Journal of Nutrition and Metabolism最新文献

Background: Malnutrition is the leading cause of morbidity and mortality among children under five, with significant regional disparities, particularly in Ethiopia, being very high. This study aims to use Geographic Information Systems (GIS) to identify hotspot areas and associated factors for stunting and wasting among children under five in Oromia Regional State, Ethiopia. Methods: A community-based cross-sectional study was conducted. Data were obtained from the 2019 Ethiopian Demographic and Health Survey (EDHS). A total of 653 children under five years old were included in this study. The data were collected using a multistage sampling technique to select the study participants. ArcGis Version 10.7 was used for geospatial analysis. A Bayesian logistic regression model was used to determine the associated factors for undernutrition. A p value < 0.05 was considered statistically significant. Results: Overall, the prevalence of stunting and wasting was 36.29% and 4.9%, respectively. In hotspot analysis, both Guji Zone and East Hararge were at high risk of stunting among children under 5 years. Eastern Guji (Gora Dola) and Eastern Hararge (Goro Muti and Meta) areas were at high risk for wasting children under 5 years old. In the adjusted model, being rural residents, mothers who had attended a secondary/above school, children aged 24-35 and 36-47 months, a preceding birth interval > 48 months, using a protected water source, and wealth index were significantly associated with stunting among children under five years. Similarly, mothers aged 25-35 years, rural residents, married women, preceding birth intervals > 48 months, and having more than three children were significantly associated with wasting among children under 5 years. Conclusion: The prevalence of stunting and wasting among children under 5 years remains high in the study setting. These findings suggest that a multifaceted approach addressing education, water access, socioeconomic conditions, and targeted health interventions for high-risk populations is essential to reducing stunting and wasting among children under 5 years old in Oromia Regional State.

Background: Delayed initiation of breastfeeding after birth can negatively impact maternal and newborn health, significantly increasing neonatal mortality. Due to the rising number of cesarean deliveries, the risk of delayed breastfeeding initiation is imminent. However, there is limited evidence on delayed initiation of breastfeeding among mothers who gave birth by cesarean section in Ethiopia. Thus, this study aims to assess factors associated with delayed initiation of breastfeeding among mothers who gave birth by cesarean section in public health facilities of Gamo and Gofa zones, south Ethiopia. Methods: This multicenter, facility-based, cross-sectional study was conducted across five hospitals in the Gamo and Gofa zones that offer cesarean delivery services. A consecutive sampling technique, which involves selecting every eligible subject until the desired sample size is reached, was employed to include 416 mothers who underwent cesarean sections between March 20 and May 21, 2023. Data collection was performed through an interviewer-administered questionnaire and chart reviews. The collected data were entered into Epi-Data Version 4.6 and subsequently exported to the Statistical Package for Social Sciences (SPSS) Version 26 for analysis. To identify factors associated with delayed initiation of breastfeeding, a logistic regression model was fitted, with statistical significance determined at a p value of less than 0.05. Results: The prevalence of delayed initiation of breast feeding was 53.4% with 95% CI: (48.5, 58.2). Being primiparous (AOR = 1.9, 95% CI: 1.1, 3.5), a lack of assistance from a health professional for early initiation breastfeeding (AOR = 5.1, 95% CI: 3.0, 8.6), not applying early skin-to-skin contact (AOR = 3.3, 95% CI: 1.7, 6.4), and not receiving postcesarean counseling about early initiation of breastfeeding (AOR = 2.0, 95% CI: 1.6, 3.8) were significantly associated with delayed initiation of breastfeeding. Conclusions: This study found a high prevalence of delayed breastfeeding initiation among mothers who had cesarean sections, with significant factors including primiparity, a lack of professional assistance, the absence of early skin-to-skin contact, and inadequate postcesarean counseling. To address this, targeted interventions are essential, including enhancing antenatal care services, providing comprehensive breastfeeding counseling, promoting immediate skin-to-skin contact, and ensuring professional support for mothers postdelivery.

Fructose, a common sweetener in modern diets, has profound effects on both metabolism and brain function, primarily due to its distinct metabolic pathways. Unlike glucose, fructose bypasses critical regulatory steps in metabolism, particularly the phosphofructokinase-1 (PFK-1) feedback inhibition, leading to uncontrolled metabolism and increased fat storage. This review delves into the metabolic consequences of fructose consumption, including its limited role in directly stimulating insulin secretion, which affects satiety signaling and contributes to increased food intake. The small intestine initially helps metabolize ingested fructose, shielding the liver and brain from excessive exposure. However, when consumed in excess, particularly in diets high in processed foods, this protective mechanism becomes overwhelmed, contributing to metabolic disorders such as insulin resistance, obesity, and fatty liver disease. The review also explores fructose's impact on the brain, with a focus on the hippocampus, a key region for memory and learning. Chronic high fructose intake has been linked to mitochondrial dysfunction, increased production of reactive oxygen species (ROS), and neuroinflammation, all of which contribute to cognitive decline and impairments in memory and learning. Additionally, fructose-induced alterations in insulin signaling in the brain are associated with increased risk for neurodegenerative diseases. These findings underscore the potential long-term neurological consequences of excessive fructose intake and highlight the need for further human studies to assess the full spectrum of its effects on brain health. Addressing the rising consumption of fructose, particularly in processed foods, is essential for developing targeted strategies to mitigate its adverse metabolic and cognitive outcomes.

Introduction: Phalsa (Grewia asiatica) fruit is known for its rich nutritional profile and diverse pharmacological properties such as antioxidants, anti-inflammatory, and anti-cancer, making it a promising contender for preventive measures against cisplatin-induced acute kidney injury (AKI) in living organisms. Material and Methods: In the present study, rats were provided with different levels of lyophilized Grewia asiatica, i.e., 200, 300, and 400 mg/kg body weight along with control, fed on the basal diet. After trial completion, blood serum samples of rats subjected to renal biomarkers, hematology, and liver function tests, interleukin-6 (IL-6), whereas enzymes (alanine aminotransferase (ALT); sodium oxide dismutase, and glutathione) for kidney tissues along with photomicrographs for kidney tissue damage were measured. Results: The findings revealed that lyophilized Grewia asiatica provision effectively reduced renal biomarkers, blood urea nitrogen, and creatinine with AKI in the rats as well as treatments demonstrated significant improvements in antioxidant activity by reducing malonaldehyde levels and increasing the activity of glutathione, catalase, and superoxide dismutase in groups treated with dosages of 300 and 400 mg/kg powder. Conclusion: Grewia asiatica exhibited remarkable hepatoprotective properties by decreasing ALT and displayed anti-inflammatory properties, as evidenced by a substantial decrease in interleukin-6 serum levels. The study findings also added valuable insight into the multiform nephroprotective reverberation of lyophilized phalsa powder, emphasizing its plausible protective use in reducing cisplatin-induced nephrotoxicity.

Nutritional anemia is a serious health concern that affects particularly children under 5 years of age and causes problems of physical and mental growth and development. A cross-sectional study determined the rates and risk factors of iron deficiency anemia (IDA) and megaloblastic anemia (MA) and assessed the effect of IDA and MA on developmental outcome at Ruhengeri Referral Hospital from April 2021 to March 2022. The Cochran's formula: n=Z ²PQ/d ² was used to calculate the sample size of 318 and children aged between 6 and 59 months were purposively selected and included in the study. Venous blood specimens were collected in EDTA and clot activator tubes for complete blood count (CBC) and ferritin, respectively, used Sysmex 500i and Cobas e411 analyzers, respectively. Demographic and clinical information was collected on participants and the data were analyzed by Statistical Package for Social Science (SPSS) Version 20. A p value of less than 0.05 was considered significant at 95% confidence level. Logistic regression analysis and Chi-square test were used to examine the significance of the associations between explanatory and outcome variables. The ratio of male to female participants was 1.7:1 and the age group 12-23 was the most predominant (35.2%). IDA was more prevalent (93.4%) than MA (6.6%). The factors significantly associated with nutritional anemia at 95% confidence level were residence in rural area (OR = 3.896 and CI = 1.504-10.094), number of meal per day (OR = 23.640 and CI = 3.561-156.949), lacking knowledge of nutritional anemia (OR = 3.242 and CI = 1.205-8.723), parity (OR = 0.197 and CI = 0.108-0.360), history of breastfeeding (OR = 0.38 and CI = 0.004-0.904), source of diet (OR = 0.295 and CI = 0.088-0.988), and lack of food supplements (OR = 3.685 and CI = 1.583-8.580). Nutritional anemia was significantly associated with developmental delay (p < 0.0001). Iron deficiency and megaloblastic anemia present a sizeable challenge in the furtherance of primary healthcare outstandingly in young children and are associated with developmental delay. The mothers' education on nutrition and early diagnosis and management of nutritional anemia would reduce the risk of IDA and MA and related morbidity and mortality in the children at risk.

Overview: SARS CoV-2 infection is accompanied by the development of acute inflammation, resolution of which determines the course of infection and its outcome. If not resolved (brought back to preinjury status), the inflamed state progresses to a severe clinical presentation characterized by uncontrolled cytokine release, systemic inflammation, and in some death. In severe CoV-2 disease, the required balance between protective inflammation and its resolution appears missing, suggesting that the ω-3-derived specialized proresolving mediators (SPMs) needed for resolution are either not present or present at ineffective levels compared to competing ω-6 polyunsaturated fatty acid (PUFA) metabolic derivatives. Aim: To determine whether ω-6 PUFA linoleic acid (LA) metabolites increased in those infected with severe disease compared to uninfected controls. Findings: Increased levels of ω-6 LA metabolites, e.g., arachidonic acid (AA), epoxyeicosatrienoic (EET) acid derivatives of AA (8,9-, 11,12-, and 14,15-EETs), AA-derived hydroxyeicosatetraenoic (HETE) acid, dihydroxylated diols (leukotoxin and isoleukotoxin), and prostaglandin E2 with decreased levels of ω-3-derived inflammation resolving SPMs. Therapeutic treatment of SARS CoV-2 patients with ω-3 PUFA significantly increased 18-HEPE (SPM precursor) and EPA-derived diols (11,12- and 14,15-diHETE), while toxic 9,10- and 12,13-diHOMEs (leukotoxin and iosleukotoxin, respectively) decreased. Conclusion: Unbalanced dietary intake of ω-6/ω-3 PUFAs contributed to SARS CoV-2 disease severity by decreasing ω-3-dependent SPM resolution of inflammation and increasing membrane-associated ferroptotic AA peroxidation.

Background: Evidence suggests the positive effects of ketogenic diet (KD) on cancers by limiting glucose availability to cancer cells. This systematic review aimed to explore the safety, feasibility, and effectiveness of KD in children with brain tumors including diet side effects, patient tolerance and compliance, tumor response, quality of life, and nutritional status. Methods: Six databases were searched for relevant publications between 1995 and 2022; non-English language publications were excluded to avoid misinterpretation. The Joanna Briggs Institute assessment scale for observational studies was used to measure study methodology quality and evaluate the extent to which the bias possibility in study design, conduct, and analysis has been stated. The study was registered in PROSPERO under registration number (CRD42021281620). Results: Ultimately, eight eligible publications involving a total of 11 children with brain tumors following KD were included. Nine patients followed classic KD with medium-chain triglyceride oil, whereas others followed a modified Atkin or low-carbohydrate diet. KD was well-tolerated, having nonsevere side effects. Six patients showed positive tumor response, five improved neurological skills, and four reported growth improvement. Six patients reported a median overall survival of 17.6 months. Lastly, statistical analyses could not be performed; hence, a meta-analysis was not possible. Conclusion: KD may be a safe and feasible dietary intervention for children with brain tumors. However, the effects on tumors remain unclear and require further study. The study limitation included the lack of high-quality and appropriately controlled trials with large samples. Moreover, heterogeneity was observed, and quality-of-life assessments were self-reported, which might have resulted in bias or inaccuracy.

Genistein[5,7-dihydroxy-3-(4-hydroxyphenyl)chromen-4-one] is a phytoestrogens known to positively impact various cardiovascular disease (CVD) risk factors. However, not all studies have yielded consistent results, and existing meta-analyses have not comprehensively addressed all CVD risk factors. We conducted a systematic search of the PubMed, ISI Web of Science, Embase, and Cochrane Library databases up to June 2024, following PRISMA 2020 guidelines. We included adult randomized controlled trials (RCTs) that examined pure genistein supplementation without other combined interventions and reported on at least one CVD risk factor. Data extraction and quality assessment were performed independently by two authors using a standardized form and the Cochrane Collaboration Scale. A total of 21 RCTs were included, with 941 participants in the genistein supplementation group and 918 participants in the control group. Statistical analyses were conducted using R software with the meta package. The meta-analysis revealed that, compared to the placebo group, genistein supplementation significantly improved the levels of TC ([MD 95% CI: -9.38 [-14.64, -4.12]; p < 0.001]), LDL-C ([MD 95% CI: -11.14 [-19.42, -2.86]; p < 0.001]), Lp(a) levels ([MD 95% CI: -0.69 [-0.98, -0.41]; p < 0.01), SBP ([MD 95% CI: -8.32 [-12.44, -4.20]; p < 0.01), DBP ([MD 95% CI: -3.57 [-5.25, -1.89]; P=0.04]), fasting blood glucose ([MD 95% CI: -3.98 [-6.79, -1.17]; p < 0.001]), fasting insulin ([MD 95% CI: -1.79 [-2.05, -1.54]; p < 0.01), HOMA-IR ([MD 95% CI: -0.56 [-0.64, -0.49]; p < 0.01), and homocysteine levels ([MD 95% CI: -0.74 [-1.05, -0.42]; p < 0.01). However, there were no significant improvements in TG, HDL-C, and CRP levels. The observed improvements align with clinically meaningful thresholds for cardiovascular risk reduction. Substantial heterogeneity observed for most outcomes was explored via subgroup analysis. Subgroup analyses were conducted based on treatment duration, geographic region, or participant health status, and heterogeneity was assessed using the I ² statistic. Subgroup analysis did not reveal any significant differences, indicating that heterogeneity was not influenced by factors such as treatment duration, geographic region, or participant health status. Overall, this meta-analysis provides consistent evidence that genistein intake significantly reduces several important CVD risk factors, including TC, LDL-C, Lp(a), SBP, DBP, fasting blood glucose, fasting insulin, HOMA-IR, and homocysteine levels.

Background: Depression and anxiety are common in UC patients due to gut microbiota dysbiosis and increased proinflammatory markers. Butyrate, a short-chain fatty acid, participates in the regulation of gut microbiota and inflammation and has neuroprotective effects in neurodegenerative disease. Therefore, we assessed the effects of sodium butyrate supplementation on the disease severity, inflammation, and psychological factors in active UC patients. Methods: This study was a randomized, parallel, double-blind controlled trial. Participants in the intervention (n = 18) and control (n = 18) groups received 600 mg/kg of sodium butyrate or rice starch as a placebo with their main meal, respectively, for 12 weeks. The partial Mayo score was used to evaluate disease severity, while the Westergren method was employed to assess the erythrocyte sedimentation rate (ESR). NLR and PLR were determined using an automated analyzer (XS-500i, Sysmex). Moreover, the psychological factors were assessed by the hospital anxiety depression scale (HADS) and the general health questionnaire (GHQ). Results: In comparison with placebo, sodium-butyrate supplementation significantly decreased the ESR level (-6.66 ± 1.56 vs. 3.00 ± 2.11, p=0.01), NLR (-0.24 ± 0.1 vs. 0.33 ± 0.23, p=0.02), Mayo score (-2.33 ± 0.41 vs. 0.22 ± 0.40, p < 0.001), HADS anxiety score (-2.77 ± 0.64 vs. 0.94 ± 0.63, p=0.001), HADS depression score (-2.38 ± 0.47 vs. 0.61 ± 0.33, p < 0.001), and GHQ total score (-12.11 ± 1.48 vs. 3.55 ± 1.39, p < 0.001). Conclusion: Butyrate could serve as an effective adjuvant treatment for reducing disease severity and alleviating psychological symptoms. This trial was registered on the Research Ethics Committee of Shiraz University of Medical Sciences, with the reference number IR.SUMS.SCHEANUT.REC.1400.037. Trial Registration: Iranian Registry of Clinical Trials: IRCT20211214053401N1.

Objective: This study has been conducted to identify the frequency of malnutrition and different factors associated with it among elderly people with Type 2 diabetes. Methods: This cross-sectional study was conducted in the National Institute of Diabetes and Endocrinology (NIDE), DUHS, Karachi, between January 2023 and October 2023. A total of 325 elderly participants aged ≥ 60 years with Type 2 diabetes were included. Mini Nutritional Assessment (MNA) was used for data collection. Results: Nutritional assessment of older diabetic patients according to the MNA revealed that 226 (69.5%) patients were at risk of malnutrition whereas 53 (16.3%) were malnourished. A total of 325 Type 2 diabetic patients were included in the study with a mean age of 65.7 ± 5.5 years, where 135 (41.5%) were male and 190 (58.5%) were female. Older patients (mean age: 65 years) were significantly more malnourished compared to those with normal nutrition (mean age: 62 years; p=0.021). Employed patients were less likely to have the risk of malnutrition as compared to housewives (p=0.005). Patients who had low family income were eight times more likely to be malnourished as compared to those who had better family income (p=0.003). It was also found that patients with low BMI and calf circumference will be more prone to be malnourished as compared to those with high levels of BMI (p=0.003) and calf circumference (p=0.013). Conclusion: The majority of study participants were at risk of malnourishment, with associated factors such as rapid weight loss, poor health status, decline in physical activity, and food intake. Therefore, these findings highlight the importance of tailored interventions for at-risk individuals, including regular screening and nutritional support.