Annals of Nutrition and Metabolism最新文献

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: Prebiotics are widely used in nutritional supplements, with water-soluble dietary fibers used as thickeners for patients with swallowing difficulties. Interactions between thickeners and medications have been reported; however, the effects of thickeners on warfarin remain unclear. Here, we examined the interaction between warfarin and thickeners through clinical and basic research studies.

Methods: The clinical research study evaluated the effects of combining warfarin and thickeners on blood coagulation, while the basic research study measured the impact of different prebiotics and mixing with gastric and intestinal fluids on warfarin concentration.

Results: The clinical research study showed no significant differences in the patients' prothrombin time-international normalized ratio and Warfarin Sensitivity Index (WSI) before and after the combination. However, the WSI decreased postcombination in half of the patients. Meanwhile, in the basic research study, a concentration-dependent decrease in the residual rate of warfarin was observed with xanthan gum, guar gum, and pectin. When mixed with artificial gastric and intestinal fluids, the residual rate decreased with xanthan and guar gum in gastric fluid and with pectin in intestinal fluid.

Conclusion: Thickeners primarily composed of xanthan gum, guar gum, and pectin may reduce the effectiveness of warfarin due to drug-food interactions.

Introduction: Adverse exposures in utero might cause adaptations of cardiovascular and metabolic organ development, predisposing individuals to an adverse cardio-metabolic risk profile from childhood onwards. We hypothesized that adaptations in metabolic pathways underlie these associations and examined associations of metabolite profiles at birth with childhood cardio-metabolic risk factors.

Methods: The study included 763 mother-child pairs participating in an ongoing population-based prospective cohort study with an overall low disease risk. Cord blood serum concentrations of amino acids (AAs), nonesterified fatty acids, phospholipids and carnitines (Carn) were obtained using a liquid chromatography coupled with tandem mass-spectrometry. We measured android/gynoid fat mass ratio, blood pressure, insulin, and lipid concentrations at the children's age of 5.9 (0.3) and 9.8 (0.9) years.

Results: We did not observe associations of cord blood metabolites with systolic or diastolic blood pressure, insulin, triglycerides, and android/gynoid fat mass ratio at both ages and cardio-metabolic risk clustering at age 10 years. Five short- and medium-chain Carn.a metabolites were positively associated with cardio-metabolic risk clustering at age 6 but did not survive more stringent confounder adjustment.

Conclusion: No consistent associations between cord blood metabolites and cardiovascular risk factors at school age were observed.

Introduction: In the principles of intensive care, nutritional support is an important part of critical care. This study was conducted to evaluate the adequacy of enteral nutrition in patients hospitalised in adult intensive care units.

Methods: The present study was designed as a cross-sectional study, and it was carried out on 124 patients who received enteral nutrition in the adult intensive care unit of a training and research hospital between March 1, 2022, and April 1, 2022. Patients who received parenteral nutrition during the 1-month follow-up were excluded from the study. The study used the enteral nutrition information form and the baseline NRS-2002 score. Energy needs of patients were calculated by Schofield method and addition of stress factors. Daily energy intake was recorded for each patient every day during hospitalisation. Backward stepwise logistic regression analysis, Shapiro-Wilk, Student's t, Mann-Whitney U, Kruskal-Wallis, Dunn-Bonferroni, Pearson chi-squared, and Fisher's exact tests were used to evaluate the data.

Results: Mean age of the patients was 70.9 ± 16.7 years (range 21-98), and 58.9% were male. The mean baseline NRS-2002 score was 5.88 ± 1.23. Enteral nutrition started an average of 2.4 ± 2.2 days (range 0-18) after ICU hospitalisation. The mean target energy intake according to Schofield method was 1,772.9 ± 284.3 kcal, while the actual intake was 1,463.5 ± 386.2 kcal. Only 37.1% of patients achieved the target dose, taking an average of 4.5 ± 4.2 days (1-20) to reach it. In 25% of patients, feeding was interrupted due to residual volumes exceeding 500 mL, with 54.8% of these receiving hypercaloric products. Patients with neurological and cardiac diagnoses had significantly higher rates of reaching the target dose (p = 0.001), while those with interruptions due to high residual volumes had lower rates (p = 0.003). Finally, the overall mortality rate was 59.7%.

Conclusion: More than half of the patients did not meet the goals set for enteral nutrition therapy. A lower baseline NRS-2002 score and low energy requirements facilitated goal attainment. Patients with cardiac or neurological conditions were more likely to reach the target nutritional dose. However, those fed with hypercaloric products experienced more interruptions due to excess residue and achieved the nutritional target less frequently.

Introduction: Candidates for bariatric surgery may have psychiatric disorders that must be evaluated. The aim of this study was to describe the psychological state and quality of life (QoL) of patients with obesity awaiting bariatric surgery prior to surgical procedure and 1 year after surgery.

Methods: A longitudinal retrospective observational study was carried out in 71 patients awaiting bariatric surgery. Anthropometric data were collected, and the following were evaluated before and 1 year after the intervention: 44 patients were evaluated to rule out personality disorder, using the Salamanca Questionnaire of Personality Disorders; eating disorder, with the Bulimia Test of Edinburgh (BITE); depression, using the Beck Depression Inventory (BDI); and 71 patients were evaluated QoL, with the "36-Item Short Form Health Survey" (SF-36).

Results: A total of 34.1% (n = 15) of patients presented personality disorder (group B most frequent). A total of 31.8% (n = 14) obtained scores suggesting anomalous food behavior (6.8%, n = 3 severe). According to the BDI, 43.2% (n = 19) showed low mood prior to the intervention. Lower scores were obtained when evaluating QoL for physical functioning (physical function: 56.81 ± 24.9; physical problems: 66.76 ± 37.64). One year after the intervention, QoL improved in those patients who underwent the sleeve gastrectomy (SG).

Conclusions: Patients with bariatric surgery more frequently presented with type B and C personalities. One year after bariatric surgery, an improvement in QoL test was observed. Patients who underwent SG technique showed better mean scores than those after biliopancreatic diversion.

Introduction: Excessive visceral fat area is a risk factor for postoperative complications in gastric cancer patients undergoing minimally invasive gastrectomy. This prospective pilot study aimed to evaluate the safety, compliance, and efficacy of prehabilitation in obese patients with gastric cancer who were scheduled to undergo curative gastrectomy.

Methods: Patients with a preoperative visceral fat area ≥100 cm2 who were scheduled to undergo curative minimally invasive gastrectomy for stage I-III gastric cancer were included. The patients were instructed to walk 10,000 steps per day and consume a low-carbohydrate, high-protein diet without energy restrictions for 1 month before surgery. The primary outcome was the visceral fat area reduction rate, and clinical significance was set at a 10% reduction.

Results: Eighteen patients were enrolled in the study, and no adverse events were observed. The mean number of steps per day was 10,572. The mean exercise time greater than or equal to moderate intensity was 42.3 min per day, and 88% of the patients completed the 1-month intervention. Although the skeletal muscle mass was preserved, the visceral fat area reduced by 17% (95% confidence interval: 11%-24%, p = 0.039).

Conclusion: Prehabilitation can safely reduce visceral fat area before performing minimally invasive gastrectomy in patients with gastric cancer who are obese.

Background: Sleep health includes quality, quantity, and timing of sleep and is negatively affected by surgery. Poor preoperative sleep health is associated with worse surgical outcomes, including greater morbidity and hospital length of stay. Summary: In this narrative review, we describe the rationale and supporting evidence for preoperative sleep interventions (i.e., sleep prehabilitation) to improve perioperative outcomes. Our review highlights the link between impaired sleep health and surgical outcomes via several mechanisms including chronic, systemic low-grade inflammation, insulin resistance, and cognitive function. Instruments and intervention strategies to measure and improve sleep health, respectively, are discussed. Key Messages: We conclude with sleep prehabilitation recommendations and identify research priorities for the field.

Introduction: Being overweight, with a body mass index (BMI) ≥25, is associated with multiple comorbidities, including chronic kidney disease (CKD). A plant-based diet, such as a vegetarian or lacto-ovo vegetarian diet, serves as a preventive strategy for CKD in patients. We hypothesized that a vegetarian diet lowers the occurrence of CKD in overweight subjects.

Methods: The retrospective study was performed in Taipei Tzu Chi Hospital by a self-paid health exam. Age younger than 40 years old and the subjects without sufficient biochemical or hematologic results were excluded. The incidence of CKD was evaluated according to the self-reported eating habits (vegetarians, lacto-ovo vegetarians, or omnivores), overweight (with a BMI ≥25 or higher abdominal circumference [>90 cm in males or >80 cm in females]) or not, or other biochemical or hematologic parameters. The interaction between different factors for the development of CKD was analyzed by structural equation modeling (SEM).

Results: Among these 6,567 subjects, the subjects with lacto-ovo vegetarian diet had a lower incidence of CKD than those with other dietary habits such as vegans and omnivores. The incidence of overweight was the highest in the omnivore group. The lacto-ovo vegetarian group had a lower risk of CKD occurrence than the omnivore group. After adjusting for age and sex in SEM, the lacto-ovo vegetarian diet lowered the risk of CKD for those with a high BMI or a higher triglyceride (TG)/high-density lipoprotein (HDL) ratio.

Conclusion: Lacto-ovo vegetarian dietary habits are associated with a lower occurrence of CKD in obese patients. The mitigating effect of the lacto-ovo vegetarian diet was due to the hazard of a higher BMI and TG/HDL ratio.

Background: Breastfeeding is the ideal method of feeding for all newborns and is associated with multiple positive health outcomes. Human milk provides all essential nutrients and bioactive molecules needed for optimal infant health and development. Maternal nutrition during lactation plays an important role in supporting breastfeeding and in preventing nutrition and metabolic imbalances. The aim of this narrative review was to describe the most prevalent nutrition issues in lactating women and provide a summary of current diet recommendations as well as controversies on supplementation, in order to facilitate the information for clinicians and health professionals.

Summary: Breastfeeding is a nutritionally demanding stage and adequate nutrition is key to avoid alterations in maternal nutritional status, to produce an adequate quantity of milk with good quality, and to avoid nutrition programming of diseases. Anemia and vitamin D, A, iodine, and iron deficiencies are common, while obesity and metabolic diseases keep rising. Inadequate maternal intake of many nutrients is also frequent in this stage.

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.