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Reporting of nutritional screening, status, and intake in trials of nutritional and physical rehabilitation following critical illness: a systematic review 危重疾病后营养和身体康复试验中营养筛查、状态和摄入的报告:系统综述
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2024.12.028
Reema Rabheru , Anne Langan , Judith Merriweather , Bronwen Connolly , Kevin Whelan , Danielle E Bear

Background

Surviving critical illness leads to prolonged physical and functional recovery with both nutritional and physical rehabilitation interventions for prevention and treatment being investigated. Nutritional status and adequacy may influence outcome, but no consensus on which nutritional-related variables should be measured and reported in clinical trials exists.

Objectives

This study aimed to undertake a systematic review investigating the reporting of nutritional screening, nutritional status, and nutritional intake/delivery in randomized controlled trials (RCTs) evaluating nutritional and/or physical rehabilitation on physical and functional recovery during and following critical illness.

Methods

Five electronic databases (MEDLINE, Web of Science, EMBASE, CINAHL, and Cochrane) were searched (last update 9 August, 2023). Search terms included both free text and standardized indexed terms. Studies included were RCTs assessing nutritional and/or physical interventions either during or following intensive care unit (ICU) admission in adults (18 y or older) with critical illness, and who required invasive mechanical ventilation for any duration during ICU admission. Study quality was assessed using the Cochrane Collaboration Risk of Bias tool for RCTs and descriptive data synthesis was performed and presented as counts (%). n t

Results

In total, 123 RCTs (30 nutritional, 87 physical function, and 6 combined) were included. Further, ≥1 nutritional variable was measured and/or reported in 99 (80%) of the studies including BMI (n = 69), body weight (n = 57), nutritional status (n = 11), nutritional risk (n = 10), energy delivery (n = 41), protein delivery (n = 35), handgrip strength (n = 40), and other nutritional-related muscle variables (n = 41). Only 3 studies were considered to have low risk of bias in all categories.

Conclusions

Few RCTs of physical rehabilitation measure and report nutritional or related variables. Future studies should measure and report specific nutritional factors that could impact physical and functional recovery to support interpretation where studies do not show benefit.
This protocol was preregistered at PROSPERO as CRD42022315122.
背景:生存的危重疾病导致长期的身体和功能恢复,营养和身体康复干预预防和治疗正在研究中。营养状况和充足性可能会影响结果,但在临床试验中应该测量和报告哪些营养相关变量,目前尚无共识。目的:开展一项系统综述,调查危重疾病期间和之后评估营养和/或身体康复对身体和功能恢复的随机对照试验(rct)中营养筛查、营养状况和营养摄入/输送的报告。方法:检索MEDLINE、Web of Science、EMBASE、CINAHL、Cochrane 5个电子数据库(最后更新日期:2023年8月9日)。搜索词包括自由文本和标准化索引词。纳入的研究为随机对照试验,评估重症监护病房(ICU)入住期间或之后的重症成人(≥18岁)的营养和/或物理干预,并在ICU入住期间的任何时间需要有创机械通气。使用Cochrane协作rct偏倚风险工具评估研究质量,进行描述性数据综合并以计数(%)表示。未进行meta分析,因为本系统综述调查的是测量和报告,而不是有效性终点。结果:纳入123项随机对照试验,其中营养组30项,体能组87项,综合组6项。在99项(80%)研究中,至少测量和/或报告了一项营养变量,包括BMI (n=69)、体重(n=57)、营养状况(n=11)、营养风险(n=10)、能量输送(n=41)、蛋白质输送(n=35)、握力(n=40)和其他与营养相关的肌肉变量(n=41)。在所有类别中,只有三项研究被认为具有低偏倚风险。结论:很少有随机对照试验测量和报告营养或相关变量。未来的研究应该测量和报告可能影响身体和功能恢复的特定营养因素,以支持研究未显示益处的解释。协议在PROSPERO上预注册(CRD42022315122)。
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引用次数: 0
The relationship between a high-fat diet, gut microbiome, and systemic chronic inflammation: insights from integrated multiomics analysis 高脂肪饮食、肠道微生物组和系统性慢性炎症之间的关系:来自综合多组学分析的见解。
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2024.12.026
Zhiwei Du , Xuxu Liu , Zhihong Xie , Qiang Wang , Zhenyi Lv , Lianghao Li , Heming Wang , Dongbo Xue , Yingmei Zhang

Background

The detrimental effects of a high-fat diet (HFD) extend beyond metabolic consequences and include systemic chronic inflammation (SCI), immune dysregulation, and gut health disruption.

Objectives

In this study, we used Mendelian randomization (MR) to investigate the relationship between HFD, gut microbiota, and SCI.

Methods

Genetic variants associated with dietary fat were utilized to explore causal relationships. Genome-wide association study data for the analyses of the gut microbiota, inflammatory cytokines, immune cell characteristics, and serum metabolites were obtained from European individuals. Mediation analysis was used to reveal potential mediating factors. The GMrepo database was used to analyze the bacterial composition in different groups. Transcriptomic and single-cell sequencing analyses explored inflammation and barrier function in colonic tissue.

Results

HFD consumption was linked to changes in the abundance of 3 bacterial families and 11 bacterial genera. Combined with the GMrepo database, the increased abundance of the genus Lachnospiraceae_FCS020group and the decreased abundance of genus Bacteroides and genus Barnesiella are consistent with the MR results. Transcriptomic and single-cell sequencing analyses revealed intestinal inflammation and mucosal barrier dysfunction in HFD-fed mice. MR revealed a link between HFD consumption and increased levels of interleukin (IL)-18 [odds ratio (OR): 3.64, 95%CI: 1.24, 10.69, P = 0.02], MIG (OR = 3.14, 95%CI: 1.17, 8.47, P = 0.02), IL-13 [OR = 3.21, 95% confidence interval (CI): 1.08, -9.52, P = 0.04], and IL-2RA (OR = 2.93, 95%CI: 1.01, 8.53, P = 0.049). Twenty-nine immune cell signatures, including altered monocyte and T-cell subsets, were affected by HFD consumption. Twenty-six serum metabolites that are linked to HFD consumption, particularly lipid and amino acid metabolites, were identified. The positive gut microbiota exhibit extensive associations with inflammatory cytokines. In particular, Lachnospiraceae_FCS020 group (OR: 1.93, 95% CI: 1.11, 3.37, P = 0.02) may play a mediating role in HFD-induced increases in IL-2RA concentrations.

Conclusions

Microbial dysbiosis appears to be an important mechanism for HFD-induced SCI. The Lachnospiraceae_FCS020 group may act as a key genus in HFD-mediated elevation of IL-2RA.
背景:高脂肪饮食(HFD)的有害影响超出了代谢后果,包括全身性慢性炎症(SCI)、免疫失调和肠道健康破坏。目的:在这项研究中,我们使用孟德尔随机化(MR)来研究HFD和肠道微生物群以及SCI之间的关系。方法:利用与膳食脂肪相关的遗传变异来探索因果关系。用于分析肠道微生物群、炎症细胞因子、免疫细胞特征和血清代谢物的GWAS数据来自欧洲个体。采用中介分析揭示潜在的中介因素。使用GMrepo数据库分析不同组的细菌组成。转录组学和单细胞测序分析用于探索结肠组织中的炎症和屏障功能。结果:食用HFD与3个细菌科和11个细菌属的丰度变化有关。结合GMrepo数据库,增加了属的丰度。lachnospirace_fcs020类群及属丰度下降。拟杆菌和属。巴内氏菌与核磁共振结果一致。转录组学和单细胞测序分析显示,饲喂hfd的小鼠出现肠道炎症和粘膜屏障功能障碍。MR显示高脂肪摄入与白细胞介素(IL)-18 (OR=3.64, 95%CI: 1.24-10.69, P=0.02)、米格(OR=3.14, 95%CI: 1.17-8.47, P=0.02)、IL-13 (OR=3.21, 95%CI:1.08-9.52, P=0.04)和IL- 2ra (OR=2.93, 95%CI: 1.01-8.53, P=0.049)水平升高有关。29种免疫细胞特征,包括单核细胞和t细胞亚群的改变,受到HFD消耗的影响。鉴定了26种与HFD消耗有关的血清代谢物,特别是脂质和氨基酸代谢物。阳性肠道菌群表现出与炎症细胞因子的广泛关联。特别是Lachnospiraceae_FCS020组(OR=1.93, 95% CI: 1.11-3.37, P=0.02)可能在hfd诱导的IL-2RA水平升高中起中介作用。结论:微生物生态失调可能是hfd诱导的脊髓损伤的重要机制。Lachnospiraceae_FCS020群可能是hfd介导IL-2RA升高的关键属。
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引用次数: 0
Planetary Health Diet Index Trends and Associations with Dietary Greenhouse Gas Emissions, Disease Biomarkers, Obesity, and Mortality in the United States (2005–2018) 全球健康饮食指数趋势及其与美国饮食温室气体排放、疾病生物标志物、肥胖和死亡率的关系(2005-2018)。
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.007
Jiada Zhan , Linh Bui , Rebecca A Hodge , Meghan Zimmer , Tung Pham , Donald Rose , Amelia Willits-Smith , Walter C Willett

Background

Diet plays a vital role in human health and environmental effects. Monitoring diet quality and its relationship to both health and environment are essential for policy making.

Objectives

This study aimed to analyze trends in the Planetary Health Diet Index (PHDI) and its associations with daily greenhouse gas (GHG) emissions from food, disease-related biomarkers, anthropometric measurements, obesity, and all-cause mortality in the United States population.

Methods

We analyzed 27,181 adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, except for the mortality analysis. 23,599 adults were analyzed as the 2017–2018 NHANES dietary data were removed due to the potential for reverse causation. We calculated PHDI scores by using 2 24-h dietary recalls and GHG by linking the consumption of individual foods to dataFRIENDS, a food-environmental impact database. To assess associations with the PHDI, we used generalized linear regression models for GHG, disease-related biomarkers, and obesity and used the Cox proportional hazards model for all-cause mortality.

Results

The energy-adjusted mean of the PHDI (140 possible points) increased from 68.6 in 2005–2006 to 71.7 in 2017–2018 (P-trend < 0.001). Compared with the lowest quintile (Q1), the highest PHDI quintile (Q5) was associated with 25% lower GHG emissions, a better cardiometabolic profile, lower prevalence ratios of obesity [0.59; 95% confidence interval (CI): 0.50, 0.69] and abdominal obesity (0.74; 95% CI: 0.66, 0.82), and a lower risk of all-cause death [hazard ratio (HR): 0.65; 95% CI: 0.54, 0.78].

Conclusions

These results underscore the potential health and GHG emission benefits aligned with the planetary health diet.
背景:饮食在人类健康和环境影响中起着至关重要的作用。监测饮食质量及其与健康和环境的关系对制定政策至关重要。目的:本研究旨在分析地球健康饮食指数(PHDI)的趋势及其与美国人口每日食物温室气体排放(GHG)、疾病相关生物标志物、人体测量、肥胖和全因死亡率的关系。方法:除死亡率分析外,我们分析了2005年至2018年国家健康与营养调查(NHANES)中的27181名成年人。由于可能存在反向因果关系,研究人员删除了2017-2018年NHANES饮食数据,对23,599名成年人进行了分析。我们通过使用两次24小时饮食召回和通过将单个食物的消费与dataffriends(一个食品-环境影响数据库)联系起来计算PHDI分数。为了评估与PHDI的相关性,我们对温室气体、疾病相关生物标志物和肥胖使用了广义线性回归模型,并对全因死亡率使用了Cox比例风险模型。结果:能量调整后的PHDI平均值(140可能点)从2005-2006年的68.6上升到2017-2018年的71.7 (p < 0.001)。与最低五分位数(Q1)相比,最高PHDI五分位数(Q5)与降低25%的温室气体排放量、更好的心脏代谢谱、较低的肥胖患病率(0.59,95% CI: 0.50-0.69)和腹部肥胖患病率(0.74,95% CI: 0.66-0.82)以及较低的全因死亡风险(HR: 0.65, 95% CI: 0.54-0.78)相关。结论:这些结果强调了与地球健康饮食相一致的潜在健康和温室气体排放益处。
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引用次数: 0
Urinary creatinine excretion—a standard that requires further calibration 尿肌酐排泄--需要进一步校准的标准
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.010
Talat A Ikizler
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引用次数: 0
Continuous glucose monitor overestimates glycemia, with the magnitude of bias varying by postprandial test and individual - a randomized crossover trial.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-26 DOI: 10.1016/j.ajcnut.2025.02.024
Katie M Hutchins, James A Betts, Dylan Thompson, Aaron Hengist, Javier T Gonzalez

Background: Continuous glucose monitors (CGM) are used to characterize postprandial glycemia, yet no study has directly tested how different test foods/beverages alter CGM accuracy.

Objectives: Assess glycemic responses to test foods/drinks using CGM compared with capillary sampling (criterion).

Methods: Fifteen healthy females (n = 9) and males (n = 6) completed 7 laboratory visits in a randomized crossover design with ≥48 h washout between visits. During each visit, participants consumed an oral carbohydrate challenge comprising either 50 g glucose or equivalent 50 g carbohydrate as whole fruits, 50 g carbohydrate as blended fruit, 50 g carbohydrate as commercially available fruit smoothie, 50 g carbohydrate as commercially available fruit smoothie ingested over 30 ± 4 min, 50 g carbohydrate as commercially available fruit smoothie with 5 g inulin, 30 g carbohydrate as commercially available fruit smoothie. The glycemia was recorded from both CGM and capillary samples every 15 min for 120 min and expressed as incremental areas under the curve. The glycemic index (GI) was calculated relative to 50 g glucose where appropriate. Exploratory analyses examined 1) interindividual heterogeneity of CGM bias compared with criterion and 2) whether CGM bias could be improved with adjustment for baseline differences.

Results: CGM-estimated fasting and postprandial glucose concentrations were (mean ± standard deviation) 0.9 ± 0.6 and 0.9 ± 0.5 mmol/L higher than capillary estimates, respectively(both, P < 0.001). CGM bias varied by postprandial test such that GI for 50 g carbohydrate as commercially available fruit smoothie was higher with CGM (69; 95% confidence interval: 48, 99) compared with capillary (53; 95% confidence interval: 40, 69; P = 0.05). Furthermore, differences in CGM compared with capillary fasting glucose concentrations varied by participant (P = 0.001). Unadjusted, CGM overestimated time >7.8 mmol/L by ∼4-fold, and adjustment for baseline differences reduced this overestimate to ∼2-fold (both P < 0.01).

Conclusions: CGM overestimated glycemic responses in numerous contexts. At times, this can mischaracterize the GI. In addition, there is interindividual heterogeneity in the accuracy of CGM in estimating fasting glucose concentrations. Correction for this difference reduces, but does not eliminate, postprandial overestimate of glycemia by CGM. Caution should be applied when inferring absolute or relative glycemic responses to foods using CGM, and capillary sampling should be prioritized for accurate quantification of glycemic response. This trial was registered at clinicaltrials.gov as NCT06333184.

{"title":"Continuous glucose monitor overestimates glycemia, with the magnitude of bias varying by postprandial test and individual - a randomized crossover trial.","authors":"Katie M Hutchins, James A Betts, Dylan Thompson, Aaron Hengist, Javier T Gonzalez","doi":"10.1016/j.ajcnut.2025.02.024","DOIUrl":"10.1016/j.ajcnut.2025.02.024","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitors (CGM) are used to characterize postprandial glycemia, yet no study has directly tested how different test foods/beverages alter CGM accuracy.</p><p><strong>Objectives: </strong>Assess glycemic responses to test foods/drinks using CGM compared with capillary sampling (criterion).</p><p><strong>Methods: </strong>Fifteen healthy females (n = 9) and males (n = 6) completed 7 laboratory visits in a randomized crossover design with ≥48 h washout between visits. During each visit, participants consumed an oral carbohydrate challenge comprising either 50 g glucose or equivalent 50 g carbohydrate as whole fruits, 50 g carbohydrate as blended fruit, 50 g carbohydrate as commercially available fruit smoothie, 50 g carbohydrate as commercially available fruit smoothie ingested over 30 ± 4 min, 50 g carbohydrate as commercially available fruit smoothie with 5 g inulin, 30 g carbohydrate as commercially available fruit smoothie. The glycemia was recorded from both CGM and capillary samples every 15 min for 120 min and expressed as incremental areas under the curve. The glycemic index (GI) was calculated relative to 50 g glucose where appropriate. Exploratory analyses examined 1) interindividual heterogeneity of CGM bias compared with criterion and 2) whether CGM bias could be improved with adjustment for baseline differences.</p><p><strong>Results: </strong>CGM-estimated fasting and postprandial glucose concentrations were (mean ± standard deviation) 0.9 ± 0.6 and 0.9 ± 0.5 mmol/L higher than capillary estimates, respectively(both, P < 0.001). CGM bias varied by postprandial test such that GI for 50 g carbohydrate as commercially available fruit smoothie was higher with CGM (69; 95% confidence interval: 48, 99) compared with capillary (53; 95% confidence interval: 40, 69; P = 0.05). Furthermore, differences in CGM compared with capillary fasting glucose concentrations varied by participant (P = 0.001). Unadjusted, CGM overestimated time >7.8 mmol/L by ∼4-fold, and adjustment for baseline differences reduced this overestimate to ∼2-fold (both P < 0.01).</p><p><strong>Conclusions: </strong>CGM overestimated glycemic responses in numerous contexts. At times, this can mischaracterize the GI. In addition, there is interindividual heterogeneity in the accuracy of CGM in estimating fasting glucose concentrations. Correction for this difference reduces, but does not eliminate, postprandial overestimate of glycemia by CGM. Caution should be applied when inferring absolute or relative glycemic responses to foods using CGM, and capillary sampling should be prioritized for accurate quantification of glycemic response. This trial was registered at clinicaltrials.gov as NCT06333184.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reducing Cardiometabolic Diseases Risk dietary pattern in the Chinese population with dyslipidemia: a single-center, open-label, randomized, dietary intervention study.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-25 DOI: 10.1016/j.ajcnut.2025.02.026
Qi Wu, Shanshan Bian, Cheng Cheng, Xukun Chen, Liyang Zhang, Li Huang, Tongtong Li, Ruiting Yan, Huilian Duan, Zehao Wang, Yuan Li, Tongyang Wu, Yue Wang, Yan Chen, Xiping Deng, Yongjie Chen, Meilin Zhang, Fei Ma, Wen Li, Guowei Huang

Background: There is no specific dietary pattern for cardiometabolic health based on Chinese food culture.

Objective: The study aimed to develop and assess the efficacy of the Reducing Cardiometabolic Diseases Risk (RCMDR) dietary pattern on cardiometabolic risk in the Chinese population with dyslipidemia.

Methods: In this single-center, open-label, randomized, 12-week dietary intervention study, 100 adults aged 35-45 years with dyslipidemia were randomized (1:1) to the RCMDR dietary pattern intervention or general health education control group.

Results: Compared with the control group, the RCMDR dietary pattern intervention resulted in a significantly lower clustered cardiometabolic risk score (primary outcome) (β = -0.17; 95% CI -0.29, -0.05); diastolic blood pressure (β = -0.23, 95% CI -0.40, -0.07); total cholesterol, low-density lipoprotein cholesterol, triglyceride (β = -0.27; 95% CI -0.49, -0.04; β = -0.24; 95% CI -0.41, -0.07; β = -0.19; 95% CI -0.35, -0.04); homocysteine (Hcy) (β =-0.19, 95% CI -0.28, -0.09); waist circumference, waist-to-hip ratio, body fat percentage, body fat mass, visceral adipose tissue, visceral fat area, and a significantly higher lean body mass (β = -1.12; 95% CI -1.65, -0.59; β = -1.01; 95% CI -1.66, -0.36; β = -1.43; 95% CI -1.87, -0.98; β = -0.98; 95% CI -1.35, -0.60; β = -1.93; 95% CI -2.75, -1.11; β =-6.52; 95% CI -9.10, -3.95; β = 1.24; 95% CI 0.84, 1.65).

Conclusions: Compared to the control group, the RCMDR dietary pattern intervention lowered cardiometabolic risk, blood lipids, blood pressure, abdominal obesity and circulating Hcy level among Chinese population with dyslipidemia.

Clinical trial registry number and website: Chinese Clinical Trial Registry (ChiCTR2300072472), https://www.chictr.org.cn/showproj.html?proj=198618.

{"title":"Reducing Cardiometabolic Diseases Risk dietary pattern in the Chinese population with dyslipidemia: a single-center, open-label, randomized, dietary intervention study.","authors":"Qi Wu, Shanshan Bian, Cheng Cheng, Xukun Chen, Liyang Zhang, Li Huang, Tongtong Li, Ruiting Yan, Huilian Duan, Zehao Wang, Yuan Li, Tongyang Wu, Yue Wang, Yan Chen, Xiping Deng, Yongjie Chen, Meilin Zhang, Fei Ma, Wen Li, Guowei Huang","doi":"10.1016/j.ajcnut.2025.02.026","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.02.026","url":null,"abstract":"<p><strong>Background: </strong>There is no specific dietary pattern for cardiometabolic health based on Chinese food culture.</p><p><strong>Objective: </strong>The study aimed to develop and assess the efficacy of the Reducing Cardiometabolic Diseases Risk (RCMDR) dietary pattern on cardiometabolic risk in the Chinese population with dyslipidemia.</p><p><strong>Methods: </strong>In this single-center, open-label, randomized, 12-week dietary intervention study, 100 adults aged 35-45 years with dyslipidemia were randomized (1:1) to the RCMDR dietary pattern intervention or general health education control group.</p><p><strong>Results: </strong>Compared with the control group, the RCMDR dietary pattern intervention resulted in a significantly lower clustered cardiometabolic risk score (primary outcome) (β = -0.17; 95% CI -0.29, -0.05); diastolic blood pressure (β = -0.23, 95% CI -0.40, -0.07); total cholesterol, low-density lipoprotein cholesterol, triglyceride (β = -0.27; 95% CI -0.49, -0.04; β = -0.24; 95% CI -0.41, -0.07; β = -0.19; 95% CI -0.35, -0.04); homocysteine (Hcy) (β =-0.19, 95% CI -0.28, -0.09); waist circumference, waist-to-hip ratio, body fat percentage, body fat mass, visceral adipose tissue, visceral fat area, and a significantly higher lean body mass (β = -1.12; 95% CI -1.65, -0.59; β = -1.01; 95% CI -1.66, -0.36; β = -1.43; 95% CI -1.87, -0.98; β = -0.98; 95% CI -1.35, -0.60; β = -1.93; 95% CI -2.75, -1.11; β =-6.52; 95% CI -9.10, -3.95; β = 1.24; 95% CI 0.84, 1.65).</p><p><strong>Conclusions: </strong>Compared to the control group, the RCMDR dietary pattern intervention lowered cardiometabolic risk, blood lipids, blood pressure, abdominal obesity and circulating Hcy level among Chinese population with dyslipidemia.</p><p><strong>Clinical trial registry number and website: </strong>Chinese Clinical Trial Registry (ChiCTR2300072472), https://www.chictr.org.cn/showproj.html?proj=198618.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dietary patterns and colorectal cancer risk: Global Cancer Update Programme (CUP Global) systematic literature review.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-25 DOI: 10.1016/j.ajcnut.2025.02.021
Anne Hy Chu, Kehuan Lin, Helen Croker, Sarah Kefyalew, Nerea Becerra-Tomás, Laure Dossus, Esther M González-Gil, Nahid Ahmadi, Yikyung Park, John Krebs, Matty P Weijenberg, Monica L Baskin, Ellen Copson, Sarah J Lewis, Jacob C Seidell, Rajiv Chowdhury, Lynette Hill, Doris Sm Chan, Dong Hoon Lee, Edward L Giovannucci

Background: The 2018 World Cancer Research Fund/American Institute for Cancer Research Third Expert Report, including studies up to 2015, determined limited-no conclusion evidence on dietary patterns and colorectal cancer (CRC) risk due to insufficient data and varying pattern definitions.

Objectives: This updated review synthesized literature on dietary patterns and CRC risk/mortality.

Methods: PubMed and Embase were searched through 31 March, 2023, for randomized controlled trials (RCTs) and prospective cohort studies on adulthood dietary patterns. Patterns were categorized by derivation method: a priori, a posteriori, or hybrid, and were then descriptively reviewed in relation to the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using predefined criteria.

Results: Thirty-two dietary scores from 53 observational studies and 3 RCTs were reviewed. Limited-suggestive evidence was concluded for higher alignment with a priori-derived patterns: Mediterranean, healthful plant-based index, Healthy Eating Index (HEI)/alternate HEI, and Dietary Approaches to Stop Hypertension (DASH), in relation to lower CRC risk. Common features across these diets included high plant-based food intake and limited red/processed meat. Hybrid-derived patterns: the empirical dietary pattern for hyperinsulinemia and empirical dietary inflammatory pattern (EDIP), showed strong-probable evidence for increased CRC risk. Evidence for a priori-derived low-fat dietary interventions and a posteriori-derived patterns was graded as limited-no conclusion. By cancer subsite, higher alignment with Mediterranean diet showed limited-suggestive evidence for lower rectal cancer risk, and that with HEI/alternate HEI and DASH showed limited-suggestive evidence for lower colon and rectal cancer risks. Empirical dietary pattern for hyperinsulinemia and EDIP showed strong-probable evidence for increased colon cancer risks. All exposure-mortality pairs and other pattern-outcome associations were graded as limited-no conclusion.

Conclusions: This review highlights the role of dietary patterns in CRC risk/mortality, providing insights for future research and public health strategies. This review was registered at PROSPERO as CRD42022324327 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).

{"title":"Dietary patterns and colorectal cancer risk: Global Cancer Update Programme (CUP Global) systematic literature review.","authors":"Anne Hy Chu, Kehuan Lin, Helen Croker, Sarah Kefyalew, Nerea Becerra-Tomás, Laure Dossus, Esther M González-Gil, Nahid Ahmadi, Yikyung Park, John Krebs, Matty P Weijenberg, Monica L Baskin, Ellen Copson, Sarah J Lewis, Jacob C Seidell, Rajiv Chowdhury, Lynette Hill, Doris Sm Chan, Dong Hoon Lee, Edward L Giovannucci","doi":"10.1016/j.ajcnut.2025.02.021","DOIUrl":"10.1016/j.ajcnut.2025.02.021","url":null,"abstract":"<p><strong>Background: </strong>The 2018 World Cancer Research Fund/American Institute for Cancer Research Third Expert Report, including studies up to 2015, determined limited-no conclusion evidence on dietary patterns and colorectal cancer (CRC) risk due to insufficient data and varying pattern definitions.</p><p><strong>Objectives: </strong>This updated review synthesized literature on dietary patterns and CRC risk/mortality.</p><p><strong>Methods: </strong>PubMed and Embase were searched through 31 March, 2023, for randomized controlled trials (RCTs) and prospective cohort studies on adulthood dietary patterns. Patterns were categorized by derivation method: a priori, a posteriori, or hybrid, and were then descriptively reviewed in relation to the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using predefined criteria.</p><p><strong>Results: </strong>Thirty-two dietary scores from 53 observational studies and 3 RCTs were reviewed. Limited-suggestive evidence was concluded for higher alignment with a priori-derived patterns: Mediterranean, healthful plant-based index, Healthy Eating Index (HEI)/alternate HEI, and Dietary Approaches to Stop Hypertension (DASH), in relation to lower CRC risk. Common features across these diets included high plant-based food intake and limited red/processed meat. Hybrid-derived patterns: the empirical dietary pattern for hyperinsulinemia and empirical dietary inflammatory pattern (EDIP), showed strong-probable evidence for increased CRC risk. Evidence for a priori-derived low-fat dietary interventions and a posteriori-derived patterns was graded as limited-no conclusion. By cancer subsite, higher alignment with Mediterranean diet showed limited-suggestive evidence for lower rectal cancer risk, and that with HEI/alternate HEI and DASH showed limited-suggestive evidence for lower colon and rectal cancer risks. Empirical dietary pattern for hyperinsulinemia and EDIP showed strong-probable evidence for increased colon cancer risks. All exposure-mortality pairs and other pattern-outcome associations were graded as limited-no conclusion.</p><p><strong>Conclusions: </strong>This review highlights the role of dietary patterns in CRC risk/mortality, providing insights for future research and public health strategies. This review was registered at PROSPERO as CRD42022324327 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Toward a better understanding of the relationship between docosahexaenoic acid and bronchopulmonary dysplasia and the questions that remain.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-24 DOI: 10.1016/j.ajcnut.2025.01.030
Richard P Bazinet, Sophie Laye
{"title":"Toward a better understanding of the relationship between docosahexaenoic acid and bronchopulmonary dysplasia and the questions that remain.","authors":"Richard P Bazinet, Sophie Laye","doi":"10.1016/j.ajcnut.2025.01.030","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.01.030","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EAT-Lancet diet pattern, genetic risk, and risk of colorectal cancer: a prospective study from the UK Biobank.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-22 DOI: 10.1016/j.ajcnut.2025.02.025
Fu-Lan Hu, Jia-Cheng Liu, Dong-Run Li, Yi-Lin Xu, Bang-Quan Liu, Xi Chen, Wen-Rui Zheng, Yi-Fan Wei, Fang-Hua Liu, Yi-Zi Li, He-Li Xu, Fan Cao, Ming-Xing Ma, Ting-Ting Gong, Qi-Jun Wu

Background: Diet and genetic risk are risk factors for colorectal cancer (CRC). The interaction between the EAT (Lancet Commission on healthy diets from sustainable food systems)-Lancet diet and genetic variants on CRC risk remains unclear.

Objectives: We aim to investigate the association between EAT-Lancet diet and CRC risk and to evaluate its combined effect with genetic risk on CRC risk.

Methods: We conducted a prospective cohort study involving 177,441 participants from the UK Biobank who completed 24-h food recall questionnaires at least once. The EAT-Lancet Diet Index (ELD-I) was calculated using the dietary recall data to assess EAT-Lancet diet, and a polygenic risk score (PRS) was constructed by using 197 single-nucleotide polymorphisms to evaluate genetic risk. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models to assess the associations.

Results: During a median follow-up of 13.05 y, 2,016 participants developed CRC. Higher ELD-I was significantly associated with a reduced CRC risk (the highest compared with the lowest HR: 0.87, 95% CI: 0.76-0.99). A significant additive interaction between PRS and ELD-I was identified on CRC risk (relative excess risk due to interaction: 0.142, 95% CI: 0.058, 0.225). The ELD-I was significantly associated with reduced CRC risk in individuals with moderate but not low and high genetic risk, with HRs (95% CIs) of 0.76 (0.63, 0.92), 0.84 (0.53, 1.33), and 0.96 (0.76, 1.20), respectively. Compared with participants with higher PRS and lower ELD-I, those with lower PRS and higher ELD-I showed a 75% reduction in CRC risk (HR: 0.25; 95% CI: 0.17, 0.36).

Conclusions: The ELD-I could reduce 13% of CRC risk, especially in individuals with a moderate genetic risk. Individuals with high ELD-I and low PRS had the lowest CRC risk than those with low ELD-I and high PRS. These findings underscore the potential role of EAT-Lancet Diet in CRC prevention.

{"title":"EAT-Lancet diet pattern, genetic risk, and risk of colorectal cancer: a prospective study from the UK Biobank.","authors":"Fu-Lan Hu, Jia-Cheng Liu, Dong-Run Li, Yi-Lin Xu, Bang-Quan Liu, Xi Chen, Wen-Rui Zheng, Yi-Fan Wei, Fang-Hua Liu, Yi-Zi Li, He-Li Xu, Fan Cao, Ming-Xing Ma, Ting-Ting Gong, Qi-Jun Wu","doi":"10.1016/j.ajcnut.2025.02.025","DOIUrl":"10.1016/j.ajcnut.2025.02.025","url":null,"abstract":"<p><strong>Background: </strong>Diet and genetic risk are risk factors for colorectal cancer (CRC). The interaction between the EAT (Lancet Commission on healthy diets from sustainable food systems)-Lancet diet and genetic variants on CRC risk remains unclear.</p><p><strong>Objectives: </strong>We aim to investigate the association between EAT-Lancet diet and CRC risk and to evaluate its combined effect with genetic risk on CRC risk.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving 177,441 participants from the UK Biobank who completed 24-h food recall questionnaires at least once. The EAT-Lancet Diet Index (ELD-I) was calculated using the dietary recall data to assess EAT-Lancet diet, and a polygenic risk score (PRS) was constructed by using 197 single-nucleotide polymorphisms to evaluate genetic risk. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models to assess the associations.</p><p><strong>Results: </strong>During a median follow-up of 13.05 y, 2,016 participants developed CRC. Higher ELD-I was significantly associated with a reduced CRC risk (the highest compared with the lowest HR: 0.87, 95% CI: 0.76-0.99). A significant additive interaction between PRS and ELD-I was identified on CRC risk (relative excess risk due to interaction: 0.142, 95% CI: 0.058, 0.225). The ELD-I was significantly associated with reduced CRC risk in individuals with moderate but not low and high genetic risk, with HRs (95% CIs) of 0.76 (0.63, 0.92), 0.84 (0.53, 1.33), and 0.96 (0.76, 1.20), respectively. Compared with participants with higher PRS and lower ELD-I, those with lower PRS and higher ELD-I showed a 75% reduction in CRC risk (HR: 0.25; 95% CI: 0.17, 0.36).</p><p><strong>Conclusions: </strong>The ELD-I could reduce 13% of CRC risk, especially in individuals with a moderate genetic risk. Individuals with high ELD-I and low PRS had the lowest CRC risk than those with low ELD-I and high PRS. These findings underscore the potential role of EAT-Lancet Diet in CRC prevention.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early full enteral nutrition with fortified milk in very preterm infants: a randomized clinical trial. 早产儿使用强化牛奶进行早期全肠内营养:随机临床试验。
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-21 DOI: 10.1016/j.ajcnut.2025.02.019
Ariel A Salas, Emily Gunawan, Seabrook Jeffcoat, Kelly Nguyen

Background: In preterm infants, the timing of human milk fortification when maternal or donor milk is offered at volumes of 60-80 mL/kg/d within the first 36 h after birth remains a matter of debate.

Objectives: This trial assessed the impact of early human milk fortification (<7 d postnatal age) on fat-free mass (FFM) z-scores.

Methods: This was an unmasked clinical trial involving preterm infants with birthweight <1800 g and gestational ages ranging from 29 0/7 to 33 6/7 weeks of gestation. Human milk-fed infants receiving feeding volumes of 60-80 mL/kg/d within the first 36 h after birth were randomly assigned to receive either early (between days 4 and 7) or delayed (between days 10 and 14) fortification using a bovine-derived fortifier. FFM was assessed at postnatal day 21 using air-displacement plethysmography.

Results: A total of 80 infants were randomly assigned. The mean birthweight was 1488 g (SD: 233). Baseline characteristics did not differ between groups. Of 80 infants randomly assigned shortly after birth, 74 had the primary outcome measured at ∼35 wk of postmenstrual age (interquartile range: 34-36). No statistically significant differences in FFM z-scores were observed between the 2 groups (-1.7 ± 0.9 compared with -1.8 ± 0.9; P = 0.64), but the early fortification group had higher weight [median difference: +131 g; 95% confidence interval (CI): 12, 236; P = 0.03], higher FFM (median difference: +103 g; 95% CI: 1, 193; P = 0.03), and higher length (mean difference: +0.9 cm; 95% CI: 0.1, 1.8; P = 0.04) at the time of body composition assessment.

Conclusions: In very preterm infants receiving early full enteral nutrition, providing early human milk fortification does not result in higher than usual FFM z-scores. This feeding strategy may, however, lead to a sustained increase in length, and transient increases in weight and FFM in grams. This study was registered at clinicaltrials.gov as NCT05525585.

{"title":"Early full enteral nutrition with fortified milk in very preterm infants: a randomized clinical trial.","authors":"Ariel A Salas, Emily Gunawan, Seabrook Jeffcoat, Kelly Nguyen","doi":"10.1016/j.ajcnut.2025.02.019","DOIUrl":"10.1016/j.ajcnut.2025.02.019","url":null,"abstract":"<p><strong>Background: </strong>In preterm infants, the timing of human milk fortification when maternal or donor milk is offered at volumes of 60-80 mL/kg/d within the first 36 h after birth remains a matter of debate.</p><p><strong>Objectives: </strong>This trial assessed the impact of early human milk fortification (<7 d postnatal age) on fat-free mass (FFM) z-scores.</p><p><strong>Methods: </strong>This was an unmasked clinical trial involving preterm infants with birthweight <1800 g and gestational ages ranging from 29 0/7 to 33 6/7 weeks of gestation. Human milk-fed infants receiving feeding volumes of 60-80 mL/kg/d within the first 36 h after birth were randomly assigned to receive either early (between days 4 and 7) or delayed (between days 10 and 14) fortification using a bovine-derived fortifier. FFM was assessed at postnatal day 21 using air-displacement plethysmography.</p><p><strong>Results: </strong>A total of 80 infants were randomly assigned. The mean birthweight was 1488 g (SD: 233). Baseline characteristics did not differ between groups. Of 80 infants randomly assigned shortly after birth, 74 had the primary outcome measured at ∼35 wk of postmenstrual age (interquartile range: 34-36). No statistically significant differences in FFM z-scores were observed between the 2 groups (-1.7 ± 0.9 compared with -1.8 ± 0.9; P = 0.64), but the early fortification group had higher weight [median difference: +131 g; 95% confidence interval (CI): 12, 236; P = 0.03], higher FFM (median difference: +103 g; 95% CI: 1, 193; P = 0.03), and higher length (mean difference: +0.9 cm; 95% CI: 0.1, 1.8; P = 0.04) at the time of body composition assessment.</p><p><strong>Conclusions: </strong>In very preterm infants receiving early full enteral nutrition, providing early human milk fortification does not result in higher than usual FFM z-scores. This feeding strategy may, however, lead to a sustained increase in length, and transient increases in weight and FFM in grams. This study was registered at clinicaltrials.gov as NCT05525585.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Clinical Nutrition
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