Asia Pacific journal of clinical nutrition最新文献

Background and objectives: Epidemiological studies often use the food frequency questionnaire (FFQ) to predict the food consumption habits of a target group and subsequently promote healthy eating in the group. In the present study, a version of the FFQ for Malaysian young adults aged 18-24 years was designed and validated.

Methods and study design: This study comprised development and validation phases. In the development phase, 129 young adults from a public university in Klang Valley completed a 3-day food record (3DFR), and the data were used to create a food list for the FFQ. Two weeks later, in the validation phase, another 100 participants recruited from the same university completed the 3DFR and a newly developed FFQ for assessing consumption of 38 food items. Finally, the data obtained from the FFQ and 3DFR were used to analyze the nutrient intake of each participant, and the developed FFQ was validated using Spearman correla-tion coefficients (r) and Bland-Altman methods.

Results: For the development phase, 38 food items were determined to contribute to 90% of the participants' total energy and macronutrient intake, and these items were included on the FFQ. For the validation phase, the average Spearman correlation coefficient for energy and all nutrients was 0.43, which indicated good agreement between the 3DFR and FFQ. Cross-classification analysis of the 3DFR and FFQ results revealed that 79% of the young adults were classified into similar or neighboring quartiles when each set of results was used. The Bland-Altman plots revealed that the results obtained using the two methods were parallel.

Conclusions: The FFQ is a simple and validated tool that can be self-administered to young adults to assess their energy and nutrient consumption.

Background and objectives: Previous literature mostly has demonstrated the efficacy of pulmonary rehabilitation (PR) combined with whole nutrition powder in patients with chronic obstructive pulmonary disease (COPD). However, the benefits of whey protein as an oral nutritional supplement (ONS) during PR are not clear.

Methods and study design: It took 12 weeks to complete the trial, we divided 90 elderly patients with stable-stage COPD into a low-intensity exercise group (n= 30, PR group), PR plus whey proteins complex group (n= 30, PRWP group), and a control group (n= 30) randomly, and assessed index such as exercise capacity, mental health status, lung function, and body composition. Eventually, 84 people persisted until the end of the trial.

Results: Compared with the control group, hand grip strength (HGS)(1.4 ± 0.6 kg, and 1.0 ± 0.2 kg respectively, p< 0.05) in the PRWP and PR group, 6 minutes of walking distance (6MWD)(14.1 ± 3.8m, p< 0.05) in PRWP group improved. Furthermore, compared with the PR group, Medical Research Council Dyspnea Scale (MRC)(-0.2 ± 0.1, p< 0.01), anxiety score (-1.2 ± 0.4, p< 0.01), and body weight (2.0 ± 0.8kg, p< 0.05) improved in the PRWP group. There were no inter-group differences in a fat-free mass index or appendicular skeletal muscle mass index.

Conclusions: Muscle strength could be enhanced in both intervention models. Adding whey protein complex was additionally successful in rectifying dyspnea, anxiety, and weight loss caused by exercise. This rehabilitation pattern might be valuable in elderly patients with COPD.

Background and objectives: Macronutrients play a vital role in liver dysfunction and affect tuberculosis treatment and prognosis. However, macronutrients intake was inadequate for most tuberculosis patients. This study aimed to clarify the associations between macronutrients intake or energy percentages and liver dys-function in tuberculosis patients.

Methods and study design: In this cross-sectional study, 2581 active tu-berculosis patients aged ≥18 years were included from local tuberculosis clinics in Linyi, China. Macronutrients intake and energy percentages were assessed by 24-hour dietary recalls. The concentration of alanine transferase (ALT) or aspartate transaminase (AST) greater than 40 U/L was defined as liver dysfunction. A restricted cubic spline (RCS) was applied to determine the dose-response relationships.

Results: Liver dysfunction was assessed for 14.6% (377 patients) of tuberculosis patients. Higher protein (Q2-Q4 in model 1 and 2) or fat intake and fat-to-energy percentages and lower carbohydrate-to-energy percentages (Q4 in model 1) were associated with a decreased incidence of liver dysfunction (p-trend < 0.05). Among those who were male, normal BMI, or consumed energy <1636 kcal/d, inverse associations between protein or fat intake and the risks of liver dysfunction in models were suggested (p-trend < 0.05). Moreover, J-shaped curves in RCS were evident in liver dysfunction tuberculosis patients with protein or fat intake (p-nonlinearity < 0.05). Conclu-sions: Significant linear associations between macronutrients intake or energy percentages and liver dysfunction prevalence were found only in male, normal BMI, or less energy intake patients. The shapes of liver dysfunction-morbidity differed significantly by macronutrients intake or energy percentage.

Background and objectives: Globally, there appears to be an ever-increasing interest in adopting a vegetarian diet. However, there are concerns that avoiding meat may increase the risk of anaemia and micronutrient deficiencies, especially for vulnerable populations, such as adolescent women. The objective of this study was to compare the micronutrient status of vegetarian and non-vegetarian adolescent women in New Zealand.

Methods and study design: Adolescent women aged 15-18 y were recruited from eight locations across New Zealand. Blood samples were analysed for: haemoglobin, serum ferritin, soluble transferrin receptor, zinc, selenium, retinol binding protein, folate, vitamin B-12, vitamin D and parathyroid hormone.

Results: Of the 182 participants who provided a blood sample, 15% self-identified as vegetarian (n=27). On average, vegetarians had 3.1% (95% CI -5.8 to -0.4, p=0.025) lower haemoglobin, and 8.3% (95%CI -14.1 to -2.1, p=0.004) lower selenium. In contrast, serum folate was 80.5% (95% CI 45.7 to 123.7, p<0.001) higher. The prevalence of zinc and selenium deficiency was higher among vegetarians (50% and 12%, respectively) than non-vegetarians (21%, and 2%, respectively).

Conclusions: Adolescent vegetarian women may be at increased risk of deficiency of micronutrients commonly found in animal products, including zinc and selenium, and may benefit from following dietary practices that enhance micronutrient intake and absorption.

Background and objectives: Emerging expert consensuses and guidelines recommend that omega-3 fatty acids may have anti-inflammatory effects in hospitalized patients with coronavirus disease (COVID-19). However, these recommendations are based on pathophysiological studies of inflammation rather than direct clinical evidence. We conducted this systematic review and meta-analysis to evaluate the efficacy of omega-3 fatty acid supplementation in hospitalized patients with COVID-19.

Methods and study design: We retrieved literature from PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WANFANG, Chinese Biomedical Literature Database, and Cochrane Library databases up to May 1, 2023. Data from studies comparing omega-3 fatty acids with a placebo or other pharmaceutical nutrients were analyzed.

Results: Of 3032 records, 42 full-text articles were reviewed, five eligible studies were identified, and one study was found in the references. In total of six studies involving 273 patients were included, pooled, and analyzed. Compared to the control group, omega-3 fatty acid intervention reduced the overall mortality of hospitalized patients with COVID-19 (RR=0.76; 95% CI, [0.61, 0.93]; p=0.010). No serious or unexpected drug-related adverse events were observed. No statistical significance was observed in inflammatory markers such as CRP (MD=-9.69; 95% CI, [-22.52, 3.15]; p=0.14; I2=97%) and IL-6; however, the neutrophil/lymphocyte ratio was significantly lower in the omega-3 FAs group on day 7 of intervention (p < 0.001).

Conclusions: Omega-3 fatty acid administration may be associated with reduced mortality in hospitalized patients with COVID-19. Given the small sample size of enrolled studies, more rigorous and large-scale trials are urgently needed in the future to verify its efficacy.

Background and objectives: We aimed to investigate the association of triglyceride-glucose (TyG) index with hypertension and compare the discriminative power of the TyG index, lipid, glycemic parameters for hypertension using the China Health Examination Collaborative study (CHEC Study).

Methods and study design: Data were collected at Ningbo Mingzhou Hospital and Beijing physical examination center from the CHEC Study during 2014 and 2021. Participants with ≥2 medical check-up times were included. The TyG index is the logarithmized product of fasting triglyceride and glucose. Generalised estimation equation (GEE) model was used to evaluate the association between the TyG index, lipid parameters, glycemic parameters and hypertension. Receiver operating characteristic (ROC) analysis was performed to explore the predictive ability of TyG index on hypertension at different years of medical check-up.

Results: 112,902 participants with an average age of 42.8 years were recruited in the study, 36,839 participants developed hypertension over the 8-year period. GEE model analysis showed that the ORs with 95% CI of hypertension were 3.35 (3.15-3.57), 1.86 (1.76-1.95), 1.67 (1.58-1.78), 1.45 (1.33-1.58), 1.24 (1.19-1.29), 0.92 (0.86-0.99), and 1.90 (1.83-1.97) in the highest versus lowest quintiles of TyG index, TG/HDL-C ratio, TG, TC, LDL-C, HDL-C and FPG in model 2. The area under the ROC curve of the overall years of medical check-up was signifi-cantly higher than a particular year in predicting hypertension (AUC: 0.883, p < 0.05).

Conclusions: TyG index is associated with hypertension and shows the superior discriminative ability for hypertension compared with lipid and glycemic parameters.

Background and objectives: Sarcopenia is prevalent in patients with stroke. However, the relationship between sarcopenia and poor functional outcome of patients with acute stroke remains unknown. A systematic review and meta-analysis was performed to evaluate the above association.

Methods and study design: Observational studies which evaluated the influence of sarcopenia on functional outcome in patients with acute stroke were retrieved by search the PubMed, Embase, Cochrane Library, and Web of Science databases. A poor functional outcome was defined as modified Rankin scale (mRS) of two or more points during follow-up. Two authors independently collected the data of study characteristics and outcomes. A random-effects model was used to pool the results via incorporating the influence of possible between-study heterogeneity.

Results: Nine datasets from seven cohort studies contributed to the meta-analysis. A total of 1774 patients with stroke were included, and 481 (27.1%) of them had sarcopenia. Compared to patients without sarcopenia, those with sarcopenia were associated with a higher risk of poor functional outcome during follow-up duration up to 6 months after stroke onset (odds ratio: 2.42, 95% confidence interval: 1.76 to 3.33, p < 0.001) with mild heterogeneity (I2 = 23%). Subgroup analyses according to study design (prospective versus retrospective), sex of the patient, type of stroke (ischemic or mixed), diagnostic methods for sarcopenia, follow-up duration and cutoff scores for mRS showed consistent results (p for subgroup analyses all > 0.05).

Conclusions: Sarcopenia may be associated with poor functional outcome in patients with acute stroke.

In 2022, Taiwan enacted the Food and Agricultural Education Act, thus officially launching its food education policy. The objective of this article is to elucidate the social background to this Act and current challenges to promoting food education. The data were obtained from the relevant literature and interviews with 11 key actors, who represented academia, the government, public education and civil society. Although having much in common with the Japanese equivalent policy, Taiwan's food education contains some notable features. Food education began as a reaction to recent food safety scandals, growing food anxiety, the prevalence of eating out, the globalisation of food systems and increasing instability, all of which characterise reflexive food modernity. The Taiwanese policy aims to avoid the nutrition-centered, gendered and nationalistic tendencies of food education in countries such as Japan by stressing the interconnection of food system actors, social responsibility for family meals and an openness to diverse food cultures. However, achieving such objectives requires consciousness of the reflexive food modernity facing Taiwan and addressing operational issues, notably the strengthening of inter-ministerial collaboration and the integration of dialogue with diverse food education actors in defining educational content and professional qualifications.

Background and objectives: This study investigated the relationship between socioeconomic factors, dietary intake, and sarcopenic obesity among older adults in Korea.

Methods and study design: Data from the seventh Korean National Health and Nutrition Examination Survey (2016-2018) were analyzed. The study included 3,690 participants (1,645 men and 2,045 women) aged 65 years and older. Sarcopenic obesity was defined as the coexistence of low muscle strength (handgrip strength <28 kg in men and <18 kg in women) and abdominal obesity (waist circumference >90 cm in men and >85 cm in women). Socioeconomic factors assessed included age, living status, residential area, employment, education, and family income level. Dietary intake was evaluated using the nutrient adequacy ratio and mean adequacy ratio derived from 24-h dietary recall data. Multiple logistic regression was used to identify factors associated with sarcopenic obesity.

Results: The prevalence rates of sarcopenic obesity were 6.5% in men and 17.4% in women. Low education levels were significantly associated with a higher prevalence of sarcopenic obesity in women, whereas lower family income levels were associated with an increased risk of sarcopenic obesity in men. In women, a lower mean adequacy ratio was significantly associated with a higher risk of sarcopenic obesity.

Conclusions: Lower family income and education level are associated with a higher prevalence of sarcopenic obesity. Ad-ditionally, overall nutritional adequacy is inversely related to the prevalence of sarcopenic obesity, particularly in women.

Background and objectives: Lack of professional and accurate diagnosis of malnutrition led to a reduction in Diagnosis Related Group (DRG) payment and a decrease in Case-Mix Index (CMI). The aim of this study was to explore the effects of adding a proper nutritional diagnosis and modifying complication groups on DRG payment and CMI.

Methods and study design: Retrospective analysis was performed on patients ad-mitted to the hospital from January to June 2022 who had received a nutritional assessment. Patients were diagnosed as well-nourished, mild malnutrition, moderate malnutrition or severe malnutrition according to patient-generated subjective global assessment (PG-SGA) scores within 24 hours of admission. CMI and DRG hospital internal control standards were recalculated and compared with the original values.

Results: A total of 254 patients were enrolled, including 40 patients with mild malnutrition, 74 patients with moderate malnutrition and 122 patients with severe malnutrition. Of all subjects, 111 changed complication groups. The median of the DRG hospital internal control standard (12006.09 vs. 13797.19, p=0.01) and the median of CMI (0.91 vs. 1.04, p=0.026) were significantly higher than those before the diagnostic change. In patients with inflammatory bowel disease (IBD), the CMI value, hospital control standard of DRG, and the classification of DRG were significantly different from those before diagnosis revision (p<0.001).

Conclusions: Fully identification and correct coding of malnutrition cases are conducive for hospitals to receive appropriate DRG compensation, and further contribute to the improvement of medical quality and the economic sustain-ability of hospitals.