BMJ Nutrition, Prevention and Health最新文献

Background: Erectile dysfunction (ED) is a common male health issue influenced by vascular and neurological factors. Although prior studies have linked micronutrients to ED, the role of thiamin (vitamin B₁) remains underexplored. Given its key role in energy metabolism and nervous system function, this study aimed to investigate the association between dietary thiamin intake and ED among men in the USA.

Methods: In this study, data from two cycles (2001-2002, 2003-2004) of the National Health and Nutrition Examination Survey were used, which included information on daily riboflavin intake from food and self-reported ED. For the assessment of clinical ED, participants were categorised as those who reported being 'sometimes able' or 'never' to maintain an erection based on a single question. Daily food intake and consumption data were obtained through questionnaires and 24-hour recall interviews. The relationship between daily food thiamin intake and ED was analysed using logistic regression models and smooth curve fitting.

Results: We found that higher food thiamin intake was significantly associated with lower incidence of hypertension, diabetes, coronary heart disease, stroke and ED (all p trend <0.05). Compared with participants with thiamin intake <1.3 μg, the full-adjusted ORs and 95% CIs for participants with thiamin intake >1.3 μg were 0.782 (0.651 to 0.940) (p<0.05). These findings suggest that dietary thiamin intake may play a protective role in the development of ED and other cardiometabolic disorders. Increasing thiamin consumption through dietary modification or supplementation could represent a potential strategy for ED prevention and management.

Conclusions: Greater dietary thiamin intake demonstrated a statistically significant association with reduced incidence of ED. Our findings suggest that a lower intake of thiamin is an independent risk factor with ED. We can consider increasing the intake of thiamine in daily food.

Introduction: While a balanced diet is crucial for human health, the food system is also a key driver of climate change. The EAT-Lancet Commission developed the Planetary Health Diet (PHD), providing guidelines for a healthy and sustainable diet.

Objectives: The aim of this study was to examine the association of PHD adherence with mortality in Switzerland.

Methods: In this analysis, data from the cross-sectional national nutrition survey menuCH (2014-2015, n=2057) were linked with Swiss mortality and census data (2015-2019). By applying the multiple source method, habitual food intake was calculated based on the reported dietary intakes of two 24- hour dietary recalls and information on food avoidance obtained through a self-administered questionnaire. PHD adherence was quantified using a score that was used to categorise participants (G1, 0-5 points; G2, 6 points; G3, 7 points; G4, 8-14 points). Regression models were fitted to assess the association of the PHD score with all-cause and cause-specific mortality. Spatial autocorrelation of residuals was evaluated using Moran's I statistic.

Results: A higher PHD score was associated with lower mortality from diseases of the circulatory system (per 1-point increment: rate ratio=0.98 (95% CI 0.97 to 1.00); G4 vs G1, 0.94 (0.88 to 1.00)). In female participants, a higher PHD score was associated with a lower risk of mortality from diseases of the circulatory system (per 1-point increment: 0.97 (0.94 to 0.99)). In male participants, a higher PHD score was associated with lower all-cancer mortality risk (per 1-point increment: 0.98 (0.96 to 1.00); G4 vs G1, 0.92 (0.86 to 0.99)).

Conclusions: This study generally indicates an inverse association between PHD adherence and mortality risk, especially for diseases of the circulatory system, although the associations varied among subgroups. This study provides further evidence on the potential beneficial effects of sustainable and balanced diets on human health.

Purpose: Psychosocial factors contributing to the continued failure of adolescents to follow the US Dietary Guidelines for Americans (2020-2025) remain poorly understood. This study investigated the relationships of adolescents' autonomous motivation, self-efficacy and social support with the healthy eating index (HEI) total (primary outcome), whole fruit, total fruit, vegetable, sodium, added sugar and caloric intake (secondary outcomes).

Methods: A secondary analysis of baseline data from a randomised controlled trial was conducted. A total of 935 5th-8th graders, aged 10-14 years, were enrolled. Generalised linear models and structural equation models examined relationships of motivation, social support and self-efficacy for healthy eating with healthy eating behaviours.

Results: In this sample (51% female, mean age=12.08±0.99), 48.24% were black/African American, and 48.2% were overweight/obese. In generalised linear models, family social support was significantly associated with HEI fruit (β=0.16, p=0.02) and higher caloric intake (β=44.09, p=0.03). Additionally, friend social support was significantly associated with HEI sodium (lower sodium intake; β=0.23, p=0.01). Structural equation models showed that through motivation, social support indirectly improved HEI total (β=0.09, p=0.006) and whole fruit intake (β=0.07, p=0.04) and increased HEI added sugar (lower added sugar intake; β=0.07, p=0.04). Through self-efficacy, social support was indirectly associated with lower HEI sodium (higher sodium intake; β=-0.04, p=0.04).

Discussion: These findings add to the growing body of research on adolescent nutrition by emphasising the complex interplay of psychosocial factors in shaping specific dietary behaviours.

Trial registration number: NCT04213014.

Objectives: To determine the sodium, potassium and iodine excretion and blood pressure (BP) of New Zealand (NZ) school children 8-13 years old and compare to recommended guidelines.

Methods: A cross-sectional study was undertaken in Auckland and Dunedin schools between July 2022 and February 2023. Sodium and potassium excretion were assessed using 24-hour urine, iodine using urine concentration and BP using standard methods; all values were compared with relevant international guidelines.

Results: 75 children from five schools took part (n=37 boys, 29 girls and 9 not stating gender). Mean (SD) 24-hour sodium excretion (n=59 complete samples) was 2420 (1025) mg, potassium excretion was 1567 (733) mg and the sodium-to-potassium molar ratio was 3.0 (1.6). 32% (19/59) of children met the WHO sodium guideline (<2000 mg/day), 2% (1/59) met the potassium guideline (≥3500 mg/day) and none met the sodium-to-potassium molar ratio guideline (<1:0). Median (25th, 75th percentile) urinary iodine concentration (n=55 complete samples) was 129 (90, 163) µg/L with 65% (36/55) above the WHO criteria for adequate iodine nutrition (≥99 µg/L). Mean (SD) systolic and diastolic BP (n=74) were 105 (10) mm Hg and 67 (9) mm Hg, respectively; 32% (21/65) of boys and girls with age and height measures had a systolic and diastolic BP measure >90th percentile for their gender, age and height.

Conclusions: This is the largest cross-sectional study using gold-standard methods to assess sodium and potassium excretion in NZ children. Findings suggest many NZ children could be at risk of developing cardiovascular disease later in life, and some are at risk of complications from low iodine intake.

Implications for public health: A national sodium reduction strategy and policies to increase potassium intake in NZ children are urgently needed, alongside adequate monitoring and a review of bread fortification as the only strategy for increasing children's iodine intake in NZ.

Background: Obesity is a growing global epidemic and is rapidly increasing in low- and middle-income countries like India. The rising rates of obesity and related health problems in India demand urgent, practical interventions involving healthy eating, physical activity and supportive community-based approaches.

Aim and objectives: This study aims to evaluate the impact of nurse-led intervention (NLI) on weight reduction among obese adults in urban Indian communities.

Methods and material: An exploratory sequential mixed methods design was adopted, combining qualitative focus group discussions (FGDs) and in-depth interviews (IDIs) with a quantitative randomised controlled trial (RCT). Adults aged 18-50 years were screened for obesity, recruited for the RCT and randomised into either the NLI arm, which was designed by experts using findings from the FGDs, or the general care group, which received routine care through primary health centres. Following RCT, postintervention IDIs were conducted with participants who achieved 5% or more weight loss to explore the factors that facilitated weight loss.

Statistical analysis used: Descriptive and inferential statistics were used.

Results: Screening of 982 adults revealed a high prevalence of obesity, particularly among women aged 29-50 years. The key barriers identified and addressed included lack of motivation, time and awareness, while the enablers were family support and community resources. At 12 months, 71% of participants in the NLI group achieved 5% or more weight loss, with statistically significant improvements in metabolic, dietary and physical activity outcomes. Post RCT IDIs revealed that motivation, behaviour change and social support were key drivers of sustained weight loss.

Conclusion: The NLI guided to meaningful weight loss and improved health indicators among obese adults in Puducherry. The findings highlight the potential of culturally adapted, nurse-led programmes and recommend broader implementation through integrated community health strategies.

Trial registration number: CTRI/2021/12/038785).

Background and aim: When extracorporeal membrane oxygenation (ECMO) was first introduced for paediatric patients, lipid emulsions were mostly administered directly into the ECMO circuit. However, clinicians have observed that lipid emulsions tend to separate and agglutinate within the circuit, raising concerns about potential complications. Many institutions therefore opted to exclude lipids from parenteral regimens, inadvertently leading to inadequate nutritional support for these critically ill patients. This study measured the caloric deficit resulting from the lack of lipid provision to paediatric ECMO patients in relation to the patients' basal energy expenditure (BEE) and explored the resulting nutritional outcomes.

Methods and results: This was a retrospective, single-centre study conducted at a tertiary care hospital. All paediatric ECMO patients receiving parenteral nutrition (PN) from the period of April 2020 to April 2023 were included in the study.Twenty-three patients were identified. Of these, 18 (78.26%) did not achieve the target BEE. The average calorie deficit of all patients was 40.23% of the calculated BEE (SD=17.468%). Of the patients who had a calorie deficit, eight (50%) died. No significant differences were found in patients' weights before and after stopping PN (p=0.3594).

Conclusion: This study explored the challenge of meeting the nutritional needs of paediatric ECMO patients when lipids are excluded from PN. Significant caloric deficits require alternative strategies to prevent patient malnourishment without affecting the ECMO circuit's functionality.

Background: Patients with anorexia nervosa (AN) have intestinal dysbiosis and are frequently affected by oral and upper gastrointestinal disorders. Until now, no metagenomic sequencing data were available on oral microbiota in AN.

Design: This observational study enrolled 46 patients with restrictive/purging AN and 20 controls. Salivary samples were performed after fasting. DNA of oral microbiota from salivary samples was analysed by whole genome shotgun deep sequencing. The primary objective was to compare the diversity of oral microbiota between patients with AN and healthy individuals. Secondary endpoints were to assess the associations between the diversity of oral microbiota and the severity of functional digestive disorders, between patients with a restrictive type of AN and patients with a mixed/purging type and between the diversity of oral microbiota and the severity of AN.

Results: We observed not only a significant decrease in the alpha diversity of oral microbiota in AN patients (4.47 (4.05; 4.75)) versus controls (4.81 (4.68; 5.04)) (p=0.001) but also in gene richness (p=0.00023). There was no significant correlation (95% CI) between oral microbiota diversity and functional digestive disorders nor between patients with a restrictive type of AN and patients with a mixed/purging type of AN, nor between the diversity of oral microbiota and the severity of AN. In addition, we observed four bacterial taxa that were decreased in AN patients.

Conclusion: Our study highlights a decreased diversity of oral microbiota in AN patients. Future larger studies may help identify the prognostic and therapeutic value of oral microbiota in AN.

Introduction: Prenatal alcohol exposure (PAE) is a well-established risk factor for adverse neurodevelopmental outcomes, particularly at high levels of consumption. The impact of low-to-moderate PAE remains unclear, with mixed results reported. This study investigates the effects of low-level PAE on neurodevelopmental outcomes at 18 months in Italian mother-child pairs enrolled in the Italian Northern Adriatic Cohort II, a part of the 'Public health impact of long-term, low-level, mixed element exposure in susceptible population strata' project PHIME.

Methods: The study population consisted of 632 children, and their mothers, who were tested with the Bayley Scales of Infant and Toddler Development third edition (BSID-III) at 18 months of age. PAE, socio-demographic and lifestyle information was collected through questionnaires at different phases of follow-up. We analysed 605 children born at term (≥37 weeks) with BSID-III data and maternal pregnancy alcohol intake estimates. Multiple linear regression assessed associations between each BSID-III composite score (cognitive, motor, language) and PAE.

Results: Mothers' alcohol consumption was very low. The median (25th percentile to 75th percentile) of the weekly alcohol intake of the 605 mothers was 0.3 (0-1.4) drinks and of the children's cognitive, language and motor composite score were 105 (100-110), 97 (91-103) and 100 (97-107), respectively. No significant association was found between maternal alcohol intake and BSID-III cognitive nor language scores. Only a suggestive, non-consistent, inverse association was found between PAE and motor neurodevelopment. Maternal IQ and promotion of child autonomy were directly associated with all neurodevelopmental outcomes.

Conclusion: Low levels of PAE were not associated with neurodevelopmental impairment at 18 months, except for possible motor impairment at higher exposures: our findings highlight the predominant influence of maternal IQ and the home environment. Further research, including a broader range of alcohol exposure, is needed to better define potential safety thresholds of PAE on early-life neurodevelopment.