Michał Gawryjołek, Michał Wiciński, Marta Michalska Gawryjołek, Jan Zabrzyński
Obesity is a risk factor for thrombosis-related diseases and a condition that leads to vitamin D deficiency. Furthermore, orthopedic conditions are also at risk for diseases associated with coagulation and endothelial function. This study aimed to assess whether vitamin D supplementation in patients with acute (AOCs) and chronic orthopedic conditions (COCs) and coexisting obesity could affect coagulation and endothelial function. Thirty-three obese individuals with AOCs or COCs were included in the study. Patients were supplemented with vitamin D at 4000 IU/day for 3 months. An enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of alpha 2-antiplasmin (α2AP), vascular cell adhesion molecule 1 (VCAM-1), plasminogen activator inhibitor-1 (PAI-1), tissue factor pathway inhibitor (TFPI), and vitamin D, which were examined at two time points-before and after supplementation. Regardless of the increase in serum vitamin D levels in both groups after supplementation, there was a statistically significant increase in VCAM-1 and PAI-1 levels in the group with AOCs, whereas only VCAM-1 increased statistically significantly in the second group. For obese patients with COCs, vitamin D does not appear to have a potentially beneficial effect on coagulation and the endothelium.
{"title":"Vitamin D Supplementation Effects on Markers Related with Endothelial Function and Coagulation in Obese Orthopedic Patients: Insights from Acute and Chronic Cases.","authors":"Michał Gawryjołek, Michał Wiciński, Marta Michalska Gawryjołek, Jan Zabrzyński","doi":"10.3390/nu17050882","DOIUrl":"10.3390/nu17050882","url":null,"abstract":"<p><p>Obesity is a risk factor for thrombosis-related diseases and a condition that leads to vitamin D deficiency. Furthermore, orthopedic conditions are also at risk for diseases associated with coagulation and endothelial function. This study aimed to assess whether vitamin D supplementation in patients with acute (AOCs) and chronic orthopedic conditions (COCs) and coexisting obesity could affect coagulation and endothelial function. Thirty-three obese individuals with AOCs or COCs were included in the study. Patients were supplemented with vitamin D at 4000 IU/day for 3 months. An enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of alpha 2-antiplasmin (α2AP), vascular cell adhesion molecule 1 (VCAM-1), plasminogen activator inhibitor-1 (PAI-1), tissue factor pathway inhibitor (TFPI), and vitamin D, which were examined at two time points-before and after supplementation. Regardless of the increase in serum vitamin D levels in both groups after supplementation, there was a statistically significant increase in VCAM-1 and PAI-1 levels in the group with AOCs, whereas only VCAM-1 increased statistically significantly in the second group. For obese patients with COCs, vitamin D does not appear to have a potentially beneficial effect on coagulation and the endothelium.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616594","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}
Sarah Moreland-Russell, Natasha Zimmermann, Jessica Gannon, Dan Ferris, Charles Alba, Rebekah R Jacob
Background: The Healthy, Hunger-Free Kids Act was passed in 2010 to update nutrition standards in the National School Lunch and Breakfast Programs to be in accordance with evidence-based guidelines. In 2017 and 2020, the United States Department of Agriculture proposed flexibilities to the nutrition standards for milk, whole grains, and sodium. Objective: This study examines the positions used by stakeholders in support for or opposition to the proposed rules. Methods: We conducted a longitudinal qualitative content analysis of public comments posted to the U.S. Federal Register in response to the USDA's proposed rules in 2017 and 2020. All public comments submitted by individuals and organizations were analyzed (n = 7323, 2017 and n = 2513, 2020). Results: Results indicated three categories of arguments: (1) comments favoring the original law, (2) comments favoring flexibilities, and (3) other. In both comment periods, constituents opposed the implementation of flexibilities, while schools and manufacturers/industry predominately supported them. Academic and advocacy organizations opposed the original proposed change (2017) but relaxed their position in 2020. Conclusions: Any flexibility to the required nutritional standards of school meals has the potential to affect the health trajectory of youth. It is imperative to understand how stakeholders view this issue and inform policy change.
{"title":"\"Salt and Eat It or No Salt and Trash It?\" Shifts in Support for School Meal Program Flexibilities in Public Comments.","authors":"Sarah Moreland-Russell, Natasha Zimmermann, Jessica Gannon, Dan Ferris, Charles Alba, Rebekah R Jacob","doi":"10.3390/nu17050839","DOIUrl":"10.3390/nu17050839","url":null,"abstract":"<p><p><b>Background:</b> The Healthy, Hunger-Free Kids Act was passed in 2010 to update nutrition standards in the National School Lunch and Breakfast Programs to be in accordance with evidence-based guidelines. In 2017 and 2020, the United States Department of Agriculture proposed flexibilities to the nutrition standards for milk, whole grains, and sodium. <b>Objective:</b> This study examines the positions used by stakeholders in support for or opposition to the proposed rules. <b>Methods:</b> We conducted a longitudinal qualitative content analysis of public comments posted to the U.S. Federal Register in response to the USDA's proposed rules in 2017 and 2020. All public comments submitted by individuals and organizations were analyzed (n = 7323, 2017 and n = 2513, 2020). <b>Results</b>: Results indicated three categories of arguments: (1) comments favoring the original law, (2) comments favoring flexibilities, and (3) other. In both comment periods, constituents opposed the implementation of flexibilities, while schools and manufacturers/industry predominately supported them. Academic and advocacy organizations opposed the original proposed change (2017) but relaxed their position in 2020. <b>Conclusions</b>: Any flexibility to the required nutritional standards of school meals has the potential to affect the health trajectory of youth. It is imperative to understand how stakeholders view this issue and inform policy change.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616197","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}
Background: Ganoderma lucidum spore oil (GLSO) is widely recognized for its notable medicinal and nutritional properties. This study aimed to systematically evaluate the efficacy and safety of GLSO extract in individuals with dyslipidemia. Methods: In a randomized, double-blind, placebo-controlled trial, 110 participants were enrolled and randomly assigned to either the intervention group or the placebo group. A chi-square test of baseline characteristics confirmed no significant differences in age or sex distribution between the two groups. Results: After 12 weeks of intervention, the intervention group exhibited significantly lower levels of total cholesterol (CHO), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), alongside significantly higher levels of high-density lipoprotein cholesterol (HDL-C), compared to the placebo group, with all differences reaching statistical significance. Furthermore, the relative percentage changes in lipid parameters also demonstrated significant intergroup differences. Safety analyses revealed that the intervention had no notable effects on renal function parameters, whereas hepatic function parameters showed statistically significant improvement in the intervention group. Conclusions: This study demonstrated that GLSO extract effectively improved lipid profiles and liver function, with a favorable safety and tolerability profile. These findings strongly support the potential clinical application of GLSO extract in the management of dyslipidemia.
{"title":"Clinical Evaluation of <i>Ganoderma lucidum</i> Spore Oil for Triglyceride Reduction: A Randomized, Double-Blind, Crossover Study.","authors":"Xinyi Wang, Xufeng Wang, Liang Zhao, Feng Zhou","doi":"10.3390/nu17050844","DOIUrl":"10.3390/nu17050844","url":null,"abstract":"<p><p><b>Background</b>: <i>Ganoderma lucidum</i> spore oil (GLSO) is widely recognized for its notable medicinal and nutritional properties. This study aimed to systematically evaluate the efficacy and safety of GLSO extract in individuals with dyslipidemia. <b>Methods</b>: In a randomized, double-blind, placebo-controlled trial, 110 participants were enrolled and randomly assigned to either the intervention group or the placebo group. A chi-square test of baseline characteristics confirmed no significant differences in age or sex distribution between the two groups. <b>Results</b>: After 12 weeks of intervention, the intervention group exhibited significantly lower levels of total cholesterol (CHO), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), alongside significantly higher levels of high-density lipoprotein cholesterol (HDL-C), compared to the placebo group, with all differences reaching statistical significance. Furthermore, the relative percentage changes in lipid parameters also demonstrated significant intergroup differences. Safety analyses revealed that the intervention had no notable effects on renal function parameters, whereas hepatic function parameters showed statistically significant improvement in the intervention group. <b>Conclusions</b>: This study demonstrated that GLSO extract effectively improved lipid profiles and liver function, with a favorable safety and tolerability profile. These findings strongly support the potential clinical application of GLSO extract in the management of dyslipidemia.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616493","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}
Alhagie Sowe, Elizabeth Wood, Santosh Kumar Gautam
Background: Iron deficiency anemia (IDA) is a significant global health problem affecting close to 2 billion people worldwide. The prevalence of IDA is higher among children younger than five years and women of reproductive age, indicating an intergenerational correlation between maternal and child anemia. This study aims to analyze the association between maternal and child anemia in The Gambia.
Methods: A nationally representative dataset comprising 3249 children under the age of five, obtained from The Gambia Demographic and Health Survey (2019-2020), was utilized for empirical analyses. Multivariate linear regression models were employed to assess the association between maternal and child anemia. The multivariate models were adjusted for various confounding variables, including birth order, age, and the gender of the child, as well as maternal education, religion, wealth quintiles, rural residence, and region-fixed effects.
Results: Fifty-three percent of children and 52% of mothers are anemic. Children from poorer households show a higher rate of anemia compared to those from wealthier households. Maternal anemia was significantly associated with the anemia status of the children. Children born to anemic mothers were 13.5% more likely to be also anemic (p < 0.001). The correlation coefficient between mother and child hemoglobin levels is 0.165 (p < 0.001). The correlation coefficient between maternal and child anemia is higher among the bottom three wealth quintiles than the top two wealth quintiles.
Conclusions: The significant intergenerational association between maternal and child anemia status highlights the need for targeted, multi-pronged strategies to combat the adverse impacts of anemia. Maternal anemia, in general, appears to influence childhood anemia beyond just the pregnancy period. Shared socioeconomic environment, dietary patterns, and exposure to infections likely contribute to this intergenerational association.
{"title":"Maternal Anemia as a Predictor of Childhood Anemia: Evidence from Gambian Health Data.","authors":"Alhagie Sowe, Elizabeth Wood, Santosh Kumar Gautam","doi":"10.3390/nu17050879","DOIUrl":"10.3390/nu17050879","url":null,"abstract":"<p><strong>Background: </strong>Iron deficiency anemia (IDA) is a significant global health problem affecting close to 2 billion people worldwide. The prevalence of IDA is higher among children younger than five years and women of reproductive age, indicating an intergenerational correlation between maternal and child anemia. This study aims to analyze the association between maternal and child anemia in The Gambia.</p><p><strong>Methods: </strong>A nationally representative dataset comprising 3249 children under the age of five, obtained from The Gambia Demographic and Health Survey (2019-2020), was utilized for empirical analyses. Multivariate linear regression models were employed to assess the association between maternal and child anemia. The multivariate models were adjusted for various confounding variables, including birth order, age, and the gender of the child, as well as maternal education, religion, wealth quintiles, rural residence, and region-fixed effects.</p><p><strong>Results: </strong>Fifty-three percent of children and 52% of mothers are anemic. Children from poorer households show a higher rate of anemia compared to those from wealthier households. Maternal anemia was significantly associated with the anemia status of the children. Children born to anemic mothers were 13.5% more likely to be also anemic (<i>p</i> < 0.001). The correlation coefficient between mother and child hemoglobin levels is 0.165 (<i>p</i> < 0.001). The correlation coefficient between maternal and child anemia is higher among the bottom three wealth quintiles than the top two wealth quintiles.</p><p><strong>Conclusions: </strong>The significant intergenerational association between maternal and child anemia status highlights the need for targeted, multi-pronged strategies to combat the adverse impacts of anemia. Maternal anemia, in general, appears to influence childhood anemia beyond just the pregnancy period. Shared socioeconomic environment, dietary patterns, and exposure to infections likely contribute to this intergenerational association.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616526","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}
Areej Alsiwat, George Kitsaras, Anne-Marie Glenny, Haya Alayadi, Michaela Goodwin
Background/Objectives: The Ministry of Health and Education in Saudi Arabia established school canteen guidelines that have been mandatory since 2014. Only one previous study has investigated the compliance of public high schools with these guidelines. The aim of this study is to explore public primary school compliance with the school canteen policy guidelines set by the Saudi Ministry of Health and Education. Methods: A cross-sectional study with a total of 80 public primary schools randomly selected from five regions in Riyadh, Saudi Arabia, was conducted. School canteens were explored using a school canteen checklist provided by the Ministry of Education. The checklist contains a list of items grouped into healthy and unhealthy foods. A final assessment for alignment with the checklist was classified as either poor, average, or good. Canteen staff were provided with a structured questionnaire on the day of the school visit to gather their opinions and feedback regarding the canteen. Results: A total of 70% of schools showed an average rating for alignment with the Ministry of Health and Education guidelines; however, most of the items available in canteens were unhealthy. The canteen staff recommended adding healthier options like milk, fruit, and vegetables to school canteens. Furthermore, canteen staff reported issues in regard to expensive foods and a lack of choice in healthy food options. Conclusions: This study has shown that public primary schools in Riyadh, Kingdom of Saudi Arabia (KSA), have an average rating alignment with the Ministry of Health and Education's school food policy guidelines. This study highlights the need for improvement in the Saudi Ministry of Education's checklist, particularly regarding the availability of healthy foods, including milk, fruits, vegetables, and other nutritious items.
{"title":"Public Primary School Compliance with School Canteen Policy in Riyadh, Saudi Arabia: A Cross-Sectional Study.","authors":"Areej Alsiwat, George Kitsaras, Anne-Marie Glenny, Haya Alayadi, Michaela Goodwin","doi":"10.3390/nu17050854","DOIUrl":"10.3390/nu17050854","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The Ministry of Health and Education in Saudi Arabia established school canteen guidelines that have been mandatory since 2014. Only one previous study has investigated the compliance of public high schools with these guidelines. The aim of this study is to explore public primary school compliance with the school canteen policy guidelines set by the Saudi Ministry of Health and Education. <b>Methods:</b> A cross-sectional study with a total of 80 public primary schools randomly selected from five regions in Riyadh, Saudi Arabia, was conducted. School canteens were explored using a school canteen checklist provided by the Ministry of Education. The checklist contains a list of items grouped into healthy and unhealthy foods. A final assessment for alignment with the checklist was classified as either poor, average, or good. Canteen staff were provided with a structured questionnaire on the day of the school visit to gather their opinions and feedback regarding the canteen. <b>Results:</b> A total of 70% of schools showed an average rating for alignment with the Ministry of Health and Education guidelines; however, most of the items available in canteens were unhealthy. The canteen staff recommended adding healthier options like milk, fruit, and vegetables to school canteens. Furthermore, canteen staff reported issues in regard to expensive foods and a lack of choice in healthy food options. <b>Conclusions:</b> This study has shown that public primary schools in Riyadh, Kingdom of Saudi Arabia (KSA), have an average rating alignment with the Ministry of Health and Education's school food policy guidelines. This study highlights the need for improvement in the Saudi Ministry of Education's checklist, particularly regarding the availability of healthy foods, including milk, fruits, vegetables, and other nutritious items.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616548","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}
Background: Zinc is an essential trace element that is crucial for numerous biological processes, including protein synthesis, antioxidant activity, and bone calcification. Preterm infants are at high risk of zinc deficiency owing to inadequate zinc stores at birth and the rapid decline in zinc concentration in breast milk. This study aimed to evaluate the relationship between zinc concentrations in breast milk and zinc supplementation in preterm infants. Methods: A prospective observational study was conducted at Showa University Hospital, enrolling preterm infants born at less than 32 weeks of gestation or with a birth weight of less than 1800 g. Serum zinc levels, breast milk zinc concentrations, and zinc acetate supplementation were analyzed. Results: The results indicated an inverse correlation between breast milk zinc concentration and the required zinc supplementation dose. Infants receiving high-dose zinc supplementation (≥3 mg/kg/day) had significantly lower breast milk zinc concentrations at 2, 4, and 5 weeks postpartum. Conclusions: These findings highlight the need for individualized zinc monitoring and supplementation strategies to prevent zinc deficiency in preterm infants. Considering the absence of zinc in human milk fortifiers in Japan, aggressive zinc supplementation may be necessary to ensure optimal growth and development.
{"title":"Zinc Concentration in Breast Milk Is Inversely Correlated with the Zinc Supplementation Requirements of Preterm Infants.","authors":"Tokuo Miyazawa, Madoka Shirai, Yutaro Noguchi, Kazuna Haruyama, Kosuke Oikawa, Akio Ebata, Tomomasa Terada, Yoshiyuki Hasebe, Katsumi Mizuno","doi":"10.3390/nu17050840","DOIUrl":"10.3390/nu17050840","url":null,"abstract":"<p><p><b>Background:</b> Zinc is an essential trace element that is crucial for numerous biological processes, including protein synthesis, antioxidant activity, and bone calcification. Preterm infants are at high risk of zinc deficiency owing to inadequate zinc stores at birth and the rapid decline in zinc concentration in breast milk. This study aimed to evaluate the relationship between zinc concentrations in breast milk and zinc supplementation in preterm infants. <b>Methods:</b> A prospective observational study was conducted at Showa University Hospital, enrolling preterm infants born at less than 32 weeks of gestation or with a birth weight of less than 1800 g. Serum zinc levels, breast milk zinc concentrations, and zinc acetate supplementation were analyzed. <b>Results:</b> The results indicated an inverse correlation between breast milk zinc concentration and the required zinc supplementation dose. Infants receiving high-dose zinc supplementation (≥3 mg/kg/day) had significantly lower breast milk zinc concentrations at 2, 4, and 5 weeks postpartum. <b>Conclusions:</b> These findings highlight the need for individualized zinc monitoring and supplementation strategies to prevent zinc deficiency in preterm infants. Considering the absence of zinc in human milk fortifiers in Japan, aggressive zinc supplementation may be necessary to ensure optimal growth and development.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616607","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}
With advancements in medical technology, biochemistry, and clinical practices, the modern approach to total parenteral nutrition (TPN) has been focused on precision, safety, and the optimization of metabolic and nutritional parameters based on the patient's needs. In the last decade, TPN mixtures have been transitioning from a lifesaving intervention for patients unable to receive enteral nutrition to a highly specialized therapy aimed at improving clinical outcomes, reducing complications, and personalizing care. Total parenteral nutrition has attracted great interest, and its adaptation to the patient's needs is a topic of interest in the scientific community. However, there are problems related to shortages in the supply of the concentrates required to balance TPN mixtures and to infections linked to the venous access devices that are necessary for administering nutrition. Adjusting the TPN composition to meet specific patient needs requires specialist knowledge, as the ingredients available on the market differ in terms of excipients and this may increase the risk of physicochemical incompatibilities, particularly the destabilization of the lipid fraction. It is common clinical practice to inject drugs into the parenteral nutrition bag, and hence there is a high demand for confirmation of the compatibility of a given drug with the TPN composition. However, methods used in clinical practice still differ from the modern solutions proposed in scientific research. In order to ensure patient safety with the use of advanced therapy, continuous education and monitoring of the latest scientific research related to TPN is required. The integration of artificial intelligence (AI) into clinical nutrition represents a paradigm shift in the management of total parenteral nutrition (TPN). As TPN transitions from a standardized, one-size-fits-all approach to a highly personalized therapy, we must examine the challenges and future directions of AI-driven TPN to provide a comprehensive analysis of its impact on clinical practice.
{"title":"The Modern Approach to Total Parenteral Nutrition: Multidirectional Therapy Perspectives with a Focus on the Physicochemical Stability of the Lipid Fraction.","authors":"Żaneta Sobol, Rafał Chiczewski, Dorota Wątróbska-Świetlikowska","doi":"10.3390/nu17050846","DOIUrl":"10.3390/nu17050846","url":null,"abstract":"<p><p>With advancements in medical technology, biochemistry, and clinical practices, the modern approach to total parenteral nutrition (TPN) has been focused on precision, safety, and the optimization of metabolic and nutritional parameters based on the patient's needs. In the last decade, TPN mixtures have been transitioning from a lifesaving intervention for patients unable to receive enteral nutrition to a highly specialized therapy aimed at improving clinical outcomes, reducing complications, and personalizing care. Total parenteral nutrition has attracted great interest, and its adaptation to the patient's needs is a topic of interest in the scientific community. However, there are problems related to shortages in the supply of the concentrates required to balance TPN mixtures and to infections linked to the venous access devices that are necessary for administering nutrition. Adjusting the TPN composition to meet specific patient needs requires specialist knowledge, as the ingredients available on the market differ in terms of excipients and this may increase the risk of physicochemical incompatibilities, particularly the destabilization of the lipid fraction. It is common clinical practice to inject drugs into the parenteral nutrition bag, and hence there is a high demand for confirmation of the compatibility of a given drug with the TPN composition. However, methods used in clinical practice still differ from the modern solutions proposed in scientific research. In order to ensure patient safety with the use of advanced therapy, continuous education and monitoring of the latest scientific research related to TPN is required. The integration of artificial intelligence (AI) into clinical nutrition represents a paradigm shift in the management of total parenteral nutrition (TPN). As TPN transitions from a standardized, one-size-fits-all approach to a highly personalized therapy, we must examine the challenges and future directions of AI-driven TPN to provide a comprehensive analysis of its impact on clinical practice.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616651","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}
Hammad Ullah, Marco Dacrema, Daniele Giuseppe Buccato, Marwa A A Fayed, Lorenza Francesca De Lellis, Maria Vittoria Morone, Alessandro Di Minno, Alessandra Baldi, Maria Daglia
Metabolic syndrome, a global health concern, is characterized by visceral obesity, hyperglycemia, dyslipidemia, hypertension, and chronic low-grade inflammation. Current therapeutic options are limited by their varying efficacy and significantly adverse side effects, fueling interest in natural products, particularly plant extracts, as potential preventive interventions for high-risk individuals. This review examines the role of plant extracts in mitigating metabolic syndrome risk factors, addressing safety concerns and exploring associated technological advancements. The literature indicates that plant extracts hold promise for addressing the pathophysiology of metabolic dysfunction. However, challenges such as safety concerns, a lack of standardized regulation, and potential drug-plant interactions currently limit their clinical application. Rigorous, long-term clinical trials are necessary to confirm the efficacy and safety of plant extracts before they can be established as a preventive strategy for managing metabolic syndrome.
{"title":"A Narrative Review on Plant Extracts for Metabolic Syndrome: Efficacy, Safety, and Technological Advances.","authors":"Hammad Ullah, Marco Dacrema, Daniele Giuseppe Buccato, Marwa A A Fayed, Lorenza Francesca De Lellis, Maria Vittoria Morone, Alessandro Di Minno, Alessandra Baldi, Maria Daglia","doi":"10.3390/nu17050877","DOIUrl":"10.3390/nu17050877","url":null,"abstract":"<p><p>Metabolic syndrome, a global health concern, is characterized by visceral obesity, hyperglycemia, dyslipidemia, hypertension, and chronic low-grade inflammation. Current therapeutic options are limited by their varying efficacy and significantly adverse side effects, fueling interest in natural products, particularly plant extracts, as potential preventive interventions for high-risk individuals. This review examines the role of plant extracts in mitigating metabolic syndrome risk factors, addressing safety concerns and exploring associated technological advancements. The literature indicates that plant extracts hold promise for addressing the pathophysiology of metabolic dysfunction. However, challenges such as safety concerns, a lack of standardized regulation, and potential drug-plant interactions currently limit their clinical application. Rigorous, long-term clinical trials are necessary to confirm the efficacy and safety of plant extracts before they can be established as a preventive strategy for managing metabolic syndrome.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616472","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}
Georgios Tzikos, Eleni Chamalidou, Dimitra Christopoulou, Aikaterini Apostolopoulou, Sofia Gkarmiri, Marianthi Pertsikapa, Alexandra-Eleftheria Menni, Ioannis M Theodorou, George Stavrou, Nektaria-Dimitra Doutsini, Anne D Shrewsbury, Theodosios Papavramidis, Joulia K Tsetis, Helen Theodorou, Anastasia Konsta, Katerina Kotzampassi
Background: Psychological disorders are prevalent in patients having undergone gastrointestinal cancer surgery, and their emotional status may further deteriorate during subsequent chemotherapy. Psychobiotics are specific probiotics that have the unique characteristics of producing neuroactive substances that are thought to act on the brain-gut axis. The aim of the present study was to evaluate the benefits of a psychobiotic formula on depression and anxiety status, as well as on perceived stress, versus a placebo in patients on a chemotherapy course following gastrointestinal surgery for cancer. Patients: The enrolled patients, allocated to the psychobiotic and placebo groups, were assessed by means of these psychometric tests: Beck's Depression Inventory and the Hamilton Depression Rating 17-item Scale for depression; the General Anxiety Disorder-7 for anxiety; and the Perceived Stress Scale-14 Item for perceived stress at three time-points: upon allocation [T1], after one month of treatment [T2], and two months thereafter [T3]. Results: In total, 266 patients were included. One month of psychobiotic treatment improved [i] depression status by 60.4% [48 depressed patients at T1, reduced to 16 at T3]; [ii] anxiety by 57.0% [72 patients at T1, 26 at T3]; and [iii] stress by 60.4% [42 at T1, 14 at T3]. The placebo-treated patients experienced a deterioration in all parameters studied, i.e., depression increased by 62.9%, anxiety by 39.7%, and stress by 142.5%. Conclusions: Based on these findings, it can be recognized that psychobiotic treatment has great potential for every patient at risk of suffering from depression, anxiety, or stress during the course of surgery/chemotherapy for gastrointestinal cancer.
{"title":"Psychobiotics Ameliorate Depression and Anxiety Status in Surgical Oncology Patients: Results from the <i>ProDeCa</i> Study.","authors":"Georgios Tzikos, Eleni Chamalidou, Dimitra Christopoulou, Aikaterini Apostolopoulou, Sofia Gkarmiri, Marianthi Pertsikapa, Alexandra-Eleftheria Menni, Ioannis M Theodorou, George Stavrou, Nektaria-Dimitra Doutsini, Anne D Shrewsbury, Theodosios Papavramidis, Joulia K Tsetis, Helen Theodorou, Anastasia Konsta, Katerina Kotzampassi","doi":"10.3390/nu17050857","DOIUrl":"10.3390/nu17050857","url":null,"abstract":"<p><p><b>Background</b>: Psychological disorders are prevalent in patients having undergone gastrointestinal cancer surgery, and their emotional status may further deteriorate during subsequent chemotherapy. Psychobiotics are specific probiotics that have the unique characteristics of producing neuroactive substances that are thought to act on the brain-gut axis. The aim of the present study was to evaluate the benefits of a psychobiotic formula on depression and anxiety status, as well as on perceived stress, versus a placebo in patients on a chemotherapy course following gastrointestinal surgery for cancer. <b>Patients</b>: The enrolled patients, allocated to the psychobiotic and placebo groups, were assessed by means of these psychometric tests: Beck's Depression Inventory and the Hamilton Depression Rating 17-item Scale for depression; the General Anxiety Disorder-7 for anxiety; and the Perceived Stress Scale-14 Item for perceived stress at three time-points: upon allocation [T1], after one month of treatment [T2], and two months thereafter [T3]. <b>Results</b>: In total, 266 patients were included. One month of psychobiotic treatment improved [i] depression status by 60.4% [48 depressed patients at T1, reduced to 16 at T3]; [ii] anxiety by 57.0% [72 patients at T1, 26 at T3]; and [iii] stress by 60.4% [42 at T1, 14 at T3]. The placebo-treated patients experienced a deterioration in all parameters studied, i.e., depression increased by 62.9%, anxiety by 39.7%, and stress by 142.5%. <b>Conclusions</b>: Based on these findings, it can be recognized that psychobiotic treatment has great potential for every patient at risk of suffering from depression, anxiety, or stress during the course of surgery/chemotherapy for gastrointestinal cancer.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615439","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}
José Adrián Montenegro-Espinosa, José Francisco López-Gil
Background/Purpose: To our knowledge, no previous study has analyzed the associations between self-efficacy and adherence to the Mediterranean diet (MedDiet) in adolescents, nor have sex-based differences in this relationship been examined. The aim of the current study was to examine the relationship between self-efficacy and MedDiet adherence in Spanish adolescents. Methods: This research was cross-sectional and involved 619 adolescents (56.5% girls) who were part of the Eating Habits and Activities of Daily Living (EHDLA) project. Self-efficacy was assessed using a 10-item scale (general self-efficacy scale), which yielded scores ranging from 20 to 100 points. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED), which consists of a 16-item questionnaire with scores ranging from -4 to 12, was used to evaluate adherence to the MedDiet. Unhealthy behaviors related to the MedDiet were assigned a score of -1, whereas healthy behaviors received a score of +1. Results: Overall, for each 20-point increase in self-efficacy, boys had a greater non-significant likelihood of having optimal MedDiet adherence (1.33%, 95% confidence interval [CI] -5.15 to 7.82, p = 0.687). Conversely, girls had a greater significant likelihood of having optimal MedDiet adherence per further point in self-efficacy (7.40%, 95% CI 2.28 to 12.53, p = 0.005). Individually, among boys, a 20-point increase in self-efficacy was associated with a 4.8% higher probability of having a dairy product for breakfast (95% CI 0.2 to 9.4, p = 0.042). Among girls, the same increase in self-efficacy was linked to a greater probability of consuming fruit or fruit juice daily (6.8%, 95% CI 2.2 to 11.4, p = 0.004), eating a second fruit every day (8.6%, 95% CI 3.4 to 13.8, p = 0.001), consuming fish regularly (6.2%, 95% CI 1.1 to 11.2, p = 0.017), enjoying pulses and eating them more than once a week (4.5%, 95% CI 0.3 to 8.8, p = 0.035), having cereals or grains for breakfast (5.4%, 95% CI 0.4 to 10.5, p = 0.035), and regularly consuming nuts (5.2%, 95% CI 0.2 to 10.2, p = 0.041). Additionally, increases in self-efficacy was associated with a 5.0% lower probability of skipping breakfast (95% CI -8.8 to -1.1, p = 0.012). Conclusions: Our results revealed a significant association between self-efficacy and MedDiet adherence among girls, whereas the relationship between self-efficacy and the MedDiet in boys was not significant. These results suggest that interventions aimed at improving adolescent dietary patterns should consider incorporating strategies to increase self-efficacy, potentially with sex-specific approaches.
{"title":"Does Sex Matter in the Link Between Self-Efficacy and Mediterranean Diet Adherence in Adolescents? Insights from the EHDLA Study.","authors":"José Adrián Montenegro-Espinosa, José Francisco López-Gil","doi":"10.3390/nu17050880","DOIUrl":"10.3390/nu17050880","url":null,"abstract":"<p><p><b>Background/Purpose:</b> To our knowledge, no previous study has analyzed the associations between self-efficacy and adherence to the Mediterranean diet (MedDiet) in adolescents, nor have sex-based differences in this relationship been examined. The aim of the current study was to examine the relationship between self-efficacy and MedDiet adherence in Spanish adolescents. <b>Methods:</b> This research was cross-sectional and involved 619 adolescents (56.5% girls) who were part of the Eating Habits and Activities of Daily Living (EHDLA) project. Self-efficacy was assessed using a 10-item scale (general self-efficacy scale), which yielded scores ranging from 20 to 100 points. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED), which consists of a 16-item questionnaire with scores ranging from -4 to 12, was used to evaluate adherence to the MedDiet. Unhealthy behaviors related to the MedDiet were assigned a score of -1, whereas healthy behaviors received a score of +1. <b>Results:</b> Overall, for each 20-point increase in self-efficacy, boys had a greater non-significant likelihood of having optimal MedDiet adherence (1.33%, 95% confidence interval [CI] -5.15 to 7.82, <i>p</i> = 0.687). Conversely, girls had a greater significant likelihood of having optimal MedDiet adherence per further point in self-efficacy (7.40%, 95% CI 2.28 to 12.53, <i>p</i> = 0.005). Individually, among boys, a 20-point increase in self-efficacy was associated with a 4.8% higher probability of having a dairy product for breakfast (95% CI 0.2 to 9.4, <i>p</i> = 0.042). Among girls, the same increase in self-efficacy was linked to a greater probability of consuming fruit or fruit juice daily (6.8%, 95% CI 2.2 to 11.4, <i>p</i> = 0.004), eating a second fruit every day (8.6%, 95% CI 3.4 to 13.8, <i>p</i> = 0.001), consuming fish regularly (6.2%, 95% CI 1.1 to 11.2, <i>p</i> = 0.017), enjoying pulses and eating them more than once a week (4.5%, 95% CI 0.3 to 8.8, <i>p</i> = 0.035), having cereals or grains for breakfast (5.4%, 95% CI 0.4 to 10.5, <i>p</i> = 0.035), and regularly consuming nuts (5.2%, 95% CI 0.2 to 10.2, <i>p</i> = 0.041). Additionally, increases in self-efficacy was associated with a 5.0% lower probability of skipping breakfast (95% CI -8.8 to -1.1, <i>p</i> = 0.012). <b>Conclusions:</b> Our results revealed a significant association between self-efficacy and MedDiet adherence among girls, whereas the relationship between self-efficacy and the MedDiet in boys was not significant. These results suggest that interventions aimed at improving adolescent dietary patterns should consider incorporating strategies to increase self-efficacy, potentially with sex-specific approaches.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"17 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615501","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}