Annals of Nutrition and Metabolism最新文献

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.

Introduction: Some studies have demonstrated the effect of the rs7903146 genetic variant on weight response after different dietary strategies. The objective of our study was to evaluate the role of this genetic variant of the TCF7L2 gene on weight loss and diabetes mellitus progression following a partial meal replacement (pMR) hypocaloric diet.

Methods: We conducted an interventional study in 214 subjects with obesity and a body mass index (BMI) >35 kg/m2. The subjects received two servings per day of a normocaloric hyperproteic formula for 24 weeks as part of a pMR diet. Body weight, BMI, fat mass, waist circumference, lipid profile, fasting insulin levels, and HOMA-IR were determined. All patients were genotyped for rs7903146 and evaluated under a dominant model (CC vs. CT + TT).

Results: The decrease at 24 weeks was higher in non-T-allele carriers compared to T-allele carriers (BMI: -3.3 ± 0.3 kg/m2 vs. -2.2 ± 0.2 kg/m2; p = 0.02; weight: -9.5 ± 1.1 kg vs. -5.0 ± 1.0 kg; p = 0.01; fat mass: -8.7 ± 0.2 kg vs. -4.0 ± 0.2 kg; p = 0.04; waist circumference: -8.0 ± 0.2 cm vs. -3.0 ± 0.4 cm; p = 0.04; glucose levels: -7.1 ± 1.2 mg/dL vs. -1.2 ± 1.1 mg/dL; p = 0.01; insulin: -10.1 ± 1.1 µIU/L vs. -4.0 ± 1.0 µIU/L; p = 0.01; HOMA-IR: -2.1 ± 1.1 units vs. -0.5 ± 0.1 units; p = 0.01; C-reactive protein: -0.9 ± 0.1 mg/dL vs. -0.4 ± 0.2 mg/dL; p = 0.01; triglycerides: -17.1 ± 0.1 mg/dL vs. -9.1 ± 0.2 mg/dL; p = 0.01; and HbA1c: -1 ± 0.1% vs. -0.3 ± 0.2%; p = 0.01). Following the dietary intervention, only non-T-allele carriers showed a significant decrease in the frequency of hypertriglyceridemia, abdominal waist, hyperglycemia, and DM2.

Conclusions: The TCF7L2 (rs7903146) polymorphism modulates pMR diet-induced changes in body weight, lipid metabolism, and insulin resistance. These changes lead to a significant decrease in the prevalence of hyperglycemia and other components of metabolic syndrome.

Background: In the perioperative setting, surgical trauma triggers an inflammatory reaction that is accompanied by an elevated risk for the development of severe immune-related complications (e.g., sepsis). The underlying pathophysiological mechanisms are partially caused by the patients' debilitated health conditions prior to the surgical procedure. As such, multimodal prehabilitation regimens (in particular preoperative exercise training and nutritional therapy) aimed at improving immune function have gained much attention. We hereby describe and highlight molecular and cellular targets for assessing the biological effects of prehabilitation and potential biomarkers for the success of these interventions.

Summary: Prehabilitation can remodel skeletal muscles at the molecular level and improve immune cell function through physical exercise and nutritional therapy. This review focuses on two emerging molecular pathways modulated by exercise-based therapies and potential biomarkers of whole-body health and of inflammation: the regulation of hypoxia inducible factors and of a class of bioactive lipids called ceramides. Additionally, we describe and highlight important cellular targets of prehabilitation which are of particular relevance for driving and sustaining the benefits of prehabilitation on the patients' immune function postoperatively.

Key messages: Dissecting the molecular mechanisms that modulate inflammation and immune cell function upon prehabilitation with beneficial effects on the patients' clinical outcomes is essential to properly diagnose the success of these interventions. And while there seems to be a multitude of organs and cells affected by physical conditioning, the key biological pathways which should be evaluated during prehabilitation interventions are yet to be uncovered and more research is needed for it. Nonetheless, some candidates are emerging as powerful regulators of inflammation and general health and deserve further investigation.

Background: Flavor, a complex sensation mediated by the chemical senses of taste, smell, and chemesthesis, is a primary driver of food acceptance. Because what we eat is an important influence on health in modern societies, we need to understand what shapes the acceptance of foods from an early age.

Summary: As infants transition from an all-milk diet to one that contains complementary foods of varying flavors and textures, biological factors interact with early experiences in shaping the acceptance or rejection of these complementary foods. Children are naturally drawn to foods that taste sweet or salty. However, repeated exposures to more complex flavors, transmitted from the mother's diet to amniotic fluid and to human milk, and inherent in infant formulas and complementary foods (with 8-10 exposures or more), familiarize and facilitate children's acceptance of the varying sensory properties of foods. Family members modeling eating these foods also encourage acceptance in children. Such functional plasticity, one of the main characteristics of the brain, highlights the ability to change behavior based on experience.

Introduction: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It is characterized by normal or possibly impaired glucose metabolism before pregnancy and abnormal glucose metabolism during pregnancy. We evaluate the predictive value of body composition indicators in early pregnancy for GDM.

Methods: Pregnant women who visited Huaibei Maternal and Child Health Hospital from November 2022 to April 2023 were selected as study participants. Body composition indicators were measured using bioelectrical impedance assessment at 11-14 weeks of gestation. Study subjects completed a 75-g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Relationships between body composition indicators and GDM were explored using multivariate logistic regression. Additionally, the predictive value of body composition indicators for GDM was assessed through the receiver operating characteristic (ROC) curve and restricted cubic spline (RCS).

Results: Five hundred eighty-eight participants were enrolled, 100 of whom had a diagnosis of GDM (17.9%). We found that percent body fat (PBF) and visceral fat index (VFI) were associated with a higher risk of GDM, with adjusting ORs of 1.82 (95% CI = 1.50-2.21) and 6.10 (95% CI = 3.91-9.51) after adjusting for confounders, respectively. The ROC showed that PBF and VFI were highly predictive values for GDM. The RCS displayed that there was a J-shaped connection between 3-point OGTT plasma glucose and PBF. There was a nonlinear relationship between 1-h plasma glucose and VFI.

Conclusions: The findings suggest that PBF and VFI have high predictive value for GDM.

Introduction: Sarcopenia is a condition characterized by muscle mass loss. Some investigations have demonstrated the role of brain-derived neurotrophic factor (BDNF) as a protector against the presence of sarcopenia in patients with chronic kidney disease. We aimed to explore the role of circulating BDNF in the development of sarcopenia among individuals with disease-related malnutrition (DRM).

Materials and methods: A total of 160 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria were enrolled. Anthropometric data, muscle mass assessed via ultrasound at the rectus femoris quadriceps (RFQ) level, bioelectrical impedance analysis (skeletal muscle mass [SMM], appendicular skeletal muscle mass [aSMM], and appendicular skeletal muscle mass index [aSMMI]), handgrip strength, biochemical parameters, dietary intake, and circulating levels of BDNF were measured.

Results: A total of 55 patients (34.4%) were classified as sarcopenic, while 105 patients (65.6%) were classified as non-sarcopenic. Phase angle (-0.6 ± 0.2°; p = 0.01), reactance (-5.8 ± 2.1 Ohms; p = 0.03), SMM (-3.3 ± 0.2 kg; p = 0.04), aSMM (-2.1 ± 0.3 kg; p = 0.03), aSMMI (-0.8 ± 0.2 kg; p = 0.03), dominant muscle area (-0.7 ± 0.2 cm2; p = 0.04), and dominant Y-axis thickness (-0.4 ± 0.1 cm; p = 0.03) were worse in patients with sarcopenia. Muscle strength was higher in non-sarcopenic patients (8.5 ± 1.2 kg; p = 0.01). Circulating BDNF levels were significantly higher in non-sarcopenic patients compared to sarcopenic patients (94.7 ± 3.9 ng/mL; p = 0.01). Logistic regression analysis indicated a reduced risk of sarcopenia (OR = 0.16, 95% CI = 0.11-0.43; p = 0.03) in patients with higher BDNF levels, after adjusting for body mass index, gender, energy intake, and age.

Conclusion: Our study identified an association between low serum BDNF levels and sarcopenia in patients with DRM.

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: First, we investigated the relationships between eating styles (cognitive restraint, uncontrolled eating, and emotional eating) and body mass index (BMI) in women. Second, we aimed to explore whether positive eating serves as a protective factor in the relationships between eating styles and BMI.

Methods: The sample comprised 404 women recruited via online surveys who completed: the Positive Eating Scale, the Three-Factor Eating Questionnaire, the sociodemographic survey. Data collection was independent.

Results: First, we found that in women cognitive restraint, uncontrolled eating, and emotional eating are all positively related to BMI. Second, as predicted, we demonstrated the effect of positive eating as a moderator in the relationship between emotional eating style and uncontrolled eating style and BMI. Specifically, in women with average and low levels of positive eating, positive relationships between emotional eating and BMI, as well as uncontrolled eating and BMI were more pronounced. The effect of positive eating on the relationship between cognitive restraint and BMI was opposite to the expected.

Conclusion: Our preliminary conclusions may suggest that food positivity should not be placed on the same continuum with unhealthy eating behaviours as its opposite end of the continuum. As a distinct construct, it may serve as a protective factor and strengthening a positive attitude towards food may possibly reduce the negative impact of unhealthy eating styles on individuals' BMI and, in turn, on health and well-being. It would be beneficial to verify these assumptions in future research.

Background: For the past 2 decades, there has been a growing appreciation of the role that the microbiota (the trillions of microorganisms within and on our bodies) plays as one of the key regulators of gut-brain function and has led to the appreciation of the importance of a distinct microbiota-gut-brain axis across the lifespan but especially during neurodevelopment.

Summary: The gut microbiota and its relevant metabolites interact with the immune and the central nervous systems during critical temporal windows of development. These critical developmental windows perinatally (during the first 1,000 days) are susceptible timepoints for insults that can endure long-lasting effects on the microbiota-gut-brain axis. Accumulating evidence shows that a variety of factors can impact the microbiota in early life, including mode of birth delivery, antibiotic exposure, mode of nutritional provision, infection, stress, as well as host genetics. Additionally, sex differences occur in response to microbial manipulations in early life although the underlying mechanisms underpinning such effects remain elusive. Animal models have been essential in delineating the role of the microbiome in neurodevelopmental disorders ranging from autism spectrum disorder to attention deficit hyperactivity disorder. This mechanistic perspective should be supplemented with more translational studies to evaluate the applicability of findings from animal models to human subjects.

Introduction: Prehabilitation programs treat modifiable risk factors to improve surgical outcomes. However, translation of research into practice remains challenging. Logic models, visual representations of how a program works, have the potential to bridge research-to-practice gaps. We aimed to develop a logic model for prehabilitation programs in tertiary care centers by interviewing stakeholders about what should be the mission, inputs, outputs (activities and participants), and targeted outcomes for prehabilitation.

Methods: A multi-site qualitative study was conducted from June 2022 to December 2023. Interviews were analyzed using manifest summative content analysis to determine logic model items. Focus groups for member checking were performed with stakeholders throughout the analysis process.

Results: Sixty-one interviews were conducted with stakeholders: prehabilitation staff (n = 12), patients (n = 10), perioperative care physicians (n = 10), nurses (n = 9), dietitians (n = 9), physiotherapists (n = 5), and hospital administrators (n = 6). Findings underscored unanimous support for prehabilitation yet revealed challenges that hindered efficient and equitable resource utilization, which have been addressed in the logic model. To evaluate the success of prehabilitation, both clinician- (n = 44) and patient-oriented outcomes (n = 32) were valued by stakeholders; however, priority outcomes varied by stakeholder group: intervention adherence (prehabilitation staff), experience and satisfaction (patients), and facilitation of discharge (clinicians and hospital administrators).

Conclusion: This co-developed logic model was designed to improve the efficiency, accessibility, and sustainability of acute care prehabilitation programs by offering a detailed blueprint. Researchers and clinicians can draw on the insights from this co-production process to develop, implement, and evaluate their own prehabilitation programs.