 37 mg·dL^-1) compared to both LOW-GI (171 ± 41 mg·dL^-1) and HIGH-GI (152 ± 28 mg·dL^-1, p < 0.001). Additionally, LDL-C levels increased in LCHF (+17 ± 21 mg·dL^-1, p = 0.001), while they decreased in both CHO groups (p < 0.05, respectively). Only the HIGH-GI group demonstrated a significant reduction in HDL-C (-3 ± 9 mg·dL^-1, p = 0.006), while a decrease in TG was only significant in LOW-GI (-18 ± 36 mg·dL^-1, p = 0.008).

Conclusion: Although mean blood lipid levels remained within the normal range, the data indicate that a low-carbohydrate, high-fat (LCHF) diet leads to unfavorable changes in individual blood lipid profiles compared to carbohydrate-rich diets. Therefore, it is recommended that the impact of a low-carbohydrate diet on blood lipids be considered when counseling active and healthy individuals.

Background: Over the past 23 years, there has been a thorough analysis of literature concerning nutritional interventions, nutrients, and feeding approaches related to stroke. Furthermore, a scientific knowledge map was established, elucidating the current state of research, examining its development and trends, and offering new research viewpoints for the future. This study aimed to investigate global and emerging research trends in nutritional interventions for stroke from 2000 to 2023 through bibliometric analysis.

Methods: A bibliometric analysis of literature from the Core Collection of Scientific Networks for the years 2000-2022 was conducted. CiteSpace, VOSviewer, and bibliometric graphical software were used to identify major contributors to publications, including authors, countries, institutions, journals, references, and keywords.

Results: The bibliometric analysis yielded a total of 464 publications. This is a gradually increasing number in terms of the number of publications during the study period. China had the highest number of publications. Clinical Nutrition" was the journal with the highest number of relevant publications, and the most commonly used keywords were "stroke," "nutrition" and "malnutrition."

Conclusion: These analyses reveal research trends in nutritional therapy for stroke from 2000 to 2023 and point to prospective research frontiers. This study provides a deeper understanding of what nutritional treatment of stroke entails and provides guidance and support for future research in this area.

Background: Anemia represents a significant global health issue affecting numerous children and women, characterized by diminished hemoglobin levels that may impede cognitive and developmental progress. Although commonly attributed to iron deficiency, the etiology of anemia in this demographic is multifaceted, encompassing nutritional, genetic, and infectious contributors. Nonetheless, there is a lack of high-quality data on anemia prevalence and causes analysis among children under 5 years. The aim of this study was to provide a comprehensive global assessment of the burden of anemia and its causes among children under 5 years, using data from the Global Burden of Disease Study 2019.

Methods: This investigation utilized data from the Global Burden of Disease Study (GBD) 2019 to assess the prevalence and years lived with disability (YLD) attributable to anemia in children under five from 1990 to 2019. Analyses were conducted to delineate age-specific YLD, prevalence rates, and etiological factors, with stratification by gender and Socio-Demographic Index (SDI).

Results: In 2019, anemia imposed a substantial global burden on children under five, with a reported YLD of 1,252.88 (95% UI: 831.62-1,831.34) per 100,000 population. The prevalence of moderate anemia was highest at 985.46 (95% UI: 646.24-1,450.49) per 100,000, surpassing both severe anemia at 197.82 (95% UI: 132.53-277.80) per 100,000 and mild anemia at 69.59 (95% UI: 24.62-152.53) per 100,000. Globally, the total prevalence was 39,517.75 (95% UI: 38,784.81 - 40,239.62) cases per 100,000 population. Notably, disparities were evident between genders, with males demonstrating higher YLD and prevalence rates than females. Iron deficiency emerged as the leading cause globally, with significant contributions from hemoglobinopathies and other nutritional deficiencies. Regions with a low Socio-Demographic Index, particularly sub-Saharan Africa and South Asia, exhibited the most pronounced burdens. Despite a declining trend over three decades, persistent regional and gender-based disparities highlight the necessity for continuous and focused public health interventions.

Conclusion: The burden of anemia among children under five continues to be considerable, marked by stark regional and socioeconomic disparities. These findings underscore the urgent need for advanced nutritional and healthcare strategies tailored to alleviate anemia in this vulnerable population, with a particular emphasis on regions exhibiting low SDIs. The sustained prevalence of high anemia rates in these areas underscores the imperative for persistent, localized intervention efforts.

Organizations and initiatives concerned with food security and nutrition have long positioned protein, together with dietary energy, as the keystone for life itself. Indeed, the word protein, derived from the Greek proteios, means 'of primary importance'. There is a long history of attention to, and controversies over, proteins in UN processes, beginning in the 1930s and continuing to this day. The importance of protein for agriculture, health, food security and nutrition is reflected in the data collected and presented in the statistical databases of the Food and Agriculture Organization (FAOSTAT), available per commodity, per country and over an extensive time series. Protein features directly and indirectly in all 17 Sustainable Development Goals (SDG), which constitute the United Nations 2030 Agenda. Most directly involved is SDG 2. The short title for SDG 2 is 'zero hunger'. The long title offers more detail: end hunger, achieve food security and improved nutrition and promote sustainable agriculture.

Introduction: Coronary artery disease (CAD) is an important public health problem with negative impacts on individual health and socioeconomics. Studies on the relationship of dietary vitamin A (DVA) to CAD are limited and conflicting. The purpose of this study was to investigate the relationship between DVA and the prevalence of CAD in U.S. adults, with particular interest in sex differences.

Methods: Data from 26,449 NHANES participants were used for analysis. The association of DVA with the prevalence of CAD was investigated utilizing multivariate logistic regression models and fitted smoothed curves, and interaction tests were performed to explore potential modifiers.

Results: This study included 12,748 males and 13,701 females aged 50.34 ± 17.54 years. Overall, adjusted DVA was linearly negatively correlated with CAD (per natural ln (DVA) increment: OR 0.91, 95% CI 0.83-0.99). Multivariate regression analysis showed that among female participants, each natural increment of ln DVA was associated with a 22% reduction in CAD prevalence (OR 0.78, 95% CI 0.68-0.89). However, there was no significant correlation in male participants (p for interaction <0.001).

Conclusion: DVA was negatively associated with the prevalence of CAD, and further analysis revealed an interaction between DVA and sex in terms of CAD prevalence.

Objective: The ketogenic diet (KD) has been explored for diabetes management; however, a quantitative synthesis of its specific effects on diabetes has not yet been conducted. This study aims to examine the current status and research hotspots of KD in diabetes management from 2005 to 2024, providing a reference for future research.

Methods: We retrieved articles published between 2005 and 2024 from the Web of Science database and analyzed them using R software, VOSviewer, and CiteSpace.

Results: This study includes 432 relevant publications. From 2005 to 2024, the volume of literature in this field has shown a steady upward trend, with a notable increase from 2017 to 2021, and a slight decline observed from 2021 to 2023. The United States is the leading country in terms of the number of publications, followed by China, Australia, and Canada. The United States not only leads in publication volume but also maintains a broader international collaboration network. Nutrients and the American Journal of Clinical Nutrition are the most frequently published and cited journals. Current research hotspots primarily focus on the impact of KD on blood glucose control, insulin resistance, and lipid metabolism in diabetic patients. Mechanistic studies on KD in diabetes management concentrate on aspects such as the "regulation of genes by β-hydroxybutyrate," "anti-inflammatory effects," and "oxidative stress." The role of the gut microbiome is also emerging as an important research area. Currently, exploring the application of KD in managing different age groups and types of diabetes has become a significant research trend.

Conclusion: As an emerging dietary intervention, KD is gradually attracting widespread attention from researchers around the world and is expected to become a major research focus in the future for diabetes management and control. This paper provides a systematic review and analysis of the current research status and hotspots of KD in diabetes management, offering important references and insights for future research in related fields.

Background: The relationship between vegetarianism and mental well-being remains a debated topic in traditional observational studies. Recent studies have revealed the genetic factors in vegetarianism. We aimed to use genetic variations to explore the potential causal relationships between vegetarianism and mental well-being, offering insights from a new perspective.

Methods: We conducted the inverse variance weighted approach as the primary analysis to explore the bidirectional genetic associations between vegetarianism (N = 442,589) and depressive symptoms (N = 180,866), neuroticism (N = 170,910), and subjective well-being (N = 298,420). The analysis used the summary data from the largest genome-wide association studies (GWAS). We also performed sensitivity analyses to ensure the robustness of the findings, accounting for potential heterogeneity and pleiotropy.

Results: Genetically predicted vegetarianism showed positive causal relationships with depressive symptoms (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.03-10.31; p = 0.044) and neuroticism (OR, 6.72; 95% CI, 2.29-19.74; p = 5.31 × 10^-4), as well as a negative causal relationship with subjective well-being (OR, 0.20; 95% CI, 0.05-0.77; p = 0.019). Additionally, depressive symptoms were found to have a causal influence on vegetarianism (OR, 1.01; 95% CI, 1.00-1.02; p = 6.87 × 10^-3). No significant heterogeneity or pleiotropy was detected.

Conclusion: Vegetarianism is causally correlated with negative mental well-being, reflected in an increased risk of depressive symptoms and neuroticism, as well as lower subjective well-being. Further research should explore the underlying mechanisms in broader populations.

Introduction: Adolescent athletes are at higher risk of developing eating disorders (ED) due to sports environment pressures and developmental characteristics. The ERASMUS+ project Sports Community against Eating Disorders (SCAED) aims to assess the prevalence of the potential risk of eating disorders among young, unprofessional European athletes and to provide them with easier access to professional support and knowledge.

Methods: The online survey included 462 unprofessional athletes from six European countries aged 12-25 (average age 18.49 ± 5.50) on their socio-demographics, sports and lifestyle habits, behaviors, concerns, and perceived pressure from coaches and teammates regarding body weight and shape. The eating disorder potential risk was assessed using the Eating Disorder Examination for Adolescents (EDE-A) and Eating Disorders Screen for Athletes (EDSA).

Results: Every seventh (14.9%, EDE-A) and fifth (19.9%, EDSA) of young, unprofessional European athletes were at possible risk for developing eating disorders. Overall potential risk (18.7% EDE-A, 26.6% EDSA), dietary restraint (12.9%), and concerns about eating (9.5%), shape (23.7%), and weight (19.6%) were significantly more prevalent among female athletes. Younger athletes showed a slightly higher prevalence and avoidance of food. Athletes training in weight-sensitive sports exhibited more behaviors related to eating disorders. Females (p = 0.003), younger, and those athletes training in less weight-sensitive sports noted higher weight- and shape-related pressure from coaches. Dissatisfaction with their current weight was expressed by 44.6% of athletes, while 46.1% thought that they needed to lose weight to improve performance.

Conclusion: The observed prevalence of the potential risk of ED among young, unprofessional European athletes is concerning, particularly due to limited access to support. Efforts to reduce the prevalence should target female and younger athletes in weight-sensitive sports. The SCAED Erasmus+ project aims to decrease ED prevalence among young, unprofessional European athletes, their families, and coaches by supporting them through education and professional consultation.

Background: Patients with severe Coronavirus Disease 2019 (COVID-19) can experience protein loss due to the inflammatory response and energy consumption, impairing immune function. The presence of excessive visceral and heart fat leads to chronic long-term inflammation that can adversely affect immune function and, thus, outcomes for these patients. We aimed to explore the roles of prognostic nutrition index (PNI) and quantitative fat assessment based on computed tomography (CT) scans in predicting the outcomes of patients with severe COVID-19.

Methods: A total of 130 patients with severe COVID-19 who were treated between December 1, 2022, and February 28, 2023, were retrospectively enrolled. The patients were divided into survival and death groups. Data on chest CT examinations following admission were collected to measure cardiac adipose tissue (CAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) and to analyze the CT score of pulmonary lesions. Clinical information and laboratory examination data were collected. Univariate and multivariate logistic regression analyses were used to explore the risk factors associated with death, and several multivariate logistic regression models were established.

Results: Of the 130 patients included in the study (median age, 80.5 years; males, 32%), 68 patients died and 62 patients survived. PNI showed a strong association with the outcome of severe COVID-19 (p < 0.001). Among each part of the fat volume obtained based on a CT scan, SAT showed a significant association with the mortality of severe COVID-19 patients (p = 0.007). However, VAT and CAT were not significantly correlated with the death of patients. In the multivariate models, SAT had a higher predictive value than PNI; the area under the curve (AUC) of SAT was 0.844, which was higher than that of PNI (AUC = 0.833), but in the model of the combination of the two indexes, the prediction did not improve (AUC = 0.830), and SAT lost its significance (p = 0.069).

Conclusion: Subcutaneous adipose tissue measured by computed tomography and PNI were found to be independent predictors of death in patients with severe COVID-19.