Clinical nutrition research最新文献

Hemodialysis (HD) patients face a common problem of malnutrition due to poor appetite. This study aims to verify the appetite alteration model for malnutrition in HD patients through quantitative data and the International Classification of Functioning, Disability, and Health (ICF) framework. This study uses the Mixed Method-Grounded Theory (MM-GT) method to explore various factors and processes affecting malnutrition in HD patients, create a suitable treatment model, and validate it systematically by combining qualitative and quantitative data and procedures. The demographics and medical histories of 14 patients were collected. Based on the theory, the research design is based on expansion and confirmation sequence. The usefulness and cut-off points of the creatinine index (CI) guidelines for malnutrition in HD patients were linked to significant categories of GT and the domain of ICF. The retrospective CIs for 3 months revealed patients with 3 different levels of appetite status at nutrition assessment and 2 levels of uremic removal. In the same way, different levels of dry mouth, functional support, self-efficacy, and self-management were analyzed. Poor appetite, degree of dryness, and degree of taste change negatively affected CI, while self-management, uremic removal, functional support, and self-efficacy positively affected CI. This study identified and validated the essential components of appetite alteration in HD patients. These MM-GT methods can guide the selection of outcome measurements and facilitate the perspective of a holistic approach to self-management and intervention.

The present study sought to examine the association between an infant's anthropometric outcomes with maternal Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index for Pregnancy (AHEI-P) scores during the third trimester of pregnancy. This prospective cohort study was applying 130 pregnant women, at the pregnancy training center in west Tehran, Iran (November 2020 to July 2021). The maternal dietary intake, and body mass index (BMI), and social economic level were evaluated. The data about birth weight, birth height, head circumference, and, gestational age at birth were extracted from each child's health records. The ultimate sample included 122 (93.8%) pairs of women/newborn children. The participants, mean age was 28.13 ± 4.66 years with gestational age between 28 to 40 weeks and the mean of BMI was 24.62 ± 3.51. Our outcomes, after adjustment for confounding factors, suggested that those newborn infants in the highest quartile of maternal DII score had a significantly lower weight (p < 0.001) and height (p = 0.05), in comparison to those in the lowest quartile, but not head circumference (p = 0.18). Moreover, after adjustment for confounding factors, results suggested that those newborn infants in the First quartile of maternal AHEI-P score had a significantly lower weight (p = 0.018) and, in comparison to those in the higher quartile. It appears that newborn infants with lower maternal DII and higher AHEI-P scores may have a better anthropometric outcome. Further longitudinal and in-depth qualitative and quantitative studies, with a longer-term follow-up, is warranted to support the integrity of our outcomes.

The prevalence of metabolic syndrome (MetS) and its cost are increasing due to lifestyle changes and aging. This study aimed to develop a deep neural network model for prediction and classification of MetS according to nutrient intake and other MetS-related factors. This study included 17,848 individuals aged 40-69 years from the Korea National Health and Nutrition Examination Survey (2013-2018). We set MetS (3-5 risk factors present) as the dependent variable and 52 MetS-related factors and nutrient intake variables as independent variables in a regression analysis. The analysis compared and analyzed model accuracy, precision and recall by conventional logistic regression, machine learning-based logistic regression and deep learning. The accuracy of train data was 81.2089, and the accuracy of test data was 81.1485 in a MetS classification and prediction model developed in this study. These accuracies were higher than those obtained by conventional logistic regression or machine learning-based logistic regression. Precision, recall, and F1-score also showed the high accuracy in the deep learning model. Blood alanine aminotransferase (β = 12.2035) level showed the highest regression coefficient followed by blood aspartate aminotransferase (β = 11.771) level, waist circumference (β = 10.8555), body mass index (β = 10.3842), and blood glycated hemoglobin (β = 10.1802) level. Fats (cholesterol [β = -2.0545] and saturated fatty acid [β = -2.0483]) showed high regression coefficients among nutrient intakes. The deep learning model for classification and prediction on MetS showed a higher accuracy than conventional logistic regression or machine learning-based logistic regression.

Adequate nutritional support is crucial in preventing complications and improving outcomes in critically ill patients. Extracorporeal membrane oxygenation (ECMO) is a mode of supportive care for patients with respiratory and/or cardiac failure. ECMO patients frequently exhibit a hypermetabolic state characterized by protein catabolism and insulin resistance, which can lead to malnutrition. Nutritional therapy is a vital component of intensive care, but its optimal administration for ECMO patients is unknown. This case report aims to provide insights into effective nutritional management for critically ill patients undergoing ECMO therapy. The patient was a 72-year-old male with a history of gastric and lung cancer who underwent a lobectomy complicated by bronchopleural fistula, postoperative bleeding, pneumonia, and acute respiratory distress syndrome (ARDS). The patient's nutritional status was assessed indicating a high risk of malnutrition, using the modified Nutrition Risk in the Critically Ill (mNUTRIC) Score. Nutritional support was administered based on the recommendations of European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN), with energy requirements set at 25-30 kcal/kg/d and protein requirements set at 1.2-2.0 g/kg/day. The patient received parenteral nutrition until the enteral nutrition target amount was reached, with zinc supplements for wound healing. The study highlights the need for further research on proactive and effective nutritional support for ECMO patients to improve compliance and prognosis.

Hepatic encephalopathy (HE) associated with liver failure is accompanied by hyperammonemia, severe inflammation, depression, anxiety, and memory deficits as well as liver injury. Recent studies have focused on the liver-brain-inflammation axis to identify a therapeutic solution for patients with HE. Lipocalin-2 is an inflammation-related glycoprotein that is secreted by various organs and is involved in cellular mechanisms including iron homeostasis, glucose metabolism, cell death, neurite outgrowth, and neurogenesis. In this study, we investigated that the roles of lipocalin-2 both in the brain cortex of mice with HE and in Neuro-2a (N2A) cells. We detected elevated levels of lipocalin-2 both in the plasma and liver in a bile duct ligation mouse model of HE. We confirmed changes in cytokine expression, such as interleukin-1β, cyclooxygenase 2 expression, and iron metabolism related to gene expression through AKT-mediated signaling both in the brain cortex of mice with HE and N2A cells. Our data showed negative effects of hepatic lipocalin-2 on cell survival, iron homeostasis, and neurite outgrowth in N2A cells. Thus, we suggest that regulation of lipocalin-2 in the brain in HE may be a critical therapeutic approach to alleviate neuropathological problems focused on the liver-brain axis.

This study aimed to find out the effect of vitamins on respiratory-related viral infections, including coronavirus disease 2019 (COVID-19), through the literature reviews. From January 2000 to June 2021, the studies (cohort studies, cross-sectional studies, case-control studies, randomized control trials) related to vitamins (vitamin A, D, E, C, B₆, folate, and B₁₂) and COVID-19/severe acute respiratory syndrome/Middle East respiratory syndrome/cold/influenza were selected from the PubMed, Embase, and Cochrane libraries and analyzed. The relationship between vitamins and virus-related respiratory diseases was identified. Through the review, 39 studies were selected on vitamin D, one study on vitamin E, 11 studies on vitamin C, and 3 studies on folate. Regarding COVID-19, 18 studies on vitamin D, 4 studies on vitamin C, and 2 studies on folate showed significant effects of the intake of these nutrients in preventing COVID-19. Regarding colds and influenza, 3 studies on vitamin D, 1 study on vitamin E, 3 studies on vitamin C, and 1 study on folate demonstrated that the intake of these nutrients significantly prevents these diseases. Therefore, this review suggested the intake of vitamins D, E, C, and folate is important for preventing respiratory diseases related to viruses, such as COVID-19, colds, and influenza. The relationship between these nutrients and virus-related respiratory diseases should be continuously monitored in the future.

Gastrectomy is the most effective method of treating gastric cancer, but it is commonly associated with weight loss, nutritional deficiencies, and the increased risk of malnutrition due to post-surgery complications, including gastric stasis, dumping syndrome, malabsorption, and maldigestion. Malnutrition is a risk factor for postoperative complications and poor prognosis. To prevent it and guarantee a quick recovery after surgery, continuous and individualized nutrition intervention should be performed both before surgery and postoperatively. The Department of Dietetics at Samsung Medical Center (SMC) performed nutritional status assessment before gastrectomy, initial nutritional assessment within 24 hours of admission, description of therapeutic diet after surgery, nutrition counselling before discharge, and nutritional status assessment and individual nutrition counselling after 1, 3, 6, and 12 months from surgery. This is a case report of a patient who underwent gastrectomy as well as intensive nutrition intervention in SMC.

A systematic review and meta-analysis were designed to summarize studies conducted on the effects of raspberry and blackcurrant consumption on blood pressure (BP). Eligible studies were detected by searching numerous five online databases including PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar, until December 17, 2022. We pooled the mean difference and its 95% confidence interval (CI) by applying a random-effects model. Overall, the impact of raspberry and blackcurrant on BP was reported in ten randomized controlled trials (RCTs) (420 subjects). Pooled analysis of six clinical trials revealed that raspberry consumption has no significant reduction in systolic blood pressure (SBP) (weighted mean differences [WMDs], -1.42; 95% CI, -3.27 to 0.87; p = 0.224) and diastolic blood pressure (DBP) (WMD, -0.53; 95% CI, -1.77 to 0.71; p = 0.401), in comparison with placebo. Moreover, pooled analysis of four clinical trials indicated that blackcurrant consumption did not reduce SBP (WMD, -1.46; 95% CI, -6.62 to 3.7; p = 0.579), and DBP (WMD, -2.09; 95% CI, -4.38 to 0.20; p = 0.07). Raspberry and blackcurrant consumption elicited no significant reductions in BP. More accurate RCTs are required to clarify the impact of raspberry and blackcurrant intake on BP.

Creating a complex balance between dietary composition, circadian rhythm, and the hemostasis control of energy is important for managing diseases. Therefore, we aimed to determine the interaction between cryptochrome circadian clocks 1 polymorphism and energy-adjusted dietary inflammatory index (E-DII) on high-sensitivity C-reactive protein in women with central obesity. This cross-sectional study recruited 220 Iranian women aged 18-45 with central obesity. The 147-item semi-quantitative food frequency questionnaire was used to assess the dietary intakes, and the E-DII score was calculated. Anthropometric and biochemical measurements were determined. By polymerase chain response-restricted length polymorphism method, cryptochrome circadian clocks 1 polymorphism was assigned. Participants were categorized into three groups based on the E-DII score, then categorized according to cryptochrome circadian clocks 1 genotypes. The mean and standard deviation of age, BMI, and high-sensitivity C-reactive protein (hs-CRP) were 35.61 ± 9.57 years, 30.97 ± 4.16 kg/m², and 4.82 ± 5.16 mg/dL, respectively. The interaction of the CG genotype and E-DII score had a significant association with higher hs-CRP level compared to GG genotype as the reference group (β, 1.19; 95% CI, 0.11-2.27; p value, 0.03). There was a marginally significant association between the interaction of the CC genotype and the E-DII score with higher hs-CRP level compared to the GG genotype as the reference group (β, 0.85; 95% CI, -0.15 to 1.86; p value, 0.05). There is probably positive interaction between CG, CC genotypes of cryptochrome circadian clocks 1, and E-DII score on the high-sensitivity C-reactive protein level in women with central obesity.

Previous studies have frequently reviewed how different macronutrients affect liver health. Still, no study centered around protein intake and the non-alcoholic fatty liver disease (NAFLD) risk relationship. This study aimed to examine the association between the consumption of total and different sources of protein and NAFLD risk. We allocated 243 eligible subjects to the case and control groups, including 121 incidence cases of NAFLD, and 122 healthy controls. Two groups were matched in age, body mass index, and sex. We evaluated the usual food intake of participants using FFQ. Binary logistic regression was conducted to estimate the risk of NAFLD in relation to different sources of protein intake. The age of participants was 42.7 years on average, and 53.1% were male. We found Higher intake of protein in total (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.11-0.52) was significantly associated with a lower risk of NAFLD, despite adjusting for multiple confounders. in detail, higher tendency to the vegetables (OR, 0.28; 95% CI, 0.13-0.59), grains (OR, 0.24; 95% CI, 0.11-0.52), and nuts (OR, 0.25; 95% CI, 0.12-0.52) as the main sources of protein, were remarkably correlated with lower NAFLD risk. In contrary, increased intake of meat protein (OR, 3.15; 95% CI, 1.46-6.81) was positively associated with a higher risk. Totally, more calorie intake from proteins was inversely associated with lower NAFLD risk. This was more likely when the protein sources were selected less from meats and more from plants. Accordingly, increasing the consumption of proteins, particularly from plants, may be a good recommendation to manage and prevent NAFLD.