Background and Objectives: Chronic Heart Failure (CHF) is one of the leading cardiovascular diseases (CVDs), particularly in the Asian population. Individuals with specific health risks, such as obesity, type 2 diabetes, hypertension, dyslipidemia, and coronary artery disease (CAD), are more susceptible to developing CHF. Current evidence is limited to understanding the link between gut microbiota dysbiosis and CHF. Therefore, this review aims to explore the potential connection between dietary patterns, gut microbiota, and its metabolites in individuals at risk of CHF in the Asian population. Methods and Study Design: A literature review of cross-sectional studies was conducted using primary keywords such as "Asian", "obesity", "type 2 diabetes", "hypertension", "dyslipidemia", "coronary artery disease", and "chronic heart failure". There was no restriction on sample size. Results: Several gut microbiotas were found to correlate with CHF risk factors. There were increased levels of Prevotella, Klebsiella, Romboutsia, Catenibacterium, Clostridium, Holdemanella, Ruminococcus, Coprococcus, Parabacteroides, Bacteroides, Lachnoclostridium, Streptococcus, and Megamonas, while decreased levels of Oscillibacter, Bifidobacterium, Lactobacillus, Akkermansia, Roseburia, Faecalibacterium, Pseudobutyrivibrio, and Eubacterium were reported. These microbiota shifts were linked to increased TMAO production and impaired short-chain fatty acids (SCFAs) production. Dietary intake and microbial metabolites were also identified as contributors to the gut microbiota associated with CHF. Conclusions: A potential link exists between the gut microbiota profile and CHF risk factors, possibly mediated by microbial metabolites. Dietary patterns may influence CHF-associated gut microbiota and metabolites. Future research is needed to investigate how dietary modifications can modulate gut microbiota and its metabolites in CHF patients.
Background and Objectives: Measurement of vitamin B-12 deficiency using different methods may cause diagnostic difficulties. In order to rapidly and safely diagnose vitamin B-12 deficiency, it is important to determine the reference ranges of serum B-12 and its related biomarkers such as homocysteine, holotranscobalamine (holo-TC) and methylmalonic acid (MMA). This study aimed to determine reference interval (RI)s for serum vitamin B-12 and related markers. Methods and Study Design: Samples were collected from 404 young-to-middle-aged healthy adults aged 18-65 years. Vitamin B-12, homocysteine, holotranscobalamin, folate were analyzed using the Arcitect i2000 device. Plasma MMA was analyzed by LC/MS. RIs were then evaluated accordingly. Results: Vitamin B-12, folate, homocysteine, holotranscobalamin and plasma MMA were 139-619 pg/mL, 3.0-14.7 ng/mL, 5.6-18.4 μmol/L, 10.7-101 pmol/L, and 0.01-0.8 μmol/L, respectively. Age group-specific RIs were also generated. Conclusions: This study revealed that the diagnosis of vitamin B-12 deficiency should not only be based on serum vitamin B-12 levels, but also of folate, homocysteine, holotranscobalamin and MMA levels; all which are related to vitamin B-12 metabolism.
Background and Objectives: This study aimed to examine whether eating alone, folate intake, and n-3 PUFA intake are independently associated with psychological distress in older adults. Methods and Study Design: We analyzed cross-sectional data from 1011 study participants aged ≥65 years in Japan. We assessed psychological distress using the Kessler 6 scale, whether the participants ate alone or with others, folate and n-3 PUFA intake using a short food frequency questionnaire. Results: Of the 1011 study participants, 465 (46.0%) were male and mean (SD) age was 71.6 (4.8) years. In a multivariable logistic regression analysis, the odds ratio (OR) for psychological distress in participants eating alone compared to those eating with others was 1.32 (95% confidence interval [CI], 0.76–2.31). The ORs in the second and third tertiles compared to the first tertile, which had the lowest folate intake, were 0.92 (95% CI, 0.62–1.37) and 1.12 (95% CI, 0.73–1.73), respectively. The ORs in the second and third tertiles compared to the first tertile, which had the lowest n-3 PUFA intake, were 0.83 (95% CI, 0.56–1.24) and 0.95 (95% CI, 0.62–1.45), respectively. Also, the OR in those eating alone combined with the first tertile of n-3 PUFA intake compared to those eating with others with the third tertile was 2.18 (95%CI, 1.05–4.55). Conclusions: Although eating alone combined with low n-3 PUFA intake was associated with psychological distress in older adults, eating alone, folate intake, and n-3 PUFA intake were not independently associated with psychological distress.
Background and Objectives: Sarcopenia is the progressive loss of muscle mass and strength that can adversely affect an individual’s health and quality of life. The objective of this study was to evaluate the effectiveness of a combined nutritional and exercise intervention among older adults who were at risk of sarcopenia. Methods and Study Design: 46 older adults were included in a 30±3 days intervention that combined oral nutritional supplements with resistance exercise. Parameters were measured at baseline (day 0) and after intervention (day 30±3), including routine parameters of sarcopenia, blood tests, and body measurements. The ITT analysis method was used, and the data were analysed using paired t-tests/paired Wilcoxon test, and ANOVA. Results: Among the 46 participants, there were no significant changes in hip circumference (HC), muscle mass of both lower limbs, appendicular skeletal muscle mass index (ASMI), and hemoglobin (Hb) after intervention. However, both hand grip strength (GS) significantly increased, as did muscle mass of both upper limbs and the total muscle strength. Blood tests showed a slight increase in albumin (ALB) levels and a significant increase in 25-OH-D levels, while the waist (WC) and calf circumferences (CC) also increased significantly after intervention. Somatic motor performance improved significantly in the 6-meter walk and 5 sit-ups tests. Conclusions: The combined nutritional and exercise intervention was feasible and effective in improving muscle mass and strength, especially in the upper limbs, as well as somatic motor performance among older adults at risk of sarcopenia. It could be beneficial among three stages of sarcopenia.
Background and Objectives: Evidence regarding the relationship between dietary and plasma lutein + zeaxanthin (L + Z) levels and the risk of depression is scarce. This study aimed to investigate the associations of dietary consumption of L + Z and plasma L + Z level with risk of depression in adult of United States by using data from National Health and Nutrition Examination Survey (NHANES). Methods and Study Design: A total of 7,829 and 7,324 individuals aged ≥ 20 years were included from the NHANES to analyze the relationship between dietary L + Z and depression, as well as plasma L+ Z levels with the risk of depression, separately. Multivariable logistic regression analyses were used. Subsequently, the dose-response relationships were conducted using restricted cubic splines. Results: In the multivariable model, the highest quartile of dietary L + Z intake was associated with a significantly lower risk of depression compared to the lowest quartile (OR = 0.68, 95%CI: 0.52, 0.89, p ˂ 0.01). Similarly, the highest quartile of plasma L + Z levels was linked to a reduced risk of depression compared to the lowest quartile (OR = 0.58, 95%CI: 0.44, 0.76, p < 0.001). Conclusions: This study suggests that an appropriate increase in dietary L + Z intake and higher plasma L + Z levels are associated with a lower risk of depression. These results should be confirmed by randomized controlled trial (RCTs) to explore the effects of supplementing L + Z on depression.
Background and Objectives: Diabetes mellitus (DM) is a major public health problem worldwide. Numerous traditional plants are used for preventing DM. However, limited evidence supports the association between garlic consumption and DM. Methods and Study Design: Data used in this study was from the 2008-2018 Chinese Longitudinal Healthy Longevity Survey. Data on garlic consumption was obtained by questionnaire, and DM by self-reported diagnosis. A multivariate adjusted Cox regression model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) to determine the incidence of DM. Results: A total of 1927 participants were included in this study, of which 24.08% consumed garlic daily and 20.08% developed DM. The HR for daily garlic consumption decreased by 42%, when compared to rare or no garlic consumption. Our subgroup analyses revealed that daily garlic consumption significantly reduced the risk of DM in older adults aged 65-79, rural, non-drinkers informal education, financial dependence, and working in agriculture (aged 65-79: HR = 0.54, 95% CI: 0.36–0.80; rural area: HR = 0.48, 95% CI: 0.29–0.77; non-drinkers: HR = 0.60, 95% CI: 0.41–0.86; informal education: HR = 0.46, 95% CI: 0.29–0.74; financial dependence: HR = 0.39, 95% CI: 0.23–0.65; agricultural work: HR = 0.49, 95% CI: 0.32–0.76). Conclusions: Garlic consumption can reduce the risk of DM in older Chinese adults. This benefit varies by age, current residence, drinking status, education level, occupation, and economic source. Future efforts should focus on developing dietary intervention strategies that consider demographic, educational, financial, and occupational disparities to effectively prevent diabetes in older populations.
Background and Objectives: Postprandial hyperglycemia is a risk factor not only for diabetes mellitus, but also arteriosclerosis. Therefore, controlling the rapid postprandial increase in blood glucose levels is necessary. This study aimed to develop a mulberry leaf and water chestnut husk tea and investigate its effect on postprandial blood glucose levels. Methods and Study Design: We measured the polyphenols and 1-deoxynojirimycin contents as well as antioxidant activity of mulberry leaf and water chestnut husk tea in an in vitro experiment. The effect of the tea on postprandial blood glucose levels in 30 participants with borderline diabetes was investigated in a randomized, double-blind, placebo-controlled crossover comparison study. Results: The 1-deoxynojirimycin and total polyphenol contents in the tea (test food, 3g) were 10.2±0.8 and 61.3±1.4 mg, respectively. The test food showed higher antioxidant activity than the placebo food. Compared with those in the placebo group, blood glucose levels in the test group significantly decreased 30 and 60 min after eating rice. Additionally, insulin was significantly lower at all time points (30, 60, 90, and 120 min after rice consumption). Conclusions: The mulberry leaves and water chestnut mix tea may be an effective beverage to reduce insulin secretion and prevent rapid increases in blood glucose levels in patients with borderline diabetes.
Background and Objectives: The association of niacin intake with dyslipidemia remains uncertain. The aim of this study was to explore the association between dietary niacin intake and the prevalence of dyslipidemia among adults in the United States (US). Methods and Study Design: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2014. The exposure variable was dietary niacin intake, measured through 24-hour dietary recall interviews and treated as both a continuous and categorical variable. Dyslipidemia, defined by diagnostic criteria, was the outcome. Logistic regression and restricted cubic spline models were applied to examine the association between niacin intake and the prevalence of dyslipidemia. Results: Among the 19,275 individuals, the prevalence of dyslipidemia was 78.8%. Compared with individuals with lower niacin consumption Q1 (≤15.9 mg/day), the adjusted OR values for dietary niacin intake and dyslipidemia in Q3 (22.7–31.8 mg/day) and Q4 (≥31.8 mg/day) were 0.78 (95% CI: 0.64–0.94, p = 0.011) and 0.77 (95% CI: 0.61–0.98, p = 0.033), respectively. The association between niacin intake and the prevalence of dyslipidemia followed a L-shaped dose-response curve (non-linear, p = 0.009). Participants with a niacin intake of <22.3 mg/day exhibited an OR of 0.98 (95% CI: 0.96–0.99, p = 0.040) for dyslipidemia. In subgroup analyses, the inverse associations of niacin intake with the prevalence of dyslipidemia remained robust only in female. Conclusions: In the 2005-2014 NHANES population, higher levels of niacin intake were associated with decreased odds of dyslipidemia overall. Further studies are needed to examine the potential protective effects of niacin on dyslipidemia risk.
Background and Objectives: The proportion of noodles in the Korean diet is increasing, but the effect of noodle intake on metabolic syndrome has not been sufficiently investigated. Therefore, we investigated noodle consumption and its relation to metabolic syndrome in Korean adults. Methods and Study Design: This study was conducted on 10,505 adults using the combined data of the 2012–2016 Korea National Health and Nutrition Examination Survey (KNHANES). Noodle intake was evaluated with a food frequency questionnaire (FFQ) based on 112 food items. To compute odds ratios (ORs) and their 95% confidence intervals (CIs) controlled for confounders, multivariable logistic regression models were used. Results: Compared to people in the lowest levels of noodle intake, the OR of the metabolic syndrome of those in the highest levels was 1.48 (95% CI, 1.16-1.90; p-trend = 0.002). This positive association was also found for hypertriglyceridemia and abdominal obesity, which were metabolic syndrome components. Specifically, the odds of having hypertriglyceridemia were 38% (OR, 1.38; 95% CI, 1.14-1.66; p-trend < 0.001) higher for people with high noodle consumption compared to those with low noodle consumption in the overall population. The tendency for people who consume a lot of noodles to have raised odds of metabolic syndrome was observed when analyzed by the type of noodles. Conclusions: This study suggested noodle intake was positively related to metabolic syndrome and its components in Korean adults. Further clinical trials and prospective cohort studies are required to identify a causal relationship between noodle intake and metabolic syndrome in Koreans.
Background and Objectives: Previous studies on the risk factors for prolonged pleural effusion (PPE) have primarily focused on surgical-related risk factors, with little research exploring the influence of nutritional factors on this delay. This study aimed to identify the nutritional risk factors for PPE in Chinese infants following congenital heart disease (CHD) surgery. Methods and Study Design: We retrospectively reviewed the medical records of patients under 3 years old with chylothorax following CHD surgery from 2016 to 2020. PPE was defined as pleural effusion lasting over 14 days. Logistical regression analysis was conducted to identify the risk factors. Results: Of 136 patients, 42 patients developed PPE (30.9%). The PPE group had lower Height-for-Age Z-scores (HAZ) compared to the non-PPE group, while other demographic factors were not significantly different. Univariate analysis revealed that patients in PPE group exhibited delayed onset of chylothorax, prolonged duration of mechanical ventilation, increased chest effusion volume on the first postoperative day, and a reduced proportion of energy intake from enteral nutrition (EN) during the stable phase. Variables with p-value of <0.1 in univariate logistic regression analysis were included in the multivariate logistic regression analysis. A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ and a reduced proportion of energy intake from EN during the recovery phase. Conclusions: A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ, and a reduced proportion of energy intake from EN during the recovery phase predict a higher risk of PPE.
Background and Objectives: This study investigated the iodine status of pregnant women at an average altitude of approximately 2000 meters in Qujing, China. The relationship between iodine and thyroid function in different trimesters as well as adverse pregnancy and fetal outcomes were also investigated. Methods and Study Design: A total of 1,025 pregnant women who were admitted to Qujing Affiliated Hospital of Kunming Medical University from January 2019 to August 2021 were included. Urinary iodine concentration (UIC) was detected by colorimetric method, and serum thyroid function was detected by chemiluminescence. Among them, 537 pregnant women were followed up to analyze the association of iodine with adverse pregnancy and fetal outcomes. Results: The median UIC was 127 μg/L. Serum triiodothyronine, thyroxine, free triiodothyronine, and free thyroxine were negatively associated with urinary iodine concentration in the first and second trimesters of pregnancy. The proportion of pregnant women testing positive for thyroid peroxidase antibody (TPO-Ab) and the prevalence of thyroid autoimmunity (TAI) increased significantly in more-than-adequate iodine and excess iodine groups. Logistic regression analysis showed maternal iodine was not associated with adverse pregnancy and fetal outcomes. Conclusions: Mild iodine deficiency is common among pregnant women in plateau areas of China. The relationship between iodine and thyroid function is significant in the first and second trimesters of pregnancy, especially in those with moderate to severe iodine deficiency. Abnormal iodine level in pregnant women was not significantly associated with adverse pregnancy and fetal outcomes in areas with predominantly mild iodine deficiency.
Background and Objectives: To investigate the underlying inflammatory markers of frailty and evaluate the predictive power of frailty and nutritional risk screening (NRS) for in-hospital complications in elderly patients with hip fractures. Methods and Study Design: A total of 233 elderly patients with hip fractures participated in the study. Frailty and nutritional risk screening was performed on all participants, who were then divided into frail (‘frail only’ and ‘frail and malnourished’) and non-frail (‘robust’ and ‘malnourished only’) cohorts. The clinical data were collected for all participants, and in-hospital complications were followed up. Results: Among the patients, 39.9% were frail, 26.2% were malnourished and 15.5% were both frail and malnourished. The frail group were older and had higher Charlson comorbidity index (CCI) scores, systemic immune–inflammation index (SII) levels and fibrinogen levels than patients in the other cohorts. After adjusting for age, CCI and nutritional status,the SII was an independent predictor of frailty, indicating its role as an inflammatory marker of frailty. Frail patients had significantly higher rates of total complications, lower limb deep vein thrombosis (DVT), infections and cardiac complications than the non-frail group. Patients who were both frail and malnourished had a 1.98 times higher risk of nosocomial infection than those who were only frail. Conclusions: The SII is a significant predictor of frailty, and it may be used as an inflammatory marker of frailty. The fatigue, resistance, ambulation, illnesses and loss of weight scale can effectively predict the in-hospital complications of elderly patients with hip fractures.