Asia Pacific journal of clinical nutrition最新文献

Background and objectives: Malnutrition is associated with a higher risk of osteoporosis. We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men.

Methods and study design: This is a nested case-control study from a prospective cohort enrolled 1109 individuals who were followed for seven years. Demographic data, medical history, signs and symptoms, and laboratory parameters were collected and analysed. Nutritional status and Geriatric Nutritional Risk Index (GNRI) were assessed. The nutrition-related indexes predictive value for osteopenia development was analyzed through multivariate Cox regression analysis and by creating a receiver operating characteristic curve (ROC), calculating the area under the curve (AUC). Kaplan-Meier (K-M) method was further used to find the nutritional status level in the elderly men.

Results: The ALB and GNRI correlated with the risk of osteopenia in Chinese elderly men. After adjusting for all covariates, people with higher ALB level (HR: 0.821; 95% CI: 0.790-0.852) and higher GNRI score (HR: 0.889; 95% CI: 0.869-0.908) had a smaller risk of osteopenia. ROC analysis showed that the AUC for ALB was 0.729 (p<0.05) and for the GNRI score was 0.731 (p<0.05). K-M curve indicated a significant difference in ALB level (p<0.001) and GNRI score (p<0.001) in the respective subgroups.

Conclusions: This study found that lower ALB level and lower GNRI score are associated with a higher prevalence of osteopenia among elderly men in China.

Background and objectives: Parkinson disease (PD), which is a neurodegenerative disorder, includes several gastrointestinal symptoms that are similar to those of Celiac disease (CD). However, the presence of celiac antibodies in PD patients has not yet been studied. Our aim in this study is to compare anti-transglutaminase (ATA) and antigliadin antibodies (AGA) as well as gastrointestinal symptoms and nutrition habits between patients with Parkinson's disease (PD) and healthy controls.

Methods and study design: Serum AGA IgG and IgA and the ATA antibodies IgA and IgG were studied in 102 PD patients and 91 healthy controls. Gastrointestinal symptoms, specifically constipation, were investigated using the gastrointestinal system rating scale (GSRS) and the constipation rating scale (CRS). Dietary habits were also investigated and compared between the groups.

Results: No significant differences were found between the two groups in terms of celiac antibodies. As expected, the hypokinetic GSRS and CRS scores were significantly higher in the PD group (p<0.001). Dietary habits, especially carbohydrate-rich diets, had a negative impact on gastrointestinal symptoms in the PD patients.

Conclusions: Studies have suggested a connection between PD and CD, which infers a probable non-celiac gluten intolerance and the need to offer PD patients an elimination diet. However, the results of our study did not support any link between celiac antibodies and PD. Notwithstanding, the negative impact of a carbohydrate-rich diet in PD patients still leaves a question regarding gluten sensitivity in these patients.

Background and objectives: The objective of this study was to examine the effects of nutritional therapy in adult patients with severe burns.

Methods and study design: Sixty adult patients with severe burns were enrolled. Data on nutritional intake through enteral nutrition (EN) or parenteral nutrition (PN) on days 7, 14, 21, and 28 post-injury were collected. Patients were divided into target and non-target groups according to whether their energy or protein intake reached the target. Age, length of ventilation, and total bilirubin (TBIL), albumin (ALB), prealbumin (pALB), and C-reactive protein (CRP) concentrations of patients were recorded.

Results: The percentage of protein targets with protein delivery was lower than that of energy target with energy delivery. The ratio of PN protein to total protein was lower than that of PN energy to total energy on days 7, 14, 21, and 28 (p<0.001, p<0.001, p=0.001, and p=0.003, respectively). Compared to the non-target group on day 21, the target group was younger, had lower TBIL on day 7, higher ALB and pALB on day 21, and lower CRP on day 14 (p=0.025, p=0.021, p=0.028, p=0.029, and p=0.049, respectively). Multivariate logistic regression analysis showed that older age and longer ventilation were independent risk factors in patients who did not meet the nutritional target on day 21 (p=0.026 and p=0.043, respectively).

Conclusions: The protein intake of adult patients with severe burns was low. Compared to the non-target group, the target group had better laboratory test results. Older age and longer ventilation were independent risk factors for patients not meeting the nutritional target.

Background and objectives: Wasting among under-five years old (U-5) children is a significant global public-health-nutrition burden. To effectively address this problem in Bangladesh, knowing its prevalence, caus-es and associated-factors are essential. This review aimed to identify evidences available in the existing-accessible literature/documents that describe the individual, socioeconomic, demographic, and contextual risk-factors associated with wasting among U-5 children in Bangladesh.

Methods and study design: Electronic-databases included were MEDLINE, EMBASE, CINAHL, WoS, and Cochrane-Library written in English and published until 29 February 2024.

Results: The search from the five databases yielded 167 publications. Of these, 50 papers/articles were duplicates and 108 were irrelevant, and nine have met the inclusion criteria. Additionally, 22 articles/documents were identified from other sources. Finally, a total of 31 articles/documents have been included in this review. The odds of childhood wasting observed were high for smaller birth-size, higher birth-order, male child, 12-24 months age-group, improper breastfeeding- and complementary-feeding practices, not-receiving DPT1 and/or measles vaccine, ≥1 sibling(s), maternal-undernutrition, less food-consumption during pregnancy, lack of maternal-education, lack of hand-washing practices by the mother/caregiver, paternal tobacco use, lower socioeconomic-status, food-insecurity, lack of access to hygienic-latrine and/or improved-water, Monsoon season (May-August), flood exposure, living es-pecially in Barishal, Rajshahi Chittagong and Rangpur-division and/or Eastern part of Bangladesh, and urban-slum.

Conclusions: The risk/associated factors of wasting among U-5 children in Bangladesh were found at various multilevel. Rarely caused by any one factor alone, wasting in U-5 children results from an interplay between pregnant-mother's health and nutrition, child-caring practices, diets, poverty, and disease, which vary by context.

Background and objectives: The precise impact of tea consumption on the risk of depression remains unclear. This study aimed to explore the relationship between the consumption patterns of tea and the likelihood of depression onset, utilizing a two-sample Mendelian randomization (MR) methodology.

Methods and study design: We utilized available genome-wide association study (GWAS) datasets on tea intake and depressive disorders. To investigate the causal relationship between tea consumption and depression, we employed a set of two-sample Mendelian Randomization (MR) methods. These included the inverse-variance weighted (IVW) analysis, weighted median approach, and MR-Egger regression. Additionally, we utilized MR-PRESSO and the MR-Egger intercept test for the detection of pleiotropic effects. To ensure the robustness and consistency of our findings, a sensitivity analysis was carried out, applying the 'leave-one-out' strategy. The Bayesian weighted Mendelian randomization (BWMR) was employed to conduct additional testing on the obtained results.

Results: The study's outcomes revealed a causal association between increased tea intake and an increased risk of depression (Inverse-Variance Weighted Analysis: Odds Ratio [OR] = 1.029, 95% Confidence Interval [CI]: 1.003-1.055, p = 0.027). This was observed despite variations in instrumental variables and the nonexistence of horizontal pleiotropy. Furthermore, the robustness of our Mendelian Randomization investigation was affirmed through the implementation of the 'leave-one-out' method in our sensitivity analysis. The findings from BWMR were in line with those obtained from IVW (BWMR: OR=1.030, 95% CI: 1.003-1.057, p = 0.029).

Conclusions: The results from this study indicate a substantial and positive causal link between the regularity of tea drinking and the risk of depression onset.

Background and objectives: Gastric cancer (GC) is the fourth leading cause of cancer death worldwide. Patients with GC have higher nutritional risk. This study aimed to construct a nomogram model for predicting preoperative nutritional risk in patients with GC in order to assess preoperative nutritional risk in patients more precisely.

Methods and study design: Patients diagnosed with GC and undergoing surgical treatment were included in this study. Data was collected through clinical information, laboratory testing, and radiomics-derived characteristics. Least absolute shrinkage selection operator (LASSO) regression analysis and multi-variable logistic regression were employed to construct a clinical prediction model, which takes the form of a logistic nomogram. The effectiveness of the nomogram model was evaluated using receiver operat-ing characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results: A total of three predictors, namely body mass index (BMI), hemoglobin (Hb) and radiomics characteristic score (Radscore) were identified by LASSO regression analysis from a total of 21 variables studied. The model constructed using these three predictors displayed medium prediction ability. The area under the ROC curve was 0.895 (95% CI 0.844-0.945) in the training set, with a cutoff value of 0.651, precision of 0.957, and sensitivity of 0.718. In the validation set, it was 0.880 (95% CI 0.806-0.954), with a cutoff value of 0.655, precision of 0.930, and sensitivity of 0.698. DCA also confirmed the clinical benefit of the combined model.

Conclusions: This simple and dependable nomogram model for clinical prediction can assist physicians in assessing preoperative nutritional risk in GC patients in a time-efficient and accurate manner to facilitate early identification and diagnosis.

Background and objectives: Study aim was to determine the levels and barriers of the Nutrition Care Process (NCP), a practical method of individualized nutrition support.

Methods and study design: Delegate of registered dietitians (RDs) from acute-care hospitals answered our nationwide web-based questionnaire (April-June, 2023) to determine the implementation status of screening, assessment, intervention (including planning), and monitoring (components of the NCP).

Results: Of 5,378 institutions contacted, 905 (16.8%) responded. For Screening, 80.0% screened all inpatients: primary personnel in charge were RDs (57.6%); the most used screening tool was Subjective Global Assessment (SGA) (49.2%). For Assessment, 66.1% assessed all inpatients: food intake (93.3%) was most evaluated whereas muscle mass and strength (13.0%, 8.8%) were least evaluated. For Intervention, 43.9% did so within 48h of hospital admission: oral nutritional supplement (92.9%) was the most common RDs intervention and parenteral nutrition (29.9%) was used less. For Monitoring, 18.5% of institutions had monitoring frequency of ≥ 3 times/week whilst 23.0% had monitoring less than once a week for severely malnourished patients. Energy and protein intake (93.7%, 84.3%) were most monitored and lipid intake (30.1%) was less monitored.

Conclusions: Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening, inaccurate patient targeting and lack of important evaluation items in Assessment, delayed timing and incomplete contents in Intervention, and inadequate fre-quency and lack of important evaluation items in Monitoring. An increase in RDs staffing in acute-care general wards, widespread NCP instruction manuals, and education about the tools and evaluation items utilized in nutritional management are possible solutions.

Background and objectives: Women are more prone to iron deficiency (ID) anemia when pregnant. The diagnostic use of mean reticulocyte volume (MRV) in identifying ID anemia during pregnancy has not been thoroughly investigated. The objective of this study is to evaluate the effectiveness of MRV in diagnosing ID in pregnant women.

Methods and study design: Firstly, MRV of 20 healthy female volunteers (healthy group) was measured on specific days for one month. Subsequently, clinical data from 724 pregnant women were thoroughly examined. These women were divided into two groups: 282 with ID (research group) and 442 without ID (control group). Parameters such as MRV, reticulocyte hemoglobin equivalent (RHE), red blood cell volume distribution width-standard deviation (RDW-SD), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), reticulocyte count (RET), MRV/MCV ratio, and serum ferritin (SF) were analyzed and compared.

Results: MRV remained consistent over a period of one month for 20 healthy individuals. In addition, there were significant differences in MRV, RHE, RDW-SD, MCV, MCH, MCHC, HCT, RET, and MRV/MCV between the research group and control group. The receiver operating characteristic (ROC) analysis showed that the areas under the curve (AUCs) for these measures were as follow: 0.840, 0.837, 0.676, 0.654, 0.639, 0.602, 0.571, 0.550, and 0.816, respectively. Ultimately, there was a substantial disparity in MRV prior to and following therapy with oral iron treatments.

Conclusions: In healthy women, MRV remains stable and is a reliable ID marker, which can be used to assess oral iron treatment effectiveness during pregnancy.

Background and objectives: There is no evidence on antioxidant-rich diets in preventing hypertension in heat-exposed workers. We aimed to evaluate the effects of formula supplemented with vitamin C (Vit C) and hawthorn beverage on reducing blood pressure (BP) and oxidative stress levels in heat-exposed workers.

Methods and study design: In the 40-day cluster-randomized controlled trial, four heat-exposed shift-teams were enrolled and randomly assigned to the intervention and control groups. The intervention group was given one Vit C tablet (130 mg) and a 500 mL hawthorn beverage containing 278.7 mg flavonoids daily whereas the control group was given 500 mL of slightly salted water daily; both groups were provided education on a healthy diet. BP and creatinine-corrected urinary 8-isoprostane-prostaglandin F2α (8-iso-PGF2α/Cr) concentrations were assessed at baseline, Day 17 (only BP) and Day 41, respectively.

Results: Compared with the control group, the systolic BP (SBP), diastolic BP (DBP), and log10-transformed 8-iso-PGF2α/Cr in the inter-vention group decreased by 7.41 mmHg, 7.93 mmHg and 0.232, respectively, from baseline to day 41 (all p<0.05). When comparing BP levels at baseline, DBP in the intervention group was reduced by 5.46 mmHg when compared to control (p<0.05) among participants with lower baseline BP; SBP and DBP experienced reductions of 9.74 and 9.22 mmHg among participants with higher baseline BP (both p<0.05).

Conclusions: Supplementation of Vit C and flavonoids rich hawthorn beverage to heat-exposed workers prevented elevated BP caused by heat exposure which may be attributed to its oxidative stress inhibition effects.

Background and objectives: The objective of our study was to explore the accuracy of previously published prediction equations in predicting resting energy expenditure (REE) in patients with liver cirrhosis (LC). We also aimed to develop a novel equation to estimate REE for Chinese patients with LC.

Methods and study design: In 90 patients with LC, the agreement between REE measured by Indirect calorimetry (IC) and predictive equations was quantified using paired T-test and visualized using a Bland-Altman Plot. Pearson correlation coefficient (R) was used to measure a linear correlation between REE measured by IC and different predictive equations. Stepwise multiple regression analysis was used to create a new REE equation.

Results: The estimated REEs of previous equations were underestimated against REE measured by IC (1610 ± 334 kcal). Lean body mass (LBM) was positively correlated with REE measured by IC (r = 0.723, p < 0.01). The newly derived estimation equation for REE (kcal) was 1274.3 - 209.0 * sex - 5.73 * age + 3.69 * waist circumference + 22.89 * LBM. The newly derived estimation equation was found to have a Pearson-r value of 0.765 compared with REE measured by IC.

Conclusions: REE in liver cirrhosis was underestimated by using predictive equations. The new predictive equation developed by using age, sex, waist circumference, and LBM may help estimate REE in Chinese patients with LC accurately and easily.