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Human MicroRNAs Modulated by Diet: A Scoping Review 人类微 RNA 受饮食调节:范围综述。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-05-10 DOI: 10.1016/j.advnut.2024.100241
Gwen M Chodur, Francene M Steinberg

Because of their role in regulating and fine-tuning gene expression in the posttranscriptional period, microRNA (miRNA) may represent a mediating factor that connects diet and metabolic regulation. Given the vast number of miRNAs and that modulations in miRNA happen in response to a variety of stimuli, a comprehensive registry of miRNAs impacted by diet and the food items that modulate them, would have utility in the identification of miRNA complements for analysis of diet interventions and in helping to establish linkages between the specific impacts of diet components. A scoping literature search of online databases (PubMed, SCOPUS, EMBASE, and Web of Science) was performed. Only studies in human populations, those that used a diet intervention or meal challenge, and those that measured miRNA profiles in the same subject at multiple time points were included. Of the 6167 studies screened, only 25 met the study criteria and were included in the review. Seven studies examined miRNA following a meal challenge, whereas 18 investigated miRNA following a sustained diet intervention. The results demonstrated that miRNA are modulated following a variety of diet interventions and that intensity of miRNA response is greater in metabolically healthy subjects. Heterogeneity in the intensity and length of the diet intervention, the study populations being observed, and the methodology through which target miRNA are identified contribute to a lack of comparability across studies. The findings of this review highlight the need for more study of miRNA responsiveness to intake and provide recommendations for future research.

由于微RNA(miRNA)在转录后调节和微调基因表达方面的作用,它们可能是连接饮食和代谢调节的中介因素。鉴于 miRNA 的数量庞大,而且 miRNA 的变化是对各种刺激的反应,因此,全面登记受饮食影响的 miRNA 以及调节这些 miRNA 的食物,将有助于确定 miRNA 补充物,以分析饮食干预措施,并帮助建立饮食成分具体影响之间的联系。我们对在线数据库(PubMed、SCOPUS、Embase、Web of Science)进行了范围性文献检索。只纳入了利用饮食干预或膳食挑战、在多个时间点测量同一受试者微RNA图谱的人类研究。在筛选出的 6167 项研究中,只有 25 项符合研究标准,被纳入综述。其中 7 项研究检测了膳食挑战后的 miRNA,18 项研究检测了持续饮食干预后的 miRNA。研究结果表明,在各种饮食干预措施后,miRNA 都会受到调节,而且代谢健康的受试者的 miRNA 反应强度更大。由于饮食干预的强度和时间长度、观察的研究人群以及确定目标 miRNA 的方法存在差异,导致不同研究之间缺乏可比性。本综述的研究结果突出表明,有必要对 miRNA 对摄入量的反应进行更多研究,并为今后的研究提供建议。
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引用次数: 0
Different Roles of Tocopherols and Tocotrienols in Chemoprevention and Treatment of Prostate Cancer 天然维生素 E 在化学预防和治疗前列腺癌中的不同作用。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-05-10 DOI: 10.1016/j.advnut.2024.100240
Qing Jiang

The vitamin E family contains α-tocopherol (αT), βT, γT, and δT and α-tocotrienol (TE), βTE, γTE, and δTE. Research has revealed distinct roles of these vitamin E forms in prostate cancer (PCa). The ATBC trial showed that αT at a modest dose significantly decreased PCa mortality among heavy smokers. However, other randomized controlled trials including the Selenium and Vitamin E Cancer Prevention Trial (SELECT) indicate that supplementation of high-dose αT (≥400 IU) does not prevent PCa among nonsmokers. Preclinical cell and animal studies also do not support chemopreventive roles of high-dose αT and offer explanations for increased incidence of early-stage PCa reported in the SELECT. In contrast, accumulating animal studies have demonstrated that γT, δT, γTE, and δTE appear to be effective for preventing early-stage PCa from progression to adenocarcinoma in various PCa models. Existing evidence also support therapeutic roles of γTE and its related combinations against advanced PCa. Mechanistic and cell-based studies show that different forms of vitamin E display varied efficacy, that is, δTE ≥ γTE > δT ≥ γT >> αT, in inhibiting cancer hallmarks and enabling characteristics, including uncontrolled cell proliferation, angiogenesis, and inflammation possibly via blocking 5-lipoxygenase, nuclear factor κB, hypoxia-inducible factor-1α, modulating sphingolipids, and targeting PCa stem cells. Overall, existing evidence suggests that modest αT supplement may be beneficial to smokers and γT, δT, γTE, and δTE are promising agents for PCa prevention for modest-risk to relatively high-risk population. Despite encouraging preclinical evidence, clinical research testing γT, δT, γTE, and δTE for PCa prevention is sparse and should be considered.

维生素 E 家族包含 α-、β-、γ- 和 δ-生育酚(αT、βT、γT 和 δT)以及 α-、β-、γ- 和 δ-生育三烯酚(αTE、βTE、γTE 和 δTE)。研究揭示了这些维生素 E 在前列腺癌(PCa)中的不同作用。ATBC 试验表明,适量的 αT 能显著降低重度吸烟者的 PCa 死亡率。然而,包括 SELECT 试验在内的其他随机对照试验表明,补充高剂量的 αT(≥ 400IU)并不能预防非吸烟者患上 PCa。临床前细胞和动物研究也不支持高剂量αT的化学预防作用,并为SELECT研究中报告的早期PCa发病率增加提供了解释。相反,越来越多的动物实验表明,在各种 PCa 模型中,γT、δT、γTE 和 δTE 似乎能有效防止早期 PCa 向腺癌发展。现有证据还支持γTE 及其相关组合对晚期 PCa 的治疗作用。机理研究和基于细胞的研究表明,不同形式的维生素 E 在抑制癌症标志和特征(包括不受控制的细胞增殖、血管生成和炎症)方面显示出不同的疗效,即 δTE ≥ γTE > δT ≥ γT >> αT,可能是通过阻断 5-脂氧合酶、NF-κB、HIF-1α、调节鞘磷脂和靶向 PCa 干细胞。总之,现有证据表明,适量补充αT可能对吸烟者有益,而γT、δT、γTE和δTE则是预防PCa的有前途的药物,适用于中度至相对高危人群。尽管临床前证据令人鼓舞,但测试γT、δT、γTE 和δTE 用于预防 PCa 的临床研究还很稀少,应加以考虑。
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引用次数: 0
Nutritional Strategies for Managing Iron Deficiency in Adolescents: Approaches to a Challenging but Common Problem 控制青少年缺铁的营养策略:解决这一具有挑战性但却普遍存在的问题的方法。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.advnut.2024.100215
Clay T Cohen, Jacquelyn M Powers

Iron deficiency (ID) is a common and challenging problem in adolescence. In order to prevent, recognize, and treat ID in this age range, it is critical to understand the recommended daily intake of iron in relation to an adolescent’s activity, dietary habits, and basal iron losses. Adolescents following vegetarian or vegan diets exclusively rely on plant-based, nonheme iron, which has decreased bioavailability compared with heme iron and requires increased total iron intake. Individuals with disordered eating habits, excessive menstrual blood loss, and certain chronic health conditions (including inflammatory bowel disease and heart failure) are at high risk of ID and the development of symptomatic iron deficiency anemia (IDA). Adolescent athletes and those with sleep and movement disorders may also be more sensitive to changes in iron status. Iron deficiency is typically treated with oral iron supplementation. To maximize iron absorption, oral iron should be administered no more than once daily, ideally in the morning, while avoiding foods and drinks that inhibit iron absorption. Oral iron therapy should be provided for ≥3 mo in the setting of ID to reach a ferritin of 20 ng/mL before discontinuation. Intravenous iron is being increasingly used in this population and has demonstrated efficacy and safety in adolescents. It should be considered in those with persistent ID despite a course of oral iron, severe and/or symptomatic IDA, and chronic inflammatory conditions characterized by decreased gastrointestinal iron absorption.

缺铁(ID)是青少年时期的一个常见且具有挑战性的问题。为了预防、识别和治疗这一年龄段的缺铁症,了解与青少年的活动量、饮食习惯和基础铁流失量相关的每日推荐铁摄入量至关重要。采用素食或纯素饮食的青少年完全依赖植物性非血红素铁,这种铁的生物利用率比血红素铁低,因此需要增加铁的总摄入量。饮食习惯紊乱、月经失血过多和患有某些慢性疾病(包括炎症性肠病和心力衰竭)的人患 ID 和症状性缺铁性贫血 (IDA) 的风险很高。青少年运动员以及患有睡眠和运动障碍的人对铁状态的变化也可能更为敏感。缺铁通常通过口服铁剂来治疗。为了最大限度地促进铁的吸收,口服铁剂每天不应超过一次,最好在早晨服用,同时避免食用抑制铁吸收的食物和饮料。在 ID 的情况下,口服铁剂治疗应持续至少三个月,以达到铁蛋白 20 纳克/毫升,然后再停止治疗。静脉注射铁剂在这一人群中的应用越来越广泛,在青少年中的疗效和安全性已得到证实。在口服铁剂后仍有持续性 ID 的患者、严重和/或有症状的 IDA 患者,以及胃肠道铁吸收减少的慢性炎症患者中,应考虑使用静脉注射铁剂。
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引用次数: 0
Perspective: Beyond the Mediterranean Diet—Exploring Latin American, Asian, and African Heritage Diets as Cultural Models of Healthy Eating 透视:超越地中海饮食--探索拉丁美洲、亚洲和非洲传统饮食作为健康饮食的文化模式
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-05-01 DOI: 10.1016/j.advnut.2024.100221
Kelly E LeBlanc , Sara Baer-Sinnott , Kristie J Lancaster , Hannia Campos , Ka Hei Karen Lau , Katherine L Tucker , Lawrence H Kushi , Walter C Willett

The Mediterranean diet is a well-studied cultural model of healthy eating, yet research on healthy models from other cultures and cuisines has been limited. This perspective article summarizes the components of traditional Latin American, Asian, and African heritage diets, their association with diet quality and markers of health, and implications for nutrition programs and policy. Though these diets differ in specific foods and flavors, we present a common thread that emphasizes healthful plant foods and that is consistent with high dietary quality and low rates of major causes of disability and deaths. In this perspective, we propose that nutrition interventions that incorporate these cultural models of healthy eating show promise, though further research is needed to determine health outcomes and best practices for implementation.

地中海饮食是一种经过充分研究的健康饮食文化模式,但对其他文化和菜系的健康模式的研究却很有限。这篇观点文章总结了传统拉美、亚洲和非洲遗产饮食的组成部分、它们与饮食质量和健康指标的关联,以及对营养计划和政策的影响。虽然这些饮食在具体食物和口味上有所不同,但我们提出了一个共同点,即强调有益健康的植物性食物,并且与高饮食质量和低主要致残和致死率相一致。从这一角度出发,我们提出,纳入这些健康饮食文化模式的营养干预措施大有可为,但仍需进一步研究,以确定健康结果和最佳实施方法。
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引用次数: 0
Effects of (Poly)phenols on Circadian Clock Gene–Mediated Metabolic Homeostasis in Cultured Mammalian Cells: A Scoping Review 多)酚对培养的哺乳动物细胞中昼夜节律时钟基因介导的代谢平衡的影响:范围综述。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-04-20 DOI: 10.1016/j.advnut.2024.100232
Noha Sulaimani , Michael J Houghton , Maxine P Bonham , Gary Williamson

Circadian clocks regulate metabolic homeostasis. Disruption to our circadian clocks, by lifestyle behaviors such as timing of eating and sleeping, has been linked to increased rates of metabolic disorders. There is now considerable evidence that selected dietary (poly)phenols, including flavonoids, phenolic acids and tannins, may modulate metabolic and circadian processes. This review evaluates the effects of (poly)phenols on circadian clock genes and linked metabolic homeostasis in vitro, and potential mechanisms of action, by critically evaluating the literature on mammalian cells. A systematic search was conducted to ensure full coverage of the literature and identified 43 relevant studies addressing the effects of (poly)phenols on cellular circadian processes. Nobiletin and tangeretin, found in citrus, (–)-epigallocatechin-3-gallate from green tea, urolithin A, a gut microbial metabolite from ellagitannins in fruit, curcumin, bavachalcone, cinnamic acid, and resveratrol at low micromolar concentrations all affect circadian molecular processes in multiple types of synchronized cells. Nobiletin emerges as a putative retinoic acid–related orphan receptor (RORα/γ) agonist, leading to induction of the circadian regulator brain and muscle ARNT-like 1 (BMAL1), and increased period circadian regulator 2 (PER2) amplitude and period. These effects are clear despite substantial variations in the protocols employed, and this review suggests a methodological framework to help future study design in this emerging area of research.

昼夜节律调节新陈代谢的平衡。饮食和睡眠时间等生活方式破坏了我们的昼夜节律,这与代谢紊乱的发病率增加有关。现在有大量证据表明,选定的膳食(多)酚(包括类黄酮、酚酸和单宁酸)可调节新陈代谢和昼夜节律过程。本综述通过批判性地评估哺乳动物细胞文献,评估了(多)酚对体外昼夜节律时钟基因和相关代谢平衡的影响,以及潜在的作用机制。为确保文献的全面覆盖,我们进行了系统性搜索,并确定了 43 项涉及(多)酚对细胞昼夜节律过程影响的相关研究。柑橘中的金钗素和橘皮素、绿茶中的(-)-表没食子儿茶素-3-棓酸盐、尿石素 A(一种来自水果中鞣花丹宁的肠道微生物代谢物)、姜黄素、巴伐醌、肉桂酸和白藜芦醇在低微摩尔浓度下都会影响多种类型同步细胞的昼夜节律分子过程。金钗素是一种推定的视黄酸相关孤儿受体(RORα/γ)激动剂,可诱导昼夜节律调节因子大脑和肌肉类 ARNT 1(BMAL1),并增加周期昼夜节律调节因子 2(PER2)的振幅和周期。尽管所采用的方案存在很大差异,但这些效应是显而易见的,本综述提出了一个方法框架,以帮助今后在这一新兴研究领域进行研究设计。
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引用次数: 0
Is Maternal Body Weight or Composition Associated with Onset of Lactogenesis II, Human Milk Production, or Infant Consumption of Mother’s Own Milk? A Systematic Review and Meta-Analysis 母体体重或组成与泌乳发生期 II 的开始、母乳产量或婴儿饮用母乳有关吗?系统回顾和荟萃分析。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-04-11 DOI: 10.1016/j.advnut.2024.100228
Amanda V Montana , Alison Mildon , Allison I Daniel , Michael A Pitino , Jo-Anna B Baxter , Megan R Beggs , Sharon L Unger , Deborah L O’Connor , Kathryn Walton

Maternal adiposity impacts lactation performance, but the pathways are unclear. We conducted a systematic review to understand whether maternal adiposity (body mass index [BMI] or percentage fat mass) is associated with onset of lactogenesis II (copious milk; hours), human milk production (expressed volume/24 h), and infant consumption of mother’s own milk (volume/24 h). We used random-effects standard meta-analyses to compare the relative risk (RR) of delayed lactogenesis II (>72 h) between mothers classified as underweight (BMI <18.5 kg/m2), healthy weight (BMI, 18.5–24.9 kg/m2), and overweight/obese (BMI ≥25 kg/m2) and random-effects meta-regressions to examine associations with hours to lactogenesis II and infant milk consumption. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. We included 122 articles. Mothers with underweight (RR: 0.64; 95% CI: 0.49, 0.83; I2 = 39.48%; 8 articles/data points) or healthy weight status (RR: 0.67; 95% CI: 0.57, 0.79; I2 = 70.91%; 15 articles/data points) were less likely to experience delayed lactogenesis II than mothers with overweight/obesity. We found no association between maternal BMI and time to onset of lactogenesis II (β: 1.45 h; 95% CI: −3.19, 6.09 h; P = 0.52, I2 = 0.00%; 8 articles, 17 data points). Due to limited data, we narratively reviewed articles examining BMI or percentage fat mass and milk production (n = 6); half reported an inverse association and half no association. We found no association between maternal BMI (β: 6.23 mL; 95% CI: −11.26, 23.72 mL; P = 0.48, I2 = 47.23%; 58 articles, 75 data points) or percentage fat mass (β: 7.82 mL; 95% CI: −1.66, 17.29 mL; P = 0.10, I2 = 28.55%; 30 articles, 41 data points) and infant milk consumption. The certainty of evidence for all outcomes was very low. In conclusion, mothers with overweight/obesity may be at risk of delayed lactogenesis II. The available data do not support an association with infant milk consumption, but the included studies do not adequately represent mothers with obesity.

This study was registered in PROSPERO as 285344.

母体脂肪对泌乳性能有影响,但其途径尚不清楚。我们进行了一项系统综述,以了解母体脂肪率(体重指数[BMI]或脂肪质量百分比)是否与泌乳发生II(乳汁丰富;小时)、母乳产量(表达量/24小时)和婴儿食用母亲自身乳汁(量/24小时)有关。我们采用随机效应标准荟萃分析比较了体重不足(体重指数为 18.5 kg/m2)、健康体重(体重指数为 18.5-24.9 kg/m2)和超重/肥胖(体重指数≥25 kg/m2)母亲泌乳发生延迟 II(72 小时)的相对风险(RR),并采用随机效应荟萃回归研究了泌乳发生延迟 II 的小时数与婴儿乳汁消耗量之间的关系。采用 "建议、评估、发展和评价分级 "方法对证据的确定性进行了评估。我们共纳入了 122 篇文章。体重不足的母亲(RR:0.64;95% CI:0.49,0.83;I2 = 39.48%;8 篇文章/数据点)或体重健康的母亲(RR:0.67;95% CI:0.57,0.79;I2 = 70.91%;15 篇文章/数据点)比超重/肥胖的母亲更不容易出现泌乳发生延迟。我们发现,产妇体重指数与泌乳期开始时间(β:1.45小时;95% CI:-3.19,6.09小时;P = 0.52,I2 = 0.00%;8篇文章,17个数据点)。由于数据有限,我们对研究 BMI 或脂肪质量百分比与产奶量的文章进行了叙述性回顾(n = 6);其中一半报告了两者之间的反向关系,一半报告了两者之间没有关系。我们发现,母体体重指数(β:6.23 mL;95% CI:-11.26,23.72 mL;P = 0.48,I2 = 47.23%;58 篇文章,75 个数据点)或脂肪质量百分比(β:7.82 mL;95% CI:-1.66,17.29 mL;P = 0.10,I2 = 28.55%;30 篇文章,41 个数据点)与婴儿乳汁消耗量之间没有关联。所有结果的证据确定性都很低。总之,超重/肥胖的母亲可能有泌乳功能延迟 II 的风险。现有数据不支持与婴儿喝奶量有关,但所纳入的研究并不能充分代表肥胖母亲的情况。
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引用次数: 0
Diet, Food, and Nutritional Exposures and Inflammatory Bowel Disease or Progression of Disease: an Umbrella Review 饮食、食物和营养暴露与炎症性肠病或疾病进展:综述
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-04-08 DOI: 10.1016/j.advnut.2024.100219
Camilla Christensen , Andrea Knudsen , Erik K Arnesen , Jan Gunnar Hatlebakk , Ida Sofie Sletten , Lars T Fadnes

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), contributes to substantial morbidity. Understanding the intricate interplay between dietary factors and the incidence and progression of IBD is essential for developing effective preventative and therapeutic strategies. This umbrella review comprehensively synthesizes evidence from systematic reviews and meta-analyses to evaluate these complex associations. Dietary factors associated with an increased incidence and/or progression of IBD include a high intake of red and processed meat, other processed foods, and refined sugars, together with a low intake of vegetables, fruits, and fiber. For most other food groups, the results are mixed or indicate no clear associations with IBD, CD, and UC. Some differences seem to exist between UC and CD and their risk factors, with increased intake of dietary fiber being inversely associated with CD incidence but not clearly associated with UC. Dietary fiber may contribute to maintaining the gut epithelial barrier and reduce inflammation, often through interactions with the gut microbiota. This seems to play an important role in inflammatory mechanisms in the gut and in IBD incidence and progression. Diets low in fermentable saccharides and polyols can alleviate symptom burden, but there are concerns regarding their impact on the gut microbiota and their nutritional adequacy. Mediterranean diets, vegetarian diets, and a diet low in grains, sugars, and lactose (specific carbohydrate diet) are also associated with lower incidence and/or progression of IBD. The associations of dietary patterns are mirrored by inflammatory biomarkers. IBD is typically treated pharmaceutically; however, many patients have a suboptimal response to medical treatments. The findings from this umbrella review could provide evidence for nutritional counseling and be a valuable addition to traditional treatment plans for IBD.

This systematic review was registered at PROSPERO as CRD440252.

炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),造成了严重的发病率。要制定有效的预防和治疗策略,就必须了解饮食因素与 IBD 的发病和发展之间错综复杂的相互作用。本综述全面综合了来自系统综述和荟萃分析的证据,以评估这些复杂的关联。与 IBD 发病率增加和/或病情恶化相关的饮食因素包括红肉和加工肉类、其他加工食品以及精制糖的高摄入量,以及蔬菜、水果和纤维素的低摄入量。至于大多数其他食物类别,研究结果不一,或表明与 IBD、CD 和 UC 没有明确的关联。UC 和 CD 与其风险因素之间似乎存在一些差异,膳食纤维摄入量的增加与 CD 的发病率成反比,但与 UC 并无明显关联。膳食纤维可能有助于维持肠道上皮屏障和减少炎症,通常是通过与肠道微生物群的相互作用来实现的。这似乎在肠道炎症机制以及 IBD 发病率和进展中发挥着重要作用。可发酵糖和多元醇含量低的饮食可减轻症状负担,但其对肠道微生物群的影响及其营养是否充足令人担忧。地中海饮食、素食以及谷物、糖和乳糖含量低的饮食(特定碳水化合物饮食)也与 IBD 的发病率和/或进展率降低有关。炎症生物标志物也反映了饮食模式的相关性。IBD 通常采用药物治疗,但许多患者对药物治疗的反应并不理想。本综述的研究结果可为营养咨询提供证据,并成为 IBD 传统治疗方案的重要补充。本系统综述在 PROSPERO 注册为 CRD440252。
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引用次数: 0
Human Milk Oligosaccharides and Respiratory Syncytial Virus Infection in Infants 母乳低聚糖与婴儿呼吸道合胞病毒感染。
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-04-05 DOI: 10.1016/j.advnut.2024.100218
Karina M Tonon, Somchai Chutipongtanate, Ardythe L Morrow, David S Newburg

In infants worldwide, respiratory syncytial virus (RSV) is the leading cause of lower respiratory infections, including bronchiolitis, which is a major source of infant mortality. Bronchiolitis is the most common lower respiratory infection and the major cause of hospitalization in the first 6 mo of life. Infant responses to RSV infection are highly diverse, with symptoms varying from asymptomatic or mild to so severe as to require mechanical ventilation. Breastfed infants present a lower incidence and less severe forms of RSV lower respiratory infections. Among the multitude of human milk bioactive compounds, human milk oligosaccharides (hMOSs) are strong candidates for having a protective effect against RSV. hMOS reduces the viral load and the inflammatory signaling in cultured RSV-infected respiratory human cells. In addition to this direct effect, indirect mechanisms, notably gut microbiota composition and metabolism, have been proposed to mediate the protective effect of hMOS. Intake of infant formula containing synthetic hMOS has been shown to increase Bifidobacterium abundance and that of its metabolites, especially acetate, in infant feces and to reduce lower respiratory tract infections during the first year of life. Breastfeeding and the use of hMOS are promising approaches to protect against and treat RSV disease. Here, we review current evidence on the role of hMOS with regard to RSV infection and disease, attending to knowledge gaps and future research directions.

在全世界的婴儿中,呼吸道合胞病毒(RSV)是包括支气管炎在内的下呼吸道感染的主要病因,也是婴儿死亡的主要原因。支气管炎是最常见的下呼吸道感染,也是婴儿出生后 6 个月内住院治疗的主要原因。婴儿对 RSV 感染的反应多种多样,症状从无症状或轻微到严重到需要机械通气不等。母乳喂养的婴儿发生 RSV 下呼吸道感染的几率较低,病情也较轻。在众多母乳生物活性化合物中,母乳低聚糖(hMOS)是对 RSV 具有保护作用的有力候选物质。除了这种直接作用外,还有人提出间接机制,特别是肠道微生物群的组成和新陈代谢,来介导 hMOS 的保护作用。研究表明,摄入含有合成 hMOS 的婴儿配方奶粉可增加婴儿粪便中双歧杆菌的数量及其代谢产物(尤其是醋酸盐)的数量,并减少婴儿出生后第一年内的下呼吸道感染。母乳喂养和使用 hMOS 是预防和治疗 RSV 疾病的有效方法。在此,我们回顾了目前有关 hMOS 在 RSV 感染和疾病方面的作用的证据,并指出了知识差距和未来的研究方向。
{"title":"Human Milk Oligosaccharides and Respiratory Syncytial Virus Infection in Infants","authors":"Karina M Tonon,&nbsp;Somchai Chutipongtanate,&nbsp;Ardythe L Morrow,&nbsp;David S Newburg","doi":"10.1016/j.advnut.2024.100218","DOIUrl":"10.1016/j.advnut.2024.100218","url":null,"abstract":"<div><p>In infants worldwide, respiratory syncytial virus (RSV) is the leading cause of lower respiratory infections, including bronchiolitis, which is a major source of infant mortality. Bronchiolitis is the most common lower respiratory infection and the major cause of hospitalization in the first 6 mo of life. Infant responses to RSV infection are highly diverse, with symptoms varying from asymptomatic or mild to so severe as to require mechanical ventilation. Breastfed infants present a lower incidence and less severe forms of RSV lower respiratory infections. Among the multitude of human milk bioactive compounds, human milk oligosaccharides (hMOSs) are strong candidates for having a protective effect against RSV. hMOS reduces the viral load and the inflammatory signaling in cultured RSV-infected respiratory human cells. In addition to this direct effect, indirect mechanisms, notably gut microbiota composition and metabolism, have been proposed to mediate the protective effect of hMOS. Intake of infant formula containing synthetic hMOS has been shown to increase <em>Bifidobacterium</em> abundance and that of its metabolites, especially acetate, in infant feces and to reduce lower respiratory tract infections during the first year of life. Breastfeeding and the use of hMOS are promising approaches to protect against and treat RSV disease. Here, we review current evidence on the role of hMOS with regard to RSV infection and disease, attending to knowledge gaps and future research directions.</p></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2161831324000528/pdfft?md5=1060f9a6c16bf3ccaa0d2a61cae23cb4&pid=1-s2.0-S2161831324000528-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials 补充抗氧化剂对黄斑色素光学密度和视觉功能的影响:随机对照试验的系统回顾和网络元分析
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-04-04 DOI: 10.1016/j.advnut.2024.100216
Weili Hu, Vernice Seah, Vanessa Huang, Jung Eun Kim

Antioxidants are bioactive molecules that function to scavenge free radicals and balance oxidative stress. Although all antioxidants can act as reactive oxygen species scavengers, their efficacy on eye health may vary. Moreover, the comparative effectiveness and potential additive effect between groups of antioxidants, hitherto, have not been systematically studied. A systematic review and network meta-analysis were conducted to investigate the comparative or additive effect of dietary antioxidant supplements on eye health. Four databases (PubMed, Embase, CINAHL, and Cochrane) were searched, and relevant randomized controlled trials were identified. Out of 60 articles selected for systematic review, 38 were included in the network meta-analysis, categorized into 8 distinct antioxidant-supplemented groups and placebo. All groups significantly increased macular pigment optical density and contrast sensitivity at low spatial frequency, whereas only the antioxidant mixture + lutein (L) + fatty acid combination exhibited significant improvements in visual acuity (hazard ratio = –0.15; 95% confidence interval: –0.28, –0.02) and L + zeaxanthin combination for photostress recovery time (hazard ratio = –5.75; 95% confidence interval: –8.80, –1.70). Especially, the L + zeaxanthin + fatty acid combination was ranked best for macular pigment optical density (surface under the cumulative ranking: 99.3%) and second best for contrast sensitivity at low spatial frequency (67.7%). However, these findings should be interpreted with caution due to low quality of evidence, primarily influenced by indirectness and potential publication bias. Overall, antioxidant supplementation was estimated to improve eye health parameters, whereas different combinations of antioxidants may also have varying effects on improving visual health from multiple perspectives.

This study was registered at PROSPERO as CRD42022369250.

抗氧化剂是一种生物活性分子,具有清除自由基和平衡氧化应激的功能。虽然所有抗氧化剂都可以作为活性氧清除剂,但它们对眼睛健康的功效可能各不相同。此外,迄今为止,还没有系统地研究过各组抗氧化剂之间的比较效果和潜在的叠加效应。为了研究膳食抗氧化剂补充剂对眼睛健康的比较或叠加效应,我们进行了一项系统综述和网络荟萃分析。研究人员检索了四个数据库(PubMed、Embase、CINAHL 和 Cochrane),并确定了相关的随机对照试验。在60篇被选中进行系统回顾的文章中,38篇被纳入网络荟萃分析,分为8个不同的抗氧化剂补充剂组和安慰剂组。所有组别都能明显提高黄斑色素光学密度和低空间频率对比敏感度,而只有抗氧化剂混合物+叶黄素(L)+脂肪酸组合能明显改善视力(危险比=-0.15;95%置信区间:-0.28,-0.02),L+玉米黄质组合能明显改善光应激恢复时间(危险比=-5.75;95%置信区间:-8.80,-1.70)。特别是,L+玉米黄质+脂肪酸组合在黄斑色素光学密度方面排名第一(累积排名下的表面积:99.3%),在低空间频率对比敏感度方面排名第二(67.7%)。然而,由于证据质量不高,主要受间接性和潜在发表偏差的影响,这些研究结果应谨慎解读。总体而言,据估计补充抗氧化剂可平均改善眼部健康参数,而不同的抗氧化剂组合也可能从多个角度对改善视觉健康产生不同的效果。
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引用次数: 0
Infant Formulas With Partially or Extensively Hydrolyzed Milk Proteins for the Prevention of Allergic Diseases: A Systematic Review and Meta-Analysis of Clinical Trials 含部分或大量水解牛奶蛋白的婴儿配方奶粉用于预防过敏性疾病:临床试验的系统回顾和元分析
IF 9.3 1区 医学 Q1 Nursing Pub Date : 2024-04-04 DOI: 10.1016/j.advnut.2024.100217
Xiaoxu Li , Tingchao He , Sufang Duan , Jinghong Liang , Gang Feng , Fang Li , Zhenyu Shen , Wenhui Ye , Biao Liu , Bibo Jiang , Yujing Chen , Nan Liu , Ignatius Man-Yau Szeto , Li Cai

Despite the widely recommended usage of partially hydrolyzed formula (PHF) or extensively hydrolyzed formula (EHF) of milk protein for preventing allergic diseases (ADs), clinical studies have been inconclusive regarding their efficacy compared with that of cow's milk formula (CMF) or breast milk (BM). We aimed to systematically evaluate the effects of PHF or EHF compared with those of CMF or BM on risk of ADs (cow's milk allergy, allergic rhinitis, eczema, asthma, wheeze, food allergy, and sensitization) in children. We searched PubMed, Embase, Cochrane Library, and Web of Science for clinical trials published from inception to 21 October, 2022. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to grade the strength of evidence. Overall, 24 trials (10,950 infants) were included, 17 of which specifically included high-risk infants. GRADE was low for the evidence that, compared with CMF, infants early fed with EHF had lower risk of cow's milk allergy at age 0–2 y [relative risk (RR): 0.62; 95% CI: 0.39, 0.99]. Moderate evidence supported that PHF and EHF reduced risk of eczema in children aged younger or older than 2 y, respectively (RR: 0.71; 95% CI: 0.52, 0.96; and RR: 0.79; 95% CI: 0.67, 0.94, respectively). We also identified moderate systematic evidence indicating that PHF reduced risk of wheeze at age 0–2 y compared with CMF (RR: 0.50; 95% CI: 0.29, 0.85), but PHF and EHF increased the risk compared with BM (RR: 1.61; 95% CI: 1.11, 2.31; and RR: 1.64; 95% CI: 1.26, 2.14). Neither PHF nor EHF had significant effects on other ADs in children of any age. In conclusion, compared with CMF, PHF, or EHF had different preventive effect on cow's milk allergy, eczema, and wheeze. Compared with BM, both PHF and EHF may increase risk of wheeze but not other ADs. Given that most trials included only high-risk infants, more research on non–high-risk infants is warranted before any generalization is attempted.

This protocol was registered at PROSPERO as CRD42022320787.

尽管人们广泛推荐使用牛奶蛋白部分水解配方奶粉(PHF)或广泛水解配方奶粉(EHF)来预防过敏性疾病(ADs),但与牛奶配方奶粉(CMF)或母乳(BM)相比,临床研究对其疗效并无定论。我们的目的是系统评估 PHF 或 EHF 与 CMF 或 BM 相比对儿童 ADs(牛奶过敏、过敏性鼻炎、湿疹、哮喘、喘息、食物过敏和致敏)风险的影响。我们在 PubMed、Embase、Cochrane Library 和 Web of Science 中检索了从开始到 2022 年 10 月 21 日发表的临床试验。我们采用建议评估、发展和评价分级法(GRADE)对证据的强度进行了分级。总共纳入了 24 项试验(10,950 名婴儿),其中 17 项试验特别纳入了高风险婴儿。有证据表明,与 CMF 相比,早期喂养 EHF 的婴儿在 0-2 岁时发生牛奶过敏的风险较低[相对风险 (RR):0.62;95% CI:0.39, 0.99],该证据的 GRADE 值较低。中度证据支持 PHF 和 EHF 可分别降低 2 岁以下或 2 岁以上儿童患湿疹的风险(RR:0.71;95% CI:0.52,0.96;RR:0.79;95% CI:0.67,0.94)。我们还发现中度系统性证据表明,与 CMF 相比,PHF 可降低 0-2 岁患喘鸣症的风险(RR:0.50;95% CI:0.29,0.85),但与 BM 相比,PHF 和 EHF 会增加患喘鸣症的风险(RR:1.61;95% CI:1.11,2.31;RR:1.64;95% CI:1.26,2.14)。PHF和EHF对任何年龄儿童的其他AD均无明显影响。总之,与CMF相比,PHF或EHF对牛奶过敏、湿疹和喘息有不同的预防效果。与 BM 相比,PHF 和 EHF 可能会增加患喘息的风险,但不会增加其他 ADs 的风险。鉴于大多数试验只纳入了高风险婴儿,因此在试图进行任何推广之前,有必要对非高风险婴儿进行更多的研究。
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引用次数: 0
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