Background and Objectives: Obesity is caused by excessive fat accumulation or abnormal fat distribution and has become one of the biggest health challenges worldwide. Considering the high thermogenic ability of brown fat tissue (BAT) and the plasticity of fat tissue, to induce the browning of white fat tissue (WAT), so increasing BAT activity provides an attractive option for the prevention and resolution of obesity. The aim of the present narrative review was to understand the relationship between diet, BAT, and obesity. Methods and Study Design: PubMed and Embase databases were searched to identify eligible studies. Results: Although cold exposure has long been known to be effective in the browning of WAT and activation of BAT, it is societally impractical for everyday body weight management aside from the tolerance of ambient temperature. An alternative is to identify specific dietary components with similar effects to cold exposure on BAT. Current evidence indicates that capsaicin and capsinoids, catechins, curcumin, quercetin, berberine, lipoic acid, polyunsaturated fatty acids, royal jelly, and some natural sweeteners are effective promoters of WAT browning, increase BAT activity and improve obesity related traits. However, only capsaicin, capsinoids, and catechins have demonstrated efficacy in clinical trials. Evidence for effects of curcumin, quercetin, berberine, lipoic acid, polyunsaturated fatty acids, royal jelly and natural sweeteners on BAT have only been observed in animal or in vitro studies, with clinical trials awaited for verification. Conclusions: Several dietary components can induce WAT browning and activate BAT, offering potential targets for obesity prevention and management.
Background and Objectives: As the Chinese economy has developed, dietary patterns have modernized, thereby increasing the incidence of chronic diseases such as cardiovascular disease (CVD). Many observational studies have shown that the Mediterranean diet based on olive oil is associated with a decreased incidence of CVD. This article aims to study the possible effects of dietary models by using three edible oils: olive oil, camellia seed oil (CSO), and soybean oil. CSO has a fatty acid composition similar to that olive oil and is unique in China, and soybean oil is a dietary oil used in traditional Chinese cooking. Methods and Study Design: This intervention is designed based on a three-arm double-blind randomized controlled feeding trial. Three dietary models are established according to traditional Chinese cooking methods, each using one of the three plant edible oils mentioned above as a leading factor. Participants will be randomly assigned to each group and provided with a designated diet for 3 months. Results: The study population is planned to be women with a high risk of CVD and aged between 35 and 69 years. Weight and other CVD-related factors are treated as primary and secondary outcomes, respectively. Conclusions: This trial may inform dietary nutrition policies to a certain extent, especially concerning traditional Chinese cooking methods, for weight control and the improvement of cardiovascular-related risk factors in women with a high risk of CVD.
Background and Objectives: To evaluate the association between anthropometric parameter of obesity and newly diagnosed hyperuricemia (HUA) in a general Chinese population. Methods and Study Design: A population-based cross-sectional survey included 9 615 participants (3777 men and 5838 women) aged 35-74 years in 2006 and 2009 in Qingdao, China. The multivariate linear regression was used to assess the linear associations between anthropometric parameter of obesity [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)] and serum uric acid. The logistic regression model was performed to estimate the associations between BMI, WC, WHR and newly diagnosed HUA. Results: The prevalence of newly diagnosed HUA was higher in men than in women (19.46% vs 11.34%, p<0.05). Multivariate liner regression showed that BMI, WC and WHR were positively correlated with serum uric acid. Multivariate logistic regression revealed that being overweight [men, odds ratios (OR): 1.69, 95% confidence intervals (95% CI): 1.37-2.08; women, OR: 1.67, 95% CI: 1.34-2.09] and obese (men, OR: 3.01, 95% CI: 2.38-3.79; women, OR: 2.91, 95% CI: 2.31-3.67) were significantly associated with a higher risk of newly diagnosed HUA. Abdominal obesity (WC: men, OR: 2.26, 95% CI: 1.88-2.73; women, OR: 1.96, 95% CI: 1.61-2.39; WHR: men, OR: 1.91, 95% CI: 1.61-2.26; women, OR: 1.39, 95% CI: 1.16-1.67) were associated with an increased risk of newly diagnosed HUA. Conclusions: This study demonstrated that BMI, WC and WHR were positively correlated with serum uric acid in both genders. Meanwhile, overweight, obese and abdominal obesity were associated with increased risk of newly diagnosed HUA.
Background and Objectives: Uterine fibroids (UFs) are the most common neoplasm affecting reproductive-age
women. The purpose of the present study is to explore the association between dietary diversity and risk of UFs in
a cross-sectional study of urban premenopausal women. Methods and Study Design: A total of 248 urban premenopausal
women with age of 20-45 were recruited in 3 randomly chosen hospitals in Shijiazhuang, China. Dietary
diversity was assessed from food frequency intake data using dietary diversity score (DDS), Prime Diet Quality
Score (PDQS) and food variety score (FVS). UFs were diagnosed by the methods of ultrasound, pelvic exam, or
surgery. Binary logistic regression was used to estimate the relationship between dietary diversity and risk of UFs.
Results: 37 of the study subjects (14.9%) had UFs. Participants with a low education level and single marital status
participants had a lower DDS and PDQS, respectively. After adjustment for confounding factors, a higher DDS 24
was associated with decreased UF risk (OR=0.22, 95% CI=0.05–1.01). Similar trends were observed for the plantbased
FVS (ptrend=0.025). Carrot (OR=0.04, 95% CI=0.00–0.48) and kiwi fruit (OR=0.03, 95% CI=0.00–0.47)
were also inversely associated with risk of UFs after adjustment for confounding factors. Conclusions: Multifarious
food groups and the increase of variety of plant-based food, especially carrot and kiwi fruit, may be associated with
the lower risk of UFs; they may play an important role in inhibiting the formation of UFs.
Background and Objectives: Urinary iodine is an essential index of iodine nutrition evaluation. To establish the
number of repeated spot urine collections necessary to reflect individual iodine status over 2 months and assess
its feasibility to serve as an independent indicator of individual iodine status. Methods and Study Design: We
performed a longitudinal, 2-months study from May to June in 2015 of 23 apparently healthy Chinese women
aged 18 to 44 (32±9) y. Spot urine samples were collected on any two days of the week, and 24-h urine samples
were collected once every 6 days. Results: 368 spot urine and 230 24-h urine samples were analysed. The median
urinary iodine concentration (UIC) was 140.5 (75.2, 246.9) μg/L. The estimated 24-h urinary iodine excretion
(24-h UIE) values from spot urine samples and measured 24-h UIE values from 24-h urine samples were
348±240 μg/24h and 330±216 μg/24h (p=0.003), respectively. Irrespective of the urinary iodine method, the intra-
individual coefficient of variation (CV%) was lower than the inter-individual CV%. Bland-Altman analysis
revealed differences between spot urine and 24-h urine. When the precision ranges with 95% confidence were
±15%, ±20%, ±25% or 30%, the number of an individual’s spot urine samples required were 30, 16, 11 or 8, respectively.
Conclusions: Repeated spot urine is not a feasible way to assess recent individual iodine intake. The
development of a multi-indicator system could provide an acceptable individual evaluation index of iodine status.
Background and Objectives: Thyroid disease in pregnancy can have devastating effect on the fetus. In Harbin,
China, there is insufficient knowledge about the incidence of and contributing factors to thyroid disease in pregnancy.
This study investigates whether urine iodine concentration (UIC), as a proxy for iodine intake, affects the
thyroid structure and/or function during each trimester. Methods and Study Design: Data of 24000 pre-pregnant
women were collected from January 2017 to August 2019. Serum thyroid hormone levels were measured, and
thyroid ultrasonography was performed. If thyroid ultrasonography and thyroid function findings were normal before
pregnancy and were abnormal after pregnancy, the current gestational age was recorded and the UIC was
measured. Finally, a total of 500 participants were included in the study. Results: There were significant differences
in the incidence of abnormal thyroid structure and function between trimester groups (p<0.05). Thyroid nodular lesions were the most common abnormal ultrasound finding, and positive thyroid peroxide antibodies (TPOAb) were the most common abnormal thyroid function test results. There were significant differences in the median UIC between trimester groups (p<0.001); the median UIC decreased with increasing gestational age. The incidence of abnormal thyroid structure or function was not significantly different across UIC groups (p>0.05).
Conclusions: In women from Harbin, thyroid structural or functional abnormalities commonly occur in the second
and third trimesters of pregnancy. Thyroid nodular lesions and positive TPOAb are the commonest thyroid
abnormalities. The median UIC significantly declines with increasing gestational age. Pregnant women in Harbin
have iodine-deficient states.
Background and Objectives: The nutritional status of infants is assessed using the WHO growth references,
based on the Multicenter Growth Reference Study (MGRS) in many countries including Sri Lanka. Birth parameters
define infant growth curves. The aim of this study was to compare the birth anthropometric data of a healthy
population of babies born in Colombo, Sri Lanka with the WHO MGRS birth data and determine its suitability
for assessment of growth in this population. Methods and Study Design: Birth data were obtained as part of a
study on longitudinal infant body composition from birth to 2 years from 2015-2019. Healthy babies, born to
non-smoking mothers, >18 years old, with a singleton pregnancy at term, living in the study area and intending to
breastfeed, were recruited. The Ethical Review Committee of the Faculty of Medicine, University of Colombo,
approved the study. Results: Compared to WHO data, the mean birth weight (2.9±0.4 kg), length (48.2±2.7 cm)
and head circumference (33.6±1.2 cm) of our study population (n=337) was significantly lower with a left shift in
the z score distribution. This was despite similar background characteristics except for significantly lower income
(USD 200) and lower maternal (154.2±9.0 cm) and paternal height (165±11.6 cm) in our study population. A significant
change in birth parameters was only seen with maternal height when disaggregated. Conclusions: WHO
birth parameters were significantly higher and underestimated the growth of healthy babies in Sri Lanka.
Background and Objectives: Neonatal nutrition is critical for the growth and development of preterm infants.
Dynamic changes in the amino acid profiles in preterm infants of different gestational ages and in different nutritional
periods were investigated. Methods and Study Design: Premature infants who received parenteral nutrition
support after birth were enrolled and divided into four groups based on their gestational ages. Blood samples
were collected as a dried blood spot before nutritional support, and in the total parenteral nutrition, partial parenteral
nutrition, and total enteral nutrition periods. Amino acid concentrations were detected in the samples by liquid
chromatography tandem mass spectrometry and compared between the different nutritional periods and gestational
ages. Results: Samples from 124 premature infants were statistically analyzed. Concentrations of all amino
acids, except glutamine, were statistically different at distinct nutritional periods. Threonine and aspartic acid
concentrations gradually increased, while valine, methionine, phenylalanine, and glycine concentrations gradually
decreased with the transition from TPN to TEN. At different gestational ages, significant differences were observed
in the concentrations of seven amino acids only in the PPN period but not in the others. Conclusions: The
concentrations of amino acids in preterm infants vary with nutritional period.
Background and Objectives: Milk promotes the growth of children’s height. However, the relationship between
milk consumption and anemia or obesity remain unclear. We explored the association between milk consumption
and the nutritional status of poor rural Chinese students, including anemia, height, weight, malnutrition, and
overweight/obesity. Methods and Study Design: A total of 22,315 students aged 8–16 years were recruited. The
frequency of milk consumption and other information were investigated using the questionnaire. Students’ morning
fasting height, weight, and whole-blood hemoglobin were measured. The children were classified as malnutrition,
normal weight, and overweight/obesity according to their age-specific height and BMI. Multivariate linear
and multiple logistic regression were used to analyze the association between milk consumption and nutritional
status. Results: In total, 10.6% of students drank milk at least once a day. Compared to students who drank milk
<1 time/week, The heights and weights of students who consumed milk 1–3 times/week, 4–6 times/week, and at
least once per day were 0.8, 0.9, and 1.3 cm greater and 0.8, 0.6, and 1.0 kg heavier. Students who drank milk at
least once a day (OR=0.817), and 1–3 times/week (OR=0.868) had a significantly lower prevalence of malnutrition.
Students who drank milk 4–6 times/week (OR=0.472) had a significantly lower prevalence of anemia. However,
no significant association was identified between milk consumption and overweight/obesity. Conclusions:
Frequent consumption of milk was associated with these students having a lower risk of malnutrition and anemia,
being taller, and being heavier.
Background and Objectives: Diet is a modifiable risk factor of T2DM with the potential to improve the patients’
quality of life. The diet–diabetes relationship has received considerable attention in past decades. This
study describes dietary intake of nutrients in a matched case-control study of adults with and without T2DM.
Methods and Study Design: Dietary nutrient intake was evaluated by semi-quantitative FFQ and biochemical
indexes were studied in enrolled 207 participants with T2DM (diabetes group) and 215 healthy participants (control
group). The t-test of two independent-sample and chi-square test were used to compare data by age and other
characters. Exploratory factor analysis was used for dietary pattern analysis. Logistic regression analysis were
used to test the effect of different dietary patterns and dietary intakes on the risk of T2DM. Results: The blood
glucose, triglyceride and low-density lipoprotein cholesterol levels were significantly higher in the diabetes group
(p<0.05). Three major dietary patterns were identified, “High-salt and high-fat”, “Traditional Chinese” and
“Western” dietary patterns. With or without adjustment, highest quintile of high-salt and high-fat dietary pattern
showed a significantly higher risk of T2DM than the lowest quintile. (OR=2.08, 95%CI: 1.24, 3.49, OR=1.70,
95%CI: 0.98, 2.54, OR=1.67, 95%CI: 0.97, 2.51). Conclusions: Individuals with a high-fat and high-salt dietary
pattern had an increased risk of T2DM. These findings offered further insights into the dietary structure of T2DM
patients. These findings put nutrition education at the center for T2DM patient management. Further follow-up
study is needed to assess the dynamic changes of nutrient-metabolism association.
Background and Objectives: The objective of this study was to explore the associations of dietary selenium and
serum selenium concentration with coronary heart disease (CHD) prevalence and all-cause mortality among participants
in United States. Methods and Study Design: Using data collected from the National Health and Nutrition
Examination Survey (NHANES) 1999–2006, 17867 individuals were included. Logistic regression analyses
were used to explore the associations between dietary selenium intake and serum selenium concentration and prevalent
of CHD. Multivariable Cox regression was used to identify the association between dietary selenium intake
and all-cause mortality. The nonlinear relationships were assessed using generalized additive models. Results: A
U-shaped association between dietary intake of selenium and all-cause mortality was observed. Compared with the
lowest quartile, the second quartile of dietary intake of selenium was inversely associated with all-cause mortality
(Hazard ratio [HR]: 0.802, 95% confidence interval [CI]: 0.658, 0.977, p=0.029). There was no evidence of association
between dietary selenium intake and CHD risk (Odds ratio [OR]: 1.001, 95% CI: 0.999, 1.003, p=0.206).
Furthermore, serum selenium concentration was negatively associated with CHD risk (OR: 0.989, 95% CI: 0.981,
0.997, p=0.006). Comparing with the lowest quartile, participants with the highest serum selenium concentration
had a statistically significant decreased prevalence of CHD, with OR (95% CI) of 0.417 (0.259, 0.669) (p<0.001).
The smoothing curve also showed a non-linear relationship between serum selenium and risk of CHD. Conclusions:
This analysis suggested that a higher serum selenium concentration was associated with reduced risk of CHD, and
that the relationship was non-linear. In addition, an appropriate dietary selenium intake might reduce all-cause
Background and Objectives: This study aimed to describe and analyze the research outputs on enteral nutrition, which is the administration of food through the gastrointestinal tract for nutrition maintenance. Methods and Study Design: We searched the Web of Science Core Collection database for original publications on enteral nutrition research from 2010 to 2019. HistCite and VOSviewer software were used for analysis and visualization of the publication outputs, journals, institutions, keywords, cocitations, and collaborations among authors in different countries or regions. Results: A total of 963 relevant articles were included. The number of publications in 2010 and 2019 were 68 and 139, respectively. Nutrition in Clinical Practice and the Journal of Parenteral and Enteral Nutrition had the highest number of publications and cocitations (76, 7.89%; 2058), respectively. The United States and China were the top contributors, accounting for 24.1% and 22.3% of the total articles, respectively. Andrew S. Day and Stephen A. McClave were core researchers in this field. Primary authors collaborated closely. Enteral nutrition, parenteral nutrition, and support were the three most common keywords. The top 10 cocited references concerned administering early enteral nutrition therapy in acutely ill patients and patients with acute Crohn’s disease. Crohn’s disease, acute pancreatitis, upper gastrointestinal malignancy, and other surgical diseases were among the research hotspots. Conclusions: Our findings can help researchers identify notable research trends and clinically relevant articles. New catheterization technologies are a future research direction.
Background and Objectives: Deficiency of vitamin D has been associated with various health conditions. The
purpose of this study was to evaluate the associations between the serum 25OHD concentration and lipid profiles
in Chinese individuals. Methods and Study Design: Serum 25OHD and lipid profiles were obtained for a cross
sectional sample of 10100 individuals aged 40-75 years from Lanzhou city, which is located in western China.
Linear-by-linear association, partial correlation analysis and multiple logistic regression analysis were used to
evaluate associations between serum 25OHD concentration and lipid profiles. Results: 10038 subjects aged 40-
75 years were included in the study. The 25OHD deficient and insufficient groups had higher TC, LDL-C and
TG when compared to the optimal group. The dyslipidemia rates of vitamin D deficiency, insufficiency, and sufficiency
groups were 45.4%, 41.6%, 38.8%, respectively. The prevalence rates of dyslipidemia, high cholesterol,
high LDL-C, hypertriglyceridemia and mixed type hyperlipidemia exhibited decline trend in vitamin D deficiency,
insufficiency and sufficiency groups. The correlation coefficients in between TC and 25OHD, LDL-C and
25OHD, TG and 25OHD were -0.033, -0.022, -0.044, respectively. Low 25OHD levels were associated with the
risk of onset of dyslipidemia [OR 1.225 (95% CI 1.075-1.397), p=0.002] in the logistical regression analyses.
Conclusions: Deficient serum 25OHD is associated with higher TC, LDL-C, and TG in middle-aged and elderly
Chinese individuals. These findings suggest that low 25OHD levels observationally is simply a marker for elevated
atherogenic lipoproteins and question a role for vitamin D supplementation in the prevention of cardiovascular
Background and Objectives: In the United States, synthetic folic acid has become an important source of folate
in the era of mandatory folic acid fortification. This study aimed to evaluate the associations between total folate,
natural folate and synthetic folic acid intakes and depressive symptoms among US adults. Methods and Study
Design: Cross-sectional data was collected from the National Health and Nutrition Examination Survey
(NHANES) 2007-2016. Dietary data were obtained through two 24-h dietary recall interviews. Depressive symptoms
were detected by PHQ-9 (Patient Health Questionnaire-9), participants whose depression scores over 10
points were diagnosed as depressive symptoms. Weighted logistic regressions were used to analyze the associations
between different forms of folate and depressive symptoms. Results: Among 19244 participants included in
this study, 9.2% of them met the definition of depressive symptoms. In fully adjusted models, total folate intake
and natural folate intake were inversely associated with depressive symptoms respectively, while synthetic folic
acid was not. The multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of depressive
symptoms were 0.69 (0.54-0.89), 0.51 (0.39-0.68) for the highest versus lowest quartile of total folate and natural
folate intake, respectively. We also found two L-shaped dose-response curves among total folate intake, natural
folate intake with depressive symptoms, respectively. Conclusions: Total folate intake, natural folate intake may
be inversely associated with depressive symptoms among US adults, while the association was not significant between
synthetic folic acid and depressive symptoms.
Background and Objectives: Pediatric obesity is associated with clustered cardiometabolic risk and the future
incidence of cardiovascular disease. However, few studies have determined the effect of pediatric obesity in Asia,
where obesity is less common than in Western countries. We aimed to clarify whether weight status including
underweight and slightly overweight is associated with metabolic risk factors in Japanese adolescents. Methods
and Study Design: We performed a cross-sectional analysis of 2241 adolescents aged 13–14 years. Participants
were classified as underweight, normal weight, slightly overweight, overweight, or obese according to the International
Obesity Task Force. The clustered cardiometabolic risk (Z-CMR) was estimated by summing standardized
sex-specific Z scores of mean arterial pressure (MAP), non-high-density lipoprotein cholesterol (non-HDLC),
and HbA1c. Results: Linear regression analysis showed that MAP, non-HDL-C, and Z-CMR were higher in
the slightly overweight, overweight, and obese groups than in the normal weight group after adjusting for confounders.
Compared with the normal weight group, the slightly overweight, overweight, and obese groups had
higher prevalence of high BP [odds ratios (ORs): 1.38 (95% CI, 1.03, 1.85); 2.63 (1.77, 3.91); and 2.39 (1.57,
3.64), respectively]. Compared with the normal weight group, underweight boys, but not girls, had a lower prevalence
of high Z-CMR [OR=0.20 (0.05, 0.84)]. Conclusions: Adolescents classified as slightly overweight had
higher levels of BP, serum lipids, and clustered cardiometabolic risk than those classified as normal weight. This
observation showed significant associations between weight status and cardiometabolic risk factors during adolescence
even in East Asians.
Background and Objectives: Diet plays a crucial role in cognition. Mild cognitive impairment has a high prevalence
in rural elderly people. However, few studies have investigated the relationship between diet and mild cognitive
impairment among rural elderly people in China. The study evaluated the association between diet and the
risk of mild cognitive impairment among them. Methods and Study Design: In this cross-sectional study, we
enrolled 1262 participants (≥65 years) living in rural Qingdao, China. Cognitive function was assessed using the
Mini-Mental State Examination, and dietary consumption was measured using a food frequency questionnaire.
Logistic regression models were used to assess the associations. Results: In all, 315 (25%) participants had mild
cognitive impairment. The weekly frequency of food consumption was lower in the mild cognitive impairment
group than in the no mild cognitive impairment group. After adjusting for covariates, compared with participants
who consumed never/less than once a week, daily consumption of coarse cereals (OR: 0.64, 95% CI: 0.44-0.91),
potatoes (OR: 0.54, 95% CI: 0.34-0.87), fruits (OR: 0.49, 95% CI: 0.35-0.69), livestock and poultry meat (OR:
0.66, 95% CI: 0.44-0.99), eggs (OR: 0.67, 95% CI: 0.47-0.97), and nuts (OR: 0.47, 95% CI: 0.28-0.80) was inversely
associated with mild cognitive impairment (all p<0.05). Conclusions: Higher dietary diversity and more
frequent consumption of coarse cereals, potatoes, fruits, livestock and poultry meat, eggs, and nuts were associated
with a lower risk of mild cognitive impairment. Elderly people should develop healthy dietary habits to prevent
or delay cognitive decline.
Background and Objectives: There is little research on the development and validation of measurement tools to
evaluate integrative concepts of food literacy; however, this is a growing research area. Methods and Study Design:
A food literacy measurement tool for young Korean adults was developed in three phases: (1) tool development
and content validation using the Delphi method (2) pilot testing (n=108) and (3) confirmatory study
(n=435) and internal consistency using Cronbach’s α and the test-retest for reliability. p<0.05 was considered statistically significant. Results: Feedback from the Delphi rounds resulted in modification and rewording of nine items, yielding 105 items with acceptable content validity ratio (CVR). Exploratory factor analysis (EFA) revealed an eight-factor construct: food and nutrition knowledge, food safety, food systems, sociocultural context, food skill, food choice, self-efficacy, and food resource management. Confirmatory factor analysis (CFA) indicated that the validated tool met the acceptable indices of basic psychometric standards, and internal consistency was satisfactory for all subscales (Cronbach’s α >0.70). Conclusions: A validated food literacy assessment tool
for young Korean adults was developed.
Background and Objectives: The popularity of takeaway has caused health problems. To analyse the basic nutrients
and composition of popular takeaway meals in Chengdu, China. Methods and Study Design: We randomly
collected 105 takeaway meals from takeaway platforms. The quality of ingredients such as grains, vegetables,
and meat were assessed and weighed. The samples were then homogenised, and the nutrients were detected
following the AOAC Official Methods of Analysis. Results: Compared with Chinese and US dietary reference
intakes, the average energy, protein, salt, fat, vitamin, and available carbohydrate contents exceeded dietary recommendations
for one takeaway meal. By contrast, the whole grain, vegetable, fruit, dairy product, egg, mineral,
and dietary fibre contents were insufficient. Food compositions and basic nutrients differed among takeaway
meals prepared with various cooking methods and meats. Fried rice had the lowest nutritional value. The fried
dish set meal had high energy density. The nutrient content of poultry takeaway meals was more balanced compared
with other meals assessed, and salt and fat were excessive in mixed meat meals. In addition, meatless takeaway
meals tended to have high fat content because of excess vegetable oil added for better taste. Conclusions:
Takeaway meals should have lower contents of energy, fat, carbohydrate, and salt and higher contents of whole
grains, vegetables, fruits, dairy products, and eggs. Attention should be paid to the high energy density of the
fried dish set meal to prevent resultant health problems such as obesity. Consumers, takeaway outlets, and government
agencies need to work together to address the health problems.
Background and Objectives: To evaluate the impacts of fistula status over 12 months on growth and development and anemia in infants with anorectal malformation (ARM) and to analyze the effects of comorbidities. Methods and Study Design: The ARM group included infants who suffered from ARM and underwent three operations including colostomy, anoplasty (group A) and fistula closure (group B). The normal group included infants aged approximately 6 months and 12 months who were classified as groups C and D. A 24-h dietary recall questionnaire was completed by the guardians of all the participants. Data on height, weight, hemoglobin (Hb) level and comorbidities were extracted from electronic medical records. Then, we compared the impacts of the 12-month fistula status on growth and development and anemia among the infants. Results: In total, 47 patients in the ARM group and 100 infants in the normal group were included. The height-for-age z-score (HAZ) was lower in group A than in group B. Compared with those in group D, weight, height, the HAZ and the weight-forage z-score (WAZ) were lower in group B. The incidence of anemia was higher in the ARM group than in the normal group. Conclusions: Patients with ARM are at risk for growth problems and anemia. The long-term impacts of fistula status on infant length presented earlier than those associated with other physical indicators. Compared to infants with urogenital comorbidities, those with congenital heart disease (CHD) seemed to be more prone to growth disorders and anemia.
Background and Objectives: The role of ursodeoxycholic acid (UDCA) in Nonalcoholic fatty liver disease (NAFLD) is not well-defined. In this meta-analysis, we analyzed the efficacy of UDCA for the treatment of NAFLD. Methods and Study Design: We searched the Web of Science, Pubmed, Embase and Cochrane library databases for relevant studies published before September 1, 2019. The randomized controlled trials (RCTs) that investigated the effectiveness of UDCA in NAFLD were selected and examined by Stata (version 12.0). Results: The forest plot displayed that UDCA treatment can significantly decrease the ALT (alanine aminotransferase) levels (p=0.007). Further, its’ significant role in subgroup analyses (p=0.003 in people from Europe, p=0.001 in people older than 50 years and p=0.008 in longer duration). Conclusions: Although UDCA treatment was found beneficial in ALT-lowering, future meta-analysis will be required to fully confirm and validate the efficacy of UDCA in NAFL.
Background and Objectives: Nutritional parameters may predict the prognosis of patients with gastric cancer. This study investigated whether changes in nutritional parameters before and after chemotherapy were associated with survival among patients who underwent gastrectomy for gastric cancer. Methods and Study Design: We retrospectively reviewed data from 77 Chinese patients who had undergone gastrectomy for stage III gastric cancer at a single center. Laboratory data from before and after chemotherapy were collected regarding peripheral albumin, prealbumin, total protein, hemoglobin, and total cholesterol concentrations. The prognostic nutritional index (PNI) values were calculated and compared before and after chemotherapy. The relationships between survival and the pre-chemotherapy and post-chemotherapy nutritional statuses were evaluated. Results: Among the 77 patients, survival was associated with the staging, the pre-chemotherapy PNI values, and the postchemotherapy body mass index (BMI) values. Significantly better overall survival was associated with a high pre-chemotherapy PNI value (hazard ratio [HR]: 0.485, 95% confidence interval (CI): 0.255–0.920) and a normal post-chemotherapy BMI value (HR: 0.475, 95% CI: 0.249–0.907). Even better survival was associated with the co-existence of a high pre-chemotherapy PNI value and a normal post-chemotherapy BMI value (vs. one or more abnormal parameter, HR: 0.337, 95% CI: 0.167–0.679). Conclusions: Chinese patients who underwent gastrectomy for gastric cancer had nutritional statuses that deteriorated after adjuvant chemotherapy. High prechemotherapy PNI values and normal post-chemotherapy BMI values were associated with better survival outcomes. Thus, low pre-chemotherapy PNI values and/or low post-chemotherapy BMI values may predict poor outcomes among these patients.
Background and Objectives: Inadequate nutrition in patients on hemodialysis causes various complications. This study aimed to investigate the association between nutritional status and risk of osteoporosis, sarcopenia, and cognitive impairment in patients on hemodialysis. Methods and Study Design: We enrolled 131 older patients on maintenance hemodialysis. Geriatric Nutrition Risk Index (GNRI) was used to assess nutritional status. Patients were divided into quartile groups according to the GNRI. Dual-energy X-ray absorptiometry, bioimpedance analysis and handgrip strength measurement, and the Korean version of the Montreal Cognitive Assessment were used to assess osteoporosis, sarcopenia, and cognitive impairment, respectively. Biochemical laboratory tests were also performed before mid-week hemodialysis session. Results: Patients from higher GNRI quartiles had a lower prevalence of osteoporosis and sarcopenia. Cognitive impairment was not associated with any GNRI quartile. In the multivariable models, longer dialysis periods (OR 1.696, 95% CI 1.053-2.729, p=0.030) and higher intact parathyroid hormone levels (OR 3.136, 95% CI 1.781-5.518, p<0.001) were significantly associated with osteoporosis risk. GNRI quartile 2 (OR 0.064, 95% CI 0.005-0.883, compared to quartile 1, p=0.040) and higher hemoglobin A1c levels (OR 3.728, 95% CI 1.033-86.4, p=0.043) were associated with a higher sarcopenia risk. Lower hemoglobin levels (OR 0.585, 95% CI 0.360-0.950, p=0.030) were associated with a higher risk of cognitive impairment. Conclusions: In patients on hemodialysis, inadequate nutrition was associated with the risk of osteoporosis and sarcopenia, but not cognitive impairment. Proper nutritional assessment and management in these patients could prevent complications related to bone and muscle loss.
Background and Objectives: It is widely recognized that sarcopenia increases postoperative complications in trauma patients. However, the effects on prognosis remain unclear. This study aimed to evaluate the impact of sarcopenia on 90-day readmission and overall survival (OS) in abdominal trauma patients. Methods and Study Design: 485 consecutive patients who underwent abdominal surgery after trauma in our institution were enrolled. Sarcopenia was diagnosed with low muscle mass and low muscle strength-handgrip. Multivariate logistic regression analysis was performed to identify factors that contributed to 90-day readmission and OS. Cox logistic regression analysis was used to assess the relationship between sarcopenia and OS. Results: Sarcopenia was present in 120 of 485 patients (24.7%) with abdominal trauma within one week after admission based on the diagnostic cut-off values (40.9 cm2 /m2 for men and 36.8 cm2 /m2 for women). 90-day readmission was significantly higher in the sarcopenia group (p=0.019), and OS lower in the sarcopenia group (p=0.025). Sarcopenia was an independent predictor of 90-day readmission [odds ratio (OR): 5.34, 95% confidence interval (CI): 2.52-11.3]. Conclusions: Sarcopenia was associated with high 90-day readmission and low OS in abdominal trauma patients, and it was an independent risk factor for 90-day readmission.
Background and Objectives: Vitamin A and zinc are interrelated, but the effects of zinc on vitamin A supplementation on morbidity are inconsistent and not well understood. We investigated the effects of zinc and vitamin A supplementation on immune responses in Indonesian pre-schoolers. Methods and Study Design: In a twostage study design, 826 children (2-5year old) were randomly assigned to receive daily zinc supplement (10 mg) or placebo for 4 months. At 2 months, both groups received a 200,000 IU vitamin A capsules through national vitamin A program. Data were collected at baseline, two and four months, resulting in 4 groups for comparisons: – no zinc no vitamin A (Placebo), zinc only, vitamin A only, and zinc plus vitamin A. Hair, blood and saliva samples were collected to measure hair zinc and serum retinol (vitamin A) concentration, ex-vivo IFN-γ, serum IgG and salivary IgA from 81 children selected randomly from each group. Results: At baseline, there were no differences between treatment groups. Zinc supplementation increased ex-vivo IFN-γ production, greatest amongst boys, younger (<3.5 years), normal weight and children with low baseline retinol concentration. Vitamin A supplementation increased IFN-γ only in those with low baseline retinol, with no effect on serum IgG and salivary IgA. After vitamin A supplementation, zinc had an effect on salivary IgA among younger and underweight children. Conclusions: Zinc supplementation increased IFN-γ (cellular immune responses) and modified the effect of vitamin A supplementation on salivary IgA (mucosal innate immune response) in younger and underweight children.
Background and Objectives: A considerable proportion of older adults are lactose intolerant. The aim of this study was to investigate the clinical safety, efficacy, and tolerability of a chicken-based oral nutritional supplement (ONS). Methods and Study Design: Double-blind randomized controlled trial. Subjects in the intervention group received chicken-based ONS, and those in the control group received a similarly flavored oral fluid placebo. All subjects were followed-up every two months for a total of 6 months. Results: Thirty-eight older adults aged ≥70 years were recruited. The mean age and BMI were 81.5±5.6 years and 19.6±2.5 kg/m2. At the end of this trial, there was no statistically significant change in sarcopenia-related variables in the intervention group. However, the higher-level physical activity (PA) group within the intervention group had a significantly improved usual gait speed (UGS) compared to the lower-level PA group (p=0.04). The adjusted mean differences in UGS between the high and low level PA groups in the intervention and placebo groups were 0.149 m/sec and 0.083 m/sec, respectively. Significant difference was observed for changes in two bone markers between the intervention and placebo groups. Conclusions: The chicken-based ONS evaluated in this study was well-tolerated. No improvement of sarcopenia-related components was shown by the study ONS. Up to nearly an 80% increase in adjusted mean difference in UGS between the high and low level PA groups was observed in the nutritional intervention group compared to the zero-protein calorie placebo group. Significant improvement in age-related bone resorption was the earliest advantage of taking our ONS.