Annals of Nutrition and Metabolism最新文献

Introduction: Enteral nutrition is used in patients with stroke, head-and-neck or esophageal cancer surgery, or repeated aspiration pneumonia. Japanese enteral nutrition guidelines recommend percutaneous endoscopic gastrostomy tube (PEG) for long-term use of >4 weeks and nasogastric tube (NGT) for short-term use of <4 weeks. Catheters may be contaminated with microorganisms because enteral feeding products passed through them daily, but there are few reports on catheter contamination in Japan and no reports on the duration of catheter use. There are also reports that enteral feeding is a risk factor for the appearance of drug-resistant bacteria. Therefore, this study aimed to determine whether microorganisms could be isolated from enteral feeding catheters and determine the percentage of drug-resistant bacteria.

Methods: Forty-six PEGs and 59 NGTs were collected at Showa University Hospital and Showa University Fujigaoka Rehabilitation Hospital from May 2019 to March 2020. Microorganisms were cultured by incubating 20 mL pass/wash solution of sterile purified water on BHI agar medium (37°C) for 24-72 h. The strains were isolated and cultured, then frozen (80°C) and stored. Antimicrobial susceptibility was determined by broth microdilution method.

Results: Microorganisms were detected in 37 PEGs and 57 NGTs (p = 0.007). Bacteria were detected in 27 PEGs and 53 NGTs (p < 0.001), and yeasts were detected in 29 PEGs and 28 NGTs (p = 0.112). Drug-resistant bacteria were isolated from 19.6% (9 of 46) in PEGs and 23.7% (14 of 59) in NGTs.

Conclusions: PEGs and NGTs were contaminated with microorganisms, and drug-resistant bacteria were isolated. This study provides a rationale for future appropriate use in enteral feeding catheters.

Introduction: The link between dietary branched-chain amino acid (BCAA) intake and metabolic health, particularly in adolescents, is not well established. In this investigation, the metabolic health of adolescents with overweight and obesity in Iran was studied in relation to their intake of dietary BCAAs.

Methods: This cross-sectional study included 203 adolescents from the general population who were either overweight or obesity. The consumption of BCAAs and other nutrients was calculated using a valid food frequency questionnaire. Blood pressure and anthropometric measurements were taken. Serum insulin, glucose, and lipid profile were determined from blood samples taken while the subjects were fasting. Subjects were categorized considering having metabolically healthy overweight/obesity and metabolically unhealthy overweight/obesity (MUO) using two distinct approaches (International Diabetes Federation [IDF] criteria and IDF/Homeostasis Model Assessment Insulin Resistance [HOMA-IR] criteria).

Results: Considering IDF criteria, increased consumption of dietary BCAAs was associated with significantly decreased odds of MUO (OR = 0.38; 95% CI: 0.18-0.77) in crude model; but in the fully adjusted model, the association became insignificant (OR = 0.49; 95% CI: 0.22-1.09). Based on IDF/HOMA-IR criteria, this association was completely significant in crude model (OR = 0.33; 95% CI: 0.15-0.69) and slightly significant in fully adjusted model (OR = 0.43; 95% CI: 0.18-1.00). Participants with overweight, as opposed to obesity, had considerably lower odds of MUO. Valine, one of the BCAAs, was negatively linked with odds of MUO in maximally adjusted model (OR = 0.43; 95% CI: 0.20-0.96).

Conclusions: Among BCAAs, increased consumption of valine via food could reduce the odds of MUO in Iranian adolescents with overweight/obesity.

Background: The development of the gut microbiome during early life plays a critical role in shaping long-term health. The first 1,000 days represent a crucial period in which the microbiome is particularly malleable, influenced by various factors such as birth mode, diet, antibiotic exposure, and environmental interactions.

Summary: This review outlines the key stages of microbiome maturation, beginning with initial colonization at birth and progressing through the diversification and stabilization phases during the first 5 years of life. Factors like breastfeeding, the introduction of solid foods, and early-life antibiotic have a critical impact on microbial diversity and immune system development. Disruptions to the microbiome during this critical window, particularly through antibiotic use, are associated with an increased risk of immune, metabolic, and neurodevelopmental disorders. Recent research emphasizes the need for a better understanding of these early-life trajectories to inform interventions that promote a healthy microbiome.

Introduction: Fibroblast growth factor 21 (FGF21) analogues may benefit patients with metabolic dysfunction-associated steatohepatitis (MASH). We aimed to compare the efficacy and safety of FGF21 analogues versus placebo for treating patients with MASH in randomized controlled trials (RCTs).

Methods: We searched PubMed, Embase, and the Cochrane Library. Primary outcomes were fibrosis improvement ≥1 stage without worsening of MASH and MASH resolution without worsening of fibrosis. Secondary outcomes were relative reduction ≥30% of the hepatic fat fraction (HFF) measured by magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) and adverse events (AEs).

Results: We included 7 RCTs (886 patients). FGF21 analogues had a higher probability of fibrosis improvement ≥1 stage without worsening of MASH (RR: 1.54; 95% CI: 1.07, 2.22), MASH resolution without worsening of fibrosis (RR: 3.31; 95% CI: 1.80, 6.06), and reduction ≥30% in the HFF by MRI-PDFF (RR: 3.03; 95% CI: 2.12, 4.33) than placebo, without significant difference in the risk of AEs. Subgroup analyses by the stage of fibrosis showed that FGF21 analogues improved fibrosis only among patients with fibrosis stages F1-F3.

Conclusion: FGF21 analogues appear to be an effective and safe treatment option for patients with MASH, although the impact on fibrosis improvement may be limited to non-cirrhotic patients.

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD), a prevalent condition, can progress to liver cirrhosis and hepatocellular carcinoma. This study evaluated the efficacy of liraglutide 3.0 mg in treating MASLD in patients with obesity in real-world clinical settings.

Methods: Adults aged 18 years or older with BMI ≥27 kg/m2 and obesity-related diseases were enrolled from ten tertiary hospitals across South Korea. Initially, 503 participants were included, with follow-up at 2, 4, and 6 months involving 244, 190, and 101 participants, respectively. Anthropometric and biochemical parameters, particularly MASLD-related ones, were assessed.

Results: In this cohort, liver enzymes, which serve as surrogate markers for MASLD, decreased continuously: aspartate aminotransferase from 33.2 ± 18.5 IU/L at baseline to 27.4 ± 12.8 IU/L at 6 months (p < 0.001); alanine aminotransferase from 41.6 ± 29.9 IU/L to 30.6 ± 18.0 IU/L at 6 months (p < 0.001). Hepatic steatosis index (HSI) and nonalcoholic fatty liver disease (NAFLD) liver fat score also decreased significantly (HSI: 44.7 ± 6.2 to 42.2 ± 5.8, p < 0.001; NAFLD liver fat score: 2.12 ± 2.90 to 0.43 ± 1.91, p < 0.001). Single-point insulin sensitivity estimator, which indicates insulin sensitivity, steadily increased from 4.38 ± 0.93 to 4.72 ± 1.06 (p < 0.001). No serious adverse events were reported.

Conclusion: Liraglutide 3.0 mg improved surrogate markers of MASLD in individuals with obesity, suggesting it may be a promising approach to address both conditions concurrently.

Background: The "first 1,000 days" - the duration of pregnancy and the first 2 years of life - is widely recognized as a sensitive period of early life, with implications for health and developmental outcomes throughout the life course. Optimal nutrition during pregnancy is therefore essential to reduce the risk of adverse pregnancy outcomes and support healthy life trajectories.

Summary: This narrative review summarizes the physiological changes during pregnancy and how these changes affect the energy and nutrient requirements in pregnancy to support maternal, placental, and fetal development and tissue accretion. Recommendations for weight gain and macro- and micronutrient requirements during pregnancy are summarized along with the current evidence.

Background: The importance of preconception care is now widely recognised. Optimisation of the lifestyle, nutrition, and the health of a couple not only affects the chances of conception and a successful pregnancy but also the health of the resulting offspring. Currently, limited data reinforce the importance of further research examining the role of individual nutrients. The complex interactions that these nutrients have with each other and the resultant effect on fertility should also be a focus for future investigation. Modifiable risk factors such as alcohol, caffeine, and body mass index should be optimised prior to attempting to conceive. New research is examining the role of personalised preconception advice.

Summary: This review examines the roles of macronutrients, micronutrients, and lifestyle in fertility and reproductive health. Raising awareness of the importance of the effect of preconception nutrition and lifestyle on hormone balance, gamete development, implantation, and pregnancy should be paramount. This applies to all healthcare professionals who come into contact with people of child-bearing age, as well as the general public.

Introduction: Constitutional thinness (CT) is an uncommon condition, allegedly non-pathological, defined by a persistently low body mass index (BMI <18 kg/m2) enduring from childhood through to later stages of life, without underlying chronic illnesses or hormonal abnormalities. Although CT is not associated with poor health outcomes, its long-term cardiovascular and metabolic implications remain unclear. Given that patients with CT often aim to achieve weight gain, and considering the lack of studies examining the outcomes of high-calorie dietary interventions in this population, we aimed to evaluate vascular and metabolic risk factors associated with atherosclerosis in CT individuals.

Methods: This prospective before-and-after study involved 60 nonsmoking, normotensive, normoglycemic participants with CT, all exhibiting normal lipid profiles (HDL: 55.8 ± 16 mg/dL; LDL: 66 ± 19.9 mg/dL). Changes in carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), fasting, and postprandial blood glucose levels before (T0) and after (T1) a 3-month high-calorie diet intervention was assessed using paired Student's t test. In addition, postprandial insulin levels were evaluated to capture potential metabolic adaptations.

Results: No significant changes were observed in CIMT (p = 0.54), FMD% (p = 0.423), BMI (p = 0.978), fasting (p = 0.297) or postprandial (p = 0.511) glucose levels, or lipid profiles (total cholesterol p = 0.138, HDL p = 0.858, LDL p = 0.66) after the 3-month high-calorie diet intervention. Both CIMT and FMD% remained within normal ranges at baseline and follow-up, suggesting that in the short term, individuals with CT do not experience substantial alterations in vascular or metabolic parameters despite increased caloric intake. A post hoc power analysis based on postprandial insulin (p = 0.007) showed a large effect size (Cohen's d = 0.71), with a power of 82% using G*Power software.

Conclusions: Short-term high-calorie dietary intervention does not lead to significant cardiovascular or metabolic changes in individuals with CT. However, these findings should be interpreted with caution due to the small sample size and short duration. Further studies with longer follow-up and larger sample sizes, or different dietary compositions, may be necessary to evaluate long-term effects.