Nutrition reviews最新文献

The purpose of the present narrative review was to propose a unifying generalized conceptual model of mechanisms and processes in appetite self-regulation (ASR) in childhood. Appetite self-regulation, along with other domains of self-regulation, develops across childhood and contributes to energy intake and balance, diet quality, weight, and therefore long-term health outcomes. There have been efforts to conceptualize and measure components of ASR and associated processes/mechanisms, but, at present, there is no unifying conceptualization of ASR in childhood. A search of key databases supplemented by snowballing was undertaken for definitions/conceptions and theoretical models of ASR with a focus on children. An interpretive synthesis approach was used to identify themes from the definitions and models. The themes formed the basis of the proposed unifying generalized model of ASR in childhood, which is the main contribution of the article. At the center of the model is bottom-up reactivity to food, food cues and hunger, satiation and satiety signals, together with top-down regulatory control. An additional contribution is the proposed 5 interacting and overlapping domains (biological, hedonics, cognitive, behavioral, and traits) that function in and influence both bottom-up reactivity and top-down regulation. The domains also contribute to ASR outcomes of enactment and competence. External contextual and intrapersonal factors are conceived as impacting the domains and the bottom-up, top-down processes. The relevance of the model for explanations of ASR phenomena in childhood and children's food choice and diet quality, as well as its implications for research directions and approaches to preventive intervention, including food parenting practices, are discussed. The model provides a framework for researchers and practitioners to support and interpret children's problems and competence in self-directing food choices, energy intake, and nutrition.

The World Health Organization (WHO) has recently published a guideline that recommends against the use of nonsugar sweeteners. Food labels are a key source of information for consumers, to enable them to make informed decisions regarding the consumption of food additives. However, discrepancies in the concepts and categorizations of sweeteners in labeling recommendations and regulations may influence the results of studies on the prevalence of sweeteners in foods. This study aimed to analyze the scientific literature related to the declaration of sweeteners on food labels. Focus was placed on methodological issues related to data collection and analysis, including the categorization of sweeteners, as well as on the reported prevalence of sweetener declaration on food labels. A scoping review was conducted based on a search for terms related to sweeteners, food labeling, and packaged foods. Nine studies, published between 2012 and 2022, were included. Variability among studies was observed in terms of data collection methods, approaches for identifying the sweeteners declared on food labels, the criteria for categorizing sweeteners, and the definitions underlying the categorization. Moreover, there was a lack of standardization in the bibliographic sources consulted in formulating the categorization, and failure to report specific sources, leading to heterogeneity in the substances regarded as sweeteners. The prevalence of the declaration of sweeteners in food labeling ranged from less than 1% to 43.6%. The findings of the present work emphasize the need to standardize the methodologies used for the identification of sweeteners declared on food labels and the criteria for their categorization.

Context: Migraines are a prevalent neurological condition that significantly impacts the quality of life. Although narrative reviews and clinical trials suggest the potential effects of fatty acid supplementation as a promising approach for migraine prophylaxis, the findings remain inconsistent.

Objective: The aim was to evaluate the efficacy of fatty acid supplementation on migraine clinical outcomes through a systematic review and meta-analysis.

Data sources: This systematic review and meta-analysis was conducted using electronic databases including Medline, Scopus, Web of Science, and CINAHL from their inception up to October 7, 2024.

Data extraction: Studies meeting the PICOS criteria were included: adults diagnosed with migraine, dietary supplementation with fatty acids, assessing migraine clinical outcomes, and only randomized controlled trials. Methodological quality and risk of bias were assessed independently by 2 reviewers using the Cochrane Risk of Bias 2 tool.

Data analysis: Meta-analyses were conducted using Review Manager software. A random-effects model was applied to account for heterogeneity among studies. A standardized mean difference (SMD) of 0.2, 0.5, and 0.8 was interpreted as small, moderate, and large effects, respectively. Six randomized controlled trials, including 407 participants with chronic migraines, were analyzed. Interventions varied, including omega-3 supplementation with or without omega-6 restriction, lasting from 8 to 16 weeks, and 1 trial assessing alpha-lipoic acid. The overall risk of bias was assessed as low. The pooled analysis demonstrated significant reductions in headache intensity (SMD = -1.77; 95% CI: -3.32 to -0.21; P = .03), headache duration (SMD = -0.77; 95% CI: -1.05 to -0.50; P < .00001), headache frequency (SMD = -1.91; 95% CI: -2.61 to -1.21; P < .00001), and HIT-6 score (SMD = -2.44; 95% CI: -4.13 to -0.76; P = .004).

Conclusion: This meta-analysis provides moderate evidence that fatty acid supplementation, particularly omega-3, improves migraine clinical outcomes. Additional high-quality, randomized controlled trials are needed to confirm these findings, particularly for the promising effects of alpha-lipoic acid.

Systematic review registration: PROSPERO registration no. CRD42024592084.

Context: Dietary fiber (DF) exhibits variations in its chemical and physical complexity, as well as in its utilization by the gut microbiota. However, the impact of these differences on the health status of adults with overweight or obesity remains unclear.

Objective: This meta-analysis aimed to explore the varying effects of supplementing with different specificities of DF on the health of adults with overweight or obesity, providing guidance on selecting DF supplementation to improve health status.

Data sources: The literature search encompassed 4 electronic databases-PubMed, Cochrane Library, Web of Science, and EMBASE-and was conducted between January 1, 2012, and November 10, 2023. Randomized controlled trials comparing DF with placebo treatment, without energy restriction, were included.

Data extraction: Two independent reviewers extracted data using a standardized form, resolving discrepancies through discussion. The data included study characteristics, participant demographics, DF specifications, and outcome measures.

Data analysis: Random-effects models and the generic inverse variance method were used to analyze data, assuming varying outcomes based on DF specificity. Meta-regression assessed the impact of population, duration, and dosage. Publication bias was evaluated using funnel plots and Egger's and Begg's tests. The analysis included 34 trials (n = 1804) examining DF supplementation at 1.5 to 40 g/day for 3 to 16 weeks. DF supplementation significantly reduced glycated hemoglobin (HbA1c) by 0.13%, fasting insulin by 0.82 μIU/mL, and homeostatic model assessment of insulin resistance (HOMA-IR) by 0.33 in adults with overweight or obesity. Subgroup analyses based on DF specificity revealed differences in effects on HbA1c, fasting insulin, and systolic blood pressure. The low-specificity subgroup showed significant heterogeneity in body weight, body mass index, HbA1c, fasting insulin, and HOMA-IR, with a decrease in fasting insulin by 1.09 μIU/mL. The low-to-intermediate-specificity subgroup had reductions in HbA1c by 0.8%, fasting insulin by 2.08 μIU/mL, and HOMA-IR by 0.61. The intermediate-specificity subgroup experienced a 2.85-kg decrease in body weight and a 9.03-mg/dL increase in LDL cholesterol. The mixed subgroup showed an increase in systolic blood pressure by 3.85 mmHg.

Conclusion: Supplementing with different specificities of DF may have distinct effects on health-related indicators in adults with overweight or obesity. Considering individuals' gut microbiota composition and specific health goals is recommended when selecting DF supplementation for adults with overweight or obesity.

Systematic review registration: PROSPERO registration no. CRD42023432920.

The demonization of seed oils "campaign" has become stronger over the decades. Despite the dietary guidelines provided by nutritional experts recommending the limiting of saturated fat intake and its replacement with unsaturated fat-rich food sources, some health experts ignore the dietary guidelines and the available human research evidence, suggesting the opposite. As contrarians, these individuals could easily shift public opinion so that dietary behavior moves away from intake of unsaturated fat-rich food sources (including seed oils) toward saturated fats, which is very concerning. Excess saturated fat intake has been known for its association with increased cholesterol serum levels in the bloodstream, which increase atherosclerotic cardiovascular disease risks. Furthermore, high saturated fat intake may potentially induce insulin resistance and non-alcoholic fatty liver disease, based on human isocaloric feeding studies. Hence, this current review aimed to assess and highlight the available human research evidence, and if appropriate, to counteract any misconceptions and misinformation about seed oils.

Chronic kidney disease (CKD) is a chronic health problem whose prevalence is increasing. Nutrition and nutrition-related factors, one of the modifiable risk factors for CKD, are of primary importance. The key to planning optimal nutritional therapy is accurately determining energy requirements and total energy expenditure. Many health problems can accompany CKD, such as protein-energy malnutrition, sarcopenia, etc, and increase the mortality rate. This study aims to present the specific factors affecting energy expenditure specific to CKD in line with the current literature, to discuss the methods used to determine energy expenditure, and to examine these methods according to groups receiving and not receiving renal replacement therapy (hemodialysis, peritoneal dialysis, and renal transplantation).

Context: Dietary protein is recommended for sarcopenia-a debilitating condition of age-related loss of muscle mass and strength that affects 27% of older adults. The effects of protein on muscle health may depend on protein quality.

Objective: The aim was to synthesize randomized controlled trial (RCT) data comparing plant with animal protein for muscle health.

Data sources: Forty-three eligible RCTs were sourced from Medline, Embase, Scopus, Web of Science, and CENTRAL databases.

Data extraction: Four reviewers (R.J.R.-M., S.F.B., N.A.W., D.L.) extracted data from RCTs (study setting, population, intervention characteristics, outcomes, summary statistics) and conducted quality assessment using the Cochrane Risk of Bias 2.0.

Data analysis: Standardized mean differences (SMDs) (95% CIs) were combined using a random-effects meta-analysis and forest plots were generated. I2 statistics were calculated to test for statistical heterogeneity.

Conclusion: Thirty RCTs (70%) were eligible for meta-analysis and all examined muscle mass outcomes. Compared with animal protein, plant protein resulted in lower muscle mass following the intervention (SMD = -0.20; 95% CI: -0.37, -0.03; P = .02), with stronger effects in younger (<60 years; SMD = -0.20; 95% CI: -0.37, -0.03; P = .02) than in older (≥60 years; SMD = -0.05; 95% CI: -0.32, 0.23; P = .74) adults. There was no pooled effect difference between soy and milk protein for muscle mass (SMD = -0.02; 95% CI: -0.20, 0.16; P = .80) (n = 17 RCTs), yet animal protein improved muscle mass compared with non-soy plant proteins (rice, chia, oat, and potato; SMD = -0.58; 95% CI: -1.06, -0.09; P = .02) (n = 5 RCTs) and plant-based diets (SMD = -0.51; 95% CI: -0.91, -0.11; P = .01) (n = 7 RCTs). No significant difference was found between plant or animal protein for muscle strength (n = 14 RCTs) or physical performance (n = 5 RCTs). No trials examined sarcopenia as an outcome. Animal protein may have a small beneficial effect over non-soy plant protein for muscle mass; however, research into a wider range of plant proteins and diets is needed.

Systematic review registration: PROSPERO registration no. CRD42020188658.

Context: Inconsistent results have been reported regarding the prevalence of and factors associated with formula feeding in Ethiopia.

Objective: This study aimed to determine the pooled prevalence of and factors associated with formula feeding among mothers with infants 0-6 months of age in Ethiopia.

Data sources: A comprehensive systematic search was conducted across 3 databases (PubMed, EMBASE, and ScienceDirect) and the Google Scholar search engine to identify relevant studies published up to April 2, 2024.

Data extraction: After assessing the quality of each study using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies, data were independently extracted by 2 authors using pre-designed forms in an Excel spreadsheet. Any disagreements were resolved through discussion and consultation with additional authors.

Data analysis: Statistical heterogeneity across studies was assessed using the I2 statistic. A random-effects meta-analysis was used to pool the proportions, due to high heterogeneity, while a fixed-effect meta-analysis was used to pool associated factors with low heterogeneity. A sensitivity analysis was performed to assess the potential impact of outlier studies on the overall estimates. Five studies, with a combined sample size of 2344 participants, were included. The pooled prevalence of formula feeding was 34.0% (95% CI: 23.0%, 44.0%). Factors significantly associated with formula feeding included cesarean delivery (POR [pooled odds ratio] = 4.72, 95% CI: 3.32, 6.71) compared with vaginal delivery, a positive attitude toward formula feeding (POR = 2.26, 95% CI: 1.45, 3.53) compared with a negative attitude, initiation of breastfeeding more than 1 hour after delivery (POR = 2.27, 95% CI: 1.25, 4.13) compared with initiation within 1 hour, and receiving information about formula feeding from friends or family (POR = 2.47, 95% CI: 1.46, 4.20) compared with receiving information from health-care professionals.

Conclusion: The prevalence of formula feeding in Ethiopia is significant. Cesarean delivery, a positive attitude toward formula feeding, late initiation of breastfeeding, and receiving formula feeding-related information from friends and family were positively associated with formula feeding. Given these findings, the authors recommend that public health interventions in Ethiopia target these key determinants to decrease the high prevalence of formula feeding practices observed in the country. Strategies addressing factors such as promoting vaginal delivery, improving attitudes toward breastfeeding, encouraging early breastfeeding initiation, and limiting the influence of social networks on formula-feeding decisions may be beneficial.

Context: Chronic pain is a debilitating condition that affects a significant proportion of the population. Palmitoylethanolamide (PEA), a naturally occurring fatty acid amide derived from omega-7 fatty acids, has emerged as a safe and effective alternative for pain management and exerts its effects by interacting with the endocannabinoid system, modulating inflammation, and regulating immune responses.

Objective: A comprehensive meta-analysis was conducted to evaluate the efficacy of PEA in alleviating pain across various pathologies, considering the nociceptive, neuropathic, or nociplastic nature of pain.

Data sources: A systematic search was conducted of 4 databases: PubMed, Embase, Scopus, and Cochrane Collaboration Library.

Data extraction: Randomized clinical trials were selected for analysis. This meta-analysis included 18 studies involving 1196 patients.

Data analysis: Continuous variables were assessed using a standard mean difference (SMD). Heterogeneity was evaluated using the χ2 test and I2 statistics. Pain was significantly reduced in the PEA group at 6 weeks (SMD, -0.9; 95% CI, -1.60 to -0.31), 8 weeks (SMD, -0.98; 95% CI, -1.61 to -0.36), and 24-26 weeks (SMD, -1.16; 95% CI, -2.15 to -0.17). Quality of life, including pain-related items, was significantly higher in the PEA group (SMD, -0.61; 95% CI, -0.93 to -0.30). Significant differences in favor of PEA were observed at 4 (SMD, -0.36; 95% CI, -0.65 to -0.07) and 8 weeks (SMD, -0.66; 95% CI, -1.15 to -0.17). Palmitoylethanolamide was effective for all pain types: nociceptive (SMD, -0.74; 95% CI, -1.42 to -0.06), neuropathic (SMD, -0.97; 95% CI, -1.54 to -0.39), and nociplastic (SMD, -0.59; 95% CI, -1.15 to -0.03).

Conclusions: This meta-analysis confirmed that PEA effectively reduces pain and enhances quality of life, with significant benefits observed within 4-6 weeks of treatment. Palmitoylethanolamide is a promising alternative to chronic opioid analgesics, potentially reducing the risk of opioid abuse and dependency.

Systematic review registration: PROSPERO registration no. CRD42024550546.

Context: Although some evidence shows the beneficial effects of meal replacements (MRs) on glucose metabolism as one of the main factors of diabetes, there are still no comprehensive findings in this field.

Objective: We investigated the effects of total and partial MRs on fasting blood sugar (FBS), insulin, glycated hemoglobin (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in this comprehensive study and meta-analysis.

Data sources: To find pertinent randomized controlled trials (RCTs) up to March 2024, databases including PubMed/Medline, Web of Science, Scopus, and Embase were searched.

Data extraction: This study included all RCTs investigating the effects of MRs on factors related to glucose metabolism. The pooled weighted mean difference (WMD) and 95% CIs were computed using the random-effects model.

Data analysis: The findings from 52 studies indicated significant reductions in FBS (WMD: -3.10 mg/dL; 95% CI: -4.99, -1.20; P < .001), insulin (WMD: -1.79 μU/mL; 95% CI: -3.51, -0.08; P = .40), HOMA-IR (WMD: -0.86; 95% CI: -1.68, -0.04; P = .040), and HbA1c (WMD: -0.24%; 95% CI: -0.35%, -0.13%; P < .001) levels following MR consumption compared with the control group. The findings obtained from the subgroup analysis showed that MRs cause a greater decrease in FBS, insulin, and HOMA-IR in the >50-years age group compared with those aged ≤50 years and also during interventions ≤24 weeks compared with >24 weeks.

Conclusion: In conclusion, it appears that MRs, along with other lifestyle factors, can lead to significant improvements in glucose metabolism.