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Validation of an web-based dietary assessment tool (RiksmatenFlex) against doubly labelled water and 24 h dietary recalls in pregnant women. 根据双标水和孕妇 24 小时膳食回顾验证基于网络的膳食评估工具 (RiksmatenFlex)。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-30 DOI: 10.1186/s12937-024-00987-5
Emmie Söderström, Johanna Sandborg, Ellinor Nilsson, Maria Henström, Eva Warensjö Lemming, Anna Karin Lindroos, Jennifer Rood, Jessica Petrelius Sipinen, Marie Löf

Introduction: Digital technologies have enabled new possibilities to assess dietary intake and have shown promise in terms of decreased participant burden, improved accuracy and lower costs. However, their potential and validity in pregnant populations are scarcely explored.

Objectives: This study aimed to (a) validate energy intakes obtained from a web-based dietary recall method developed for national surveys (RiksmatenFlex) against total energy expenditure (TEE) by means of the doubly labelled water (DLW) method, and (b) to compare intakes of macronutrients, key unhealthy and healthy foods as well as adherence to food-based dietary guidelines between RiksmatenFlex and repeated 24 h telephone dietary recalls in healthy Swedish pregnant women.

Methods: This study was conducted as a nested validation within the HealthyMoms trial. Intakes of foods, macronutrients and energy were assessed during three days through RiksmatenFlex and 24 h telephone dietary recalls, and Swedish Healthy Eating Index (SHEI) scores were also calculated for both methods (n = 52). For 24 women, TEE was also assessed through the DLW method. Paired Samples T-tests and Wilcoxon Signed Ranks Tests were used to identify differences between means for foods, macronutrients, energy and SHEI scores. Pearson correlation coefficient or Spearman's rho were performed to identify relationships between variables. To compare energy intake (RiksmatenFlex) with TEE (DLW method) and 24 h telephone dietary recalls, Bland and Altman plots were constructed.

Results: Average energy intake from RiksmatenFlex (10,015 [SD 2004] kJ) was not statistically different from TEE (10,252 [SD 1197] kJ) (p = 0.596) (mean difference: -237 kJ/24 h). Correspondingly, there were small mean differences between average intakes of key unhealthy and healthy foods and average SHEI scores between RiksmatenFlex and 24 h telephone dietary recalls. However, the Bland and Altman plots showed wide limits of agreement for all dietary variables (e.g., for energy intake using RiksmatenFlex versus TEE: ±4239 kJ/24 h). High correlations between the investigated dietary variables for the two dietary methods were observed (r = 0.751 to 0.931; all p < 0.001).

Conclusion: RiksmatenFlex captured average intakes of energy, unhealthy and healthy food groups and adherence to food-based dietary guidelines in a comparable way to 24 h telephone dietary recalls and the DLW method. Our results support the validity of RiksmatenFlex as a web-based dietary assessment method for future use in pregnancy for intervention studies and national dietary surveys.

简介数字技术为评估膳食摄入量提供了新的可能性,并在减轻参与者负担、提高准确性和降低成本方面显示出前景。然而,这些技术在妊娠人群中的潜力和有效性却鲜有探索:本研究的目的是:(a) 将为全国性调查开发的网络膳食回顾法(RiksmatenFlex)与通过双标水(DLW)法获得的总能量消耗(TEE)进行对比,验证能量摄入量;(b) 比较瑞典健康孕妇的宏量营养素、主要不健康和健康食物摄入量,以及 RiksmatenFlex 和重复 24 小时电话膳食回顾法对基于食物的膳食指南的遵守情况:这项研究是在HealthyMoms试验中进行的嵌套验证。通过 RiksmatenFlex 和 24 小时电话膳食回顾,对三天内的食物、宏量营养素和能量摄入量进行了评估,并计算了两种方法的瑞典健康饮食指数(SHEI)得分(n = 52)。还通过 DLW 方法对 24 名女性的 TEE 进行了评估。采用配对样本 T 检验和 Wilcoxon Signed Ranks 检验来确定食物、宏量营养素、能量和 SHEI 分数平均值之间的差异。皮尔逊相关系数或斯皮尔曼rho用于确定变量之间的关系。为了比较能量摄入量(RiksmatenFlex)与TEE(DLW法)和24小时电话膳食回忆,绘制了布兰德和阿尔特曼图:RiksmatenFlex 的平均能量摄入量(10,015 [SD 2004] kJ)与 TEE 的平均能量摄入量(10,252 [SD 1197] kJ)在统计学上没有差异(p = 0.596)(平均差异:-237 kJ/24 h)。相应地,RiksmatenFlex 和 24 小时电话膳食回顾之间主要不健康和健康食物的平均摄入量以及 SHEI 平均得分的平均差异也很小。然而,布兰德和阿尔特曼图显示,所有膳食变量的一致性范围都很大(例如,RiksmatenFlex 与 TEE 的能量摄入量比较:±4239 kJ/24 h)。两种膳食方法的调查膳食变量之间存在高度相关性(r = 0.751 至 0.931;均为 p):RiksmatenFlex 能够捕捉到能量、不健康和健康食物组的平均摄入量,以及对以食物为基础的膳食指南的遵守情况,与 24 小时电话膳食回忆和 DLW 方法具有可比性。我们的研究结果证明了 RiksmatenFlex 作为一种基于网络的膳食评估方法的有效性,未来可用于孕期干预研究和全国膳食调查。
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引用次数: 0
Disproportionately higher cardiovascular disease risk and incidence with high fructose corn syrup sweetened beverage intake among black young adults-the CARDIA study. 黑人青壮年摄入高果糖玉米糖浆甜饮料导致心血管疾病风险和发病率过高--CARDIA 研究。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-29 DOI: 10.1186/s12937-024-00978-6
Luanne Robalo DeChristopher, Katherine L Tucker

Background: The black/white heart disease mortality disparity began increasing in the early 1980's, coincident with the switch from sucrose to high-fructose-corn-syrup/(HFCS) in the US food supply. There has been more fructose in HFCS than generally-recognized-as-safe/GRAS, which has contributed to unprecedented excess-free-fructose/(unpaired-fructose) in foods/beverages. Average- per-capita excess-free-fructose, from HFCS, began exceeding dosages/(5-10 g) that trigger fructose-malabsorption in the early 1980's. Fructose malabsorption contributes to gut-dysbiosis and gut-in-situ-fructosylation of dietary peptides/incretins/(GLP-1/GIP) which forms atherosclerotic advanced-glycation-end-products. Both dysregulate gut endocrine function and are risk factors for cardiovascular disease/(CVD). Limited research shows that African Americans have higher fructose malabsorption prevalence than others. CVD risk begins early in life.

Methods: Coronary-Artery-Risk-Development-in-Adults/(CARDIA) study data beginning in 1985-86 with 2186 Black and 2277 White participants, aged 18-30 y, were used to test the hypothesis that HFCS sweetened beverage intake increases CVD risk/incidence, more among Black than White young adults, and at lower intakes; while orange juice-a low excess-free-fructose juice with comparable total sugars and total fructose, but a 1:1 fructose-to-glucose-ratio, i.e., low excess-free-fructose, does not. Cox proportional hazards models were used to calculate hazard ratios.

Results: HFCS sweetened beverage intake was associated with higher CVD risk (HR = 1.7) than smoking (HR = 1.6). CVD risk was higher at lower HFCS sweetened beverage intake among Black than White participants. Intake, as low as 3 times/wk, was associated with twice the CVD risk vs. less frequent/never, among Black participants only (HR 2.1, 95% CI 1.2-3.7; P = 0.013). Probability of an ordered relationship approached significance. Among Black participants, CVD incidence jumped 62% from 59.8/1000, among ≤ 2-times/wk, to 96.9/1000 among 3-6 times/wk consumers. Among White participants, CVD incidence increased from 37.6/1000, among ≤ 1.5-times/wk, to 41.1/1000, among 2 times/wk-once/d - a 9% increase. Hypertension was highest among Black daily HFCS sweetened beverage consumers.

Conclusion: The ubiquitous presence of HFCS over-the-past-40 years, at higher fructose-to-glucose ratios than generally-recognized-as-safe, may have contributed to CVD racial disparities, due to higher fructose-malabsorption prevalence among Black individuals, unpaired/excess-free-fructose induced gut dysbiosis and gut fructosylation of dietary peptides/incretins (GLP-1/GIP). These disturbances contribute to atherosclerotic plaque; promote incretin insufficiency/dysregulation/altered satiety/dysglycemia; decrease protective microbiota metabolites; and increase hypertension, CVD morbidity and mortality.

背景:20 世纪 80 年代初,美国食品供应从蔗糖转向高果糖玉米糖浆/(HFCS),黑人/白人心脏病死亡率的差距开始扩大。HFCS 中的果糖含量超过了公认的安全标准/GRAS,导致食品/饮料中的游离果糖/(未配对果糖)空前超标。从 20 世纪 80 年代初开始,来自 HFCS 的人均过量游离果糖开始超过引发果糖吸收不良的剂量/(5-10 克)。果糖吸收不良会导致肠道菌群失调和膳食肽/促泌素/(GLP-1/GIP)的肠道原位果糖化,从而形成动脉粥样硬化的高级糖化终产物。这两者都会导致肠道内分泌功能失调,是心血管疾病/(CVD)的风险因素。有限的研究表明,非裔美国人的果糖吸收不良率高于其他人。心血管疾病风险始于生命早期:方法:利用 1985-86 年开始的冠状动脉-成人发病风险/(CARDIA)研究数据(2186 名黑人和 2277 名白人参与者,年龄在 18-30 岁之间)来验证以下假设:摄入 HFCS 甜饮料会增加心血管疾病的风险/发病率,黑人比白人更容易增加心血管疾病的风险/发病率,而且摄入量更低;而橙汁--一种低过量游离果糖的果汁,其总糖和总果糖含量相当,但果糖与葡萄糖的比例为 1:1,即:低过量游离果糖、低过量游离果糖、低过量游离果糖和低过量游离果糖、而低过量游离果糖果汁则不然。采用 Cox 比例危险模型计算危险比:结果:与吸烟(HR = 1.6)相比,摄入 HFCS 甜饮料与更高的心血管疾病风险(HR = 1.7)相关。黑人比白人摄入较少的 HFCS 甜饮料时心血管疾病风险更高。仅在黑人参与者中,摄入量低至每周 3 次与较少摄入/从不摄入相比,心血管疾病风险高出一倍(HR 2.1,95% CI 1.2-3.7;P = 0.013)。有序关系的概率接近显著性。在黑人参与者中,心血管疾病发病率从每周≤2次的59.8/1000猛增62%至每周3-6次的96.9/1000。在白人参与者中,心血管疾病发病率从≤1.5次/周的37.6/1000上升到2次/周-1次/日的41.1/1000--增加了9%。高血压在每日饮用含氢氟碳化合物甜味饮料的黑人中发病率最高:结论:在过去的 40 年中,HFCS 无处不在,其果糖与葡萄糖的比率高于公认的安全比率,这可能是导致心血管疾病种族差异的原因之一,因为黑人的果糖吸收率较高、未配对/过量的游离果糖诱发肠道菌群失调以及膳食肽/蛋白(GLP-1/GIP)的肠道果糖基化。这些紊乱会导致动脉粥样硬化斑块;促进胰岛素不足/失调/饱腹感改变/血糖异常;减少保护性微生物群代谢物;增加高血压、心血管疾病的发病率和死亡率。
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引用次数: 0
Validation of a digital food frequency questionnaire for the Northern Sweden Diet Database. 为瑞典北部饮食数据库验证数字式食物频率问卷。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-24 DOI: 10.1186/s12937-024-00984-8
Maria Wennberg, Lisa Kastenbom, Linda Eriksson, Anna Winkvist, Ingegerd Johansson

Background: Dietary habits strongly influence health, with poor diets contributing to numerous deaths annually. Addressing this requires improved dietary habits and consistent monitoring thereof. In northern Sweden, a validated food frequency questionnaire (FFQ) has been used for decades, but trends show that its ability to accurately measure intake has diminished. With changing eating habits and food supply, updating the FFQ was crucial, leading to the development of FFQ2020. This study assessed FFQ2020's relative validity using 24-hour recalls and evaluated its reproducibility.

Methods: Participants were recruited from one of the northern-Sweden population-based health screenings and by advertising. Food intake was registered in an electronic food frequency questionnaire (FFQ2020) (test instrument) and reference data were obtained by six repeated electronic 24-hour dietary recalls (24HDR). Intakes of single foods were aggregated into food groups and healthy diet index scores, and daily energy and nutrient intakes were estimated. Results from the two methods were described and tested in univariate analyses and correlation tests, Bland Altman plots, cross-classification validity, and intra-class correlation analyses.

Results: Totally, 628 adults were invited to participate in the study. Of these, 320 joined, and 244 completed at least four 24HDRs. The median intakes in food groups, as well as the mean index scores and estimated nutrient intakes, were largely similar between the FFQ2020 and 24HDR recordings. The correlation coefficients between the two assessments ranged from 0.253 to 0.693 for food groups, 0.520 to 0.614 for diet indices, and 0.340 to 0.629 for energy and nutrients. Intra-class correlation coefficients indicated at least good reproducibility for intakes of food groups, diet index scores, and nutrients. Generally, Bland-Altman plots did not reveal any gross systematic disagreement between the two methods for any of the assessments. However, there were single observations located outside the upper or lower 95% confidence interval (CI) limits for the difference between FFQ2020 and the 24HDR recordings.

Conclusion: In concert, the results suggest that the relative validity and reproducibility of FFQ2020 are acceptable for trend analyses and group comparisons in large-scale studies but also that extended reference periods would improve the precision of less frequently consumed foods.

背景:饮食习惯对健康有很大影响,不良饮食习惯每年导致无数人死亡。要解决这一问题,就必须改善饮食习惯并对其进行持续监测。在瑞典北部,经过验证的食物频率问卷(FFQ)已经使用了几十年,但趋势表明,其准确测量摄入量的能力已经下降。随着饮食习惯和食品供应的变化,更新食物频率调查表至关重要,因此开发了 FFQ2020。本研究采用 24 小时回忆法评估了 FFQ2020 的相对有效性,并评价了其可重复性:方法:参与者是从瑞典北部的一次人口健康筛查和广告中招募的。在电子食物频率问卷(FFQ2020)(测试工具)中登记食物摄入量,并通过重复六次电子 24 小时膳食回顾(24HDR)获得参考数据。将单一食物的摄入量汇总为食物类别和健康饮食指数得分,并估算出每日能量和营养素摄入量。对两种方法的结果进行了描述,并通过单变量分析和相关性检验、布兰德-阿尔特曼图、交叉分类有效性和类内相关性分析进行了检验:共有 628 名成年人受邀参与研究。其中,320 人参加了研究,244 人完成了至少四次 24 小时动态体重监测。FFQ2020 和 24HDR 记录的食物类别摄入量中位数、平均指数得分和营养素估计摄入量基本相似。两次评估的相关系数分别为:食物组 0.253 至 0.693,膳食指数 0.520 至 0.614,能量和营养素 0.340 至 0.629。类内相关系数表明,食物组、膳食指数得分和营养素摄入量至少具有良好的重现性。一般来说,布兰-阿尔特曼图没有显示两种方法在任何一项评估中存在严重的系统性差异。不过,FFQ2020 和 24HDR 记录之间的差异有个别观测值超出了 95% 置信区间 (CI) 上限或下限:总之,研究结果表明,FFQ2020 的相对有效性和可重复性对于大规模研究中的趋势分析和组间比较是可以接受的,但延长参考期将提高较少食用食物的精确度。
{"title":"Validation of a digital food frequency questionnaire for the Northern Sweden Diet Database.","authors":"Maria Wennberg, Lisa Kastenbom, Linda Eriksson, Anna Winkvist, Ingegerd Johansson","doi":"10.1186/s12937-024-00984-8","DOIUrl":"10.1186/s12937-024-00984-8","url":null,"abstract":"<p><strong>Background: </strong>Dietary habits strongly influence health, with poor diets contributing to numerous deaths annually. Addressing this requires improved dietary habits and consistent monitoring thereof. In northern Sweden, a validated food frequency questionnaire (FFQ) has been used for decades, but trends show that its ability to accurately measure intake has diminished. With changing eating habits and food supply, updating the FFQ was crucial, leading to the development of FFQ2020. This study assessed FFQ2020's relative validity using 24-hour recalls and evaluated its reproducibility.</p><p><strong>Methods: </strong>Participants were recruited from one of the northern-Sweden population-based health screenings and by advertising. Food intake was registered in an electronic food frequency questionnaire (FFQ2020) (test instrument) and reference data were obtained by six repeated electronic 24-hour dietary recalls (24HDR). Intakes of single foods were aggregated into food groups and healthy diet index scores, and daily energy and nutrient intakes were estimated. Results from the two methods were described and tested in univariate analyses and correlation tests, Bland Altman plots, cross-classification validity, and intra-class correlation analyses.</p><p><strong>Results: </strong>Totally, 628 adults were invited to participate in the study. Of these, 320 joined, and 244 completed at least four 24HDRs. The median intakes in food groups, as well as the mean index scores and estimated nutrient intakes, were largely similar between the FFQ2020 and 24HDR recordings. The correlation coefficients between the two assessments ranged from 0.253 to 0.693 for food groups, 0.520 to 0.614 for diet indices, and 0.340 to 0.629 for energy and nutrients. Intra-class correlation coefficients indicated at least good reproducibility for intakes of food groups, diet index scores, and nutrients. Generally, Bland-Altman plots did not reveal any gross systematic disagreement between the two methods for any of the assessments. However, there were single observations located outside the upper or lower 95% confidence interval (CI) limits for the difference between FFQ2020 and the 24HDR recordings.</p><p><strong>Conclusion: </strong>In concert, the results suggest that the relative validity and reproducibility of FFQ2020 are acceptable for trend analyses and group comparisons in large-scale studies but also that extended reference periods would improve the precision of less frequently consumed foods.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"23 1","pages":"83"},"PeriodicalIF":4.4,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11267735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply to Ghobadi and Jafari: diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study. 回复 Ghobadi 和 Jafari:饮食质量与伊朗成年人高血压风险的关系:Fasa PERSIAN 队列研究的横断面分析。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-24 DOI: 10.1186/s12937-024-00988-4
Amir Motamedi, Maryam Ekramzadeh, Ehsan Bahramali, Mojtaba Farjam, Reza Homayounfar

Ghobadi and Jafari have mentioned some points about our article titled "Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study" which was published in the Nutrition Journal. Thanks for their consideration, the following is provided as a response to their comments.

Ghobadi 和 Jafari 对我们发表在《营养学杂志》上的题为 "饮食质量与伊朗成年人高血压风险的关系:Fasa PERSIAN 队列研究的横断面分析 "的文章提出了一些看法。感谢他们的考虑,以下是对他们意见的回应。
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引用次数: 0
Very high high-density lipoprotein cholesterol may be associated with higher risk of cognitive impairment in older adults. 极高的高密度脂蛋白胆固醇可能与老年人认知障碍的高风险有关。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-17 DOI: 10.1186/s12937-024-00983-9
Huifan Huang, Bin Yang, Renhe Yu, Wen Ouyang, Jianbin Tong, Yuan Le

Background: Previous studies have shown that high-density lipoprotein cholesterol (HDL-C) levels are positively associated with cognitive function across a range of concentrations. However, recent studies have suggested that very high HDL-C levels may lead to poorer outcomes. Therefore, we aimed to investigate the relationship between different concentrations of HDL-C and cognitive impairment risk.

Methods: We collected data from 3632 participants aged over 60 years from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014 to assess the relationship between HDL-C and cognitive function. Cognitive function was evaluated with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the animal fluency test (AFT), and the digit symbol substitution test (DSST). We used restricted cubic spline models and logistic regression to examine the association between HDL-C and cognitive function.

Results: A U-shaped was observed between HDL-C and cognitive outcomes, individuals with higher risk in those with both low and very high HDL-C levels compared with those with midrange values. Very high HDL-C levels (≥ 2.50 mmol/L) were associated with increased risk of cognitive impairment (OR = 2.19; 95% CI, 1.12-4.28) compared with those with HDL-C levels in the range of 1.50 to 1.99 mmol/L in older adults after adjustment for confounding factors. Interaction test demonstrated that relationship between very high HDL-C and the risk of cognitive impairment was not changed in different sex and race group (P for interaction > 0.05).

Conclusions: Very high HDL-C levels were associated with an increased risk of cognitive impairment. HDL-C may not be a protective factor for maintaining brain health in older adults at very high levels.

背景:以往的研究表明,在不同浓度范围内,高密度脂蛋白胆固醇(HDL-C)水平与认知功能呈正相关。然而,最近的研究表明,极高的 HDL-C 水平可能会导致较差的结果。因此,我们旨在研究不同浓度的 HDL-C 与认知障碍风险之间的关系:我们收集了 2011 年至 2014 年间美国国家健康与营养调查(NHANES)中 3632 名 60 岁以上参与者的数据,以评估 HDL-C 与认知功能之间的关系。认知功能通过阿尔茨海默病登记联盟(CERAD)测试、动物流畅性测试(AFT)和数字符号替换测试(DSST)进行评估。我们使用限制性三次样条模型和逻辑回归来研究高密度脂蛋白胆固醇与认知功能之间的关系:结果:HDL-C 与认知结果之间呈 U 型关系,HDL-C 水平较低和很高的个体与中等水平的个体相比风险更高。在对混杂因素进行调整后,与 HDL-C 水平在 1.50 至 1.99 mmol/L 之间的老年人相比,HDL-C 水平极高(≥ 2.50 mmol/L)的老年人认知功能受损的风险更高(OR = 2.19;95% CI,1.12-4.28)。交互检验表明,在不同性别和种族组中,极高的高密度脂蛋白胆固醇与认知障碍风险之间的关系没有变化(交互检验的 P > 0.05):结论:极高的高密度脂蛋白胆固醇水平与认知障碍风险增加有关。结论:超高的高密度脂蛋白胆固醇水平与认知障碍风险的增加有关。超高的高密度脂蛋白胆固醇可能不是老年人保持大脑健康的保护因素。
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引用次数: 0
Serum levels of vitamin B12 combined with folate and plasma total homocysteine predict ischemic stroke disease: a retrospective case-control study. 血清维生素 B12 和叶酸水平以及血浆同型半胱氨酸总量可预测缺血性中风疾病:一项回顾性病例对照研究。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-16 DOI: 10.1186/s12937-024-00977-7
Li Zhou, Jiani Wang, Haiyun Wu, Pingping Yu, Zhongxiang He, Yongjun Tan, Youlin Wu, Xiaosong Song, Xia Chen, Yilin Wang, Qin Yang
<p><strong>Purpose: </strong>This study aimed to identify and quantify the association and investigate whether serum vitamin B12 alone or vitamin B12 combined with folate and plasma total homocysteine (tHcy) levels could be used to predict the risk of acute ischemic stroke.</p><p><strong>Materials and methods: </strong>This retrospective case-control study was conducted in the Department of Neurology, First Affiliated Hospital of Chongqing Medical University. It included 259 inpatients experiencing their first-ever acute ischemic stroke and 259 age-matched, sex-matched healthy controls. Patients were categorized into groups based on the etiology of their stroke: large-artery atherosclerosis (LAAS, n = 126), cardio embolism (CEI, n = 35), small vessel disease (SVD, n = 89), stroke of other determined etiology (ODE, n = 5), and stroke of undetermined etiology (UDE, n = 4). The associations of serum vitamin B12, folate, and plasma tHcy levels with the risk of ischemic stroke were evaluated using multivariable logistic regression analysis. Receiver operator characteristic (ROC) curves were used to assess the diagnostic power of vitamin B12, folate, and tHcy levels for ischemic stroke.</p><p><strong>Results: </strong>Serum vitamin B12 and folate levels were significantly lower in ischemic stroke patients compared to controls, while plasma tHcy levels were significantly higher. The first quartile of serum vitamin B12 levels was significantly associated with an increased risk of LAAS (aOR = 2.289, 95% CI = 1.098-4.770), SVD (aOR = 4.471, 95% CI = 1.110-4.945) and overall ischemic stroke (aOR = 3.216, 95% CI = 1.733-5.966). Similarly, the first quartile of serum folate levels was associated with an increased risk of LAAS (aOR = 3.480, 95% CI = 1.954-6.449), CEI (aOR = 2.809, 95% CI = 1.073-4.991), SVD (aOR = 5.376, 95% CI = 1.708-6.924), and overall ischemic stroke (aOR = 3.381, 95% CI = 1.535-7.449). The fourth quartile of tHcy levels was also significantly associated with an increased risk of LAAS (aOR = 2.946, 95% CI = 1.008-5.148), CEI (aOR = 2.212, 95% CI = 1.247-5.946), SVD (aOR = 2.957, 95% CI = 1.324-6.054), and overall ischemic stroke (aOR = 2.233, 95% CI = 1.586-4.592). For predicting different types of ischemic stroke, vitamin B12 alone demonstrated the best diagnostic value for SVD, evidenced by a sensitivity of 71.0% and negative predictive value of 90.3%, along with the highest positive likelihood ratio (+ LR) for SVD. Vitamin B12 + tHcy + folate are valuable in predicting different types of ischemic stroke, with the most significant effect observed in SVD, followed by LAAS, and the weakest predictive effect in CEI. Additionally, vitamin B12 alone in combination with other indicators, such as folate alone, tHcy alone, and folate + tHcy could reduce negative likelihood ratio (-LR) and improve + LR.</p><p><strong>Conclusions: </strong>Vitamin B12 was an independent risk factor for acute ischemic stroke. The risk calculation model constructed
目的:本研究旨在确定和量化血清维生素B12单独或维生素B12与叶酸和血浆总同型半胱氨酸(tHcy)水平的相关性,并探讨是否可用于预测急性缺血性脑卒中的风险:这项回顾性病例对照研究在重庆医科大学附属第一医院神经内科进行。研究纳入了 259 例首次急性缺血性脑卒中住院患者和 259 例年龄、性别匹配的健康对照者。根据脑卒中的病因将患者分为以下几组:大动脉粥样硬化(LAAS,126 人)、心脏栓塞(CEI,35 人)、小血管疾病(SVD,89 人)、其他病因脑卒中(ODE,5 人)和病因未定脑卒中(UDE,4 人)。采用多变量逻辑回归分析评估了血清维生素 B12、叶酸和血浆 tHcy 水平与缺血性脑卒中风险的关系。使用接收者操作特征(ROC)曲线评估维生素 B12、叶酸和 tHcy 水平对缺血性中风的诊断能力:结果:与对照组相比,缺血性脑卒中患者的血清维生素 B12 和叶酸水平明显较低,而血浆 tHcy 水平则明显较高。血清维生素 B12 水平的前四分位数与 LAAS(aOR = 2.289,95% CI = 1.098-4.770)、SVD(aOR = 4.471,95% CI = 1.110-4.945)和整个缺血性中风(aOR = 3.216,95% CI = 1.733-5.966)风险的增加明显相关。同样,血清叶酸水平的第一四分位数与 LAAS(aOR = 3.480,95% CI = 1.954-6.449)、CEI(aOR = 2.809,95% CI = 1.073-4.991)、SVD(aOR = 5.376,95% CI = 1.708-6.924)和总体缺血性卒中(aOR = 3.381,95% CI = 1.535-7.449)风险增加相关。tHcy 水平的第四四分位数也与 LAAS(aOR = 2.946,95% CI = 1.008-5.148)、CEI(aOR = 2.212,95% CI = 1.247-5.946)、SVD(aOR = 2.957,95% CI = 1.324-6.054)和总体缺血性卒中(aOR = 2.233,95% CI = 1.586-4.592)风险的增加显著相关。在预测不同类型的缺血性中风时,维生素 B12 本身对 SVD 的诊断价值最高,灵敏度为 71.0%,阴性预测值为 90.3%,对 SVD 的阳性似然比 (+ LR) 也最高。维生素 B12 + tHcy + 叶酸对预测不同类型的缺血性卒中具有重要价值,其中对 SVD 的预测效果最显著,其次是 LAAS,而对 CEI 的预测效果最弱。此外,维生素 B12 单独与其他指标(如叶酸单独、tHcy 单独和叶酸 + tHcy)结合使用可降低负似然比(-LR),提高 + LR:维生素 B12 是急性缺血性脑卒中的独立危险因素。结论:维生素 B12 是急性缺血性卒中的独立危险因素,维生素 B12 + tHcy + 叶酸构建的风险计算模型对 SVD 具有最大的诊断价值。
{"title":"Serum levels of vitamin B12 combined with folate and plasma total homocysteine predict ischemic stroke disease: a retrospective case-control study.","authors":"Li Zhou, Jiani Wang, Haiyun Wu, Pingping Yu, Zhongxiang He, Yongjun Tan, Youlin Wu, Xiaosong Song, Xia Chen, Yilin Wang, Qin Yang","doi":"10.1186/s12937-024-00977-7","DOIUrl":"10.1186/s12937-024-00977-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to identify and quantify the association and investigate whether serum vitamin B12 alone or vitamin B12 combined with folate and plasma total homocysteine (tHcy) levels could be used to predict the risk of acute ischemic stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This retrospective case-control study was conducted in the Department of Neurology, First Affiliated Hospital of Chongqing Medical University. It included 259 inpatients experiencing their first-ever acute ischemic stroke and 259 age-matched, sex-matched healthy controls. Patients were categorized into groups based on the etiology of their stroke: large-artery atherosclerosis (LAAS, n = 126), cardio embolism (CEI, n = 35), small vessel disease (SVD, n = 89), stroke of other determined etiology (ODE, n = 5), and stroke of undetermined etiology (UDE, n = 4). The associations of serum vitamin B12, folate, and plasma tHcy levels with the risk of ischemic stroke were evaluated using multivariable logistic regression analysis. Receiver operator characteristic (ROC) curves were used to assess the diagnostic power of vitamin B12, folate, and tHcy levels for ischemic stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Serum vitamin B12 and folate levels were significantly lower in ischemic stroke patients compared to controls, while plasma tHcy levels were significantly higher. The first quartile of serum vitamin B12 levels was significantly associated with an increased risk of LAAS (aOR = 2.289, 95% CI = 1.098-4.770), SVD (aOR = 4.471, 95% CI = 1.110-4.945) and overall ischemic stroke (aOR = 3.216, 95% CI = 1.733-5.966). Similarly, the first quartile of serum folate levels was associated with an increased risk of LAAS (aOR = 3.480, 95% CI = 1.954-6.449), CEI (aOR = 2.809, 95% CI = 1.073-4.991), SVD (aOR = 5.376, 95% CI = 1.708-6.924), and overall ischemic stroke (aOR = 3.381, 95% CI = 1.535-7.449). The fourth quartile of tHcy levels was also significantly associated with an increased risk of LAAS (aOR = 2.946, 95% CI = 1.008-5.148), CEI (aOR = 2.212, 95% CI = 1.247-5.946), SVD (aOR = 2.957, 95% CI = 1.324-6.054), and overall ischemic stroke (aOR = 2.233, 95% CI = 1.586-4.592). For predicting different types of ischemic stroke, vitamin B12 alone demonstrated the best diagnostic value for SVD, evidenced by a sensitivity of 71.0% and negative predictive value of 90.3%, along with the highest positive likelihood ratio (+ LR) for SVD. Vitamin B12 + tHcy + folate are valuable in predicting different types of ischemic stroke, with the most significant effect observed in SVD, followed by LAAS, and the weakest predictive effect in CEI. Additionally, vitamin B12 alone in combination with other indicators, such as folate alone, tHcy alone, and folate + tHcy could reduce negative likelihood ratio (-LR) and improve + LR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Vitamin B12 was an independent risk factor for acute ischemic stroke. The risk calculation model constructed ","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"23 1","pages":"76"},"PeriodicalIF":4.4,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seafood intake in childhood/adolescence and the risk of obesity: results from a Nationwide Cohort Study. 儿童/青少年时期的海鲜摄入量与肥胖风险:全国队列研究的结果。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-16 DOI: 10.1186/s12937-024-00986-6
Tianyue Zhang, Hao Ye, Xiaoqin Pang, Xiaohui Liu, Yepeng Hu, Yuanyou Wang, Chao Zheng, Jingjing Jiao, Xiaohong Xu

Background & aims: Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort.

Methods: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611-2018).

Results: During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance.

Conclusion: Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.

背景与目的:肥胖与各种有害健康的后果有关。虽然已有证据表明海鲜摄入量与成人肥胖之间存在负相关,但目前还缺乏对儿童/青少年海鲜摄入量与肥胖风险之间关系的研究。我们的目的是评估中国全国队列中儿童/青少年海鲜摄入量与肥胖风险之间的关系:我们利用了中国健康与营养调查(CHNS)1997 年至 2015 年的数据。海鲜摄入量通过 3 天 24 小时回忆进行评估。在我们的研究中,超重/肥胖状态根据《中国学龄儿童和青少年超重和肥胖标准》(WS/T 586-2018)确定,而腹型肥胖状态则根据《中国儿童青少年腰围筛查阈值标准》(WS/T 611-2018)确定:在平均7.9年的随访期间,2206名海产品超重/肥胖分析参与者中有404例出现超重/肥胖,而2256名海产品腹部肥胖分析参与者中有381例出现腹部肥胖。在对社会人口学和生活方式因素进行充分调整后,与非消费群体相比,高消费群体的超重/肥胖风险降低了35%,腹部肥胖风险降低了26%。考虑到不同的烹饪方法,在完全调整模型中,水煮海鲜与超重/肥胖风险降低43%和腹部肥胖风险降低23%相关,而炒海鲜则没有统计学意义:结论:儿童/青少年海鲜摄入量越高,尤其是水煮海鲜摄入量越高,肥胖风险越低。
{"title":"Seafood intake in childhood/adolescence and the risk of obesity: results from a Nationwide Cohort Study.","authors":"Tianyue Zhang, Hao Ye, Xiaoqin Pang, Xiaohui Liu, Yepeng Hu, Yuanyou Wang, Chao Zheng, Jingjing Jiao, Xiaohong Xu","doi":"10.1186/s12937-024-00986-6","DOIUrl":"10.1186/s12937-024-00986-6","url":null,"abstract":"<p><strong>Background & aims: </strong>Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort.</p><p><strong>Methods: </strong>We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611-2018).</p><p><strong>Results: </strong>During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance.</p><p><strong>Conclusion: </strong>Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"23 1","pages":"77"},"PeriodicalIF":4.4,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is the frequency of breakfast consumption associated with life satisfaction in children and adolescents? A cross-sectional study with 154,151 participants from 42 countries. 吃早餐的频率与儿童和青少年的生活满意度有关吗?一项针对 42 个国家 154 151 名参与者的横断面研究。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-16 DOI: 10.1186/s12937-024-00979-5
José Francisco López-Gil, Mark A Tully, Carlos Cristi-Montero, Javier Brazo-Sayavera, Anelise Reis Gaya, Joaquín Calatayud, Rubén López-Bueno, Lee Smith

Background: The promotion of daily breakfast consumption and the importance of making appropriate breakfast choices have been underscored as significant public health messages. The aim of this study was to examine the relationship between breakfast frequency and life satisfaction in large and representative samples of school-going children and adolescents aged 10-17 years from 42 different countries.

Methods: This study used information from the 2017/2018 Health Behavior in School-aged Children study, comprising nationally representative samples of children and adolescents aged 10-17 years who were attending school. The total number of participants from the 42 countries included in the study was 155,451 (51.3% girls). The evaluation of breakfast consumption in this study involved a specific question: "How often do you typically have breakfast (more than a glass of milk or fruit juice)?". To measure life satisfaction, a subjective assessment scale was used in the form of a ladder, visually spanning from 0 to 10. On this scale, the topmost point (10) denotes the highest conceivable quality of life, whereas the bottom point (0) represents the worst imaginable quality of life.

Results: After adjusting for several covariates, the lowest estimated marginal mean of life satisfaction was identified in those participants who skipped breakfast (mean [M] = 5.6, 95% confidence interval [CI] 5.5 to 5.8). Conversely, the highest estimated marginal mean of life satisfaction was observed in those who had breakfast every day (M = 6.5, 95% CI 6.3 to 6.6). Overall, a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents was identified (p-for-trend < 0.001). In addition, the highest estimated marginal mean of life satisfaction score was identified in those participants from Portugal who had breakfast every day (M = 7.7; 95% CI 6.9 to 8.5 points). Conversely, the lowest estimated marginal mean of life satisfaction was observed in those participants from Romania who no breakfast (M = 3.5; 95% CI 2.6 to 4.4 points).

Conclusions: There is a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents. Considering the potential health advantages associated with breakfast during this critical age phase, these findings imply the necessity for additional global efforts to promote increased breakfast consumption among children and adolescents.

背景:提倡每天食用早餐和选择适当早餐的重要性已被强调为重要的公共健康信息。本研究的目的是在来自 42 个不同国家的 10-17 岁在校儿童和青少年的大型代表性样本中,研究早餐频率与生活满意度之间的关系:本研究使用了 2017/2018 年学龄儿童健康行为研究的信息,其中包括具有全国代表性的 10-17 岁在校儿童和青少年样本。来自 42 个国家的参与者共计 155 451 人(51.3% 为女孩)。在这项研究中,对早餐消费的评估涉及一个具体问题:"您通常多长时间吃一次早餐(一杯牛奶或果汁以上)?为了测量生活满意度,采用了一种主观评估量表,其形式为阶梯式,视觉跨度从 0 到 10。在这个阶梯上,最高点(10)代表可以想象的最高生活质量,而最低点(0)则代表可以想象的最差生活质量:在对几个协变量进行调整后,不吃早餐的参与者的生活满意度估计边际平均值最低(平均值 [M] = 5.6,95% 置信区间 [CI] 5.5 至 5.8)。相反,每天都吃早餐的参与者的生活满意度估计边际平均值最高(平均值[M] = 6.5,95% 置信区间[CI] 为 6.3 至 6.6)。总体而言,儿童和青少年吃早餐的频率越高,生活满意度越高,两者之间几乎呈线性关系(P-趋势结论):儿童和青少年吃早餐的频率越高,生活满意度越高,两者之间几乎呈线性关系。考虑到在这一关键年龄阶段吃早餐对健康的潜在益处,这些发现意味着有必要在全球范围内加大力度,促进儿童和青少年更多地食用早餐。
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引用次数: 0
Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: an investigation in Vermont. 在 COVID-19 大流行的最初几个月参与联邦营养援助计划的经历:佛蒙特州的一项调查。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-15 DOI: 10.1186/s12937-024-00963-z
Emma H Spence, Meredith T Niles, Farryl Bertmann, Emily H Belarmino

Background: Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes.

Methods: Using data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality.

Results: One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use.

Conclusions: We found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.

背景:联邦营养援助计划是许多美国家庭的安全网,参与该计划可提高粮食安全,在某些情况下还可改善饮食质量和心理健康。COVID-19 大流行带来了新的和更多的经济、社会和心理挑战,因此有必要调查营养援助计划是如何运作的以及与公共卫生结果的关联:利用 2020 年 7 月至 9 月期间在佛蒙特州进行的一项具有代表性的全州调查(n = 600)中的数据,我们研究了参与者在主要联邦营养援助计划方面的经验:补充营养援助计划 (SNAP)、妇女、婴儿和儿童特别补充营养计划 (WIC) 以及学校膳食计划。我们探讨了有关对计划效用看法的定量和定性回答,并结合使用近邻匹配分析和双变量统计检验来评估计划参与与食物不安全、感知压力以及作为饮食质量指标的水果和蔬菜摄入量之间的关联:四分之一的受访者(27.3%)至少参加过一项联邦营养援助计划。与未参与计划的受访者相比,我们发现参与计划的受访者中粮食不安全的比例更高(57.5% 对 18.1%;P 结论:我们发现,联邦营养援助计划作为一种膳食质量指标,能够帮助受访者提高膳食质量:我们发现,在 COVID-19 大流行的最初几个月中,联邦营养援助计划作为一个群体并不足以解决佛蒙特州的食物不安全和压力问题,也不足以增加水果和蔬菜的摄入量。尽管如此,参与者还是认为参与这些计划是有益的。要优化营养援助计划的效用,就必须对其在巨大压力条件下的功能进行严格审查。
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引用次数: 0
Lower energy intake associated with higher risk of cardiovascular mortality in chronic kidney disease patients on a low-protein diets. 低蛋白饮食的慢性肾病患者能量摄入较低与心血管死亡风险较高有关。
IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-07-15 DOI: 10.1186/s12937-024-00980-y
Yao Liu, Fei Deng, Ping Zhou, Cong Peng, ChunPeng Xie, Wuyu Gao, Qianyu Yang, Tingyu Wu, Xiang Xiao

Objective: An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD.

Methods: This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD.

Results: Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83).

Conclusion: CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD.

目的:越来越多的研究表明,能量摄入不足会导致低蛋白饮食(LPD)的慢性肾脏病(CKD)患者不良事件的增加。本研究旨在调查低蛋白饮食的慢性肾脏病患者的能量摄入与心血管死亡率之间的关系:这是一项横断面研究,2009年至2018年期间,共有4264名CKD患者从NHANES数据库中注册。研究采用限制立方样条图和 Cox 回归分析方法,分析接受 LPD 的 CKD 患者能量摄入与心血管疾病死亡率之间的关系。此外,还构建了一个提名图来估算接受低密度脂蛋白血症治疗的 CKD 患者的心血管存活率:结果:在美国接受低密度脂蛋白胆固醇治疗的 CKD 患者中,90.05% 的能量摄入量低于 25 千卡/千克/天,而在非低密度脂蛋白胆固醇治疗的 CKD 患者中,这一比例为 36.94%。接受低密度脂蛋白胆固醇治疗的慢性肾脏病患者的能量摄入量与心血管死亡率呈线性关系,而接受非低密度脂蛋白胆固醇治疗的慢性肾脏病患者的能量摄入量与心血管死亡率呈 "U "型关系。多因素 Cox 回归模型显示,能量摄入量每标准差(Per-SD)下降,低密度脂蛋白血症患者的心血管死亡风险增加 41%(HR:1.41,95% CI:1.12,1.77;P = 0.004)。提名图的一致性指数为 0.79 (95% CI, 0.75, 0.83):结论:慢性肾脏病患者,尤其是接受低密度脂蛋白血症治疗的患者,能量摄入明显不足。结论:接受低密度脂蛋白血症治疗的慢性肾脏病患者,尤其是低密度脂蛋白血症患者,能量摄入不足与心血管死亡率升高有关。
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引用次数: 0
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Nutrition Journal
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