Nutrition最新文献

Objective

This study investigated the effects of a soy protein-rich meal intervention on the muscle health of older adults in long-term care facilities.

Methods

A 12-week single-center randomized controlled trial with a control-group and open-label design was conducted. Eighty-four older adults from a long-term care facility participated in the study. The chefs at the facility cooked three meals using soy protein-rich recipes designed by dieticians. For 12 weeks, the intervention group participants consumed three meals with 30 g of soy protein (10 g/meal) per day, and the control group participants maintained their habitual diets.

Results

The 84 participants (mean age, 84.9 ± 7.0 years; 61.9% female) were randomly assigned to an intervention group (43 participants) and a control group (41 participants). The intervention group exhibited significant increases in several lean mass indicators, namely soft lean mass (mean, 1.43 kg; 95% confidence interval [CI]: 0.20–1.65 kg), skeletal muscle mass (mean, 1.20 kg; 95% CI: 0.43–1.96 kg), appendicular skeletal muscle mass (mean, 0.79 kg; 95% CI: 0.07–1.52 kg), and skeletal muscle index (mean, 0.37 kg/m²; 95% CI: 0.05–0.68 kg/m²) (all P < 0.05). These changes were not observed in the control group (all P > 0.05). Notably, calf circumference decreased significantly in the control group (mean, −0.98 cm; 95% CI: −1.61 to −0.36 cm) but was maintained in the intervention group. The differences in the calf circumference and 6-m walk performance of the two groups were significant (P < 0.05).

Conclusions

The 12-week soy protein-rich meal intervention improved the muscle mass and 6-m walk performance of older adults in a long-term care facility.

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a seriously increasing liver disorder affecting nearly 32% of adults globally. Hepatic triglycerides (TG) accumulation is the hallmark of MASLD, which results from dysregulated lipid and fatty acid uptake, increased de novo lipogenesis (DNL), and decreased lipid removal. More recently, selective autophagy of lipid droplets (LDs), termed lipophagy, has emerged to be closely associated with disrupted hepatic lipid homeostasis. Recent studies have indicated that a series of natural products have shown promise as an alternative approach in attenuating MASLD via regulating lipophagy in vivo and in vitro. Therefore, lipophagy could be a new approach for natural products to be used to improve MASLD. This article aims to provide a comprehensive overview on the interrelationship between dysregulated lipid metabolism, lipophagy, and MASLD pathogenesis. In addition, the role of some natural products as lipophagy modulators and their impact on MASLD will be discussed.

Background

Iron is an important micronutrient in pathways of energy production, adequate nutrient intake and its balance is essential for optimal athletic performance. However, large studies elucidating the impact of iron deficiency on athletes’ performance are sparse.

Methods

Competitive athletes of any age who presented for preparticipation screening 04/2020–10/2021 were included in this study and stratified for iron deficiency (defined as ferritin level <20 µg/l with and without mild anemia [hemoglobin levels ≥11 g/dl]). Athletes with and without iron deficiency were compared and the impact of iron deficiency on athletic performance was investigated.

Results

Overall, 1190 athletes (mean age 21.9 ± 11.6 years; 34.2% females) were included in this study. Among these, 19.7% had iron deficiency. Patients with iron deficiency were younger (18.1 ± 8.4 vs. 22.8 ± 12.1 years, P < 0.001), more often females (64.5% vs. 26.8%, P < 0.001), had lower VO₂ peak value (43.4 [38.5/47.5] vs. 45.6 [39.1/50.6]ml/min/kg, P = 0.022) and lower proportion of athletes reaching VO₂ peak of >50 ml/min/kg (8.5% vs. 16.1%, P = 0.003). Female sex (OR 4.35 [95% CI 3.13–5.88], P > 0.001) was independently associated with increased risk for iron deficiency. In contrast, the risk for iron deficiency decreased by every life year (OR 0.97 [95% CI 0.95–0.99], P = 0.003). Iron deficiency was independently associated with reduced VO₂ peak (OR 0.94 [0.91–0.97], P < 0.001) and lower probability to reach VO₂ peak >50 ml/min/kg (OR 0.42 [95% CI 0.25–0.69], P = 0.001).

Conclusions

Iron deficiency is common in athletes (predominantly in female and in young athletes). Iron deficiency was independently associated with reduced VO₂ peak during exercise testing and lower probability to reach a VO₂ peak >50 ml/min/kg.

Background

Complementary feeding is a process starting at 6 months of age when breastfeeding alone cannot provide the nutrients infants require. Foods and liquids are started along with breastfeeding up to 24 months, while complementary foods are available either from a garden or local market appropriate to complement breast milk at 6 months to satisfy the nutritional needs of the infant. Infancy is from birth to 12 months of age, and the term young child is used when referring to infants and children from 12 months to 2 years of age. Infants and young children require a sufficient diet that includes all nutrients that support overall growth and development. Appropriate feeding practices are crucial during infancy and early childhood. In addition to breastfeeding, complementary feeding should be started on time, administered safely and appropriately, and in sufficient amounts with regularity, consistency, and a variety of foods to meet nutritional needs.

Objectives

This work was designed to understand the perceptions and practices of infant and young child feeding among mothers with children under 2 years in the West Shewa Zone Toke Kutaye districts.

Methods

The study was conducted from December 05 to December 30, 2023. Twenty-seven mothers with children under 2 years old participated. The study was a cross-sectional descriptive qualitative study that employed focus group discussions and in-depth interviews to gather perceptions, opinions, practices, beliefs, and experiences about infant and young child feeding. Before coding, texts were double-checked against audio files to ensure accuracy and consistency. Afan Oromo conducted verbatim transcriptions of the focus group discussions and in-depth interviews, transcribed into Microsoft Word 2010.

Results

The study revealed that most infants were not initiated early into breastfeeding and were not exclusively breastfed because most mothers gave cow milk, especially after 2 months, when mothers returned to working on other activities. Most mothers begin complementary feeding at the age of 4 months.

Conclusions

The responses of mothers from all age strata regarding factors that hinder appropriate infant and young child feeding show a lack of awareness about initiating early breastfeeding. Extreme work overload prevented the feeding of breast milk and preparation of a complementary diet as per protocol, low utilization of family planning, and a perceived shortage of food items to prepare a balanced diet for complementary feeding were factors that hindered appropriate infant and young child feeding. Concerned stakeholders should work to alleviate the extreme workload among mothers with children under 2 years old and reduce their lack of awareness by designing appropriate infant and young child feeding education; cooking demonstrations are strongly recommended.

Objectives

Whole-grain pearl millet is a nutritious cereal source of dietary fiber, vitamins, minerals, and bioactive compounds. It offers health benefits such as glycemic control and satiety. Extrusion cooking for diverse formulations, including beverages, can alter its chemical composition, impacting the nutritional value. This study aimed to evaluate the sensory acceptability of an extruded millet flour beverage and its acute effects on glycemic index (GI), glycemic and insulinemic response, food intake, and subjective appetite sensations in euglycemic and eutrophic adults.

Methods

This is an acute, single-blind, randomized, controlled, cross-over clinical study comprising 14 euglycemic and eutrophic adults. Initially, beverages based on whole extruded millet flour were developed, and sensorially and chemically analyzed. Next, a clinical trial was conducted with participants undergoing four sessions and consuming one of the following options: extruded millet beverage, a maltodextrin control beverage, or a glucose solution administered in two separate sessions. Blood glucose, insulin, and appetite responses were assessed over a 2-h period, in addition to determining the GI of the beverages and analyzing food intake in the 24 h following each session.

Results

The extruded millet flour strawberry-flavored beverage had the best sensory acceptance and was classified as having as high GI. Consumption of the extruded millet beverage showed similar glycemic and insulinemic responses, as well as appetite control and food intake of the subjects, when compared with consumption of the maltodextrin control beverage.

Conclusions

Intake of the extruded millet beverage maintained glycemic and insulinemic responses, appetite control, and food intake in euglycemic and eutrophic subjects.

Objectives

Given the innovative nature of the method, our study aimed to assess the prognostic significance of body mass index (BMI)-adjusted calf circumference (CC) in older patients who are hospitalized.

Methods

This was a unique analysis as part of other cohorts comprising general hospitalized patients aged 60 years or older of both sexes. Only patients with excess weight (BMI ≥ 25 kg/m²) were included. CC was adjusted by reducing 3, 7, or 12 cm for BMI (in kg/m²) within 25-29.9, 30–39.9, and ≥40 kg/m², respectively. CC was considered low if ≤ 34 cm for males and ≤ 33 cm for females. Clinical outcomes included prolonged length of hospital stay (LOS) and mortality.

Results

A total of 222 patients were included. After BMI adjustments, 72.1% of the patients were reclassified from a normal CC category to a low CC category. The frequency of low CC increased from 33.8% to 81.9% following BMI adjustments. Among those reclassified to the low CC, 11 died, compared to only 2 patients in the group that maintained a normal CC classification. BMI-adjusted CC was inversely associated with mortality (HR _adjusted 0.84, 95% CI 0.73 to 0.95), but not with prolonged LOS.

Conclusions

Our novel study highlights the prognostic value of BMI-adjusted CC. As an anthropometric marker of muscle mass, it proved to be a predictor of mortality in older patients with high BMI. This adjustment is further important because it may help to better detect low muscle mass in these patients where such conditions might be masked.

Objective

The aim of this study was to assess the relationship between cognitive and physical frailty and malnutrition in older adults.

Methods

The study was cross-sectional and observational. A total of 992 patients who applied to the geriatric outpatient clinic between January 2018 and December 2022 were included in the study. All patients underwent comprehensive geriatric assessment. Demographic characteristics, geriatric syndromes, comorbidities, and laboratory parameters were recorded. Fried's Frailty Scale was used to determine physical frailty. The Mini Nutritional Assessment Short Form was performed to determine nutritional status. Cognitive frailty was defined as the coexistence of physical frailty and mild cognitive impairment.

Results

Of 992 patients participating in the study, 66% were female, and the mean age was 73.2 ± 7.4. The rate of physical frailty was 13.4%, and 96 patients were cognitively frail. Malnutrition rates were 18.8%, 12.5%, and 2.2% in the cognitive frailty, physical frailty, and healthy control groups, respectively. The healthy control group had a lower median age, fewer geriatric syndromes (excluding orthostatic hypotension), and lower rates of diabetes and hypertension than the frailty groups. The frequency of malnutrition was similar in the cognitive and physical frailty groups. The cognitive frailty group had higher median age, sarcopenia rate, and Timed Up and Go duration; were less likely to be female; and showed lower albumin, mobility, and functionality scores than the physical frailty group (P < 0.05). After adjusting for demographic characteristics, comorbidities, geriatric syndromes, and laboratory parameters, cognitive frailty showed a stronger relationship with malnutrition (odds ratio 1.96, confidence interval 1.13–5.04, P = 0.04).

Conclusions

Cognitive and physical frailty were found to be associated with malnutrition in older adults. Even after accounting for confounding factors, it appears that cognitive frailty is more closely related to nutritional status than physical frailty.

Objective

This study assessed the therapeutic benefits and modeled the cost-effectiveness of oral nutritional supplements (ONS) in China.

Methods

Data were collected from 27 152 adult inpatients between January 1, 2018, and December 31, 2020. Propensity score matching was used for balancing the baseline characteristics between the ONS group and non-ONS group. A decision-tree model was developed to assess the cost-effectiveness of ONS for patients with nutritional risk, and the incremental cost-effectiveness ratio was the metric to determine the most cost-effective strategy. One-way sensitivity and probabilistic sensitivity analyses were conducted to assess the model's stability. In addition, subgroup analysis was conducted based on clinical characteristics. Differences in clinical outcomes between the groups were compared using Student's t test, Mann–Whitney U test, or chi-square test.

Results

The ONS group displayed significantly lower levels of prealbumin, albumin, hemoglobin, and BMI than the non-ONS group at admission. The incidence of malignant tumors, intestinal obstruction, and inflammatory bowel disease was significantly higher in the ONS group than the non-ONS group. The ONS group had a significantly higher effective rate than the non-ONS group (51.7% versus 50.3%, P < 0.05). Analysis of the decision-tree model revealed that the ONS group experienced an increase in cost of 19 850.96 yuan but achieved an additional 1.3406 effectiveness rate, resulting in an incremental cost-effectiveness ratio of 14 807.51, which fell below China's 2020 per capita gross domestic product of 71 965 yuan. Sensitivity analysis further confirmed the robustness of the model.

Conclusions

ONS are demonstrated a high rate of efficacy, although patients currently using ONS are typically in a severe disease state. In addition, ONS is cost-effective. We suggest that the reimbursement coverage of ONS be expanded to include in-hospital patients who are at high nutritional risk.

Objectives

The purpose of the present study was to explore the latent growth trajectory of body mass index (BMI) from birth to 24 months and comprehensively analyze body composition development influencing factor in preschool children.

Methods

This ambidirectional cohort study was conducted in Tianjin, China, from 2017 to 2020, and children's regular medical check-up data from birth to 24 months were retrospectively collected. The growth models were used to fit BMI z-score trajectories for children aged 0–24 months. Crossover analysis and interaction model were used to explore the interaction of influencing factors.

Results

We analyzed the growth trajectories of 3217 children, of these, 1493 children with complete follow-up data were included in the influencing factors analysis. Trajectories and parental prepregnancy BMI (ppBMI) were independent factors influencing children's body composition. When paternal ppBMI ≥24 kg/m², regardless of maternal ppBMI, the risk of overweight and obesity in senior-class children was increased. The high trajectories played a partial mediating role in the association between paternal ppBMI and body composition in preschool children.

Conclusions

BMI growth in children aged 0–24 months can be divided into three latent trajectories: low, middle, and high. These trajectories and parental ppBMI were independent and interactive factors influencing children's body composition. The high trajectories played a partial mediating role in the association between paternal ppBMI and body composition in preschool children. It is necessary to pay attention to the BMI growth level of children aged 0–24 months, which plays an important role in the development of body fat in the future.

Objectives

We hypothesized that a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet may be associated with the disease severity of ulcerative colitis (UC). Therefore, this cross-sectional study was undertaken to assess the association between FODMAP score and UC severity.

Methods

In this study, 158 patients with UC were enrolled. The disease severity was designated using the Mayo score. The diet relation information was obtained using the 160-item food frequency questionnaire. To calculate the FODMAP score, the consumption of all food items was converted to a gram per day and multiplied by the FODMAP factor. The FODMAP factor was obtained from the application developed by Monash University (Melbourne, Victoria, Australia). The association between disease severity (dependent factor) and FODMAP score tertiles (independent factors) was assessed by logistic regression adjusted for different covariates.

Results

In the present study, the age range of participants was 18 to 64 y old, and 46.2% of patients had moderate or severe disease activity. There were significant differences in sex, body mass index, and supplement use across different tertiles of FODMAP score. There was no significant association between the FODMAP score tertiles and disease severity in the crude model and adjusted models.

Conclusions

The results of the present study showed that there was no significant association between the FODMAP score and UC severity. However, considering the limitations of the study, more studies with prospective and interventional designs using more accurate methods of dietary assessments are needed to confirm these preliminary results.