Asia Pacific journal of clinical nutrition最新文献

Background and objectives: The prevalence of overweight or obesity in adolescents is steadily increasing in most countries around the world. Adolescent obesity increases the risk of chronic diseases such as cardiovascular disease, and is associated with negative health consequences, increasing the burden on health services.

Methods and study design: Literature searching was conducted in PubMed and Google Scholar using the keywords "overweight", "obesity", "adolescent", "weight management", "dietary management" and "nutri-tional intervention" combined with Boolean operators "AND" and "OR".

Results: Multicomponent lifestyle interventions, including diet, physical activity, and behavioural interventions, are used as first-line treatment for anti-obesity interventions. Dietary management methods such as energy-restricted diet are beneficial to control body weight, and it is important to ensure their normal growth and development while restricting en-ergy.

Conclusions: Multicomponent lifestyle intervention is the first choice for anti-obesity intervention. It is recommended that intensive health behaviour lifestyle treatment combined with anti-obesity medications be used at the beginning of anti-obesity treatment in adolescents.

Background and objectives: Malaysian Healthy Diet Online Survey (MHDOS) is an online survey designed to measure diet quality of Malaysian adults. This study aimed to assess the relative validity and test-retest reliability of the MHDOS.

Methods and study design: This nationwide cross-sectional study was conducted from May to November 2022 among 218 Malaysian adults. Participants completed the MHDOS, underwent an interview-administered 24-hour diet recall (24DR), and repeated the MHDOS within two weeks. Relative validity was assessed by correlating food group servings from the MHDOS and 24DR using Spearman's cor-relation coefficients. Construct validity was evaluated by comparing Diet Score tertiles with food group servings, energy, and nutrient intakes from the 24DR. Linear trend analysis was used to compare food group and nutrient intakes across the Diet Score tertiles. Reliability was measured using the Intra-class correlation coefficient (ICC) between the initial and repeated MHDOS administrations.

Results: The MHDOS demonstrated moderate-to-good reliability, with ICC ranging from 0.70-0.86 for different components and 0.90 for the total Diet Score. Spearman correlation coefficients for mean food group intakes estimated from the MHDOS and 24DR ranged from 0.21-0.44 (p <0.001). Higher Diet Scores were associated with greater intake of total fibre, vitamin C, thiamine, niacin, potassium, calcium, phosphorus, and iron, as well as increased consump-tion of vegetables, fruits, and water (p-trend <0.01).

Conclusions: MHDOS has good test-retest reliability and its derived Diet Score is associated with better nutrient and food group intake as estimated from 24DR. The MHDOS is a valid and reliable tool for assessing diet quality among Malaysian adults.

Background and objectives: Parenteral nutrition (PN) provides nutrition intravenously, often as two-in-one (TIO) or all-in-one (AIO) solutions. These solutions are complex, containing around 50 chemical components, which can affect the admixture stability. While there is substantial data on stability tests for PN solutions, the methodologies and acceptance criteria are not well-defined in current literature. This scoping review aimed to identify and summarise the current tests and methods used to assess the stability of AIO solutions in hospital settings.

Methods and study design: Comprehensive searches on stability tests and parenteral nutrition were conducted in Web of Science (WoS), PubMed, and Scopus on 11 January 2024, updated on 4 April 2025. Searches were limited to articles published in English from January 2010 to March 2025. Data extraction was done on the included studies for descriptive analysis.

Results: 33 articles met the inclusion criteria, 25 fo-cused on AIO solutions, six included both AIO and TIO, and one was on lipid emulsion only. Eleven stability tests were identified and classified into physical, chemical, and microbiological categories. The suggested core set of tests for assessing AIO solution stability includes visual inspection, pH measurement, particle size distribution using dynamic light scattering and light obstruction, zeta potential measurement, lipid peroxidation using the thiobarbituric acid reactive substances (TBARS) assay, and sterility testing via membrane filtration.

Conclusions: This review identifies a suggested core set of stability tests essential for evaluating AIO so-lutions in hospital settings. Adoption of these standardised methods can enhance the reliability and consistency of stability assessments.

Background and objectives: This study compared the accuracy of current energy formulas in predicting resting energy expenditure (REE) in overweight and obese women with fertility problems.

Methods and study design: This study evaluated REE prediction formulas in 82 overweight/obese women (18-49 years) with fertility problems. REE is accurately measured using indirect calorimetry, which is considered the gold standard for evaluating energy. Anthropometric data, including height, weight, and waist circumference. Body composition analysis was performed using bioelectrical impedance analysis to determine fat-free mass and other related indicators. Statistical analyses included Spearman correlation coefficients to assess the relationship between REE and various predictors. The accuracy and reliability of the existing prediction equations were evaluated by comparing their predicted values with resting energy expenditure values measured by Indirect Calorimetry using Bland-Altman analysis.

Results: Among the prediction equations assessed, Mifflin's equation demonstrated superior performance in estimating REE in overweight/obese women experiencing fertility problems, exhibiting the least bias (-9.7 kcal/day) and a low standard deviation (240 kcal/day). Variables such as body weight, lean body weight, and central obesity indicators like waist circumference and waist-height ratio emerged as significant predictors of REE, with their impacts being age-dependent. The Mifflin-St. Jeor Equation, which integrates weight, height, and age variables, offers a reasonably accurate estimation of energy needs for this specific demographic.

Conclusions: The Mifflin-St. Jeor Equation is an accurate tool for predicting REE in overweight and obese women with fertility problems, offering important insights for nutritional assessment and intervention strategies in fertility management.

Background and objectives: Childhood undernutrition, especially wasting, remains a significant public health challenge in Bangladesh. Wasting, or low weight-for-height, is associated with a heightened risk of mortality in children under five. Although several national policies exist, the burden of wasting persists above the global target of <5%. This review focuses on identifying gaps and opportunities within Bangladesh's policy landscape concerning the prevention and management of wasting.

Methods and study design: A desk review was conducted of eight key national documents, including nutrition policies, action plans, national programs, and guidelines. These were assessed for their stated goals, objectives, action plans, gaps, and recommendations regarding undernutrition, with particular attention to wasting. Special emphasis was given to Integrated Management of Childhood Illness (IMCI), Community-Based Management of Acute Malnutrition (CMAM), and the availability of Ready-to-Use Therapeutic Food (RUTF).

Results: While Bangladesh has adopted a multi-sectoral approach through its National Nutrition Policy (2015), Food Policy Plan of Action (2008-2015), and National Food and Nutrition Security Policy (2021-2030), implementation gaps remain. Challenges include weak governance, insufficient facility readiness, and inconsistent RUTF supply, particularly in remote areas. Community-level interventions are underutilized, and coordination with NGOs is limited despite their proven success.

Conclusions: To reduce the prevalence of wasting, it is critical to strengthen multi-sectoral collaboration, improve CMAM coverage and supply chains, and ensure the integration of community-based approaches. Focused investments in health systems and nutrition governance are essential to achieve the Sustainable Development Goals related to child nutrition.

Background and objectives: Dietary intervention is an important strategy for the treatment and management of metabolic syndrome (MetS). This study is aimed to investigate the effectiveness of a canteen-based dietary intervention on MetS in occupational men.

Methods and study design: A randomized controlled study was conducted in May 2022. A total of 321 men with MetS aged 25 to 59 years were recruited from Shengli Oil-field. Participants in one canteen were randomly allocated to dietary intervention group (IG) and those in the other canteen as control group (CG). CG received health education for 6 months. IG received a 6-month healthy lunch and personalized dietary advice added health education. Blood pressure, fasting blood glucose (FBG), lipid profiles, waist circumference (WC) and body mass index (BMI) were measured before and after intervention.

Results: Compared with CG, FBG (β: -0.72, p = 0.010), TC (β: -1.49, p <0.001), LDL-C (β: -0.65, p <0.001), WC (β: -7.73, p <0.001), BMI (β: -2.01, p <0.001) decreased and HDL-C (β: 0.13, p <0.001) increased significantly in IG. The IG had a 30.4% reduction in MetS, whilst there was a 1.3% reduction in CG (p <0.01). Moreover, a significant reduction in central obesity (-30.4%, p <0.001), high FBG (-8.8%, p <0.001), and low HDL-C (-4.1%, p = 0.008) was observed in IG. Conversely, the CG showed an increase in low HDL-C (10.7%, p <0.001).

Conclusions: Canteen-based intervention with a healthy lunch and personal-ized dietary advice can reduce the risk of MetS in occupational men. This study provides new empirical data for dietary intervention in ameliorating MetS.

Background and objectives: The increasing prevalence of hyperuricemia in children is a global health con-cern. Plant dietary fiber may influence uric acid levels by improving gut health and lowering blood glucose and lipid levels. This study aims to examine the relationship between plant-based dietary fiber intake and hyperuricemia risk in Chinese children aged 6-17 years.

Methods and study design: This study analyzed di-etary fiber intake data from 11,423 children (aged 6-17 years) from the China Children and Lactating Wom-en Nutrition and Health Surveillance (CCLWNHS) conducted between 2016 and 2019. Plant dietary fiber intake was assessed using a food frequency questionnaire. Logistic regression was performed, adjusting for age, sex, body mass index (BMI), smoking, alcohol consumption, physical activity, and energy intake. Restricted cubic splines (RCS) and receiver operating characteristic (ROC) curves were utilized to explore nonlinear relationships and identify cut-off values for dietary fiber intake.

Results: Among the 11,423 children, 1,730 (15.1%) were diagnosed with hyperuricemia. The average daily fiber intake was 8.28 ± 5.90g, with cereal fiber accounting for 56.1-57.8%. A significant negative correlation was found between cereal dietary fiber intake and hyperuricemia risk (p = 0.0004). Stratified analysis indicated that overweight/obesity status modi-fied this relationship. ROC curve analysis identified optimal intake cut-off values: 8.35 g/day for boys and 11.1 g/day for girls.

Conclusions: Processed and ultraprocessed foods still have a lower contribution to ener-gy and nutrient intake in Jakarta than nonprocessed foods and processed ingredients.

Background and objectives: Overweight and obesity represent critical public health challenges, impacting over one-third of the global population. This issue is particularly pressing for women of reproductive age, who are more vulnerable to weight gain. Addressing this connection is vital for promoting overall reproduc-tive health and ensuring the well-being of future generations. This systematic review evaluates the critical relationship between preconception dietary interventions and weight loss, along with their impacts on the nutri-tional status and fertility of women with obesity.

Methods and study design: Our research draws from various literature sources, including CINAHL Plus (EBSCO), Medline, PubMed, the Cochrane Library, Scopus, and the Web of Science Core Collection, covering findings from 2010 to April 30, 2024.

Results: Out of 180 studies screened, 16 met the inclusion criteria. Short-term weight loss programs showed limited impact on fertility in overweight women, and intensive weight-loss interventions were not more effective than exercise-focused programs. A preconception diet that is high in fruits, vegetables, and omega-3 fatty acids, but low in trans fats and processed foods, was associated with better fertility. The evidence regarding the benefits of weight loss is inconsistent, partly due to the reliance on indirect measures and limited use of biomarkers.

Conclusions: Weight loss programs assist women with obesity in conceiving, but rapid weight loss may pose nutritional risks. Inconsistent nutritional assessments limit understanding of these programs. More objective measures are necessary to clarify the role of diet in fertility.

Background and objectives: Alzheimer's disease (AD) is the most prevalent form of dementia in older individuals. Ferroptosis, a programmed cell death characterized by iron-dependent membrane lipid peroxida-tion is implicated in AD pathology. Increasing evidences have shown that plant-derived dietary antioxidants exhibit their anti-ferroptosis activity. However, the anti-AD mechanism of plant-derived dietary antioxidants remains elusive. Therefore, this review aims to explore the anti-AD effects of plant-derived dietary antioxidants via ferroptosis regulation.

Methods and study design: This review examines the available published data from all peer-reviewed original research articles on following topics: ferroptosis mechanisms, the role of ferroptosis in AD, the preclinical or clinical studies of plant-derived dietary antioxidants in cell, animal models of AD or patients with AD.

Results: Ferroptosis is involved in AD pathology. Importantly, we clarify why docosahexaenoic acid (DHA)-rich brain phospholipids are extremely susceptible to lipid peroxidation. In addition, plant-derived dietary antioxidants such as vitamin E (VE), resveratrol, epigallocatechin-3-gallate (EGCG), curcumin, quercetin, baicalein and alpha-lipoic acid (ALA) show the anti-AD effects in preclinical AD models and prevent decline of cognition in healthy elderly population. Clinical studies show that ALA prevents decline of cognition of AD patients although most plant-derived dietary antioxidants exhibit con-flicting results.

Conclusions: It suggests that a plant-based diet may lead to potential health benefits in preventing cognitive decline in healthy elderly population. In regard to ALA, further clinical studies are highly recommended to evaluate its therapeutic potential that could optimize its dietary intake for preventing and alleviating decline of cognition of patients with AD.

Background and objectives: Caloric restriction is the most popular dietary intervention for preventing metabolic disorders. However, its benefits are limited in normal-weight individuals. This study aimed to examine the association between composite dietary antioxidant index (CDAI) and metabolically unhealthy normal weight (MUNW), as well as the relationship between CDAI and cardiometabolic mortality among normal-weight individuals, in order to provide personalized dietary recommendations.

Methods and study design: This study consisted of two parts: (1) a cross-sectional analysis exploring the association between CADI and MUNW; and (2) a prospective cohort analysis assessing CDAI in relation to cardiometabolic mortality. Adult participants with normal weight from the National Health and Nutrition Examination Survey (2007-2018) were enrolled and classified into quartile groups based on CDAI for the analyses.

Results: Among 4,590 participants included in this study, 472(7.82%) were diagnosed with MUNW. After full adjustment, the odds ra-tios (95% confidence intervals) for MUNW across the increasing CDAI levels were 0.80 (0.50-1.29), 0.85 (0.51-1.41), and 0.48 (0.26-0.87), respectively (p for trend = 0.026). This inverse association appeared to be attenuated among participants aged 20~59 years old (p for interaction = 0.035). During 32,113 person-years of follow-up, 82 cardiometabolic deaths occurred. After full adjustment, the hazard ratios (95% confidence intervals) for cardiometabolic mortality across the increasing CDAI levels were 0.78 (0.35-1.73), 0.51 (0.20-1.27), and 0.40 (0.19-0.87), respectively (p for trend = 0.014).

Conclusions: CDAI was inversely associated with MUNW and cardiometabolic mortality in a normal-weight population in the United States. These findings warrant confirmation through interventional studies.