Asia Pacific journal of clinical nutrition最新文献

Background and objectives: This study aimed to analyze the relationship between thyroid volume (TVOL) and physical development of children, and explore the suitable TVOL correction methods.

Methods and study design: 1500 children aged 8-10 years from Gansu province northwest China were selected. The height (H), weight (W), urine iodine of children was measured and their thyroid was examined by ultrasound. Body mass index (BMI), body surface area (BSA) and TVOL were calculated (BSA calculated by three formulas). The relationship between TVOL and age, sex, physical development was analyzed. The applicability of TVOL correction methods including BMI corrected volume (BMIV), BSA corrected volume (BSAV), weight and height corrected volume indicator (WHVI) and height corrected volume indicator (HVI) were compared.

Results: Median urinary iodine concentrations of children aged 8, 9, 10 years were 166.6 μg/L, 167.2 μg/L and 178.8 μg/L respectively. The rate of iodine deficiency was 20.3%, the rate of thyroid goiter was 3.2%. Physical development indexes (height, weight, BMI and BSA) and TVOL increased with age. Also, physical development indexes (height, weight, BMI and BSA) of boys were higher than girls (p <0.05). Only BSAV1 had no correlation with all physical development indexes (p >0.05). The TVOL P97 (97th percentile) of children aged 8, 9, 10 years were 4.4 ml, 4.9 ml, 6.5 ml, the values were 4.6 mL, 4.7 mL, 5.9 mL after BSAV1 corrected. The difference between TVOL and BSAV1 ranges from -0.37% to 0.36%.

Conclusions: The thyroid volume is not only affected by age, but it is also affected by physical development. Thyroid goiter should be assessed based on age and physical development. The formula BSAV1=TVOL/ (W0.425×H0.725×71.84×10-4) was a suitable TVOL correction method.

Background and objectives: Sleeve gastrectomy (SG) is a commonly utilized surgical procedure for managing weight and patients must adopt healthy lifestyle practices and dietary modifications to sustain weight loss and prevent relapse. This study aims to evaluate the dietary habits, levels of physical activity, and weight outcomes among Saudi women post-gastric sleeve surgery.

Methods and study design: This study involved 352 female participants aged 20 to 50, who had undergone gastric sleeve surgery. The Bariatric Patients As-sociation, Bariatric World and Patients Forum were also used and contacted via phone. Surveys were used to ascertain their physical activity levels and dietary behaviors; a food frequency questionnaire (FFQ) was also utilized and each participant's BMI was calculated.

Results: The study involved 352 women, of whom the highest proportion was in the 40-50 age group. Prior to the surgery, nearly all of the participants (98.9%) were diagnosed as having obesity or morbid obesity, which significantly decreased following the surgery. According to the participants, the primary reason for undergoing the surgery was failed dietary regimens (26.4%). A considerable portion of participants continued consuming dietary supplements post-surgery (35.59%) and frequently consumed juices and sweets. Most of the participants did not meet the WHO rec-ommendations for regular physical activity. Correlation analysis revealed a significant relationship between BMI and the consumption of healthy foods post-surgery.

Conclusions: The study identified concerning life-style habits among the participants, underscoring the importance of maintaining a healthy diet and engaging in regular physical activity to optimize the long-term benefits of weight loss surgery and enhance overall well-being.

Background and objectives: Consuming a diet that ensures adequate nutrient intake is essential to address all forms of malnutrition. In Japan, a meal combining staple food, main dish, and side dish is considered a balanced diet. This study was conducted to investigate the frequency of meals combining staple food, main dish, and side dish associated with nutrient adequacy.

Methods and study design: This cross-sectional study included 6,264 adults. All data were obtained from the 2015 Health and Nutrition Survey in Shiga prefecture. Staple food, main dish, and side dish were each defined as a dish with primary ingredients of ≥50 g. Regarding the frequency, participants were divided into ≥2 and <2 times/d groups. The nutrient adequacy evaluated using the Dietary Reference Intakes for Japanese 2020 (DRIs-J) score is based on the reference values provided in the DRIs-J. The t-test was used to evaluate nutrient adequacy between the 2 groups.

Results: Of the total participants, only 1,423 (22.7%) were classified into the ≥2 times/d group, and they had significantly higher DRIs-J scores than participants in the <2 times/d group (p < 0.001). The adequacy percentage of all nutrients except saturated fatty acid, particularly dietary fiber and most micronutrients, was > 1.5-fold higher in the ≥2 times/d group than in the <2 times/d group (p < 0.001).

Conclusions: This study provides important information that meals combining staple food, main dish, and side dish at least twice a day is effective in maintaining a diet with high nutrient adequacy.

Background and objectives: Obese and diabetic individuals tend to have insulin resistance, but are less like-ly to develop osteoporosis. The association of triglyceride-glucose (TyG) related indices with osteoporosis remains controversial, and longitudinal evidence exploring the male osteoporosis (MOP) is limited. This study aims to examine TyG, TyG-body mass index (TyG-BMI) and the metabolic score for insulin resistance (METS-IR) with osteoporosis risk among older men.

Methods and study design: A cohort study based on 1622 middle-aged and older men in 2015 was conducted, and followed up until 2022. Participants with oste-oporosis and admittedly secondary risk factors were excluded. TyG, TyG-BMI, METS-IR and corresponding quantiles were calculated. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence interval (CI). Receiver operating characteristic (ROC) curve was applied to estimate their performance in osteoporosis screening.

Results: 72 of 1622 participants were newly developed OP during the 9317 person-years. The adjusted HRs of TyG, TyG-BMI, and METS-IR for MOP were 0.573 (95%CI 0.336-0.976), 0.991 (95%CI 0.984-0.999) and 0.929 (95%CI 0.892-0.968), respectively, and pre-sented at linear dose-response relationships. Subgroup analysis showed that the estimated benefit for MOP incidence was consistent among participants aged more than 70 years and related to BMI and eating mount of milk, fresh fruit and vegetables. No difference was found in the area under ROC curve for screening osteo-porosis, ranging from 0.585 to 0.617.

Conclusions: TyG and relevant indices were associated with the inci-dence of osteoporosis in the senile men, and the relationship was thought to correlate with BMI and nutritional behaviors.

Human history began with the understanding of food, including what can be eaten, what cannot be eaten, and what is beneficial for health. This is the earliest and simplest form of food nutrition for humans. The history of nutrition, from ancient dietary habits to modern nutritional science as we know it today, is a fascinating journey spanning thousands of years. This article provides a comprehensive overview of the development history of human nutrition.

Background and objectives: Globally, there is an increasing trend in the number of individuals utilizing home enteral nutrition (HEN). In China, HEN is currently at a nascent stage. We aim to investigate the current situation of home enteral tube feeding (HETF) caregivers to provide more convenient services and assistance to them in China.

Methods and study design: We conducted a questionnaire survey among family caregivers of enteral tube feeding patients preparing for hospital discharge to assess their awareness, needs, and preferences for resources.

Results: 108 family caregivers were recruited in the study. 65 caregivers were considered proficient in tube feeding knowledge, while 43 were not, resulting in a non-proficiency rate of 39.8%. Education levels (p <0.001), employment status (p = 0.029), and the patients' age-adjusted Charlson Comorbidity Index (aCCI) (p = 0.032) were the critical factors affecting the caregivers' tube feeding knowledge. The risk of non-proficiency in tube feeding knowledge was increased for those with lower education levels compared with those with higher education levels (OR=5.08, 95% CI: 1.77-14.52). The family's monthly income and expenditure (p = 0.030) was the sole factor impacting the type of tube feeding service needs.

Conclusions: Providing tube feeding knowledge to HETF patients and their caregivers before dis-charge is essential. Personalized training, especially for caregivers with lower education levels, can improve their understanding. Additionally, implementing online nutrition follow-ups and Nutrition-Nursing Joint Clinics can help address healthcare resource disparities and offer more accessible services to HETF patients in China.

Background and objectives: Patients with gastrointestinal (GI) malignancies are at high risk for malnutrition because of reduced food intake, poor digestion, and altered absorption.

Methods and study design: In a ret-rospective review of medical records for patients admitted to urban hospitals in an Asian nation for GI tumor surgery (gastric, colon, or anorectal cancers), we found that malnutrition was common yet often overlooked. Our review identified records for 349 adult GI-tumor surgery patients. The Nutrition Risk Screening-2002 (NRS-2002) was the most frequently used screening instrument. In further review, we compared outcomes for malnourished GI tumor surgery patients given daily oral nutritional supplements (ONS) to outcomes for patients who were not given ONS.

Results: Review of results revealed that only 20% of patients in our sample underwent nutritional screening or assessment on admission. Of those who did, nearly 60% were malnourished. Although due to small sample sizes, no statistically significant differences were observed, mal-nourished patients who received ONS had fewer complications and shorter lengths of stay by 1-day. Such findings reveal many missed opportunities to improve patient outcomes and to avert excess healthcare costs for treatment of complications, slowed recovery, longer hospital stays, and readmissions.

Conclusions: Based on our findings, nutritional training for professionals is necessary to address the serious problems of under-recognition and inadequate treatment of malnutrition in hospitalized patients.

Background and objectives: Critically ill patients require individualized nutrition support, with assessment tools like Nutrition Risk Screening 2002 and Nutrition Risk in the Critically Ill scores. Challenges in continu-ous nutrition care prompt the need for innovative solutions. This study develops an artificial intelligence assisted nutrition risk evaluation model using explainable machine learning to support intensive care unit dietitians.

Methods and study design: Ethical approval was obtained for a retrospective analysis of 2,122 pa-tients. Nutrition risk assessment involved six dietitians, with 1,994 patients assessed comprehensively. Artificial intelligence models and shapley additive explanations analysis were used to predict and understand nutrition risk.

Results: High nutrition risk (35.2%) correlated with elder age, lower body weight, BMI, albumin, and higher disease severity. The AUROC scores achieved by XGBoost (0.921), CatBoost (0.926), and LightGBM (0.923) were superior to those of Logistic Regression. Key features influencing nutrition risk included Acute Physiology and Chronic Health Evaluation II score, albumin, age, BMI, and haemoglobin.

Conclusions: The study introduces an artificial intelligence assisted nutrition risk evaluation model, offering a promising avenue for continuous and timely nutrition support in critically ill patients. External validation and exploration of feature relationships are needed.

Background and objectives: The aim of this study was to elucidate the dose-response relationship between dietary carbohydrate consumption and the improvement of glycemic control and insulin sensitivity in indi-viduals with type 2 diabetes mellitus (T2DM), following an intensive dietary intervention.

Methods and study design: Randomized controlled trials published up to December 2023 were systematically reviewed from four databases: PubMed, Embase, Web of Science, and Cochrane Database of Systematic Reviews. Primary outcomes included: glycated hemoglobin (HbA1c), fasting glucose (FG); and secondary outcomes included: BMI, fasting insulin (FI), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). We performed a random-effects dose-response meta-analysis to estimate mean differences (MDs) for each 10% reduction in carbohydrate intake.

Results: A total of 38 articles were analyzed, encompassing 2,831 total par-ticipants. Compared to the highest recorded carbohydrate intake (65%), reducing carbohydrate intake to 5% showed that for every 10% decrease, the following improvements were observed: HbA1c (MD: 0.39%; 95%CI: -0.5 to -0.28%), FG (MD: 0.55 mmol/L; 95%CI: -0.82 to -0.28 mmol/L), BMI (MD: -0.83 kg/m2; 95%CI: -1.27 to -0.38 kg/m2), FI (MD: -2.19 pmol/L; 95%CI: -3.64 to -0.73 pmol/L), HOMA-IR (MD: -1.53; 95%CI: -3.09 to 0.03).

Conclusions: Reducing dietary carbohydrate intake significantly improves glycemic control and insulin resistance in individuals with type 2 diabetes. A linear reduction in carbohydrate intake was observed, with significant effects occurring within the first 6 months of the intervention. However, these effects diminished beyond this period. Notably, the improvements in glycemic parameters were not significantly affected by whether calorie restriction was implemented.

Background and objectives: Exploring the effects of circulating micronutrients on Graves' disease (GD) through observational research or randomized controlled trials has drawn more attention. In order to investigate the putative causal inference, we provide an illustrative estimate of two-sample Mendelian randomization (MR) study.

Methods and study design: Inverse-variance weighted (IVW) method was employed as the primary approach to determine the causal relationships between micronutrients level and GD. Several complementary sensitivity analyses were also undertaken to evaluate the impact of potential violations of MR assumptions. In addition, we utilized cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) to analyze the differences in the prevalence of GD among participants with different levels of trace nutrient concentrations.

Results: In terms of vitamins, IVW MR analysis revealed a suggestive relationship between each standard deviation decrease in vitamin D level and increased risk of GD (OR=1.28, 95% CI: 1.04-1.59, p = 0.0212). A nominally significant association was also noted for genetically predicted vitamin B-6 concentration and higher risk of GD (OR=1.56, 95% CI: 1.08-2.25, p = 0.0171). Genetically predicted concentrations of other vitamins level and 6 minerals levels were not in association with GD susceptibility. The causal estimates from other complementary MR approaches were consistent with these findings. Additionally, we found that participants from NHANES with vitamin D and vitamin B-6 deficiency had a higher prevalence of GD.

Conclusions: Our study provides an obvious unidirectional causality of circulating vitamin B-6 and vitamin D with GD. Dietary supplementation with micronutrients may be a complement to classical therapies for preventing and treating GD.