Nutrition Journal最新文献

Background: Among cancer patients, pancreatic cancer patients have the highest rate of sarcopenia, which is a critical prognostic factor. Serum creatine kinase (CK) is closely related to skeletal muscle mass and has been reported to decline with the progression of cancer. This study investigated whether preoperative serum CK is associated with the survival of patients with pancreatic cancer.

Methods: Data were obtained from patients with pathologically confirmed pancreatic cancer between June 2016 and March 2022. The prognostic significance of CK was analyzed based on sex-stratified groups. The Kaplan-Meier method was used to compare overall survival (OS) and disease-free survival (DFS). Multivariate Cox proportional hazards models were used to determine prognostic factors. Body composition was analyzed based on preoperative abdominal CT images to explore the sex-specific associations between skeletal muscle area (SMA) and serum CK levels.

Results: A total of 166 patients were included in this study. Sarcopenia was presented in 70 patients (42.2%). A low serum CK level showed a significant correlation with the diagnosis of sarcopenia in male patients (P = 0.026). The levels of CK did not predict the outcome in female patients, while a low preoperative CK was notably linked to shorter OS in male patients (median OS: 15 months vs. 33 months, P = 0.011; median DFS: 5 months vs. 14 months, P = 0.007). Multivariate analyses further confirmed the effect of CK in predicting OS (CK>44 IU/L, HR:0.226, 95% CI:0.107-0.478, P < 0.001) and DFS (CK>44 IU/L, HR:0.272, 95% CI:0.139-0.529, P < 0.001) of male patients. Correlation analysis revealed a significant association between SMA and CK levels in male patients (r = 0.225, P = 0.025), and such a correlation was not observed in female patients (r = 0.088, P = 0.478).

Conclusion: The pretherapeutic CK may represent a simple marker for predicting poor survival in male patients with resectable pancreatic cancer, thereby aiding in the selection of therapeutic strategies.

Background: Meta-analyses of observational studies on the effect of dairy on cognitive function have yielded inconclusive results, potentially due to unmeasured confounding. To avoid the no-unmeasured confounding assumption, we used lactase persistence genetic variant as an instrumental variable, for which the CC genotype is associated with lower lactase production and, consequently, lower dairy consumption. We used it to assess the effect of long-term consumption of total and non-fermented dairy on cognitive function.

Methods: We included 43,836 individuals over 55 years old with genotyping, dietary data, and cognitive function measurements from three population-based studies: CoLaus|PsyCoLaus (Switzerland), the Rotterdam Study (the Netherlands) and the Canadian Longitudinal Study on Aging (CLSA - Canada). We performed a one-sample Mendelian randomization using two-stage least-squares regression. First, we estimated total and non-fermented dairy consumption by T-allele frequency. Second, we used the estimated dairy consumption in linear regression models on general cognition, assessed by the Mini-Mental State Examination (MMSE) and the Mental Alternation Test, executive function, verbal fluency, verbal learning, and memory.

Results: Per T-allele, total dairy intake and non-fermented was 24.8 and 15.3 g/day higher in PsyCoLaus, 57.9 and 49.8 g/day in the Rotterdam Study, and 0.31 and 0.29 times/day in CLSA, respectively. We found no association between the genetically predicted difference and the MMSE in PsyCoLaus and the Rotterdam Study. However, lactase persistent individuals scored 3.4 (95% CI 2.1- 4.7) and 3.5 (95% CI 2.3-4.7) points more in the Mental Alternation Test for total and fermented dairy, respectively, in CLSA. Similarly, lactase persistent participants in CLSA had higher verbal fluency, verbal learning and executive function, but no differences were found in the other cohorts. Such inconsistencies might stem from different FFQs across cohorts and consumption ranges. Nonetheless, the generally small magnitude of effect sizes may suggest that there is no real effect between total or non-fermented dairy intake and cognitive function.

Conclusion: The evidence for a causal effect of dairy consumption on general cognitive function is weak, consistent with previous results from classic analysis from observational studies. Interventions targeting dairy are unlikely to have a relevant effect on cognitive function.

Background: Ultra-processed food (UPF) intake is positively associated with multiple adverse health outcomes. However, the underlying biological mechanisms remain unclear. Serum metabolites may elucidate these mechanisms. We investigated serum metabolites correlated with UPF and un/minimally processed food (UNPF) intake and evaluated their association with selected biochemical markers.

Methods: Cross-sectional study within the UK biobank, including a total of 72,817 participants with 24-hour recall dietary data and 134 nuclear magnetic resonance metabolites. UPF and UNPF intakes were evaluated using the NOVA classification, and related metabolites were identified using elastic net penalized regression. A UPF metabolomic signature was computed as a weighted sum of UPF-related metabolites, using elastic net coefficients as weights. Associations between UPF and UNPF-related metabolites, and serum C-reactive protein (CRP), insulin-like growth factor-1(IGF-1), sex hormone-binding globulin (SHBG), and testosterone were examined using multiple quantile regression.

Results: Elastic net model identified 17 and 15 metabolites uniquely related to UPF and UNPF intake, respectively. Acetoacetate, acetone, high-density lipoprotein (HDL) diameter, docosahexaenoic acid, linoleic acid, ω-3 fatty acids (FA), total lipids in large HDL cholesterol, and valine levels were decreased, but free cholesterol in extremely small very low-density lipoproteins (LDL), glutamine, glycine, glycoprotein acetyls, lactate, saturated FA, sphingomyelins, triglycerides in large LDL, and triglycerides in medium HDL levels were increased with high UPF intake. Opposite relationships were observed for UNPF intake. Heterogeneous associations were observed between UPF-related metabolites and CRP, IGF-1, SHBG, and testosterone levels. A UPF metabolomic signature was positively associated with CRP (regression coefficient per standard deviation, 1.45, 95% confidence interval, 1.385, 1.515) and negatively associated with IGF-1 (-3.16, -4.493, -1.827) and SHBG (-13.878, -15.291, -12.465).

Conclusion: A UPF metabolomic profile, including VLDL free cholesterol, saturated FA, triglycerides, glutamine, glycine, and glycoprotein acetyl was associated with inflammatory, insulin signalling, and reproductive biomarkers. This metabolomic profile should be explored as a potential mediators of UPF-disease associations, and as an objective marker of UPF intake.

Background & aim: Metabolic and cardiovascular health outcomes are strongly influenced by diet. Dietary habits established in early childhood may persist into adulthood. This study aimed to examine the association between dietary patterns at both 2 and 8 years of age, explaining the maximum variability of high- and low-quality fats, sugars, and fibre, and cardiometabolic markers at age 8 years.

Methods: This was a secondary analysis of the European Childhood Obesity Project, formerly a randomized clinical trial across five European countries performed in healthy term newborns. Children in the study were categorized at ages 2 and 8 years into two groups based on cluster analysis of dietary patterns (DP) derived from Reduction Rank Regression (RRR). A cross-sectional and prospective analysis was conducted to evaluate the associations between these DPs and cardiometabolic outcomes, including body mass index (BMI), blood pressure (BP), and biochemical markers. Triglycerides, HDL cholesterol and insulin resistance index (HOMA-IR) were also categorized as altered versus normal values. Asociations between dietary patterns and health outcomes were assessed using linear and logistic regression models, adjusting for covariates based on a step-wise approach.

Results: A total of 336 children were classified based on quality of nutrient intakes into either a "Poor-Quality dietary pattern" (PQ-DP) (48% and 66% of infants at 2 and 8 years, respectively) or the "Health-Conscious dietary pattern" (HC-DP) (52% and 34% of infants at 2 and 8 years, respectively). Following a PQ-DP at both ages 2 and 8 was associated with higher triglycerides (β = 0.061, p = 0.049), systolic and diastolic BP (β = 13.019, p < 0.001 & β = 7.612, p = 0.014, respectively) and altered levels of HOMA-IR (OR = 3.1, p = 0.037, 95% CI = 1.1-9.1) at 8 years, compared to children with an HC-DP at both ages, after adjusting for confounders.

Conclusion: Adherence to a dietary pattern with a poorer nutritional profile in early childhood and school age is associated with worse cardiometabolic risk markers at 8 years old.

Background: A better understanding of correlates of sugary drink consumption is essential to inform public health interventions. This study examined differences in perceived healthiness of sugary drinks and related social norms between countries, over time, and sociodemographic groups and associations with sugary drink intake.

Methods: This study used annual cross-sectional data from the International Food Policy Study from 2018 to 2021 in Australia, Canada, the United Kingdom, the United States, and Mexico. Analyses examined perceived healthiness of eight beverage types and two types of perceived social norms (descriptive, injunctive) that discourage sugary drink consumption. The 24-item Beverage Frequency Questionnaire was used to estimate beverage intake in the past 7 days. Logistic regression models examined trends over time in odds of perceiving each beverage type as unhealthy and agreeing with social norms discouraging sugary drink consumption, across countries and sociodemographic characteristics. Negative binomial regressions examined associations between perceived healthiness, social norms and consumption.

Results: Energy drinks, regular soft drinks, and diet soft drinks were most frequently perceived as unhealthy in all countries, while water and 100% juice were least frequently perceived as unhealthy. Participants in Mexico had higher odds of perceiving 100% juice, chocolate milk, and iced tea as unhealthy in 2021 compared to 2018 (AOR = 1.71 99%CI 1.10-2.64; AOR = 2.69, 99%CI 1.70-4.26; AOR = 1.79, 99%CI 1.15-2.76; respectively), with little change in other countries. Agreement with social norms discouraging consumption of sugary drinks was higher in Mexico than in other countries. Trends in social norms over time were mostly stable, except in Mexico where participants had higher odds of agreeing with both norms in 2020 compared to 2018 (AOR = 1.27, 99%CI 1.09-1.48 for a descriptive norm and AOR = 1.27 99%CI 1.09-1.49 for an injunctive norm). In most countries, perceiving a beverage as unhealthy and agreeing with social norms discouraging consumption of sugary drink were associated with lower sugary drink consumption, with varying strength of associations across countries and beverage types.

Conclusions: Shifts over time in social norms and perceived healthiness observed in Mexico and associations with intake of sugary drinks in most countries suggest that targeted interventions to change norms and perceptions could help reduce sugary drink consumption.

Background: The French West Indies are facing increasing rates of obesity and diet-related chronic diseases. Food prices are more than 30% higher compared with mainland France, while a large part of the population is socioeconomically disadvantaged. The affordability of a healthy diet is a key issue.

Objective: To identify dietary shifts allowing to achieve nutritional adequacy while reducing the cost of Guadeloupean and Martinican adult diets.

Methods: Dietary intakes of 1112 adults (≥ 16y) were obtained from a cross-sectional survey conducted on a representative sample of the Guadeloupean and Martinican populations. Diet cost was based on mean prices of 1357 foods compiled from a Martinican supermarket website. Individual optimized diets respecting all nutritional recommendations with minimized departure from the initial diet were designed under different scenarios of cost constraint: none, not exceeding the initial diet cost (COSTinit), and 10%-step reductions (COST-X%); the initial diet cost referring to the cost of the diet based on initial dietary intakes and mean food prices.

Results: Without cost constraint, achieving nutritional adequacy while departing the least from initial diet increased diet cost on average (+ 20%) and for 74% of adults. In COSTinit, achieving nutritional adequacy was possible for 98% of adults and induced an increase in the amount of fruit & vegetables, unrefined starches, dairy products (especially milk), eggs and vegetable fats, and a decrease in sweetened beverages (especially among < 30y), refined cereals, sweetened products, meat and fish. In COST-30% scenario, achieving nutritional adequacy was possible for 93% of adults and induced the same dietary shifts as in COSTinit, but modified their magnitude, notably a smaller increase of vegetables (increase of + 7 g/d in the COST-30% scenario and + 86 g/d in the COSTinit scenario, both relative to initial diet), a larger increase of dairy (+ 90 g/d and + 72 g/d, respectively) and starchy foods (+ 112 g/d and + 54 g/d), and a larger reduction of meat (-48 g/d and -12 g/d). Increases in fruits (~ + 80 g/d) and unrefined starches (+ 127 g/d), and decreases in sweetened beverages (~ -100 g/d) and fish (~ -40 g/d) were maintained.

Conclusions: Nutrition prevention programs promoting the affordable and nutritious dietary shifts identified in the present study, i.e. reduction in animal flesh foods (meat, fish) as well as refined cereals and sweet products in favour of an increase in healthy plant-based foods and animal co-products (dairy, eggs), could help improve nutritional adequacy of the Guadeloupean and Martinican populations.

Background: Cirrhosis is a medical condition marked by persistent liver damage, which leads to the development of fibrous tissue and compromised liver function. In the present study, we decided to investigate the possibility of a connection between the consumption of fermentable olig-, di-, monosaccharides, and polyols (FODMAPs) and mortality rates in cirrhotic patients by utilizing data obtained from a prospective cohort study.

Methods: This cohort study enrolled 166 ambulatory patients from two hospitals in Tehran, Iran, between 2016 and 2018, and followed them up for 5 48 months until April 30, 2022. During the 3,955 person-months of follow-up, 43 fatalities were recorded (36 men and 7 women). The study classified participants into three groups based on their FODMAPs consumption and assessed the risk of mortality using Cox proportional hazards regression models.

Results: Total FODMAPs intake was associated with increased overall mortality risk (T3 vs. T1, HR = 3.5; 95%CI: 1.05, 11.7; P-trend = 0.036). This significant trend was also observed for total fructans (T3 vs. T1, HR = 5.15; 95% CI: 1.15, 23.2; P-trend = 0.006) and fructose (T3 vs. T1, HR = 5.55; 95% CI: 0.54, 57.14; P-trend = 0.018). Mortality risk was U-shaped with galactooligosaccharide intake, a lower mortality risk was observed with lactose intake and a higher mortality risk with polyols intake, although these associations did not reach statistical significance.

Conclusion: In conclusion, this study highlights a higher risk of mortality with higher intake of fructans, excess fructose and total FODMAPs.

Background: The evidence regarding dietary antioxidant intake and all-cause and cardiovascular disease (CVD) mortality among patients with hypertension is scarce.

Methods and results: This study included 16,190 adults with hypertension from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2019. Overall dietary intake was estimated with composite dietary antioxidant index (CDAI). Cox proportional hazards models were used to estimate the risk for all-cause and CVD mortality. Kaplan-Meier curve was used to illustrate the survival probabilities among CDAI quartiles. Weighted quantile sum (WQS) regression was conducted to evaluate the joint and independent associations of antioxidants with all-cause and CVD mortality. The median (interquartile range) age of participants was 59.00 (47.00, 69.00) years. During a median of 94 months of follow-up, 3,858 deaths were documented. Compared to participants with the lowest quartile of CDAI, the multivariable adjusted HR and 95% CI for participants with the highest quartile was 0.76 (0.64, 0.91) for all-cause mortality. The highest quartile (Q4) of vitamin E (HR = 0.69; 95% CI, 0.59-0.80), selenium (HR = 0.84; 95% CI, 0.70-1.00) and total carotenoids (HR = 0.86; 95% CI, 0.75-0.98) intakes were negatively associated with all-cause mortality. Vitamin E and selenium intakes might be the major contributors to this negative relationship. The highest quartile (Q4) of vitamin E (HR = 0.72; 95% CI, 0.56-0.93) intake was negatively associated with CVD mortality.

Conclusion: Higher overall dietary antioxidant intake was significantly associated with decreased all-cause and CVD mortality among patients with hypertension. Further randomized controlled trials are required to confirm our findings.

Background: FAO/WHO introduced food-based dietary guidelines (FBDG) to promote healthy dietary habits. To translate the FBDG, optimized food-based recommendations (FBR) can be developed using linear programming (LP) to address problem nutrients. Despite the importance of local-specific FBR for anemia prevention, no study has reported the effect of nutrition education which promoted FBR in adolescent girls. Therefore, this study aimed to investigate the effect of optimized FBR in adolescent girls in improving dietary and nutrient intakes, hemoglobin levels, and memory performance.

Methods: The intervention study was carried out in Malang District, Indonesia amongst 14-18 year adolescent girls. The study's Indonesian slogan was Remaja which meant Active, Healthy, Smart, and Creative adolescents. The optimized FBR was developed using LP and translated into six key messages. Twenty-week nutrition education was integrated into the weekly school's system.

Results: After 20 weeks, a significant increase in dietary practices (animal protein, liver, plant protein, vegetables), nutrient intakes (protein, fat, iron), and memory performance (digit span forward and backward) were found in the intervention group. In contrast, there was decreases in the control group's intakes of animal and plant protein.

Conclusions: This finding shows that nutrition education with optimized FBR increased intakes of nutrient-dense food, protein, fat, iron, and memory performance (concentration). Nutrition education with optimized FBR should be integrated into the school system together with weekly iron supplementation for anemia prevention among these adolescent girls.

Trial registration: The study was registered on ClinicalTrials.gov (ID No: NCT03946475).