Annals of Nutrition and Metabolism最新文献

Background: The global epidemiology of food allergies and anaphylaxis exhibits complex, heterogeneous patterns. While food allergy prevalence has stabilized in Western countries, anaphylaxis incidence continues to rise. In developing regions, data are limited, but urban centers show increasing food allergy prevalence, contrasting with lower rates in rural areas. These disparities likely stem from differences in environmental factors and urbanization levels across the globe. Furthermore, the dominant food allergens vary significantly by regions. Peanuts and tree nuts are the primary triggers in the USA and Europe, whereas eggs, milk, and shellfish are more common in Asia and Latin America.

Summary: In this upcoming review, we will delve into the recommendations for preventing food allergies across Eastern and Western regions. These regional differences in allergen profiles and dietary patterns underscore the need for tailored food allergy prevention strategies. Current prevention guidelines focus on the timing and route of allergen exposure in early life. In high-prevalence regions, early oral exposure is recommended to promote oral tolerance and reduce allergy risk. Conversely, in lower-prevalence areas, non-delayed introduction of allergenic solids is preferred. Moreover, early skin exposure may increase allergy risk, and the role of early, whole-body use of specialized emollients requires further study. Proactive treatment of atopic dermatitis may reduce the incidence of food allergies in infants. Adapting prevention approaches to local contexts and continuously updating guidelines based on emerging evidence is crucial to comprehensively addressing the global burden of food allergies.

Introduction: Phosphate ion is common in the core of urinary stones and may initiate stone formation. However, the precise role of phosphate in the initiation of stone formation remains obscure. We assessed the effects of dietary phosphate load on urinary stone risk and phosphate metabolism.

Methods: Ten non-stone-forming healthy volunteers completed this randomized, crossover study. Each subject was provided a high- or low-phosphate diet for 3 days. After a 2-day equilibration period with a moderate-phosphate diet, the participants received a low- or high-phosphate diet for another 3 days. Serum, fecal, and 24-h urine samples were collected at the end of each intervention.

Results: High dietary phosphate load increased urinary phosphate excretion, and low dietary phosphate decreased urinary phosphate excretion. In addition, urine pH was lower and supersaturation (SS) index of uric acid (UA) was higher after a high-phosphate diet. There was no significant difference in the SS index for calcium oxalate, brushite and hydroxyapatite, or 24-h urinary citrate between the high and the low dietary phosphate. Also, no significant change was observed in fecal phosphate excretion after a high- or low-phosphate diet. The serum phosphate level increased after a high-phosphate diet, but there was no difference in serum phosphate between low-phosphate and moderate-phosphate diets.

Conclusion: High dietary phosphate load led to higher urinary phosphate excretion, a higher SS index of UA, and lower urine pH. Stone formers should be advised to limit the intake of high-phosphate source diet, including high-protein diets and phosphate-based food additives.

Background: Two essential micronutrients over the life course are calcium and iron, and both are especially important during the reproductive cycle. The role of calcium in maternal and offspring bone health and in the prevention of pre-eclampsia in pregnancy are well described, although results from randomised controlled trials for both outcomes vary. Iron is essential for synthesis of red blood cells, being a core component of haemoglobin, which carries oxygen around the body, and hence is key in the prevention of anaemia and sequelae.

Summary: This article reviews the evidence across the reproductive life course for dietary calcium and iron intakes and health outcomes. For calcium, focusing on bone health and prevention of pre-eclampsia, for iron considering its crucial role in foetal and neonatal development and how requirements may be impacted through inflammation and infection, particularly in environments where iron availability may be low.

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: It is well known that obese children frequently have high C-reactive protein (CRP) values. There are controversies about the association of the CRP and components of the metabolic syndrome (MetS). The aim of this study was to determine among children and adolescents the link between the most routinely used inflammation marker, CRP, and components of the MetS.

Methods: The study recruited 506 obese/overweight and 249 normal weight participants (ages 4-18 years) with complete fasting laboratory and anthropometric data. Statistical analyses, including multinomial logistic regression, were conducted in R, with significance set at p < 0.05.

Results: Children were divided into three groups according to CRP concentration (low <1 mg/L, medium: 1-3 mg/L, high >3 mg/L). The children were also classified whether they had MetS (n = 249) or were free of MetS (n = 421). We found highly significant difference between CRP groups in the occurrence of the MetS components (p < 0.001), hypertension (p < 0.001), hypertriglyceridemia (p < 0.001), and low high-density lipoprotein (HDL) cholesterol (p = 0.001), waist circumference (p < 0.001), body mass index (BMI) z-score (p < 0.001), fasting plasma glucose (p < 0.001), homeostasis model assessment of insulin resistance (p < 0.001), respectively. However, when BMI z-score was included in the model this relationship disappeared, suggesting that BMI has a more significant effect on the MetS components than CRP.

Conclusion: Our results demonstrate that BMI z-score is the main determinant of the MetS and its components. However, CRP remains an important factor to be checked in overweight and obese children.

Background: Prehabilitation, the process of optimizing a patient's physical and nutritional status before surgery, has gained increasing attention for its potential to improve outcomes by enhancing physiological reserves and functional capacity. While body composition may play a role in these outcomes, its specific contribution remains underexplored. This narrative review summarizes current evidence on the effects of prehabilitation on body composition, focusing on exercise, nutritional interventions, and multimodal approaches.

Summary: Exercise, particularly a combination of aerobic and resistance training, has been shown to improve cardiorespiratory fitness, reduce fat mass, and enhance skeletal muscle and strength. Nutritional interventions, including increased protein intake, support skeletal muscle preservation, and recovery. A multimodal approach, integrating both exercise and nutrition, yields the most significant improvements in body composition, showing enhanced skeletal muscle, reduced fat mass, and better functional outcomes. However, the limited duration of prehabilitation and the time required for detectable changes in body composition often prevent consistent observations. Furthermore, variations in assessment techniques and protocols across studies confound definitive conclusions.

Key messages: Despite some promising results, further research is needed to standardize protocols and explore the effects of prehabilitation on body composition across diverse patient populations. Finally, further research is needed to investigate the impact of prehabilitation on measurable changes in body composition as this represents a critical gap in the field.

Introduction: This study aimed to evaluate safety and feasibility of perioperative exercise and nutrition therapy and to explore perioperative changes in skeletal muscle mass (SMM) in patients with esophageal cancer.

Methods: Patients scheduled for curative esophagectomy at two hospitals were enrolled. Exercise and nutrition therapy were performed for 3 weeks preoperatively and 4 weeks postoperatively. Outcomes included SMM, which was the sum of both mid-thigh cross-sectional area on computed tomography and physical function, assessed at T1 (intervention start), T2 (just before surgery), and T3 (1-month postoperatively). The SMM change rate between T1 and T3 was compared with the hypothesized value (-7.5%) from our previous study.

Results: Thirty-six patients underwent intervention and esophagectomy (intervention completion rate: 94.4%, no serious adverse events). The SMM increased by 4.9% for T1-T2 (p < 0.001) but decreased by 10.1% for T1-T3 (p < 0.001), suggesting that the primary outcome was not achieved. Physical function results were significantly better at T3 than at T1. Postoperative SMM loss was lower in patients who maintained postoperative caloric intake and physical activity than in those who could not (-8.3% vs. -15.4%, p = 0.011).

Conclusions: Perioperative exercise and nutrition therapy were safe and feasible. An increase in preoperative SMM and postoperative physical function were observed, although SMM decreased after surgery. Further investigation is warranted to evaluate the efficacy of this intervention.

Introduction: Malnutrition during a critical window of development in a fetus or infant can result in abnormal cardiac remodeling and function. It is uncertain whether the contribution of these effects continues to impact the cardiac remodeling and function of adults over the course of several decades of growth. Our study examined the impact of early Chinese famine exposure on cardiac remodeling, left ventricular (LV) diastolic function, and LV systolic function in adults.

Methods: Participants at high risk of cardiovascular disease from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project (PEACE MPP) were enrolled. The famine in China lasted from 1959 to 1962. A total of three groups were formed based on the participants' birth dates: pre-famine group, famine exposure group, and post-famine group. Logistic regression and linear mixed models were used to explore the association between famine exposure and cardiac remodeling, LV diastolic function and LV systolic function in adults.

Results: The study included 2,758 participants, the mean age was 57.05 years, 62.8% were female, 26.4% had LV hypertrophy (LVH), 59.6% had LV diastolic dysfunction (LVDD), and 10.5% had reduced global longitudinal strain (GLS). Compared to post-famine exposure, participants had independently increased risk of LVH in the famine exposure group (OR: 2.02, 95% CI: 1.60-2.56) and pre-famine exposure (OR: 1.36, 95% CI: 1.06-1.76). Compared to post-famine exposure, the risk of LVDD remarkably increased in the famine exposure group (OR: 3.04, 95% CI: 2.49-3.71) and pre-famine exposure group (OR: 1.87, 95% CI: 1.52-2.31). Famine exposure had no significant impact on GLS but was associated with a significant increase in LV ejection fraction (LVEF) and LV end-diastolic diameter (LVEDD). Significant interactions were observed between the effects of famine exposure and other clinical/sociodemographic variables (gender, systolic blood pressure [SBP] ≥140 mm Hg or not, high school or above or not, and annual income <50,000 RMB or not) on these outcomes.

Conclusion: Exposure to famine, particularly during fetal and infant stages, increases the risk of LVH and LVDD in adults. However, the LV systolic function remains preserved. These impacts are more pronounced in females, individuals with SBP ≥140 mm Hg, those with low income, or those with high educational status.