Journal of Health, Population, and Nutrition最新文献

Background: This umbrella meta-analysis evaluates the effects of probiotics on cognitive function and metabolic health in Alzheimer's disease (AD) and mild cognitive impairment (MCI) by synthesizing findings from meta-analyses of randomized controlled trials (RCTs), as existing evidence remains inconclusive.

Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus to identify meta-analyses of RCTs investigating the impact of probiotic supplementation on cognitive function and metabolic biomarkers. The random-effects model was used. Heterogeneity and publication bias were assessed.

Results: Thirteen meta-analyses, comprising 3910 patients, were included. Probiotics significantly improved cognitive function in AD (SMD = 0.78, 95% CI: 0.33 to 1.23) and MCI (SMD = 0.43, 95% CI: 0.15 to 0.70). Probiotics also increased total antioxidant capacity (SMD = 0.40, 95% CI: 0.11 to 0.70) and reduced MDA (SMD =  - 0.35, 95% CI: - 0.62 to - 0.09) and hs-CRP (SMD =  - 0.59, 95% CI: - 0.87 to - 0.30). Insulin resistance improved, as reflected by decreased HOMA-IR (SMD =  - 0.34, 95% CI: - 0.43 to - 0.26). No significant effects were observed on glutathione, nitric oxide, or lipid profiles.

Conclusion: Probiotic supplementation appears to enhance cognitive function and metabolic parameters in individuals with MCI and AD, likely through mechanisms involving inflammation reduction, oxidative stress modulation, and improved insulin sensitivity. Further high-quality RCTs are required to validate these findings and determine optimal probiotic formulations.

Background: To assess and rank the comparative effects of different exact macronutrient compositions for type 2 diabetes management rather than examining single macronutrients or as a dietary pattern.

Methods: PubMed, Scopus, and Cochrane Library Central Register of Controlled Trials were searched. Randomized controlled trials were included. A random-effects network meta-analysis with a Bayesian framework was performed to calculate the mean difference (MD) and 95% credible intervals (CrIs). The certainty of evidence was rated using the GRADE approach.

Results: 80 trials with 9232 patients with type 2 diabetes were included in the network meta-analysis. A very low-carbohydrate, high-protein, and calorie-restricted diet had the greatest effect on reducing HbA_1c (range of mean difference: - 1.0% to - 1.79%), weight (range of mean difference: -5.83 kg to -10.96 kg), and FPG (range of mean difference: - 2.20 mmol/L to - 2.88 mmol/L) at 6-month follow-up, but at 12-month follow-up, the effect remained only for HbA_1c (range of mean difference: - 1.25% to - 1.30%) and FPG (range of mean difference: - 1.21 mmol/L to - 1.27 mmol/L). For weight loss in 12-month follow-up, the low-carbohydrate, high-protein diet was probably the most effective approach (range of mean difference: - 10.05 kg to - 14.52 kg). The best dietary approach to reduce LDL at 6-month follow-up was a low carbohydrate, high protein, calorie-restricted diet (range of mean difference: - 0.49 mmol/L to - 0.59 mmol/L) and at 12-month follow-up, a moderate carbohydrate, standard protein, calorie-restricted diet was effective in reducing LDL (mean difference: - 0.87 mmol/L, 95%CrI - 1.55 to - 0.16).

Conclusions: A very low carbohydrate, high protein, calorie-restricted diet can be an effective dietary composition in managing diabetes, but milder dietary carbohydrate restriction for weight loss in the long-term, and improving lipid profiles is needed.

Background: Assessing vitamin A (VA) status using retinol and retinol-binding protein (RBP) in the presence of infection and inflammation remains challenging, as both markers prove to be unreliable during such physiological disturbances.

Objective: This study aimed to assess the association between common infections and inflammation and VA status of children in rural Burkina Faso.

Methods: Two community-based cross-sectional studies were conducted in the villages of Sourkoudougou and Banakeledaga, in Southwestern Burkina Faso, one during the dry season (November 2016- January 2017) and the second during the rainy season (August- September 2017). In total, 115 children, 36-59 months of age, were included. The ¹³C-retinol isotope dilution test (RID) was used to assess total body VA stores (TBS) and VA total liver reserves (TLR). Malaria infection and intestinal parasites were evaluated at enrollment. Serum C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) were measured. Univariable and multivariable linear regressions were used to test the associations between VA status and infection and inflammation status.

Results: No VA deficiency (TLR ≤ 0.1 µmol/g liver) was detected using RID method. Geometric means (95% confidence interval) of TBS and TLR were respectively 473 (412; 543) µmol and 0.86 (0.75; 0.99) µmol/g liver. One-third of study participants were found to have hypervitaminosis A (TLR > 1.0 µmol/g liver). Elevated CRP (> 5.0 mg/L) and AGP (> 1.0 g/L) were respectively detected in 1.9% and 28.6% of children. Positive malaria was diagnosed in 5 children. Intestinal parasites were found in one out of two (47.6%) participants, and other morbidities were detected in 2 participants. In a multivariable adjusted regression, significant positive weak associations were found between Log TLR and CRP concentrations (N = 79, β = 0.058, p = 0.004) and between Log TBS and CRP concentrations (N = 79, β = 0.054, p = 0.005).

Conclusion: Study children were apparently healthy with high prevalence of asymptomatic intestinal parasites and chronic inflammation. TLR and TBS were positively associated with the acute phase protein CRP warranting further investigation.

Trial registration: The study was registered retrospectively (22 March 2018) as a clinical trial with the Pan African Clinical Trials Registry (Cochrane South Africa; PACTR201803002999356).

Objective: This study aimed to assess the relationship between magnesium depletion score (MDS) and overactive bladder (OAB) prevalence.

Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Multivariate logistic regression was employed to investigate the association between MDS and OAB. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between MDS and OAB. Interaction analyses were conducted on subgroups to validate the findings.

Results: There was a significant positive association between MDS and OAB. After adjusting for covariates, with each unit increase in MDS, there was an 11% increase in the prevalence of infertility (P < 0.001). In addition, the incidence of OAB was significantly increased in the higher MDS group compared to the low MDS group (MDS = 0) (P for trend < 0.001). The dose-response curve indicated a linear association between MDS and OAB, with higher MDS associated with higher OAB.

Conclusion: The results of this study show a strong positive correlation between MDS and the prevalence of OAB. These findings suggest that monitoring and managing magnesium status may be a potential strategy for reducing the risk of OAB.

Background: The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD.

Methods: We obtained participant-related data from the National Health and Nutrition Examination Survey (NHANES), including complete information on DKD, CMI, and other covariates. We employed weighted multivariable logistic regression models, restricted cubic spline (RCS) regression analysis, subgroup analyses, and interaction tests to explore the relationship between CMI and DKD. Additionally, we utilized receiver operating characteristic (ROC) curves to compare the performance of CMI in identifying DKD relative to a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), and lipid accumulation product (LAP) indices.

Results: According to the logistic regression analysis, a positive correlation between CMI and DKD was observed among the 2371 participants included in the study (OR: 1.40, 95% CI: 1.19-1.66). RCS analysis indicated that this relationship is nonlinear. When CMI was converted from a continuous variable to quartiles, the prevalence of DKD in the highest quartile group showed a significant 84% increase compared to the lowest quartile group (OR: 1.84, 95% CI: 1.24-2.72). The area under the ROC curve of CMI for identifying DKD was 0.67, outperforming other indices. The results of subgroup analyses and interaction tests were stable.

Conclusion: Elevated CMI is associated with an increased risk of DKD and can serve as a low-cost screening tool, allowing physicians to potentially identify high-risk diabetic patients early and implement timely interventions to slow the progression of DKD.

Objective: Chronic bronchitis and emphysema (CBE) are two main types of chronic obstructive pulmonary disease (COPD). We aimed to investigate the relationship between dietary calcium intake and the risk of CBE.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. The ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) < 0.7 was used to define airflow obstruction. Multivariate logistic regression was performed to assess the effects of dietary calcium intake on CBE and airflow obstruction. Dietary calcium intake was divided into quartiles, with the lowest quartile set as the reference group. Linear regression models were applied to explore the association between dietary calcium intake and lung function.

Results: A total of 10,143 participants were enrolled in the study, including 594 CBE and 9549 non-CBE individuals. The average dietary calcium intake was 908.5 ± 636.1 mg/day in the CBE group and 951.9 ± 599.7 mg/day in the non-CBE group. When using the lowest quartile of dietary calcium intake as a reference, the second, third, and fourth quartiles reduced the risk of CBE by 0.803 [95% confidence interval (CI): 0.802-0.804; P < 0.001], 0.659 (95% CI: 0.659-0.660; P < 0.001) and 0.644 (95% CI: 0.643-0.644; P < 0.001) times, respectively. Increased dietary calcium intake was correlated with reduced risk of airflow obstruction. Dietary calcium intake positively predicts FEV1 (β = 0.225, P < 0.001) and FVC (β = 0.232, P < 0.001).

Conclusion: Increased intake of dietary calcium may contribute to higher lung function, a lower risk of CBE and airflow obstruction. Since the cross-sectional design makes it difficult to determine a causal relationship, further research is needed to confirm these findings and explore the underlying mechanisms.

Background: Bacterial infections in pregnancy pose significant health risks in East Africa. This study estimates pooled prevalence and identifies key risk factors, addressing limited data to improve maternal health outcomes in the region.

Methods: This study employed a systematic review and meta-analysis, analyzing data from eight East African studies (2016-2021). Searches spanned PubMed, Embase, Scopus, and more, with manual reference checks. Data quality was assessed via the Newcastle-Ottawa Scale. RevMan software with a random-effects model estimated pooled prevalence and hazard ratios for risk factors.

Results: A pooled analysis of antimicrobial resistance (AMR) bacterial isolates from pregnant women in East Africa highlights concerning prevalence rates of various pathogens. Escherichia coli emerged as the most common pathogen, present in 43% (95% CI: 37-48%) of cases, followed by Staphylococcus aureus at 20% (95% CI: 0.12, 0.29) and Corynebacterium, Enterococcus, and Nocardia species (CONs) in 16% (95% CI: 10-23%) and 16% (95% CI: 12-21%) (Prevalence of K. pneumoniae). A very small proportion 6% (95% CI: 2 - 11%) was found to be infected with Pseudomonas aeruginosa. The forest plot highlights risk factors for infections in pregnant women in East Africa: antibiotic use (HR: 2.0, 95% CI: 1.5-2.6), smoking (HR: 1.3, 95% CI: 1.0-1.6), poor sanitation (HR: 1.8, 95% CI: 1.2-2.4), diabetes (HR: 2.1, 95% CI: 1.5-2.8), and age > 30 years (HR: 1.5, 95% CI: 1.1-2.0).

Conclusions: This analysis reveals a significant prevalence of bacterial infections, particularly Escherichia coli, among pregnant women in East Africa, with antimicrobial resistance (AMR) complicating treatment. The study identified several key risk factors, including antibiotic use, smoking, poor sanitation, diabetes, and age over 30, which are associated with higher rates of infection. While these findings emphasize the need for further research, the results suggest that routine bacterial screening, AMR surveillance, improved sanitation, and antibiotic stewardship are important steps in mitigating the impact of these infections. Public health strategies should prioritize high-risk groups, encourage hygiene practices, and continue to guide policy and interventions through ongoing studies.

Sturge-Weber Syndrome (SWS), is a rare neuro-oculo-cutaneous disorder that presents unique diagnostic and management challenges, particularly in resource-limited settings. This editorial reflects on a recent case of an undiagnosed SWS in an Ethiopian refugee patient in Sudan, highlighting systemic barriers to healthcare access during a time of war and the importance of clinical vigilance. We advocate for local and global initiatives to further enhance diagnostic capabilities, develop integrated care systems in recognition and management of such a rare and complex condition.

A current investigation was performed to review and summarize the results of randomized clinical trials (RCTs) studies that have assessed the effectiveness of fasting regimens (FRs) including intermittent fasting (IF), time-restricted feeding (TRF), alternate day fasting (ADF) and fasting-mimicking diet (FMD) on some weight regulation hormones included; leptin, adiponectin, ghrelin, and resistin in healthy, overweight and obese adults recently. Four databases have been reviewed until June 2024 using keywords related to the subject of the study. Overall, 16 documents were considered in this study. Based on Pooled effect sizes, the FRs marginal significantly increased the level of adiponectin (weighted mean differences (WMD): 0.41 µg/ml, 95% confidence interval (CI): - 0.07 to 0.89, P: 0.09) and also significantly decreased the level of leptin (WMD: - 2.65 ng/ml, 95% CI: - 3.86 to - 1.44, p < 0.001) and ghrelin (WMD: - 0.57 ng/ml, 95% CI: - 1.01 to - 0.03, P: 0.01). There was no significant effect of this regimen approach on resistin levels. In general, according to this evaluation, FRs have a beneficial impact on weight-regulating hormone levels, still the long-term effects of these dietary approaches should also be evaluated in future studies.

Background: The prevalence of malnutrition in hospitalized patients continues to be high across countries, including Ethiopia. Although Nurses have key role to provide nutritional care, their practice is unknown in Ethiopia.

Objective: we aimed to assess nurses' nutritional care practice and associated factors for hospitalized surgical patients in Bahir Dar city.

Methods: An institution based cross-sectional study was conducted among 422 nurses in Bahir Dar City referral hospitals from February 1 to March 1/ 2023. Participants were selected by trained data collectors using simple random sampling. Data was collected using structured, self-administered and pre-tested tool and entered into Epi-info 7 & exported to SPSS version 23 for analysis. Multiple binary logistic regression used to identify factors and p-value of < 0.05 used to determine significant association with 95% CI odds ratio.

Result: In this study, 410 of 422 nurses were participated. Overall, 143 (35%) 95% CI: 30.5, 39.8) of nurses had good practice on the nutritional care. Female nurses (AOR = 2.69, 95% CI, 1.62, 4.44), nutrition guidelines (AOR = 2.59, 95% CI, 1.52, 4.39), physician order (AOR = 1.82 95% CI, 1.11, 3.00), experience sharing with peers (AOR = 1.74, 95%CI 1.05, 2.87) nurse to patient ratio < 1:5 (AOR = 1.75, 95%CI, 1.01, 3.02), were positively associated with their practice. But, poor knowledge (AOR = 0.50, 95%CI, 0.30, 0.83), and unfavorable attitude (AOR = 0.51 95%CI, 0.30, 0.84) were negatively associated with their practice.

Conclusion: The practice of nurses in nutritional care was low. Gender, access to nutritional information sources, physician orders, nurses to patient ratio, knowledge, and attitude of nurses were factors associated with their practice. Therefore; training, guideline access, experience sharing, and increasing nursing staff is crucial to provide optimal nutritional care for hospitalized patients.