Annals of Nutrition and Metabolism最新文献

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.

Introduction: Cancer poses a significant burden in Africa, where limited resources and infrastructure compound the challenges of managing the disease. Undernutrition, a critical concern among cancer patients, can profoundly affect treatment outcomes and overall prognosis. Despite its importance, the prevalence of undernutrition among African cancer patients remains poorly understood.

Methods: Five major databases were searched for observational studies that reported the prevalence of undernutrition, from inception till February 2024. Study selection, data extraction, and quality assessment were conducted by at least two independent reviewers. The NIH criteria for observational studies were used for quality assessment. A random-effects meta-analysis model was used to estimate the overall undernutrition prevalence, with subgroup analyses conducted based on country and population characteristics.

Results: Twenty-four studies involving 4,283 participants met the inclusion criteria and most studies included children (41%), followed by adults (37%) and women (19%). The overall undernutrition prevalence among African cancer patients was estimated at 32.8% (95% CI, 25.1%, 41.67%) with substantial heterogeneity observed (I2 = 95.4%, p < 0.0001). Subgroup analyses revealed significant variations in prevalence across countries and population groups.

Conclusion: Undernutrition is a serious issue among African cancer patients and requires an urgent response with targeted interventions. Tailored nutritional support strategies, considering demographic and regional contexts, are essential for improving patient outcomes.

Background: The term "faltering growth" (FG) is widely used to refer to a slower rate of weight gain in childhood than expected for age and gender. The prevalence varies depending on the definition and the studied population. Early recognition is important when considering the short- and long-term consequences, which include reduced cognitive development and increased risk of morbidity and mortality.

Summary: The causes of FG are traditionally classified into being either illness- or non-illness-related. However, such a rigid classification does not acknowledge the fact that poor growth may be multifactorial. While many definitions for FG exist, a recent consensus document suggested that a drop of weight-for-height of 1 z-score warrants the consideration for FG. The nutritional assessment supports the calculation of energy and protein requirements, which should be tailored to the underlying cause.

Introduction: Vitamin D deficiency is associated with bone metabolism and immune disorders. Radiation's seasonal variation affects vitamin D status more at the poles. In Mexico, near the equator, there have been reports of 10-20% vitamin D deficiency in children. There is no consensus on the definition of vitamin D deficiency, different organizations consider that a vitamin D level should be above 20-30 ng/mL. This study aimed to analyze vitamin D serum concentrations in children and adolescents from Mexico City and the Metropolitan Area (MA) during different seasons.

Methods: Cross-sectional study in children and adolescents aged 5-20 years from Mexico City and Metropolitan Area, from autumn 2016 to winter 2017. Variables of interest such as anthropometric measurements, food consumption, and physical activity were analyzed.

Results: A total of 816 children and adolescents were included. A high frequency of vitamin D deficiency was detected in 40.7% of the sample. The lowest vitamin D status occurred in winter 2016 and winter 2017.

Conclusion: We found a higher frequency of vitamin D deficiency during winter in children and adolescents in Mexico City and MA. This risk persisted after adjusting for age, sex, body mass index Z-score, milk consumption, physical activity, and screen time.

Introduction: This study aimed to determine the effects of Stored Energy on changes in body weight (BW) and skeletal muscle mass (SMM) in patients with post-acute stroke and sarcopenia.

Methods: This retrospective cohort study included patients with stroke and sarcopenia consecutively admitted to a Japanese rehabilitation hospital between 2015 and 2022. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia in 2019 criteria. Total Stored Energy (kcal) was defined as total energy intake minus total energy requirements during hospitalization, and energy requirements were estimated as actual BW (kg) × 30 (kcal/day). Multiple regression analysis was used to adjust for the effects of confounders and to analyze the association between Total Stored Energy divided by length of hospital stay (= Stored Energy) and changes in BW and SMM during hospitalization.

Results: Of the total 556 patients, 193 patients (mean age, 80 years; 43% male) were analyzed. The median (IQR) Total Stored Energy was -1,544 (-18,524, 16,566) kcal and Stored Energy was -23 (-169, 165) kcal/day; 90 patients had Stored Energy >0. Multiple linear regression analysis showed that Stored Energy was independently and positively associated with BW gain (β = 0.412, p < 0.001) and SMM gain (β = 0.263, p < 0.001).

Conclusion: Stored Energy has a positive impact on BW and SMM in patients with post-acute stroke and sarcopenia.

Introduction: Nutritional therapy is an important component of intensive care. We investigated the associations of nutritional therapy in the acute phase of severe COVID-19 with the long-term outcomes of post-intensive care syndrome (PICS) and post-COVID-19 conditions.

Methods: A questionnaire on the health status after COVID-19 was sent to patients 1 year after infection and PICS was evaluated. Total energy and protein intakes during the first week after admission to the intensive care unit (ICU) were calculated. The primary endpoint was a decrease in quality of life (QOL) defined by EuroQol5-dimensions 5-level (EQ5D5L) <0.8. A multivariable regression analysis was used to examine.

Results: A total of 220 ICU patients were included in this study. Median total energy and protein intakes were 65.1 kcal/kg/week and 3.3 g/kg/week, respectively. Total energy and protein intakes were associated with EQ5D5L scores (energy: unit odds ratio 0.98 [0.97-0.99], p value <0.01; protein: unit odds ratio 0.72 [0.59-0.87], p value <0.01). Insufficient total energy and protein intakes were associated with malaise, arthralgia, myalgia, palpitations, sleep disturbance, and muscle weakness.

Conclusions: Poor nutrition during the first week after ICU admission was associated with a decreased QOL 1 year after. These nutrition shortages were also associated with an increased risk of developing PICS, post-COVID-19 conditions, which may contribute to decreased QOL.

Introduction: Hudda-Index is a prediction model for fat mass (FM) based on simple anthropometric measures. FM is a crucial factor in the development of comorbidities, i.e., type 2 diabetes. Hence, Hudda-Index is a promising tool to facilitate the identification of children at risk for metabolic comorbidities. It has been validated against deuterium dilution assessments; however, independent validation against the gold standard for body composition analysis, magnetic resonance imaging (MRI), is lacking. The aim of this study was to validate FM calculated by Hudda-Index against FM measured by MRI. The secondary aim was to compare Hudda-Index to other anthropometric measures including body mass index (BMI), BMI-standard deviation score (BMI-SDS), waist/hip-ratio, waist circumference (WC), and skinfold thickness.

Methods: The study cohort consists of 115 individuals between the age of 9 and 15 years, recruited at Paracelsus Medical University Hospital in Salzburg (Austria) and Uppsala University Children's Hospital (Sweden). Anthropometry, blood samples, and oral glucose tolerance tests followed standard procedures. MRI examinations were performed to determine visceral adipose tissue (VAT) and subcutaneous adipose tissue.

Results: BMI and WC showed slightly stronger associations with the reference standard VAT (r = 0.72 and 0.70, p < 0.01, respectively) than Hudda-Index (r = 0.67, p < 0.01). There is an almost perfect linear association between BMI and Hudda-Index. Accordingly, BMI and Hudda-Index both showed an acceptable association with cardiometabolic parameters. VAT was strongly associated with markers of liver status (LFF r = 0.59, p < 0.01) and insulin resistance (HOMA-IR r = 0.71, p < 0.01) and predicted metabolic dysfunction-associated steatotic liver disease.

Conclusion: BMI, although an imperfect measure, remains the most reliable tool and estimates cardiometabolic risk more reliably than other anthropometry-based measures.

Introduction: Appropriate cooking methods can improve food safety, decrease contaminants, and increase nutrient bioavailability. Few studies assessed the sociodemographic characterization of their use in European populations. We aimed to characterize the socio-demographic, lifestyle, and anthropometric predictors of cooking methods in the Swiss population.

Methods: Adults aged 18-75 years (n = 2,050) participating in the cross-sectional national nutrition survey in Switzerland (menuCH) (2014-2015), representing the 7 main regions in the country. We used logistic regressions to assess the probability of the presence or absence of boiled, roasted, microwaved, oven-cooked, gratinated, fried, steamed, and grilled foods by sociodemographic variables.

Results: Among all participants, the most frequently used cooking methods were boiling (46%), stove-cooking (19%), and steaming (8%). Single participants had a higher probability of consuming grilled or fried foods (68%) than their married counterparts and participants with obesity had a higher probability of consuming grilled or fried foods (67% or 135%) compared to those with normal weight. Divorced or separated participants had a 55% lower probability of consuming roasted foods than married participants. Those following a diet had a 57% lower probability of consuming grilled foods compared to those not on a diet.

Conclusion: We found differences in the distribution of cooking methods in the Swiss population by sociodemographic variables. Further studies should examine the link between cooking methods and disease risk.