Annals of Nutrition and Metabolism最新文献

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: Prehabilitation programs have advanced considerably; however, critical issues related to sex- and gender-specific factors remain largely unaddressed. Historically, research has been male-centered due to the underrepresentation of females in clinical trials, often attributed to concerns over hormonal variability. This focus has resulted in significant knowledge gaps and potential biases that impact effectiveness across sexes. We aim to highlight the need for integrating sex- and gender-specific considerations into prehabilitation to optimize surgical outcomes and promote equitable care for all patients.

Summary: Both biological (sex-related) factors, such as differences in muscle mass, metabolism, and body composition, and social (gender-related) factors, such as caregiving roles and stress management, influence individuals' responses to presurgical preparation. A review of the existing literature reveals a scarcity of data on sex and gender differences in prehabilitation, highlighting a major barrier to designing equitable and effective programs. Evidence underscores that comprehensive prehabilitation approaches, integrating physical, nutritional, and psychological elements, must account for these differences to optimize recovery outcomes.

Key messages: Sex- and gender-specific factors significantly shape patients' responses to prehabilitation and should be systematically incorporated into program design. The current lack of research on these differences limits the effectiveness of prehabilitation strategies, emphasizing the need for focused investigations. Addressing these gaps will facilitate the development of tailored, equitable prehabilitation programs that enhance presurgical care and improve recovery outcomes for all patients.

Introduction: Larger mean platelet volume (MPV), a measure of platelet activity, increases atherosclerotic cardiovascular disease (ASCVD) risk. Intake of n-3 polyunsaturated fatty acid (n-3 PUFA) found in fish may lower platelet count (PLC) and activity. We investigated the relationship between fish intake, PLC, MPV, and n-3 PUFA intake.

Methods: We conducted a cross-sectional study among 9,870 participants (average age: 47.5 years; 55.9% men). N-3 PUFA intake was calculated based on fish intake frequency and information from the Nutritional Health Survey of Japan.

Results: The average fish intake frequency was 2.14 ± 1.26 days/week. Higher fish intake frequency was associated with lower PLC and larger MPV. In a multi-regression analysis, fish intake frequency was a determinant of PLC (β = -0.081, p < 0.0001) but not MVP; however, lower PLC was a determinant of larger MPV (β = -0.421, p < 0.0001). N-3 PUFA intake significantly increased with increased fish intake frequency.

Conclusion: Although higher fish intake frequency is associated with greater MPV, this relationship is not direct; instead, it may depend on lower PLC linked to higher fish intake. The antiplatelet effect of n-3 PUFA, which intensifies with higher fish intake, may suppress platelet activity with larger MPV, preventing ASCVD risk.

Introduction: The diet during pregnancy has long-term effects on the health outcomes of both mothers and their children. This 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-fiber 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-fiber 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 (-109.54 g; 95% CI: -204.84 to -14.24). The adherences to the 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 the 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, the high-fiber diet and adherences to the Mediterranean diet and DASH diet were associated with lower risk of adverse metabolic outcomes in pregnant women and their children.

Background: Current scientific research on breastfeeding provides substantial evidence of its numerous positive impacts, not only for children in both the short and long term but also for mothers who engage in breastfeeding.

Summary: In addition to the gold standard effect of human milk on infant nutrition, breastfeeding is associated with a lower incidence of infections, reduced infant/childhood mortality, necrotizing enterocolitis, and obesity during childhood and later in life, better cognitive performance, and a higher IQ score. For mothers, breastfeeding prolongs lactational amenorrhea, may facilitate postpartum weight loss, and may reduce breast and ovarian cancers and cardiovascular diseases. Breastfeeding can also play a beneficial role in preventing antibiotic resistance, which is a global concern across all age groups. Implementing exclusive breastfeeding for all infants has the potential to enhance child development and decrease healthcare expenses, leading to economic savings for both individual families and society. Human milk is a biologically active food that functions as both prebiotic and probiotic because of its oligosaccharides and the composition of its microbiota, which act as synergistic synbiotics.

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.