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Dietary Intake Trajectories from Early Life and Associated Health Outcomes: A Systematic Review 从生命早期开始的饮食摄入轨迹和相关的健康结果:一项系统综述
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-29 DOI: 10.1016/j.advnut.2025.100528
Miaobing Zheng , Seon Y Park , Kristy A Bolton , Mary Foong-Fong Chong , Sara Grafenauer , Bo Xi
The vital role of early dietary intake in shaping later health has been widely acknowledged, but how changes in dietary intake from early life influence health outcomes remains unclear. This review systematically synthesized the literature that examined the longitudinal associations between changes in dietary intake (i.e., trajectories) from early life and health outcomes. Electronic searches were conducted in PubMed, Embase, and ScienceDirect to gather longitudinal cohort studies that investigated dietary intake trajectories from infancy, childhood, or adolescence (with first dietary assessment before age 18 y) and any health outcomes published from inception to September 2024 (CRD42024512716). Of 16 included studies, 14 reported significant associations between dietary intake trajectories (intakes of macronutrients, food groups, diet quality or dietary patterns) in childhood or from childhood to adolescence/early adulthood and dental, obesity, cardiometabolic, neurocognitive, liver or gut health outcomes from age 2 y up to age 41 y. Most studies were of high (n = 2) or acceptable (n = 12) quality. A high or increasing sugar intake trajectory during infancy was linked to an increased risk of dental caries in early childhood, whereas a healthy dietary pattern trajectory was associated with lower risk. Trajectories of poor diet quality, red meat dietary pattern, and high discretionary food intake from infancy/early childhood were associated with adiposity and adverse cardiometabolic outcomes at adolescence and adulthood. Significant associations were also found between trajectories of dietary patterns or macronutrient intakes (e.g., protein, carbohydrate, and dietary fiber) from infancy and neurocognitive outcomes in childhood. High energy intake trajectory from early childhood to adolescence and carbohydrate intake from infancy to early adulthood were associated with poor liver health outcomes and gut microbiota composition in adulthood, respectively. Dietary intake trajectories established from infancy or early childhood were associated with various health outcomes. Dietary interventions should be initiated from infancy or early childhood for early health promotion.
早期饮食摄入对塑造后期健康的重要作用已得到广泛认可,但早期饮食摄入的变化如何影响健康结果仍不清楚。本综述系统地综合了研究早期饮食摄入变化(即轨迹)与健康结果之间纵向关联的文献。在PubMed、Embase和ScienceDirect中进行电子检索,收集调查婴儿期、儿童期或青春期(18岁前首次饮食评估)饮食摄入轨迹的纵向队列研究,以及从开始到2024年9月发表的任何健康结果(CRD42024512716)。在16项纳入的研究中,14项报告了儿童时期或从童年到青春期/成年早期的饮食摄入轨迹(大量营养素的摄入量、食物组、饮食质量或饮食模式)与2岁至41岁的牙齿、肥胖、心脏代谢、神经认知、肝脏或肠道健康结果之间的显著关联。大多数研究质量高(n=2)或可接受(n=12)。婴儿时期高糖或增加糖摄入量的轨迹与儿童早期患龋齿的风险增加有关,而健康的饮食模式轨迹与患龋齿的风险降低有关。不良的饮食质量、红肉饮食模式、婴儿期/幼儿期随意食物摄入量高的轨迹与青春期和成年期的肥胖和不良的心脏代谢结果有关。研究还发现,婴儿期饮食模式或常量营养素(如蛋白质、碳水化合物、膳食纤维)摄入轨迹与儿童期神经认知结果之间存在显著关联。从儿童早期到青春期的高能量摄入轨迹和从婴儿期到成年早期的碳水化合物摄入轨迹分别与成年后肝脏健康状况和肠道微生物群组成不良相关。从婴儿期或幼儿期建立的饮食摄入轨迹与各种健康结果有关。饮食干预应从婴儿期或幼儿期开始,以促进早期健康。
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引用次数: 0
Probiotics and Synbiotics Supplementation Reduce Inflammatory Cytokines in Individuals with Prediabetes and Type 2 Diabetes Mellitus: Findings from a Systematic Review Meta-analysis 补充益生菌和合成制剂可降低糖尿病前期和2型糖尿病患者的炎症细胞因子:一项系统综述荟萃分析的结果
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-27 DOI: 10.1016/j.advnut.2025.100526
Azin Setayesh , Mehdi Karimi , Fereshteh Valizadeh , Omid Asbaghi , Samira Pirzad , Sayed Hossein Davoodi , Bagher Larijani
Chronic inflammation plays a significant role in the development and progression of diabetes. Despite growing interest in probiotic and synbiotic supplementation, there is limited consensus on their efficacy in modulating inflammatory cytokines. This meta-analysis evaluates the impact of these supplements on inflammatory cytokines in adults with prediabetes and type 2 diabetes mellitus (T2DM). A comprehensive search was conducted on online databases from their inception to September 2025 to identify relevant randomized controlled trials (RCTs). Data were extracted from selected studies, and the overall effect size was determined using weighted mean differences (WMD) with 95% confidence intervals (CIs) through a random-effects model. The pooled analysis of 22 RCTs, including 1321 individuals with prediabetes and T2DM, showed that probiotic and synbiotic supplementation significantly reduced C-reactive protein (CRP) (WMD: −0.46 mg/L, 95% CI: [−0.77, −0.15], p=0.003), interleukin-6 (IL-6) (WMD: −0.43 pg/ml, 95% CI: [−0.76, −0.09], p=0.012), and tumor necrosis factor-alpha (TNF-α) (WMD: −1.42 pg/ml, 95% CI: [−2.15, −0.69], p<0.001). Subgroup analyses revealed that CRP reduction was greatest among participants with baseline CRP ≥3 mg/L, those undergoing longer interventions (≥12 weeks), individuals with T2DM, overweight participants, and when probiotics were administered. IL-6 levels were significantly reduced in obese individuals, particularly with longer treatment durations and synbiotic interventions, while TNF-α reductions were most pronounced in long-term interventions (≥12 weeks), especially among T2DM patients with normal BMI and when probiotics were used. In conclusion, probiotic and synbiotic supplementation significantly reduces inflammatory cytokines (CRP, IL-6, TNF-α) in individuals with prediabetes and T2DM, with the strongest effects observed in those with higher baseline inflammation and longer intervention durations, underscoring the importance of tailoring supplementation strategies to individual inflammation status, intervention duration, and metabolic profile to optimize therapeutic outcomes.
背景:慢性炎症在糖尿病的发生发展中起着重要作用。尽管人们对益生菌和合成菌的补充越来越感兴趣,但对它们调节炎症细胞因子的功效的共识有限。本荟萃分析评估了这些补充剂对糖尿病前期和2型糖尿病(T2DM)成人炎症细胞因子的影响。方法:全面检索在线数据库自成立至2025年9月的相关随机对照试验(RCTs)。数据是从选定的研究中提取的。通过随机效应模型,采用加权平均差(WMD)和95%置信区间(ci)确定总体效应大小。结果:对1321例糖尿病前期和T2DM患者的22项随机对照试验进行汇总分析,结果显示,益生菌和合成益生菌可显著降低c -反应蛋白(CRP) (WMD: -0.46 mg/L, 95%CL: [-0.77, -0.15], p=0.003)、白细胞介素-6 (IL-6) (WMD: -0.43 pg/ml, 95%CI: [-0.76, -0.09], p=0.012)和肿瘤坏死因子-α (TNF-α) (WMD: -1.42 pg/ml, 95%CI: [-2.15, -0.69]), p。益生菌和合成菌补充剂可显著降低糖尿病前期和T2DM患者的炎症因子(CRP、IL-6、TNF-α),在基线炎症水平较高、干预时间较长的人群中效果最强。这些发现强调了根据个体炎症状态、干预持续时间和代谢特征定制补充策略以优化治疗结果的重要性。
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引用次数: 0
A Comprehensive Review of Nutritional Influences on the Serotonergic System 营养对血清素能系统影响的综合综述。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-23 DOI: 10.1016/j.advnut.2025.100524
Justin Tang , Luke Krushelnycky , Abir Shaqo , Clara E Cho
Serotonin (5-hydroxytryptamine) is a critical monoamine neurotransmitter and hormone that orchestrates a vast array of physiological and psychological processes, including mood, sleep, appetite, and gastrointestinal motility. Serotonin synthesis is dependent on the availability of its dietary precursor, the essential amino acid tryptophan, and it affects biochemical pathways that may be modulated by other nutrients. We conducted a literature search to comprehensively examine the nutritional influences on the serotonergic system. Relevant original research, systematic reviews, meta-analyses, and clinical trial reports were retrieved from PubMed, Scopus, and Google Scholar, with additional articles identified from reference lists of published review papers. Key nutritional determinants of serotonergic function include macronutrients that influence the tryptophan-to-large neutral amino acid ratio (a regulator of tryptophan availability in the brain) and micronutrients, such as B-vitamins, vitamin D, iron, and magnesium, that serve as essential cofactors in serotonin synthesis and metabolism. Emerging evidence also highlights the role of the gut microbiota, shaped by dietary components, prebiotics, and probiotics, in modulating serotonergic function across both central and peripheral systems. Nutritional factors that affect serotonin have been increasingly linked to conditions such as depression, anxiety, sleep disturbances, disordered eating, obesity, and irritable bowel syndrome. Altogether, this review emphasizes the profound impact of nutrition on serotonergic regulation and advocates for targeted dietary approaches as promising catalysts for optimizing human health. Key research gaps and future directions are outlined to help advance the translation of current evidence into precise nutritional guidelines and clinical applications, with the complexity of serotonin pathways as an important consideration.
5-羟色胺(5-羟色胺)是一种重要的单胺神经递质和激素,它协调了大量的生理和心理过程,包括情绪、睡眠、食欲和胃肠运动。它的合成取决于其膳食前体——必需氨基酸色氨酸(Trp)的可用性,其对生化途径的影响可能由其他营养物质调节。我们进行了文献综述,以全面研究营养对血清素能系统的影响。相关的原始研究、系统综述、荟萃分析和临床试验报告从PubMed、Scopus和谷歌Scholar中检索,其他文章从已发表的综述论文的参考列表中确定。5 -羟色胺能功能的关键营养决定因素包括影响色氨酸与大中性氨基酸(Trp/LNAA)比率的宏量营养素(Trp/LNAA是脑色氨酸可用性的调节剂)和微量营养素,如b族维生素、维生素D、铁和镁,它们是5 -羟色胺合成和代谢的必要辅助因子。新出现的证据还强调了肠道微生物群(由饮食成分、益生元和益生菌形成)在调节中枢和外周系统的血清素能功能中的作用。影响血清素的营养因素与抑郁、焦虑、睡眠障碍、饮食失调、肥胖和肠易激综合症等疾病的联系越来越紧密。总之,这篇综述强调了营养对血清素能调节的深远影响,并倡导有针对性的饮食方法作为优化人类健康的有希望的催化剂。关键的研究差距和未来的方向概述,以帮助推进当前的证据转化为精确的营养指南和临床应用,与复合胺途径的复杂性作为一个重要的考虑。重要意义:血清素影响身体的许多生理过程,但营养对血清素相关结果调节的影响尚未整合。本综述综合了大量营养素和微量营养素对血清素通路的影响,连接中枢和外周机制,包括肠-脑相互作用的新证据,提出了营养靶点和各种血清素相关疾病(包括精神、代谢和胃肠道结果)的转化潜力的新视角。
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引用次数: 0
Nutritional Factors and Arrhythmic Risk in Long QT Syndrome: A Narrative Review of Mechanistic and Clinical Evidence 营养因素与长QT综合征的心律失常风险:机制和临床证据的叙述性回顾。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-22 DOI: 10.1016/j.advnut.2025.100525
Andrea Mazzanti , Matteo Floriano , Deni Kukavica , Alessandro Trancuccio , Silvia G Priori
Long QT syndrome (LQTS) is an umbrella term for a group of genetic cardiac channelopathies characterized by prolonged ventricular repolarization and increased risk of life-threatening arrhythmias. Although β-blockers and lifestyle modifications remain central to management, specific dietary components may influence repolarization and arrhythmic risk, particularly in genetically predisposed individuals. This review summarizes mechanistic and clinical evidence on the electrophysiological effects of selected nutrients, food constituents, and supplements—including grapefruit juice, licorice, over-the-counter products, and energy drinks. Gene–nutrient interactions and their impact on ion channel function, drug metabolism, and electrolyte balance are discussed. The second part of the review outlines genotype-specific considerations, such as potassium supplementation and dietary guidance for rare forms of LQTS, including Andersen-Tawil and Timothy syndromes. Clinical data are presented in tabular format to facilitate interpretation. By integrating mechanistic and clinical data, the review aims to support dietary counseling and inform clinical decision making in the management of LQTS.
长QT综合征(LQTS)是一组遗传性心脏通道病变的总称,其特征是心室复极延长和危及生命的心律失常风险增加。虽然-受体阻滞剂和生活方式的改变仍然是治疗的核心,但特定的饮食成分可能会影响复极和心律失常风险,特别是在遗传易感个体中。这篇综述总结了选定的营养素、食品成分和补充剂(包括葡萄柚汁、甘草、非处方产品和能量饮料)的电生理作用的机理和临床证据。讨论了基因-营养相互作用及其对离子通道功能、药物代谢和电解质平衡的影响。第二部分概述了基因型特异性考虑因素,如钾补充和罕见LQTS的饮食指导,包括Andersen-Tawil综合征和Timothy综合征。临床数据以表格形式呈现,以方便解释。通过整合机制和临床数据,本综述旨在为LQTS管理的饮食咨询和临床决策提供支持。
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引用次数: 0
A Systematic Review on the Influence of Feeding Expressed Mother’s Own Milk Using Varying Expression Practices or Treatments on Health and Growth of Recipient Infants 采用不同表达方式或处理方式喂养母乳对受体婴儿健康和生长影响的系统综述。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-19 DOI: 10.1016/j.advnut.2025.100523
Serena Gandino , Tanya Cassidy , Marzia Giribaldi , Magdalena Babiszewska-Aksami , Agnieszka Bzikowska-Jura , Laura Cavallarin , Karolina Karcz , Daniel Klotz , Chiara Peila , Carolyn Smith , Bartłomiej Walczak , Aleksandra Wesolowska
When feeding at the breast is not possible, infants can still receive expressed mother’s own milk (MOM). Method of expression, hygiene practices and settings during expression, and processing can affect MOM composition. This study aimed to review current evidence on the influence of feeding MOM expressed using varying expression methods, hygiene practices or settings during expression, or treatments on the health and growth of recipient infants. We systematically searched CENTRAL, CINAHL, clinicaltrials.gov, Embase, Emcare, EU trials, Global Health, Global Index Medicus, MEDLINE, Scopus, Web of Science, and WHO for primary research studies, including observational studies, published up to March 2024 evaluating different methods of MOM expression, hygiene practices or settings during expression, and methods processing of MOM and reporting clinical outcomes on recipient infants. Key outcomes of interest were growth, mortality, morbidity, feeding tolerance, adverse events, cytomegalovirus (CMV) infection, retroviral infection, other infections, nutrient deficiencies, neurodevelopment, and breastfeeding. Qualitative thematic synthesis was conducted. An evidence gap map was produced using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Of 29,320 studies screened, 45 met the inclusion criteria. No expression method or pump type showed clear benefits for breastfeeding rates or infant growth. Three studies reported improved weight gain in infants receiving hindmilk. Evidence on the effect of processing methods on morbidity and mortality was inconclusive. Limited evidence was found on the efficacy of the freeze-thaw cycle in reducing CMV transmission, whereas pasteurization proved more effective. No studies assessed clinical outcomes related to hygiene practices or expression settings. The use of hindmilk improves infant weight gain with some certainty of evidence. Hand expression of MOM has similar efficacy to that of electric pumping on the growth of recipient infants, including preterm infants. Evidence on clinical outcomes of different MOM expression practices and treatments is very limited. This work underscores the need for future studies to address the substantial evidence gaps identified.
This study was registered at PROSPERO as CRD42024523299.
背景:当不能母乳喂养时,婴儿仍然可以接受母乳(MOM)。表达方法、表达过程中的卫生习惯和设置以及加工都会影响MOM的组成。目的:回顾目前关于不同表达方法、不同表达过程中的卫生习惯或环境、或不同治疗对受体婴儿健康和生长的影响的证据。方法:我们系统地检索了CENTRAL、CINAHL、ClinicalTrials.gov、Embase、Emcare、EU trials、Global Health、Global Index Medicus、MEDLINE、Scopus、Web of Science、WHO,检索了截至2024年3月发表的主要研究,包括观察性研究,评估了不同的MOM表达方法、表达过程中的卫生实践或设置、MOM处理和报告受体婴儿的临床结果。主要结局为生长、死亡率、发病率、喂养耐受性、不良事件、巨细胞病毒感染、逆转录病毒感染、其他感染、营养缺乏、神经发育、母乳喂养。进行了定性的专题综合。使用GRADE评估生成证据缺口图。结果:在筛选的29,320项研究中,有45项符合纳入标准。没有表达方法或泵类型显示出明显的母乳喂养率或婴儿生长的好处。三项研究报告说,接受母乳的婴儿体重增加有所改善。关于加工方法对发病率和死亡率影响的证据尚无定论。有限的证据表明冻融在减少巨细胞病毒传播方面的有效性,而巴氏杀菌被证明更有效。没有研究评估与卫生习惯或表达设置相关的临床结果。结论:使用后乳可改善婴儿体重增加,有一定的证据。手表达MOM对受体婴儿生长的影响与电抽吸相似,对早产儿母亲也是如此。关于不同MOM表达方法和治疗的临床结果的证据非常有限。这项工作强调了未来研究解决已确定的实质性证据差距的必要性。系统评价或荟萃分析的注册和注册号:该研究在PROSPERO上注册(CRD42024523299)。意义说明:以前的综述主要集中在对母乳的处理方法的影响,如表达方法,表达过程中的卫生习惯/设置,以及储存和加工处理对母乳成分的影响;然而,成分的变化并不一定对应于临床结果的变化。据我们所知,这是唯一一项评估这些做法对受体婴儿大量临床相关结果(生长、主要发病率、喂养耐受性、不良事件、病毒和逆转录病毒感染、其他感染、营养缺乏、神经发育和母乳喂养)影响的系统综述。在这种背景下,目前的工作对于确定知识差距(包括现有证据的方法局限性)和指导未来的研究非常重要。
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引用次数: 0
Food Acquisition, Preparation, and Consumption Practices in South Asia: A Scoping Review of Assessment Tools 南亚的食品获取、准备和消费实践:评估工具的范围审查。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-18 DOI: 10.1016/j.advnut.2025.100518
Sharvari Patwardhan , Morgan Boncyk , Rasmi Avula , Christine E Blake , Fahmida Akter , Jai K Das , Renuka Silva , Purnima Menon , Samuel Scott
Assessing behaviors related to food choice at individual and household levels is essential for improving household diets, but assessment tools are limited. We conducted a scoping review to identify gaps in existing assessment tools for food acquisition, preparation, and household consumption practices in South Asia, where diets are rapidly changing. We undertook systematic keyword searches of 3 databases (PubMed, Scopus, and Web of Science Core Collection) to identify studies assessing food acquisition, food preparation, and household consumption practices in Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka, published in English between 2000 and April 2025. Two reviewers independently screened titles, abstracts, and full texts and extracted data on study characteristics and the assessment tools used to examine the food choice behaviors. Of 13,160 unique articles identified, 50 were included for synthesis. Food acquisition behaviors (e.g., what and how often food is purchased, changes in food purchases) were assessed by 26 studies, food preparation (e.g., cooking habits, intrahousehold distribution of responsibilities, preparation methods) by 9 studies, and household consumption practices (e.g., timing, snacking, meal skipping, eating away from the home) by 30 studies. Most studies used quantitative methods (n = 34), some used qualitative methods (n = 13), and few used mixed methods (n = 3). Likert scales and semistructured interviews were the most used tools for quantitative and qualitative assessments, respectively. Across the 50 studies, 40 different tools were used to assess food-related behaviors, and only 14 studies claimed to be using validated tools. Few studies included a full tool in the text or supplemental material (n = 23). Currently, there is little alignment on how to assess food choice behaviors in South Asia, highlighting the need for a contextually adaptable repository of tools. Adapting and validating existing tools, rather than creating new ones, could improve efficiency, continuity, and comparability.
This study was registered at Open Science Framework Registries as https://doi.org/10.17605/OSF.IO/5GPEF.
在个人和家庭层面评估与食物选择相关的行为对于改善家庭饮食至关重要,但评估工具有限。我们进行了范围审查,以确定南亚地区食品获取、准备和家庭消费实践的现有评估工具存在的差距,南亚地区的饮食正在迅速变化。我们对三个数据库(PubMed、Scopus和Web of Science Core Collection)进行了系统的关键字搜索,以确定2000年至2025年4月期间在阿富汗、孟加拉国、不丹、印度、马尔代夫、尼泊尔、巴基斯坦和斯里兰卡发表的评估食物获取、食物制备和家庭消费实践的研究。两位审稿人独立筛选标题、摘要和全文,并提取有关研究特征和用于检查食物选择行为的评估工具的数据。在鉴定出的13,160个独特文章中,有50个被纳入合成。26项研究评估了食物获取行为(例如,购买食物的种类和频率,购买食物的变化),9项研究评估了食物准备(例如,烹饪习惯,家庭内部责任分配,准备方法),30项研究评估了家庭消费实践(例如,时间,零食,不吃饭,离家吃饭)。多数研究采用定量方法(n=34),部分研究采用定性方法(n=13),少数研究采用混合方法(n=3)。李克特量表和半结构化访谈分别是定量和定性评估中最常用的工具。在这50项研究中,有40种不同的工具被用来评估与食物相关的行为,只有14项研究声称使用了经过验证的工具。很少有研究在文本或补充材料中包含完整的工具(n=23)。目前,在如何评估南亚的食物选择行为方面几乎没有一致意见,这突出表明需要一个适应环境的工具库。调整和验证现有的工具,而不是创建新的工具,可以提高效率、连续性和可比性。注册中心:开放科学框架注册中心DOI: https://doi.org/10.17605/OSF.IO/5GPEF。
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引用次数: 0
A Systematic Review of Food-Derived DNA Methyltransferase Modulators: Mechanistic Insights and Perspectives for Healthy Aging 食物来源的DNA甲基转移酶调节剂的系统综述:健康衰老的机制见解和观点。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-18 DOI: 10.1016/j.advnut.2025.100521
Manuela Campisi , Luana Cannella , Francesco Visioli , Sofia Pavanello
DNA methylation represents a crucial epigenetic mechanism orchestrating gene expression, cellular homeostasis, and the aging trajectory. Dysregulation of DNA methyltransferases (DNMTs)—the enzymes catalyzing this process—has been implicated in a wide spectrum of chronic conditions, including cancer, cardiovascular and metabolic disorders, and neurodegenerative diseases. Emerging evidence suggests that food-derived bioactive compounds can act as DNMT inhibitors, reshaping epigenetic landscapes. This systematic review, registered in PROSPERO (CRD42022320316), critically evaluated in vitro, in vivo animal, and ex vivo studies investigating the effects of dietary bioactives on DNMT expression and activity. A thorough search of PubMed up to 23 May, 2025, yielded 103 studies, of which 76 met the inclusion criteria. Eligible publications were original, peer-reviewed, and provided evidence from in vitro, in vivo animal, or ex vivo models. Frequently studied bioactives included epigallocatechin-3-gallate, curcumin, genistein, resveratrol, sulforaphane, and folate. Notably, nearly 90% of studies reported DNMT inhibition—often dose- and time-dependent. Approximately 21% defined minimal effective concentrations, predominantly for isolated compounds. Several studies described synergistic interactions between bioactives, and emerging data highlighted the gut microbiota’s mediating role in epigenetic modulation. Despite promising outcomes, the predominance of preclinical evidence and variability in experimental protocols and dosing limit the immediate translational impact. Nonetheless, current findings underscore the promise of dietary DNMT modulators as foundational elements for precision nutrition strategies aimed at promoting healthy aging and mitigating age-associated disease risk. The potential application of DNA methylation age as a biomarker of biological aging has been increasingly supported by recent literature, reinforcing its relevance in future nutritional epigenetics research. Further well-designed clinical trials are warranted to assess long-term efficacy, safety, and bioavailability of these compounds and to validate their use in personalized epigenetic interventions using biological aging markers. This review was funded by the European Union—Next Generation EU, PNRR Project Age-It (DM 1557 11.10.2022), and the University of Padua SID Grant (2024DCTV1SIDPROGETTI-00194).
DNA甲基化是调控基因表达、细胞稳态和衰老轨迹的重要表观遗传机制。DNA甲基转移酶(dnmt)——催化这一过程的酶——的失调与多种慢性疾病有关,包括癌症、心血管和代谢紊乱以及神经退行性疾病。新出现的证据表明,食物来源的生物活性化合物可以作为DNMT抑制剂,重塑表观遗传景观。该系统综述在PROSPERO (CRD42022320316)上注册,对研究膳食生物活性对DNMT表达和活性影响的体外、体内和离体研究进行了严格评估。到2025年5月23日,在PubMed上进行了彻底的搜索,得出103项研究,其中76项符合纳入标准。符合条件的出版物是原创的、同行评审的,并提供来自体外、体内或离体动物模型的证据。常见的候选药物包括表没食子儿茶素-3-没食子酸酯、姜黄素、染料木素、白藜芦醇、萝卜硫素和叶酸。值得注意的是,近90%的研究报告了DNMT的抑制作用——通常是剂量和时间依赖性的。大约21%的人定义了最小有效浓度,主要是分离化合物。一些研究描述了生物活性物质之间的协同相互作用,新出现的数据强调了肠道微生物群在表观遗传调节中的介导作用。尽管有很好的结果,临床前证据的优势和实验方案和剂量的可变性限制了直接的转化影响。尽管如此,目前的研究结果强调了膳食DNMT调节剂作为旨在促进健康老龄化和减轻年龄相关疾病风险的精确营养策略的基础要素的前景。DNA甲基化年龄(DNA methylation age, DNAmAge)作为生物衰老标志物的潜在应用已得到越来越多的文献支持,并加强了其在未来营养表观遗传学研究中的相关性。需要进一步精心设计的临床试验来评估这些化合物的长期疗效、安全性和生物利用度,并利用生物衰老标志物验证它们在个性化表观遗传干预中的应用。本综述由欧盟-下一代欧盟,PNRR项目年龄- it (DM 1557 11.10.2022)和帕多瓦大学SID资助(2024DCTV1SIDPROGETTI-00194)资助。
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引用次数: 0
Nutritional Challenges of Incretin-Based Obesity Management Medications: Implications for Clinical Practice 以肠促胰岛素为基础的肥胖管理药物的营养挑战:对临床实践的影响。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-18 DOI: 10.1016/j.advnut.2025.100522
Tair Ben-Porat , Shiri Sherf-Dagan , Marilou Côté , Cherie Josephine Miner , Assaf Buch
Several novel incretin-based obesity management medications (OMMs) have recently been approved for chronic weight management in adults with obesity or overweight. These agents have demonstrated substantial weight reduction effects alongside glucoregulatory and cardioprotective benefits. However, the use of incretin-based OMMs presents nutritional challenges that remain insufficiently addressed. These include side effects such as gastrointestinal disturbances and loss of lean body mass, which may compromise nutritional status, reduce energy expenditure, and heighten risk of rebound weight gain, sarcopenia, and frailty. Moreover, although these medications effectively suppress energy intake and reduce food quantity, they may also have unintended effects on diet quality, potentially influencing macronutrient distribution, ultraprocessed food consumption, risk of vitamin and mineral deficiencies, and disordered eating behaviors, which could undermine long-term weight maintenance and the cardiometabolic benefits achieved through these pharmacotherapy agents. Emerging evidence suggests that specific dietary and behavioral strategies, such as higher protein intake, resistance training, nutrient-dense eating patterns, and fostering adaptive eating behaviors, may help mitigate nutritional challenges and physiologic deterioration during significant weight reduction while also supporting cardiometabolic health maintenance. However, the application of these strategies as adjunct treatments alongside the new OMMs remains unclear. This narrative review summarizes the current literature on these issues and proposes dietary interventions and behavioral modification strategies aimed at mitigating the adverse effects that can be associated with incretin-based OMMs. These considerations are increasingly important given the expanding use of these medications, the degree of weight reduction they induce, and the implications for specific at-risk groups, including aging populations prone to muscle and functional decline and individuals with pre-existing conditions of nutritional deficiencies, chronic diseases, and disordered eating patterns.
最近,一些新的基于肠促胰岛素的肥胖管理药物(OMMs)被批准用于肥胖或超重成人的慢性体重管理。这些药物已经证明了大量的减肥效果,以及血糖调节和心脏保护的好处。然而,使用基于肠促胰岛素的OMMs带来的营养挑战仍然没有得到充分解决。这些副作用包括胃肠道(GI)紊乱和瘦体重(LBM)下降,这可能会损害营养状况,减少能量消耗,并增加反弹体重增加、肌肉减少和虚弱的风险。此外,虽然这些药物有效地抑制能量摄入和减少食物量,但它们也可能对饮食质量产生意想不到的影响,可能影响宏量营养素的分布、超加工食品的消费、维生素和矿物质缺乏的风险以及饮食行为紊乱,这可能会破坏这些药物治疗药物实现的长期体重维持和心脏代谢益处。新出现的证据表明,特定的饮食和行为策略,如高蛋白质摄入、抗阻训练、营养密集的饮食模式和培养适应性饮食行为,可能有助于减轻显著减肥期间的营养挑战和生理恶化,同时也支持心脏代谢健康的维持。然而,这些策略作为辅助治疗与新的OMMs的应用仍不清楚。本文总结了目前关于这些问题的文献,并提出了饮食干预和行为改变策略,旨在减轻与基于肠促胰岛素的OMMs相关的不良反应。考虑到这些药物的广泛使用,它们引起的体重减轻程度,以及对特定风险群体的影响,这些考虑变得越来越重要,这些风险群体包括容易出现肌肉和功能衰退的老年人,先前患有营养缺乏、慢性疾病和饮食模式紊乱的个体。
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引用次数: 0
Gut Microbiota and Nutrition in Nursing Homes: Challenges and Translational Approaches for Healthy Aging 肠道微生物群和营养在养老院:挑战和转化方法的健康老龄化。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-17 DOI: 10.1016/j.advnut.2025.100520
Cristina Jiménez-Arroyo, Natalia Molinero, M Victoria Moreno-Arribas
The growing aging population is leading to an increase in demand for long-term care. This is particularly true in nursing homes, where residents are exposed to various challenges such as immunosenescence, frailty, multimorbidity, and dietary and environmental constraints. These interrelated factors contribute to gut microbiota alterations, underscoring the need for tailored strategies to preserve health and resilience in a long-term care setting. Despite its recognized relevance in healthy aging, the gut microbiome of institutionalized elderly remains markedly understudied. This review provides a comprehensive report of the current evidence on the interplay between diet, gut microbiota, and aging among nursing-home residents. The available literature suggests that both aging and institutional living contribute to a less favorable microbiome profile, and several contributing factors, many of them dietary, have been identified. Altered gastrointestinal physiology, malnutrition, and other common conditions in residential care, such as functional or cognitive impairments, frequently lead to changes in food intake that affect the gut ecosystem. Decline in immune system, increased infection risk, sarcopenia, cognitive deterioration, and high medication burden have also been linked to microbiota disruptions in this population. Importantly, adjusting several modifiable features of institutional care, particularly those related to diet and lifestyle, may help counteract these effects by supporting gut health. We further examine how appropriate nutritional strategies can positively influence gut microbiota composition and function, offering a pathway to promote resilience and functionality even in the presence of geriatric syndromes. In addition to identifying these challenges, this review outlines feasible, microbiota-informed strategies to improve quality of life and health outcomes. These include individualized dietary adaptations, targeted supplementation, physical activity interventions, and the integration of digital and artificial intelligence tools to support personalized nutrition. Finally, we highlight the need for standardized protocols and implementation science frameworks to enhance clinical translation, thereby advancing an integrative and as yet underrepresented perspective on microbiota-based strategies to promote healthier aging trajectories in institutionalized elderly.
日益增长的老龄化人口增加了对长期护理的需求,特别是在养老院,那里的居民面临着一系列挑战,如免疫衰老、虚弱、多种疾病以及饮食和环境限制。这些相互关联的因素有助于肠道微生物群的改变,强调需要制定量身定制的策略,以在长期护理环境中保持健康和适应能力。尽管肠道微生物组与健康老龄化的相关性得到了公认,但对制度化老年人的肠道微生物组的研究仍显着不足。这篇综述提供了一个全面的综合目前的证据之间的相互作用的饮食,肠道微生物群,和老化在养老院的居民。现有文献表明,衰老本身和机构生活都导致了不太有利的微生物群特征。已经确定了几个影响因素,其中许多是饮食因素。胃肠生理机能改变、营养不良以及住院护理中的常见情况,如功能或认知障碍,往往会导致食物摄入的变化,从而影响肠道生态系统。此外,免疫系统下降、感染风险增加、肌肉减少、认知退化和高药物负担也与这一人群的微生物群破坏有关。重要的是,机构护理的一些可改变的特征——特别是与饮食和生活方式有关的特征——可能有助于通过支持肠道健康来抵消这些影响。我们进一步研究了适当的营养策略如何积极影响肠道微生物群的组成和功能,提供了一种促进恢复力和功能的途径,即使在老年综合征存在的情况下。除了确定这些挑战之外,该综述还概述了可行的、了解微生物群的策略,以改善生活质量和健康结果。这些措施包括个性化饮食调整、有针对性的补充、身体活动干预,以及整合数字和人工智能工具以支持个性化营养。最后,我们强调需要标准化的协议和实施科学框架,以加强临床翻译-推进基于微生物群的综合视角,以促进制度化老年人更健康的衰老轨迹。意义声明:这篇综述是第一个全面整合老年人机构背景下饮食-微生物群相互作用的综述,综合了老年学、营养学和微生物学证据,同时提出了可行的、多模式的策略来增强弹性和支持养老院环境中的健康老龄化。
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引用次数: 0
Folate 叶酸。
IF 9.2 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-09-17 DOI: 10.1016/j.advnut.2025.100519
Zoe Lofft , Timothy J Green , Angela M Devlin
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引用次数: 0
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Advances in Nutrition
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