APJCN

Nutrition science has been represented as biomedical, environmental, societal and economic field, but quantum biology is sidestepped, thereby obscuring cognate problems and solutions. We are generally nourished for health, optimal well-being, longevity and personal security through sustainable livelihoods. Our nourishments include not only food and energy but also light from the sun, the firmament and the earth itself, along with information transmitted in subatomic particles and electromagnetic wave forms. We propose ‘quantum nutrition’ as an approach to reconcile quantum phenomena with nutritional biology. Appreciating quantum nutrition and recognizing its potential applications will provide opportunities for future health and well-being and for planetary habitability.

Background and Objectives: Mechanism studies have indicated that magnesium (Mg) and calcium (Ca) have important biological functions in glucose regulation, but epidemiological data on their associations with glycosylated hemoglobin (HbA1c) are sparse. We aimed to explore the associations of Mg and Ca with abnormal HbA1c, and examine the mediating effects of inflammation in coronary artery disease (CAD) Chinese adults. Methods and Study Design: A hospital–based cross–sectional study of 11934 patients with CAD was conducted. Serum Mg and Ca concentrations were measured. Results: In multivariable analyses, Mg and Mg/Ca ratio were inversely associated with abnormal HbA1c (Q4 vs Q1: OR_Mg: 0.61, 95% CI_Mg: 0.53, 0.71; OR_{Mg/Ca ratio}: 0.67, 95% CI_{Mg/Ca ratio}: 0.54, 0.84). However, null association of Ca with abnormal HbA1c was shown (Q4 vs Q1: OR: 1.15, 95% CI: 0.92, 1.44). Serum Mg and Mg/Ca ratio were inversely associated with abnormal fasting blood glucose (FBG). In contrast, serum Ca was positively associated with abnormal FBG. Path analysis indicated that there were no mediating effects of hypersensitivity C reactive protein (hsCRP) on Mg and Mg/Ca-abnormal HbA1c associations. Conclusions: Our study suggested that serum Mg and Mg/Ca ratio were inversely associated with abnormal HbA1c in Chinese adults with CAD. The Mg-abnormal HbA1c relationship might not be mediated by hsCRP.

Background and Objectives: While previous population-based studies have suggested a link between serum vitamin D levels and depression in individuals with non-alcoholic fatty liver disease (NAFLD), the exact correlation between serum vitamin D and depression among NAFLD patients remains controversial and disputed. Thus, we conducted this study to evaluate the relationship between serum vitamin D and depression in NAFLD participants diagnosed via transient elastography. Methods and Study Design: This cross-sectional study was extracted from the latest NHANES 2017–2018 dataset. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) score of ≥10. NAFLD phenotype was identified by vibration-controlled transient elastography (VCTE) examination based on diagnostic criteria. Binary logistic regression models were applied to estimate the impact of increased serum vitamin D on the reduced risk of depression based on sample weights. Results: A total of 1339 participants with NAFLD were included in this investigation, of which 127 (8.58%) were diagnosed with depression according to PHQ-9 scores. Binary logistic regression analysis presented that high serum vitamin D level was a protective factor for depression in NAFLD (OR=0.61, 95% CI: 0.37–0.99, p=0.048) after adjusting for all confounding factors. In subgroup analyses, these associations were more pronounced among men (OR=0.32, 95% CI: 0.13-0.81, p=0.024) and obese population (OR=0.53, 95% CI: 0.33-0.86, p=0.019). Conclusions: Increased serum vitamin D was negatively associated to the prevalence of depression in males and obese individuals with NAFLD diagnosed by VCTE.

Background and Objectives: Growing evidence has explored the effects of water-soluble vitamins supplementation on glycemic control and insulin resistance in diabetic patients; however, the results of previous meta-analyses are inconsistent. To address this, we conducted an umbrella review to synthesize the evidence on these effects. Methods and Study Design: A systematic literature search in Web of science, PubMed, and Cochrane Database of Systematic Reviews was performed from 2012 to November 2022. he quality of the meta-analyses was assessed using AMSTAR-2 and GRADE. Results: Fourteen systematic reviews and meta-analyses met the inclusion criteria, examining the effects of five water-soluble vitamins (B-1, B-3, biotin, B-9, and C) on glycemic control and insulin resistance. The findings suggest that vitamin C supplementation can improve glycemic control in type 2 diabetes, as indicated by reduced FBG and HbA1c, with more significant effects observed for durations longer than 30 days. Conclusions: Insulin resistance is improved by folic acid supplementations. More well-designed individual randomized controlled trials are needed in the future, as well as meta-analysis of higher quality.

Background and Objectives: This study investigated the influence of dietary intake on the relationship between serum uric acid (SUA) levels and the risk of hypertension. Methods and Study Design: Data from the 7th and 8th Korean National Health and Nutrition Examination Survey, a nationally representative survey, were analyzed. A total of 19,140 adults aged 19–64 years were included. Dietary intake was assessed using a 24–hour recall method. SUA levels were measured using a Hitachi Automatic Analyzer 7600–210. Hypertension was defined as a systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medication. Statistical analyses included generalized linear regression, Cochran–Mantel–Haenszel analysis, and multivariate logistic regression. Results: The highest SUA quartile (Q4) had an odds ratio (OR) of 1.68 (95% CI: 1.41–1.99) for hypertension compared to the lowest quartile (Q1). Additionally, the association between elevated SUA levels and increased hypertension risk was stronger in participants who consumed fewer fruits (OR: 1.79, 95% CI: 1.44–2.21), vegetables (1.80, 1.43–2.25), nuts (1.87, 1.51–2.33), and milk (2.20, 1.73–2.79). The ORs (95 % CI) for the highest SUA quartile on hypertension were 1.68 (1.39–2.04), 1.35 (1.13–1.62), and 1.89 (1.57–2.27) in those consuming more seafood, meat, and alcohol, respectively. Conclusions: Reduced intake of fruits, vegetables, nuts, and milk, and increased consumption of seafood and alcohol, exacerbates the positive association between SUA levels and the risk of hypertension. These findings suggest dietary modifications as a potential strategy for hypertension prevention and management.

Background and Objectives: Prioritizing key preventive and therapeutic interventions is one of the actions to accelerate the reduction of anemia. This study aimed to examine interventions designed to prevent anemia. Methods and Study Design: A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Analysis of publication bias was done using The Joanna-Briggs Institute critical appraisal tool. Data collected from articles included author, year of publication, setting and location of the study, study type, participant of the study, intervention and control given, main outcome, main findings, and risk of bias. Results: Three nutrition-specific interventions aimed at preventing iron deficiency anemia in low- and middle-income countries used various types and dosages of iron. While most studies showed success, some indicated a worsening trend in anemia, even with standard dosages and the same form of iron. Determining effective interventions requires consideration of factors such as other micronutrient composition, compliance rate, availability of educational intervention, and dietary backgrounds in those countries. Conclusions: Supplementation, fortification, and food-based interventions generally lead to higher hemoglobin levels and a lower prevalence of anemia. However, it is important to consider several factors before deciding on an approach.

Background and Objectives: Nutrient Reference Values (NRVs) play an important role in nutrition labeling and nutrition and health claims based on scientific data. This study, with a global perspective, reviewed recent trends in NRVs for adults and their establishment for infants and toddlers. Methods and Study Design: We searched for laws and regulations on official government websites for nutrition labeling in the United States, Canada, Australia, New Zealand, China, South Korea, Japan, the Codex Committee, and the European Union. Results: NRV revisions have been made in the United States, Canada, and South Korea. In the United States and Canada, NRVs for most nutrients, including macronutrients, vitamins, and minerals, were revised in 2016, reflecting updated Dietary Reference Intakes and new scientific findings. NRVs for infants and toddlers have already been formulated in the United States, Canada, Australia, New Zealand, and South Korea and are used for nutrition labeling. However, concerns have been raised regarding the labeling of all foods with NRVs for infants and toddlers, which may result in challenges in distinguishing foods formulated under different standards as appropriate for infants and toddlers. Conclusions: This study highlights recent general NRV revisions and formulation status for infants and toddlers. This provides useful information for determining the basis for future updates and the development of NRVs in various countries.

Background and Objectives: Dyslipidemia has been reported to contribute to the psoriasis pathogenesis. Thus, evinacumab, a novel lipid-lowering drug targeting angiopoietin-like 3, may have therapeutic potential to treat and/or manage psoriasis. Methods and Study Design: Summary statistics were obtained from genome-wide association studies addressing psoriasis (FinnGen Consortium; n=216,752) and serum lipid concentrations (United Kingdom Biobank; n=403,943–440,546). Two-sample Mendelian randomization analyses were conducted to evaluate the associations of serum lipid concentrations and genetically mimicked effects of evinacumab, respectively, with the risks of psoriasis and its subtypes. Results: Genetically determined per standard deviation increase in triglyceride concentrations was associated with increased risk of psoriasis (OR: 1.17, 95% CI: 1.03–1.32, p=0.018), whereas that in low-density lipoprotein-cholesterol (LDL-C) was associated with both psoriasis (OR: 1.22, 95% CI: 1.05–1.43, p=0.011) and its subtypes, including arthropathic psoriasis (OR: 1.30, 95% CI: 1.02–1.65, p=0.032), psoriasis vulgaris (OR: 1.87, 95% CI: 1.16–2.99, p=0.0095), and guttate psoriasis (OR: 2.19, 95% CI: 1.17–4.07, p=0.014). Moreover, genetically mimicked effects of evinacumab, via angiopoietin-like 3 inhibition, significantly reduced the risk of psoriasis (OR: 0.752 per standard deviation reduction in triglycerides, 95% CI: 0.577–0.982, p=0.036) and arthropathic psoriasis (OR: 0.266 per standard deviation reduction in LDL-C, 95% CI: 0.0886–0.799, p=0.018). Conclusions: The genetically mimicked effect of evinacumab has the potential to reduce the risk of psoriasis and arthropathic psoriasis by lowering circulating triglyceride and LDL-C concentrations, respectively. These findings suggest that evinacumab may help prevent psoriasis and psoriatic arthritis progression in clinical practice.

Background and Objectives: Previous studies have reported there were associations between ovarian function and dietary factors, metabolic factors and gut microbiota. However, it is unclear whether causal associations exist. We aimed to explore the causal relationship of these factors with risk of primary ovarian failure (POF). Methods and Study Design: Two-sample Mendelian randomization (MR) analysis was performed to genetically predict the causal effects of dietary and metabolic factors and gut microbiota on POF. The inverse variance weighted (IVW) method was used as the primary statistical method. A series of sensitivity analyses, including weighted median, MR-Egger, simple mode, weighted mode methods, and leave-one-out analysis, were conducted to assess the robustness of the MR analysis results. Results: IVW analysis revealed that cigarettes smoked per day, coffee intake and cooked vegetable intake were not causally correlated with POF at the genetic level. However, POF were associated with fresh fruit intake, BMI, Eubacterium (hallii group), Eubacterium (ventriosum group), Adlercreutzia, Intestinibacter, Lachnospiraceae (UCG008), and Terrisporobacter. These findings were robust according to extensive sensitivity analyses. Conclusions: This study identified several dietary factors, metabolic factors and gut microbiota taxa that may be causally implicated in POF, potentially offering new therapeutic targets.

Background and Objectives: This study aimed to investigate the respiratory quotient (RQ) levels and its trend in the early postoperative period of patients with heart disease. Additionally, we explored factors influencing RQ and evaluated the predictive capabilities of RQ and lactic acid for various outcomes. Methods and Study Design: In this prospective observational study, participants included were heart disease patients aged 18-80 years who underwent elective open-heart surgery and were subsequently admitted to the cardiothoracic surgery ICU post-operation. Indirect calorimetry (IC) measurements were conducted on patients during the first three days after surgery to assess their RQ levels. Clinical data, including personal information, postoperative characteristics, and duration of surgery, were documented based on the patient's medical history. Results: In this study, 135 patients, of whom 57.04% were male, underwent a total of 247 IC measurements following cardiac surgery. On the first, second, and third days of admission to the ICU, the RQ values were 0.77±0.09, 0.80±0.07, and 0.78±0.05, respectively. The ROC curve analysis showed that on the first day of admission to the ICU, RQ was a better predictor of prolonged mechanical ventilation, LOS in ICU, and LOS in hospital compared to lactate level. However, on the second day of ICU admission, neither RQ nor lactate level could predict longer durations of mechanical ventilation, LOS in ICU, and LOS in hospital. Conclusions: RQ may serve as a potential predictor for LOS in patients after cardiac surgery.

Background and Objectives: This study aimed to investigate readiness for hospital discharge of patients requiring home nutrition support and explore the factors that influence this readiness. Methods and Study Design: This cross-sectional survey included 220 patients discharged from the general surgery department of a tertiary-care teaching hospital in China with home nutrition support. Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale scores were calculated and general, disease- and therapy-related information were collected. Univariate, correlation, and multiple linear regression analyses were performed. Results: The mean standardized total Readiness for Hospital Discharge Scale score was 7.33±1.65, with the subscales expected support, personal status, perceived coping ability, and knowledge scoring 7.40±1.78, 7.35±1.66, 7.30±1.73, and 7.26±1.74, respectively. The mean standardized Quality of Discharge Teaching Scale score was 7.48±1.59. The Quality of Discharge Teaching Scale score, length of hospital stay, expected length of home nutrition support, first-time use of home nutrition support, Nutrition Risk Screening 2002 score, and diagnosis were all identified as influencing factors of readiness for discharge (adjusted R²=0.564, F=14.5, p<0.001). Conclusions: Patients requiring home nutrition support were only moderately ready for discharge. Enhancing the quality of education on patient discharge could significantly improve readiness for discharge, in which patients who have been admitted for longer periods require more attention. They are expected to utilize home nutrition support in the long-term, are at risk of malnutrition, are using home nutrition support for the first time, or have a digestive system malignancy.

Background and Objectives: The role of serum copper in modulating body composition in patients with spinal muscular atrophy (SMA) remains uncertain. This study aimed to illustrate the correlation between serum copper concentration and body composition in children with SMA. Methods and Study Design: This study was conducted at a pediatric medical center in China from July 2019 to August 2022. The study included anthropometric measurements, serum analysis for copper, magnesium, zinc, and iron, as well as comprehensive body composition assessments. Multivariate analysis was utilized to assess the connection between serum copper concentration and body composition metrics. Results: This cross-sectional analysis included 87 patients [median (IQR) age: 7 years (5–10), 57.5% male] diagnosed with SMA receiving comprehensive multidisciplinary management. The results revealed a positive association between serum copper concentration and both fat mass percentage (β = 0.50, 95% confidence interval (CI): 0.07 to 0.92, p = 0.025) and fat-muscle ratio (β = 0.02, 95% CI: 0.01 to 0.03, p = 0.009). Conversely, a negative correlation was found between serum copper concentration and muscle mass percentage (β = -0.70, 95% CI: -1.11 to -0.29, p = 0.001). Conclusions: These findings suggest a correlation between copper concentration and body composition in SMA, offering valuable insights for addressing metabolic dysregulation in these patients.

Background and Objectives: This cross-sectional study aimed to examine associations between diet quality scores and adverse cardiometabolic status in young Japanese women. Methods and Study Design: In total, 1084 female dietetics students aged 18–22 years completed a validated self-administered diet history questionnaire. Diet quality was assessed using the Diet Quality Score for Japanese (DQSJ), Healthy Eating Index-2015 (HEI-2015), Alternate Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet score (AMED), Dietary Approaches to Stop Hypertension score (DASH), and Japanese Food Guide Spinning Top score (JFGST). Adverse cardiometabolic status was defined as the highest quartile of the sum of z scores for waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (multiplied by –1), triacylglycerol, glucose, and insulin. Results: After adjustment for potential confounding factors, adverse cardiometabolic status was significantly associated with all the diet quality scores except for AMED, with adjusted odds ratios (95% confidence interval) in the highest quartile compared with the lowest of 0.39 (0.25–0.61) for DQSJ, 0.40 (0.26–0.61) for DASH, 0.44 (0.30–0.66) for AHEI-2010, 0.59 (0.39–0.88) for HEI-2015, 0.67 (0.45–0.99) for JFGST, and 0.80 (0.54–1.18) for AMED. Associations with each of the cardiometabolic risk factors were most prominent for AHEI-2010 (significant associations with all factors except triacylglycerol), followed by DQSJ (significant associations with all factors except triacylglycerol and glucose). Conclusions: This cross-sectional study of young Japanese women showed associations between several diet quality scores and cardiometabolic status. These associations should be confirmed in other populations, prospectively where possible.