Journal of Health, Population, and Nutrition最新文献

Purpose: The Oxidative Balance Score (OBS) is a composite measure of systemic oxidative stress. This study aims to evaluate the impact of OBS on all-cause mortality in patients with cardiovascular disease-cancer comorbidity and to use machine learning to identify related factors.

Methods: We analyzed data from the 2007-2018 US National Health and Nutrition Examination Survey (NHANES). Cox regression, Kaplan-Meier analysis, restricted cubic splines (RCS), and subgroup analysis were used to explore the association between OBS and CVD-cancer comorbidity. Five machine learning models were constructed and compared to identify the optimal CVD-cancer comorbidity risk prediction model, and feature importance was assessed.

Results: Among the study participants, compared to participants in the lowest tertile of the OBS score, those in the highest tertile exhibited a lower risk of all-cause mortality (HR = 0.78, 95% CI: 0.64-0.95, p = 0.016). RCS showed that OBS had a no nonlinear evidences with CVD-cancer comorbidity. In subgroup analyses, the association remained consistent across all subgroups, with no statistically significant interaction observed (all P for interaction > 0.05). The random forest algorithm was identified as the optimal predictive model through machine learning evaluation. Decision curve analysis (DCA) and calibration curves further supported the internal validity of the model. SHAP analysis revealed that age, smoking intensity, niacin intake, and selenium levels were the most influential predictive factors.

Conclusions: This study demonstrates a significant inverse association between higher OBS and all-cause mortality in patients with cardiovascular disease-cancer comorbidity and provides an interpretable machine learning model to predict this comorbidity.

Background: The specific objectives of this paper are to identify Slovenian global health activities, compare the national global health strategies of France, Germany, and the Netherlands with the European Union Global Health Strategy, and assess how well Slovenia's global health activities align with the strategies of these three countries.

Methods: A document review of Slovenia's global health engagement was conducted using official reports, policy briefs, and legislative texts, analysed through predefined thematic areas. A comparative policy analysis assessed the alignment and divergence of health strategies of France, Germany, and the Netherlands with the European Union Global Health Strategy.

Results: The study identifies 14 key thematic areas in global health (e.g., health for all, health policy, climate change, etc.). In Slovenia, global health activities involve various governmental and non-governmental institutions across all identified thematic areas, implemented through guidelines, legislative acts, programs, projects, and initiatives. These thematic areas are also reflected in global health strategies of France, Germany and the Netherlands, indicating a shared focus on key global health priorities across national frameworks (e.g. universal health coverage, climate change, and disease prevention).

Conclusions: The comparative analysis of three reviewed national global health strategies reveals diverse national approaches to global health, tailored to specific priorities while maintaining alignment with European Union Global Health Strategy's objectives, and highlights the importance of cross-sector collaboration in fostering policy coherence. Although Slovenia lacks an official Global Health Strategy, its existing activities comprehensively address all thematic areas outlined in the European Union Global Health Strategy, demonstrating strong alignment with European Union priorities. By leveraging European Union frameworks, Slovenia ensures policy coherence while avoiding the resource-intensive development of a separate strategy. Strengthening international collaboration, enhancing policy coherence, and improving evaluation mechanisms could further optimize Slovenia's role in global health.

Background: Evidence on the relationship between dietary fat intake and bone mineral density (BMD) remains inconsistent, particularly regarding sex- and site-specific differences in femoral bone health among older adults.

Methods: This cross-sectional study analyzed data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) to explore associations between dietary fat intake and femoral BMD in U.S. adults aged ≥ 50 years. Femoral BMD at four anatomical sites (total femur, neck, trochanter, intertrochanteric region) was measured using dual-energy X-ray absorptiometry (DXA). A high-fat diet was defined as > 35% of total energy intake from fat (%E). Sex-stratified, survey-weighted multivariable logistic regression models were applied to examine associations with osteopenia/osteoporosis after adjustment for relevant covariates.

Results: Among 1,127 adults aged ≥ 50 years (612 men; 515 women), high-fat diet consumption was more prevalent in men (59.5%) than in women (54.0%). Women showed a higher baseline prevalence of osteopenia/osteoporosis, approximately 1.7-2.0 times that of men across femoral sites. After multivariable adjustment, a high-fat diet was associated with lower odds of femoral neck osteopenia/osteoporosis in men (OR = 0.45, p = 0.03) and women (OR = 0.43, p = 0.04), with no significant associations observed at other sites. Sensitivity and substitution analyses yielded directionally similar results, suggesting a modest, potentially protective association when carbohydrates were replaced with dietary fat. Restricted cubic spline and exploratory dose-response analyses demonstrated a protective effect of moderate fat intake in both sexes, with distinct sex-specific patterns: a nonlinear trend in women-with maximal protection observed at 40-45%E (OR = 0.22, p = 0.02)-and a linear inverse association in men, with the lowest risk at 35-40%E (OR = 0.35, p = 0.01).

Conclusions: These findings suggest a modest, sex- and site-specific association between dietary fat intake and femoral bone health in older adults. The observed relationships should be interpreted as exploratory and hypothesis-generating, emphasizing the need for longitudinal studies to confirm causality. Maintaining balanced macronutrient intake, rather than strict fat restriction, may be a reasonable dietary strategy for preserving bone health in aging populations.

Background/objectives: Syphilis remains a growing public health concern, with increasing reported incidence globally. Future healthcare professionals play a key role in prevention, early detection, and education. This study aimed to analyze the epidemiological trends of syphilis in the Autonomous Province (AP) Vojvodina and to assess the level of factual knowledge about syphilis and prevention measures, as well as attitudes toward education, stigma, and preventive strategies, among students at the Faculty of Medicine, University of Novi Sad.

Methods: Epidemiological data on syphilis in the AP Vojvodina from 1997 to 2024 were analyzed using annual case numbers, crude incidence rates, age-specific and sex-specific incidence rates, and age-standardized incidence rates calculated by direct standardization to the European standard population. Second, a structured survey was administered to 356 students at the Faculty of Medicine, University of Novi Sad from December 1 to 30, 2024 to assess their knowledge and attitudes toward syphilis and its prevention.

Results: From 1997 to 2024, 1,034 syphilis cases were reported in AP Vojvodina, mostly among individuals aged 25-34. The age-standardized rate of incidence showed a rising trend, peaking in 2023 at 9.33 per 100,000. Among 356 surveyed students (mean age 22.2; 74.4% female), medical students had significantly higher self-assessed knowledge scores compared to students from other health-related study programmes (36.99% vs. 8.03%; p < 0.001). Prior sexually transmitted infections education was strongly associated with better knowledge scores (OR = 5.98; 95% CI: 3.41-10.49; p < 0.001). Most students (60%) cited stigma as a barrier to care, and while 87% supported the need for syphilis education, only 15% felt confident advising patients on prevention.

Conclusions: The increasing syphilis incidence in AP Vojvodina, particularly among young men, mirrors EU trends and highlights a growing public health concern. Despite favourable attitudes, students demonstrated notable knowledge gaps. Targeted education on sexually transmitted infections, with emphasis on practical prevention strategies and counselling skills, is essential to equip future healthcare professionals for effective prevention and stigma reduction, while taking current epidemiological trends into account.

Background: Cancer treatments can affect nutritional status by impairing a person's ability to consume an adequate amount of food and absorb nutrients, which are important factors in reducing health-related quality of life (HRQoL). Consequently, this research aimed to investigate the correlation between the likelihood of malnutrition and quality of life among individuals with solid cancer in Palestine. In addition, factors that are linked to the HRQoL of these patients should be identified.

Methods: A cross-sectional study was conducted at two major cancer referral hospitals in the northern West Bank, Al-Watani Government Hospital and An-Najah National University Hospital in Nablus, between July 31, 2022, and February 28, 2023. The five-level EuroHRQOL five-dimensional instrument (EQ-5D-5 L) was used to assess HRQOL. Nutritional status was assessed via the Nutrition Risk Screening 2002 (NRS-2002) tool. Multiple linear regression analysis was performed to determine the most important variables related to HRQOL.

Results: A total of 304 patients with solid tumors were included in this study. The most common cancers among these patients were breast (40.5%) and colorectal (26%) cancers. A moderate negative correlation was observed between the EQ-5D-5 L score and the NRS-2002 score (r = - 0.207; 95% CI: - 0.26 to - 0.15; p < 0.001). Regression analysis revealed that working patients (β = 0.152; 95% CI: 0.045 to 0.255; p = 0.005), those with fewer disease-related complications related to dietary intake (β = - 0.311; 95% CI: - 0.415 to - 0.208; p < 0.001), and individuals with lower NRS scores (β = - 0.135; 95% CI: - 0.243 to - 0.027; p = 0.015) were independently associated with higher HRQoL.

Conclusions: Our results suggest that lower nutritional risk, employment, and fewer disease complications are associated with better HRQoL among cancer patients, underscoring the importance of early nutritional assessment and patient-centred care, especially in low-resource settings.

Background: Sarcopenia is a generalized and progressive loss of skeletal muscle mass and function, which is associated with various adverse health outcomes, such as fractures, impaired mobility, and increased mortality. Bioactive peptides (BPs) are absorbable protein fragments that remain bioaccessible after digestion. In the present study, we investigated whether the intake of BPs derived from dairy products could reduce the risk of sarcopenia by analyzing the dietary habits of elderly individuals with sarcopenia.

Methods: This case-control study used data collected from a population-based cross-sectional study conducted at healthcare centers in Shiraz, Iran. A total of 80 individuals diagnosed with sarcopenia and 80 control subjects without sarcopenia were selected. Sarcopenia was defined according to the diagnostic criteria established by the Asian Working Group for Sarcopenia. Dietary intake over the previous year was assessed using a semi-quantitative food frequency questionnaire consisting of 168 items. The amount of digestion-resistant BPs in dairy products was estimated by multiplying the grams of dairy consumed by the peptide content present in these products. The association between the intake of digestion-resistant BPs from dairy products and the risk of sarcopenia was evaluated using logistic regression analysis.

Results: In the unadjusted analysis, participants with higher total peptide consumption had markedly reduced odds of sarcopenia compared with those in the lower-intake reference group (odds ratio [OR ]= 0.163, 95% confidence interval [CI]: 0.082-0.323, P < 0.001). After adjusting for potential confounders, the inverse association between total peptide intake and the odds of sarcopenia remained statistically significant. Individuals with greater total peptide intake showed substantially lower odds of sarcopenia than those in the low-intake reference group (OR = 0.336, 95% CI: 0.149-0.897, P = 0.028).

Conclusions: In summary, our findings suggest that BPs derived from dairy products are inversely associated with the risk of sarcopenia. Given the cross-sectional and retrospective design, causality cannot be established, and further prospective or interventional studies are needed to confirm these associations.

Introduction: Social support in pregnancy and postpartum is important for optimizing maternal and infant health. Group prenatal care offers the opportunity for in-person social support yet does not extend into the postpartum period. Mobile social support models may further meet the needs of pregnant individuals and partners during pregnancy and into the postpartum period. However, the use and utility of mobile social support for pregnant people and their partners in the context of group prenatal care and beyond has not been studied. Assessing Centering patients' utilization of existing social media platforms can inform programmatic development.

Methods: We conducted a retrospective cross-sectional study among recent participants of UCSF's Centering Pregnancy^® program and their partners. Study participants were recruited through UCSF's electronic health record system or direct email and partners were recruited through referral from participants. Online surveys sought to understand participant perspectives on mobile groups, educational and social support needs, and recommendations.

Results: Participants gave birth between 2018 and 2021 (68%), were college-educated (97.3%), and regularly accessed social media (> 75% across platforms). Most participants engaged in Centering Pregnancy^® online communications outside of formal activities (79% during pregnancy, 74% postpartum) for social support (78.1%) and knowledge sharing (65.2%). Most posted content monthly (54.6%) but read content more frequently (48.0% at least weekly). Communication frequency and topics changed with the COVID-19 pandemic. Respondents wanted more information on infant sleep (42.6%), maternal recovery/health (38.7%), breastfeeding/formula feeding (37.4%), newborn health and care (34.2%), and child development (27.1%). Social group engagement was higher for individuals reporting depressive or anxiety symptoms during pregnancy and postpartum.

Discussion: The findings confirm the importance of social support, especially postpartum, for health, how mobile support groups can impact these outcomes, and needs and areas of improvement for group prenatal care. Integration of a social media support component to the evolving post-COVID Centering Pregnancy^® model may be an important addition to improve participating parent wellbeing.

Background: Renal dysfunction poses a significant global health burden, with occupational hazards in the petroleum industry potentially contributing to its development. This cohort study aimed to evaluate the impact of four occupational hazards-high temperature, noise, benzene compounds, and shift work-on renal dysfunction in a cohort of oil workers.

Methods: A prospective cohort study was conducted using data from the "Beijing-Tianjin-Hebei Occupational Population Health Effects Cohort." A total of 2,292 petroleum workers without baseline renal dysfunction were followed from 2017 to 2021. Renal dysfunction was defined as an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m². Occupational exposures were assessed using national standards and weighted shift index (WSI) for shift work. Cox regression models, restricted cubic spline analysis, and interaction assessments were employed to analyze associations.

Results: Over four years, 24.52% of workers developed renal dysfunction. Multivariate Cox regression revealed significant risks for workers exposed to high temperature (P = 0.003, HR = 1.33, 95% CI:1.10-1.61), noise (P = 0.001, HR = 1.43, 1.18-1.72), benzene compounds (P = 0.001, HR = 1.70, 1.42-2.05), and high-intensity shift work (WSI > 1022.75; P = 0.001, HR = 1.96, 1.60-2.40). Additive interactions were observed between high-intensity shift work and high temperature (RERI = 1.89), noise (RERI = 1.40), and benzene compounds (RERI = 3.07). Moderate shift work intensity showed a protective effect.

Conclusions: Exposure to noise, benzene compounds, and high-intensity shift work independently increased renal dysfunction risk among petroleum workers. An association was also observed for high-temperature exposure, and interactions between these hazards amplified risks, highlighting the need for targeted interventions to mitigate occupational exposures.

Tirzepatide, a novel dual GIP and GLP-1 receptor agonist, has demonstrated robust efficacy in clinical trials; however, discontinuation rates due to gastrointestinal adverse events have been reported at 6-10% in Western populations. In contrast, our real-world study of 219 Japanese patients revealed a markedly lower discontinuation rate of approximately 1.3%. Dietary questionnaires indicated that patients experienced reduced appetite for high-fat and high-calorie foods while maintaining consumption of low-carbohydrate traditional Japanese foods such as fish and meat, which may have contributed to the low discontinuation rate.