The contributors to and consequences of disordered health are increasingly complex with sociodemographic, eco- logical, economic and food system change. But there are opportunities for any adversity to be mitigated by ad- vances in the understanding of human, especially nutritional, ecobiology and in its more accessible and affordable evaluation and monitoring. Viral pandemics are on the rise with climate change and loss of ecosystems. They threaten human civilisation and planetary habitability. Human security is dependent on sustainable livelihoods of which food and water systems are a vital part. We are socioecological beings and depend for our health on biodi- versity and the food diversity that ensures; and on connectedness and communication, made more difficult in pandemics. Rapid and accessible point-of-care (POC) tools are now becoming available to compliment other self- monitoring network approaches, whether checklist or questionnaire, physical, chemical, or biological, for healthcare and nutritional health. They can provide information as several complimentary and interdependent health indices to facilitate personal, group and community action and management plans. This applies to indices of both communicable and non-communicable disease which problems separately and together are compromising health prospects. These indices include ones of physical and mental activities, dietary patterns, metabolites, blood pressure and now the presence and severity of viruses like Covid-19.Of imminent relevance and promise are opti- cally-readable biosensor based strips for nasal, pharyngeal or salivary samples to check viral presence or finger prick blood for immunoglobulins and interleukins. These should allow less socially prohibitive measures to curb viral transmission and promote personal and societal wellbeing.
Background and Objectives: The association between diet and macrocytic and hypochromic anemia in young Chinese men and women remains unclear. The present study aimed to investigate the relationship between dietary pattern and macrocytic and hypochromic microcytic anemia in young Chinese men and women. Methods and Study Design: Some 4,840 first-year students (2,385 men and 2,455 women) were recruited for this study from Qingdao University, China. Biochemical and hematological parameters, and food frequency questionnaires were obtained from the subjects. Based on dietary intake, participants were divided into three dietary patterns: seafood dietary pattern (SDP), vegan dietary pattern (VDP) and omnivorous dietary pattern (ODP). The risks for macro- cytic and microcytic hypochromic anemia in three dietary patterns were assessed. Results: Macrocytic and hypo- chromic anemia were less common in participants who adhered to the omnivorous dietary pattern than to the ve- gan or seafood dietary patterns (p<0.05). Adhering to an omnivorous dietary pattern was negatively associated with macrocytic anemia in men [odds ratio (95% CI): 0.74 (0.62, 0.89), p<0.001] and microcytic, hypochromic anemia in both genders [men: odds ratio (95% CI): 0.64 (0.45, 0.92), p=0.01; women: odds ratio (95% CI): 0.71 (0.51, 0.99), p=0.04]. Conclusions: Adhering to an omnivorous dietary pattern was associated with less common macrocytic anemia in young men and microcytic, hypochromic anemia. Dietary diversity is important in prevent- ing macrocytic anemia in men and also microcytic, hypochromic anemia in young men and women. Excessive al- cohol intake is the most plausible explanation for macrocytosis in the young men.
Background and Objectives: Current guidelines recommend reducing intake of diets rich in saturated fats and replacing it with diets rich in unsaturated fats. Palm oil contains a high amount of saturated fatty acids, but its ef- fect on serum lipid levels is unclear. The study aimed to compare the effects of palm oil consumption with other edible oils rich in monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) on serum lipid profiles. Methods and Study Design: We searched Medline, Embase, Cochrane Central Registry of Controlled Trials and CINAHL. Clinical trials were eligible if they compared palm oil-rich diets with diets rich in MUFAs or PUFAs. We pooled results of included studies using a random effects model and assessed the quality of the evi- dence and certainty of conclusions using the GRADE approach. Results: Intake of palm oil intake compared to oils rich in MUFA was associated with increased levels of total cholesterol (TC) [mean difference (MD)=0.27 mmol/L; 95% CI 0.08 to 0.45], LDL-C (MD=0.20 mmol/L; 95% CI 0.02 to 0.37) and HDL-C (MD=0.06 mmol/L; 95% CI 0.02 to 0.10). Similarly, for comparison with oils rich in PUFAs, palm oil showed increased in TC (MD=0.38 mmol/L; 95% CI 0.14 to 0.62), LDL-C (MD= 0.44 mmol/L; 95% CI 0.01 to 0.88) and HDL-C (MD=0.08 mmol/L; 95% CI 0.03 to 0.13). For both comparisons, there were no significant effects on triglycer- ides. Conclusions: Even though palm oil increases marginally the level of serum lipids, the evidence is mostly of low to moderate quality.
Background and Objectives: As the incidence and prevalence of Alzheimer’s disease increases, so does the body of epidemiological and clinical research that suggests a relationship between dietary fatty acids, in particular saturates, and cognitive decline. In this study, we investigated the association between serum apolipoprotein B48 (apoB48), saturated fatty acid intake and consumption behaviour, and cognitive performance, in healthy, older aged Australians. Methods and Study Design: We retrospectively analysed fasted serum apoB48 concentrations, food frequency questionnaire, and cognitive performance data collected from 147 participants (98F|49M) over the age of 50. We used Spearman’s correlations and a nested domain model to evaluate the relationship between se- rum apoB48, dietary behaviour and measures of cognitive performance. Results: Overall, we found that higher fasted apoB48 concentrations, and/or dietary behaviours which led to increased dietary consumption of diets high in saturated fatty acids, were inversely associated with cognition. Interestingly however, dietary behaviour pat- terns of saturated fatty acid consumption and serum apoB48 were linked with better secondary memory and per- ceptual speed, respectively. Conclusions: This is the first time that fasted apoB48 has been implicated as a bi- omarker for cognitive decline and Alzheimer’s disease risk.
Background and Objectives: Indonesia’s community health delivery system offers services such as prenatal care and supplementation. Despite accessibility to these services, compliance with supplementation is low, and childhood stunting rates remain high. To address undernutrition, a National Nutrition Communication Campaign (NNCC) – using interpersonal communication (IPC) strategies – was implemented to promote consumption of iron-folic acid (IFA) supplements and iron-rich foods (ATIKA). The purpose of this study was to understand how participation in IPC activities influenced knowledge, attitude/intention, and consumption of IFA supplements and ATIKA among pregnant Indonesian women. Methods and Study Design: Cross-sectional data came from 766 pregnant women that participated in a survey that was based on the constructs from the Theory of Planned Behav- ior and Health Belief Model. Adjusted linear and logistic regression models were conducted to analyze the differ- ences between self-reported IPC participants and non-IPC participants. Approximately 20% of women were ex- posed to the IFA portion of the IPC campaign, and 18% were exposed to the ATIKA portion. Results: Women that were exposed to the campaign reported significantly higher knowledge of IFA tablets and ATIKA, and im- proved attitudes/intentions towards IFA, compared to non-exposed women. Exposure was not associated with ac- tual consumption behaviors. Conclusions: These findings suggest that exposure to a low-intensity intervention can increase knowledge but may not be sufficient to impact behavior. As such, future efforts to reduce stunting through improved maternal nutrition should seek to increase exposure, address barriers, understand perceived susceptibility, and improve self-efficacy in order to expand intervention reach in Indonesia.
Background and Objectives: To examine whether a parenteral mixed lipid emulsion containing fish oil reduces the incidence of cholestasis, retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW, birth weight <1500 g) infants. Methods and Study Design: This retrospective study was conducted in the neonatal intensive care unit of the Children’s Hospital of Fudan University. Patients re- ceived either a soybean and medium-chain oil (MCT)-based lipid emulsion (Lipofundin) or a mixed lipid emul- sion consisting of soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) as parenteral nutrition. The primary outcomes were cholestasis, ROP and BPD, and the secondary outcomes were necrotizing enterocol- itis (NEC) and sepsis. Results: A total of 149 premature infants (78 in the soybean oil group and 71 in the fish oil group) were included in this study. Multivariate logistic regression analysis showed that gestational age was asso- ciated with the incidence of ROP [odds ratio: 0.446, 95% confidence interval (CI): 0.332-0.576, p<0.001] and BPD [odds ratio: 0.428, 95% CI: 0.316-0.555, p<0.001]. The type of lipid emulsion had no statistically signifi- cant effect on any other neonatal morbidity. Conclusions: Both fish oil-containing and soybean oil-based paren- teral lipid emulsions are safe and well-tolerated by preterm infants. However, the use of the SMOF lipid emulsion did not significantly reduce the incidence of cholestasis, ROP and BPD in VLBW infants.
Background and Objectives: To investigate whether the tempo of weight gain of children during infancy (from birth up to two years of age) or childhood (between two and five years old) is associated with metabolic and car- diovascular disease. Methods and Study Design: Cluster sampling was employed to obtain a random sample of preschool children. In total, 1450 children aged five to six years participated in this survey. We obtained data on body weight, height, blood pressure (BP), and serum levels of total cholesterol, triglycerides, glucose, and uric acid, as well as anthropometry at birth and at age 2. Results: The prevalence of obesity at five years old was 14.5%. At five years of age, children with rapid growth (change in body mass index, BMI z-score >0.67) during infancy had a higher odds ratio (OR) of childhood obesity (OR: 2.97 [95% CI: 2.15–4.11]) compared to children with non-rapid growth (change in BMI z-score ≤0.67). Also, children with rapid growth during childhood had a higher OR of childhood obesity (OR: 17.90 [95% CI: 12.31–26.04]), higher systolic BP (OR: 2.38 [95% CI: 1.68–3.39]), higher diastolic BP (OR: 2.42 [95% CI: 1.53–3.83]), and higher triglycerides (OR: 4.09 [95% CI: 1.47–11.33]) or hyperuricemia (OR: 2.23 [95% CI: 1.51–3.29]). Conclusions: Rapid growth in early childhood is associated with risk factors for both cardiovascular outcomes and metabolic outcomes among preschool children. Developing effective prevention and intervention programs for pre-school children might be important to reduce incidence of long-term metabolic and cardiovascular disease as adults.
Background and Objectives: Vitamin A is involved in immune function, vision, reproduction, and cell differen- tiation and is essential for child growth. Vitamin A deficiency (VAD) contributes significantly to mortality and morbidity in developing countries. This study assessed the current vitamin A status in Chinese children. Methods and Study Design: A cross-sectional survey was conducted in 26 provinces in China between 2015 and 2018, and 277,064 children aged 0–14 years were enrolled. Data on sociodemographic factors and dietary supplements were obtained through interviews with their parents. Serum vitamin A concentrations were measured using HPLC. To reduce the sampling error, a weighted distribution was produced to estimate the distribution of serum vitamin A concentration in Chinese children. A new method was used calculate the CI. Results: The results revealed that 10.4% (23.9 million) (95% CI: 10.1%–10.8%) of Chinese children aged 0–14 years were at risk of suffering from subclinical VAD (SVAD) (<0.2 mg/L). Sick children, especially those with recurrent respiratory infections (21.3%, 95% CI: 20.5%–22.2%), were vulnerable to SVAD. A high prevalence of SVAD was observed in western and northeastern areas in China. Serum vitamin A concentrations in ethnic minority groups were significantly lower than those in Han Chinese children (p<0.01). Conclusions: VAD is still a moderate public health problem in Chi- nese children, especially in those with respiratory symptoms. Regular consumption of vitamin A–rich foods should be promoted through nutrition education for parents.
Background and Objectives: To improve the iron status of school children through noon meals prepared using a multiple micronutrient–fortified salt. Methods and Study Design: Children from a randomly selected school who consumed (intervention) and did not consume (reference) a noon meal prepared using a multiple micronutri- ent–fortified salt were studied over 1 year. A pre–post-test design for children aged 5–17years in reference (n=100) and intervention (n=128) groups was used. Levels of serum ferritin, soluble transferrin receptor (sTfR), alpha glycoprotein (AGP), and C-reactive protein (CRP) were assessed at baseline and at 1 year. In a subsample, urinary iodine was assessed. Results: sTfR decreased in the intervention group (−0.80 mg/L) but increased in the reference group (0.47 mg/L) at 1 year (p=0.0001).Body iron stores (BIS) increased in the intervention group (0.09 mg/kg body weight) and decreased (−0.58 mg/kg body weight) in the reference group at 1 year (p=0.028).These findings indicate an increase in iron deficiency in the reference group and a decrease in the intervention group. However, no changes in serum ferritin and urinary iodine were observed in either group or between groups. Con- clusions: Iron status can be improved in schoolchildren in Tamil Nadu by increasing the amount of micronutri- ents in the fortified salt used for preparing noon-time school meals.
Background and Objectives: Gangliosides (GAs) are important components of neural tissue and cell membrane. This study aims to investigate the association between toddlers’ neurodevelopment, dietary GA intake, and serum GA concentration. Methods and Study Design: A cross-sectional study was conducted in Beijing and Xuchang, Henan Province in China. 110 eligible healthy toddlers aged 24–48 months were recruited. Food frequency ques- tionnaire (FFQ) and 24-h dietary recall were used to collect dietary information. Blood serum samples obtained from participants were used to perform GA composition analysis with high-performance liquid chromatography- mass spectrometry (HPLC–MS). The neurodevelopment level was assessed with the Gesell Developmental Scale (GDS). Results: Dietary ganglioside GD3, total GA, and seafood intake were identified to be associated with the gross motor developmental quotient (DQ). An inverse association was revealed between the fine motor DQ and fruit intake. No correlation was detected between serum GA concentration and DQ. Conclusions: Dietary GA in- take but not serum GA concentration is associated with neurodevelopment. Further prospective studies are need- ed to probe the relationships between the recommended dietary GA intake and toddlers.
Background and Objectives: The high mortality rate of H7N9 strain of avian influenza virus (AIV) infected pa- tients has been a major clinical concern. Iron overload increases the susceptibility of host for several kinds of mi- crobial infection. However, the study on patients’ iron and ferritin status associated with clinical outcome of AIV- H7N9 virus infection is poorly understood, and in order to explain the linkage we carried out this study. Methods and Study Design: We retrospectively collected serum from 46 patients infected with H7N9 virus from the hos- pital in Hangzhou city, Zhejiang province of China in 2013. We measured the level of serum iron and ferritin by Enzyme-Linked Immunosorbent Assay (ELISA). The correlation analysis of iron and ferritin with disease severi- ty was done by SPSS 16.0 and MedCalc Software. Results: After H7N9 infection, there is a reduction in iron level and an increase in ferritin, hepcidin and C-reactive protein (CRP) level in patient’s serum compared to those of the control (p<0.001), and there’s little correlation between procalcitonin (PCT) level and H7N9 infection. At week 1 and week 2 post-infection, serum iron level is much lower and ferritin level is much higher in the patients who died later than those in the patients who survived. The sensitivity, specificity, and Area Under the Curve (AUC) of the assay was calculated with MedCalc software and they were 85.5%, 65.9% and 0.803 for iron and 84.9%, 80.7% and 0.900 for ferritin, 95.2%, 51.1% and 0.684 for PCT and 100%, 94.6% and 0.988 for CRP, re- spectively. Conclusions: Our study found that low serum iron and high serum ferritin levels are correlated with the disease severity of H7N9-infected patients and can predict fatal outcomes.
Lean body mass (LBM) agglomerates the bulk of nitrogen (N)-containing molecules following well-identified age and sex evolutionary patterns best appraised in clinical practice using the serial measurement of plasma trans- thyretin (TTR). Methionine (Met), the sole essential amino acid bearing a sulfur (S) atom, presides at the initia- tion of protein synthesis while maintaining stable body tissue S:N molar ratios of approximately 1:14.5. In pro- tein-depleted states, N- and Met-deficiencies operate as limiting factors for LBM protein synthesis and accretion, causing growth retardation and subnormal TTR plasma values. In inflammatory disorders, LBM is subjected to cytokine-induced tissue breakdown reflecting the S:N ratio found in healthy tissues whereas the liver secretion of TTR declines in proportion. Both malnutrition and inflammation are characterized by stepwise LBM downsizing and reduced bioavailability of Met body stores setting in motion molecular mechanisms safeguarding Met home- ostasis at the expense of augmented homocysteine (Hcy) values in biological fluids. Divergent TTR and Hcy al- terations indicate that rising Hcy values measured in plasma and cerebrospinal fluid should be regarded as the dark side of efficient compensatory processes. As a result, the neuroprotective activities normally exerted by TTR are weakened, whereas the oxidative burden generated by supranormal Hcy concentrations are strengthened. The combination of protein malnutrition and inflammatory disorders of any cause maximizes the risk of incurable neurodegenerative effects.
Background and Objectives: The relationship between nutritional status of iodine and thyroid tumor is unclear. We investigated the association between urinary iodine concentration and thyroid function in patients with papil- lary thyroid cancer, benign thyroid tumor and healthy individuals. Methods and Study Design: We compared the biomarkers of thyroid function and urinary iodine concentration within and between each group. A regression analysis was used to identify risk factors for papillary thyroid cancer. Correlation analysis was performed to de- termine whether any significant correlation exists between urinary iodine concentration and thyroid function bi- omarkers. Results: The iodine nutrition statuses of these three groups were adequate (median urinary iodine con- centration=100–199 μg/L). However, the median urinary iodine concentration of papillary thyroid cancer (174.7 μg/L) and benign thyroid tumor (165.04 μg/L) groups was significantly higher than that of the healthy control group (135.8 μg/L) (p<0.05). The regression analysis showed that thyroglobulin antibody was an independent risk factor for papillary thyroid cancer. After adjusting for age and gender, the association between thyroglobulin an- tibody and urinary iodine concentration was significant (β: 0.002; p<0.05). In subgroup analyses, significant cor- relations was noted only in the papillary thyroid cancer group (adjusted β: 0.002; 95% confidence interval: 0.000– 0.003). Conclusions: Excessive iodine in patients with thyroid tumors may affect thyroglobulin antibody, which may be an independent risk factor for papillary thyroid cancer.
Background and Objectives: The association of dietary and nutritional factors with hyperuricemia and gout is well-known in Western populations. The present study aimed to examine the association of dietary and nutritional factors with hyperuricemia among Korean adults. Methods and Study Design: This cross-sectional study included 10,175 participants from the seventh Korean National Health and Nutrition Examination Survey 2016-2017. Die- tary information was collected using a single 24-hour recall method, and nutritional information was derived from the 9th Korean Food Composition Table. The associations between serum uric acid and intake of meat, seafoods, nuts, and legumes, sugar-sweetened products, dairy products, alcohol, sodium, vitamin A, vitamin B1, vitamin C, and dietary fiber were analyzed using linear regression analysis adjusting for confounding variables. The associa- tion with hyperuricemia was analyzed using logistic regression analysis. All analyses were weighted by the sam- pling design. Results: Alcohol intake was associated with serum uric acid in both men and women. In men, the highest quartile of alcohol intake was associated with a 1.5-times higher prevalence of hyperuricemia (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.16–1.95), while vitamin C and dietary fiber intakes were found to be inversely associated with hyperuricemia. For vitamin C and dietary fiber intake, the ORs for a quartile increase were 0.93 (95% CI 0.86–0.99) and 0.92 (95% CI 0.85–0.99), respectively. Conclusions: The associations between vitamin C, dietary fiber and alcohol intakes and hyperuricemia in men support the Dietary Approach to Stop Hy- pertension (DASH)-based approach and attention to alcohol intake for managing hyperuricemia in Korean men.
Background and Objectives: The prevalence of adult thyroid structural abnormalities has increased significantly worldwide. However, no study has examined the thyroid structure and urine iodine levels of adults in Hei- longjiang Province in the last decade. Therefore, this study aims to investigate the rate and risk factors of thyroid structural abnormalities among the residents of this province. Methods and Study Design: A probability propor- tional sampling method was used, and a total of 3,645 individuals in Heilongjiang Province were included. The subjects was asked to complete a thyroid ultrasound and fill out a questionnaire. Furthermore, urine iodine levels and salt iodine content were determined, and multivariate logistic regression was used to identify the independent risk factors for thyroid diseases. Results: The prevalence of thyroid structural abnormalities in Heilongjiang Province was 56.0%. Univariate analysis showed that there were significant differences between the structural abnormalities group and the normal thyroid group in terms of sex, age, body mass index, hypertension, diabetes, smoking, alcohol consumption, frequency of seafood consumption and pickled food consumption, employment status, and urine iodine level (p<0.05). Multivariate analysis showed that the following were independent risk fac- tors of thyroid disease: female, increased age, hypertension, diabetes, cigarette smoking frequent seafood con- sumption, employment, and urine iodine levels. Conclusions: The prevalence of thyroid structural abnormalities in adults in Heilongjiang Province was relatively high. Therefore, to help prevent the occurrence of thyroid dis- ease in adults in Heilongjiang Province, the risk factors of thyroid structural abnormalities should be better under- stood.
Background and Objectives: To examine the association of dietary diversity and physical activity with lipid- related indices in a Beijing population. Methods and Study Design: This cross-sectional study included 21,472 participants (72.3% men) aged 16 to 78 years. Data were obtained through a physical examination that included anthropometric measurements, biochemical tests, and questionnaires. The dietary diversity score (0-8) was calcu- lated according to the baseline consumption frequencies of eight food groups (cereals, fruits, vegetables, meat, eggs, fish, dairy, and legumes). Physical activity level was classified as low, moderate, or high according to In- ternational Physical Activity Questionnaire scoring protocol. Abnormalities in lipid-related indices were assessed using the criteria of the National Cholesterol Education Program Adult Treatment Panel III guidelines. Results: Compared with individuals with poor dietary diversity (score 0–5), higher dietary diversity was associated with lower risk of abnormal levels of triglycerides and high-density lipoprotein cholesterol. Dairy intake was associat- ed with a lower risk of having a high triglyceride–to–high-density lipoprotein cholesterol ratio after adjusting for potential covariates. Participants with the lowest risk of abnormal lipid profiles were those who had high levels of physical activity. Conclusions: Dietary diversity and physical activity level were associated with lipid-related in- dices. Therefore, to maintain healthy lipid profiles in the general population, improving dietary diversity and physical activity is essential.
Background and Objectives: Iron deficiency is prevalent in New Zealand, with low dietary haem intake and blood loss previously identified as risk factors. However, the influence of the hormone hepcidin on iron status has not been investigated. Methods and Study Design: Females (n=170) aged 18-45 residing in Auckland partici- pated in a cross-sectional study. Iron status and inflammation were assessed with serum biomarkers including; se- rum ferritin, haemoglobin, soluble transferrin receptor, hepcidin, C-reactive protein and interleukin-6. Lifestyle factors were assessed using a series of validated questionnaires, including an iron food frequency questionnaire. Potential determinants of serum ferritin were identified using multiple linear regression analysis. Results: Iron insufficiency was confirmed in 55.8% of participants (Serum ferritin <30 μg·L-1). Hepcidin levels were higher in those who were iron sufficient (Serum ferritin ≥30 μg·L-1) (6.62 nM vs 1.17 nM, p<0.001). South Asian females had higher hepcidin (8.78 nM) levels, compared to New Zealand Europeans (6.28 nM) (p=0.018), a result likely due to South Asians presenting with higher interleukin-6 (1.66 vs 0.63 pg·mL-1, p<0.001). Hepcidin (β=0.082, p<0.001) and frequency of meat intake (β=0.058, p=0.001) were identified as significant predictors of serum fer- ritin in New Zealand Europeans, while hepcidin was the only identified predictor in South Asians (β=0.138, p<0.001) and those of other ethnicities (β=0.117, p<0.002). Conclusions: This is the first study in New Zealand to show that hepcidin levels strongly predict serum ferritin in premenopausal females. Additionally, frequency of meat intake appears to be an important determinant of iron status in New Zealand Europeans.
There are many studies investigating nutritional factors that affect both sarcopenia and muscle formation. Ac- cording to extensive research, protein has an essential role in muscle formation. More recently, vitamin D has emerged as an important factor that regulates muscle metabolism. However, studies and research of association between 25-Hydroxyvitamin D (25(OH)D) status and components of homeostasis model assessment of insulin resistance (HOMA-IR) in older are limited. Nineteen studies were found through a search of electronic databases and were subjected to a meta-analysis to investigate the differences in serum levels of 25(OH)D and HOMA-IR between patients with controls and sarcopenia. The random-effects standardized mean difference (SD) and 95% confidence interval (CI) were calculated as the effect size. Nineteen studies with 19,528 participants (5,081 with sarcopenia and 14,447 without) were analyzed. Sarcopenic participants had significantly lower serum levels of 25(OH)D (SD =1.163; 95% CI 0.514, 1.812; p<0.001; I2=99.652%) and HOMA-IR (SD=-2.040; 95% CI -3.376, -0.705; p<0.005; I2=99.837%) than controls. It has been reiterated that sarcopenia may be related serum levels of 25(OH)D and HOMA-IR. This relationship needs to be clarified by future longitudinal studies.
Background and Objectives: Vitamin D deficiency has been reported in patients with ulcerative colitis, and polymorphism in the gene encoding the vitamin D binding protein can affect the characteristics of vitamin D binding protein, thus affecting the level and function of vitamin D in vivo. Previous studies have rarely reported on the potential relationship between vitamin D binding protein polymorphisms and ulcerative colitis. The objec- tive of this study is to investigate the associations between genetic variants in vitamin D binding protein genes and ulcerative colitis susceptibility in the Han Chinese population. Methods and Study Design: In this case- control study, the genotyping of vitamin D binding protein rs4588 and rs7041 polymorphisms was conducted us- ing polymerase chain reaction-ligase detection reactions, genotypes were detected by polymerase chain reaction- ligase fragment length polymorphism. We also measured inflammatory factors, oxidation and antioxidant indica- tors. Results: There was no significant difference in the distribution of two loci genotypes, alleles and haplotypes between the two groups (p>0.05). However, the differences in the distribution of serum MDA in different haplo- types in the case group were statistically significant (p=0.014): CG>, CT>AT. Conclusions: Our results suggest that polymorphism of these two sites (rs4588 and rs7401) in the vitamin D binding protein gene may have no cor- relation with susceptibility to ulcerative colitis in the Han Chinese population. But, interestingly, haplotype GC may affect the level of oxidative stress in ulcerative colitis patients, especially the level of malondialdehyde.
Background and Objectives: Malnutrition is frequent in patients with head and neck (HN) and esophageal can- cer, aggravated by radiochemotherapy (RCT), and increases morbidity and mortality and treatment toxicity. Re- cent studies suggest that the immune, nutritional, or inflammatory status can be modulated by the use of pharma- conutrients in RCT-treated patients. In this study, the effect of immunonutrition, including arginine, ω-3 fatty acid, and nucleotide enriched diet, on nutritional status in patients with HN or esophageal cancer undergoing RCT was investigated. Methods and Study Design: A retrospective review of 88 patients undergoing RCT was conducted. Either an immune-modulating enteral nutrition (IEN) (Impact formula) or a standard enteral nutrition (SEN) (isonitrogenous and isoenergetic formula) was administered. Anthropometric parameters, nutritional risk index (NRI), serum albumin, and functional capacity were recorded at the beginning and end of the RCT. Results: Ap- proximately 45% of patients were moderate to severely malnourished (NRI <97.5) at the beginning of the RCT in the SEN (n=19) and IEN (n=21) groups alike. Significant improvement was observed in the NRI of malnourished patients of the IEN group (97.3±11.9 vs 98.0±12.0, p=0.021). Additionally, a significant difference in the body weight (BW) between the two groups was observed, and BW increased (65.4±14.8 kg vs 66.3±14.3 kg, p=0.03) in the IEM group but decreased (62.3±12.3 kg vs 61.7±12.0 kg, p=0.023) in the SEM group. Conclusions: Phar- maconutrient-enriched IEN had a more potent effect than SEN in preventing deterioration of nutritional status during RCT.
Background and Objectives: We assessed the effect of enteral ecoimmunonutrition (enteral nutrition involving probiotics and immune nutrients) on gastric cancer in the postoperative period. Methods and Study Design: In total, 60 patients with gastric cancer were randomized into an enteral ecoimmunonutrition group or an enteral nu- trition group. Information on postoperative complications; hospitalization length; time to first bowel movement and first flatus; and differences between preoperative and postoperative nutritional status, inflammatory reactions, and immune function was collected. Results: No significant between-group differences in nutritional status and complications were observed. C-reactive protein concentrations were lower in the enteral ecoimmunonutrition group than in the enteral nutrition group on postoperative day 7 (p<0.001) and CD4+ concentrations were signifi- cantly higher (p=0.01). The enteral ecoimmunonutrition group had a significantly shorter time to first flatus than the enteral nutrition group (p=0.03). Conclusions: Early postoperative enteral ecoimmunonutrition significantly improved immune function, reduced inflammatory responses, and promoted intestinal function recovery in pa- tients with gastric cancer undergoing gastrectomy.
Background and Objectives: Although roles of ABC (HbA1c, blood pressure [BP] and LDL-cholesterol) goal attainment on CVD risk outcomes have been well established, it is less studied whether ABC goal attainment as- sociates with ABC variability, non-traditional risk factors. Methods and Study Design: : Intrapersonal mean levels and standard deviation (SD) of HbA1c, BP and LDL-cholesterol, fasting and post-breakfast plasma glucose (PG) and serum triglyceride (TG) during 12 months were calculated in 168 type 2 diabetes patients (aged 62.3 years, 53.6% men). Associations of ABC goal attainment with non-traditional glycemic, BP and lipid risk factors were analyzed. Results: Among 168 patients, 92 (54.8%), 91 (54.2%) and 111 (66.1%) patients achieved HbA1C, BP and cholesterol goal, respectively, and 47 (28.0 %), 45 (26.8 %), 63 (37.5 %) and 13 (7.7 %) achieved triple- goal, dual-goal, single-goal and no-goal, respectively. Achieving more ABC goals was associated with stepwise decreases in mean levels and SD of fasting and post-breakfast PG, and HbA1c. It was also associated with step- wise decreases in mean levels and SD of fasting and post-breakfast TG, and LDL-cholesterol. Further, achieving more ABC goals was associated with stepwise decreases in brachial pulse pressure and mean levels and SD of systolic BP. Conclusions: ABC goal achievement was associated with a broad range of non-traditional glycemic, BP and lipid risk factors in type 2 diabetic patients. Reaching more ABC treatment targets may be important for reductions in long-term ABC variability and postprandial dysmetabolism.
Background and Objectives: To study the effects of a low-carbohydrate and high-fiber diet and education on patients with nonalcoholic fatty liver disease. Methods and Study Design: We randomly divided 44 patients with nonalcoholic fatty liver disease into two groups: low-carbohydrate and high-fiber diet and education (inter- vention group), and education alone (control group). Liver and kidney function, fasting plasma glucose, insulin resistance index, body composition, and controlled attenuation parameter were detected before and after the in- tervention. Results: After 2 months, the body fat, body weight, abdominal circumference, and visceral fat area, fasting plasma glucose, insulin resistance index, and levels of serum alanine aminotransferase, aspartate transam- inase, uric acid, and insulin of the intervention group were significantly lower than before (p<0.05). In the female intervention group, the insulin resistance index and levels of serum alanine aminotransferase, uric acid, triglycer- ide, fasting plasma glucose, and C-peptide were lower and the level of serum high-density lipoprotein cholesterol was higher than in the female control group (p<0.05). In the male intervention group, the levels of serum alanine aminotransferase, triglyceride, and fasting plasma glucose were lower and the level of serum high-density lipo- protein cholesterol was higher compared with the male control group (p<0.05). Conclusions: A low-carbohydrate and high-fiber diet and education can effectively reduce the body weight and body fat of patients with nonalco- holic fatty liver disease and improve metabolic indicators such as liver enzymes, blood glucose, blood lipid, and uric acid. Our female patients showed significantly better improvement in the indicators than our male patients.
Background and Objectives: Our aim was to evaluate the effect of consuming tomato juice before carbohydrate on postprandial glucose concentrations in healthy women. Methods and Study Design: In this randomized con- trolled cross-over study, 25 healthy women (age 21.6±3.8 years, HbA1c 5.3±0.2 %, mean±SD) consumed either 200 g of tomato juice, tomato, or water (control) at 30 min before consuming 200 g of boiled white rice at 9:00 and consumed identical lunch at 13:00 for 3 days. The blood glucose concentrations were measured by self- monitoring blood glucose at 0, 30, 45, 60, 90, 150, and 210 min pre- and post-breakfast, and at 0, 30, 60, 120, 150, and 180 min pre- and post-lunch. The concentration of postprandial glucose, incremental glucose peak (IGP), and incremental area under the curve for glucose after the test meals were compared among 3 days. Results: Incre- mental blood glucose concentrations at 60 min (2.32±0.16 vs 2.97±0.19 mmol/L, p<0.05, mean±SEM), 90 min (2.36±0.23 vs 3.23±0.24 mmol/L, p<0.01), and IGP (2.77±0.19 vs 3.68±0.22 mmol/L, p<0.001) in consuming tomato juice 30 min before carbohydrate were all significantly lower than those of water, while IGP of consum- ing tomato was tended to be lower than that of water (2.82±0.19 mmolL, p=0.023). No significant difference was observed in glycaemic parameters after consuming lunch among 3 days. Conclusions: Consuming tomato juice half hour before carbohydrate ameliorates the postprandial blood glucose concentrations, although total amounts of energy and carbohydrate of tomato juice are higher than those of water.
Background and Objectives: Support from fortified food during hospitalization is an important factor to in- crease nutritional intakes of patients to meet nutritional needs and nutritional status. The objective of the study was to analyze the effects of eel biscuits on the nutritional intake of sick children. Methods and Study Design: The study had an experimental post-test design, and included 40 hospitalized children at Dr. Hasan Sadikin Hos- pital, Bandung, who were selected by consecutive sampling. The inclusion criteria were children aged from 1 to 18 years old who received standard hospital food. The exclusion criteria were patients with fish allergies and those undergoing special diet therapy. The intervention was conducted for 5 days, in which the intervention group was given eel biscuits while the control group was given standard hospital snacks. The food intake was assessed using the food record and 24-hour recall methods. Unpaired t-test and Mann-Whitney test were used in data anal- ysis. Results: There was an increase in nutritional intake from snacks in the intervention group, namely energy (p<0.001), protein (p<0.001), fat (p<0.001), carbohydrate (p=0.005), zinc (p=0.012), and vitamin A (p=0.046) in- take. There was also a positive impact on the main meal intake, especially in protein (p=0.037), fat (p=0.032), and zinc (p=0.037) intake. Conclusions: Consumption of eel biscuits to hospitalized children could increase their nu- trient intake. Eel biscuits could be given as a snack to fulfill the nutritional requirements for sick children.
Background and Objectives: Konjac powder has the effect of improving blood lipids in the general population, but there is no research on schizophrenic patients who are susceptible to dyslipidemia. The aim of our study is to evaluate the effects of konjac powder on blood lipid, glucose levels, body weight, and blood pressure in schizo- phrenia inpatients with dyslipidemia. Methods and Study Design: After a two-week adaptation period, 76 peo- ple with schizophrenia were enrolled in a 30-day double-blind randomized controlled trial. The subjects in the experimental group were given a beverage containing konjac powder 30 minutes before each meal, whereas those in the control group were given a beverage containing resistant maltodextrin. Results: The lipid profile, plasma glucose, blood pressure, and body weight were measured at baseline and at the end of 30-day treatment. Fifty- nine subjects completed the study. There was a substantial decrease in total serum cholesterol in the experimental group, but an increase in the control group. Likewise, apolipoprotein B decreased in the experimental group but increased in the control group. Conclusions: We concluded that a diet supplemented with konjac powder may prevent the deterioration of dyslipidemia in people with schizophrenia, demonstrating its potential value in the treatment of metabolic disorders in schizophrenia as a new therapeutic method.