American Journal of Clinical Nutrition最新文献_第8页

The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production 胎儿发育相关妊娠并发症与后续母乳喂养持续时间和母乳产量指标的前瞻性关联。

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.11.008

Wei Wei Pang , Donna T Geddes , Ching-Tat Lai , Navin Michael , Jonathan Huang , Yiong Huak Chan , Clara Y Cheong , Doris Fok , Shikha Pundir , Sharon Ng , Mark H Vickers , Mei Chien Chua , Kok Hian Tan , Keith M Godfrey , Lynette P Shek , Yap-Seng Chong , Johan G Eriksson , Shiao-Yng Chan , Mary E Wlodek

Background

The development of the breast for lactation occurs throughout pregnancy. It is unknown whether pregnancy complications resulting in poor fetal growth can affect breastfeeding (BF) success.

Objectives

We examined whether fetal growth-related pregnancy complications were associated with earlier BF cessation and changes in the concentrations of human milk biomarkers of low milk production.

Methods

We used data from the Growing Up in Singapore Toward healthy Outcomes study (n = 954). Human milk concentrations of protein, lactose, citrate, sodium, potassium, and zinc at 3 wk postpartum were available for 180 mother-infant dyads. We examined the associations of fetal growth measures, including term infants born small-for-gestational-age (SGA) (<10th percentile), pregnancies complicated by fetal growth deceleration (second to third trimester fetal growth dropped between major centiles), elevated umbilical artery resistance (>90th percentile) or hypertensive disorders of pregnancy (HDP) with 1) risk of ceasing BF (Cox regression) and 2) concentrations of human milk components (weighted linear regression).

Results

Adjusting for maternal education, smoking exposure, BF intentions, and prepregnancy BMI (in kg/m²), individuals who delivered SGA infants and those with HDP were more likely to breastfeed for a shorter duration when compared to those with uncomplicated pregnancies {adjusted hazard ratio [95% confidence interval (CI)]: 1.45 (1.11, 1.89) and 1.61 (1.14, 2.29), respectively}; associations were nonsignificant for fetal growth deceleration and umbilical artery resistance. SGA was not associated with concentrations of human milk biomarkers, but compared to participants with uncomplicated pregnancies, milk produced by those with HDP contained lower zinc concentrations [adjusted β coefficient (95% CI): –0.56 mg/L (–1.08, –0.04) mg/L].

Conclusions

Individuals with HDP and those with SGA infants tend to breastfeed for a shorter duration; however, only HDP appear to be associated with biomarkers of compromised milk production. Further research and support are needed to help individuals with HDP and SGA achieve their BF goals.

This trial was registered at clinicaltrials.gov as NCT01174875.

背景：哺乳期乳房的发育贯穿整个孕期。妊娠并发症导致胎儿发育不良是否会影响母乳喂养的成功率，目前尚不清楚：我们研究了与胎儿生长相关的妊娠并发症是否与较早停止母乳喂养以及母乳中乳产量低的生物标志物浓度的变化有关：我们使用了新加坡健康成长（GUSTO）研究（n=954）的数据。我们获得了 180 个母婴双亲在产后 3 周的母乳中蛋白质、乳糖、柠檬酸盐、钠、钾和锌的浓度。我们研究了胎儿生长指标（包括小于胎龄儿（SGA）（第 90 百分位数）或妊娠高血压疾病（HDP））与（i）停止母乳喂养风险（Cox 回归）和（ii）母乳成分浓度（加权线性回归）之间的关系：结果：在对母亲教育程度、吸烟情况、母乳喂养意愿和孕前体重指数进行调整后，与无并发症妊娠的母亲相比，分娩 SGA 婴儿和患有 HDP 的母亲更有可能缩短母乳喂养时间（调整后的危险比 [95% CI]：1.45 [1.11，1.11 [1.11，1.11]）：分别为 1.45 [1.11, 1.89] 和 1.61 [1.14, 2.29]）；FGD 和 UAR 的相关性不显著。SGA与母乳生物标志物的浓度无关，但与无并发症妊娠的参与者相比，HDP患者的母乳含锌浓度较低（调整后的β系数[95% CI]：-0.56 mg/L [-1.08, -0.04]）：结论：HDP 患者和 SGA 婴儿的母乳喂养时间往往较短；但是，只有 HDP 似乎与母乳产量受损的生物标志物有关。需要进一步的研究和支持，以帮助 HDP 和 SGA 患者实现母乳喂养目标。该研究已注册为 NCT01174875，可在 https://clinicaltrials.gov/study/NCT01174875 上查阅。

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引用次数: 0

Are dietary changes over eight years in the prospective NutriNet-Santé cohort consistent with the EAT-Lancet reference diet? 前瞻性nutrinet - sant<e:1>队列的8年饮食变化与EAT-Lancet参考饮食一致吗？

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.12.004

Gabrielle Rochefort , Hafsa Toujgani , Florine Berthy , Justine Berlivet , Elie Perraud , Benjamin Allès , Mathilde Touvier , Benoît Lamarche , Julia Baudry , Emmanuelle Kesse-Guyot

Background

The transition toward sustainable dietary patterns, such as the planetary diet proposed by the EAT-Lancet Commission, is warranted to optimize health and achieve environmental sustainability.

Objectives

To examine the extent to which the evolution of dietary changes over an 8-y period in the French NutriNet-Santé cohort aligned with the EAT-Lancet diet.

Methods

A sample of 17,187 participants of the prospective NutriNet-Santé study was used. Dietary intakes were evaluated in 2014, 2018, and 2022 using a food frequency questionnaire. The alignment of dietary patterns with the EAT-Lancet diet was assessed using the EAT-Lancet dietary index (ELD-I). Changes over time in the ELD-I score and component sub-scores were evaluated using linear mixed regression models.

Results

The mean ELD-I score in 2014 (35.1 ± 0.4 points) increased by a mean of 5.5 points [95% confidence interval (CI): 5.0, 5.9] in 2018, with no further increase in 2022 (+4.2 points compared with 2014: 95% CI: 3.6, 4.9). The increase in the ELD-I observed in 2018 was mostly explained by increases in the sub-scores of these components: Beef, lamb, and pork (+3.4 points; 95% CI: 3.1, 3.6, i.e., lower consumption), Fruits (+1.6 points; 95% CI: 1.3, 1.9, i.e., greater consumption), and Nuts (+1.1 points; 95% CI: 1.0, 1.2, i.e., greater consumption). Changes of similar magnitudes were observed between 2014 and 2022, except for the Fruits component, which showed a decrease (–1.3 points; 95% CI: –1.7, –0.9). Greater changes in the ELD-I score over time were observed for females, younger adults, and adults with high education levels.

Conclusions

Results suggest that the slight shift toward more sustainable dietary patterns within the NutriNet-Santé cohort between 2014 and 2018 has stabilized in 2022. This suggests the need for strong efforts from various actors in the field of nutrition and public health that may facilitate the transition toward sustainable dietary patterns.

背景：向可持续饮食模式过渡，如EAT-Lancet委员会提出的全球饮食，是优化健康和实现环境可持续性的必要条件。目的：研究8年来法国nutrinet - sant队列中饮食变化的演变程度与EAT-Lancet饮食一致。方法：采用前瞻性nutrinet - sant研究的17,187名参与者的样本。使用食物频率问卷对2014年、2018年和2022年的膳食摄入量进行了评估。使用EAT-Lancet饮食指数（ELD-I）评估饮食模式与EAT-Lancet饮食的一致性。使用线性混合回归模型评估ELD-I评分和成分子评分随时间的变化。结果：2014年的平均ELD-I评分（35.1±0.4分）在2018年平均上升5.5分（95%CI, 5.0 ~ 5.9）， 2022年没有进一步上升（与2014年相比+4.2分，95%CI, 3.6 ~ 4.9）。2018年观察到的ELD-I增加主要是由于这些成分的分值增加：牛肉，羊肉和猪肉（+3.4点，95%CI， 3.1至3.6，即消费量减少），水果（+1.6点，95%CI， 1.3至1.9，即消费量增加）和坚果（+1.1点，95%CI， 1.0至1.2，即消费量增加）。2014年至2022年间，除了水果成分出现下降（-1.3点，95%CI, -1.7至-0.9）外，观察到类似幅度的变化。随着时间的推移，在女性、年轻人和受过高等教育的成年人中，ELD-I得分的变化更大。结论：结果表明，在2014年至2018年期间，nutrinet - sant队列中向更可持续的饮食模式的轻微转变在2022年趋于平稳。这表明营养和公共卫生领域的各个行动者需要作出强有力的努力，以促进向可持续饮食模式的过渡。

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引用次数: 0

Corrigendum to “Association data to promote fish and omega-3 consumption for brain health: caution required” [Am J Clin Nutr 119 (2024) 1082-1083] “协会数据促进鱼类和ω -3摄入对大脑健康的影响：需要谨慎”的更正[美国临床医学杂志119(2024)1082-1083]。

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.12.019

引用次数: 0

Characterization of iron status biomarkers and hematological indices among young adults of East Asian or Northern European ancestry: A cross-sectional analysis from the Iron Genes in East Asian and Northern European Adults Study (FeGenes)

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.10.014

Alexa Barad , Yaqin Xu , Erica Bender , Wanhui Kang , Ruihan Xu , Zhenglong Gu , Eva K Pressman , Kimberly O O’Brien

Background

Excess body iron (Fe) accrual is linked to chronic diseases. East Asian (EA) adults (median age 50 y) were reported to have higher Fe stores compared to other populations despite lacking the mutation that causes Fe overload in Northern European (NE) adults. It is unknown if these differences are evident in a healthy population under 50 y of age.

Objectives

This cross-sectional study aims to compare Fe-related markers in young adults of EA and NE ancestry and identify determinants of Fe status.

Methods

Participants were healthy United States males and premenopausal/nonpregnant females of genetically confirmed EA (n = 251) or NE (n = 253) ancestry, aged 18–50 y and without obesity. A complete blood count was obtained. Serum ferritin (SF; μg/L), c-reactive protein, and interleukin-6 were measured by immunoassay, and serum soluble transferrin receptor (mg/L) and transferrin by quantitative immunoturbidimetry. Total body Fe (mg/kg) was calculated. Elevated Fe stores were defined as SF >200 (females) or >300 (males) and c-reactive protein <5 mg/L. Results are shown as the geometric mean 95% confidence interval (CI) or mean ± standard deviation.

Results

The mean age of the population was (26.3 y; 25.6, 26.9 y), with 69.2% of participants aged under 30 y. SF was higher in EA (172; 152, 194) compared with NE (85.3; 76.8, 94.8) males (P < 0.001), and in EA (42.6; 36.7, 49.5) compared with NE (31.9; 27.8, 36.5) females (P = 0.004). The prevalence of elevated Fe stores was 16.7% in EA compared with 0.8% in NE males (P < 0.001) and 1.6% in EA compared with 0% in NE females (P = 0.47). Total body Fe was higher in EA (11.7 ± 2.7) compared with NE (9.1 ± 2.6) males (P < 0.001) and in EA (6.7 ± 3.6) compared with NE (5.6 ± 3.4) females (P = 0.01). All differences persisted after adjustment for confounders (all P < 0.05).

Conclusions

Individuals of EA ancestry had a significantly greater body Fe burden compared to NE individuals. Of concern, these differences were evident in a cohort primarily consisting of young individuals aged 18–29 y.

This trial was registered at clinicaltrials.gov as NCT04198545.

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引用次数: 0

Diet quality patterns and chronic kidney disease incidence: a UK Biobank cohort study 饮食质量模式与慢性肾病发病率：英国生物库队列研究。

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.12.005

Javier Maroto-Rodriguez , Rosario Ortolá , Veronica Cabanas-Sanchez , David Martinez-Gomez , Fernando Rodriguez-Artalejo , Mercedes Sotos-Prieto

Background

Only a few studies have investigated the role of diet on the risk of chronic kidney disease (CKD) in European populations and have mainly focused on the Mediterranean diet. This is the first study to evaluate the association between various diet quality indices and CKD incidence in British adults.

Objective

To study the relationship between a set of 6 different diet quality indices and CKD incidence among British adults.

Methods

: A prospective cohort with 106,870 participants from the UK Biobank, followed from 2009 to 2012 through 2021. Food consumption was obtained from ≥2 24-h dietary assessments. Dietary patterns were assessed using previously established indices: Alternate Mediterranean Index (aMED), Alternative Healthy Eating Index 2010, dietary approaches to stop hypertension (DASH), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), and dietary inflammatory index (DII). Incident CKD was obtained from clinical records, death registries, and self-reports. Analyses were performed with Cox regression models and adjusted for the main confounders.

Results

After a median follow-up of 9.27 y, 2934 cases of CKD were ascertained. Hazard ratios (95% confidence interval) of CKD for the highest compared with lowest tertile of adherence to each diet score were 0.84 (0.76, 0.93) for aMED, 0.94 (0.85, 1.03) for alternative healthy eating index 2010, 0.77 (0.70, 0.85) for DASH, 0.79 (0.72, 0.87) for hPDI, 1.27 (1.16, 1.40) for uPDI, and 1.20 (1.18, 1.33) for DII. The results were robust in sensitivity analyses.

Conclusions

In British adults, higher adherence to the aMED, DASH, and hPDI patterns was associated with lower risk of CKD, whereas greater adherence to the uPDI and DII patterns was associated with greater risk.

背景：在欧洲人群中，只有少数研究调查了饮食对慢性肾脏疾病（CKD）风险的作用，主要集中在地中海饮食。这是第一个评估英国成人各种饮食质量指标与CKD发病率之间关系的研究。方法：从2009-2012年到2021年，来自英国生物银行的106870名参与者进行了前瞻性队列研究。从至少两次24小时饮食评估中获得食物消耗。使用先前建立的指数评估饮食模式：替代地中海指数（aMED），替代健康饮食指数2010 (AHEI-2010)，停止高血压的饮食方法（DASH），健康植物性饮食指数（hPDI），不健康植物性饮食指数（uPDI）和饮食炎症指数（DII）。从临床记录、死亡登记和自我报告中获得CKD事件。采用Cox回归模型进行分析，并根据主要混杂因素进行调整。结果：中位随访9.27年，确诊CKD 2934例。CKD对每种饮食评分的最高和最低四分位数的风险比（95%置信区间）分别为：aMED 0.84 (0.76, 0.93), AHEI 0.94 (0.85, 1.03), DASH 0.77 (0.70, 0.85), hPDI 0.79 (0.72, 0.87), uPDI 1.27 (1.16, 1.40), DII 1.20（1.18, 1.33）。结果在敏感性分析中是稳健的。结论：在英国成年人中，较高的阿米德、DASH和hPDI模式的依从性与较低的CKD风险相关，而较高的uPDI和DII模式的依从性与较高的风险相关。

{"title":"Diet quality patterns and chronic kidney disease incidence: a UK Biobank cohort study","authors":"Javier Maroto-Rodriguez , Rosario Ortolá , Veronica Cabanas-Sanchez , David Martinez-Gomez , Fernando Rodriguez-Artalejo , Mercedes Sotos-Prieto","doi":"10.1016/j.ajcnut.2024.12.005","DOIUrl":"10.1016/j.ajcnut.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Only a few studies have investigated the role of diet on the risk of chronic kidney disease (CKD) in European populations and have mainly focused on the Mediterranean diet. This is the first study to evaluate the association between various diet quality indices and CKD incidence in British adults.</div></div><div><h3>Objective</h3><div>To study the relationship between a set of 6 different diet quality indices and CKD incidence among British adults.</div></div><div><h3>Methods</h3><div>: A prospective cohort with 106,870 participants from the UK Biobank, followed from 2009 to 2012 through 2021. Food consumption was obtained from ≥2 24-h dietary assessments. Dietary patterns were assessed using previously established indices: Alternate Mediterranean Index (aMED), Alternative Healthy Eating Index 2010, dietary approaches to stop hypertension (DASH), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), and dietary inflammatory index (DII). Incident CKD was obtained from clinical records, death registries, and self-reports. Analyses were performed with Cox regression models and adjusted for the main confounders.</div></div><div><h3>Results</h3><div>After a median follow-up of 9.27 y, 2934 cases of CKD were ascertained. Hazard ratios (95% confidence interval) of CKD for the highest compared with lowest tertile of adherence to each diet score were 0.84 (0.76, 0.93) for aMED, 0.94 (0.85, 1.03) for alternative healthy eating index 2010, 0.77 (0.70, 0.85) for DASH, 0.79 (0.72, 0.87) for hPDI, 1.27 (1.16, 1.40) for uPDI, and 1.20 (1.18, 1.33) for DII. The results were robust in sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>In British adults, higher adherence to the aMED, DASH, and hPDI patterns was associated with lower risk of CKD, whereas greater adherence to the uPDI and DII patterns was associated with greater risk.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 2","pages":"Pages 445-453"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820014","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

Association of the glucose patterns after a single nonstandardized meal with the habitual diet composition and features of the daily glucose profile in individuals without diabetes 非糖尿病患者单次非标准化膳食后葡萄糖模式与习惯性饮食组成和每日葡萄糖谱特征的关系

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.11.028

Annalisa Giosuè , Viktor Skantze , Therese Hjorth , Anna Hjort , Carl Brunius , Rosalba Giacco , Giuseppina Costabile , Marilena Vitale , Mikael Wallman , Mats Jirstrand , Robert Bergia , Wayne W Campbell , Gabriele Riccardi , Rikard Landberg

Background

The postprandial glucose response (PPGR), contributing to the glycemic variability (GV), is positively associated with cardiovascular disease risk in people without diabetes, and can thus represent a target for cardiometabolic prevention strategies.

Objectives

The study aimed to distinguish patterns of PPGR after a single nonstandardized meal and to evaluate their relationship with the habitual diet and the daily glucose profile (DGP) in individuals at high-cardiometabolic risk.

Methods

Baseline 4-d continuous glucose monitoring was performed in 159 adults recruited in the MEDGI-Carb trial. After a nonstandardized breakfast, parameters of the PPGR were estimated by a mechanistic model: baseline glucose; amplitude—the magnitude of postmeal glucose concentrations; frequency—the velocity of postmeal glucose oscillations; damping—the rate of postmeal glucose decay. PPGR patterns were identified by cluster analysis. Differences between clusters and the relationship between PPGR parameters and individual features were explored by one-way analysis of variance and correlation analysis, respectively.

Results

Two patterns of PPGR emerged. Pattern A had a higher baseline, amplitude, frequency, and damping than B. Individuals in cluster A compared with B had higher energy (2002 ± 526 compared with 1766 ± 455 kcal, P = 0.025), protein (82 ± 22 compared with 72 ± 21 g, P = 0.028), and fat (87 ± 30 compared with 75 ± 22 g, P = 0.041), but not carbohydrate habitual intake. Pattern A compared to B associated with a higher average daily glucose (6.12 ± 0.50 compared with 5.88 ± 0.62 mmol/L, P = 0.019) and lower GV (11.67 ± 3.52 compared with 13.43 ± 3.78%, P = 0.010). Mean daily glucose correlated directly with baseline (r_s = 0.419, P < 0.001) and amplitude (r_s = 0.189, P = 0.022) of the PPGR, whereas DGP variability correlated directly with amplitude (r_s = 0.218, P = 0.008), and inversely with frequency (r_s = –0.179, P = 0.031) and damping (r_s = –0.309, P < 0.001).

Conclusions

Two PPGR patterns after a single nonstandardized breakfast were identified in high-cardiometabolic risk individuals. The habitual diet was associated with the patterns and their dynamic parameters, which, in turn, could predict the individuals’ DGP. Our findings could support the implementation of dietary strategies targeting the PPGR to ameliorate the cardiometabolic risk profile.

Trial registration number

This study was registered at clinicaltrials.gov as NCT03410719.

背景：促进血糖变异性（GV）的餐后葡萄糖反应（PPGR）与非糖尿病人群的心血管风险呈正相关，因此可以代表心脏代谢预防策略的目标。目的：本研究旨在区分单次非标准化膳食后PPGR的模式，并评估其与高心脏代谢风险个体的习惯性饮食和每日葡萄糖谱（DGP）的关系。方法：对MEDGI-Carb试验招募的159名成年人进行基线连续4天血糖监测（CGM）。在非标准化早餐后，通过机制模型估计PPGR的参数：基线血糖；振幅-餐后葡萄糖浓度的大小；频率-餐后葡萄糖振荡的速度；阻尼-餐后葡萄糖衰变的速率。聚类分析确定了PPGR模式。通过单因素方差分析和相关分析分别探讨聚类之间的差异以及PPGR参数与个体特征之间的关系。结果：PPGR出现两种模式。模式A的基线、振幅、频率和阻尼均高于B。与B相比，模式A个体的能量（2,002±526比1,766±455 Kcal, p=0.025）、蛋白质（82±22比72±21 g， p=0.028）和脂肪（87±30比75±22 g， p=0.041）更高，但碳水化合物的习惯性摄入量不高。模式A与较高的日均葡萄糖（6.12±0.50 vs. 5.88±0.62 mmol/L, p=0.019）和较低的GV（11.67±3.52 vs. 13.43±3.78%,p=0.010）相关。平均每日葡萄糖与PPGR基线（rs=0.419, ps=0.189, p=0.022）直接相关，而DGP变异性与幅度（rs=0.218, p=0.008）、频率（rs=-0.179, p=0.031）和阻尼（rs=-0.309, p）直接相关。结论：在高心血管代谢风险人群中，单次非标准化早餐后PPGR有两种模式。习惯饮食与模式及其动态参数有关，进而可以预测个体的DGP。我们的研究结果可以支持针对PPGR的饮食策略的实施，以改善心脏代谢风险概况。临床试验编号：NCT03410719。

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引用次数: 0

The null need not be nil: Clarifying the parallel arbitrariness of difference testing and equivalence testing null不一定是nil：澄清差异检验和等价检验的并行任意性。

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.12.017

Paul R Hibbing , Gregory J Welk , Philip M Dixon

In every statistical analysis, a critical step is to determine the smallest effect size of interest, namely, the arbitrary dividing line between meaningful and negligible results. Different tests address this in different ways, and the contrasting approaches can sometimes lead to confusion. We discuss a key example of such confusion, whereby equivalence testing is perceived to be more arbitrary than difference testing. Our comments are intended to clarify that the latter methods share parallel arbitrariness, and to show how the contrary perception is fueled by the habituated use of “nil null hypotheses” in difference testing. The main premise is that nil null hypotheses give an appearance of objectivity by making the smallest effect size of interest an implicit factor in the interpretation stage of difference testing. When contrasted with the requirements of equivalence testing (where the smallest effect size of interest must be explicitly declared and justified a priori, in the form of the equivalence zone), it is therefore understandable how the misperception of greater arbitrariness could emerge. By combating the latter misperception, our comments serve to promote good practice in both difference testing and equivalence testing.

在每一个统计分析中，关键的一步是确定兴趣的最小效应大小（即有意义和可忽略的结果之间的任意分界线）。不同的测试以不同的方式解决这个问题，而不同的方法有时会导致混淆。我们讨论了这种混淆的一个关键例子，即等价检验被认为比差异检验更任意。我们的评论旨在澄清后一种方法具有平行的随意性，并表明在差异检验中习惯使用“零零假设”是如何助长相反的看法的。主要前提是，零假设通过使最小的兴趣效应大小成为差异检验解释阶段的隐含因素，从而提供客观的外观。当与等效测试的要求形成对比时（在等效测试中，必须明确声明最小的利益效应大小，并以等效区域的形式先验地证明其合理性），因此可以理解为什么会出现更大的任意性的误解。通过消除后一种误解，我们的评论有助于促进差异测试和等效测试的良好做法。

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引用次数: 0

Effect of medium-chain triglycerides and whey protein isolate preloads on glycaemia in type 2 diabetes: a randomized crossover study 中链甘油三酯和乳清蛋白分离预负荷对2型糖尿病患者血糖的影响：一项随机交叉研究

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.12.022

Pardeep Pabla , Joanne Mallinson , Aline Nixon , Mia Keeton , Scott Cooper , Melanie Marshall , Matthew Jacques , Sara Brown , Odd Erik Johansen , Bernard Cuenoud , Leonidas G Karagounis , Kostas Tsintzas

Background

Small nutritional preloads can reduce postprandial glucose excursions in individuals with and without metabolic syndrome or type 2 diabetes (T2D). However, most studies have focused on preloads administered before single meals and have predominantly used protein-based preloads.

Objectives

To investigate the effects of sequential consumption of medium-chain triglycerides (MCT) and whey protein isolate (WPI) preloads before breakfast, lunch, and dinner on postprandial, diurnal, and 24-h glycaemia in individuals with T2D.

Methods

Participants with T2D were studied over 3 randomized 24-h periods. They consumed either water before standardized breakfast, lunch, and dinner (CONTROL), 15 g MCT before breakfast and water before lunch and dinner (MCT), or 15 g MCT before breakfast and 10 g WPI before lunch and dinner (MCT + WPI). Diurnal (08:00–23:00 h) and 24 h (08:00–08:00 h) glycaemia (incremental AUC [iAUC]) and glycaemic variability (%coefficient of variation [%CV]) were evaluated by continuous glucose monitoring. Postprandial glycaemia (PPG) after breakfast and lunch was assessed by arterialized blood glucose iAUC.

Results

In 21 enrolled patients (8 males/13 females, mean ± standard deviation age 55.1 ± 8.5 y, body mass index 31.7 ± 4.3 kg·m⁻², glycated hemoglobin 59 ± 12 mmol·mol⁻¹) diurnal and 24-h iAUC were similar across interventions, whereas 24-h %CV was lower in MCT (16.8 ± 0.8%, P = 0.033) and MCT + WPI (16.1 ± 0.9%, P = 0.0004) than CONTROL (18.7 ± 0.9%). PPG iAUC was ∼17% lower after breakfast in MCT and MCT + WPI compared with CONTROL, but only the MCT + WPI lowered glucose by 20% (P = 0.002) over the entire day (08:30–17:30 h). Gastric inhibitory polypeptide (GIP) (P = 0.00004), peptide YY (PYY) (P = 0.01), and β-hydroxybutyrate (P = 0.0001) were higher in MCT and MCT + WPI than CONTROL. Subjective appetite ratings were lower after breakfast and lunch in MCT + WPI (P = 0.001).

Conclusions

Sequential consumption of MCT and WPI preloads did not affect diurnal or 24-h glycaemia but lowered PPG and 24-h glycaemic variability in individuals with T2D. These effects were associated with increased circulating β-hydroxybutyrate, PYY, and GIP, and suppression of appetite.

This trial was registered at clinicaltrials.gov as NCT04905589 (https://clinicaltrials.gov/study/NCT04905589).

背景：小的营养预负荷可以减少有或没有代谢综合征或T2D的个体餐后葡萄糖漂移。然而，大多数研究都集中在单餐前的预负荷，并主要使用基于蛋白质的预负荷。目的：探讨早、中、午餐和晚餐前连续摄入中链甘油三酯（MCT）和乳清分离蛋白（WPI）对糖尿病患者餐后、日及24小时血糖的影响。方法：T2D患者在三个随机的24小时内进行研究。他们要么在标准化早餐、午餐和晚餐前喝水（对照组），要么在早餐前喝15g MCT，在午餐和晚餐前喝水（MCT），要么在早餐前喝15g MCT，在午餐和晚餐前喝10g WPI （MCT+WPI）。采用连续血糖监测（CGM）评价每日（08:00-23:00h）和24小时（08:00-08:00h）血糖[曲线下增量面积（iAUC）]和血糖变异性（%变异系数（%CV））。采用动脉化血糖iAUC评价早餐和午餐后餐后血糖（PPG）。结果：21例入组患者（男性8例/女性13例，平均±SD年龄55.1±8.5岁，BMI 31.7±4.3 kg·m-2, HbA1c 59±12 mmol·mol-1）每日和24小时iAUC在不同干预措施中相似，而MCT（16.8±0.8%，P=0.033）和MCT+WPI（16.1±0.9%，P=0.0004）的24小时%CV低于对照组（18.7±0.9%）。与对照组相比，MCT和MCT+WPI组早餐后的PPG - iAUC降低了约17%，但在一整天（08:30-17:30h）中，只有MCT+WPI组降低了20%的葡萄糖（P=0.002）。MCT组和MCT+WPI组的GIP （P=0.00004）、PYY （P=0.01）和β-羟基丁酸（P=0.0001）均高于对照组。MCT+WPI组早餐和午餐后主观食欲评分较低（P=0.001）。结论：连续服用MCT和WPI预负荷对T2D患者的每日或24小时血糖没有影响，但降低了PPG和24小时血糖变异性。这些作用与循环β-羟基丁酸、PYY和GIP增加以及食欲抑制有关。临床试验注册号：ClinicalTrials.gov标识符NCT04905589注册网址：https://clinicaltrials.gov/study/NCT04905589。

{"title":"Effect of medium-chain triglycerides and whey protein isolate preloads on glycaemia in type 2 diabetes: a randomized crossover study","authors":"Pardeep Pabla , Joanne Mallinson , Aline Nixon , Mia Keeton , Scott Cooper , Melanie Marshall , Matthew Jacques , Sara Brown , Odd Erik Johansen , Bernard Cuenoud , Leonidas G Karagounis , Kostas Tsintzas","doi":"10.1016/j.ajcnut.2024.12.022","DOIUrl":"10.1016/j.ajcnut.2024.12.022","url":null,"abstract":"<div><h3>Background</h3><div>Small nutritional preloads can reduce postprandial glucose excursions in individuals with and without metabolic syndrome or type 2 diabetes (T2D). However, most studies have focused on preloads administered before single meals and have predominantly used protein-based preloads.</div></div><div><h3>Objectives</h3><div>To investigate the effects of sequential consumption of medium-chain triglycerides (MCT) and whey protein isolate (WPI) preloads before breakfast, lunch, and dinner on postprandial, diurnal, and 24-h glycaemia in individuals with T2D.</div></div><div><h3>Methods</h3><div>Participants with T2D were studied over 3 randomized 24-h periods. They consumed either water before standardized breakfast, lunch, and dinner (CONTROL), 15 g MCT before breakfast and water before lunch and dinner (MCT), or 15 g MCT before breakfast and 10 g WPI before lunch and dinner (MCT + WPI). Diurnal (08:00–23:00 h) and 24 h (08:00–08:00 h) glycaemia (incremental AUC [iAUC]) and glycaemic variability (%coefficient of variation [%CV]) were evaluated by continuous glucose monitoring. Postprandial glycaemia (PPG) after breakfast and lunch was assessed by arterialized blood glucose iAUC.</div></div><div><h3>Results</h3><div>In 21 enrolled patients (8 males/13 females, mean ± standard deviation age 55.1 ± 8.5 y, body mass index 31.7 ± 4.3 kg·m<sup>−2</sup>, glycated hemoglobin 59 ± 12 mmol·mol<sup>−1</sup>) diurnal and 24-h iAUC were similar across interventions, whereas 24-h %CV was lower in MCT (16.8 ± 0.8%, <em>P =</em> 0.033) and MCT + WPI (16.1 ± 0.9%, <em>P =</em> 0.0004) than CONTROL (18.7 ± 0.9%). PPG iAUC was ∼17% lower after breakfast in MCT and MCT + WPI compared with CONTROL, but only the MCT + WPI lowered glucose by 20% (<em>P =</em> 0.002) over the entire day (08:30–17:30 h). Gastric inhibitory polypeptide (GIP) (<em>P =</em> 0.00004), peptide YY (PYY) (<em>P =</em> 0.01), and β-hydroxybutyrate (<em>P =</em> 0.0001) were higher in MCT and MCT + WPI than CONTROL. Subjective appetite ratings were lower after breakfast and lunch in MCT + WPI (<em>P =</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Sequential consumption of MCT and WPI preloads did not affect diurnal or 24-h glycaemia but lowered PPG and 24-h glycaemic variability in individuals with T2D. These effects were associated with increased circulating β-hydroxybutyrate, PYY, and GIP, and suppression of appetite.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT04905589 (<span><span>https://clinicaltrials.gov/study/NCT04905589</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 2","pages":"Pages 232-245"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations of early childhood exposure to severe acute malnutrition and recovery with cardiometabolic risk markers in later childhood: 5-year prospective matched cohort study in Ethiopia 儿童早期暴露于严重急性营养不良和儿童后期心脏代谢风险标志物恢复的关系：埃塞俄比亚5年前瞻性匹配队列研究

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.12.014

Getu Gizaw , Jonathan CK Wells , Alemayehu Argaw , Mette Frahm Olsen , Alemseged Abdissa , Yaregal Asres , Feyissa Challa , Melkamu Berhane , Mubarek Abera , Kate Sadler , Erin Boyd , Henrik Friis , Tsinuel Girma , Rasmus Wibaek

Background

Impaired fetal and accelerated postnatal growth are associated with cardiometabolic disease. Few studies investigated how recovery from severe acute malnutrition (SAM) is associated with childhood cardiometabolic risk.

Objectives

We evaluated cardiometabolic risk in children with SAM treated through community-based management, relative to controls, 5-y postrecovery. Recognizing the heterogeneity of SAM case definitions and patterns of nutritional recovery, we also identified distinct body mass index-for-age z-score (BAZ) trajectories of children with SAM in the first year postrecovery and examined their associations with anthropometry, body composition, and cardiometabolic risk markers, relative to controls, 5-y postrecovery.

Methods

A prospective cohort study in 2013 enrolled children aged 6–59 mo, recovered from SAM (n = 203), or nonwasted controls (n = 202), in Jimma Zone, Ethiopia. Anthropometry, body composition, and cardiometabolic markers were assessed 5 y postrecovery. Multiple linear regression models compared outcomes between SAM-recovered children and controls. We used latent class trajectory modeling to identify BAZ trajectories in the first year postrecovery and compared these trajectory groups with controls.

Results

We traced 291 (71.9%) children (mean age 6.2 y) at 5-y follow-up. Overall, compared with controls, SAM-recovered children did not differ in cardiometabolic risk. We identified 4 BAZ trajectories among SAM-recovered children: “increase” (74.6%), “decrease” (11.0%), “decrease–increase” (5.0%), and “increase–decrease” (9.4%). Compared with controls, all BAZ trajectories except “decrease–increase” had lower weight, height, and fat-free mass index. Compared with controls, the “decrease–increase” trajectory had lower glucose [–15.8 mg/dL; 95% confidence interval (CI): –31.2, –0.4], whereas the “increase–decrease” trajectory had higher glucose (8.1 mg/dL; 95% CI: –0.8, 16.9). Compared with controls, the “decrease–increase” and “decrease” trajectories had higher total cholesterol (24.3 mg/dL; 95% CI: –9.4, 58.4) and low-density lipoprotein cholesterol (10.4 mg/dL; 95% CI: –3.8, 24.7), respectively. The “increase” trajectory had the lowest cardiometabolic risk.

Conclusions

Both rapid BAZ increase and decrease during early postrecovery from SAM were associated with greater cardiometabolic risk 5 y later. The findings indicate the need to target postrecovery interventions to optimize healthy weight recovery.

背景：胎儿受损和出生后生长加速与心脏代谢疾病有关。很少有研究调查严重急性营养不良（SAM）的恢复与儿童心脏代谢风险的关系。目的：我们评估通过社区管理治疗的SAM儿童的心脏代谢风险，相对于对照组，康复后5年。认识到SAM病例定义和营养恢复模式的异质性，我们还确定了SAM儿童在恢复后第一年的不同年龄bmi （BAZ）轨迹，并检查了其与5年后人体测量、身体成分和心脏代谢风险标志物的关联。设计：2013年的一项前瞻性队列研究，招募了埃塞俄比亚Jimma地区6-59个月的儿童，从SAM中康复（n=203），或非消瘦对照组（n=202）。康复后5年评估人体测量、身体成分和心脏代谢指标。多元线性回归模型比较了sam恢复儿童和对照组的结果。我们使用潜在类别轨迹模型来确定恢复后第一年的BAZ轨迹，并将这些轨迹组与对照组进行比较。结果：随访5年，共追踪291例儿童（71.9%），平均年龄6.2岁。总的来说，与对照组相比，sam恢复的儿童在心脏代谢风险方面没有差异。我们在sam恢复的儿童中确定了4种BAZ轨迹：“增加”（74.6%），“减少”（11.0%），“减少-增加”（5.0%）和“增加-减少”（9.4%）。与对照组相比，除“减少-增加”外，所有BAZ轨迹的体重、身高和无脂质量指数都较低。与对照组相比，“减少-增加”轨迹下的血糖较低(-15.8 mg/dL；95%CI: -31.2, -0.4)，而“增加-减少”轨迹的血糖较高(8.1 mg/dL；Ci: -0.8, 16.9)。与对照组相比，“减少-增加”和“减少”轨迹具有更高的总胆固醇(24.3 mg/dL；CI: -9.4, 58.4)和低密度脂蛋白胆固醇(10.4 mg/dL；CI分别为-3.8和24.7)。“增加”轨迹的心脏代谢风险最低。结论：急性心肌梗死恢复后早期BAZ的快速升高和降低与5年后更高的心脏代谢风险相关。研究结果表明，需要有针对性的康复后干预措施，以优化健康的体重恢复。

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引用次数: 0

Efficacy of a 24-month behavioral intervention focused on sugary beverage reduction for Latino mother-infant dyads: evidence from a randomized controlled trial

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition

Pub Date : 2025-02-01 DOI: 10.1016/j.ajcnut.2024.11.009

Christopher J Machle , Paige K Berger , Sarah-Jeanne Salvy , Claudia Rios , Ramon Durazo-Arvizu , Michael I Goran

Background

Childhood obesity disproportionately impacts marginalized and under-resourced communities, particularly Latinos. Although consumption of sugar-sweetened beverages and juices (SSBJs) in infancy is linked to increased obesity, few early-life interventions have targeted SSBJ reduction.

Objectives

To determine the efficacy of a culturally tailored home intervention for reducing SSBJ intake and obesity risk in Latino mothers and infants.

Methods

Mother-infant dyads (N = 210) were randomly assigned to 1 of 3 interventions for 2 years: 1) general health education (Control); 2) SSBJ intake reduction education (Intervention); 3) intervention plus home water delivery (Intervention + Water Delivery). Trained interventionists delivered education sessions 2 days/month during year 1 and 1 day/month during year 2. Mixed-effects models were used to examine changes in sugar consumption and weight-related outcomes over time by group for mothers and infants separately.

Results

The mean prepregnancy BMI for mothers was 28.1 ± 5.6 kg/m². Mothers receiving Intervention + Water Delivery demonstrated significantly greater reductions in consumption of free sugars from beverages from baseline to 12 months compared to the other 2 groups, where free sugars are total sugars except lactose (B: –7.98 g; 95% CI: (–13.96 g, –2.00 g), P = 0.009, P_FDR = 0.036). However, this effect was not apparent in year 2. Group differences for infant sugar consumption followed a similar pattern but were smaller and nonsignificant. Weight-related outcomes were not significantly associated with treatment group for mothers or infants.

Conclusions

This intervention, combined with home delivery of bottled water, was effective in reducing sugar consumption from beverages for Latina mothers by roughly 8 g/day in the first year after childbirth. However, this effect was not maintained and was not significant for infants. More comprehensive and sustained strategies are likely needed to maintain efficacy and improve outcomes related to weight or body composition, particularly for infants.

This trial was registered at clinicaltrials.gov as NCT03141346.

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引用次数: 0