Journal of the American Nutrition Association最新文献

Background and objectives: Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) typically undergo surgery followed by postoperative radiotherapy/chemoradiotherpy. Nutritional issues often arise during treatment, potentially affecting outcomes. This study aimed to investigate whether early initiation of oral nutritional supplements (ONS) would prevent weight loss in HNSCC patients undergoing postoperative radiotherapy/chemoradiotherapy compared to conventional nutritional intervention.

Subjects and methods: Sixty-five surgically treated HNSCC patients were randomized to early nutritional intervention (ENI) or conventional nutritional intervention (CNI) groups. The ENI group started ONS two weeks before radiotherapy, while the CNI group initiated ONS based on dietitian's advice when dietary intake was insufficient. Primary endpoint was body weight change from baseline to two weeks post-radiotherapy. Secondary endpoints included nutritional status, body composition, adverse events, quality of life, and survival.

Results: Patients in the ENI group experienced less pronounced weight loss compared to those in the CNI group. Lower serum prealbumin levels were observed in the CNI group during radiotherapy, while no significant between-group differences existed in other nutritional parameters, QoL, or survival.

Conclusion: Early ONS intervention effectively prevented significant weight loss in HNSCC patients undergoing postoperative radiotherapy/chemoradiotherapy. Our findings strongly support prioritizing and integrating early nutritional support with ONS into routine care for this patient population, given its clear benefits in improving nutritional outcomes during treatment.

Clinical trial registration: www.ClinicalTrials.gov. NCT03545490.

Menatetrenone (MK-4), a potent form of vitamin K2, has gained significant attention for its diverse therapeutic potential, particularly in bone health, cardiovascular protection, and metabolic disorders. This manuscript explores the origins and chemical structure of menatetrenone, highlighting its synthesis from dietary sources and its enzymatic conversion in the body. The review examines the extensive therapeutic applications of MK-4, focusing on its role in treating osteoporosis, diabetes, and cardiovascular diseases, along with emerging evidence of its anticancer and neuroprotective effects. Furthermore, the manuscript discusses innovative delivery systems, such as nanostructured lipid carriers and other advanced formulations, designed to enhance the bioavailability and therapeutic efficacy of menatetrenone. By addressing the challenges associated with its pharmacokinetics and exploring novel drug delivery strategies, this review provides a comprehensive overview of menatetrenone's therapeutic promise and outlines future directions for its clinical use.

Objective: The objective of this study was to examine the differences in fruit and/or vegetable consumption (FVC) among Brazilian adults by examining various social markers, such as gender, race, income, and education level.

Method: A cross-sectional study of 88,531 Brazilian adults aged 18 years or older who participated in the 2019 National Health Survey was conducted. The dependent variable was irregular FVC (<5 d/wk). Individuals at the highest risk for irregular FVC include those who are men and Black and who have lower education levels and lower income. Individuals at lower risk include those who are women and White and who have higher education levels and higher income. The prevalence of irregular FVC was calculated considering the levels of the social risk index for FVC and the intersections among two, three, and four risk categories. Odds ratio (OR) and 95% confidence interval (CI) analyses were performed to compare groups at higher risk with those at lower risk.

Results: The prevalence of irregular FVC was 57.2% in the general population, 38.1% for individuals in the lowest risk group, 47.5% for individuals in one risk category, 57.9% for individuals in two risk categories, 67.6% for individuals in three risk categories, and 74.4% for individuals in the highest-risk group, and there were significant differences at each level. The highest risk group had a 4.36 (95% CI, 3.86-4.92) times greater chance of irregular FVC.

Conclusions: The complex path to promote FVC among the Brazilian population underscores the need for intersectoral policies aimed at reducing inequalities.

Objective: Experimental studies suggest that carotenoids and tocopherols modulate pancreatic carcinogenesis because they have antioxidant and other functions. We investigated the associations between intakes of these compounds and the risk of pancreatic cancer in a case-control study conducted in 1994-1998.

Methods: The present analysis included 150 cases of pancreatic cancer recruited from all hospitals in the metropolitan area of the Twin Cities and Mayo Clinic and 459 controls randomly selected from the general population and frequency matched to cases by age, sex, and race. The intakes of carotenoids and tocopherols were assessed with a validated food frequency questionnaire. Unconditional logistic regression analysis was performed to evaluate the associations of interest.

Results: The energy-adjusted intake of lutein/zeaxanthin was significantly lower in cases (2410 µg/day) than in controls (3020 µg/day). After adjustment for confounders, persons in the fourth quartile of lutein/zeaxanthin intake had a reduced risk of pancreatic cancer compared with those in the first quartile [odds ratio (OR) (95% CI): 0.40 (0.17-0.91)]. There were no significant associations with intakes of other carotenoids and tocopherols considered and with a composite score created from all individual carotenoids examined. We did not detect any significant interactions of intakes of carotenoids and tocopherols with age, sex, cigarette smoking, or alcohol intake in relation to pancreatic cancer risk.

Conclusion: The present study suggests an inverse association between lutein/zeaxanthin intake and pancreatic cancer risk, but a potential beneficial effect was not observed for other carotenoids and tocopherols.

Objective: Physalis Peruviana Linnaeus (PPL) is an herbaceous species characterized by a wide variety of bioactive compounds to which anti-inflammatory properties have been attributed. This makes this fruit a possible complementary therapy for diseases that involve chronic inflammation, such as inflammatory bowel diseases (IBD). In the present study, the effect of a PPL extract on the expression of inflammatory markers in the Caco-2 cell line was evaluated.

Methods: An in vitro gastric digest (50 g PPL pulp) was performed, obtaining an extract that was used to challenge Caco-2 cells for 24 and 72 hours. This extract was characterized by LC-MS/MS. Then, the relative mRNA expression of NF-kB, TLR4, IL-18 and MCP-1 was determined through qRT-PCR and the protein levels of TNF-α, IL-6, IL-8, IL-18 and MCP-1 through Luminex Immunoassay.

Results: From the characterization of the extract, compounds with bioactive potential such as isothiocyanates, indoles and coumarins were found. Treatment of Caco-2 cells with PPL extract (80 µg/ml), particularly for 72 hours, produced a reduction of IL-18 and MCP-1 mRNA expression (p < 0.01), in addition to IL-18 (p < 0.01), IL-8 (p < 0.0001) and MCP-1 (p < 0.01) protein levels, however, no effects on NF-kB p65 (p = 0.09) and TLR4 (p = 0.20) mRNA expression were observed.

Conclusion: The results obtained in this study open the possibility that the regular consumption of 50 g of PPL could constitute a possible complementary therapy for the treatment of IBD, improving the quality of life of these patients.

Objective: Life expectancy and obesity prevalence are increasing worldwide, leading to an increase in the prevalence of cardiovascular disease. High-density lipoprotein (HDL) functionality and immunosenescence play key roles in cardiovascular disease, longevity, and quality of aging. Both molecular hallmarks of aging are impacted by obesity and metabolic syndrome and can be modulated by lifestyle. We aimed to evaluate the effect of a lifestyle intervention focused on an energy-reduced Mediterranean diet (erMedDiet), physical activity (PA), and behavioral support on HDL cholesterol efflux capacity (CEC) and immunosenescence.

Method: CEC and immunosenescent T cells were determined in 60 participants from the control group (CG) and 56 from the intervention group (IG) of the PREDIMED-Plus trial at baseline and after 1 and 3 years of follow-up. PREDIMED-Plus is a randomized, controlled, parallel-group trial with an IG of erMedDiet, PA promotion, and behavioral support for weight loss and a CG of usual primary care advice. The sample included 116 volunteers from the PREDIMED-Plus-IMDEA subsample of the PREDIMED-Plus trial. Men aged 55 to 75 years and women aged 60 to 75 years with a body mass index between 27 and 40 kg/m² and metabolic syndrome were included.

Results: Participants within the IG had significantly improved CEC (2.42% and 10.69% after 1 and 3 years of follow-up) and a decreased in senescent T cell profile (-3.32% ± 12.54% and -6.74% ± 11.2%, p < 0.001, after 1 and 3 years of follow-up). Baseline obesity status impacted the response to the intervention.

Conclusions: A weight loss intervention program with erMedDiet and PA ameliorated senescence markers.

Excess body adiposity, referred to as overweight and obesity, represents a major health concern given that it increases the risk of various diseases, including cardiovascular diseases, type 2 diabetes, and cancer. Body weight reduction can be achieved via a wide variety of dietary strategies as long as an energy deficit is achieved. However, the effect of such diets on disease risk and mortality will depend on the foods included. Increasing evidence shows that consumption of whole plant foods (e.g., fruits, vegetables, whole grains, nuts, seeds, legumes) in place of animal foods (e.g., meat, poultry, dairy, fish, eggs, and seafood and their derivatives) and non-whole plant foods (e.g., refined grains, French fries, sugar-sweetened beverages) is associated with improvements in cardiometabolic risk factors and lower risk of chronic diseases and mortality. This review focuses on the effect of a whole plant-foods diet on overweight and obesity from observational to clinical studies and discusses the potential mechanisms involved. According to existing evidence, a whole plant foods diet seems to be more advantageous than other dietary approaches for the prevention and treatment of excess adiposity given that it is composed of the foods that lead to the best health outcomes.

Objective: To explore the association between oxidative balance score (OBS) and osteoporosis risk, as well as to identify the specific population group.

Methods: In this cross-sectional study, we included the data of 5,413 participants using the National Health and Nutrition Examination Survey of 2013-2014 and 2017-2018. Restricted cubic spline (RCS) curves, logistic regression models, trend tests, and stratification analyses were used to evaluate the association between the OBS and osteoporosis risk. Generalized linear models (GLM) were used to identify independent factors related to OBS. Finally, whether OBS played a mediating role in osteoporosis was evaluated using a mediation analysis.

Results: Patients with osteoporosis had a lower OBS, and a high OBS score was associated with a decreased risk of osteoporosis (p < 0.05). Further stratification analysis revealed that the relationship between OBS and osteoporosis was robust in the three models in female patients aged < 70 years, which was validated using a trend test (p < 0.05). Age and sex were independent predictors of osteoporosis and the OBS. The OBS was a mediator in the association between sex, but not age, and disease.

Conclusion: Our findings indicate a negative relationship between OBS and osteoporosis risk, which was pronounced in younger women and individuals aged < 70 years. Moreover, sex may be related to osteoporosis through the regulation of OBS.

Objective: High consumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of all-cause and cardiovascular disease (CVD) mortality; however, the data and results for Asian populations, particularly in Korea, are limited and unclear. Therefore, this research aimed to investigate the association between types of SSB consumption and risk of all-cause and cause-specific mortality in South Korean adults.

Methods: This prospective study included Korean adults aged 40 to 79 who participated in the Health Examinees Study. The baseline survey was conducted from 2004 to 2013, and death data were obtained until December 2022. A food frequency questionnaire was used to assess SSB intake, and all-cause, CVD, and cancer mortality were estimated. The SSB included total SSB, soda, and other drinks (Korean traditional SSB).

Results: A total of 126,856 participants were included (mean [standard deviation]: age, 53.1 [8.3] years; 82,311 [64.9%] women). During a mean follow-up of 11.0 years, 5741 all-cause, 936 CVD, and 2662 cancer deaths were recorded. Increased soda consumption was associated with higher all-cause mortality (1-3 servings/wk: hazard ratio [HR], 1.125; 95% confidence interval [CI], 1.003-2.263; ≥3 servings/wk: HR, 1.190, 95% CI, 1.011-1.401), compared with low soda intake (never-<1 serving/wk). However, there was no association between total SSB consumption and other drinks with all-cause and cause-specific mortality. In the dose-response analysis, a trend in which a higher risk of all-cause and CVD cancers was observed with increasing soda intake.

Conclusion: In this large prospective study, soda intake of >1 serving/wk was associated with an increased risk of all-cause mortality among Korean adults. However, there was no association between total SSB or other drinks and mortality. As the consumption of SSBs increases in the Korean population, appropriate control strategies are needed to reduce SSB consumption and the disease burden.

Background: Diabetes is closely related to hypertension, and insulin resistance-related indices are novel metrics used to evaluate the risk of diabetes and cardiovascular diseases. This study aims to explore the relationships between the TyG index, METS-IR, TG/HDL-C, and HOMA-IR with hypertension.

Methods: Data from the NHANES spanning ten consecutive survey cycles from 1998 to 2018 were utilized, focusing on adults with complete blood pressure data and comprehensive information for calculating the TyG index, METS-IR, TG/HDL-C, and HOMA-IR. A multivariable logistic regression model was employed to examine the relationship between insulin resistance indices and hypertension as well as blood pressure levels, while subgroup analyses were conducted to explore potential influencing factors. RCS curves were used to describe both linear and non-linear relationships.

Results: This NHANES-based study included 16,062 adults. Regardless of the adjustment for covariates, significant associations were found between the TyG index, METS-IR, TG/HDL-C, HOMA-IR and hypertension risk. The ROC curve demonstrated the stability of the TyG index, METS-IR, TG/HDL-C, and HOMA-IR in predicting hypertension risk. The RCS curves uncovered a linear relationship between the TyG index, METS-IR, and hypertension, whereas TG/HDL-C and HOMA-IR exhibited a non-linear association with hypertension. Subgroup analyses indicated that smoking and diabetes may influence the relationship between insulin resistance-related indices and hypertension.

Conclusion: Elevated levels of the insulin resistance indices TyG index, METS-IR, TG/HDL-C, and HOMA-IR are closely associated with hypertension risk. These indices can serve as effective markers for monitoring hypertension risk in clinical practice. However, larger-scale prospective cohort studies are needed to validate these findings and further explore the clinical application potential of the TyG index, METS-IR, TG/HDL-C, and HOMA-IR as tools for cardiovascular risk assessment. Such studies will help elucidate the specific causal relationships between these insulin resistance-related indices and hypertension and advance their practical application in clinical settings.