The prevalence of malnutrition in surgical patients is high, particularly in elderly, oncologic, critically ill and morbidly obese patients. In recent years, as the concept of enhanced recovery after surgery (ERAS) has gained in popularity, the concept and strategy of nutritional care for surgical patients has also evolved. The concept of nutritional management is relatively new in surgical patient management, which promotes integrating the “nutritional screening-assessment-diagnosis-treatment” (NSADT) scheme into the preoperative, intraoperative, postoperative, and post-discharge processes of disease treatment and rehabilitation. This article will review the practice of perioperative nutrition management in surgical patients in China.
Background and Objectives: Older adults residing in senior homes are at a high risk of malnutrition. In this study, we investigated the nutritional status of these individuals and factors associated with malnutrition in this population. Methods and Study Design: This cross-sectional study (September 2020–January 2021) included a total of 583 older adults residing in a senior home in Shanghai (mean age, 85.0±6.6 years). The Mini Nutritional Assessment Short Form (MNA-SF) questionnaire was administered to assess the nutritional status of the participants. Patients with possible sarcopenia were identified according to the guidelines recommended by the Asian Working Group for Sarcopenia in its 2019 consensus (AWGS 2019). Moreover, the factors influencing malnutrition were determined through multivariate analyses. Results: The likelihoods of having malnutrition and being at a risk of malnutrition were noted in 10.5% and 37.4% of the participants, respectively. In both male and female participants, handgrip strength (HGS) and calf circumference (CC) increased significantly with increasing scores on the aforementioned questionnaire (p<0.001). Among the participants, 44.6% had ≥3 chronic diseases and 48.2% used multiple medicines. Multivariate analyses revealed that dysphagia (OR, 3.8; 95% CI, 1.7–8.5), possible sarcopenia (OR, 3.6; 95% CI, 2.2–5.6), and dementia (OR, 4.5; 95% CI, 2.8–7.0) were correlated with a relatively high prevalence of malnutrition/malnutrition risk. Exercise (at least thrice a week) reduced malnutrition risk. Conclusions: Malnutrition is common among older adults residing in senior homes; therefore, the associated factors must be identified, and appropriate interventions should be administered.
Background and Objectives: The Asian Working Group for Sarcopenia (AWGS) recommended various measures for identifying patients with possible sarcopenia in its 2019 consensus. The present survey aimed to assess older adults in a senior home to determine the prevalence and associated factors for possible sarcopenia and to compare the differences between various assessment pathways based on AWGS 2019 criteria. Methods and Study Design: This cross-sectional study examined 583 participants of a senior home. Patients with possible sarcopenia were determined through the following four pathways: [I] calf circumference (CC) + handgrip strength (HGS); [II] SARC-F+HGS; (III) SARC-CalF+HGS; and (IV) CC, SARC-F, and/or SARC-CalF+HGS. Results: The four assessment pathways revealed a high prevalence of possible sarcopenia in the older adults in the senior home ([I]=50.6%; [II]=46.8%; [III]=48.2%; [IV]=65.9%). There is significant difference in prevalence between pathway IV and the other pathways (p<0.001). A multivariate analysis revealed that advanced age, risk of malnutrition, malnutrition, high level of care, an exercise frequency of <3 times per week, and osteoporosis were correlated with a higher risk of possible sarcopenia. By contrast, oral nutritional supplements (ONS) reduced the risk of possible sarcopenia. Conclusions: This survey reported a high prevalence of possible sarcopenia in the older adults of the senior home and determined the associated influencing factors. Furthermore, our findings suggested that pathway IV is the most suitable pathway for the examined older adults which enabled the detection and early intervention of more possible sarcopenia.
Background and Objectives: Conventional soybean oil-based intravenous lipid emulsions (SO-ILEs) have high polyunsaturated fatty acid (PUFA) contents and phytosterols that may have adverse effects in preterm infants. Recently, the multi-oil-based intravenous lipid emulsion (MO-ILE), SMOFlipid, has been widely utilized in the neonatal intensive care unit (NICU), but significant benefits over SO-ILEs in low gestational age neonates have yet to be demonstrated. This study was performed to compare the effects of the SO-ILE, Intralipid, and the MO-ILE, SMOFlipid, on neonatal health outcomes in preterm infants. Methods and Study Design: We performed a retrospective review of preterm infants born at gestational week (GW) <32 receiving parenteral nutrition for longer durations (≥14 d) in the NICU between 2016 and 2021. The primary aim of this study was to investigate differences in morbidity between preterm infants receiving SMOFlipid and Intralipid. Results: A total of 262 preterm infants were included in the analysis, with 126 receiving SMOFlipid and 136 receiving Intralipid. The SMOFlipid group had lower rates of ROP (23.8% vs 37.5%, respectively; p=0.017), although the rate of ROP was not different in multivariate regression analysis. The length of hospital stay was significantly shorter in the SMOFlipid than SO-ILE group (median [IQR]=64.8  vs 72.5  days; p<0.001). Conclusions: The use of SMOFlipid as the lipid emulsion was associated with higher clinical efficacy than SO-ILE in preterm infants.
Background and Objectives: Malnutrition is a major public health concern that increases morbidity and mortality in hospitalized patients, particularly those in developing countries. This study aimed to investigate its prevalence, risk factors, and impact on clinical outcomes in hospitalized children and adolescents. Methods and Study Design: We conducted a prospective cohort study in patients aged 1 month to 18 years who were admitted to four tertiary care hospitals between December 2018 and May 2019. We collected demographic data, clinical information, and nutritional assessment within 48 hours of admission. Results: A total of 816 patients with 883 admissions were included. Their median age was 5.3 years (interquartile range 9.3). Most patients (88.9%) were admitted with mild medical conditions (e.g., minor infection) or noninvasive procedures. The prevalence of overall malnutrition was 44.5%, while that of acute and chronic malnutrition was 14.3% and 23.6%, respectively. Malnutrition was significantly associated with age ≤2 years, preexisting diseases (cerebral palsy, chronic cardiac diseases, and bronchopulmonary dysplasia), and muscle wasting. Additional risk factors for chronic malnutrition included biliary atresia, intestinal malabsorption, chronic kidney disease, as well as inability to eat and decreased food intake for >7 days. Malnourished patients had a significantly longer hospitalization duration, higher hospital cost, and nosocomial infection rates than did well-nourished patients. Conclusions: Patients with chronic medical conditions on admission are at risk for malnutrition. Therefore, determination of admission nutritional status must be assessed, and its management are requisites for improved inpatient outcomes.
Background and Objectives: Obesity and related target organ damage such as high carotid intima-media thickness (cIMT) in children is associated with cardiovascular disease (CVD) later in life. However, the association between gut microbiota and obesity combined with high cIMT among children remains unclear. Therefore, we compared differences in composition, community diversity, and richness of gut microbiota among normal children and obesity combined with or without high cIMT to identify differential microbiota biomarkers. Methods and Study Design: A total of 24 children with obesity combined with high cIMT (OB+high-cIMT), 24 with obesity but normal cIMT (OB+non-high cIMT), and 24 with normal weight and normal cIMT aged 10-11 years matched by age and sex from the “Huantai Childhood Cardiovascular Health Cohort Study” were included. All included fecal samples were tested using 16S rRNA gene sequencing. Results: The community richness and diversity of gut microbiota in OB+high-cIMT children were decreased compared with OB+non-high cIMT children and normal children. At the genus level, the relative abundances of Christensenellaceae_R-7_group, UBA1819, Family_XIII_AD3011_group, and unclassified_o_Bacteroidales were associated with reduced odds of OB+high-cIMT among children. Receiver operating characteristic (ROC) analysis showed that combined Christensenellaceae_R-7_group, UBA1819, Family_XIII_AD3011_group, and unclassified_o_Bacteroidales performed a high ability in identifying OB+high-cIMT. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) showed that several pathways such as biosynthesis of amino acids and aminoacyl-tRNA pathways were lower in the OB+high-cIMT group compared with the normal group. Conclusions: We found that the alteration of gut microbiota was associated with OB+high-cIMT among children, which indicates that the gut microbiota may be a marker for obesity and related cardiovascular damage among children.
Background and Objectives: Falls are common among older females. This study investigated the relationships among falls and dietary patterns, nutritional inadequacy and prefrailty in community-dwelling older Japanese females. Methods and Study Design: This cross-sectional study involved 271 females aged 65 and over. Prefrailty was defined as exhibiting one or two of the five Japanese version of the Cardiovascular Health Study criteria. Frailty was excluded (n=4). Energy, nutrient and food intakes were estimated using a validated FFQ. Dietary patterns were determined from intakes of 20 food groups assessed with FFQ, by cluster analysis. Nutritional inadequacy for the selected 23 nutrients in each dietary pattern was examined based on DRIs. Binomial logistic regression was applied to examine the relationships among falls and dietary patterns, prefrailty, and inadequate nutrients. Results: Data from 267 participants were included. The incidence of falls was 27.3%, and 37.4% of participants were classified as prefrailty. Three dietary patterns identified were namely; ‘rice and fish and shellfish’ (n=100); ‘vegetables and dairy products’ (n=113); and ‘bread and beverages’ (n=54). A binomial logistic regression analysis revealed that dietary patterns of ‘rice and fish and shellfish’ (OR, 0.41; 95% CI, 0.16–0.95), and ‘vegetables and dairy products’ (OR, 0.30; 95% CI, 0.12–0.78) were negatively correlated with falls, and falls was positively associated with prefrailty. Conclusions: Dietary patterns characterized by ‘rice and fish and shellfish’, and ‘vegetables and dairy products’ were associated with a reduced incidence of falls in community-dwelling older Japanese females. Larger prospective studies are needed to validate these results.
Background and Objectives: Few studies have investigated the effects of dietary theobromine intake on the cognitive performance of older adults. Therefore, we investigated these effects in older adults in the United States. Methods and Study Design: In this cross-sectional study, we used data (2011–2014) from the National Health and Nutrition Examination Survey. Intake of theobromine intake was obtained through two 24-h dietary recall interviews and was adjusted by energy. Cognitive performance was assessed using the animal fluency test, Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest (CERAD), and Digit Symbol Substitution Test (DSST). Logistic regression and restricted cubic spline models were constructed to evaluate the correlation between the dietary intake of theobromine from different sources and the likelihood of low cognitive performance. Results: The fully adjusted model revealed that compared with the lowest quintile, the odds ratios (with 95% confidence intervals) of cognitive performance in the CERAD test were 0.42 (0.28–0.64), 0.34 (0.14–0.83), 0.25 (0.07–0.87), and 0.35 (0.13–0.95) for the highest quintile of total theobromine intake and that from chocolate, coffee, and cream, respectively. Dose–response relationship analysis indicated nonlinear correlations between the likelihood of low cognitive performance and dietary theobromine (total intake and that from chocolate, coffee, and cream). An L-shaped relationship was observed between total theobromine intake and cognitive performance in the CERAD test. Conclusions: The dietary intakes of theobromine (total and that from chocolate, coffee, and cream) may protect older adults, particularly men, against low cognitive performance.
Background and Objectives: The composition of the human diet is complex and diverse, and the relationship between dietary composition and cognitive decline has not been adequately studied. Therefore, this study explored the possible association between food items and the risk of cognitive impairment. Methods and Study Design: This cross-sectional study was based on an ecological longevity cohort and included 2881 participants (1086 men and 1795 women) aged ≥30 years between December 2018 and November 2019. The association between food items and the risk of cognitive impairment was explored using the Bayesian kernel machine regression (BKMR) learning model. Results: Finally, 2881 participants (1086 men and 1795 women) were included. In all participants, the multivariable logistic analysis showed that fresh fruit consumption was associated with cognitive function (OR=0.999, 95% CI: 0.998-0.999, p=0.021). Using the BKMR model, none of the 18 food items were significantly correlated with cognitive function among women. In men, when the other food items were fixed at the 25th, 50th, and 75th percentile values (P25, estimate=-0.239; P50, estimate=-0.210; P75, estimate=-0.158), there was a negative correlation between fresh fruit consumption and the predicted risk of cognitive function disorders. Conclusions: Men displayed a negative association between fresh fruit consumption and the risk of cognitive function disorders, but this was not apparent among women.
Background and Objectives: To explore the relationship between water intake, hydration biomarkers and physical activity of young male athletes. Methods and Study Design: A 7-day cross-sectional study was conducted among 45 male athletes aged 18-25 years in Beijing, China. Total drinking fluids (TDF) was obtained using 7-day 24-h fluid intake questionnaire. Water from food (WFF) was assessed using the methods of food weighing, duplicate portion method and laboratory analysis. Physical activity was evaluated using physical activity energy expenditure (PAEE) and metabolic equivalent of task (MET). Results: Totally, 42 participants completed the study. The medians of total water intake (TWI), TDF and WFF of participants were 2771 mL, 1653 mL and 1088 mL respectively. Jonckheere-Terpstra test showed a significant increase trend toward higher TWI and TDF with higher PAEE level (Z=2.414, p=0.016; Z=2.425, p=0.015). Spearman’s rank correlation showed that TWI was positively correlated with PAEE (rs=0.397, p=0.009). TDF showed a positive correlation with PAEE and MET (rs=0.392, p=0.010; rs=0.315, p=0.042). The median urine volume was 840 mL, urine specific gravity was 1.020, and 24-h urine osmolality was 809 mOsm/kg. Significant differences were found in plasma cortisol among the four MET groups (χ2=8.180; p=0.042). Conclusions: Young male athletes with higher physical activity level had higher amounts of TWI and TDF than their counterparts but had similar hydration biomarkers. There was a high incidence of dehydration in athletes, and attentions need to be paid on the intake of TDF among them to maintain the optimal hydration status.
Background and Objectives: The relationship between dietary folate intake and Non-alcoholic fatty liver disease (NAFLD) is controversial. This study aimed to investigate the relationship between dietary folate equivalent (DFE) intake and NAFLD in U.S. adults. Methods and Study Design: Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 were used. NAFLD was defined as a US fatty liver index (FLI) value ≥30. DFE intake was assessed by two 24-hour dietary recall interviews. Multivariable logistic regression models and restricted cubic spline models were used to investigate the association between DFE intake and NAFLD risk. Results: A total of 6,603 adult participants were included in this study. After adjusting for multiple confounding factors, the odds ratios and 95% confidence intervals of NAFLD for the highest quartile versus lowest quartile of DFE intake was 0.77(0.59-0.99). In stratified analyses by sex, age, and body mass index (BMI), there were statistically significant negative associations between DFE intake and NAFLD risk in women and participants with BMI ≥25. Dose-response analysis indicated a negative linear correlation between DFE intake and NAFLD risk. Conclusions: Dietary folate equivalent intake is negatively associated with NAFLD risk in the general U.S. adult population.
Background and Objectives: Intestinal permeability (IP) is known to contribute to the immune system activation and inflammation; thus, it is proposed to have a role in the pathogenesis and exacerbation of many chronic diseases. Several studies have indicated that diet and nutritional status are risk factors for increased IP. In this mini review, we discussed the recent evidence on the association of diet, nutritional status, and intestinal permeability assessed by zonulin concentrations in serum and feces. Methods and Study Design: Literature searching was conducted in Pubmed, ProQuest and Google Scholar using the keywords “diet quality”, “intestinal permeability”, “nutritional status”, and “zonulin” combined with Boolean operators “AND” and “OR”. Results: Some studies indicated that intake of proper nutrition and good diet such as low total calorie intake, high intakes of omega-3 polyunsaturated fatty acids, fiber, vitamins, minerals, probiotics, and polyphenol-rich diet have significant impact on improvement of intestinal permeability marked by lower zonulin concentrations. Higher zonulin concentrations are found in those with overweight and obesity indicating that these population have increased IP. Most studies were conducted in adults and there are limited studies in children and adolescents. In addition, no studies have assessed diet quality to obtain a comprehensive picture on the complexities of diet in the population in relation to intestinal permeability. Conclusions: Diet and nutritional status are linked to zonulin concentrations, indicating a role in intestinal permeability. Further research should be conducted to investigate the relationship between diet quality, as measured by appropriate diet quality indices, and intestinal permeability in children, adolescents, and adults.
Background and Objectives: Evidence for gene-diet interactions is lacking among individuals with specific dietary practices including vegetarians. This study aimed to determine the interactions of rs174547 in the fatty acid desaturase 1 (FADS1) gene with macronutrient such as carbohydrate (particularly fibre), protein and fat intakes on abdominal obesity among middle-aged Malaysian vegetarians of Chinese and Indian ethnicity. Methods and Study Design: The present cross-sectional study was conducted among 163 vegetarians in Kuala Lumpur and Selangor, Malaysia. Dietary intakes of vegetarians were assessed by using a food frequency questionnaire. Waist circumference of vegetarians was measured by using a Lufkin tape W606PM. Genotypes of the rs174547 of vegetarians were determined by using Agena® MassARRAY. A multiple logistic regression model was used to determine the interactions of the rs174547 with macronutrient on abdominal obesity. Results: About 1 in 2 vegetarians (51.5%) had abdominal obesity. Individuals with CT and TT genotype at T3 intake of carbohydrates, protein, fat and fibre as well as individuals with TT genotype at T2 intake of carbohydrates and protein had higher odds of abdominal obesity (pinteration <0.05). The gene-diet interaction remained significant for fibre intake (OR: 4.71, 95% CI: 1.25-17.74, pinteraction=0.022) among vegetarians with TT genotype at T2 intake of fibre after adjusting for age and sex and considering the effects of ethnicity and food groups. Conclusions: The rs174547 significantly interacted with fibre intake on abdominal obesity. A specific dietary fibre recommendation based on genetics is needed among Chinese and Indian middle-aged vegetarians.
Background and Objectives: Osteoporosis is a common complication of chronic obstructive pulmonary disease (COPD). It is impractical to measure bone mineral density (BMD) in all patients with COPD. This study aimed to investigate the relationship between Mini Nutritional Assessment Short-Form (MNA-SF), a simple nutritional status questionnaire, and osteoporosis, and to determine whether it can be used as a reliable screening tool for osteoporosis in patients with COPD. Methods and Study Design: Thirty-seven patients with stable COPD were enrolled in this prospective cohort study. Patients with MNA-SF scores >11 were defined as well-nourished, and those with scores of ≤11 being at risk for malnutrition. Body composition, BMD, and undercarboxylated osteocalcin (ucOC), a bone metabolism marker, were measured using bioelectrical impedance, dual energy X-ray, and electrochemiluminescence immunoassay, respectively. Results: Seventeen (45.9%) were classified as at risk for malnutrition, and 13 (35.1%) had osteoporosis. Patients at risk for malnutrition had significantly more osteoporosis and higher ucOC values than well-nourished patients (p=0.007, p=0.030, respectively). Patients with osteoporosis also had significantly lower body mass index (BMI) and fat-free mass index than those without osteoporosis (p= 0.007 and p=0.005, respectively), although FEV1 % pred was not significantly different. MNA-SF (cutoff value; 11) had better sensitivity to identify the presence of osteoporosis than BMI (cutoff value; 18.5 kg/m2) (sensitivity, 0.769; specificity, 0.708; sensitivity, 0.462; specificity, 0.875, respectively). Conclusions: MNA-SF was associated with osteoporosis and bone metabolism markers in patients with COPD. MNA-SF may be a useful screening tool for osteoporosis in patients with COPD.
Background and Objectives: We aimed to apply a novel nutrition screening tool to stroke patients and assess its reliability and validity. Methods and Study Design: Cross-sectional data among 214 imaging-confirmed stroke patients were collected between 2015 and 2017 in two public hospitals in Hebei, China. Delphi consultation was conducted to evaluate the items in the NRS-S scale. Anthropometric indices including body mass index (BMI), triceps skin fold thickness (TSF), upper arm circumference (AMC) and mid-arm muscle circumference (MAMC) were measured. Internal consistency reliability, test-retest reliability, construct validity and content validity were assessed. In order to estimate content validity, two rounds Delphi consultation of fifteen experts were conducted to evaluate the items in the Nutrition Risk Screening Scale for Stroke (NRS-S). Results: High internal consistency was indicated by Cronbach’s alpha of 0.632 and a split-half reliability of 0.629; test-retest reliability of NRS-S items ranged from 0.728 to 1.000 (p˂0.0001), except for loss of appetite (0.436, p˂0.001) and gastrointestinal symptoms (0.213, p=0.042). Content validity index of 0.89 indicated robust validity of the items. Regarding construct validity, the Kaiser-Meyer-Olkin value was 0.579, and the result of the Bartlett test of sphericity was 166.790 (p˂0.001). Three factors were extracted by exploratory factor analysis, which contributed to 63.079% of the variance. Confirmatory factor analysis was performed on the questionnaire, finding the p-value of the model to be 0.321, indicating a high model fitting index. Conclusions: A novel stroke-specific nutritional risk screening tool demonstrated a relatively high reliability and validity in its clinical application.
Background and Objectives: The impacts of nutritional status on clinical outcomes in children receiving umbilical cord blood stem cell transplantation (UCBT) are not fully described. We evaluated the risk for malnutrition before transplantation admission and influence of weight loss during hospitalization on short-term clinical outcomes in children with UCBT. Methods and Study Design: We conducted a retrospective study of pediatric patients up to age 18 years who received UCBT and were treated at the Children’s Hospital of Fudan University between January 2019 and December 2020. Results: The mean age of the 91 patients was 1.3 years, with 78 (85.7%) men and 13 (14.3%) women (p<0.001). UCBT was performed mostly for primary immunodeficiency disease (PID) (83, 91.2%). The weight loss differences among children with different primary diseases were statistically significant (p=0.003). Children with a large amount of weight loss during hospitalization (n = 24) had higher risks of skin graft-versus-host disease (GVHD) (multivariate OR=5.01, 95% CI: 1.35-18.65), intestinal GVHD (multivariate OR=7.27, 95% CI: 1.74-30.45), a longer median hospital stay (p=0.004), higher antibiotic costs (p=0.008) and higher total hospitalization costs (p=0.004). Malnutrition on admission was significantly positively correlated with longer parenteral nutrition (PN) time (p=0.008). Early nutritional intervention effects on clinical outcomes need further assessment. Conclusions: Underweight recipient child and excessive weight loss during transplantation increases the length and cost of hospital stay, and is associated with a high incidence of GVHD, which affects the prognosis of transplantation and medical resources consumption.
Background and Objectives: Observational studies have shown that energy restriction could be beneficial for controlling bodyweight in patients with polycystic ovary syndrome (PCOS). We aim to compare the effects of a high-protein diet (HPD), a high-protein and high-dietary fiber diet (HPHFD), and a calorie-restricted diet (CRD) on metabolic health and gut microbiota in overweight/obese PCOS patients. Methods and Study Design: We will enroll a total of 90 overweight/obese PCOS patients into this eight-week open-label randomised controlled trial. Participants will be randomly assigned to three groups: CRD group (energy coefficient 20 kcal/kg.day, water ≥1500 mL, 0.8-1.2 g/kg protein, carbohydrate energize 55-60%, and fat energize 25-30%), HDP group (energy coefficient 20 kcal/kg.day, water ≥1500 mL, and 1.5-2.0 g/kg protein) and HPHFD group (based on the high protein diet with 15 g more dietary fiber supplement). The primary outcome is body weight, body fat percentage, and lean body mass. The secondary outcomes will include changes in blood lipids, inflammation, glucose tolerance, blood pressure, and gut microbiota compositions. Between-group differences in adiposity measurements at baseline will be compared using one-way analysis of variance (ANOVA) or Kruskal-Wallis test when appropriate. Within-group difference after 8-week intervention will be compared using paired t-test or Wilcoxon signed rank test. Between-group differences in adiposity measurements after 8-week diet intervention will be compared using linear mixed model and ANCOVA. The gut microbiota will be analyzed using 16S amplicon sequencing and the sequencing data will be analyzed using the standardized QIIME2 piperline.
Background and Objectives: Barley mixed rice, “Mugi gohan,” is traditionally eaten with yam paste in Japan. Both ingredients contain dietary fiber and reportedly reduce postprandial hyperglycemia. However, evidence supporting the benefits of combining barley mixed rice with yam paste is limited. In this study, we evaluated whether ingesting a combination of barley mixed rice and yam paste affected postprandial blood glucose concentration and insulin secretion. Methods and Study Design: This study followed an open-label, randomized controlled crossover design, following the unified protocol of the Japanese Association for the Study of Glycemic Index. Fourteen healthy subjects each consumed four different test meals: white rice only, white rice with yam paste, barley mixed rice, and barley mixed rice with yam paste. We measured their postprandial blood glucose and insulin concentrations after every meal, and we calculated the area under curve for glucose and insulin. Results: Participants had significantly reduced area under curve for glucose and insulin after eating barley mixed rice with yam paste compared to when they ate white rice only. Participants had similar area under curve for glucose and insulin after eating barley mixed rice only, or eating white rice with yam paste. Participants had lower blood glucose concentrations 15 min after eating barley mixed rice only, whilst eating white rice with yam paste did not maintain lower blood glucose after 15 min. Conclusions: Eating barley mixed rice with yam paste decreases postprandial blood glucose concentrations and reduces insulin secretion.
Background and Objectives: Few studies exist on resistant starch in rice grains. The Okinawa Institute of Science and Technology Graduate University (OIST) has developed a new rice (OIST rice, OR) rich in resistant starch. This study aimed to clarify the effect of OR on postprandial glucose concentrations. Methods and Study Design: This single-center, open, randomized, crossover comparative study included 17 patients with type 2 diabetes. All participants completed two meal tolerance tests using OR and white rice (WR). Results: The median age of the participants was 70.0 [59.0–73.0] years, and the mean body mass index was 25.9±3.1 kg/m2. The difference in total area under the curve (AUC) of plasma glucose was -8223 (95% confidence interval [CI]: -10100 to -6346, p<0.001) mg·min/dL. The postprandial plasma glucose was significantly lower with OR than with WR. The difference in the AUC of insulin was -1139 (95% CI: -1839 to -438, p=0.004) µU·min/mL. The difference in the AUC of total gastric inhibitory peptide (GIP) and total glucagon-like peptide-1 (GLP-1) was -4886 (95% CI: -8456 to -1317, p=0.011) and -171 (95% CI: -1034 to 691, p=0.673) pmol·min/L, respectively. Conclusions: OR can be ingested as rice grains and significantly reduced postprandial plasma glucose compared to WR independent of insulin secretion in patients with type 2 diabetes. OR could have escaped absorption not only from the upper small intestine but also from the lower small intestine.
Background and Objectives: To describe nutritional status and inflammation of elderly patients with chronic kidney disease and to confirm the association between a Malnutrition-Inflammation Score and physical function and functional disability. Methods and Study Design: A total of 221 chronic kidney disease patients (aged ≥60 years) were included. A malnutrition-Inflammation Score was used to assess malnutrition and inflammation. Physical function was assessed using the SF-12. Functional status was evaluated using basic activities of daily living and instrumental activities of daily living. Results: Thirty percent of participants had a Malnutrition-Inflammation Score ≥6, which denoted poor nutritional status. Participants with a Malnutrition-Inflammation Score ≥6 had decreased concentration of hemoglobin, albumin, prealbumin, handgrip strength and walking speed and increased concentration of inflammatory markers, including CRP, IL-6 and fibrinogen. Physical function and physical component summary were lower and basic activities of daily living dependence and instrumental activities of daily living dependence were higher among patients with higher Malnutrition-Inflammation Score than those with a lower Malnutrition-Inflammation Score. The Malnutrition-Inflammation Score was an independent risk factor for physical function and instrumental activities of daily living dependence. Conclusions: The elderly chronic kidney disease patients with a high Malnutrition-Inflammation Score had a decreased physical function and an increased risk of functional instrumental activities of daily living dependence.