Asia Pacific journal of clinical nutrition最新文献

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.

Background and objectives: Consumption of refined white rice, a staple food in most Asian countries, reportedly causes postprandial hyperglycemia and facilitates the development of diabetes. However, cereal grains with low glycemic indices may reduce postprandial glycemic response. We developed a highland barley-multigrain rice by combining traditional Chinese grains including, highland barley, brown rice, oats, corn grit, and buckwheat. This study aimed to evaluate the glycemic impact, sensory attributes, and appetite response of our highland barley-multigrain rice compared to white rice.

Methods and study design: In this randomized crossover trial, ten healthy participants consumed highland barley-multigrain rice, white rice, and glucose, each containing 50 g of available carbohydrate under continuous glucose monitoring to compare postprandial glycemic responses over 180 min. The sensory and appetite ratings for the test foods were also evaluated.

Results: The glucose response of highland barley-multigrain rice, based on the incremental area under the curve and peak glucose change levels, showed statistically lower values than white rice. The glycemic index at 120 min (42.9±4.4 vs.79.5±8.0, p <0.001) and 180 min (45.3±4.7 vs. 86.1±8.7, p <0.01) after the consumption of highland barley-multigrain rice was all significantly lower than those of regular white rice. Despite its relatively poor taste and overall preference rating, the highland barley-multigrain rice achieved a higher satiety score at 120 min after intake than white rice.

Conclusions: As a low-glycemic index food, highland barley-multigrain rice could decrease postprandial glucose response and reduce hunger in healthy adults, indicating a potential role in improving glycemic control for patients with diabetes.

Background and objectives: The presence and accumulation of inflammation may exacerbate the develop-ment of dyslipidemia. Therefore, this study aimed to explore the relationship between blood inflammatory markers and the dietary inflammatory index (DII) in American adults as well as their association with dyslipidemia.

Methods and study design: This cross-sectional study included participants with complete data on lipid levels, dietary intake, and blood inflammatory markers. The associations between dyslipidemia and two sets of exposures-blood inflammatory markers and the DII-were analysed using weighted univariate and multivariate logistic regression models.

Results: Among the 9,441 participants (2009-2018), 6,689 (70.9%) had dyslipidemia. Logistic regression analysis revealed that higher DII quartiles were significantly associated with an increased risk of dyslipidemia, with the fourth quartile exhibiting an odds ratio of 1.33 (95% CI: 1.10-1.62; p < 0.001). Furthermore, DII combined with various blood inflammatory markers was consistently associated with an increased dyslipidemia risk (all OR > 1.0, all p < 0.05). A non-linear relationship was observed between the systemic immune-inflammation index (SII) and dyslipidemia risk, which became significant when the SII exceeded 434.65.

Conclusions: DII and blood inflammation markers showed a positive association with dyslipidemia. Nonetheless, these findings still offer valuable insights to public health policymakers for developing evidence-based strategies to prevent dyslipidemia and potentially reduce inflammation-associated dyslipidemia risk.

Background and objectives: Chronic obstructive pulmonary disease (COPD) is a disease characterized by malnutrition, a catabolic process, and chronic inflammation; thus, vitamin deficiency may occur frequently. We aimed to evaluate the levels of micronutrients in stable COPD patients.

Methods and study design: There were 168 COPD patients from six pulmonology departments, with 36 healthy controls. The patients also performed pulmonary function tests and filled out the St. George's Respiratory Questionnaire (SGRQ). Serum vitamin B-12 and folate levels were measured using the chemiluminescence immunoassay (CLIA) method. Plasma 25-OH D3 levels were measured by high-performance liquid chromatography (HPLC).

Results: Our results revealed vitamin D deficiency in 68.9% (mild: 59.6%, intermediate: 25.7%, severe: 14.7%), vitamin B-12 deficiency in 21.7%, and folic acid deficiency in 50% of COPD patients. There was a significant difference between the COPD and healthy control groups regarding vitamin D deficiency (68.9% vs. 16.6%; p <0.001). Mean plasma 25-OH-D level was significantly lower in COPD patients (p <0.01). There was a positive correlation of plasma 25-OH-D level with the SGRQ impact score (r = 0.174, p = 0.028) and a negative correlation with age and number of exacerbations (respectively; r = -0.248, p = 0.002, and r = -0.160, p = 0.044).

Conclusions: Vitamin D, B-12, and folate deficiencies frequently occur in COPD patients. Low plasma levels of 25-OH-D may be associated with advanced age and a higher number of exacerbations in patients with COPD. COPD patients with low vitamin D and folate may experience a decrease in quality of life.

Background and objectives: Stunting is a global health challenge, especially in developing countries like Indonesia, where its prevalence reached 21.6% in 2022. This condition stems from malnutrition, recurrent infections, and inadequate care during the first 1,000 days of life. Maternal nutrition is critical for fetal growth, as deficiencies can lead to low birth weight and short birth length, increasing the risk of stunting. This study evaluates the potential of fortified tempeh as a nutritional intervention to improve birth outcomes.

Methods and study design: A quasi-experimental study with a quantitative approach was conducted to compare the effects of regular and fortified tempeh on BW and BL among pregnant women in Kuningan Regency. Participants were divided into two groups: one receiving fortified tempeh and the other regular tempeh. BW and BL were measured at birth and statistically analyzed for differences.

Results: The results showed no statistically significant differences in BW and BL between the two groups. However, the fortified tempeh group exhibited a positive trend, with an average BW of 2.92 kg and an average BL of 49.1 cm, compared to the regular tempeh group.

Conclusions: Fortified tempeh demonstrates potential as a cost-effective, locally sourced intervention to support fetal growth and reduce stunting risks. Its integration into public health programs could enhance maternal nutrition and improve birth outcomes in Indonesia.

Background and objectives: The aim of this study was to investigate the effect of dietary iron and zinc in-take on the risk of preterm labor before and during different trimesters, and to assess whether there is an interaction between iron and zinc intake and the risk of preterm labor.

Methods and study design: The study was a nested case-control study of 880 cases and 8017 controls in Lanzhou City, northwest China. Unconditional logistic regression was used to determine the association between dietary iron/zinc intake and the risk of preterm labor and its clinical subtypes. Multivariable-adjusted restricted cubic spline (RCS) modeling was used to explore the non-linear relationship between dietary iron/zinc intake levels and the risk of preterm birth. Lower iron/zinc intake before and during pregnancy was associated with a higher risk of preterm labor and some of its subtypes, and there was a non-linear trend between iron/zinc intake and risk of preterm labor (p non-linear <0.05). A synergistic effect of low iron and zinc intake on the risk of preterm labor was also observed.

Results: We observed a significant increase in the risk of preterm labor in women with low dietary zinc intake before and during pregnancy, with a dose-response relationship. Similarly, there was a significant negative association between lower dietary iron intake during pregnancy and preterm labor. In addition, there was a multiplicative interaction between low dietary iron and zinc intake and preterm delivery before pregnancy and during three different periods of pregnancy.

Conclusions: Higher dietary intake of iron and zinc before and during pregnancy may reduce the risk of preterm labor. Low intakes of iron and zinc during pregnancy appear to have a synergistic effect on the risk of preterm labor.

Background and objectives: Large-scale studies on the role of multivitamin-mineral (MVM) supplementation in preventing and managing acute respiratory infections (AURIs) are limited in Chinese populations. This study evaluated the impact of routine MVM use on AURI prevalence and symptom severity in a community-based Chinese cohort.

Methods and study design: This retrospective study was conducted among community-based populations across China (n=3,415). Using a structured questionnaire, participants self-reported epi-sodes of AURIs over three months. Based on regular use of MVM for at least 3 months, eligible participants were categorized into the MVM group and the control group. The impact of MVM on the frequency and severity of AURIs was assessed. Rigorous methodological approaches were applied to minimize potential biases.

Results: The period prevalence of AURIs was significantly lower in the MVM group (29.9%) compared to controls (45.6%), odds ratio (OR) =0.508 (p<0.001). After propensity score matching, demographic and lifestyle factors were comparable between groups. The period prevalence of AURIs was 31.7% and 44.8% in the MVM and control groups (OR=0.572, p<0.001). Subgroup analysis indicated the protective effect of MVM supplementation was particularly significant among participants aged ≥45 years (OR=0.407, p<0.001). The MVM group reported lower prevalence of nasal congestion (OR=0.624, p<0.001), sore throat (OR=0.575, p<0.001), headache (OR=0.642, p<0.001), diarrhea (OR=0.718, 0.026), sneezing (OR=0.651, p=0.002), and fatigue (OR=0.694, p=0.004) relative to the control group.

Conclusions: Daily MVM supplementation for at least 3 months reduced the period prevalence of the common cold and influenza and may contribute to enhanced immune resilience in the Chinese population.

Background and objectives: We retrospectively evaluated the efficacy and safety of early enteral nutrition (within 48 h) and late enteral nutrition (after 48 h; control) in improving the nutritional status of surgical intensive care unit patients.

Methods and study design: This single-center, retrospective, observational study was conducted using data from 82 patients (age > 18 years) who were admitted to surgical intensive care units between June and November 2019. Patients who received enteral nutrition for >7 days were included in this study, and those who received total parenteral nutrition or palliative care were excluded.

Results: The early and late enteral nutrition groups comprised 41 patients each. Early enteral nutrition significantly increased the actual intake of calories and protein (p < 0.0001) as well as the length of stay in the surgical in-tensive care unit (p = 0.047) and hospital (p = 0.028). Late enteral nutrition significantly reduced albumin concentration (p < 0.05), hemoglobin concentration (p < 0.05), and lymphocyte count (p < 0.05) but significantly increased weight loss (p < 0.05). However, no significant between-group difference was observed in mortality rate.

Conclusions: Early enteral nutrition improves the nutritional status of surgical intensive care unit patients. It shortens overall hospitalization duration and increases actual calorie and protein intake at dis-charge. Thus, early enteral nutrition is recommended for critically ill patients.

Background and objectives: Cancer patients at nutritional risk have a worse prognosis, but this can be improved by nutritional support. Food for special medical purposes (FSMP), as a new form of nutritional support, needs to be further evaluated for its safety and efficacy in these patients. Our study elucidate the impact of FSMP on nutritional status and sarcopenia among nutritional risk cancer outpatients by assessing the NRS2002 score, exercise performance, muscle mass, and inflammatory factors pre- and postintervention.

Methods and study design: We conducted a single-centre, double-blind, randomized controlled interventional study. Patients from the oncology clinic with nutritional risk were randomly allocated to the control group or the FSMP group and received oral intervention for 8 weeks. The primary outcome was improvement in nutritional risk, while the secondary outcomes were improvements in sarcopenia prevalence and physical performance indicators. Other outcomes included alterations in calf circumference, hsCRP, 25(OH)VD3, Alb. etc. A linear mixed-effects model was used to compare the prepost-intervention changes in these results.

Results: Thirty-six cancer patients were included, 25 completed the study. The percentage of patients at nutritional risk after intervention in the FSMP group was significantly lower than the control group (Χ2=4.186, p=0.041). The FSMP group demonstrated significant improvements in the TUG test, gait speed, grip strength, and upper-limb muscle mass. However, there was no significant improvement in the rate of sarcopenia. Moreover, calf circumference, hsCRP, 25(OH)VD3, Alb exhibited no significant changes.

Conclusions: FSMP can effectively improve the nutritional status, physical performance and upper-limb muscle mass of cancer patients.

Background and objectives: Refeeding syndrome (RS) is a potentially life-threatening condition character-ised by significant electrolyte and fluid imbalances, posing a considerable risk in patients undergoing parenteral nutrition (PN) therapy. This study aimed to determine the occurrence, risk factors, severity, and complications of RS in a teaching hospital in Malaysia.

Methods and study design: A retrospective observational study was conducted using universal sampling from October to December 2023. Data were collected for adult patients receiving PN for more than 48 hours between July 2022 and July 2023 at Hospital Canselor Tuanku Muhriz.

Results: Among 90 patients included, 30 (33.3%) developed RS. Upon consideration of interaction terms due to collinerity of variables, a statistically significant correlation was observed between pre-existing electrolyte derangements and RS occurrence (p = 0.001). Phosphate levels showed the most significant decline post-PN initiation (43%), followed by potassium (19%) and magnesium (17%), primarily within the first 24 hours. No significant associations were found between BMI, fasting duration, unintentional weight loss, or medication history and RS. However, fasting for more than five days (AOR 2.8, 95% CI 0.4-17.7) and ≥10% unintentional weight loss (AOR 1.8, 95% CI 0.4-7.7) increased the likelihood of RS.

Conclusions: RS is prevalent among adult PN patients, predominantly with mild severity. Pre-existing electrolyte abnormalities, especially in phosphate levels, were robust predictors. Larger studies are needed to better elucidate the associations between risk factors and RS in the local population.