BMC Nutrition最新文献

Background: Online forums play a crucial role for cancer patients seeking nutrition-related information and support. This study investigated the most common nutrition-related questions and concerns among members of the Women's Self-Help Association Against Cancer, focusing on emotional, physical, and practical aspects of dietary changes in cancer patients.

Methods: A mixed-methods approach was used, combining qualitative and quantitative content analysis of 5314 forum responses. The themes identified included common questions, patient contributions, physician involvement, and the impact of the COVID-19 pandemic on the discussions.

Results: In total, 2246 posts across 22 threads were analyzed, spanning 3867 days and receiving 654,100 visits. Key topics included 41 themes and 356 questions, with common inquiries like "Has your diet changed since your diagnosis?" (45 responses) and "Is sugar allowed in your diet?" (29 responses). There were 4958 contributions, with 558 evidence-based responses (e.g., recommending balanced diets) and 200 non-evidence-based responses (e.g., fasting, cancer-specific diets). Concerns regarding sugar (188 responses), dairy (121 responses), and emotional stress (187 responses) were common. Despite evidence-based recommendations from healthcare professionals supporting balanced diets, members frequently encounter non-evidence-based advice on fasting- and cancer-specific diets, leading to significant emotional and nutritional challenges. Additionally, Members emphasized the need to balance the enjoyment of food with dietary restrictions.

Conclusion: The forum is a valuable resource for sharing experiences and advice; however, non-evidence-based content underscores the need for moderation and expert input. Collaboration between medical professionals and moderators can improve content reliability, enabling informed dietary decisions for cancer patients.

Background: Productive Safety Net Program (PSNP) is a livelihood intervention to improve food insecurity among the poor and has been implemented in Ethiopia. However, there is inconsistent evidence on the impacts of PSNP on improving the nutritional status of vulnerable segments (children). The current review was to synthesize evidence on the effects of PSNP on the nutritional status of children in Ethiopia.

Methods: A comprehensive search for Google, Google Scholar, PubMed, and other relevant repositories, coupled with a manual search (till March 15, 2024), was done using a combination of relevant key words. Hence, the search was conducted on "productive safety net," "Ethiopia," "nutritional status," and "undernutrition." An updated systematic review without meta-analysis guideline was used to select relevant literature. Data were extracted using MS Excel format by two reviewers and cross-checked. The extracted data were grouped, and summarized in narrative summaries, descriptions, and quantitative summaries whenever applicable. The risk of bias was assessed, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to assess the strength of the evidence.

Results: A total of nine studies (n = 14,114) were included in this review, and the studies assessed the risk of undernutrition among PSNP members and non-PSNP members, in the form of pre- and post-design, survey, and cohort studies. The program has the potential to improve income, food security, dietary diversity, and reduce the occurrence of acute malnutrition, with a limited effect on stunting reduction. Moreover, food aid or cash transfer plus food aid was found to be superior compared to cash transfer mode in improving child nutrition than cash transfer alone, which could be frustrated by food inflation, subjects' knowledge and attitude about child feeding. Overall, evidence from survey studies reporting the comparative risk of undernutrition could limit the conclusiveness of the causation which could be confounded.

Conclusion: PSNP could improve wasting with limited evidence on stunting reduction, where the causal pathway could be frustrated by the purchasing power of cash vouchers, household income expenditure patterns, and subjects' knowledge and attitude limiting its impact. Well-designed implementation research could further help. A comprehensive review, considering more recent evidence, could help.

Clinical trial registration: Not applicable.

Background: Oral nutrition supplement (ONS) prescription in older adults is affordable for preventing malnutrition through the use of multiple nutrients and energy products. However, there is a gap in knowledge regarding the benefits of ONS supplementation on anthropometric and functional parameters in malnourished older adults without complicated conditions, known as community-dwelling older people.

Methods: Electronic databases, including PubMed/Medline, SCOPUS, Web of Science, and the Cochrane Central Register of Controlled Trials, were searched to answer this question through August 10, 2023. The study adhered to the PRISMA guidelines and was registered on PROSPERO. The Cochrane risk of bias tool assessed the quality of randomized controlled trials (RCTs). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. In total, 12 RCTs (n = 1320) were initially included.

Results: ONS had a positive effect on body weight (weighted mean difference (WMD): 1.33, 95% CI: 0.94, 1.72, P = 0.00) with moderate certainty, BMI (WMD: 0.36, 95% CI: 0.06, 0.68, P = 0.02), calf circumference (WMD: 0.27, 95% CI: 0.08, 0.46, P < 0.001) with low certainty and midarm circumference (WMD: 0.38, 95% CI: -0.14, 0.89, P = < 0.15, I2: 87.2 P < 0.00) with very low certainty. Significant improvements in grip strength (WMD: 1.012, 95% CI: 0.37, 1.65, P < 0.00) and a slightly positive change in gait speed (WMD: 0.04, 95% CI: 0.004.0.083, P = 0.03, I2:0.0, P:0.72) were also observed.

Conclusion: ONS in community-dwelling older persons without complicated conditions can also have beneficial effects in terms of anthropometric and functional parameters.

Background & aims: Sarcopenia, characterized by the loss of muscle mass and strength, is a significant concern in cirrhotic patients. Nutritional interventions have been explored for its management, but the comparative efficacy of these interventions remains unclear. This study synthesizes current evidence to evaluate the effectiveness of nutritional interventions for sarcopenia in cirrhosis.

Methods: Data sources included Scopus, PubMed, Web of Science Core Collection, and Cochrane Library up to Dec 2024. Eligible trials compared different nutritional interventions against control diets, placebos, or each other. A Bayesian network meta-analysis was performed to combine direct and indirect evidence. Effect sizes were calculated as mean differences (MD) with 95% confidence intervals (CIs). Intervention rankings were assessed using P-score, and evidence quality was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

Results: A total of 14 randomized controlled trials (RCTs) involving 1,437 patients met the inclusion criteria. For improving muscle mass (MAMC), post-paracentesis intravenous nutritional support combined with an oral nutritional protocol (Treat A) showed the greatest effect compared to high-calorie, high-protein diets (HCHP) (MD: 2.78 cm, 95% CI: 1.15 to 4.40, low certainty), and oral nutritional protocol (Treat B) (MD of 3.41 cm, 95% CI: 2.12, 4.69). For muscle strength, the HINT diet (MD: 8.01 kg, 95% CI: 7.64 to 8.37, low certainty) and the HCHP (MD: 5 kg, 95% CI: 3.90 to 6.10, low certainty) were more effective than control diets. HCHP also demonstrated greater handgrip improvement than the HINT diet (MD: 3.00 kg, 95% CI: 1.84, 4.16; low certainty evidence). BCAA combined with vitamin D (2000 IU once a day) significantly improved skeletal muscle index (SMI) compared to both BCAA (MD: 0.72 kg/m², 95% CI: 0.11 to 1.34; low certainty evidence) and placebo (MD: 0.25 kg/m², 95% CI: -0.05 to 0.05; very low certainty evidence). BCAA supplementation effectively improved handgrip strength compared to placebo (MD: 2.36 kg, 95% CI: 1.85, 2.88; low certainty evidence).

Conclusions: Post-paracentesis intravenous nutritional support combined with an oral nutritional protocol effectively improves muscle mass, while high-calorie, high-protein diets enhance handgrip strength. BCAA supplementation alone or with vitamin D has been shown to effectively enhance muscle strength and muscle mass. However, these findings should be interpreted cautiously due to low evidence certainty.

Background: Food environments on university campuses have an important influence on the diets of staff and students. This study aimed to assess the healthiness, equitability and environmental sustainability of Australian university food environments, and identify priority recommendations for policy and practice.

Methods: We applied the previously developed 'Uni-Food' tool in nine universities (17 campuses, 165 food retail outlets) in Australia between 2021 and 2022. Data on three components: (1) 'university systems and governance'; (2) 'campus facilities and environment'; and (3) 'food retail outlets' were collected from desk-based policy audits and in-person campus audits. Universities were given an overall score from 0-100, based on their performance across all components.

Results: University scores ranged from 27/100 to 66/100 (median = 46). Universities scored highest in the 'campus facilities and environment' component, reflecting that the broad campus environment (including areas such as catering, advertising on campus, and food-related environmental sustainability initiatives) has been an area of focus. Universities scored lowest in the 'university systems and governance' component, reflecting a relative lack of policy action, funding and governance in this area, with few initiatives to promote the availability and affordability of healthy and environmentally sustainable foods.

Conclusion: Stronger action is needed to improve Australian university food environments, including in food retail outlets, vending, catering and at campus events. Universities can demonstrate leadership by implementing university-wide policies that limit the availability of unhealthy foods and beverages (e.g. sugary drinks) on campus, and setting targets for the proportion of healthy and environmentally sustainable foods procured and sold on campus. Other stakeholders, including governments, can play a role in incentivising universities to adopt recommended actions.

Background: Childhood overweight and obesity have implications that extend beyond physical health. Despite evidence linking obesity to poorer cognition, the combined effects of weight status and dietary habits on cognitive function in children remain insufficiently studied. This study took a comprehensive approach investigating effects of weight status on cognition, incorporating socio-economic factors, parental anthropometrics, and detailed nutrition assessments in primary school children.

Methods: Anthropometric measurements, cognitive testing and short interviews were performed in schools from October 2021 until July 2022 in the Rhein-Neckar region, Germany. Cognitive testing included the distractibility and flexibility modules of the PSYTEST KiTap battery, alongside a self-designed short-term memory assessment. Parents were asked to provide information on physical activity, socioeconomic status (SES) and nutrition (3-day food diary and a questionnaire). Pearson's correlations were used for normally distributed continuous data, and Spearman's correlations for nonparametric data Pearson's or Spearman's correlation coefficients were calculated based on data distribution.

Results: A total of 256 children with a mean age of 8.0 years participated in the study. According to German growth reference tables, 16% were underweight, 75% normal weight, 5% overweight and 5% obese. Cognitive testing resulted in an average age- and sex adjusted performance. No significant correlations were found between any of the anthropometric variables collected and the cognitive domains studied. At the same time, cognition was associated with nutrition, physical activity and SES with strongest associations between reaction time in the flexibility task and fat consumption (R -0.35, p < 0.001), total kilocalories (R -0.30, p < 0.001) and protein (R -0.30, p < 0.001).

Conclusions: The cognitive domains studied are not associated with anthropometric variables in primary school children. Nutrition appears to have strongest associations with cognition followed by other factors such as physical activity and SES. This study underlines the importance of nutrition for cognitive function and emphasizes the need to include nutrition in studies on cognitive performance and body weight status in schoolchildren. The study was registered at clinicaltrials.gov on September 21st 2021 under the registration number NCT05077059.

Background: Burn patients, due to their damaged skin, may not be able to synthesize vitamin D. In this study, we aimed to evaluate the effects of vitamin D supplementation on the recovery of hospitalized burn patients.

Methods: Fifty-four patients participated in a randomized controlled trial. Eighteen patients were randomly assigned to group C (control, received gelatin soft gel as placebo), 18 patients to group D₁ (received 1000 IU/day vitamin D), and 18 patients to group D₂ (received 3000 IU/day vitamin D). After supplementation, wound biopsy and blood samples were obtained from the patients. Weight, height, 25(OH)D level, wound healing, scar formation, quality of pain, and blood parameters were evaluated.

Results: There were no significant differences in the serum vitamin D levels between the groups at admission (P = 0.52), and 81.5% of the participants were deficient, with a noteworthy increase during study in supplemented groups (P < 0.001). The Bates-Jensen Wound Assessment Tool demonstrated significant differences in wound healing between the C group and the D₁ and D₂ groups (P = 0.003), and the supplemented groups experienced greater improvement. The D₂ group showed significant differences in thickness and total score on the Vancouver scar scale up to three months after discharge (P = 0.03). Moreover, there was a notable decrease in insulin requirements and the number of injected insulin units in the supplemented groups compared with those in group C (P = 0.006 and P = 0.01, respectively). In addition, shorter hospitalization was observed in group D₂ (P = 0.04).

Conclusion: Supplementation with vitamin D at doses of 1000 and 3000 IU/day improved wound healing and decreased scar thickness as well as exogenous insulin requirements. Overall, at 3000 IU/day, better results were achieved than at 1000 IU/day.

Trial registration: This article is registered in 24/04/2020 on the Iranian Randomized Clinical Trials Registry (trial registration number (IRCT, code: IRCT20200420047141N1.

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder which may progress from simple steatosis to liver failure. Patients with NAFLD have higher levels of systemic inflammation. Resveratrol, a natural polyphenolic compound, has been shown to have anti-inflammatory effects through various mechanisms. The aim of this study was to evaluate the effect of resveratrol supplementation on serum levels of plasminogen activator inhibitor-1 (PAI-1), adiponectin, fibroblast growth factor-21 (FGF-21) as well as high-sensitivity C-reactive protein (hs-CRP) in patients with NAFLD.

Methods: In this double-blind randomized controlled trial, 50 adults with NAFLD aged 20-60 years were allocated into two groups; the intervention and the placebo group received two capsules per day each containing 300 mg resveratrol and placebo, respectively. Fasting blood samples and anthropometric measurements were collected for all patients at baseline and at the end of the trial. Cges in the outcomes were analyzed using analysis of covariance (ANCOVA).

Results: After 12 weeks of intervention, resveratrol supplementation did not cause significant changes in serum levels of liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) compared to the control group. No significant differences were observed in the serum levels of PAI-1, adiponectin, FGF-21, and hs-CRP between the two groups at the end of the study.

Conclusions: Resveratrol supplementation for 12 weeks did not show favorable effects on serum levels of liver enzymes, PAI-1, adiponectin, FGF-21, and hs-CRP.

Trial registration: Iranian Registry of Clinical Trials (IRCT201511233664N16) (2016-02-08).

Background and objectives: Chronic kidney disease (CKD) is a progressive illness linked to higher rates of morbidity and death. One of the main causes of CKD is diabetes mellitus (DM), and oxidative stress is essential to the disease's development. It has been demonstrated that the natural antioxidant melatonin reduces inflammation and oxidative damage in renal tissues. Given the lack of robust evidence, this double-blind clinical trial sought to investigate the effects of melatonin supplementation on oxidative stress and inflammatory markers in diabetic CKD patients.

Materials and methods: This trial included 41 diabetic patients with CKD (stages 3-4) from Shariati Hospital, Tehran, Iran. For ten weeks, participants were randomized to receive either a placebo or 5 mg of melatonin twice a day. Baseline characteristics, dietary intake, physical activity, and anthropometric measurements were recorded. Oxidative stress (TAC, TOS, MDA) and inflammatory markers (IL-6, hs-CRP) were measured before and after the intervention. Statistical analysis was performed using SPSS, with significance set at p < 0.05.

Results: The 10-week trial was completed by 41 participants in total, and no adverse effects were noted. Dietary intake, physical activity, and anthropometric parameters did not significantly differ between the melatonin and control groups in baseline characteristics. Melatonin supplementation decreased oxidative stress and inflammatory biomarkers, including hs-CRP, MDA, TOS, and IL-6. However, these changes were not statistically significant.

Conclusion: Our study showed that melatonin supplementation did not significantly affect oxidative stress or inflammatory markers, including TAC, TOS, MDA, IL-6, and hs-CRP, in diabetic patients with CKD. Despite a decrement in TOS, MDA, IL-6, and hs-CRP levels after 10 weeks, this was not statistically significant. Further studies with larger sample sizes, greater dosages, and longer follow-up periods are recommended.

Background: There has been relatively little research on youth's exposure to food marketing on digital media, which is important as new digital platforms emerge and youth spend more time online. Evidence evaluating different policy approaches to restricting digital food marketing to children is also limited. This study examined differences in self-reported exposure to digital food marketing between children and adolescents in different policy environments: Ontario (where food marketing is self-regulated) and Quebec (where advertising is government regulated).

Methods: An observational cross-sectional online survey was conducted in April 2023 among children (aged 10-12 years) and adolescents (13-17 years) from Ontario and Quebec, recruited by Leger Marketing. Participants self-reported their frequency of exposure to food marketing via various digital platforms and marketing techniques. Logistic regression and proportional odds models examined differences in exposure by province and age group, adjusting for sociodemographic characteristics and digital device usage.

Results: The odds of reporting more frequent exposure to marketing of sugary drinks (OR: 0.48; 95% CI: 0.33, 0.69), sugary cereals (OR: 0.59; 95% CI: 0.41, 0.86), salty/savoury snacks (OR: 0.67; 95% CI: 0.47, 0.96), fast food (OR: 0.65; 95% CI: 0.45, 0.92), and desserts/sweet treats (OR: 0.54; 95% CI: 0.37, 0.78) were lower among Quebec children than Ontario children. Quebec children were less likely than Ontario children (OR: 0.56; 95% CI: 0.38, 0.84), but more likely than Quebec adolescents (OR: 1.58; 95% CI: 1.04, 2.42), to report exposure to unhealthy food marketing on one or more gaming/TV/music streaming platform/website(s). Compared with Ontario children, Quebec children were less likely to report exposure to marketing featuring characters or child/teenage actors (OR: 0.51; 95% CI: 0.34, 0.76), child-appealing subjects, themes and language (OR: 0.59; 95% CI: 0.40, 0.89), and visual design, audio and special effects (OR: 0.64; 95% CI: 0.41, 0.99), and to report exposure to a greater number of marketing techniques (OR: 0.60; 95% CI: 0.43, 0.84).

Conclusions: Exposure to unhealthy food marketing on digital media is high for youth from Ontario and Quebec, particularly for Ontario children. These findings reinforce the need for federal regulations to protect Canadian youth from unhealthy food marketing on digital media.