Nutrition Journal最新文献

Background: The initiation time and formula for supplemental parenteral nutrition after surgery require optimization, especially in older patients undergoing major gastrointestinal surgery. This study aimed to assess the effect of early supplementation with a branched-chain amino acid (BCAA)-enriched formula (BAF) on short-term postoperative outcomes in older patients undergoing gastric surgery.

Methods: This single-center, prospective, double-blinded, randomized clinical trial was conducted from March 10, 2020, to September 15, 2022. Patients aged 65-80 years with gastric cancer scheduled for curative resection were assessed for eligibility and randomly allocated to a high-proportion BCAA (HBCAA) (early supplementation with the BAF) or control (routine nutrition) group. The primary outcome was the standardized length of hospital stay (LOS).

Results: A total of 150 patients were randomized. Thirteen patients were excluded due to the resection of other organs, presence of metastasis, or withdrawal of consent. Finally, we included 70 and 67 patients in the HBCAA and control groups, respectively (mean age: 70.5 ± 4.2 years; 96 men [70.1%]). The standardized LOS was significantly shorter in the treatment group than in the control group (median [interquartile range]: 8.0 [7.8, 8.0] vs. 8.5 [8.0, 9.0] days; mean difference, 0.38; 95% confidence interval [CI], 0.02-0.74 days; P < .001). Patients in the HBCAA group showed better gastrointestinal function with faster defecation (4.0 [3.6, 5.0] vs. 5.0 [4.0, 5.5] days; mean difference, 0.6 days; 95% CI, 0.26-0.94 days; P < .001) and semi-liquid diet initiation (8.0 [7.5, 8.0] vs. 8.0 [8.0, 8.8] days; mean difference, 0.36 days; 95% CI, 0.03-0.7 days; P < .001) and had lesser weight loss at postoperative day 5 than those in the control group did (3.5 [2.7, 6.5] vs. 4.9 [3.3, 7.6]%; mean difference, 1.23%; 95% CI, 0.27-2.19%; P = .011).

Conclusions: In this randomized clinical trial, compared with routine nutrition, early supplementation with a BAF was associated with a shorter standardized LOS in older patients undergoing gastric surgery, suggesting that it may be a favorable strategy for patients with a poor tolerance to external nutrition who are undergoing major surgery.

Trial registration: ClinicalTrials.gov; Identifier: ChiCTR2000029635.

Background: Oral sensory hypersensitivity has been linked with fussy eating predominantly in non-typically developing children. We hypothesized that child 'Oral' (touch, smell and taste in the mouth) and 'Social-Emotional' (response to social expectations) sensory processing are associated with child appetitive traits in typically developing preteen children. Additionally, we explored relationships between maternal sensory profiles and their offspring's sensory profile.

Methods: This is secondary analysis of 130 mother-child dyads from the 9-11-year-old follow-up of the ROLO longitudinal birth cohort study. The Dunn Sensory Profile (Adolescent/Adult) and the Dunn Child Sensory Profile 2 were used to assess maternal and child sensory profiles, respectively. The Children's Eating Behaviour Questionnaire was used to assess child appetitive traits. Multiple linear regression examined associations between 'Oral' and 'Social-Emotional' segments of the child sensory profile and child appetitive traits. Associations between maternal and child sensory profiles were examined using sensory profile quadrants (Dunn's sensory processing framework). These refer to four distinct patterns of sensory processing that indicate how an individual responds to sensory input.

Results: In total, 130 mother-child dyads were included. In adjusted analysis child 'Oral' sensory processing was associated with higher mean scores in the appetitive traits 'Desire to Drink' (B = 0.044, 95% CI = 0.025,0.062) and 'Food Fussiness' (B = 0.080, 95% CI = 0.059,0.101) and with lower mean scores in 'Enjoyment of Food' (B=-0.038, 95% CI -0.055,-0.022). Child 'Social-Emotional' responses were associated with higher mean scores in 'Desire to Drink' and 'Food Fussiness'. Higher scores in the maternal sensory profile quadrants of 'Sensitivity', 'Avoiding' and 'Registration' were positively associated with higher scores in the corresponding child sensory profile quadrants.

Conclusion: Our findings suggest that in typically developing children presenting with fussy eating, oral sensory hypersensitivity and higher scores in social-emotional responses to sensory processing may be an underlying determinant. The relationship observed between 'Oral' and 'Social-Emotional' sensory processing segments and 'Desire to Drink' requires further research to ascertain the type of drinks being consumed and how this impacts appetite. Further research is also required to explore the influence of maternal sensory profile on their offsprings response to sensory input.

Background: Disordered eating behaviors and body dissatisfaction are highly prevalent among adolescents and linked to negative health outcomes. While Hispanic adolescents appear to be at high risk of disordered eating and body dissatisfaction, validated tools for assessment of these health concerns among this population are lacking.

Methods: This study used Confirmatory Factor Analysis to establish factorial validity for the Kids Eating Disorder Survey (KEDS) among a community sample of Hispanic adolescents. Internal consistency was measured by the Kuder-Richardson Formula 20 (KR-20).

Results: Participants (N = 690) were Hispanic (100%) and female (53%), with a mean age of 12 years. After testing the psychometric properties of KEDS and implementing modifications, the resulting two-factor KEDS model (M-KEDS) showed acceptable fit (TLI = 0.98, CFI = 0.99, RMSEA = 0.06) for the Weight Dissatisfaction (renamed to Negative Weight Attitudes) and Purging/Restriction (renamed to Extreme Weight Control Behaviors) sub-scales and good internal consistency (KR-20 = 0.77).

Conclusion: M-KEDS is a factorial valid instrument for assessing Extreme Weight Control Behaviors and Negative Weight Attitudes among Hispanic adolescents. Hispanics are among the fastest-growing racial/ethnic groups in the United States, warranting further research on negative weight attitudes and extreme weight control behaviors in this population.

Background: Developing interventions for older adults with subjective cognitive decline (SCD) has the potential to prevent dementia in this at-risk group. Preclinical models indicate that Citrus-derived phytochemicals could benefit cognition and inflammatory processes, but results from clinical trials are still preliminary. The aim of this study is to determine the effects of long-term supplementation with Citrus peel extract on cognitive performance and inflammation in individuals with SCD.

Methods: Eighty participants were randomly assigned to active treatment (400 mg of Citrus peel extract containing 3.0 mg of naringenin and 0.1 mg of auraptene) or placebo at 1:1 ratio for 36 weeks. The primary endpoint was the change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total score across the 36-week trial period. Other cognitive outcomes included tests and scales evaluating verbal memory, attention, executive and visuospatial functions, and memory concerns. The secondary endpoint was the change of interleukin-8 (IL-8) levels over the 36-week trial period in a subsample of 60 consecutive participants. An Intention-to-treat approach with generalized linear mixed models was used for data analysis.

Results: The RBANS total score showed significant improvement in both Citrus peel extract and placebo groups at 36 weeks (p for time < .001, d = 0.36, p time x treatment = .910). Significant time effects were also found in cognitive domains of short- and long-term verbal memory (p < .001) and scales of subjective memory (p < .01), with no significant time x treatment interaction. The largest effect sizes were observed in verbal memory in the placebo group (d = 0.69 in short-term, and d = 0.78 in long-term verbal memory). Increased IL-8 levels were found at 36-week follow-up in both Citrus peel extract and placebo groups (p for time = .010, d = 0.21, p time x treatment = .772). Adverse events were balanced between groups.

Conclusions: In this randomized clinical trial, long-term Citrus peel extract supplementation did not show cognitive benefits over placebo in participants with SCD, possibly due to high placebo response. These findings might have specific implications for designing future nutraceutical trials in individuals experiencing SCD.

Trial registration: The trial has been registered at the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT04744922 on February 9th, 2021 ( https://www.

Clinicaltrials: gov/ct2/show/NCT04744922 ).

Background: Observational studies have indicated that breakfast skipping and gut microbiome dysbiosis are associated with a higher risk of major depressive disorder (MDD). However, it remains unknown whether the alteration of gut microbes is implicated in the associations between breakfast skipping and MDD.

Methods: Leveraging genome-wide association studies (GWAS) on breakfast skipping, gut microbes, and MDD, we conducted a two-step Mendelian randomization (MR) study to determine the causal associations between breakfast skipping (N = 193,860) and MDD (N = 1,815,091), and evaluate the role of gut microbes (N = 18,340). Genetic variants with a P-value less than 5E-08 were selected as instrumental variables (IVs). The false discovery rate (FDR) method was employed to correct the P-values for multiple tests in gut microbes.

Results: Breakfast skipping was associated with an increased risk of MDD (odds ratio [OR] = 1.36, 95%CI = 1.12-1.65, P = 0.002), but no effect of MDD on breakfast skipping was observed (β per doubling odds of MDD =-0.001, 95%CI=-0.024 to 0.023, P = 0.957). After adjusting for multiple comparisons, the MR analysis provided little evidence for an association between breakfast skipping and the abundance of any gut microbes (P_FDR>0.05). Among the 21 gut microbes with IVs available, only the abundance of Class Actinobacteria was causally associated with a reduced risk of MDD (OR = 0.85, 95%CI = 0.75-0.97, P_FDR=0.015).

Conclusions: Our findings demonstrated that breakfast skipping was associated with an increased risk of MDD, but provided little evidence supporting the role of the abundance of gut microbes in it. Further efforts with a large sample size are warranted to clarify the findings.

Background: Prosthetic Joint Infection (PJI) is the most devastating complication of arthroplasty surgery and affects 1-5% of patients. Despite strict adherence to aseptic protocols and preventive measures, infection is the most common reason for revision arthroplasty, and the incidence is increasing. Treatment of PJI is challenging and often requires repeated major surgeries with sequentially poor results. The continued occurrence of PJI, and persistence after treatment, brings into question the current treatment paradigm. Preclinical evidence suggests a link between altered gut health and the risk of PJI in arthroplasty patients. Resistant starches helps to restore gut physiology by enhancing the beneficial microbiome and producing short-chain fatty acids, which have several health-conferring properties. The primary aim of this study is to investigate the effect of a commercially available prebiotic fibre formulation on the gut microbiome in PJI patients planned for a two-stage revision surgery.

Methods: A double-blind placebo-controlled trial will assess the effect of 8-week supplementation of a commercially available prebiotic supplement in patients presenting with first-time PJI undergoing two-stage revision surgery. The supplementation phase will start after the first stage revision, and 80 patients will be randomised to receive either a test product (34 g of resistant starch) or a placebo (custard powder) daily for eight weeks. Stool and blood specimens will be collected at baseline, four weeks and eight weeks after the first-stage surgery and once at second-stage surgery. Gut microbiome profile, inflammatory cytokines and gut permeability biomarkers will be measured. Tissue specimens will be collected intra-operatively during first and second-stage surgeries. Baseline dietary patterns and gut symptoms will be recorded using validated questionnaires. Treatment outcomes will be reported for both cohorts using the Delphi criterion at one and two years after second-stage surgery.

Discussion: This will be the first study to investigate the relationship between gut health optimisation and preventing PJI recurrence in arthroplasty patients. If supplementation with resistant starch improves gut health and reduces systemic inflammation, optimising the gut microbiome will be a recommended preoperative management strategy for arthroplasty patients.

Trial registration no: ACTRN12623001273673.

Background: The Mediterranean diet (MD) has shown promising results in preventing type 2 diabetes, particularly in Mediterranean and European populations. However, the applicability of these benefits to non-Mediterranean populations is unclear, with contradictory findings in the literature.

Methods: In this study, we included 12,575 participants without diabetes at baseline from the China Health and Nutrition Survey (CHNS). Dietary intake was measured by three consecutive 24-h dietary recalls. The Mediterranean diet adherence (MDA) was measured by a score scale that included nine components of vegetables, legumes, fruits, nuts, cereals, fish, red meat, dairy products, and alcohol. New-onset diabetes was defined as self-reported physician-diagnosed diabetes during the follow-up.

Results: During a median follow-up of 9.0 years, 445 (3.5%) subjects developed diabetes. Overall, there was an inverse association between the MDA score and new-onset diabetes (per score increment, HR 0.83, 95% CI 0.76-0.90). Moreover, age, sex, BMI, and energy intake significantly modified the association between the MDA score and the risk of new-onset diabetes (all P interactions < 0.05). Greater fruit, fish, and nut intake was significantly associated with a lower risk of new-onset diabetes.

Conclusion: There was an inverse association between Mediterranean diet adherence and new-onset diabetes in the Chinese population.

Purpose: The Composite Dietary Antioxidant Index (CDAI) is a novel, inclusive measure for evaluating the antioxidant potential of diets. We aim to explore the link between the CDAI and abdominal aortic calcification (AAC) in U.S. adults aged ≥ 40 years.

Methods: This cross-sectional study collected dietary and AAC data for individuals aged ≥ 40 years from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) database. The CDAI was calculated using six dietary antioxidants. AAC was evaluated using a semi-quantitative scoring system known as AAC-24, with an AAC score greater than 6 as severe AAC (SAAC). To examine the association between CDAI and AAC, including SAAC, liner/logistic regression analyses and smooth curve fitting were applied.

Results: A total of 2,640 participants were included in this study, and significant decreases in AAC score and SAAC prevalence were observed with ascending CDAI levels (P < 0.01). After adjusting for confounding factors, a clear link was established between the CDAI and both AAC score (β = -0.083, 95% CI -0.144-0.022, P = 0.008) and SAAC (OR = 0.883, 95% CI 0.806-0.968, P = 0.008), respectively. Further smooth curve fitting indicated a negative correlation between CDAI and both AAC score and SAAC.

Conclusions: Dietary antioxidant consumption, as quantified by the CDAI, shows an inverse relationship with AAC risk. Additional longitudinal and intervention studies are essential.

Background: Emotional eating (EE) is particularly prevalent in overweight or obese women, who may turn to food as a way to cope with stress, sadness, or anxiety. Limited research has been conducted on the association between EE and nutritional intake. Therefore, present study was designed to explore this association in adult women with overweight and obesity.

Methods: In this cross-sectional study, the relationship between EE and nutritional intake in 303 overweight and obese women (aged 18-50 years) was examined. The researchers used the validated semi-quantitative Food Frequency Questionnaire (FFQ) to assess participants' nutritional intake and the Dutch Eating Behavior Questionnaire (DEBQ) to evaluate their eating behavior. To determine the association between EE and nutritional intake, we employed the multiple linear regression analysis.

Results: The frequency of high intensity EE was 64.4% among the study participants and the mean total score of EE subscale of DBEQ was 2.32 ± 0.81. The total score of EE was positively associated with the energy intake (β = 0.396, P = 0.007), even after adjusting for age and BMI. In addition, a significant inverse association was found between the score of EE and the daily intake of calcium (β= -0.219, P = 0.026), riboflavin (β= -0.166, P = 0.043), and vitamin B12 (β= -0.271, P = 0.035), independent from energy and age. Also the results showed a significant positive association between the score of EE and the frequency of daily intake of cracker, muffin, cake, cream cake, pastry, candy, ice cream, pickles, melon, hydrogenated vegetable oil, peanut, salted and roasted seeds, and corn-cheese puff snack.

Conclusion: This study found that overweight or obese women with higher intensity of EE might have a higher intake of energy and a lower intake of dietary calcium, riboflavin and vitamin B12. Integrating a balanced diet with psychotherapy is suggested to help individuals with EE reducing the urge to eat in response to emotions.

Background: Diet and sleep are both established risk factors for cardiometabolic diseases. Prior evidence suggests a potential link between these behaviors, though longitudinal evidence for how diet associates with sleep is scarce. This study aimed to determine the prospective association between diet quality in young adulthood and multiple sleep outcomes at midlife in the Bogalusa Heart Study (BHS).

Methods: This prospective study included 593 BHS subjects with dietary assessment at the 2001-2002 visit and sleep questionnaire responses from the 2013-2016 visit, after an average of 12.7 years (baseline mean age: 36 years, 36% male, 70%/30% White and Black persons). A culturally tailored, validated food frequency questionnaire assessed usual diet. Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015, and the alternate Mediterranean (aMed) dietary score. Robust Poisson regression with log-link function estimated risk ratios (RR) for insomnia symptoms, high sleep apnea score, and having a healthy sleep pattern by quintile and per standard deviation (SD) increase in dietary patterns. Models adjusted for potential confounders including multi-level socioeconomic factors, depression, and body mass index. Trends across quintiles and effect modification by sex, race, and education were tested.

Results: Higher diet quality in young adulthood, measured by both AHEI and HEI, was associated with lower probability of having insomnia symptoms at midlife. In the adjusted model, each SD-increase in AHEI (7.8 points; 7% of score range) conferred 15% lower probability of insomnia symptoms at follow-up (RR [95% confidence interval CI]: 0.85 [0.77, 0.93]), those in Q5 of AHEI had 0.54 times the probability as those in Q1 (95% CI: 0.39, 0.75), and there was a significant trend across quintiles (trend p = 0.001). There were no significant associations between young adult diet quality and having a high sleep apnea risk or a healthy sleep pattern at follow-up.

Conclusions: A healthy diet was associated with a lower probability of future insomnia symptoms. If replicated, these findings could have implications for chronic disease prevention strategies incorporating the lifestyle behaviors of sleep and diet.