Asia Pacific journal of clinical nutrition最新文献

Background and objectives: Irritable bowel syndrome (IBS) stands as a prevalent functional gastrointestinal condition known for causing persistent abdominal pain, changes in bowel patterns, and diminished quality of life. The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has emerged as a potential approach to managing IBS through dietary adjustments. To explore how the low FODMAP diet affects symptom relief, nutritional well-being, and overall quality of life in IBS patients when compared to those adhering to a standard diet.

Methods and study design: A retrospective cohort study was conducted, including patients with IBS categorized into a regular diet group and a low FODMAP diet group. Dietary intake, daily nutrient intake, IBS symptom severity, adverse events, and quality of life were assessed.

Results: The low FODMAP diet group demonstrated significantly lower intake of fermentable carbohydrates, including total dietary fiber, fructose, lactose, sorbitol, and total carbohydrates, compared to the regular diet group. Additionally, the low FODMAP diet group exhibited favourable nutritional profiles, reflecting higher intake and utilization of essential nutrients such as vitamin C, iron, calcium, vitamin D, and omega-3 fatty acids. Moreover, significant improvements in symptom severity, adverse event profiles, and quality-of-life scores were observed in the low FODMAP diet group compared to the regular diet group.

Conclusions: The Low-FODMAP Diet significantly alters nutrient intake in IBS patients, which may contribute to the observed symptom relief.

Background and objectives: Postprandial variations in plasma triacylglycerol (TAG) responses to vegetable oils are well established, but their origins remain unclear. This study examined the variability of postprandial plasma long-chain omega-3 fatty acids (LC omega-3) in response to commonly used supplements and foods and considers the biological implications of this variability.

Methods and study design: A literature review was conducted to identify postprandial studies that reported variability in plasma LC omega-3 responses to supplementation. Studies were included if variability could be expressed as the coefficient of variation (CV) for the area under the curve (AUC).

Results: Twenty-one studies encompassing 36 different treatments were identified. Supplements included LC omega-3 in the form of TAG, monoacylglycerols (MAG), free fatty acids (FFA), ethyl esters (EE), EE with emulsification agents, and whole foods. Variability was consistently observed across all forms; 65% of treatments showed a CV >50% for the AUC. Gastrointestinal (GI) symptoms were reported in some studies, suggesting possible malabsorption.

Conclusions: Substantial inter-individual variability existed in postprandial LC omega-3 responses, independent of the chemical form of supplementation. This variability likely reflects differences in absorption, enterocyte metabolism, and including malabsorption. Postprandial variability may therefore contribute significantly to observed differences in tissue LC omega-3 status following LC omega-3 supplementation.

Background and objectives: Vitamin D deficiency has been linked to urticaria, but causality remains uncer-tain. We used Mendelian randomization (MR) to investigate potential causal effects of vitamin D and its me-tabolites on urticaria risk.

Methods and study design: Summary statistics from genome-wide association studies (GWAS) of total 25-hydroxyvitamin D [25(OH)D] (n=120,618), 25-hydroxyvitamin D3 [25(OH)D3] (n=40,562), and C3-epimer-25-hydroxyvitamin D3 [C3-epi-25(OH)D3] (n=40,562) in Europeans were used, along with data on urticaria and its subtypes from FinnGen consortium (R10 release). For validation, we performed additional MR analyses using a larger dataset that meta-analyzed data from the UK Biobank and GWAS results from the SUNLIGHT consortium (n=496,946) as exposure variables. We performed compre-hensive sensitivity analyses, including heterogeneity tests, pleiotropy assessments, and leave-one-out analyses to evaluate result robustness. Statistical power calculations were conducted to validate the reliability of our findings.

Results: MR analysis revealed a causal protective effect of higher total 25(OH)D levels on urticaria risk [odds ratio (OR) = 0.81, 95% confidence interval (CI):0.69-0.95, p =0.008, statistical power = 81.1%]. Similar causal effects were observed for 25(OH)D3 levels (OR = 0.85, 95% CI: 0.74-0.98, p = 0.023, statistical power = 67.4%).These findings were validated in the replication cohort using serum 25(OH)D measurements (OR = 0.69, 95%CI: 0.56-0.85, p = 0.001, statistical power = 96.1%). Sensitivity analyses showed no significant heterogeneity or pleiotropy. Reverse MR analysis found no evidence that genetic risk of urticaria affects vitamin D levels, suggesting a potentially unidirectional causal relationship.

Conclusions: This study provides the first genetic evidence that higher vitamin D levels may reduce urticaria risk, offering a new theoretical basis for urticaria prevention and treatment strategies.

Background and objectives: Type 2 diabetes mellitus (T2DM) has emerged as a significant global public health concern. Multiple studies have shown that traditional nutraceuticals are potential to treat T2DM and its complications. This review will explore traditional nutraceuticals with antidiabetic properties with a focus on traditional Asian nutraceuticals and their antioxidant effects on gene expression associated to T2DM.

Methods and study design: Literature searching was conducted in Pubmed, Scopus, and Science Direct using the keywords "nutraceutical", "antidiabetic", "insulin resistance", "Diabetes Mellitus", "herbal medicine", "mechanism", "pathway", "traditional food", "functional food", "antioxidant", "clinical", "preclinical", "animal studies", and "Asian" combined with Boolean operators "OR".

Results: Nutraceuticals sourced from traditional Indonesian herbal beverages, including Galohgor, Bir Pletok, and Wedang Uwuh, have shown potential efficacy in reducing hyperglycemia, oxidative stress, and obesity in T2DM. Furthermore, multiple Asian plants and their bioactive compounds, such as curcumin, kaempferol, cinnamon, saponin, quercetin, myricetin, anthocyanin, terpenoid, alkaloid, and gallic acid, have been shown to beneficially influence glucose ho-meostasis, insulin sensitivity, and problems associated with diabetes. Moreover, bioactive compounds of these traditional nutraceuticals have been proven in modulating gene expression associated with β-cell function, insulin signaling pathway, and antioxidant activity, which may offer a new therapeutic target.

Conclusions: This review highlights the increasing scientific evidence on the role of traditional nutraceuticals for the prevention and management of diabetes mellitus, presenting promising alternatives to standard pharmacologi-cal therapy. Nonetheless, double-blind randomized clinical trials are required to validate these antidiabetic effects.

Background and objectives: Dietary nutrition plays an essential role in the progression of chronic obstruc-tive pulmonary disease (COPD). This study aimed to use Chinese Healthy Eating Index (CHEI) to evaluate dietary quality in COPD patients and investigate the relationship between dietary quality and COPD disease severity.

Methods and study design: A total of 525 COPD inpatients were collected from December 1st, 2022, to December 1st, 2023. The dietary intake was collected through food frequency questionnaires (FFQ), and diet quality was assessed by the CHEI. Modified Medical Research Council Dyspnea Scale (mMRC), the COPD assessment test (CAT), and Global Initiative for Obstructive Lung Disease (GOLD) stage were used to assess disease severity. Multivariable logistic regression was used to analyze the association between the total CHEI score, and its component scores and COPD disease severity.

Results: The CHEI score with COPD pa-tients is 56.75±8.89. The CAT score of the low CHEI group was significantly higher than that of the high CHEI group (p <0.05). Ordinal logistic regression analysis indicated that the group with higher CHEI total scores was significantly associated with the low grade of mMRC (OR: 0.982, 95%CI: 0.964, 1.000, p <0.05). And the higher intake of tubers, whole grains and mixed beans, and fish and seafood were all associated with lower mMRC grades (p <0.05).

Conclusions: COPD patients have poor dietary quality. High CHEI scores were associated with the low mMRC grades. Patients with COPD should be encouraged to maintain a good quality diet to reduce the risk of disease exacerbation.

Malnutrition is a crucial factor affecting the prognosis of various diseases, especially among elderly, surgical and critically ill patients. With the implementation of Diagnosis Related Groups (DRGs) and Diagnosis-Intervention Packet (DIP) in China, accurate diagnosis and treatment of malnutrition is essential for enhancing clinical decision-making and patient prognosis. These guidelines were developed by multidisciplinary experts through a systematic review of evidence-based medical literature. They adopt the new international standard for malnutrition diagnosis from the Global Leadership Initiative on Malnutrition (GLIM) proposed by the Global Nutrition Organization and categorize evidence levels, providing recommendations tailored to the Chinese population's data and characteristics. The guidelines cover the entire process of malnutrition diagnosis in adult patients, including definition, epidemiology, nutrition risk screening, multi-level nutrition assessment, and diagnostic procedures. They also propose individualized diagnostic strategies for specific patient groups, such as obese or critically ill patients, and establish a standardized process for malnutrition diagnosis. At last, the guidelines form 27 questions, 38 recommendations, in order to improve the practical capac-ity of malnutrition diagnosis in China.

Background and objectives: Evidence suggests that bioactive components present in plant foods have beneficial effects. Fenugreek is commonly used in Indian culinary practices and can help to keep blood sugar levels under control. The objective of this study was to assess the efficacy of defatted fenugreek seed flakes (FenuflakesTM) on the 24-hour glycaemic response (Incremental Area Under the Curve, iAUC), variability (Mean Amplitude Glycaemic Excursion assessed by Continuous Glucose Monitoring system) in participants with type 2 diabetes.

Methods and study design: Twenty-one type 2 diabetes participants, aged 42 to 50 years, were provided with 5-day cyclic iso-caloric diets for 14 days without (control diet) and with 30 g of FenuflakesTM (test diet) in a randomized crossover trial. The Abbott Pro sensor recorded interstitial glucose concentration every 15 minutes consecutively for 14 days in the participants. Additionally, fasting plasma glucose and glycated hemoglobin (HbA1c) were assessed at the baseline and end of the study.

Results: 15 out of 21 participants completed the randomized control and test diet feeding periods as per protocol. There was a significant reduction in 24-hour iAUC (p=0.02) and mean amplitude glycemic excursions (p=0.006) in the test diet as compared to control diet. Furthermore, within the test diet, there was a significant reduction in fasting plasma glucose and HbA1c (p<0.05) at the end of the 14-day intervention period.

Conclusions: The results suggest that the inclusion of FenuflakesTM, into regular dietary practices may effectively reduce glucose levels and enhance glycemic control in Asian Indian adults with type 2 diabetes.

Background and objectives: This study aims to investigate the association between dietary patterns and cognitive function among older adults with lower educational backgrounds living in China.

Methods and study design: We analyzed data from the 2018 Health Survey of individuals aged over 50 in Chengyang, Qingdao, China. Questionnaires were used to collect information on the behaviors and lifestyles of the elderly. The Montreal Cognitive Assessment (MoCA) was administered to evaluate cognition, with a total score of less than 19 indicating cognitive impairment for participants with low educational attainment. Using Principal Component Analysis, we identified three dietary patterns: Shellfish, Fruit, and Red Meat. Cross-sectional data regarding dietary intake, cognition, and demographics from 964 participants was analyzed using multivariate regression models to explore the relationship between dietary patterns and cognitive function.

Results: Our findings indicated that the 'Shellfish-based' dietary pattern ("Shellfish" DP) was significantly associated with cognitive function in both the third quartile (Q3: Odds Ratio = 0.58, 95% CI: 0.36-0.93, p <0.05) and the fourth quartile (Q4: OR = 0.54, 95% CI: 0.33-0.87, p <0.05). Furthermore, stratified analysis based on specific covariates revealed that significant results among individuals with a BMI of less than 25 kg/m² (OR = 0.57, 95% CI: 0.33-0.99, p <0.05). No significant interaction effects were observed between shellfish dietary intake and various subgroups (all interaction p >0.05).

Conclusions: Our research demonstrates that "Shell-fish" DP is negatively correlated with cognitive decline among the elderly population. This correlation is particularly significant in individuals with BMI < 25kg/m2, as well as among women and under the age of 65. However, no interaction was observed between the shellfish DP and the various subgroups. These findings can effectively guide older adults in optimizing their dietary structures, thereby safeguarding their cognition.

Background and objectives: Healthy diets are crucial in disease prevention and balanced diets can slow te-lomere shortening. Currently, it is still unclear which dietary factors are causally related to telomere length.

Methods and study design: The inverse variance weighted, Mendelian Randomization-Egger, weighted median, simple mode, and weighted mode methods were used. Additionally, heterogeneity, pleiotropy, MR-PRESSO and leave-one-out tests were conducted to ensure accuracy. Outcomes included granulocyte, lym-phocyte, naive T-cell, memory T-cell, B-cell, and natural killer-cell telomere lengths. Exposures included alcohol intake frequency, alcoholic drinks per week, average weekly beer plus cider intake, average weekly red wine intake, intake of beef, bread, cereal, coffee, cooked vegetable, dried fruit, fresh fruit, lamb/mutton, non-oily fish, oily fish, pork, processed meat, salad/raw vegetable, tea and water.

Results: The positive causal relationships were found between dried fruit intake and granulocyte telomere length (OR: 4.31; 95% CI: 1.29 to 14.4; p = 0.02), lymphocyte telomere length (OR: 4.22; 95% CI: 1.21 to 14.7; p = 0.02), naive T-cell telomere length (OR: 5.49; 95% CI: 1.58 to 19.0; p = 0.01). Oily fish intake was positively associated with memory T-cell telomere length (OR: 2.55; 95% CI: 1.16 to 5.58; p = 0.02). No significant causal relationships were found between other exposures and outcomes.

Conclusions: This study found positive causal associations between telomere length and the intake of dried fruit and oily fish. No significant causal relationships were observed with other dietary factors. These findings provide insights into how specific dietary components may help maintain telomere length.

Background and objectives: Children with developmental disabilities commonly experience feeding problems; however, tools to assess the nature and extent of these difficulties are not available in Arabic. This study aims to validate the Arabic version of the Screening Tool for Feeding Problems (STEP) and evaluate its factorial structure in children with developmental disabilities.

Methods and study design: This cross-sectional study involved 167 children with developmental disabilities, recruited from nine disability centers and schools in Madinah, Saudi Arabia. Data were collected from caregivers using a paper version of the Arabic version of STEP, which was sent home with the child along with a consent form for signature. The English-to-Arabic translation of the tool was conducted by a bilingual professional using the forward-backward translation method.

Results: Confirmatory factor analysis was performed to evaluate the factorial structure of the Arabic version of STEP using two models. Model 1 included all 23 items; Model 2 excluded six items with low factor loadings, resulting in a 17-item version. Model 2 demonstrated improved goodness of fit indices, supporting a modified five-factor structure. Reliability analysis showed acceptable internal reliability for the total scale in both models, with Cronbach's alpha of 0.80 and McDonald's omega of 0.79 for Model 1, and alpha of 0.83 and omega of 0.82 for Model 2. Internal consistency for individual factors ranged from 0.31 to 0.70.

Conclusions: The Arabic version of STEP demonstrates satisfactory psychometric properties and appears to be a valid and reliable tool for screening feeding difficulties in children with developmental disabilities in the Saudi Arabian context.