Nutrition Journal最新文献

Aim: This study aimed to explore the association between the geriatric nutritional risk index (GNRI) and the risk of mortality in critically ill older patients with community-acquired pneumonia (CAP).

Methods: This retrospective study included 1924 critically ill patients with CAP from the Medical Information Mart for Intensive Care-IV3.1 (MIMIC-IV3.1) database. The participants were grouped into four groups based on GNRI levels. The clinical outcome was 30-day, 90-day, 180-day, and 1-year mortality. Cox proportional hazards regression analysis and restricted cubic spline regression were used to evaluate the association between the GNRI and clinical outcomes in critically ill older patients with CAP.

Results: A total of 1924 patients (56.9% male) were included in the study. The 30-day, 90-day, 180-day, and 1-year mortality were 37.7%, 47.7%, 54.0% and 59.1%, respectively. Multivariate Cox proportional hazards analysis showed that the GNRI was independently associated with all-cause mortality. After adjusting for confounders, GNRI remained significantly associated with both short- and long-term mortality. Restricted cubic splines revealed a linear association between GNRI and all-cause mortality in CAP patients.

Conclusion: Our study indicates that the GNRI has a significant association with all-cause mortality in critically ill older patients with CAP. However, further confirmation of these findings requires larger prospective studies.

Background: Obesity has been identified as one of the contributing factors to obstructive sleep apnea (OSA). The current obesity assessment indicators have poor ability to distinguish between fat and muscle. Relative fat mass (RFM) a new indicator of obesity that takes into account gender differences and can predict body fat conditions has advantage in this respect. This study aimed to investigate the potential association between RFM and OSA, as well as the possible mediating effect of hypertension.

Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey conducted in 2005-2008 and 2015-2018. Multivariate logistic regression, restricted cubic splines (RCS), and subgroup analyses were performed to evaluate the association between RFM and OSA. In addition, the receiver operating characteristic curve (ROC) of different obesity indicators was compared to assess their predictive ability for OSA. Mediation analysis was used to explore the potential mediating role of hypertension in the positive correlation.

Results: The study included 13,532 participants with complete study data, of which 6854 were assessed as having OSA according to the criteria, accounting for 50.65% of the study population. The results of the multivariate logistic regression model with fully adjusted covariates showed that the odds ratio of RFM was 1.096 (95%CI:1.084-1.109, P < 0.001). The results of the RCS show that RFM is nonlinearly correlated with OSA (P for nonlinear < 0.01). Subgroup analysis showed that the association between RFM and OSA was stronger in female and people younger than 60. The ROC also indicates that, compared with the body roundness index and weight-adjusted-waist index, RFM showed potential as a predictor. Mediation analysis and sensitivity analysis showed that hypertension had a statistically significant but poorly robust mediating effect between RFM and OSA.

Conclusion: There is a positive and nonlinear correlation between RFM and OSA. Hypertension plays a potential mediating role in the positive association between RFM and OSA, but its robustness is poor. RFM shows potential as a predictor of OSA, but more prospective studies are needed to confirm these findings and determine the causal relationship between RFM and OSA.

Background: Research on the association between carbohydrate intake and psoriasis risk is limited. We aimed to examine the associations of carbohydrate and its different subtypes with psoriasis risk, as well as the interaction between genetic predisposition and carbohydrate intake.

Methods: We performed a prospective cohort study based on UK Biobank that included 210,474 participants who did not have psoriasis at baseline. A 24-hour dietary assessment tool was used to assess detailed dietary intake information. Incident psoriasis events were identified through hospitalization records. The association between carbohydrate intake and psoriasis was examined by Cox proportional hazard regression models. Multiplicative interaction between genetic risk and carbohydrate intake was assessed by incorporating a cross-product term in the model.

Results: A total of 1907 incident psoriasis events were recorded during the follow-up period (median: 13.25 years). Compared to the lowest intake quartile (Q1), the highest intake quartile (Q4) of total sugars [HR (95% CI) = 1.14 (1.01-1.29), FDR-P_trend = 0.116], free sugars [1.22 (1.07-1.38), 0.021], and sucrose [1.14 (1.01-1.30), 0.058] was associated with an increased psoriasis risk. In contrast, the highest intake of starch [0.86 (0.76-0.98), 0.049] and fiber [0.84 (0.74-0.96), 0.021] showed an inverse association with psoriasis risk. However, there was no statistically significant interaction between carbohydrate intake and genetic risk.

Conclusion: Intake of total sugars, free sugar, and sucrose was positively associated with psoriasis risk, while fiber and starch were inversely associated.

Background: Skeletal muscle health influences overall health and functionality. Nutrition is an important contributor to muscle health, however there is insufficient research on the relation between nutrition and muscle composition, i.e. mass and fatty infiltration, on a population-based level.

Objective: We aimed to investigate the association of habitual dietary intake of energy-providing nutrients (carbohydrates, fat, protein and alcohol) and of essential amino acids with skeletal muscle fat and muscle area derived by magnetic resonance imaging (MRI) in a sample of middle-aged individuals from a population-based cohort.

Methods: We analyzed N = 294 individuals (45% women, mean age 56.5 years) from the KORA-MRI study, Southern Germany. Muscle fat (%) and muscle area (cm²) were assessed by a multi-echo Dixon sequence on whole-body MRI. Habitual dietary intake was calculated based on repeated 24 h recalls and a food frequency questionnaire. Correlation analyses and adjusted regression models were calculated.

Results: Alcohol intake was associated with increased skeletal muscle fat, particularly in men (β = 0.28%, 95% confidence interval [0.10%,0.45%]; p = 0.002) per percent of total energy intake). Protein intake was tentatively associated with lower muscle fat (β=-0.33% [-0.68%,0.01%]; p = 0.052). Accounting for overall protein and energy, specific essential amino acids were tentatively associated with lower muscle fat, e.g. leucine (β=-0.63%, [-1.27%,0.01%]; p = 0.054).

Conclusion: In middle-aged adults, habitual alcohol and protein intake are associated with fatty infiltration of skeletal muscle. Individualized diet adaptations might improve muscle composition and function.

Background: Avenanthramides (AVAs) and Avenacosides (AVEs) are unique to oats (Avena Sativa) and may serve as biomarkers of oat intake. However, information regarding their validity as food intake biomarkers is missing. We aimed to investigate critical validation parameters such as half-lives, dose-response, matrix effects, relative bioavailability under single dose, and in relation to the abundance of Feacalibacterium prausnitzii, and under repeated dosing, to understand the potential applications of AVAs and AVEs as biomarkers of oat intake.

Methods: Twenty-one healthy participants consumed two oat products (solid and liquid) in a non-blinded randomized crossover study for the pharmacokinetics (PK) assessment of multiple AVAs (2p, 2c,2f, 2fd and 2pd) and AVEs (A and B). At phase I, postprandial data were collected after a single dose of either product. At phase II, fasting sample was drawn after a 4-days repeated dose setup. The postprandial data were used in a compartmental PK model and the PK parameters were consequently utilized to predict individual plasma concentrations, which were compared with the data of the second phase of the study.

Results: T_max values were shorter in liquid compared to solid form for AVAs (0.7-1.6 h and 1.1-2.3 h, respectively). In liquid, T_1/2 were 1.3 h (AVA 2p and AVA 2fd), 3.2 h (AVA 2f, AVE A) and 2.5 h (AVA 2pd, AVE B). In solid form, T_1/2 were shorter for AVAs (1.4-2.6 h) compared to AVEs (3.3-3.8 h). The normalized area under the curve (AUC_norm) was greater for liquid than solid form for AVA2p, 2f and AVE-A [0.7-27 nM∙h (liquid), 0.4-20.1 (solid)] while for AVE-B AUC_norm were comparable [1.8 ± 0.2 nM∙h (liquid),2.1 ± 0.3 nM∙h (solid)]. A pharmakcokinetic prediction model described 75% of the experimental plasma-concentration data from phase II, with good agreement (bias: -0.145 nM).

Conclusions: AVAs are promising candidates as compliance biomarkers of oat intake in intervention studies regardless of the tested food matrices. However, due to their short elimination half-lives, their applicability in nutritional epidemiology where long-term habitual intake is of main interest, seems restricted.

Clinical trial number: This study was registered at clinicaltrials.gov with the clinical trial number: NCT05511077, on August 22nd, 2022.

Background: The potential association between dietary inflammatory index (DII) and colorectal cancer (CRC) risk, as well as colorectal adenomas (CRA) risk, has been extensively studied, but the findings remain inconclusive. We conducted this systematic review and dose-response meta-analysis to investigate the relationship between the DII and CRC and CRA.

Methods: We comprehensively searched the PubMed, Embase, Cochrane Library, and Web of Science databases for cohort and case-control studies reporting the relationship between DII and CRA, or between DII and CRC, as of 15 July 2025. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Dose-response analysis was conducted where possible. Subgroup analyses were conducted to account for possible sources of heterogeneity. Funnel plot, Egger's test, and Begg's test were utilized to assess publication bias.

Results: Twenty-two studies were included, involving 7,612 CRA patients, 25,359 CRC patients, and 896,592 controls. The pooled ORs for CRC and CRA in total population comparing the highest DII to the lowest DII were 1.61 (95% CI, 1.42-1.83) and 1.19 (95% CI, 0.96-1.47), respectively. The pooled ORs for CRC and CRA per unit increase in DII were 1.14 (95% CI, 1.08-1.20) and 1.19 (95% CI, 1.03-1.38), respectively. Stratification by sex revealed a positive association between DII and CRC risk in both males and females. However, this association was stronger in males (Highest DII vs. lowest DII: OR = 1.67, 95% CI [1.39, 2.00]) (Continues DII: OR = 1.16, 95%CI [1.06, 1.26]). Dose-response analysis revealed a nonlinear positive correlation between CRC risk and DII (P _{for non-linearity} < 0.0001).

Conclusions: Our findings suggest that dietary habits characterized by a high inflammatory index may increase the risk of CRA and CRC. TRIAL REGISTRATION : PROSPERO registration number: CRD42025641934.

Objective: This study analyzed data from the US population to examine how oral microbiome diversity and diet quality individually and synergistically affect frailty.

Methods: This study included 6,283 participants aged 20 years or older from the 2009-2010 and 2011-2012 NHANES cycles. A frailty index (FI) consisting of 36 items was developed, with items related to nutritional status excluded. The diversity of the oral microbiome was assessed using α-diversity, including observed ASVs, the Shannon-Weiner index, Faith's phylogenetic diversity (PD), and the Simpson index. Dietary quality was assessed using Dietary Inflammatory Index (DII), Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet Score (MED), and Alternate Healthy Eating Index (AHEI). Multivariable logistic models were employed to examine the separate and combined associations of oral microbiome diversity and four dietary quality scores with FI, with interaction effects were explored. Several subgroup analyses and sensitivity analyses were conducted to assess the robustness of our findings. Furthermore, the mediation analysis was used to explore oral microbiome diversity as a mediator in the relationship between dietary scores and FI.

Results: Both oral microbiome diversity and dietary quality scores showed significant individual associations with FI. Jointly, those in the highest tertile of oral microbiome diversity and the lowest tertile of DII had lower FI [β_{Observed ASVs} (95% CI) = -2.544(-3.678,-1.411); β_{Faith's PD} (95% CI) = -2.688(-3.783,-1.593); β_{Shannon-Weiner index} (95% CI) = -2.359(-3.333,-1.386); β_{Simpson index} (95% CI) = -1.93(-2.879,-0.981)], compared to participants in the lowest tertile of oral microbiome diversity and the highest tertile of DII. A significant interaction between oral microbiome diversity (Observed ASVs and Faith's PD) and DII in relation to FI reduction was found (P for interaction_{Observed ASVs*DII} = 0.032, P for interaction_{Faith's PD*DII} = 0.014). Other dietary scores showed similar joint associations of oral microbiome diversity with FI, but no significant interactions were observed. Further mediation analysis indicated that the proportion of DII's effect on FI mediated through Observed ASVs, Faith's PD, and the Shannon-Weiner index was 8.7%, 7.5%, and 3.4%, respectively.

Conclusion: This study demonstrates that a high-quality diet and greater α-diversity of oral microbiota are significantly associated with a reduced risk of frailty. Notably, the interaction between DII and the diversity of the oral microbiota exerts a particularly substantial influence on frailty risk.

Background: No study has been conducted to investigate the association between adherence to the EAT-Lancet diet and odds of irritable bowel syndrome (IBS) and functional dyspepsia (FD). This cross-sectional study was aimed to assess the association between adherence to the EAT-Lancet diet and odds of IBS and FD.

Methods: This cross-sectional analysis was done among 1892 Iranian apparently healthy adults, aged 18 to 65 years, in Isfahan, Iran. Usual dietary intakes of participants were assessed using a validated Dish-based, 106-item food frequency questionnaire. To measure participants' adherence to the EAT-Lancet diet, the EAT-Lancet diet index (ELD-I) was calculated. IBS and FD were assessed using ROME IV criteria.

Results: In total, 5.29% and 3.17% of participants had IBS and FD, respectively. The mean age of study participants was 39.64 ± 10.24 years, and the mean BMI was 27.08 ± 4.91 kg/m². After adjustment for potential confounding factors, a significant positive association between lower adherence to the EAT-Lancet diet and odds of IBS was revealed (OR: 1.74; 95% CI: 1.00-3.04), but not for FD (OR: 1.37; 95% CI: 0.65-2.89).

Conclusion: A significant positive association was observed between lower adherence to EAT-Lancet diet and odds of IBS. More prospective studies are needed to affirm these associations.