BMJ Nutrition, Prevention and Health最新文献

Background: The unexpectedly increased burden of metabolic-associated fatty liver disease (MAFLD) continues in China, and the differences between rural and urban areas remain unclear. We aimed to clarify the prevalence and risk factors in rural areas of China.

Methods: This cross-sectional study used the most densely populated area with highly unbalanced development differences in China (Guangdong Province) as a representative sample, and multistage stratified random sampling was performed. The participants' demographic, socioeconomic and lifestyle data were collected. Fatty liver and liver stiffness were screened by FibroScan.

Results: A total of 7287 individuals were enrolled (rural: 2684; urban: 4603). The overall MAFLD prevalence was 35.7%, and MAFLD was higher among rural individuals (38.0% vs 34.4%, p<0.001) than urban individuals. Rural individuals had more severe hepatic fibrosis (fibrosis stage 3-4) overall (3.0% vs 1.3%) and among different sexes (male: 4.2% vs 2.0%; female: 1.5% vs 0.5%) (all p<0.05) than urban individuals. For both rural and urban individuals, lifestyle and dietary habits, including midnight snacks, dining out, and overeating salt, red meat and sugar, were associated with an increased risk of MAFLD, and drinking tea and consuming dietary fibres were associated with a decreased risk of MAFLD. However, midnight snacks and overeating red meat were associated with a higher risk of hepatic fibrosis only in urban individuals.

Conclusion: There is a surprisingly high burden of MAFLD in rural Guangdong, China, which implicates a lack of awareness among rural individuals and a warrant the need for disease counteraction strategies.

Trial registration number: ChiCTR2000033376.

Introduction: This study examines dietary network in Northwest China, focusing on food group consumption and regional trends using network analysis.

Methods: Data from 106 424 participants in the Regional Ethnic Cohort Study were calculated using a semiquantitative food frequency questionnaire. We compared intake with the 2022 Chinese Dietary Guidelines and employed the EBICglasso method to construct dietary and staple food-related network, assessing its stability and accuracy.

Results: Northwest China's staple food intake was 37.5% of total consumption, dominated by wheat. Compared with the Chinese dietary guidelines, participants' intake of staple foods, soybeans and nuts was within the acceptable range, with insufficient intake of whole grains and beans, animal source of foods, eggs, fruits and vegetables but excessive intake of salt. Intake varied by province, sex and age. In overall participants, the strongest correlations were found between the two food groups, namely fruits and vegetables (0.33), and animal source of foods and dairy products (0.24) in dietary network. Soybeans and nuts appeared to connect to more other foods and also higher correlation with other foods and were followed by animal source of food. The staple food-related food network indicated that the intake of rice, whole grains and beans, and potatoes was positively correlated with the intake of most other foods, while intake of wheat was negatively correlated with foods of animal source of food, milk and dairy products.

Conclusions: Northwest China's diet exhibits irrational patterns, highlighting the importance of assessing overall dietary patterns in nutritional evaluation.

Background: Undernutrition during childhood can negatively impact a child's health, growth, cognitive abilities, and future educational and economic attainment in adulthood. Also, childhood undernutrition can lead to a higher risk of developing non-communicable diseases. Alongside several socioeconomic and environmental factors contributing to children's undernutrition, maternal nutrition literacy is of noticeable importance. The ubiquity of mobile devices and their use in daily life create new paths for health promotion interventions.

Objectives: The aim of our study was to evaluate the efficacy of the MyKid'sNutrition application in promoting maternal nutritional knowledge, attitude and practice, as well as children's nutritional status.

Methods: We conducted a two-arm parallel randomised controlled trial (1:1 ratio) involving 116 mothers of children aged 2-6 years with undernutrition. Participants were allocated to the intervention (MyKid'sNutrition application+standard care) or the control group (standard care alone). All outcomes were measured at baseline and after a 3-month intervention period.

Results: There were no significant differences between baseline characteristics of mothers and children. We found that the interaction effect of time and group was significant for weight and body mass index (BMI) for age, but not significant for height for age. We also observed that the effect of time and group interaction was significant for maternal nutritional knowledge, feeding attitudes and nutrition practices.

Conclusions: The maternal nutritional knowledge, attitudes and practices in the intervention group were higher than the control group. Also, children's weight and BMI for age z-scores changed more compared with the control group.

Trial registration number: IRCT20140907019082N11.

Abstract:

Background: Stunting in young children continues to be a public health concern in Rwanda. The effect of stunting in the first 1000 days of life has long-term consequences, including decreased brain development and a higher risk of developing diseases later in life. To design proper interventions, identifying the risk factors of stunting too early is paramount. The study thus aimed to identify the prevalence of stunting too early (6-23 months) and its associated risk factors.

Methods: The research study analysed secondary data from the nationally conducted demographic health survey of 2019-2020, which was analysed by using bivariate analysis and multivariable logistic regression models to determine the factors associated with stunting that occurred too early. P value of <0.05, regression coefficients and their 95% CI were used to assess the level of significance as well as insights related to the strength and direction of the relationship between being stunted too early and other covariates.

Results: A total of 1180 children aged 6-23 months were included in the analysis. The overall prevalence of stunting too early was 30% with a 95% CI of 27.4%-32.6%. Moreover, the prevalence of stunting was 29.0%, 20.0%, 23.0% and 35% among the 6 months, 7-8 months, 9-12 months and 13-23 months age groups, respectively. After adjusting for potential confounding variables, the following factors were independently associated with stunting too early: being male (aOR:2.3; 95% CI:1.68 to 3.00), not currently being breastfed (aOR:1.97, 95% CI:1.21 to 3.19), mothers aged 25-34 and more than 34 years (aOR:1.64; 95% CI:1.11 to 2.43) and (aOR:1.63; 95% CI:1.07 to 2.47), respectively, households with poor wealth index (aOR:2.61; 95%CI: 1.72 to 3.09), child age group of 13-23 months (aOR:2.00; 95% CI:1.14 to 5.51) and small child size at birth (aOR:2.36; 95% CI:1.42 to 3.92).

Conclusions: The prevalence of stunting too early was high, and the factors significantly associated with it were the sex and age of the child, the mother's age, low socio-economic status and small child size at birth. There is a need to address those factors through campaigns of health education, emphasis on girls' education for their empowerment and strengthening of nutritional programme implementation.

Background: Severe acute malnutrition (SAM) is a leading cause of mortality among under-five children in Ethiopia. Despite prior systematic reviews and meta-analyses in Ethiopia, the pooled recovery rate of SAM from 2019 to 2024 remains unknown, and the pooled effect of other contributing factors has not been investigated. Therefore, this study aimed to update the pooled estimate of the recovery rate of SAM and its associated factors among under-five children admitted to therapeutic feeding units (TFUs) in Ethiopia.

Methods: We searched PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online from 1 May to 30 June 2024. The Joanna Briggs Institute checklist was used to critically appraise the selected studies. Heterogeneity was identified using I² statistics. Funnel plots and Egger's tests were used to determine publication bias.

Results: This analysis identified 1254 studies, of which 24 were included. The pooled recovery rate of SAM among under-five children admitted to TFUs was 71.4% (95% CI: 68.4 to 74.4). Anaemia (HR: 1.42, 95% CI: 1.28 to 1.58), being on a nasogastric tube (HR: 1.66, 95% CI: 1.44 to 1.91), pneumonia (HR: 1.51, 95% CI: 1.28 to 1.79), HIV (HR: 2.32, 95% CI: 1.69 to 3.19) and tuberculosis (HR: 1.9, 95% CI: 1.60 to 2.26) were associated with poor recovery, while vitamin A supplementation (HR: 1.40, 95% CI: 1.21 to 1.62) was associated with better recovery.

Conclusions: The pooled recovery rate aligns with the minimum international standard. In addition to therapeutic feeding, prevention and early treatment of comorbidities should be emphasised. Vitamin A supplementation may also help improve the recovery rate.

Prospero registration number: CRD42024549424.

Objective: The primary goal of this study was to assess whether a nutrition education programme had an effect on nutrition literacy and body composition of adolescents enrolled in an undergraduate ballet programme.

Methods: 27 students, aged 15-18, volunteered and provided informed consent following ethics approval. The nutrition programme included two workshops and four cooking classes throughout the academic year, with an additional workshop for female students on low energy availability's effects on menstrual function. Each participant also attended two individual counselling sessions with a nutritionist to develop personalised nutrition goals. Data were collected at baseline, postintervention (9 months later) and follow-up (12 months from baseline). Eating attitudes and behaviours were assessed using the Eating Disorder Examination Questionnaire-Adolescents (EDE-A), the Dance-specific Energy Availability Questionnaire and a survey developed by researchers. Body composition was measured using a body impedance analysis scale. Changes from baseline were analysed with Wilcoxon signed-rank tests.

Results: Students showed improvements in several aspects of eating self-efficacy and nutrition knowledge postintervention. Though no change in mean EDE-A scores were observed, fewer students reached clinically significant scores postintervention and at follow-up. Female participants showed significant increases in body mass index (BMI) (Z=-2.527, p=0.011) and lean body mass (Z=-3.102, p=0.002) postintervention, which persisted at follow-up.

Conclusions: This study suggests that a nutrition programme can lead to improvements in eating attitudes and behaviours among undergraduate ballet students, demonstrating its importance in dance education. In addition, positive changes in BMI and lean body mass of female students were observed. Ongoing research is needed to establish best practices in this population of adolescent dancers at increased risk of nutritional deficits.

Despite evidence that nutrition can play a substantial role in curbing the burden of chronic disease, findings reported in the nutrition literature have been plagued with debate and uncertainty, including questions about the confidence we can place in evidence from observational studies, the validity of dietary intake data, and the applicability of randomised trials to real-world patients or members of the public. Structured nutrition users' guides (NUGs) to evaluate common research study designs (ie, randomised trials, cohort studies, systematic reviews and clinical practice guidelines) addressing nutrition questions will help clinicians and their patients, as well as health service workers and policy-makers, use the evidence to make more informed decisions on disease management and prevention. In addition, NUGs will provide comprehensive teaching materials for nutrition trainees on how to appraise, interpret and apply the research evidence. We hereby introduce a series of structured NUGs for the literature on nutrients, foods and dietary patterns and programmes. Each article will address three key components when assessing different study designs used to assess nutrition interventions or exposures, including (1) assessing the methodological quality of the study, (2) interpreting study results (magnitude and precision of treatment or exposure effects for outcomes of benefit and harm) and (3) applying the results to unique patient or population scenarios based on their health-related values and preferences related to the potential benefits, harms, convenience and cost of an intervention. This series of articles will serve to empower clinicians, health service workers and health policy-makers to better understand the validity, interpretability and applicability of the nutrition literature, while also helping practitioners and their clients make more evidence-based, value-sensitive and preference-sensitive nutrition decisions.