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Hericium erinaceus: A possible future therapeutic treatment for the prevention and delayed progression of Alzheimer's disease? - A narrative review. 猴头菌:预防和延缓阿尔茨海默病进展的一种可能的未来治疗方法?-叙述评论。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2025-02-24 DOI: 10.1017/S0954422425000058
Nisha Cornford, Margaret Charnley

At present, the treatment of Alzheimer's disease involves only symptomatic medications which have continually demonstrated little efficacy, primarily due to the presence of biological barriers. Despite efforts, researchers have yet to discover a therapeutic treatment that delays neurodegenerative progression or restores associated Alzheimer neuropathological processes. For centuries, Hericium erinaceus (HE) has been used predominantly in Asian countries for its culinary and medicinal purposes; however, this mushroom has not yet been utilised in western pharmacology. This review systematically investigates evidence pertaining to the use of HE as a potential future therapeutic treatment for the prevention and delayed progression of Alzheimer's disease, by highlighting any fundamental neurotrophic and neuroprotective properties. In total, three human clinical trials and thirteen animal-model studies were included in review. The use of HE demonstrated positive significant differences in results obtained from behavioural, histological and biochemical assessments from both human clinical trials and animal model studies accentuating its utility for the improvement of cognitive function. In addition, erinacine-A-enriched HE appears to demonstrate the highest bioactive potency of all HE extracted compounds, providing the greatest effects while also showing transportability ease across biological barriers. In conclusion, evidence suggests that intake of HE may be an appropriate and relevant future therapeutic treatment for the prevention and delayed progression of Alzheimer's disease; however, continued research is necessary to provide further significant evidence of this relationship, through an increased quantity of human clinical trials.

目前,阿尔茨海默病的治疗只涉及对症药物,这些药物的疗效一直很低,主要是由于存在生物屏障。尽管做出了努力,但研究人员尚未发现一种治疗方法,可以延缓神经退行性进展或恢复相关的阿尔茨海默病神经病理过程。几个世纪以来,猴头菌(Hericium erinaceus, HE)在亚洲国家主要用于烹饪和药用,然而,这种蘑菇的使用尚未在西方药理学中得到利用。本综述通过强调任何基本的神经营养和神经保护特性,系统地调查了有关HE作为预防和延迟阿尔茨海默病进展的潜在未来治疗方法的证据。本研究共纳入3项人体临床试验和13项动物模型研究。从人类临床试验和动物模型研究中获得的行为学、组织学和生化评估结果显示,HE的使用具有积极的显著差异,强调了其在改善认知功能方面的效用。此外,在所有HE提取的化合物中,富含erinacine A的HE似乎表现出最高的生物活性效力,提供了最大的效果,同时也证明了可运输性,易于跨越生物屏障。总之,有证据表明,摄入HE可能是预防和延缓阿尔茨海默病进展的适当和相关的未来治疗方法,然而,有必要继续进行研究,以提供更多的重要证据,最有可能通过增加人体临床试验的数量。
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引用次数: 0
What diet to recommend before pregnancy to reduce the risk of gestational diabetes and during pregnancy to affect its course and improve perinatal outcomes? A review of the current evidence. 怀孕前推荐什么饮食来降低妊娠糖尿病的风险,怀孕期间推荐什么饮食来影响其病程并改善围产期结局?对现有证据的回顾。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2025-06-03 DOI: 10.1017/S0954422425100103
Janusz Krzymien, Dariusz Wlodarek, Piotr Ladyzynski

Several dietary strategies are designed to achieve optimal glycaemic control in managing gestational diabetes mellitus (GDM), considering factors such as energy needs, the glycaemic index, high fibre content and the reduction or exclusion of sugary foods and drinks. However, in achieving therapeutic goals, there is a lack of consensus in the formulation of uniform recommendations. This article reviews the literature to assess the impact of dietary interventions on GDM risk - measured by the percentage of at-risk women who develop GDM - and on the progression of GDM pregnancies, including weight gain, hyperglycaemia severity, insulin requirements and perinatal outcomes such as macrosomia, hypertensive disorders, caesarean delivery and neonatal size. We conducted a thorough search of PubMed and the Cochrane Library, focusing on randomised controlled trials, cohort studies, systematic reviews and meta-analyses involving women either at risk of or diagnosed with GDM. These search criteria yielded 2800 articles, whose titles and abstracts were reviewed to determine their relevance to the research objective. In the initial search, 192 relevant articles met the inclusion criteria. The comprehensive analysis of these studies highlights the current uncertainty regarding the long-term consequences of recommended diets during pregnancy, especially among women with GDM. While the available literature is substantial, conclusions drawn from various methodologies and study populations have not yielded a consensus on the most effective diet for reducing perinatal complications. Nonetheless, it is reasonable to advocate for the early initiation of dietary interventions, particularly during pregnancy planning, especially among women exhibiting risk factors for GDM.

考虑到能量需求、血糖生成指数、高纤维含量以及减少或排除含糖食物和饮料等因素,设计了几种饮食策略来实现妊娠糖尿病(GDM)的最佳血糖控制。然而,在实现治疗目标的过程中,在制定统一的建议方面缺乏共识。这篇文章回顾了文献,以评估饮食干预对GDM风险的影响——通过患GDM的高危妇女的百分比来衡量——以及对GDM妊娠的进展,包括体重增加、高血糖严重程度、胰岛素需求和围产期结局,如巨大儿、高血压疾病、剖腹产和新生儿尺寸。我们对PubMed和Cochrane图书馆进行了彻底的搜索,重点是随机对照试验、队列研究、系统评价和荟萃分析,涉及有GDM风险或诊断为GDM的女性。这些搜索标准产生了2,800篇文章,这些文章的标题和摘要被审查,以确定它们与研究目标的相关性。在最初的搜索中,有192篇相关文章符合纳入标准。对这些研究的综合分析强调了目前关于怀孕期间推荐饮食的长期后果的不确定性,特别是对于患有GDM的妇女。虽然现有文献大量,但从各种方法和研究人群中得出的结论尚未就减少围产期并发症的最有效饮食达成共识。尽管如此,提倡尽早开始饮食干预是合理的,特别是在怀孕计划期间,特别是在有GDM危险因素的妇女中。
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引用次数: 0
Dietary guidelines for pregnant and lactating women, adherence levels and associated factors: a scoping review. 孕妇和哺乳期妇女膳食指南、遵守水平及相关因素:范围界定综述。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2024-10-21 DOI: 10.1017/S0954422424000283
Sofa Rahmannia, Kevin Murray, Gina Arena, Siobhan Hickling

This scoping review addresses gaps in the existing literature on dietary guidelines for pregnant and lactating women globally. The study delves into adherence levels, identifies influencing factors and examines outcomes associated with these guidelines. Analysing food-based dietary guidelines (FBDG) from around the world, the review reveals that half of the countries lack FBDG, with only 15% providing tailored advice for pregnant and lactating women. Utilising data extracted from forty-seven articles across MEDLINE and EMBASE, the study highlights a scarcity of adherence studies, particularly in low- or middle-income countries (LMIC), and emphasises the lack of research during lactation. Overall adherence to dietary guidelines is low, with disparities in fruit, vegetable, whole grain and fish consumption. Positive correlations with adherence include age, education, employment, social class and certain medical histories, while negative correlations involve smoking, alcohol consumption, metropolitan residence and elevated BMI. The study documented significant associations between adherence and reduced risks of gestational complications but calls for further exploration of intermediate nutritional outcomes such as micronutrient deficiencies and child growth. Emphasising the urgency for globally standardised guidelines, especially in LMIC, this review provides a foundational call for prioritised studies and strategies to enhance dietary practices for pregnant and lactating women worldwide.

本范围界定综述探讨了现有文献中有关全球孕妇和哺乳期妇女膳食指南的不足之处。研究深入探讨了这些指南的遵守水平、影响因素,并研究了与这些指南相关的结果。通过分析世界各地基于食物的膳食指南(FBDGs),研究发现半数国家缺乏FBDGs,只有15%的国家为孕妇和哺乳期妇女提供量身定制的建议。该研究利用从 MEDLINE 和 EMBASE 的 47 篇文章中提取的数据,突出强调了遵守研究的稀缺性,尤其是在中低收入国家(LMICs),并强调了哺乳期研究的缺乏。膳食指南的总体遵守率较低,水果、蔬菜、全谷物和鱼类的食用量也存在差异。年龄、教育、就业、社会阶层和某些病史与膳食指南的遵守情况呈正相关,而吸烟、饮酒、居住在大都市和体重指数升高则与膳食指南的遵守情况呈负相关。研究结果表明,坚持摄入鱼类与降低妊娠并发症风险之间存在重要关联,但需要进一步探讨微量营养素缺乏症和儿童生长等中间营养结果。本综述强调了制定全球标准化指南的紧迫性,尤其是在低收入和中等收入国家,因此呼吁开展优先研究并制定相关策略,以改善全球孕妇和哺乳期妇女的饮食习惯。
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引用次数: 0
Biological properties of vitamins of the B-complex, part 2 - vitamins B6 and B7 (biotin, vitamin H). 维生素b复合物的生物学特性,第2部分-维生素B6和B7(生物素,维生素H)。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2025-05-30 DOI: 10.1017/S0954422425100097
Patrícia Dias, Tomáš Siatka, Marie Vopršalová, Monika Moravcová, Jana Pourová, Nikola Přívratská, Lenka Kujovská Krčmová, Lenka Javorská, Přemysl Mladěnka

Vitamins B6 (that is, pyridoxin and its analogues) and B7 (that is, biotin or vitamin H) are essential molecules for many physiological processes. In addition to their well-known involvement in several enzymatic reactions, recent discoveries revealed their participation in other processes, for example, in gene expression via epigenetic processes, such as biotinylation of proteins in the case of biotin. Plants, fungi, archaea and most bacteria synthesise both vitamins, whereas animals and humans lack enzymes for their biosynthesis and depend on their exogenous supply. At least in the case of biotin, human gastrointestinal microbiota can likely partly satisfy the need. Both vitamins are water soluble and require a transporter for efficient absorption after oral administration; they can be rapidly excreted; hence, they are considered largely non-toxic. In addition to physiological and kinetic aspects of vitamin B6 and biotin, this review, which is based on a search in PubMed up to 2023, covers sources of these vitamins, the impact of food treatment on their content, causes and symptoms of deficiency and specific mutations related to their function. Currently available literature on the analytical determination of these vitamins in biological fluids, possible pharmacological uses and symptoms of toxicity, although rare, are also included.

维生素B6(即吡哆素及其类似物)和B7(即生物素或维生素H)是许多生理过程所必需的分子。除了众所周知的参与几种酶促反应外,最近的发现揭示了它们参与其他过程,例如通过表观遗传过程参与基因表达,包括生物素中蛋白质的生物素化。植物、真菌、古生菌和大多数细菌都能合成这两种维生素,而动物和人类缺乏用于生物合成的酶,依赖于外源供应。至少在生物素的情况下,人类胃肠道微生物群可能会部分满足需求。这两种维生素都是水溶性的,口服后需要转运体才能有效吸收;它们可以迅速排出体外,因此被认为是无毒的。除了维生素B6和生物素的生理和动力学方面,这篇综述基于PubMed到2023年的搜索,涵盖了这些维生素的来源,食物处理对其含量的影响,缺乏的原因和症状以及与其功能相关的特定突变。目前可获得的关于生物体液中这些维生素的分析测定、可能的药理学用途和毒性症状的文献,虽然罕见,但也包括在内。
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引用次数: 0
Mediterranean diet and oral health: is there an association? A scoping review. 地中海饮食与口腔健康:是否存在关联?范围审查。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2024-11-18 DOI: 10.1017/S0954422424000337
Aleksandra Popovac, Jelena Jaćimović, Antonia Trichopoulou, Eleni Peppa, Kostas Kotrokois, Ivica Stančić, Aleksandra Milić-Lemić, Anastassia Kossioni

As the Mediterranean diet (MDi) has demonstrated a powerful preventative effect on various medical conditions, a positive effect on oral health may also be speculated. Tooth loss, pain or tooth mobility may discourage the consumption of specific food types, affecting MDi adherence. The aim of this study was to investigate the association between adherence to MDi and oral health in adult populations. The study protocol was registered in Open Science Framework (https://osf.io/vxbnh/) and adhered to PRISMA-ScR guidelines. The principal research questions were: (1) Does better oral health enable adults to better adhere to MDi? and (2) Does better adherence to MDi enable adult individuals to have better oral health? The content of three databases, Clarivate Analytics' Web of Science, Scopus and PubMed was searched without language, date or any other restrictions. The search results were imported into the Rayyan environment, and from the initial 1127 studies identified, only 20 remained after the exclusion process. Three articles composed the first group, revealing significant associations between various oral health parameters and adherence to MDi, with large variations in methodology and no safe conclusions. The studies investigating the effect of the level of adherence to MDi on various oral parameters were more numerous and revealed negative associations with the prevalence of periodontal disease and upper aero-digestive tract cancer. Further studies to explore the existence and direction of the association between oral health and MDi are needed, with public health interventions encouraging adherence to the MDi to reduce the burden of oral conditions and other non-communicable diseases.

地中海饮食(Mediterranean diet,MDi)对各种疾病都有很强的预防作用,因此也可以推测它对口腔健康也有积极影响。此外,牙齿脱落、疼痛或牙齿移动也可能阻碍人们食用特定类型的食物,从而影响对地中海饮食的坚持。本研究的目的是调查成年人口中坚持 MDi 与口腔健康之间的关系。研究方案已在开放科学框架(https://osf.io/vxbnh/)中注册,并遵守 PRISMA-ScR 指南。主要研究问题是1)更好的口腔健康是否能使成年人更好地坚持 MDi? 2)更好地坚持 MDi 是否能使成年人拥有更好的口腔健康?对 Clarivate Analytics 的 Web of Science、Scopus 和 PubMed 这三个数据库的内容进行了搜索,没有语言、日期或任何其他限制。搜索结果被导入到 Rayyan 环境中,在最初确定的 1127 项研究中,经过排除程序后只剩下 20 项。第一组有三篇文章,揭示了各种口腔健康参数与坚持 MDi 之间的重要关联,但研究方法差异很大,也没有可靠的结论。调查坚持 MDi 的程度对各种口腔参数影响的研究数量较多,并揭示了与牙周病和上消化道癌症发病率的负相关。有必要开展进一步研究,探讨口腔健康与千年发展目标之间是否存在关联以及关联的方向,同时采取公共卫生干预措施,鼓励千年发展目标,以减轻口腔疾病和其他非传染性疾病的负担。
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引用次数: 0
Impact of omega-3 fatty acid supplementation on clinical manifestations in autism spectrum disorders: an umbrella review of meta-analyses. 补充 Omega-3 脂肪酸对自闭症谱系障碍临床表现的影响:荟萃分析综述。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2024-11-21 DOI: 10.1017/S0954422424000325
Hamid Abbasi, Abdolrahman Parhiz, Sara Khoshdooz, Farnush Bakhshimoghaddam, Saeid Doaei, Maryam Gholamalizadeh

Autism spectrum disorder (ASD) is a neurodevelopmental condition. Omega-3 fatty acid insufficiency has been linked to ASD. This umbrella meta-analysis was performed to investigate the effects of omega-3 supplementation on clinical manifestations in participants with ASD. Based on the PRISMA statement, databases including Web of Science, PubMed and Scopus were systematically searched for published meta-analyses on the effect of omega-3 supplementation on ASD up to December 2023. To assess the risk of bias, the assessment of multiple systematic reviews (AMSTAR)-2 was utilised. The outcomes were core and non-core symptoms of ASD including social withdrawal/lethargy, cluttering speech, hyperactivity, irritability and stereotypy. Seven meta-analyses eventually remained in the umbrella review. The results revealed that omega-3 fatty acid supplementation caused a significant reduction in cluttering speech in studies conducted on age ≤8 years (effect size (ES) -0·30; 95% confidence interval (CI) -0·55, -0·06; P = 0·02). Omega-3 supplementation caused a significant reduction in hyperactivity in participants ≤8 years (ES -0·30; 95% CI -0·55, -0·06; P = 0·02) and in participants who received the supplements for more than 14 weeks (ES -0·30; 95% CI -0·55, -0·06; P = 0·02). A dosage of ≤1000 mg/d of omega-3 supplementation led to a significant increase in the stereotypy/restricted and repetitive interests and behaviours (ES 0·19; 95% CI 0·03, 0·35; P = 0·02). This umbrella review revealed that omega-3 fatty acid may be a beneficial supplement to control cluttering speech and hyperactivity in children with ASD who are 8 years old or younger.

自闭症谱系障碍(ASD)是一种神经发育疾病。欧米伽-3脂肪酸不足与自闭症谱系障碍有关。本总括荟萃分析旨在研究欧米伽-3 补充剂对 ASD 患者临床表现的影响。根据PRISMA声明,系统地检索了包括Web of Science、PubMed和Scopus在内的数据库,以查找已发表的有关补充欧米伽-3对ASD影响的荟萃分析。为了评估偏倚风险,采用了多重系统综述评估(AMSTAR)-2。研究结果为 ASD 的核心和非核心症状,包括社交退缩/嗜睡、言语杂乱、多动、易怒和刻板。总综述最终保留了七项荟萃分析。结果显示,在年龄≤8岁的研究中,补充欧米伽-3脂肪酸可显著减少杂乱言语(ES=-0.30;95% CI:-0.55,-0.06;P=0.02)。补充欧米伽-3可显著降低≤8岁参与者的多动程度(ES=-0.30;95% CI:-0.55,-0.06;P=0.02),并显著降低接受补充剂超过14周的参与者的多动程度(ES=-0.30;95% CI:-0.55,-0.06;P=0.02)。补充欧米伽-3的剂量≤1000毫克/天会导致刻板/受限和重复的兴趣和行为显著增加(ES= 0.19;95% CI:0.03,0.35;P=0.02)。本综述显示,ω-3脂肪酸可能是一种有益的补充剂,可控制8岁以下患有自闭症的儿童的杂乱言语和多动症。
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引用次数: 0
The effect of healthy food guidance for schools on food availability, purchasing and consumption among school children in New Zealand and Australia: an integrative review. 学校健康食品指南对新西兰和澳大利亚学童食品供应、购买和消费的影响:综合评述。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2024-11-27 DOI: 10.1017/S0954422424000362
Danika Pillay, Ajmol Ali, Carol Wham

Modifying the food environment holds promise for instilling healthier behaviours in children and may be an effective public health strategy for preventing childhood obesity and adverse health outcomes. The school food environment is a valuable setting to influence most children's dietary behaviours from an early age, yet evidence suggests that the New Zealand and Australian school food environment is not conducive to healthy food and drink consumption. The present study aimed to investigate the level of compliance in New Zealand and Australia with government guidelines for food and drink availability within schools and the subsequent effect on food consumption and purchasing behaviours of children. A systematic review utilising three databases, PubMed, Scopus and the Cochrane Library, was conducted. The research covered peer-reviewed studies from both New Zealand and Australia that met predefined inclusion criteria. Fifteen studies focused on assessing food availability within schools on the basis of government guidelines, and ten studies explored food purchasing and consumption by students influenced by changes to the school food environment. Results showed low compliance with government healthy food guidelines for schools, and significant socioeconomic disparities. Western Australia's clear targets as well as the mandatory monitoring systems in place stand out as being a significant enabler of greater compliance with government food policies. Interventions aimed at improving healthy food availability and promoting healthy options in the canteen may positively influence student purchasing and consumption habits. Strategies such as feedback models and incentivisation hold promise for promoting healthier school environments and influencing children's food choices.

改变饮食环境有望向儿童灌输更健康的行为,并可能成为预防儿童肥胖症和不良健康后果的有效公共卫生策略。学校食品环境是影响大多数儿童从小饮食行为的重要环境,但有证据表明,新西兰和澳大利亚的学校食品环境不利于健康饮食消费。本研究旨在调查新西兰和澳大利亚在学校食品和饮料供应方面遵守政府指导方针的程度,以及随后对儿童食品消费和购买行为的影响。本研究利用 "PubMed"、"Scopus "和 "Cochrane Library "三个数据库进行了系统性回顾。研究涵盖了新西兰和澳大利亚符合预定纳入标准的同行评审研究。其中 15 项研究重点评估了学校根据政府指南提供食品的情况,10 项研究探讨了学校食品环境变化对学生购买和消费食品的影响。结果表明,学校对政府健康食品指南的遵守率很低,而且社会经济差异很大。西澳大利亚州的明确目标和强制监督制度是促进学生更好地遵守政府食品政策的重要因素。旨在改善健康食品供应和促进食堂健康选择的干预措施可能会对学生的购买和消费习惯产生积极影响。反馈模式和激励机制等策略有望促进更健康的学校环境并影响儿童的食品选择。
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引用次数: 0
Feeding weanling piglets for optimal health and performance: what can we learn from research on complex diets? 饲喂断奶仔猪以获得最佳健康和生产性能:我们可以从复杂日粮研究中学到什么?
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2025-05-15 DOI: 10.1017/S095442242510005X
Bruno B Carnino, Bruno Bd Muro, Rafaella F Carnevale, Flávio A Coelho, Caio A da Silva, Ines Andretta, Sam Millet, Cesar Ap Garbossa

Weaning and introduction to a solid diet result in physiological stress in piglets. This can be offset by using complex diets. The terms 'complexity' and 'complex diets' are used in practice and academia but are not precisely defined. The aim of this review was to identify the ingredients in weaner diets, their inclusion levels and how the number of ingredients or complexity of diets influences weaner performance, intestinal and systemic health, environmental sustainability and antibiotic use. Not all diets are formulated equally. Some prioritise meeting the weaner's nutritional needs, while other diets seek to align health promotion and adaptation to the environment. As diet composition is of vital importance for young piglets, the components needed in these complex diets must be defined. Healthy, environmentally adapted pigs have excellent growth performance. We therefore recommend use of a new term, 'gut health supporting diets', to encompass the many concepts associated with diet complexity.

断奶和饲喂固体日粮会导致仔猪的生理应激。这可以通过使用复杂的饮食来抵消。“复杂性”和“复杂饮食”这两个术语在实践和学术界都有使用,但没有精确的定义。本综述的目的是确定断奶仔猪日粮中的成分,它们的添加水平以及成分的数量或日粮的复杂性如何影响断奶仔猪的生产性能、肠道和系统健康、环境可持续性和抗生素的使用。并不是所有的饮食都是一样的。一些饮食优先考虑满足断奶仔猪的营养需求,而其他饮食则寻求将健康促进和适应环境结合起来。日粮组成对仔猪至关重要,因此必须确定这些复杂日粮中所需的成分。健康、适应环境的猪具有优异的生长性能。因此,我们建议使用一个新的术语,“支持肠道健康的饮食”,以涵盖与饮食复杂性相关的许多概念。
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引用次数: 0
The impact of whey protein on plasma branched-chain amino acids and glycaemic control in humans. A narrative review. 乳清蛋白对人血浆支链氨基酸和血糖控制的影响。叙述性评论
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2025-07-10 DOI: 10.1017/S0954422425100140
Hannah L Bell, Kim G Jackson, Les A Crompton, David I Givens, Julie A Lovegrove

Impaired glycaemic control is a major risk factor for developing type 2 diabetes (T2D), a worldwide health epidemic intrinsically linked to diet and obesity. Whey proteins (WP) are increasingly popular supplements that are a rich source of branched-chain amino acids (BCAA), essential for muscle protein synthesis and metabolic regulation. In humans, fasting plasma concentrations of BCAA are maintained around 350 µM but become chronically elevated by 10-25% in persons with T2D. Little is known about whether BCAA from WP impacts circulating BCAA concentrations and contributes to this phenomenon. This narrative review used a systematic search approach with relevant keywords to identify evidence from randomised controlled trials in normoglycaemic humans and those with insulin resistance or T2D, on the effects of WP intake on plasma BCAA and glycaemic control. This review is, to the authors' knowledge, the first to specifically examine the effects of WP intake on plasma BCAA concentrations in relation to glycaemic control. Whilst the majority of acute studies identified (n = 6) reported that WP consumption between 10 and 50 g significantly elevates postprandial BCAA and insulin responses (as evidenced by peak concentration and/or area under the curve), evidence from chronic studies (n = 3) report inconsistent findings on the impact of 9-51 g of WP/d on fasting BCAA and glycaemic control (for example, fasting glucose and insulin, insulin clearance). Findings from this literature review highlight the need for further studies that investigate the relationship between WP consumption with BCAA and glycaemic control, and to determine underlying mechanisms of action.

血糖控制受损是发生2型糖尿病(T2D)的主要危险因素,2型糖尿病是一种与饮食和肥胖有着内在联系的全球性健康流行病。乳清蛋白(WP)是越来越受欢迎的补充剂,它是支链氨基酸(BCAA)的丰富来源,对肌肉蛋白质合成和代谢调节至关重要。在人类中,空腹血浆BCAA浓度维持在350µM左右,但在T2D患者中会长期升高10-25%。很少有人知道来自WP的BCAA是否会影响循环BCAA浓度并导致这一现象。本叙述性综述采用系统搜索方法,结合相关关键词,从血糖正常人群和胰岛素抵抗或T2D患者的随机对照试验中寻找证据,研究白蛋白摄入对血浆BCAA和血糖控制的影响。据作者所知,这篇综述是第一次专门研究白蛋白摄入对血浆BCAA浓度与血糖控制的影响。虽然大多数急性研究(n=6)报告说,10至50克的白蛋白摄入显著提高餐后BCAA和胰岛素反应(通过峰值浓度和/或曲线下面积证明),但来自慢性研究(n=3)的证据表明,每天摄入9至51克白蛋白对空腹BCAA和血糖控制(例如,空腹血糖和胰岛素,胰岛素清除率)的影响不一致。这篇文献综述的发现强调了需要进一步的研究来调查白蛋白摄入与BCAA和血糖控制之间的关系,并确定其潜在的作用机制。
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引用次数: 0
Understanding the complexity of barriers and facilitators to adherence to oral nutritional supplements among patients with malnutrition: a systematic mixed-studies review. 了解营养不良患者坚持服用口服营养补充剂的障碍和促进因素的复杂性:一项系统性混合研究综述。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2024-10-09 DOI: 10.1017/S0954422424000192
Evelina Liljeberg, Liz Payne, Malin Skinnars Josefsson, Lisa Söderström, Sandra Einarsson

The aim of this systematic mixed-studies review is to summarise barriers/facilitators to adherence to and/or consumption of oral nutritional supplements (ONS) among patients with disease-related malnutrition. In March 2022, the Cochrane CENTRAL, PUBMED, PsycINFO (Ovid) and CINAHL were searched for articles with various study designs, published since 2000. Articles were identified on the basis of 'population' (patients ≥18 years with malnutrition/at nutritional risk), 'intervention' (ONS with ≥2 macronutrients and micronutrients), 'comparison' (any comparator/no comparator) and 'outcome' (factors affecting adherence or consumption) criteria. A sequential exploratory synthesis was conducted: first, a thematic synthesis was performed identifying barriers/facilitators; and second, the randomised controlled trials (RCTs) were used to support these findings. The five WHO dimensions of adherence guided the analysis. Study inclusion, data extraction, analysis and risk-of-bias assessment (MMAT 2018) were carried out independently by two researchers. From 21 835 screened articles, 171 were included with 42% RCTs and 20% qualitative studies. The two major populations were patients with malignancies (34%) and older adults (35%). In total, fifty-nine barriers/facilitators were identified. Patients' health status, motivation, product tolerance and satisfaction as well as well-functioning healthcare routines and support were factors impacting ONS consumption. Few barriers/facilitators (n = 13) were investigated in RCTs. Two of those were serving a small ONS volume and integrating ONS into ward routines. Given the complexity of ONS adherence, non-adherence to ONS should be addressed using a holistic approach. More studies are needed to investigate the effect of different approaches to increase adherence to ONS.

本系统性混合研究综述旨在总结疾病相关营养不良患者坚持和/或食用口服营养补充剂(ONS)的障碍/促进因素。2022 年 3 月,我们在 Cochrane CENTRAL、PUBMED、PsycINFO (Ovid) 和 CINAHL 中检索了 2000 年以来发表的各种研究设计的文章。根据 "人群"(≥18 岁的营养不良/有营养风险的患者)、"干预"(含有≥2 种宏量营养素和微量营养素的 ONS)、"比较"(任何比较者/无比较者)和 "结果"(影响依从性或消耗量的因素)标准确定文章。我们进行了有序的探索性综合:首先,进行了专题综合,以确定障碍/促进因素;其次,使用随机对照试验(RCT)来支持这些发现。世界卫生组织关于坚持治疗的五个方面为分析提供了指导。研究纳入、数据提取、分析和偏倚风险评估(MMAT 2018)由两名研究人员独立完成。在筛选出的 21 835 篇文章中,有 171 篇被纳入,其中 42% 为 RCT 研究,20% 为定性研究。两个主要人群是恶性肿瘤患者(34%)和老年人(35%)。总共发现了 59 个障碍/促进因素。患者的健康状况、积极性、对产品的耐受性和满意度以及运作良好的医疗保健常规和支持是影响 ONS 消费的因素。在研究性临床试验中调查的障碍/促进因素很少(n = 13)。其中两个障碍是安眠药用量过少和将安眠药纳入病房常规。鉴于坚持服用 ONS 的复杂性,应采用综合方法解决不坚持服用 ONS 的问题。需要开展更多研究,探讨不同方法对提高坚持服用 ONS 的效果。
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Nutrition Research Reviews
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