Annals of Nutrition and Metabolism最新文献

Background: The gut microbiota, or microbiome, is essential for human health. Early-life factors such as delivery mode, diet, and antibiotic use shape its composition, impacting both short- and long-term health outcomes. Dysbiosis, or alterations in the gut microbiota, is linked to conditions such as allergies, asthma, obesity, diabetes, inflammatory bowel disease, and necrotizing enterocolitis in preterm infants.

Summary: This article reviews current strategies to influence the early-life gut microbiome and their potential health impacts. It also briefly summarizes guidelines on using biotics for gastrointestinal and allergic diseases in children. Key strategies include vaginal or fecal microbiota transplantation for cesarean-born infants, breastfeeding, and biotic-supplemented formulas. While vaginal microbial transfer and maternal fecal microbiota transplantation show short-term benefits, further research is needed to determine long-term safety and efficacy. Breast milk, rich in human milk oligosaccharides, promotes a healthy microbiota and offers protection against infections. Biotic-supplemented formulas can improve the gut microbiota in formula-fed infants and show clinical effects, though each biotic must be evaluated separately. Probiotics given as dietary supplements outside of infant formulas show promise for treating gastrointestinal disorders but require further investigation.

Background: Knowledge of the complex interplay between gut microbiota and human health is gradually increasing as it has just recently been a field of such great interest.

Summary: Recent studies have reported that communities of microorganisms inhabiting the gut influence the immune system through cellular responses and shape many physiological and pathophysiological aspects of the body, including muscle and bone metabolism (formation and resorption). Specifically, the gut microbiota affects skeletal homeostasis through changes in host metabolism, the immune system, hormone secretion, and the gut-brain axis. The major role on gut-bone axis is due to short-chain fatty acids (SCFAs). They have the ability to influence regulatory T-cell (Tregs) development and activate bone metabolism through the action of Wnt10. SCFA production may be a mechanism by which the microbial community, by increasing the serum level of insulin-like growth factor 1 (IGF-1), leads to the growth and regulation of bone homeostasis. A specific SCFA, butyrate, diffuses into the bone marrow where it expands Tregs. The Tregs induce production of the Wnt ligand Wnt10b by CD8+ T cells, leading to activation of Wnt signaling and stimulation of bone formation. At the hormonal level, the effect of the gut microbiota on bone homeostasis is expressed through the biphasic action of serotonin. Some microbiota, such as spore-forming microbes, regulate the level of serotonin in the gut, serum, and feces. Another group of bacterial species (Lactococcus, Mucispirillum, Lactobacillus, and Bifidobacterium) can increase the level of peripheral/vascular leptin, which in turn manages bone homeostasis through the action of brain serotonin.

Introductions: The diet during pregnancy has long-term effects on the health outcomes of both mothers and their children. Study aimed to undertake a systematic review to explore the association of high-fiber diet, DASH diet, and Mediterranean diet with metabolic outcomes among mothers and their children.

Methods: We searched for relevant articles published from Jan 2012 to Nov 2022 through PubMed, MEDLINE and Embase. Randomized trials and observational studies that considered high-fibre diet, DASH diet, Mediterranean diet during pregnancy and metabolic outcomes in pregnant women and their children were included in the systematic review. Thirty studies were included involving 41,424 pregnant women and children.

Results: A high-fibre diet was associated with reduced risk of gestational diabetes mellitus (GDM) (OR: 0.22; 95%CI: 0.11-0.42), pregnancy hypertensive disorders (OR: 0.45; 95% CI: 0.25-0.81) and lower birth weight (-109.54g; 95%CI: -204.84 to -14.24). The adherences to Mediterranean diet and DASH diet were associated with reduced risk of GDM (OR: 0.60; 95%CI: 0.45-0.80; OR: 0.36; 95%CI: 0.26-0.51), and lower risk of excessive gestational weight gain (OR: 0.41; 95%CI: 0.18-0.93; OR: 0.3, 95%CI: 0.16-0.57). Adherence to Mediterranean diet was associated with a lower risk of small for gestational age, fetal growth restriction and childhood overweight in the progeny (OR: 0.83, 95%CI: 0.73-0.95; OR: 0.50; 95%CI: 0.28-0.89; OR: 0.85; 95%CI: 0.74-0.97).

Conclusions: During pregnancy, high-fibre diet and adherences to Mediterranean diet and DASH diet were associated with lower risk of adverse metabolic outcomes in pregnant women and their children.

Background: Early infant feeding is essential for children's development and future health, particularly in preventing obesity, which is the most common nutrition-related disorder in children worldwide.

Summary: Obesity, characterized by excess body fat and numerous complications, arises from a combination of genetic susceptibility and an obesogenic environment, including lifestyle behaviors related to energy balance. Eating habits start to be shaped early in life, making the introduction of solid foods a critical period. Given the high prevalence of obesity, its long-term health consequences, and social implications, prevention is crucial. This narrative review aimed to identify factors related to the introduction of solid foods that influence obesity and suggest feeding strategies to prevent it. Tracking studies indicate that overweight and obesity during childhood often persist into adulthood, with associated complications such as hyperglycemia, dyslipidemia, hypertension, and nonalcoholic fatty liver disease. Complementary feeding involves introducing solid foods besides breast milk or formula. The timing and content of complementary feeding are crucial in influencing obesity risk. Introduction of solid foods before 4 months is associated with higher BMI in childhood. The method of introducing complementary feeding, such as baby-led weaning, has been proposed to predict later obesity risk, though findings are currently inconclusive. Parental feeding practices and socioeconomic factors significantly influence complementary feeding and obesity risk. Early prevention programs, especially those involving parental education on responsive feeding and diet, are promising for reducing obesity risk. Future programs should incorporate parents' perceptions and motivations to improve intervention effectiveness.

This editorial explores the intricate landscape of supplement use in oncology, highlighting the growing interest and challenges surrounding their integration into cancer care. It discusses the disparity in regulatory oversight between supplements and pharmaceutical drugs, the blurred lines in their classification, and the ethical complexities in patient-doctor communication. The importance of transparency, shared decision-making, and realistic expectations is emphasized. While acknowledging the value of traditional research models, the editorial advocates for innovative approaches like retrospective studies, biomarker analysis, and personalized medicine to advance our understanding of supplement efficacy and safety. By integrating these diverse perspectives, we can unlock the full potential of supplements in oncology, ensuring that they are used effectively and responsibly to enhance patient outcomes.

Introduction: Phosphate ion is common in the core of urinary stones and may initiate stone formation. However, the precise role of phosphate in the initiation of stone formation remains obscure. We assessed the effects of dietary phosphate load on urinary stone risk and phosphate metabolism.

Methods: Ten non-stone-forming healthy volunteers completed this randomized, crossover study. Each subject was provided a high- or low-phosphate diet for 3 days. After a 2-day equilibration period with a moderate-phosphate diet, the participants received a low- or high-phosphate diet for another 3 days. Serum, fecal, and 24-h urine samples were collected at the end of each intervention.

Results: High dietary phosphate load increased urinary phosphate excretion, and low dietary phosphate decreased urinary phosphate excretion. In addition, urine pH was lower and supersaturation (SS) index of uric acid (UA) was higher after a high-phosphate diet. There was no significant difference in the SS index for calcium oxalate, brushite and hydroxyapatite, or 24-h urinary citrate between the high and the low dietary phosphate. Also, no significant change was observed in fecal phosphate excretion after a high- or low-phosphate diet. The serum phosphate level increased after a high-phosphate diet, but there was no difference in serum phosphate between low-phosphate and moderate-phosphate diets.

Conclusion: High dietary phosphate load led to higher urinary phosphate excretion, a higher SS index of UA, and lower urine pH. Stone formers should be advised to limit the intake of high-phosphate source diet, including high-protein diets and phosphate-based food additives.

Introduction: The Global Leadership Initiative in Malnutrition (GLIM) consensus highlights the importance of using the GLIM criteria as a standardized approach to diagnosing malnutrition, particularly in patients with cachexia. Although many existing studies have utilized the GLIM criteria to assess the association between malnutrition and malignant tumor patients, there remains relatively little research exploring the specific relationship between malnutrition and sarcopenia. This study aimed to investigate the correlation between malnutrition under the GLIM criteria and preoperative sarcopenia in patients with gastrointestinal malignancies. By looking into the relationship, we hope to find better ways to prevent and treat sarcopenia in these patients, which will lead to better clinical outcomes.

Methods: In this study, we selected 210 patients with gastrointestinal malignant tumors from Northern Jiangsu People's Hospital between June 2022 and July 2023. We diagnosed and graded the nutritional status of these patients using the GLIM criteria. At the same time, body composition analysis, calf circumference, and grip strength were detected in all patients to observe whether they had sarcopenia.

Results: According to GLIM criteria, 30.1% of the patients were diagnosed with malnutrition, of which 25.1% were classified as moderate malnutrition and 15% as severe malnutrition. The risk of sarcopenia in patients with severe malnutrition was 2.5 times that of patients with good nutrition, and 1.19 times that of patients with moderate malnutrition. Patients with BMI <18.5 kg/m2 were 9.12 times more likely to develop sarcopenia than those with BMI ≥18.5 kg/m2. Due to inadequate nutrient intake and resultant malnutrition in patients with malignant tumors, muscle protein synthesis is affected, exacerbating muscle protein breakdown and leading to an overall decline in muscle strength and function.

Conclusion: This study highlights the urgent need for nutritional screening in early gastrointestinal tumor patients, revealing a strong link between sarcopenia and malnutrition. Higher malnutrition levels, low BMI, and high nutritional risk significantly predict sarcopenia, with risk increasing alongside worsening malnutrition and disease stage.

Background: Growth assessments are a pillar of public health surveillance, individual health screening, and clinical care. Normal growth is defined differently for individuals versus populations. The World Health Organization (WHO) growth standards were developed to describe the pattern of growth in healthy children without socioeconomic limitations whose mothers planned to breastfeed. The growth standards' cut-off points of ±2 standard deviations (z-scores) were defined for population assessments, based on attained size, to describe stunting and wasting at the lower end and overweight at the higher end. In a healthy population, one would expect 2.3% of the population to be above and below these cut-points. Higher child mortality rates associated with higher rates of stunting and wasting noted in observational studies validated these WHO cut-offs. There are knowledge gaps influencing the accuracy and effectiveness of growth assessments in individual children, posing challenges for health care providers.

Summary: The principles of assessing normal growth in children and preterm infants are reviewed, along with pitfalls to be avoided. Growth is determined by genetics and modified by the interplay with nutritional, environmental, socioeconomic, and possibly intergenerational factors. This complexity is reflected at both the population and individual level. However, normal growth in an individual has unique-specific factors so requires a comprehensive assessment. Normal growth for an individual child could be defined as the progression of changes in anthropometric measurements to achieve the individual's genetic potential. A misdiagnosis of growth faltering can occur if infants and children are asses with one-time rather than serial measures, and if age is not corrected for prematurity. Health care provider sensitivity and cognizance when communicating about a child's size is important for parental reassurance and avoiding stigma and unnecessary pressures or restrictions around feeding.

Background: Growth trajectories during the first 1,000 days from conception to 2 years influence human capital, predicting intelligence, skills and health in adults.

Summary: This review describes current evidence on the impacts of adverse pregnancy outcomes such as low birth weight, preterm birth, small for gestational age, and infant nutrition on long-term neurodevelopment and summarizes interventions that have proven to be effective in improving child development and further impact human capital. To date, no globally standardized measurements of child development in low-medium-income countries exist, and comparisons among studies using different developmental scales are challenging. In the perinatal period, birth weight, gestational age at delivery and elevated placental blood flow resistance have been identified as the main risk factors for global neurological delay, poor neurosensory development and cerebral palsy. Although these adverse neurological outcomes have decreased in developed settings, it is still a problem in low-resource populations. Nutritional deficiencies are the main drivers of developmental impairment, notably iron, iodine and folate deficiencies, and environmental stressors during pregnancy such as air pollution, exposure to chemicals, substance abuse, smoking, and maternal/parental psychiatric disorders can affect the developing brain. Interventions aiming to improve maternal macro- and micronutrient status, delayed cord clamping, exclusive breastfeeding and nurturing care have demonstrated to be effective strategies to prevent perinatal complications known to affect child development.