Advances in Nutrition最新文献_第6页

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

Advances in Nutrition

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

Advances in Nutrition

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

Advances in Nutrition

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

Advances in Nutrition

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

Advances in Nutrition

Pub Date : 2025-09-17 DOI: 10.1016/j.advnut.2025.100519

Zoe Lofft , Timothy J Green , Angela M Devlin

引用次数: 0

Universal Subconstructs of a Healthy Diet for Children and Adolescents: A Critical Review 儿童和青少年健康饮食的普遍亚构：一个重要的回顾。

IF 9.2 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-09-15 DOI: 10.1016/j.advnut.2025.100511

Teresa R Schwendler , Edward A Frongillo , Hope C Craig , Giles T Hanley-Cook , Isabela Fleury Sattamini , Chika Hayashi , Vrinda Mehra , Alissa M Pries , Kuntal Saha , Jennifer C Coates

To monitor diets among children and adolescents, a thorough understanding of the underlying subconstructs of a healthy diet is needed to inform what should be measured. The aim of this study was to identify universal subconstructs of a healthy diet for children and adolescents aged 2–19 y, understand alignment with subconstructs for adults, and inform recommendations for metrics that aim to monitor the healthiness of diets among children and adolescents at global and national levels. A critical narrative review was carried out in 3 phases. Phase 1: A systematic review of literature published between 2014 and 2024 was conducted. A subset of articles (n = 100) was purposefully sampled based on predefined characteristics. Then, content analysis was performed to identify subconstructs of healthy diets. Phase 2: The identified dietary subconstructs were compared with the 6 subconstructs for adults recognized by the Healthy Diets Monitoring Initiative (HDMI). Phase 3: The identified subconstructs were compared with existing healthy diet metrics concurrently identified by HDMI as suitable for global monitoring of child and adolescent diets. Eight subconstructs specific to children and adolescents were identified: nutrient, energy, and food group requirements; foods and nutrients to limit or avoid; food group diversity and variety; macronutrient and energy balance; nutrient-rich foods or food groups; food safety; eating frequency; and eating regularity. Compared with the 6 subconstructs of adult healthy diets identified by HDMI, 2 subconstructs differed in their operationalization and 2 child- and adolescent-specific subconstructs were considered to be not conceptually distinct. Diet metrics identified as suitable for global monitoring of child and adolescent diets reflect nutrient, energy, and food group requirements; foods and nutrients to limit or avoid; and food group diversity and variety but no other diet subconstructs. The findings inform the development and validation of healthy diet metrics for children and adolescents.

背景：为了监测儿童和青少年的饮食，需要全面了解健康饮食的潜在亚结构，以告知应该测量什么。目的：确定2-19岁儿童和青少年健康饮食的普遍亚构，了解与成人亚构的一致性，并为旨在监测全球和国家层面儿童和青少年饮食健康的指标提供建议。方法：分三个阶段进行批判性叙事回顾。第一阶段：对2014年至2024年间发表的文献进行系统回顾。文章的一个子集（n=100）基于预定义的特征有目的地采样。然后，内容分析用于确定健康饮食的亚结构。第二阶段：将确定的饮食亚结构与健康饮食监测倡议（HDMI）认可的成人饮食亚结构进行比较。第3阶段：将确定的亚结构与HDMI同时确定的适用于全球儿童和青少年饮食监测的现有健康饮食指标进行比较。结果：确定了儿童和青少年特有的8个亚结构：营养、能量和食物组需求；要限制或避免的食物和营养；食物群体的多样性和多样性；常量营养素和能量平衡；营养丰富的食物或食物组；食品安全;饮食频率;还有饮食规律。与HDMI确定的成人健康饮食的六个亚构相比，两个亚构在操作上存在差异，两个儿童和青少年特异性亚构被认为在概念上没有区别。确定的适用于全球监测儿童和青少年饮食的饮食指标反映了营养、能量和食物组的需求；要限制或避免的食物和营养；食物群体的多样性和多样性，但没有其他饮食结构。结论：研究结果为儿童和青少年健康饮食指标的制定和验证提供了信息。

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引用次数: 0

Systemic Availability of Human Milk Oligosaccharides in Infants and Adults: A Narrative Review 人乳低聚糖在婴儿和成人中的全身可得性：一项叙述性综述。

IF 9.2 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-09-01 DOI: 10.1016/j.advnut.2025.100488

Sabrina Schenk , Lars Bode , Stina Rikke Jensen , Yannik Bernd Schönknecht , Marie-Christine Simon

Human milk contains many components with physiological effects beyond basic nutrition, including large quantities of structurally diverse oligosaccharides. Human milk oligosaccharides (HMOs) have been linked to health outcomes through microbiome-dependent and microbiome-independent mechanisms. To investigate the microbiome-independent effects of individual HMOs and their role in human health, it is necessary to understand their systemic availability. This narrative review focuses on the systemic availability of HMOs and summarizes studies that investigated the presence of HMOs in blood and urine following oral intake in humans. We searched PubMed using the following terms individually or in combination: human milk oligosaccharides, HMO, 2′-fucosyllactose, 3-fucosyllactose, 3′-sialyllactose, 6′-sialyllactose, difucosyllactose, lacto-N-tetraose, and lacto-N-neotetraose. The inclusion criteria were as follows: 1) study design observational or interventional; 2) cohort included breastfed infants, HMO–formula-fed infants or individuals taking HMO supplements; and 3) methods defined HMO absorption/excretion and described analysis. We identified 15 human studies. They varied in design, populations (healthy infants, infants with medical indications, and adults), administration (breastfeeding, formula, and supplement), ingested dose, sampling time points, and analytical methods. HMOs were absorbed into the bloodstream and excreted in urine, as they were detected in the blood and urine of breastfed infants, infants receiving HMO–fortified formula, and adults receiving HMO supplements, demonstrating their systemic availability. Most orally ingested HMOs appeared in blood, but some structures were not absorbed. Studies also reported that blood and urine concentrations of HMOs correlated with increasing doses. Some studies showed a difference between the number of HMOs ingested and the number of oligosaccharides found in urine. Current evidence supports the systemic availability of HMOs in both infants and adults, but absorption kinetics, rates, mechanisms, and metabolic fate remain unknown. Further research investigating the systemic availability of HMOs is needed to improve our understanding of the microbiome-independent effects of HMOs on human health.

母乳中含有许多具有基本营养以外的生理作用的成分，包括大量结构多样的低聚糖。人乳寡糖（HMOs）通过微生物依赖和不依赖的机制与健康结果相关。为了研究单个hmo的微生物组独立效应及其在人类健康中的作用，有必要了解它们的全身可用性。这篇叙述性综述侧重于HMOs的系统可用性，并总结了调查人类口服HMOs后血液和尿液中HMOs存在的研究。我们使用以下术语单独或组合检索PubMed：人乳寡糖，HMO, 2'- focusyllactose, 3- focusyllactose, 3'-sialyllactose, 6'-sialyllactose, di focusyllactose，乳酸-n -四糖和乳酸-n -neotetraose。纳入标准为：(1)研究设计为观察性或干预性；(2)队列包括母乳喂养的婴儿、HMO配方奶粉喂养的婴儿或服用HMO补充剂的个人；(3)定义HMO吸收/排泄和描述分析的方法。我们确定了15项人体研究。它们在设计、人群（健康婴儿、有医学指征的婴儿、成年人）、给药（母乳喂养、配方奶粉、补充剂）、摄入剂量、采样时间点和分析方法等方面各不相同。在母乳喂养的婴儿、接受HMO强化配方奶粉的婴儿和接受HMO补充剂的成年人的血液和尿液中检测到HMO被吸收到血液中并随尿液排出，证明了它们的全身可用性。大多数口服的HMOs出现在血液中，但有些结构不被吸收。研究还报告，血液和尿液中HMOs的浓度与剂量增加有关。一些研究表明，摄入的HMOs数量与尿液中发现的低聚糖数量之间存在差异。目前的证据支持HMOs在婴儿和成人的全身可用性，但吸收动力学，速率，机制和代谢命运仍然未知。需要进一步研究HMOs的系统可用性，以提高我们对HMOs对人类健康的微生物组无关效应的理解。临床试验注册编号和获取的网站：（不适用）系统评价或荟萃分析的注册编号：（不适用）显著性声明：这篇对近期研究的综述证实，婴儿和成人口服的人乳寡糖（HMOs）可以被吸收到血液中并通过尿液排出，这表明了HMOs的全身可利用性，并支持了HMOs的生理益处可能不限于其益生元模式的作用，也可能是由于其全身可利用性和作用的假设。关于HMOs的吸收机制、吸收动力学、结构特异性差异和代谢命运的关键问题仍然存在，这些见解对于促进我们对HMOs作为具有系统相关性的生物活性成分的理解至关重要。

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引用次数: 0

Gastrointestinal Symptoms During Cancer Therapy: The Clinician’s Role 肿瘤治疗期间的胃肠道症状：临床医生的作用

IF 9.2 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-09-01 DOI: 10.1016/j.advnut.2025.100472

Robert Dunn

引用次数: 0

Nutrition Interventions in the Treatment of Gastrointestinal Symptoms during Cancer Therapy: A Systematic Review and Meta-analysis 营养干预治疗癌症治疗期间胃肠道症状：一项系统综述和荟萃分析。

IF 9.2 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-09-01 DOI: 10.1016/j.advnut.2025.100485

Zainab Alzoubi , Brett R Loman

Modern cancer therapy is effective at reducing tumor burden and extending lifespan. However, cancer therapy also induces various gastrointestinal (GI) side-effects that are dose-limiting, reduce quality of life, and potentially lead to treatment failure. Standard medical nutrition therapy for patients undergoing cancer treatment focuses on preventing weight loss and malnutrition but not reducing GI symptoms. Therefore, the objective of this study was to assess efficacy of nutrition therapy to reduce GI side-effects during cancer treatment via systematic review and meta-analysis. A systematic search was conducted in Scopus and PubMed databases. A meta-analysis was performed on articles meeting inclusion criteria to estimate the pooled effect size on GI symptoms, separated by nutrition intervention type (nutrient supplementation, oral nutrition supplement, or dietary counseling). Further subgroup analyses were conducted based on cancer type, cancer therapy, and nutrient intervention. All statistical analyses were performed in Stata/MP version 17.0 using 2-sided tests with P < 0.05 as the threshold for statistical significance. A total of 15,556 articles were captured by the search algorithm, and 139 studies met inclusion criteria for meta-analysis. Articles reported 12 different GI symptoms, resulting in 151 total meta-analyses across symptom, cancer treatment, and nutrition intervention subtypes. Meta analyses indicated that collectively (all interventions combined), nutrient supplementation reduced nausea, vomiting, and diarrhea incidence (all P < 0.001). Oral nutrition supplements had no effects on GI symptoms (all P > 0.05). Dietary counseling reduced constipation and diarrhea incidence. Although 9 individual nutrient supplementation interventions reduced 8 symptoms, probiotic supplementation had some of the strongest effects on abdominal pain, vomiting, and diarrhea incidence. This meta-analysis supports implementation of specific medical nutrition therapies to treat GI symptoms during cancer therapy and identifies those requiring additional investigation. Given the large variation in responses within and across studies, future experiments should explore personalized nutrition-based strategies to optimize treatment efficacy.

This study was register at PROSPERO as 549116.

现代癌症治疗在减轻肿瘤负担和延长寿命方面具有显著效果。然而，癌症治疗也会诱发各种胃肠道（GI）副作用，这些副作用会限制剂量，降低生活质量，并可能导致治疗失败。接受癌症治疗的患者的标准医学营养治疗侧重于预防体重减轻和营养不良，而不是减轻胃肠道症状。因此，本研究的目的是通过系统回顾和荟萃分析来评估营养疗法对减少癌症治疗期间胃肠道副作用的疗效。系统检索Scopus和PubMed数据库。对符合纳入标准的文章进行荟萃分析，以估计胃肠道症状的综合效应大小，并按营养干预类型（营养补充、口服营养补充或饮食咨询）进行分类。进一步的亚组分析是基于癌症类型、癌症治疗和营养干预。所有统计分析均在Stata/MP 17.0版本中进行，采用双侧检验，p < 0.05为统计学显著性阈值。搜索算法捕获了15556篇文章，139篇研究符合meta分析的纳入标准。文章报道了12种不同的胃肠道症状，总共进行了151项荟萃分析，涉及症状、癌症治疗和营养干预亚型。Meta分析表明，总的来说（所有干预措施结合起来），营养补充减少了恶心、呕吐和腹泻的发生率（均p < 0.001）。口服营养补充剂对胃肠道症状无影响（p < 0.05）。饮食咨询减少了便秘和腹泻的发生率。虽然个体营养补充干预可以减轻症状，但益生菌补充对腹痛、呕吐和腹泻的发生率有最强的影响。这项荟萃分析支持在癌症治疗期间实施特定的医学营养疗法来治疗胃肠道症状，并确定那些需要进一步调查的症状。鉴于研究内部和研究之间的反应差异很大，未来的实验应探索个性化的基于营养的策略，以优化治疗效果。系统评价或荟萃分析的注册和注册编号：该研究在PROSPERO注册为549116。

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引用次数: 0

Dietary Polyunsaturated to Saturated Fatty Acid Ratio as an Indicator for LDL Cholesterol Response: A Systematic Review and Meta-Analysis of Randomized Clinical Trials 膳食多不饱和脂肪酸与饱和脂肪酸的比值作为ldl -胆固醇反应的指标：随机临床试验的系统回顾和荟萃分析。

IF 9.2 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-08-28 DOI: 10.1016/j.advnut.2025.100502

Tricia L Hart, Janhavi J Damani, Zachary S DiMattia, Kayla E Tate, Fatemeh Jafari, Kristina S Petersen

Background

Dietary guidelines recommend limiting saturated fatty acid (SFA) intake by replacing SFA with polyunsaturated fatty acid (PUFA). PUFA and SFA have opposing effects on low density lipoprotein (LDL) cholesterol, and therefore, the dietary ratio of PUFA to SFA (P:S) may be a better indicator of LDL cholesterol response than SFA alone.

Objectives

A systematic review and meta-analysis of randomized clinical trials was conducted to examine LDL cholesterol responses to higher P:S ratio diets compared with isoenergetic, total fat-matched diets with lower P:S ratios in healthy adults.

Methods

A systematic search of PubMed, Cochrane Central, and Web of Science was conducted. Randomized complete feeding trials lasting ≥3 wk, including 2 test diets with P:S ratios differing by >0.3 that were matched for energy, fiber, and total fat, were included. Random effects meta-analysis was used to evaluate the mean difference (MD) in LDL cholesterol with higher P:S ratio diets compared to lower P:S ratio diets. Heterogeneity in the effect of the P:S ratio by SFA content of the test diets was also evaluated.

Results

In total, 1001 publications were identified, and 24 publications reporting 24 trials (n = 1011) were eligible. Higher P:S ratio diets (median P:S ratio 1.2; PUFA 10.6% kcal; SFA 8.0% kcal; and MUFA 12.6% kcal) lowered LDL cholesterol [MD −9.83 mg/dL; 95% confidence interval (CI): −13.63, −6.04; I² = 79%] compared with lower P:S ratio diets (median P:S ratio 0.4; PUFA 4.4% kcal; SFA 12.5% kcal; and MUFA 14.6% kcal). Heterogeneity in the P:S ratio effect was observed by the test diet SFA content (P < 0.001). Higher compared to lower P:S ratio diets lowered LDL cholesterol (MD −15.72 mg/dL; 95% CI: −20.51, −10.92; I² = 68%) when the test diets differed in SFA (≥2% kcal), but not when diets were SFA-matched (MD −3.45 mg/dL; 95% CI: −7.88, 0.98; I² = 70%).

Conclusions

Compared with lower P:S ratio diets, higher P:S ratio diets were associated with greater LDL cholesterol reductions in generally healthy adults, and this effect was stronger when PUFA replaced SFA.

This trial was registered at Prospective Register of Systematic Reviews (PROSPERO) as CRD42023452550.

背景：膳食指南建议通过用多不饱和脂肪（PUFA）代替饱和脂肪（SFA）来限制饱和脂肪（SFA）的摄入量。PUFA和SFA对低密度脂蛋白胆固醇（LDL-C）的影响相反，因此PUFA与SFA的膳食比例（P:S）可能比单独SFA更好地指示LDL-C反应。目的：对随机临床试验进行了系统回顾和荟萃分析，以检查健康成人对高P:S比饮食的LDL-C反应，并将其与等能、总脂肪匹配的低P:S比饮食进行比较。方法：系统检索PubMed、Cochrane Central和Web of Science。纳入持续≥3周的随机完全饲养试验，包括两种P:S比相差>.3的试验饲粮，能量、纤维和总脂肪匹配。采用随机效应荟萃分析评价高P:S比饮食与低P:S比饮食LDL-C的平均差异（MD）。试验饲料中SFA含量对P:S比影响的异质性也进行了评价。结果：共纳入1001篇文献，其中24篇文献报道了24项试验（n=1011）。高磷硫比饮食（中位数磷硫比1.2;PUFA 10.6%kcal; SFA 8.0%kcal; MUFA 12.6%kcal）比低磷硫比饮食（中位数磷硫比0.4;PUFA 4.4%kcal; SFA 12.5%kcal; MUFA 14.6%kcal）降低LDL-C （MD -9.84 mg/dL; 95%CI -13.65, -6.04; I2=79%）。当试验饲粮SFA含量不同（≥2%kcal）时，试验饲粮SFA含量（p2=68%）观察到P:S比效应的异质性，但当试验饲粮SFA匹配（MD -3.45 mg/dL; 95%CI -7.88, 0.98; I2=70%）时，试验饲粮SFA含量不存在异质性。结论：与低P:S比饮食相比，高P:S比饮食与一般健康成年人LDL-C的降低有关，当PUFA取代SFA时，这种效果更强。注册：前瞻性系统评价注册（PROSPERO）注册号：CRD42023452550。

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引用次数: 0