Asia Pacific journal of clinical nutrition最新文献

Background and objectives: To describe nutritional status and inflammation of elderly patients with chronic kidney disease and to confirm the association between a Malnutrition-Inflammation Score and physical func-tion and functional disability.

Methods and study design: A total of 221 chronic kidney disease patients (aged ≥60 years) were included. A Malnutrition-Inflammation Score was used to assess malnutrition and inflammation. Physical function was assessed using the SF-12. Functional status was evaluated using basic activities of daily living and instrumental activities of daily living.

Results: Thirty percent of participants had a Malnutrition-Inflammation Score ≥6, which denoted poor nutritional status. Participants with a Malnutrition-Inflammation Score ≥6 had decreased concentration of hemoglobin, albumin, prealbumin, handgrip strength and walking speed and increased concentration of inflammatory markers, including CRP, IL-6 and fibrinogen. Physical function and physical component summary were lower and basic activities of daily living dependence and instrumental activities of daily living dependence were higher among patients with higher Malnutrition-Inflammation Score than those with a lower Malnutrition-Inflammation Score. The Malnutrition-Inflammation Score was an independent risk factor for physical function and instrumental activities of daily living dependence.

Conclusions: The elderly chronic kidney disease patients with a high Malnutrition-Inflammation Score had a decreased physical function and an increased risk of functional instrumental activities of daily living dependence.

Background and objectives: Evidence for gene-diet interactions is lacking among individuals with specific dietary practices including vegetarians. This study aimed to determine the interactions of rs174547 in the fatty acid desaturase 1 (FADS1) gene with macronutrient such as carbohydrate (particularly fibre), protein and fat intakes on abdominal obesity among middle-aged Malaysian vegetarians of Chinese and Indian ethnicity.

Methods and study design: The present cross-sectional study was conducted among 163 vegetarians in Kuala Lumpur and Selangor, Malaysia. Dietary intakes of vegetarians were assessed by using a food frequency questionnaire. Waist circumference of vegetarians was measured by using a Lufkin tape W606PM. Genotypes of the rs174547 of vegetarians were determined by using Agena® MassARRAY. A multiple logistic regression model was used to determine the interactions of the rs174547 with macronutrient on abdominal obesity.

Results: About 1 in 2 vegetarians (51.5%) had abdominal obesity. Individuals with CT and TT genotype at T3 intake of carbohydrates, protein, fat and fibre as well as individuals with TT genotype at T2 intake of carbohydrates and protein had higher odds of abdominal obesity (pinteration <0.05). The gene-diet interaction remained significant for fibre intake (OR: 4.71, 95% CI: 1.25-17.74, pinteraction=0.022) among vegetarians with TT genotype at T2 intake of fibre after adjusting for age and sex and considering the effects of ethnicity and food groups.

Conclusions: The rs174547 significantly interacted with fibre intake on abdominal obesity. A specific dietary fibre recommendation based on genetics is needed among Chinese and Indian middle-aged vegetarians.

Background and objectives: Barley mixed rice, "Mugi gohan," is traditionally eaten with yam paste in Japan. Both ingredients contain dietary fiber and reportedly reduce postprandial hyperglycemia. However, evidence supporting the benefits of combining barley mixed rice with yam paste is limited. In this study, we evaluated whether ingesting a combination of barley mixed rice and yam paste affected postprandial blood glucose concentration and insulin secretion.

Methods and study design: This study followed an open-label, randomized controlled crossover design, following the unified protocol of the Japanese Association for the Study of Glycemic Index. Fourteen healthy subjects each consumed four different test meals: white rice only, white rice with yam paste, barley mixed rice, and barley mixed rice with yam paste. We measured their postprandial blood glucose and insulin concentrations after every meal, and we calculated the area under curve for glucose and insulin.

Results: Participants had significantly reduced area under curve for glucose and insulin after eating barley mixed rice with yam paste compared to when they ate white rice only. Participants had similar area under curve for glucose and insulin after eating barley mixed rice only, or eating white rice with yam paste. Participants had lower blood glucose concentrations 15 min after eating barley mixed rice only, whilst eating white rice with yam paste did not maintain lower blood glucose after 15 min.

Conclusions: Eating barley mixed rice with yam paste decreases postprandial blood glucose concentrations and reduces insulin secretion.

Background and objectives: The impacts of nutritional status on clinical outcomes in children receiving umbilical cord blood stem cell transplantation (UCBT) are not fully described. We evaluated the risk for malnutrition before transplantation admission and influence of weight loss during hospitalization on short-term clinical outcomes in children with UCBT.

Methods and study design: We conducted a retrospective study of pediatric patients up to age 18 years who received UCBT and were treated at the Children's Hospital of Fudan University between January 2019 and December 2020.

Results: The mean age of the 91 patients was 1.3 years, with 78 (85.7%) men and 13 (14.3%) women (p<0.001). UCBT was performed mostly for primary immunodeficiency disease (PID) (83, 91.2%). The weight loss differences among children with different primary diseases were statistically significant (p=0.003). Children with a large amount of weight loss during hospitalization (n = 24) had higher risks of skin graft-versus-host disease (GVHD) (multivariate OR=5.01, 95% CI: 1.35-18.65), intestinal GVHD (multivariate OR=7.27, 95% CI: 1.74-30.45), a longer median hospital stay (p=0.004), higher antibiotic costs (p=0.008) and higher total hospitalization costs (p=0.004). Malnutrition on admission was significantly positively correlated with longer parenteral nutrition (PN) time (p=0.008). Early nutritional intervention effects on clinical outcomes need further assessment.

Conclusions: Underweight recipient child and excessive weight loss during transplantation increases the length and cost of hospital stay, and is associated with a high incidence of GVHD, which affects the prognosis of transplantation and medical resources consumption.

Background and objectives: The effects of muscle meat and vegetable intake on body fat mass remain unclear in the general population. This study aimed to investigate the association of body fat mass and fat dis-tribution with a muscle meat-vegetable intake (MMV) ratio.

Methods and study design: In total, 29,271 par-ticipants aged 18-80 years were recruited from the Shaanxi cohort of the Regional Ethnic Cohort Study in Northwest China. The associations of muscle meat, vegetable and MMV ratio, as the independent variable, with body mass index (BMI), waist circumference, total body fat percentage (TBF) and visceral fat (VF), as dependent variables were evaluated by gender-specific linear regression models.

Results: There was 47.9% of men whose MMV ratio was greater than or equal to 1 and this figure was about 35.7% for women. For men, higher muscle meat intake was associated with higher TBF (standardized coefficient [ß], 0.508; 95% CI, 0.187-0.829), higher vegetable intake was associated with lower VF (ß, -0.109; 95% CI, -0.206 - -0.011), and higher MMV ratio was associated with higher BMI (ß, 0.195; 95% CI, 0.039-0.350) and VF (ß, 0.523; 95% CI, 0.209-0.838). For women, both higher muscle meat consumption and MMV ratio were associated with all fat mass markers, but vegetable intake was not correlated with body fat mass markers. The positive association of MMV on body fat mass was more pronounced in higher MMV ratio group, with both men and women. The intake of pork, mutton and beef was associated positively with fat mass markers but no such as-sociation was observed for poultry or seafood.

Conclusions: An increased intake of muscle meat or a higher MMV ratio was associated with increased body fat, especially among women, and such impact may mainly be attributed to increasing intake of pork, beef and mutton. The dietary MMV ratio could be thus a useful parameter for nutritional intervention.

Background and objectives: Gastrectomy causes vitamin B-12 deficiency since vitamin B-12 requires gastric acid and intrinsic factor for its absorption. Vitamin B-12 deficiency is considered to develop years after gastrectomy because of large hepatic storage. However, most gastric cancer develops after long-standing atrophic gastritis with vitamin B-12 malabsorption.

Methods and study design: We have investigated vita-min B-12 status in 22 patients before gastrectomy and 53 patients after gastrectomy due to gastric cancer, also with consideration on post-gastrectomy anemia.

Results: Blood vitamin B-12, folic acid, homocysteine concentrations, parameters of anemia, and dietary intake were evaluated. Percentage of patients with severe vitamin B-12 deficiency (serum vitamin B-12 < 150 pmol/L), vitamin B-12 deficiency (150 pmol/L to < 258 pmol/L) was 19.0 %, and 52.4 % respectively in patients gastrectomized within three years. Before gastrectomy, three and seven patients exhibited severe deficiency and deficiency, respectively. In gastrectomized patients, plasma homocysteine concentration was inversely associated with serum vitamin B-12 concentration, and vitamin B-12 deficiency- and iron deficiency- anemia coexisted with their mean corpuscular volume within the reference range.

Conclusions: Vitamin B-12 deficiency is prevalent in patients early after and before gastrectomy. Coexistence of vitamin B-12 and iron deficiency obscures the diagnosis of post-gastrectomy anemia, and necessitates the blood vitamin B-12 measurement.

Background and objectives: Amino acids (AAs) are crucial nutrients and fundamental building blocks of organisms that can be utilized to assess nutritional status and detect diseases. However, insufficient information has been reported on plasma AA in the Eastern Chinese population.

Methods and study design: 1859 persons who underwent physical examination in our hospital from January to December 2020 were enrolled. Plasma AA levels were determined by ultra-performance liquid chromatography mass spectrometry (UPLC-MS/MS.), and the effects of age and sex on 19 plasma AA profiles were analyzed. The Python language was used for data analysis and graphic visualization.

Results: Plasma arginine, proline, threonine, as-paragine, phenylalanine, and glycine in males, and plasma lysine, leucine, proline, valine, isoleucine, alanine, tyrosine, phenylalanine, and hydroxyproline levels in females increased with age. The 2-aminobutyric acid and serine levels in both sexes, and isoleucine, valine, leucine, and histidine levels in males decreased with age. Glycine level was higher in females than in males, and other 17 AAs except arginine and aspartate were higher in males than in females.

Conclusions: Our study indicated that plasma AA levels can reflect the nutritional status and dietary structure of the population, with high obesity rate and high incidence of chronic diseases in eastern China. Age has certain effects on plasma AA levels, especially compared with sex.

Background and objectives: Few studies have investigated the effects of dietary theobromine intake on the cognitive performance of older adults. Therefore, we investigated these effects in older adults in the United States.

Methods and study design: In this cross-sectional study, we used data (2011-2014) from the National Health and Nutrition Examination Survey. Intake of theobromine intake was obtained through two 24-h dietary recall interviews and was adjusted by energy. Cognitive performance was assessed using the animal fluency test, Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD), and Digit Symbol Substitution Test (DSST). Logistic regression and restricted cubic spline models were constructed to evaluate the correlation between the dietary intake of theobromine from different sources and the likelihood of low cognitive performance.

Results: The fully adjusted model revealed that compared with the lowest quintile, the odds ratios (with 95% confidence intervals) of cognitive performance in the CERAD test were 0.42 (0.28-0.64), 0.34 (0.14-0.83), 0.25 (0.07-0.87), and 0.35 (0.13-0.95) for the highest quintile of total theobromine intake and that from chocolate, coffee, and cream, respectively. Dose-response relationship analysis indicated nonlinear correlations between the likelihood of low cognitive performance and die-tary theobromine (total intake and that from chocolate, coffee, and cream). An L-shaped relationship was ob-served between total theobromine intake and cognitive performance in the CERAD test.

Conclusions: The dietary intakes of theobromine (total and that from chocolate, coffee, and cream) may protect older adults, particularly men, against low cognitive performance.

Background and objectives: The Asian Working Group for Sarcopenia (AWGS) recommended various measures for identifying patients with possible sarcopenia in its 2019 consensus. The present survey aimed to assess older adults in a senior home to determine the prevalence and associated factors for possible sarcope-nia and to compare the differences between various assessment pathways based on AWGS 2019 criteria.

Methods and study design: This cross-sectional study examined 583 participants of a senior home. Patients with possible sarcopenia were determined through the following four pathways: [I] calf circumference (CC) + handgrip strength (HGS); [II] SARC-F+HGS; (III) SARC-CalF+HGS; and (IV) CC, SARC-F, and/or SARC-CalF+HGS.

Results: The four assessment pathways revealed a high prevalence of possible sarcopenia in the older adults in the senior home ([I]=50.6%; [II]=46.8%; [III]=48.2%; [IV]=65.9%). There is significant difference in prevalence between pathway IV and the other pathways (p<0.001). A multivariate analysis revealed that advanced age, risk of malnutrition, malnutrition, high level of care, an exercise frequency of <3 times per week, and osteoporosis were correlated with a higher risk of possible sarcopenia. By contrast, oral nutritional supplements (ONS) reduced the risk of possible sarcopenia.

Conclusions: This survey reported a high prevalence of possible sarcopenia in the older adults of the senior home and determined the associated influencing factors. Furthermore, our findings suggested that pathway IV is the most suitable pathway for the examined older adults which enabled the detection and early intervention of more possible sarcopenia.

Background and objectives: Intestinal permeability (IP) is known to contribute to the immune system activation and inflammation; thus, it is proposed to have a role in the pathogenesis and exacerbation of many chronic diseases. Several studies have indicated that diet and nutritional status are risk factors for increased IP. In this mini review, we discussed the recent evidence on the association of diet, nutritional status, and intestinal permeability assessed by zonulin concentrations in serum and feces.

Methods and study design: Literature searching was conducted in Pubmed, ProQuest and Google Scholar using the keywords "diet quality", "intestinal permeability", "nutritional status", and "zonulin" combined with Boolean operators "AND" and "OR".

Results: Some studies indicated that intake of proper nutrition and good diet such as low total calorie intake, high intakes of omega-3 polyunsaturated fatty acids, fiber, vitamins, minerals, probiotics, and polyphenol-rich diet have significant impact on improvement of intestinal permeability marked by lower zonulin concentrations. Higher zonulin concentrations are found in those with overweight and obesity indicating that these population have increased IP. Most studies were conducted in adults and there are limited studies in children and adolescents. In addition, no studies have assessed diet quality to obtain a comprehensive picture on the complexities of diet in the population in relation to intestinal permeability.

Conclusions: Diet and nutritional status are linked to zonulin concentrations, indicating a role in intestinal permeability. Further research should be conducted to investigate the relationship between diet quality, as measured by appropriate diet quality indices, and intestinal permeability in children, adolescents, and adults.