Nutrition and health最新文献

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease causing joint damage and disability. Vitamin D (VD) shows immunomodulatory effects in RA, but its causal role and potential mediation by sex hormones remain unclear.ObjectivesTo examine the VD-RA causal relationship and investigate androgen/estrogen mediation using Mendelian randomization (MR).MethodsWe conducted two-sample MR analyses using UK Biobank and IEU OpenGWAS data, with genetic variants as instruments. Mediation analyses assessed sex hormone effects.ResultsDietary VD associated with reduced RA risk (odds ratio (OR) = 0.994, 95%CI 0.992-0.996). Protective effects were stronger in males with seropositive RA (OR = 0.97, 95%CI 0.96-0.99) and females with seronegative RA (OR = 0.99, 95%CI 0.98-0.99). VD significantly lowered female testosterone (OR = 0.54, 95%CI 0.42-0.66), a RA risk factor (OR = 1.03, 95%CI 1.01-1.04), but did not affect male testosterone or female estrogen levels.ConclusionVD may reduce RA risk via gender-specific mechanisms, particularly by decreasing female testosterone. While MR supports causality, potential confounding requires cautious interpretation.

BackgroundGrowing evidence suggests positive association between sodium intake and the risk of obesity. Evidence on this topic is lacking from Finland, despite the population's historically high sodium intake and long-standing national salt reduction initiatives.AimsTo examine whether sodium intake and spot urine sodium concentration are associated with general or abdominal obesity in Finnish adults.MethodsWe used cross-sectional, population-based data of the National FinHealth 2017 Study (men=2222, women=2792, ≥18 years-old). Sodium intake was estimated using a validated food frequency questionnaire. A subsample of participants provided spot urine samples (men=558; women=702). General and abdominal obesity were assessed using body mass index and waist circumference. Associations on sex-specific quartiles were examined using multinomial logistic regression, adjusting for key sociodemographic and lifestyle confounders. Spot urine samples were validated against 24-h urine collections.ResultsWomen in the highest quartile of sodium intake had higher odds of general obesity (OR 4.30, 95% CI 2.60-7.12) and abdominal obesity (OR 3.42, 95% CI 2.11-5.56) compared with the lowest quartile. Men in the highest quartile of urine sodium concentration had higher odds of general obesity (OR 6.05, 95% CI 2.83-12.93) and abdominal obesity (OR 4.68, 95% CI 2.44-8.96) compared with the lowest quartile. Spot urine samples showed moderate agreement with 24-h urine collections, with a Spearman's rho of 0.45.ConclusionIn this cross-sectional analysis, higher dietary sodium intake and urine sodium concentration were associated with higher odds of general and abdominal obesity. Prospective studies are needed to confirm causality and to better understand underlying biological mechanisms.

BackgroundRestaurant portions generally exceed the calories needed for most adults to maintain weight. We developed guidelines for plating standard portions (≤700 calories for lunch or dinner) and recruited restaurants willing to offer them.ObjectiveTo understand the customer impact of standard portions (vs. regular, larger portions) in restaurants on calories ordered, calories consumed and feelings of fullness.MethodsIn this cross-sectional sample, customers in restaurants that served standard portion meals were offered a $25 gift card to take pictures of their meals (before their first bite and after their last bite) and complete a brief survey. Digital images were analyzed with a modified Comstock scale to determine calories provided and consumed across meal types (standard portion vs. regular). Participants self-reported their height, weight, activity level and fullness after the meal. Two-sample t-tests and chi-squared tests tested group differences (standard portion vs. regular). Analysis of Covariance (ANCOVA) tested associations between group and outcomes (calories ordered, consumed, fullness), adjusting for demographics, and differences by participant characteristics.ResultsDigital images submitted from 63 participants were used. Those who ordered a standard portion meal were older and consumed 346 fewer calories than from the regular menu, which lowered to 246.2 fewer calories after adjusting for individual demographics (p < 0.01). There were no significant differences in reported fullness between those who ordered from the regular menu versus standard portions (p = 0.87).ConclusionsPeople who ordered and consumed meals ≤700 calories found them satiating and most would order them again, verifying that standard restaurant portions are acceptable.

BackgroundZinc deficiency (ZD) is one of the most prevalent nutritional deficiencies reported in celiac disease (CeD). Oral supplementation and dietary modifications are the primary strategies for addressing it. However, it is unclear whether individuals with CeD would prefer to make additional dietary modifications or opt for supplementation to treat ZD.AimThis study aimed to explore patient preferences for the treatment of ZD.MethodsAdult patients (≥18 years) with a confirmed diagnosis of CeD who were already adopting a gluten-free diet (GFD) and had untreated ZD were recruited from the Adult Celiac Disease Clinic at McMaster University. After providing informed consent, participants completed study questionnaires at baseline and three months after initiating zinc supplementation. Data were collected using REDCap. Statistical analyses were performed using IBM SPSS software (V22, Chicago, USA).ResultsFrom March 2022 to January 2024, 44 participants were enrolled in the study. All completed baseline questionnaires, of them 25 (57%) completed questionnaires at follow-up. At baseline, 34% of participants preferred to treat nutrient deficiencies through dietary changes, compared with 28% at follow-up. Plasma zinc level normalized in all participants after 3 months of supplementation. At follow-up, the proportion of participants with significant gastrointestinal symptoms increased from 72% at baseline to 80% (p = 0.01).ConclusionsOne-third of patients with CeD preferred to manage nutrient deficiencies through dietary modifications. A zinc-optimized GFD may represent a promising approach to address zinc deficiency in this population. These findings provide preliminary evidence to inform the design of future randomized clinical trials.

BackgroundGut microbiota plays an essential role in metabolic and immune functions, and its composition is influenced by diet and probiotic intake. The Mediterranean diet (MD) improves microbiota diversity and health outcomes. However, the association between microbiota awareness, MD adherence, and probiotic consumption among adults is underexplored.AimThis study aimed to examine the relationship between MD adherence, microbiota awareness, and probiotic consumption among adults aged 18-64 years in the central district of Kırklareli, Türkiye.MethodsA cross-sectional survey was conducted with 420 individuals familiar with the term "probiotic." Data were collected via face-to-face interviews using a structured questionnaire including sociodemographic data, dietary habits, physical activity, anthropometrics, probiotic use, the Microbiota Awareness Scale (MAS), and the MD Adherence Scale. Descriptive and inferential statistics were used.ResultsAmong participants, 45% showed high MD adherence. Higher MAS scores were observed in females, those aged 26-35, with normal BMI, or prior nutrition education. Regular probiotic consumers had significantly higher MD adherence (p = 0.011) and MAS scores (p = 0.000). A weak but significant correlation was found between MAS and MD adherence (r = 0.120, p = 0.014). Awareness of probiotic microorganisms and consumption for digestive, immune, or cancer-related benefits were also associated with greater MAS and MD scores.ConclusionMicrobiota awareness is positively associated with probiotic consumption and MD adherence. Increasing microbiota literacy could potentially inform future dietary education strategies.

BackgroundSevere Acute Malnutrition (SAM) among children is often characterized by the presence of morbidities, impacting recovery pathways. Even so, the effect of morbidity at admission on Length of Stay (LoS) among children with SAM admitted in Outpatient Therapeutic Program (OTP) in Rohingya contexts remains unexamined.Aims/objectivesTo estimate the effects of morbidity at admission on LoS of children with SAM admitted in OTP in Rohingya refugee camps in Bangladesh.Methods/methodologyA longitudinal study design was employed and data was collected from children with SAM admitted in four OTP centers in Rohingya refugee camps at Cox's Bazar, Bangladesh. A Kaplan-Meier survival estimate and Cox proportional hazards model were used to estimate the relevant effect.Results/FindingsA total of 297 children with SAM were included. Among them, 190 (63.97%) had morbidity at admission. The mean LoS (days) among children with SAM with and without morbidity at admission was 68 ± 10 and 64 ± 9 (p = 0.002), respectively. Furthermore, at any given time during follow-up, children with SAM who had morbidity at admission had 25% lower hazard (rate) of being discharged as cured (adjusted HR: 0.75, 95% CI: 0.59, 0.96, p = 0.03) compared with those without morbidity at admission, indicating a longer LoS and slower rate of recovery.ConclusionEffective prevention of morbidity at admission can improve nutrition program efficacy by decreasing the LoS and increasing the likelihood of recovery. These findings can inform integrated health-nutrition interventions in refugee contexts.

BackgroundPatients with irritable bowel syndrome (IBS) often experience food-related symptoms. Both a diet low in fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) and a starch- and sucrose-reduced diet (SSRD) alleviate symptoms.Aims/ObjectivesThe aim of this randomized clinical trial was to evaluate the proportion of participants with symptoms and the type of food items triggering symptoms during intervention by either diet.Methods/MethodologyPatients with IBS according to Rome IV were included for a four-week intervention. Participants completed a three-day food diary, study questionnaire, Rome IV questionnaire, IBS-severity scoring system (IBS-SSS), and visual analog scale for IBS (VAS-IBS) at baseline, after 4 weeks of either SSRD or low FODMAP, and at a six-month follow-up. The food items that triggered symptoms were registered along with the type of symptoms.Results/FindingsTotally, 155 participants (84% women), 42 (32-55) years, were included; 77 were randomized to SSRD and 78 to low FODMAP. SSRD rendered a reduction of participants with symptoms triggered by food avoided/modified such as fast food (p < 0.001), snacks/cakes (p = 0.008), pasta (p = 0.034), and fruit (p = 0.046), and the reduction remained at follow-up for fast food (p = 0.021), when also symptoms were reduced for vegetables/legumes (p = 0.002) and potatoes (p = 0.046). In the low FODMAP group, the proportion of participants with symptoms decreased for onion week 4 and coffee/tea at follow-up (both p = 0.046). Trigger symptoms were associated with higher intake and/or impaired psychological well-being.ConclusionThe proportion of participants with food-triggered symptoms was reduced for six food groups during/after the SSRD intervention and for two food groups during/after low FODMAP.

BackgroundSevere obesity is increasing in prevalence globally, placing a significant burden on an individual's health and to public healthcare systems. Multidisciplinary and group-based interventions - which involve coordinated input from dietetics, psychology, physiotherapy and peer support - may improve health behaviours and weight outcomes in individuals living with severe obesity. At current, there is no assessment of the efficacy of group-based, multidisciplinary interventions, in severe obesity management.Aims/ObjectivesThus, this study aims to evaluate the efficacy of an 8-week group-based multidisciplinary intervention, termed Be Well, on initial changes to dietary behaviours, weight and mood outcomes in patients living with severe obesity. The study was conducted at a hospital-based and publicly funded obesity service, based in New South Wales, Australia.Method127 were registered to attend Be Well. Of these, 98 attended the first session, and 77 proceeded to complete the intervention. Changes in dietary behaviours (i.e. reported discretionary and non-discretionary food intake), body mass index (BMI) and mood (i.e. scores on the DASS-21), from pre to post intervention, were evaluated.ResultsFrom pre to post intervention, patients had significant reductions in BMI, self-reported discretionary food intake, stress and depression scores. Patients reported feeling less isolated and having an improved understanding of health beyond weight, post the intervention.ConclusionMultidisciplinary group interventions are an effective first step for the treatment of severe obesity by tertiary services, with more work needed to understand barriers and facilitators of engagement.

Background: Ageing is frequently associated with systemic inflammation and cognitive decline, yet the impact of diet and lifestyle factors on these age-related processes remains unexplored. Nutrient deficiencies, particularly in essential vitamins and minerals, may accelerate cognitive decline and heighten inflammation in older adults. Aim: This pilot study aimed to examine how dietary intake, body mass index (BMI) and physical activity affect plasma cytokine levels and cognitive performance in older adults. Methods: Twenty-nine healthy Irish adults, aged 65-85 years participated in the study. Physical examination, cognitive testing using the Cambridge Neuropsychological Test Automated Battery and plasma cytokine analysis (tumor necrosis factor-alpha [TNF-α], interleukin [IL]-6, IL-10, IL-8, IL-4, IL-1β) were conducted. Dietary intake was assessed using a validated Food Frequency Questionnaire, and physical activity was evaluated using the International Physical Activity Questionnaire. Summary: Participants with higher BMI and lower physical activity levels exhibited increased plasma concentrations of TNF-α, indicating elevated systemic inflammation and altered IL-10 levels, reflecting changes in anti-inflammatory regulation. Cognitive performance was poorer in participants who consumed excessive carbohydrates and polyunsaturated fatty acids and also in those whose total caloric intake fell below European Food Safety Authority dietary reference values. In contrast, participants with higher intake of saturated and monounsaturated fatty acids demonstrated better cognitive function. Deficiencies in vitamin B12, magnesium, manganese and copper were linked to elevated inflammatory markers and poorer cognitive outcomes. Conclusion: This study highlights the importance of nutrition and lifestyle in managing inflammation and cognitive decline in ageing. Targeted dietary interventions which address nutrient deficiencies may help preserve cognitive health and reduce inflammation in older adults.

Chylothorax, a rare condition, results when excessive chyle accumulates in the thoracic region. The etiological basis of chylothorax is categorized into three types: spontaneous, non-spontaneous, and idiopathic. However, it is usually manifested as a post-operative complication after thoracic or abdominal surgeries. Due to its rarity, limited research has been done to explore its causes and treatment. This review aims to explore treatment options for chylothorax with a special focus on its management through medium-chain triglyceride provision. In this article, we discussed the etiology, complications, clinical manifestations, and diagnosis of chylothorax, and reviewed the effectiveness of the medium-chain triglycerides diet as a first-line approach in the treatment of chylothorax. As chylothorax diagnosis is established by the presence of triglycerides in chyle fluid, the provision of medium-chain triglycerides has been thought to be an effective treatment strategy due to their efficient absorption. However, chylothorax complications have not only included immunological and localized complications, but nutritional complications are also an important concern during their management. Medium-chain triglyceride provision has emerged as an important therapeutic aid in the medical nutrition therapy of chylothorax. However, there is no current consensus on specific parameters reflecting the effectiveness of medium-chain triglycerides in chylothorax. Therefore, it is reflected by reduced chyle output, improved nutritional status, shortened drainage duration, and decreased need for surgical intervention in cases where medium-chain triglycerides intervention was done.