Surgical resection is the primary and most effective treatment for cancer patients. While such a traumatic intervention often accompanies different degrees of postoperative risk largely depending on the patient’s health status. Due to the high prevalence of malnutrition or low cardiorespiratory fitness in elderly cancer patients, prehabilitation is an optimal program to reduce postoperative complications and enhance recovery from surgical trauma. An increasing body of evidence suggests that improving nutrition and taking aerobic exercise or strength training prior to major surgery can help reduce postoperative morbidity, mortality, or length of stay. However, there are still controversies regarding the manner, intensity, or duration of preoperative nutrition and exercise training in elderly patients, as well as the impact on delaying cancer treatment. This article reviews the impact of prehabilitation on improving postoperative outcomes in the multi-modal or single-modal pathway, aiming to maximize its effectiveness and increase medical practitioners’ attention on enhancing the physical condition of the elderly cancer patients preoperatively.
Background and Objectives: People with dental problems and dysphagia frequently consume foods in paste form. A strategy is required to mitigate the glycemic responses of these foods. Methods and Study Design: The effect of yam paste ingestion on postprandial glycemic responses was assessed using a two-arm study design for yam paste ingestion: (1) as low– and medium–glycemic index food and (2) as preload and coingested food in a rice meal. In a randomized crossover trial, 18 healthy volunteers consumed (1) low-intensity-cooked yam paste; (2) medium-intensity-cooked yam paste; (3) cooked white rice; (4) coingested low-intensity-cooked yam paste with rice; (5) coingested medium-intensity-cooked yam paste with rice; (6) a preload of low-intensity-cooked yam paste before rice; (7) a preload of medium-intensity-cooked yam paste before rice. Postprandial glycemic responses and satiety assessments were conducted for each food approach. The glycemic characteristics of yam paste were manipulated with the preparatory treatment. Results: Ingesting a preload of 10 g of yam paste before a rice meal resulted in better glycemic responses for 0–60 min in terms of peak glucose value and positive increments under the curve than co-ingesting yam paste with rice, with no adverse effect on satiety, irrespective of the glycemic index of the yam paste. Conclusions: Regarding isocarbohydrates, both low- and medium-glycemic index yam paste preloads curbed the glucose peak value of a rice meal and lowered the glycemic index value of mixed meals in young healthy people.
Background and Objectives: As an endocrine organ, the mass of skeletal muscle is closely related to human health. The present study aimed to investigate the relationship between regional skeletal muscle and nonalcoholic fatty liver disease (NAFLD) in Chinese elders. Methods and Study Design: A total of 1,328 participants (579 males and 749 females), aged 65 to 96 years were recruited between March to November 2020 in Qingdao, China. Of these, 400 cases and 400 healthy controls, matched by gender and age (±3 years), were included in the study. Skeletal muscle mass was measured by bioelectrical impedance analysis, and body weight was adopted to standardize skeletal muscle mass to obtain skeletal muscle mass indexes. Results: Inverse associations were observed for trunk muscle mass index (TMI) (OR=0.42; 95% CI: 0.19, 0.93; p for trend=0.083) and leg skeletal muscle mass index (LMI) (OR=0.41; 95% CI: 0.18, 0.97; p for trend=0.012) with NAFLD risk after adjustment for age, body mass index, glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, dietary intakes of energy, carbohydrate, protein and fat, smoking, alcohol drinking, education and physical activity. Dose-response analysis indicated that per standard deviation increment of LMI was associated with 23% (95%CI: 0.63, 0.95) reduction of NAFLD risk. Conclusions: The present study demonstrates that higher TMI and LMI are associated with a lower NAFLD risk.
Background and Objectives: Frailty and malnutrition are geriatric syndromes with common risk-factors. Limited studies have investigated these two conditions simultaneously in hospitalised patients. This study investigated the overlap of frailty and malnutrition in older hospitalised patients. Methods and Study Design: This prospective study enrolled 263 patients ≥65 years in a tertiary-teaching hospital in Australia. Frailty status was assessed by use of the Edmonton-Frail-Scale (EFS) and malnutrition risk was determined by use of the Malnutrition Universal Screening Tool (MUST). Patients were divided into four categories for comparison: normal, at malnutrition-risk only, frail-only and both frail and at malnutrition risk. Multivariable regression models compared clinical outcomes: length of hospital stay (LOS), in-hospital mortality, health-related quality of life (HRQoL) and 30-day readmissions after adjustment for age, sex, Charlson comorbidity index (CCI) and living-status. Results: The mean (SD) age was 84.1 (6.6) years and 51.2% were females. The prevalence of patients who were at malnutrition-risk only was 14.8%, frailty only 27.8% and 33.5% were both frail and at malnutrition-risk. Frail-only patients were more likely to be older, from a nursing home and with a higher CCI than malnourished only patients. Frail patients had a worse HRQoL (coefficient –0.08, 95% -0.0132–-0.031, p=0.002) and were more likely to have a longer LOS (coefficient 5.91, 95% CI 0.77–11.14, p=0.024) than patients at-risk of malnutrition. Other clinical outcomes were similar between the two groups. Conclusions: There is a substantial overlap of frailty and malnutrition in older hospitalised patients and frailty is associated with worse clinical outcomes than malnutrition.
Background and Objectives: The role of maternal vitamin D in infantile growth remains unclear. Methods and Study Design: Serum 25-hydroxyvitamin D [25(OH)D] concentrations were examined for pregnancies who visited the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from January 2016 to December 2017. Anthropometric measurements of corresponding offspring were performed from birth to 2 to 3 years old. Infantile body mass index (BMI) was transformed into age-, sex- and height- normalized z-scores, and Latent Class Growth Mixture (LCGM) model was used to identify trajectories of BMI-Z. Results: Among the 329 included pregnancy women, 109 (33.13 %), 190 (57.75%) and 30 (9.12%) were defined as vitamin D deficiency [25(OH)D <30 nmol/L], insufficiency [30 nmol/L≤25(OH)D<50 nmol/L] and sufficiency [25(OH)D ≥50 nmol/L], respectively. When compared with vitamin D sufficiency, maternal vitamin D deficiency was not associated with preterm birth [odds ratio (OR)=2.69, 95% confidence interval (95% CI)=0.57-12.80], small for gestation age (OR=0.99, 95% CI=0.29-3.46), and low birth weight (OR=1.69, 95% CI=0.34-8.51). Similarly, no significant relationships were found between maternal vitamin D concentrations and anthropometric indices (such as weight, length, BMI) during 0 to 3 years old. Furthermore, LCGM model identified two patterns of offspring growth: stable moderate BMI-Z and early transient BMI-Z groups. Maternal vitamin D levels were higher in the former group than the latter (p=0.037); however, maternal vitamin D status appeared to be unrelated with offspring BMI-Z trajectories in multivariable logistic regression models. Conclusions: Maternal vitamin D deficiency may not be related to adverse pregnancy outcomes as well as offspring growth.
Background and Objectives: The effect of fiber, especially the effect of specific fiber in different food groups, on gestational diabetes mellitus (GDM) has seldomly been investigated. This study aimed to examine the association between GDM risk and consumption of total fiber, fiber in specific food groups, and glycemic load (GL) in the second trimester in Chinese women. Methods and Study Design: A total 162 GDM cases were matched to 324 controls on women’s age and pre-pregnancy BMI. Dietary survey was conducted twice to evaluate dietary factors between 13-16 gestational weeks (GW) and 21-24 GW respectively. Multivariable logistic regression analysis was used to compute the odds ratios (ORs) and 95% confidence intervals (CIs). Results: Intake of total fiber and fruit fiber in both 13-16 GW and in 21-24 GW were significantly correlated with decreased risk of GDM, with adjusted ORs (95% CIs): 0.06 (0.03-0.13) and 0.03 (0.01-0.08) for total fiber in the highest quartile, 0.003 (0.0002-0.02) and 0.01 (0.001-0.02) for fruit fiber in the highest quartile, respectively. In contrast, consumption of cereal fiber in 21-24 GW and daily average GL in 13-16 GW were positively associated with GDM risk, with adjusted ORs (95% CIs) of the highest quartile: 3.34 (1.45-7.92) and 3.88 (1.43-10.89) respectively. Conclusions: Our findings suggested consumption of dietary fiber in various food groups in the second trimester might be associated with GDM risk. Particularly, diet rich in total fiber and fruit fiber may play a protective role.
Background and Objectives: The associations between oil tea and type 2 diabetes (T2D) have been little studied in the population. This study aimed to evaluate whether oil tea intake is related to the reduced risk of T2D in adults. Methods and Study Design: A rural-based cross-sectional study was conducted in Gongcheng Yao Autonomous County, Guangxi, southern China (2018–2019), with a total of 3178 population included in the final analysis. A multivariable logistic regression model was used to analyze the associations between the intake frequency, daily intake of oil tea and the risk of T2D. We further compared the association differences between the daily intake of oil tea and the risk of diabetes under different dietary patterns, which were generated from food frequency intake data using principal factor analysis. Results: The differences in the frequency and daily intake of oil tea in both groups (diabetes group and the non-diabetes group) were statistically significant (p<0.05). After adjusting for age, sex, smoking status, physical activity, body mass index (BMI), compared with non-oil tea drinkers, intake ≥3 times /d had an inverse association with T2D (OR=0.417; 95% CI: 0.205–0.848, p<0.05); while daily intake of more than 600 mL/d but less than 900 mL/d was significantly associated with reduced T2D risk (OR=0.492; 95% CI: 0.284–0.852, p=0.011). In the Chinese traditional dietary and the plant-based dietary model, compared with the non-oil tea drinkers, the fourth intake group had a lower risk of diabetes, with an OR (95%CI) value of 0.500 (0.291–0.854) and 0.505 (0.298–0.855), respectively, but no statistical significance (All p>0.05). Conclusions: Our study suggests that oil tea was associated with a reduced risk of T2D aged 30 years or older.
Background and Objectives: Carotid intima-media thickness (IMT) is a risk predictor for myocardial infarction and stroke. Patients with type 2 diabetes mellitus are at higher risk for such conditions. The association of alcohol consumption with IMT is still controversial. Methods and Study Design: We undertook a cross-sectional study of patients hospitalized in the Department of Endocrinology at Zhoushan Hospital from January 1st, 2013 to December 31st, 2015. Patients with a past medical history of cerebrovascular events, acute myocardial ischemia or unable to provide a detailed alcohol consumption history were excluded. Carotid IMT, together with blood biochemical examinations were collected. Data were analyzed using least significant difference t test, Tamhane’s T2 test, Levene test, χ2-test and binary logistic regression model. Results: 281 patients were enrolled in the study. The number of patients with elevated carotid IMT in moderate alcohol consumers was apparently less than alcohol non/heavy-consumers. In addition, the number of participants with elevated carotid IMT in liqueur consumers was higher than alcohol non-consumers and rice wine/beer consumers. Systolic blood pressure, C-reactive protein, glycosylated hemoglobin, low density lipoprotein cholesterol, triglyceride, gamma glutamyl transpeptidase, uric acid, cholesterol and creatinine levels were higher in elevated IMT patients, while high density lipoprotein cholesterol level was levels were significantly lower (p value<0.05). Conclusions: Moderate alcohol consumption has a protective effect on atherosclerosis in patients with type 2 diabetes mellitus, requiring consideration to dietary intake and physical activity, among other influences. Inflammation theory and lipid metabolism could be involved in such prophylaxis effects.
Background and Objectives: The Sakata’s Eating Behavior Questionnaire (SEBQ) was developed to grasp distortions and habits in eating behavior. This study aimed to validate the factor structure and psychometrics properties of the Chinese version of the SEBQ, and examine the relationship between eating behavior and hypertension. Methods and Study Design: Individuals were recruited from a community in Xuhui district in Shanghai. The 30-item SEBQ was used to measure eating behavior. Confirmatory factor analysis was performed to evaluate the dimensional structure, logistic regression analysis and mediating effect analysis were conducted to evaluate the relation between SEBQ with obesity and hypertension. Results: Cronbach’s alpha coefficient was 0.81 revealed good internal reliability. The values of root mean square error of approximation [90% confidence intervals (CI)], comparative fit index and Tucker–Lewis index were 0.053 (0.050, 0.056), 0.90 and 0.89 for the original version, and 0.062 (0.045, 0.079), 0.91 and 0.86 for the 7-item short form respectively. SEBQ can be used as a predictor of general obesity [odds ratio (OR): 5.14, 95%CI: 2.91-9.08], central obesity (OR: 2.87, 95%CI: 1.86-4.42) and abdominal obesity (OR: 2.59, 95%CI: 1.67-4.01). Its effect on hypertension was mediated by obesity (β=0.018, p=0.027), and the percentage of mediated effect by obesity between eating behavior and hypertension was 43.9%. Conclusions: This study shown that SEBQ is a valid and reliable measurement tool to define obesity in Chinese as well and the associations between eating behavior and hypertension was mediated by obesity. Further validation among different populations is needed in the future study.
Background and Objectives: In adolescents, adequate nutrition education is essential for making decisions regarding healthy eating habits. We aimed to investigate differences in dietary habits and body image misperception according to nutrition education status. Methods and Study Design: We analyzed 60,389 adolescents aged 12-18 years old, using the 2017 Korea Youth Risk Behavior Web-based Survey data. Participants were divided into nutrition-educated (EDU) and uneducated (non-EDU) groups, according to nutrition education status within the past year. Skipping breakfast was defined as skipping breakfast ≥5 times/week. Desirable dietary behaviors were divided into the frequency of consumption of 3 items: vegetables ≥1 time/day, milk ≥1 time/day, and fruits ≥1 time/day. Participants with normal weight who reported being slightly fat or very fat were defined as having body image misperception. Results: Compared to the non-EDU group, the odds ratio (OR) and 95% confidence interval (CI) for desirable dietary behaviors in the EDU group were 1.08 (1.04-1.13), 1.14 (1.09-1.19), and 1.16 (1.12-1.20) for the intake of fruits, milk, and vegetables, respectively. The EDU group was less associated with skipping breakfast than the non-EDU group (OR=0.91, 95% CI: 0.87-0.95, p<0.001). The OR and 95% CI of body image misperception in the EDU group were lower than in the non-EDU group (OR=0.92, 95% CI: 0.87-0.97, p<0.001). Conclusions: Nutrition education have positive effects on healthy dietary behaviors. It also shows a negative association with body image misperception, confirming the importance of nutrition education at school.
Background and Objectives: Previous studies had shown that trends in diet quality between children and adults may vary but lack quantitative comparisons. We aimed to compare diet quality and its trends between US children and adults in this research. Methods and Study Design: Children aged 2 to 18 and adults aged 19 to 59 years old in the US were enrolled the serial cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) cycles from 1999 to 2018. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015), and trends were analyzed by joinpoint regression model. Results: This study included 31988 children and 34317 adults. From 1999 to 2018, there was a trend-change among 5 children’s components trends (including total fruits in 2011-2012, whole fruits in 2005-2006, greens and beans in 2013-2014, dairy in 2013-2014, and total protein foods in 2013-2014, p for joinpoint <0.05 for each) and overall trend in 2013-2014, whereas no significant trend-change in adults’ trend. The trends of overall HEI-2015 between children (average annual percent change 0.3%; 95% CI: -0.1% to 0.8%) and adults (0.3%; 95%CI: 0.0% to 0.6%) showed no significant difference in parallelism (p for parallelism=0.60), but a significant difference in coincidence (intercept -7.7±3.7 among children; -2.3±2.5 among adults; p for coincidence <0.05). Conclusions: Children had a different trend with more trend-changes in diet quality compared with adults, and the diet quality of children was worse than that of adults during 1999-2018 in the US.
Background and Objectives: Primary Intestinal Lymphangiectasia (PIL) is a rare congenital and digestive disease, which could present through a broad spectrum of clinical manifestations, diagnostic and treatment management. The aim of this study was to introduce the diagnosis and nutrition treatment of children with PIL through the twelve years of experience. Methods and Study Design: The patients diagnosed with PIL admitted to the Department of Gastroenterology and Nutrition in Xinhua Hospital from June 2006 to September 2017 were included in the study. Results: Ten patients were found to have PIL, and 5 of them were male. The mean age was 66 months at the time of diagnosis and 11 months at onset. The main clinical manifestations were diarrhea, edemas and abdominal distention. Marked dilatation of the intestinal lymphatic vessels was the characteristic of the endoscopic. All the patients presented with hypoproteinemia and hypoimmunoglobulinia. Six of them were treated with parenteral nutrition, and 9 of them were treated with a low-long-chain triglycerides (LCT), high-protein diet supplemented with medium-chain triglycerides (MCT). The clinical symptoms of the patients have improved after the MCT diet therapy. Conclusions: PIL should be considered first when there are clinical manifestations of chronic diarrhea, edema and abdominal distention, and biochemical results indicated the hypoproteinemia and hypoimmunoglobulinia, and the general treatment is invalid. Gastroscopy and E-colonoscopy with biopsies are the preferred method of diagnosis. Diet intervention (MCT diet) is the cornerstone and longtime medical treatment, which can improve the nutritional status and promote the survival quality of patients with PIL.
Tocotrienols have been reported to exert anticancer, anti-inflammatory, antioxidant, cardio-protective and bone-protective effects through modulation of NFκB signalling pathway. The objective of this systematic review is to evaluate available literature showing the effect of tocotrienols on NFκB signalling pathway and identify the potential mechanisms involved. A comprehensive search was conducted using PubMed and SCOPUS databases using the keywords “tocotrienol” and “NFκB” or “nuclear factor kappa b”. Main inclusion criteria were English language original articles showing the effect of tocotrienol on NFκB signalling pathway. Fifty-nine articles were selected from the total of 117 articles initially retrieved from the literature search. Modulation of regulatory proteins and genes such as inhibition of farnesyl prenyl transferase were found to be the mechanisms underlying the tocotrienol-induced suppression of NFκB activation.
Background and Objectives: The study aimed to explore the association between energy intake (EI), the proportion of enteral nutrition intake (EN%), and prognostic-related indicators. Methods and Study Design: This was a prospective observational study. Patients aged 18-80 years old, who had undergone cardiothoracic surgery, were enrolled between January 2017 and January 2018. The measured REE (mREE) was evaluated by indirect calorimetry (IC). The observational data on EI, EN% and EI/mREE% were collected following admission to ICU, ICU discharge, and prior to discharge. Results: A total of 160 patients (60.6% male) were studied. The pre-albumin and total protein were positively correlated with EN% at the time of ICU discharge; liver function index levels were negatively correlated with EI/mREE% at discharge (p<0.05). Multiple linear regression indicated that ALT levels as well as EI/mREE% were related to the duration of mechanical ventilation; ALT, AST, APACHE II were related to the ICU duration; EN% and EI/mREE% were related to the length of stay (LOS) following ICU discharge. EN% was related to the LOS in the hospital. Conclusions: The patients treated cardiothoracic surgery demonstrated associations of EN% with LOS in the hospital. Increased EN% and EI/mREE% were associated with higher serum protein levels and maintain normal liver function.
Background and Objectives: Surgical patients with depleted skeletal muscle mass tend to have a worse outcome. Whether perioperative change of urea to creatinine ratio (CUCR) can reflect muscle wasting and predict postoperative complications have not been investigated. This study aimed to evaluate the relationship of perioperative CUCR with postoperative complications and skeletal muscle wasting in pancreatic cancer patients undergoing pancreatoduodenectomy (PD). Methods and Study Design: Pancreatic cancer patients undergoing PD were included retrospectively. The association between postoperative complications and perioperative CUCR as well as other nutritional biomarkers was analyzed. In a subset of patients with serial CT scans, the correlation of the CUCR and the changes of CT-derived skeletal muscle area (SMA) were tested. Furthermore, the capacity of complication prediction of CUCR and CT-derived parameter were compared in these patients. Results: A total of 321 surgical patients were included. Univariable and multivariable logistic regression demonstrated CUCR was a strong predictor for complications in these patients, independent of age, BMI and comorbidity. Patients with CUCR above the median have higher complication rate (p=0.007) and longer postoperative days to discharge (p=0.017). In a subset patients with both pre- and postoperative digital abdominal CT scans, spearman correlation analysis shown both L3 muscle area and L4-psoas area were significantly correlated with CUCR (R2=0.64, p<0.05; R2=0.62, p<0.05, respectively). Conclusions: Perioperative CUCR is an independent predictor for postoperative complications in pancreatic cancer patients undergoing PD. Elevated CUCR is a reflection of skeletal muscle wasting in postoperative surgical patients.
Background and Objectives: Poor nutritional status is associated with benign paroxysmal positional vertigo (BPPV). Transthyretin (TTR) is a more sensitive marker than is albumin for nutritional status assessment. This study was conducted to confirm an association between serum transthyretin levels and BPPV. Methods and Study Design: In total, 320 patients with BPPV and 320 age- and gender-matched controls were recruited between July 1, 2018, and July 1, 2020. All patients underwent audiovestibular tests, including the Dix–Hallpike test for the posterior semicircular canal and the supine roll test for the horizontal semicircular canal. Furthermore, serum transthyretin levels and other biochemical indicators were tested. Risk factors, including a history of heart and cerebral vascular diseases, were examined, and compared between groups. Hematolgical and biochemical tests were performed and subjected to between-group analysis. Multiple logistic regression models were employed to evaluate the TTR–BPPV. Interaction and stratified analyses were conducted. Results: Patients with BPPV had significantly lower TTR levels than controls (213±49.3 vs 284±56.4 p<0.001). Alcohol consumption and anemia played an interactive role in the association between BPPV and low TTR levels. After adjustments for triglycerides, BMI, uric acid, HbA1C, 25-OH vitamin D3, alcohol consumption, and anemia, the multiple logistic regression revealed that participants with low TTR levels had a significantly increased risk of BPPV (OR: 5.5; 95% CI, 2.55–11.9; p<0.001). Conclusions: Chinese older adults with low serum transthyretin levels have an increased risk of BPPV.
Background and Objectives: We aim to evaluate the efficacy and safety of VBF on critically ill patients. Methods and Study Design: We systematically retrieved the related literature from January 1, 2000, to March 30, 2021, sources include MEDLINE, Wed of Science, Cochrane Library and China National Knowledge Infrastructure. Randomized controlled trials or cohort studies of enteral nutrition based on VBF versus rate-based feeding (RBF) in critically illness of adult participants were selected. Results: After screening, seven studies involving 691 patients were finally included. Six of them were high quality. The percentage of goal energy received in the VBF group was significantly high-er than that in the RBF group [MD=9.11, 95% CI (5.82, 12.41), p<0.001]. ICU length of stay in the VBF group [MD=-0.8, 95% CI (-1.59, -0.01), p=0.05], mechanical ventilation length [MD=-1.27, 95% CI (-2.04, -0.51), p=0.001] were significantly shorter in the VBF group, but hospital length of stay [MD=0.62, 95% CI (-4.46, 5.69), p=0.81] was not significantly different. Our study shows that VBF has some non-significant advantages in reducing mortality [RR=0.70, 95% CI (0.44, 1.11), p=0.13]. The rates of adverse reactions, such as diarrhea RR=1.17, 95% CI (0.91, 1.50), p=0.23), emesis (RR=0.80, 95% CI (0.42, 1.55), p=0.51), feeding intolerance [RR=0.97, 95% CI (0.64, 1.48), p=0.90) were not significantly different between the two groups. Conclusions: The VBF protocol significantly improves the successive rate of enteral nutrition in critically ill patients.
Background and Objectives: Human milk fat globule membrane (MFGM) has multifunctional health benefits. We evaluated neurodevelopment and growth of healthy term infants fed bovine milk-derived MFGM-enriched formula (MF) over 12 months. Methods and Study Design: A prospective, multi-center, double-blind, randomized trial was conducted in Fuzhou, China. Healthy term infants (n=212), aged <14 days, were assigned randomly to be fed MF or a standard formula (SF) for 6 months and then switched to stage 2 MF and SF formula until 12 months. A reference group (n=206) contained healthy breastfed infants (BFR). Neurodevelopment was assessed with Bayley-III Scales. Results: At 12 months, the composite social emotional (+3.5) and general adaptive behaviour (+5.62) scores were significantly higher in MF than SF (95% CIs 0.03 to 6.79 and 1.78 to 9.38; p=0.048 and 0.004, respectively). Mean cognitive (+2.86, 95% CIs -1.10 to 6.80, p=0.08), language (+0.39, 95% CIs -2.53 to 3.30, p=0.87) and motor (+0.90, 95% CIs -2.32 to 4.13, p=0.49) scores tended to be higher in MF than SF, but the differences between the two groups were not significant. BFR scored higher on Bayley-III than either MF or SF at 6 and 12 months. Cognitive scores were significantly higher in BFR than SF (95% CI 0.05 to 7.20; p=0.045), but not MF (p=0.74) at 6 months. Short-term memory was significantly higher in MF than SF at 12 months (95% CI 1.40 to 12.33; p=0.002). At 4 months, serum gangliosides were significantly higher in MF and BFR than SF (95% CI 0.64 to 13.02; p=0.025). Milk intake, linear growth, body mass and head circumference were not significantly different between formula-fed groups. Conclusions: MFGM supplementation in early life supports adequate growth, increased serum gangliosides concentration and improves some measures of cognitive development in Chinese infants.
Background and Objectives: To evaluate the effect of oral nutritional supplements (ONS) on community elderly people with malnutrition or risk of malnutrition. Methods and Study Design: A single arm intervention trial for 3 months was conducted. Whole nutrient powder was given to all the participants. Dietary intakes were measured by 3-day diet record. Nutritional status was evaluated using body weight, body mass index (BMI), calf circumference (CC), and Mini Nutritional Assessment Short-Form (MNA-SF) scores. Muscle mass was measured by bioimpedance analysis (BIA). All these parameters as well as muscle strength, physical function, and quality of life were measured at both the baseline and the end. Results: Compared with the baseline, ONS increased protein intake (58.32±16.67 vs 41.90±18.49 g/d, p<0.001), body weight (57.03±8.31 vs 56.68±8.23 kg, p<0.05), BMI (22.16±2.13 vs 22.02±2.08 kg/m2, p<0.05), CC (34.21±2.53 vs 33.80±2.53 cm, p<0.001), MNA-SF scores (12.61±1.43 vs 10.48±0.99, p<0.05), hand grip strength (24.54±8.05 vs 23.27±7.74 kg, p<0.001), and 6-m gait speed (1.11±0.33 vs 0.96±0.28 m/s, p<0.001). Moreover, SF-36 scores of the overall subjects have been improved in all dimensions (p<0.05). Conclusions: The study demonstrated that ONS can effectively increase protein intake and improve nutritional status, muscle strength, physical function and quality of life of the elderly with malnutrition or malnutrition risk in communities.
Background and Objectives: Red yeast rice contains monacolin K, an inhibitor of cholesterol synthesis, and gamma-aminobutyric acid, a neurotransmitter. The daily dose of red yeast rice and monacolin K in previous studies was relatively high; therefore, there were safety concerns. We aimed to examine the effects of low daily dose red yeast rice on arteriosclerosis in patients with mild dyslipidemia. Methods and Study Design: Eighteen patients without known cardiovascular disease and unsatisfactory low-density lipoprotein cholesterol (3.96±0.19 mmol/L) controlled only by diet therapy were randomly allocated to receive low dose red yeast rice (200 mg/day) containing 2 mg monacolin K or diet therapy alone for 8 weeks. The primary outcome was the absolute change in low-density lipoprotein cholesterol. Secondary outcomes included total cholesterol, apolipoprotein B, and blood pressure. Results: Low-density lipoprotein cholesterol decreased significantly in the red yeast rice group than in the diet therapy group (median [interquartile range]: control −0.20 [−0.62, 1.19] mmol/L vs. red yeast rice −0.96 [−1.05, −0.34] mmol/L, p=0.030). The red yeast rice group also exhibited significant decreases in total cholesterol, apolipoprotein B, and blood pressure. No severe treatment-related adverse effects on muscles, liver, or renal function were observed. Conclusions: We found that patients in the red yeast rice group exhibited significant reductions in low-density lipoprotein cholesterol, total cholesterol, apolipoprotein B, and blood pressure without any recognised adverse effect. This suggests that low daily dose red yeast rice could reduce cardiovascular risk in patients with dyslipidemia.