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Exploring the Nutrition Care Journey of People Living With Obesity in Acute Care 肥胖症患者急性期营养护理之旅探索
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2025-01-13 DOI: 10.1111/jhn.70003
Andrea Elliott, Kia Noble, Daphne Flynn, Judy Bauer, Simone Gibson

Background

Recent studies show a high prevalence in hospital populations and best practice evidence indicates that people living with obesity should receive dietetic advice. However, patients often do not receive this care in acute settings. Understanding the experiences of people living with obesity is crucial to designing successful strategies for management.

Objective

This qualitative study aimed to understand the experience of nutrition care for patients living with obesity in the acute hospital setting and to redesign an optimised patient journey using a design approach. Using patient journey mapping, nutrition care across the inpatient admission was explored. A lived experience perspective was applied to reflect on the patient journey and interactions of patients with dietetic services in the acute setting. A co-creation session was conducted with dietitians and consumers to redesign the patient journey.

Results

The patient journey revealed that for patients living with obesity, discussions about weight were absent from the journey from all healthcare professionals. For patients receiving dietetic care, the Nutrition Care Process was followed; nutrition intervention focused on acute nutrition issues with increased energy and protein prescription: a lack of goal setting and absence of discharge planning. The redesign of the nutrition care journey identified pivot points in the pathway to support engagement in obesity-related care.

Conclusion

The findings from this study provide new insights into current nutrition care for people living with obesity in the acute setting. These findings can inform future education, research and advocacy for practice changes to improve dietetic care for people living with obesity.

背景:最近的研究表明,肥胖症在医院人群中的患病率很高,最佳实践证据表明,肥胖患者应该接受饮食建议。然而,在急性环境中,患者往往得不到这种护理。了解肥胖患者的经历对于设计成功的管理策略至关重要。目的:本定性研究旨在了解急性住院肥胖症患者的营养护理经验,并使用设计方法重新设计优化的患者旅程。利用病人旅程图,探讨了住院病人住院期间的营养护理。一个生活经验的观点被应用于反映病人的旅程和互动的病人在急性设置饮食服务。与营养师和消费者进行了一次共同创造会议,以重新设计患者的旅程。结果:患者旅程显示,对于患有肥胖症的患者,所有医疗保健专业人员都没有讨论体重问题。对于接受营养护理的患者,遵循营养护理流程;营养干预侧重于急性营养问题,增加能量和蛋白质处方:缺乏目标设定和缺乏出院计划。营养护理旅程的重新设计确定了通路中的支点,以支持参与与肥胖相关的护理。结论:本研究结果为当前急性肥胖患者的营养护理提供了新的见解。这些发现可以为未来的教育、研究和倡导实践变革提供信息,以改善肥胖患者的饮食保健。
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引用次数: 0
A Realist Scoping Review of Community Nutrition Interventions in the UK: Implications for the ‘Nutrition Skills for Life’ Programme 英国社区营养干预的现实主义范围审查:对“生命营养技能”计划的影响。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2025-01-08 DOI: 10.1111/jhn.70008
J. Lisa Williams, Carolyn Wallace, Teresa Filipponi

Background

Nutrition Skills for Life (NSFL) provides training and support for communities and organisations to implement Community Nutrition Interventions (CNIs) that meet identified needs. To inform future NSFL evaluation, this scoping review, using a realist approach sought to determine the underpinning initial programme theory (IPT) for how CNIs support socioeconomically disadvantaged (SED) communities to access a healthy diet, as detailed in the protocol doi.org/10.17605/OSF.IO/D56FK.OSF.IO/D56FK.

Methodology

Reporting standards for realist syntheses (RAMESES) and scoping reviews (PRISMA-ScR) were used. Four electronic databases and grey literature were searched. Of the 1920 documents identified, 45 were included in the analysis. Data relating to Context, Mechanism and Outcomes were extracted and presented as C-M-O configurations (CMOCs). Documents were assessed for relevance to the research question and usefulness in terms of their contribution towards the IPT.

Results

The IPT, underpinned by the Ottawa Charter for Health Promotion, comprises 17 consolidated CMOCs. These are narratively discussed as follows: understanding community needs; consistent nutrition messages; knowledgeable, skilled, confident practitioners/facilitators and practising new skills.

Conclusions

Realist research and analysis of CMOCs provided a deeper understanding of how CNIs can be implemented to support SED communities in accessing a healthy diet. Interventions ‘worked’ when they acknowledged and addressed identified barriers to healthy eating, provided reliable, trusted, easy-to-understand nutrition messages, were delivered by confident, knowledgeable practitioners, and facilitated strategies such as meal preparation. Further realist evaluation to refine the IPT could inform the evaluation of other complex public health interventions.

背景:生命营养技能(NSFL)为社区和组织提供培训和支持,以实施社区营养干预(CNIs),以满足已确定的需求。为了为未来的NSFL评估提供信息,本范围审查采用现实主义方法,试图确定cni如何支持社会经济弱势群体(SED)获得健康饮食的基础初始计划理论(IPT),详见方案doi.org/10.17605/OSF.IO/D56FK.OSF.IO/D56FK.Methodology:使用现实主义综合报告标准(RAMESES)和范围审查(PRISMA-ScR)。检索了四个电子数据库和灰色文献。在查明的1920份文件中,有45份被列入分析。提取与上下文、机制和结果相关的数据,并以C-M-O结构(cmoc)呈现。评估了文件与研究问题的相关性以及它们对IPT的贡献的有用性。结果:IPT在《渥太华健康促进宪章》的支持下,由17个综合cmoc组成。这些被叙述如下:理解社区需求;一致的营养信息;知识渊博,技能熟练,自信的从业者/促进者,并练习新技能。结论:对cmoc的现实主义研究和分析提供了如何实施cni以支持SED社区获得健康饮食的更深层次的理解。当干预措施承认并解决已确定的健康饮食障碍,提供可靠、可信、易于理解的营养信息,由自信、知识渊博的从业人员传达,并促进膳食准备等策略时,干预措施就会“起作用”。为完善IPT而进行的进一步现实评价可为其他复杂公共卫生干预措施的评价提供信息。
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引用次数: 0
Emotional Eating Interventions for Adults Living With Overweight and Obesity: A Systematic Review and Meta-Analysis of Behaviour Change Techniques 情绪饮食干预超重和肥胖的成年人:行为改变技术的系统回顾和荟萃分析。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2025-01-06 DOI: 10.1111/jhn.13410
D. Power, A. Jones, C. Keyworth, P. Dhir, A. Griffiths, K. Shepherd, J. Smith, G. Traviss-Turner, J. Matu, L. Ells

Background

Emotional eating (EE) is a barrier to the long-term success of weight loss interventions. Psychological interventions targeting EE have been shown to reduce EE scores and weight (kg), though the mechanisms remain unclear. This review and meta-analysis aimed to identify the specific behaviour change techniques (BCTs) associated with improved outcomes.

Methods

This is a review update and extension, with new studies extracted from searches of CINAHL, PsycINFO, MEDLINE and EMBASE 1 January 2022 to 31 April 2023. EE interventions for adults with BMI > 25 kg/m2 were considered for inclusion. Paper screening, extraction, BCT-coding and risk of bias were completed using the Template for Intervention Description and Replication (TIDieR) checklist, Behaviour Change Taxonomy v1 (BCTTv1) and Risk of Bias2 (RoB2)/Risk of Bias In Non-randomised Studies (ROBINS-I) tool. Narrative syntheses and random effects multi-level meta-analyses were conducted.

Results

In total, 6729 participants were included across 47 studies (13 identified in the update). Forty-two studies contributed to the pooled estimate for the impact of interventions on EE (SMD = −0.99 [95% CI: −0.73 to −1.25], p < 0.001). Thirty-two studies contributed to the pooled estimate for the impact of interventions on weight (−4.09 kg [95% CI: −2.76 to −5.43 kg], p < 0.001). Five BCTs related to identity, values and self-regulation were associated with notable improvements to both weight and EE (‘incompatible beliefs’, ‘goal setting outcome’. ‘review outcome goals’, ‘feedback on behaviour’ and ‘pros/cons’).

Conclusion

Implementation and evaluation of the highlighted BCTs are required. Weight management services should consider screening patients for EE to tailor interventions to individual needs.

背景:情绪性进食(EE)是减肥干预长期成功的障碍。针对情感表达的心理干预已被证明可以降低情感表达得分和体重(公斤),尽管其机制尚不清楚。本综述和荟萃分析旨在确定与改善预后相关的特定行为改变技术(bct)。方法:这是一篇更新和扩展的综述,从2022年1月1日至2023年4月31日的CINAHL、PsycINFO、MEDLINE和EMBASE检索中提取了新的研究。考虑纳入BMI为25 kg/m2的成人的情感表达干预。使用干预描述和复制模板(TIDieR)检查表、行为改变分类法v1 (BCTTv1)和非随机研究中偏倚风险2 (RoB2)/偏倚风险(robis - i)工具完成论文筛选、提取、bct编码和偏倚风险。进行叙事综合和随机效应多层次元分析。结果:47项研究共纳入6729名参与者(其中13项在更新中确定)。42项研究对干预措施对情感表达的影响进行了汇总估计(SMD = -0.99 [95% CI: -0.73至-1.25],p结论:需要实施和评估重点突出的bct。体重管理服务应考虑筛查患者的情感表达,以根据个人需求量身定制干预措施。
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引用次数: 0
Nutrient Intake Among Lactating Women With Overweight and Obesity in Norway: A Comparison With the Nordic Nutrition Recommendations 2023 挪威哺乳期超重和肥胖妇女的营养摄入:与北欧营养建议2023的比较
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2025-01-06 DOI: 10.1111/jhn.70000
Maria Fossli, Elisabeth A. Øhman, Malin Andal, Beate F. Løland, Kirsten B. Holven, Hilde K. Brekke

Background

During lactation, maternal requirements for many nutrients increase due to the physiological demands of breast milk production, reflected in dietary recommendations. BMI is negatively associated with dietary quality postpartum, and 40% of women in Norway have pre-pregnancy overweight and obesity. Currently, there is limited data on dietary intake among lactating women in Norway and whether they meet nutritional requirements. We aimed to evaluate the nutrient intake in a study sample of lactating women with overweight and obesity, compared with the Nordic Nutrition Recommendations (NNR 2023).

Methods

In this cross-sectional analysis, we included baseline data from 112 lactating women with a pre-pregnancy BMI of 25–35 kg/m2, participating in a weight loss and breastfeeding promotion intervention trial in Oslo, Norway. Data were collected at 2 weeks postpartum (subject characteristics, anthropometry and dietary supplement use), at 7 weeks postpartum (dietary assessment) and post-weaning (retrospective dietary supplement use). Dietary data were obtained from a 4-day dietary record before randomisation to dietary treatment for weight loss. Nutrient intake was compared to the dietary reference values for lactating women in NNR 2023. Increased risk of inadequate intake of micronutrients was assessed as the proportion of women with intakes below the average requirement (AR), with and without dietary supplements.

Results

Mean ± SD BMI at 2 weeks postpartum was 30.7 ± 2.5 kg/m2. At 7 weeks postpartum the women reported a mean energy intake of 9.2 ± 2.0 MJ/day, with a higher intake of saturated fat and a lower intake of carbohydrate, dietary fibre and docosahexaenoic acid than recommended. The majority had an increased risk of inadequate intake of vitamin A (92%), folate (92%), vitamin D (84%), selenium (87%) and iodine (71%) from the diet alone. When dietary supplements were taken into account, ≥ 50% of the women still had an increased risk of inadequate intake of vitamin A, folate and selenium.

Conclusions

The high proportion of lactating women with overweight and obesity failing to meet the newly updated Nordic Nutrition Recommendations highlights the need to raise awareness among new mothers and healthcare professionals about the increased maternal nutritional demands during lactation and hence, the importance of nutrient-dense diets.

背景:在哺乳期间,由于母乳生产的生理需求,母亲对许多营养素的需求增加,这反映在饮食建议中。体重指数与产后饮食质量呈负相关,挪威40%的女性在孕前超重和肥胖。目前,关于挪威哺乳期妇女的饮食摄入量以及她们是否满足营养要求的数据有限。我们的目的是评估超重和肥胖哺乳期妇女的营养摄入量,并与北欧营养建议(NNR 2023)进行比较。方法:在这项横断面分析中,我们纳入了112名参加挪威奥斯陆减肥和母乳喂养促进干预试验的哺乳期妇女的基线数据,这些妇女孕前体重指数为25-35 kg/m2。在产后2周(受试者特征、人体测量和膳食补充剂使用情况)、产后7周(膳食评估)和断奶后(回顾性膳食补充剂使用情况)收集数据。饮食数据是从随机分配到饮食治疗减肥前的4天饮食记录中获得的。将营养摄入量与NNR 2023中哺乳期妇女的膳食参考值进行比较。对微量营养素摄入不足的风险增加进行了评估,即摄入低于平均需求(AR)的妇女比例,无论是否服用膳食补充剂。结果:产后2周BMI平均值±SD为30.7±2.5 kg/m2。产后7周,这些妇女报告的平均能量摄入量为9.2±2.0 MJ/天,饱和脂肪的摄入量高于推荐值,碳水化合物、膳食纤维和二十二碳六烯酸的摄入量低于推荐值。大多数人单独从饮食中摄入维生素A(92%)、叶酸(92%)、维生素D(84%)、硒(87%)和碘(71%)不足的风险增加。当考虑到膳食补充剂时,≥50%的妇女仍然有维生素A、叶酸和硒摄入不足的风险增加。结论:哺乳期妇女超重和肥胖的高比例未能满足新更新的北欧营养建议,这突出了需要提高新妈妈和保健专业人员对哺乳期产妇营养需求增加的认识,因此,营养密集饮食的重要性。
{"title":"Nutrient Intake Among Lactating Women With Overweight and Obesity in Norway: A Comparison With the Nordic Nutrition Recommendations 2023","authors":"Maria Fossli,&nbsp;Elisabeth A. Øhman,&nbsp;Malin Andal,&nbsp;Beate F. Løland,&nbsp;Kirsten B. Holven,&nbsp;Hilde K. Brekke","doi":"10.1111/jhn.70000","DOIUrl":"10.1111/jhn.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During lactation, maternal requirements for many nutrients increase due to the physiological demands of breast milk production, reflected in dietary recommendations. BMI is negatively associated with dietary quality postpartum, and 40% of women in Norway have pre-pregnancy overweight and obesity. Currently, there is limited data on dietary intake among lactating women in Norway and whether they meet nutritional requirements. We aimed to evaluate the nutrient intake in a study sample of lactating women with overweight and obesity, compared with the Nordic Nutrition Recommendations (NNR 2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional analysis, we included baseline data from 112 lactating women with a pre-pregnancy BMI of 25–35 kg/m<sup>2</sup>, participating in a weight loss and breastfeeding promotion intervention trial in Oslo, Norway. Data were collected at 2 weeks postpartum (subject characteristics, anthropometry and dietary supplement use), at 7 weeks postpartum (dietary assessment) and post-weaning (retrospective dietary supplement use). Dietary data were obtained from a 4-day dietary record before randomisation to dietary treatment for weight loss. Nutrient intake was compared to the dietary reference values for lactating women in NNR 2023. Increased risk of inadequate intake of micronutrients was assessed as the proportion of women with intakes below the average requirement (AR), with and without dietary supplements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean ± SD BMI at 2 weeks postpartum was 30.7 ± 2.5 kg/m<sup>2</sup>. At 7 weeks postpartum the women reported a mean energy intake of 9.2 ± 2.0 MJ/day, with a higher intake of saturated fat and a lower intake of carbohydrate, dietary fibre and docosahexaenoic acid than recommended. The majority had an increased risk of inadequate intake of vitamin A (92%), folate (92%), vitamin D (84%), selenium (87%) and iodine (71%) from the diet alone. When dietary supplements were taken into account, ≥ 50% of the women still had an increased risk of inadequate intake of vitamin A, folate and selenium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The high proportion of lactating women with overweight and obesity failing to meet the newly updated Nordic Nutrition Recommendations highlights the need to raise awareness among new mothers and healthcare professionals about the increased maternal nutritional demands during lactation and hence, the importance of nutrient-dense diets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Unlocking the Vitamin Puzzle: Investigating Levels in People With Alzheimer's Disease Versus Healthy Controls Through Systematic Review and Network Meta-Analysis 解开维生素之谜:通过系统回顾和网络荟萃分析调查阿尔茨海默病患者与健康对照者的维生素水平。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2025-01-06 DOI: 10.1111/jhn.70007
Sagar Marwaha, Rachna Agarwal, Manjari Tripathi, Shashank Tripathi

The progression of Alzheimer's disease (AD) is intricately tied to the impairment of neurons, crucial for neurological functions. Despite extensive research, the precise mechanism underlying AD development remains elusive due to its multifaceted aetiology. Vitamin deficiency has emerged as a notable contributor to AD onset and progression, exerting a significant influence on brain function. To explore this link, we conducted a thorough review using PubMed, Web of Science and MEDLINE databases to gather literature on average vitamin concentrations in people with AD and healthy controls. Applying frequentist network meta-analysis techniques, we calculated standardised mean differences (SMDs) in vitamin concentrations between AD and control groups, both directly and indirectly. Our analysis, based on 67 articles, revealed statistically significant findings for various vitamins. Notably, vitamin C displayed the most substantial difference in average concentration between AD and control groups, supported by a high p-score of 0.92. Other vitamins that showed significant differences included vitamin D, folate, vitamin E, vitamin A and vitamin B12. Moreover, by considering alternative reference groups of vitamins, we derived indirect estimates, which further emphasised the role of vitamins in AD pathology. The ranking of vitamins based on their discrepancy in concentration between AD and control groups underscored the importance of vitamin C, followed by vitamin D, vitamin E, folate, vitamin A and vitamin B12. In conclusion, our comprehensive analysis highlights the potential significance of vitamin levels in understanding AD pathology. This underscores avenues for further research and potential therapeutic interventions targeting vitamin deficiencies in people with AD, potentially offering new strategies for managing the disease.

Trial Registration: CRD42023447203

阿尔茨海默病(AD)的进展与神经元的损伤有着复杂的联系,而神经元对神经功能至关重要。尽管进行了广泛的研究,但由于其多方面的病因,阿尔茨海默病发展的确切机制仍然难以捉摸。维生素缺乏已成为阿尔茨海默病发病和发展的重要因素,对大脑功能产生重大影响。为了探索这种联系,我们使用PubMed、Web of Science和MEDLINE数据库进行了一次全面的回顾,以收集有关AD患者和健康对照者平均维生素浓度的文献。应用频率网络元分析技术,我们计算了AD组和对照组之间维生素浓度的标准化平均差异(SMDs),包括直接和间接的差异。我们的分析基于67篇文章,揭示了各种维生素在统计学上的显著发现。值得注意的是,维生素C在AD组和对照组之间的平均浓度差异最大,p值高达0.92。其他显示出显著差异的维生素包括维生素D、叶酸、维生素E、维生素A和维生素B12。此外,通过考虑维生素的替代参考组,我们得出了间接估计,这进一步强调了维生素在AD病理中的作用。根据AD组和对照组之间的维生素浓度差异对维生素进行排名,强调了维生素C的重要性,其次是维生素D、维生素E、叶酸、维生素A和维生素B12。总之,我们的综合分析强调了维生素水平对理解AD病理的潜在意义。这强调了进一步研究和针对AD患者维生素缺乏症的潜在治疗干预的途径,可能为控制该疾病提供新的策略。试验注册:CRD42023447203。
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引用次数: 0
A Positive Relationship Between Caffeine Intake and Endometriosis: A Cross-Sectional Study of the National Health and Nutrition Examination Survey 1999–2006 咖啡因摄入与子宫内膜异位症的正相关:1999-2006年全国健康与营养调查的横断面研究。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-12-30 DOI: 10.1111/jhn.70005
Rongyan Qin, Yuni Yang, Baoli Xie, Yingqing Huang, Yuying Guo, Yanhui Li, Jiaxin Yu, Ming Liao, Aiping Qin

Background

Caffeine has been suggested to have a relationship with endometriosis as a widely consumed psychoactive substance, although findings are inconsistent.

Objective

This study explored the potential associations and threshold effects between caffeine intake and endometriosis using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006.

Methods

The study included 248 women with endometriosis and 2944 without, aged 20–50 years. Caffeine intake was assessed through a 24-h dietary recall, and endometriosis was identified via self-report. Logistic regression models were used to investigate the associations between caffeine intake and endometriosis, adjusting for age, race, body mass index, marital status, education, ever pregnant, smoke, drink, hypertension, hyperlipidemia, diabetes, energy, protein, total fat and dietary fibre. The restricted cubic spline (RCS) regression was employed to examine nonlinear relationships and threshold effects.

Results

This study found a significant correlation between endometriosis and caffeine intake, with both high and low levels associated with the condition (OR 1.65, 95% CI: 1.12, 2.42, p = 0.011 for high; OR 1.60, 95% CI: 1.05, 2.44, p = 0.028 for low). Their relationship is still significant after adjustment for covariates. This suggests a complex dose–response relationship, confirmed by RCS regression, which revealed a U-shaped curve. Endometriosis incidence was lowest at 170.25 mg/day caffeine intake.

Conclusion

The research suggests that an optimal caffeine intake is 170.25 mg/day, with both higher and lower levels associated with endometriosis. We acknowledge that the cross-sectional design limits causal inference and that reliance on self-reported data may introduce bias. Nevertheless, our findings lay the groundwork for future investigations into the dose–response relationship between caffeine intake and endometriosis.

背景:咖啡因作为一种广泛使用的精神活性物质被认为与子宫内膜异位症有关,尽管研究结果并不一致。目的:本研究利用1999年至2006年国家健康与营养调查(NHANES)的横断面数据,探讨咖啡因摄入与子宫内膜异位症之间的潜在关联和阈值效应。方法:研究对象为子宫内膜异位症248例,非子宫内膜异位症2944例,年龄20 ~ 50岁。通过24小时的饮食回顾来评估咖啡因摄入量,通过自我报告来确定子宫内膜异位症。在调整了年龄、种族、体重指数、婚姻状况、教育程度、是否怀孕、吸烟、饮酒、高血压、高脂血症、糖尿病、能量、蛋白质、总脂肪和膳食纤维等因素后,采用Logistic回归模型调查咖啡因摄入与子宫内膜异位症之间的关系。采用限制三次样条(RCS)回归分析非线性关系和阈值效应。结果:本研究发现子宫内膜异位症与咖啡因摄入之间存在显著相关性,高或低水平的咖啡因摄入均与此病相关(OR 1.65, 95% CI: 1.12, 2.42, p = 0.011;OR 1.60, 95% CI: 1.05, 2.44, p = 0.028(低)。在协变量调整后,两者的关系仍然显著。这表明存在复杂的剂量-反应关系,RCS回归显示为u型曲线。子宫内膜异位症的发生率在170.25 mg/天咖啡因摄入量时最低。结论:研究表明,咖啡因的最佳摄入量为170.25毫克/天,高或低的摄入量都与子宫内膜异位症有关。我们承认,横断面设计限制了因果推断,对自我报告数据的依赖可能会引入偏见。然而,我们的发现为进一步研究咖啡因摄入与子宫内膜异位症之间的剂量-反应关系奠定了基础。
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引用次数: 0
Investigating the Links Between Food Addiction, Emotional Dysregulation, Impulsivity and Quality of Life in Brazilian and Canadian College Students: A Network Analysis 研究巴西和加拿大大学生食物成瘾、情绪失调、冲动和生活质量之间的关系:网络分析。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-12-30 DOI: 10.1111/jhn.70006
Rosemeire Aparecida Simone Dejavitte, Carla Cristina Enes, Hyoun S. Kim, Laura Soares da Silva, André Luiz Monezi Andrade

Introduction

Food addiction (FA) has been associated with emotional dysregulation, impulsivity and reduced quality of life, but its interrelationships remain underexplored. This cross-sectional descriptive study aimed to examine these connections using network analysis.

Methods

Data were collected from 1777 university students in Brazil and Canada through an online survey. Participants were classified into three groups based on the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0): No food addiction (NFA), mild food addiction (MFA) and moderate/severe food addiction (MSFA).

Results

The MSFA group reported significantly higher levels of depression, anxiety, stress, impulsivity and emotional dysregulation, as well as lower quality of life compared to the other groups. Network analysis identified stress as the most influential variable in both samples, whereas impulsivity played a key role in connecting FA with emotional problems, particularly, in the MSFA group.

Conclusions

This study addresses this gap by identifying impulsivity as central to the co-occurrence of FA and emotional dysfunction, thereby offering insights for future research and interventions targeting FA.

食物成瘾(FA)与情绪失调、冲动和生活质量下降有关,但其相互关系仍未得到充分探讨。这项横断面描述性研究旨在使用网络分析来检验这些联系。方法:采用在线调查的方法,对巴西和加拿大的1777名大学生进行调查。根据改良的耶鲁食物成瘾量表2.0 (mYFAS 2.0)将参与者分为3组:无食物成瘾(NFA)、轻度食物成瘾(MFA)和中/重度食物成瘾(MSFA)。结果:与其他组相比,MSFA组报告的抑郁、焦虑、压力、冲动和情绪失调水平明显更高,生活质量也较低。网络分析发现,在两个样本中,压力是影响最大的变量,而冲动在将FA与情绪问题联系起来方面发挥了关键作用,尤其是在MSFA组中。结论:本研究通过确定冲动是FA和情绪功能障碍共同发生的核心,从而解决了这一差距,从而为未来针对FA的研究和干预提供了见解。
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引用次数: 0
Legumes as a Substitute for Red and Processed Meat, Poultry or Fish, and the Risk of Non-Alcoholic Fatty Liver Disease in a Large Cohort 豆类作为红肉和加工肉、家禽或鱼的替代品,与非酒精性脂肪性肝病的风险
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-12-30 DOI: 10.1111/jhn.70004
Fie Langmann, Daniel B. Ibsen, Luke W. Johnston, Aurora Perez-Cornago, Christina C. Dahm

Background

Dietary recommendations have globally shifted towards promoting the consumption of legumes as an environmentally friendly and healthy source of protein. This study investigated the replacement of red and processed meat, poultry or fish for equal amounts of legumes on the risk of non-alcoholic fatty liver disease (NAFLD).

Methods

UK Biobank participants who completed ≥ 2 dietary assessments and had complete covariate information were included in the analyses (N = 124,546). Information on dietary intake was collected using two to five 24-h dietary assessments. Incident cases of NAFLD were determined through linkage to the National Health Service registries. The rate of developing NAFLD when replacing 80 g/week of red and processed meat, poultry or fish with legumes was estimated using multivariable-adjusted Cox proportional hazards regression.

Results

During follow-up (median 10.49, IQR: 10.4–10.9 years), 1205 individuals developed NAFLD. Replacing 80 g/week of red and processed meat or poultry with legumes was associated with 4% and 3% lower rates of NAFLD, respectively (red and processed meat HR: 0.96, 95% CI: 0.94; 0.98; poultry HR: 0.97, 95% CI: 0.95; 0.99). Replacing 80 g/week of fish with legumes was not associated with NAFLD (fish HR: 0.98, 95% CI: 0.96; 1.00). Results did not change markedly after adjustment for BMI.

Conclusions

Consuming one serving of legumes weekly instead of red and processed meat or poultry was associated with a slightly lower rate of NAFLD, while consuming legumes instead of fish did not show an association with NAFLD. Further research in cohorts with higher legume consumption is needed to confirm these findings.

背景:全球膳食建议已转向促进食用豆类,将其作为一种环境友好和健康的蛋白质来源。这项研究调查了用红肉和加工肉、家禽或鱼代替等量的豆类对非酒精性脂肪性肝病(NAFLD)风险的影响。方法:将完成≥2次饮食评估并具有完整协变量信息的UK Biobank参与者纳入分析(N = 124,546)。通过2 - 5次24小时饮食评估收集饮食摄入信息。NAFLD的病例是通过与国家卫生服务登记处的联系来确定的。用豆类代替80克/周的红肉和加工肉类、家禽或鱼类时,NAFLD的发生率采用多变量调整Cox比例风险回归进行估计。结果:在随访期间(中位10.49,IQR: 10.4-10.9年),1205人发展为NAFLD。用豆类代替80克/周的红肉和加工肉或家禽,NAFLD发病率分别降低4%和3%(红肉和加工肉HR: 0.96, 95% CI: 0.94;0.98;家禽HR: 0.97, 95% CI: 0.95;0.99)。用豆类代替80 g/周的鱼类与NAFLD无关(鱼类风险比:0.98,95% CI: 0.96;1.00)。调整BMI后,结果无明显变化。结论:每周食用一份豆类而不是红肉和加工肉类或家禽与NAFLD的发病率略低相关,而食用豆类而不是鱼类与NAFLD没有关联。需要在豆类食用量较高的人群中进行进一步的研究来证实这些发现。
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引用次数: 0
The Influence of Caffeine on Tolerance to Sport-Specific High-Intensity Exercise in Young Elite Soccer Players 咖啡因对青少年优秀足球运动员运动特异性高强度运动耐受性的影响。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-12-24 DOI: 10.1111/jhn.70002
Eduard Bezuglov, Timur Vakhidov, Georgiy Malyakin, Elizaveta Kapralova, Anton Emanov, Egana Koroleva, Marina Manina, Svetlana Erdes, Oleg Talibov

Background

Modern elite football places extremely high demands on the athlete's body, so it is of practical interest to study the effect of various dietary supplements on load tolerance and postexercise recovery. Furthermore, there is a lack of research on the effects of caffeine on key measures of load tolerance in football such as delayed-onset muscle soreness (DOMS), rate of perceived exertion (RPE) and heart rate (HR) at different time points after the exercise.

Methods

54 young players aged 15–17 years from a leading Russian football academy took part in a randomised trial using the balanced placebo design. They were divided into 4 groups: 1 – told caffeine/given caffeine, 2 – told caffeine/given placebo, 3 – told placebo/given placebo and 4 – told placebo/given caffeine. All participants consumed two capsules 60 min before testing, each containing 200 mg of caffeine or placebo. Sprinting, counter-movement jump, change of direction run, dribbling, T-test and the repeated sprint ability test were used to create conditions for high-intensity sports-specific load. A visual analogue scale was used to assess the severity of muscle soreness. RPE was assessed using the Borg Rating of Perceived Exertion scale. HR immediately postexercise (HRpe), HR after 2 min of passive rest (HRrest) and recovery HR (HRrec = HRpe − HRrest) were obtained.

Results

The data demonstrated that a single caffeine intake of 400 mg had no statistically significant effect on RPE (p = 0.948), HRpe (p = 0.698) or HRrec (p = 0.920) across the groups. Additionally, the severity of DOMS 24 h postexercise did not differ significantly between the groups (p = 0.077).

Conclusion

Acute caffeine ingestion does not affect the subjective and objective indicators of training load in young football players aged 15–17 years with low levels of anxiety and low levels of daily caffeine intake.

背景:现代精英足球对运动员身体的要求极高,因此研究各种膳食补充剂对负荷耐受性和运动后恢复的影响具有现实意义。此外,关于咖啡因对足球运动中延迟性肌肉酸痛(DOMS)、运动后不同时间点的感知运动率(RPE)和心率(HR)等关键负荷耐受性指标的影响,目前还缺乏研究。方法:54名年龄在15-17岁的俄罗斯足球学院的年轻球员参加了一项随机试验,使用平衡安慰剂设计。他们被分成4组:1组服用咖啡因/服用咖啡因,2组服用咖啡因/服用安慰剂,3组服用安慰剂/服用安慰剂,4组服用安慰剂/服用咖啡因。所有参与者在测试前60分钟服用了两粒胶囊,每粒含有200毫克咖啡因或安慰剂。采用冲刺、反动作跳跃、变向跑、运球、t检验和重复冲刺能力检验,为高强度运动专项负荷创造条件。采用视觉模拟量表评估肌肉酸痛的严重程度。RPE采用Borg感知运动量表进行评估。获得运动后立即HR (HRpe)、被动休息2 min后HR (HRrest)和恢复HR (HRrec = HRpe - HRrest)。结果:数据显示,单次摄入400 mg咖啡因对两组RPE (p = 0.948)、HRpe (p = 0.698)和HRrec (p = 0.920)均无统计学意义。此外,运动后24小时DOMS的严重程度在两组之间没有显著差异(p = 0.077)。结论:15-17岁低焦虑水平、低咖啡因日摄入量的青少年足球运动员急性咖啡因摄入不影响训练负荷的主客观指标。
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引用次数: 0
Life Challenges and Quality of Life of People Living With Coeliac Disease: Time of Diagnosis Matters 乳糜泻患者的生活挑战和生活质量:诊断时间问题
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-12-24 DOI: 10.1111/jhn.13413
Nanette Stroebele-Benschop, Christine J. Rau, Anastasia Dieze, Andreas Bschaden

Background

Previous studies have examined the quality of life of patients with coeliac disease. There is a lack of understanding about potential changes in emotional responses and life challenges after diagnosis. This exploratory study aimed to evaluate the emotional impact, life challenges and quality of life in people living with coeliac disease in Germany.

Methods

An online survey was conducted among patients with coeliac disease to assess difficulties in implementing a gluten-free diet in daily life activities, including food shopping and preparation, and eating away from home, as well as additional costs of time and money. Furthermore, the questionnaire assessed the time of diagnosis, emotions felt after diagnosis and today, compliance regarding the gluten-free diet and sociodemographic data. Participants were recruited in 2022 via social media, newsletters and websites. Out of 1286 participants who had taken part in the survey, 766 met the inclusion criteria and were included in the data analysis.

Results

The majority of the respondents (aged 18–83 years) were female (93%) and almost 50% were diagnosed more than 5 years ago. Negative emotion ratings related to the disease were associated with age at the time of diagnosis and years passed since diagnosis. While compliance was high with 89% of respondents strictly adhering to the gluten-free diet, patients with coeliac disease reported mainly life challenges in social situations involving food such as out-of-home consumption in restaurants, at work and while travelling. These challenges appear to persist over time.

Conclusions

Negative emotions and difficulties in implementing a gluten-free diet are negatively impacting individuals with coeliac disease, particularly in the first months after diagnosis. Particularly adolescents and young adults appear to be negatively impacted. The study emphasises the need to improve the quality of life in all impacted areas through better guidance and improved training of health professionals as well as food providers outside of home and through psychological counselling in the first year of diagnosis to better help individuals improve their quality of life.

背景:以前的研究已经检查了乳糜泻患者的生活质量。人们对诊断后情绪反应和生活挑战的潜在变化缺乏了解。本探索性研究旨在评估德国乳糜泻患者的情绪影响、生活挑战和生活质量。方法:在乳糜泻患者中进行一项在线调查,以评估在日常生活活动中实施无麸质饮食的困难,包括食品采购和准备,离家吃饭,以及额外的时间和金钱成本。此外,问卷还评估了诊断时间、诊断后和今天的情绪、对无麸质饮食的依从性和社会人口数据。参与者是在2022年通过社交媒体、时事通讯和网站招募的。在参与调查的1286名参与者中,有766人符合纳入标准,并被纳入数据分析。结果:大多数受访者(18-83岁)为女性(93%),近50%的人在5年前确诊。与疾病相关的负面情绪评分与诊断时的年龄和诊断后的年数有关。虽然依从性很高,89%的受访者严格遵守无麸质饮食,但乳糜泻患者报告的主要生活挑战是在涉及食物的社交场合,如在餐馆、工作场所和旅行时的户外消费。这些挑战似乎会持续一段时间。结论:负面情绪和实施无麸质饮食的困难对乳糜泻患者产生负面影响,特别是在诊断后的头几个月。尤其是青少年和年轻人似乎受到了负面影响。该研究强调,需要通过更好的指导和改进对保健专业人员以及家庭以外的食品提供者的培训,以及通过在诊断的第一年提供心理咨询,更好地帮助个人提高生活质量,从而改善所有受影响地区的生活质量。
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引用次数: 0
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