Background and Objectives: Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody and/or thyroglobulin antibody. In recent decades, HT disease has become more and more widespread. Patients always report multiple symptoms, even though their thyroid hormone levels are kept in normal ranges. However, no treatment exists to effectively reduce the levels of thyroid antibodies. Our study aims to determine whether calorie-restricted diet is helpful in improving health of HT patients. Methods and Study Design: This is a 3-month randomized controlled trial. HT patients will be randomized into a calorie-restricted (CR) group or a calorie-unrestricted control group. All the participants will be instructed to consume a diet that includes a combination of 45-55% calories from carbohydrates, 20-30% from fats, and 15-25% from proteins, according to current Chinese Dietary Guidelines. Participants in CR group need to limit their calories intake equal to their basal energy expenditure, which means that their daily caloric intake will be limited by about 20-30%. Results: The study population is planned to be 66 HT patients aged 18 to 65 years. The primary outcome is change of thyroid antibody levels from baseline. Secondary outcomes include the changes of non-hypothyroid symptoms scores, thyroid function indexes, morphology of thyroid, T lymphocyte subpopulations, inflammatory biomarkers and lipids from baseline to 12 weeks. Conclusions: This trial will have implications for nutrition treatment policy in regard to thyroid antibodies control, immune dysfunction and related non-hypothyroid symptoms improvement among HT patients.
Background and Objectives: Mechanism studies have indicated that magnesium (Mg) and calcium (Ca) had 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 examined 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: ORMg: 0.61, 95% CIMg: 0.53, 0.71; ORMg/Ca ratio: 0.67, 95% CIMg/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: 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, and folate and n-3 PUFA intake using a short food frequency questionnaire. Results: Of 1011 study participants, 465 (46.0%) were male and the 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. In an additional analysis, the OR in those eating alone combined with the first tertile of n-3 PUFA intake compared to those eating with others combined with the third tertile was 2.18 (95%CI, 1.05–4.55). Conclusions: Eating alone, folate intake, and n-3 PUFA intake were not independently associated with psychological distress in older adults, although eating alone combined with low n-3 PUFA intake was associated with psychological distress.
Background and Objectives: Evidence regarding the relationship between dietary and plasma lutein + zeaxanthin levels and the risk of depression is scarce. This study aimed to investigate the associations of dietary consumption of lutein + zeaxanthin and plasma lutein + zeaxanthin 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 separately the relation between dietary lutein + zeaxanthin and depression, as well as plasma lutein + zeaxanthin levels with the risk of depression, respectively. The 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 lutein + zeaxanthin 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 lutein + zeaxanthin 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 appropriate increased dietary lutein + zeaxanthin intake and higher plasma lutein + zeaxanthin 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 lutein + zeaxanthin on depression.
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 postoperative 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: : A total of 136 patients were included in this study, with 42 patients developing PPE (30.9%). The PPE group had significantly 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 support, 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, and a lower HAZ were significantly correlated with the development of PPE. 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: 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: This study investigated the iodine status of pregnant women at an average altitude of about 2000 meters in Qujing, China, and analyzed the relationship between iodine and thyroid function in different trimesters, as well as the relationship between iodine and adverse pregnancy and fetal outcomes. 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 nutrition with adverse pregnancy and fetal outcomes. Results: The median UIC was 127.2 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 positive proportion of thyroid peroxidase antibody (TPO-Ab) and the prevalence of thyroid autoimmunity (TAI) increased significantly in the iodine more than adequate and iodine excess groups. Logistic regression analysis showed maternal iodine nutrition 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 with moderate to severe iodine deficiency. Abnormal iodine nutrition 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 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.
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: 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: 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). Conclusion: 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: 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 139.1-619.1 pg/mL, 3.0-14.7 ng/mL, 5.6-18.4 μmol/L, 10.7-101.4pmol/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: 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: 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 analyzed 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-VD 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: 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: The aim of this study was to elucidate the dose-response relationship between dietary carbohydrate consumption and the improvement of glycemic control and insulin sensitivity in individuals with type 2 diabetes mellitus (T2DM), following an intensive dietary intervention. Methods and Study Design: Randomized controlled trials published up to December 2023 were systematically reviewed from four databases: PubMed, Embase, Web of Science, and Cochrane Database of Systematic Reviews. Primary outcomes included: glycated hemoglobin (HbA1c), fasting glucose (FG); and secondary outcomes included: BMI, fasting insulin (FI), Homeostasis Model Assessment−Insulin Resistance (HOMA−IR). We performed a random−effects dose−response meta−analysis to estimate mean differences (MDs) for each 10% reduction in carbohydrate intake. Results: A total of 38 articles were analyzed, encompassing 2,831 total participants. Compared to the highest recorded carbohydrate intake (65%), reducing carbohydrate intake to 5% showed that for every 10% decrease, the following improvements were observed: HbA1c (MD: 0.39%; 95%CI: -0.5 to -0.28%), FG (MD: 0.55mmol/L; 95%CI: -0.82 to -0.28mmol/L), BMI (MD: -0.83kg/m2; 95%CI: -1.27 to -0.38kg/m2), FI (MD: -2.19pmol/L; 95%CI: -3.64 to -0.73pmol/L), HOMA-IR (MD: -1.53; 95%CI: -3.09 to 0.03). Conclusions: Reducing dietary carbohydrate intake significantly improves glycemic control and insulin resistance in individuals with type 2 diabetes. A linear reduction in carbohydrate intake was observed, with significant effects occurring within the first 6 months of the intervention. However, these effects diminished beyond this period. Notably, the improvements in glycemic parameters were not significantly affected by whether calorie restriction was implemented.
Background and Objectives: This study aimed to assess the predictive power of the Geriatric Nutritional Risk Index (GNRI) and the triglyceride-glucose (TyG) index for poor prognosis in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients post-percutaneous coronary intervention (PCI). Methods and Study Design: A cohort of 393 NSTE-ACS patients who underwent PCI at the People’s Hospital of Nanjing Jiangbei from 2016 to 2022 was analyzed. Major adverse cardiovascular events (MACEs), including death, non-fatal myocardial infarction, and target vessel revascularization, served as the primary outcome. Relationships between GNRI, TyG index, and MACEs were explored using univariate and multivariate logistic regression, with results presented as odds ratios (OR) and 95% confidence intervals (CI). The predictive value was further evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve. Results: MACEs occurred in 34 patients. A TyG index ≥1.359 was associated with a significantly increased risk of MACEs (OR=5.07, 95%CI: 1.64-15.71), while a GNRI ≥107.514 indicated a decreased risk (OR=0.17, 95%CI: 0.04-0.68). These associations were consistent across various subgroups, including age, gender, and specific pre-existing conditions. The combined predictive value of TyG index and GNRI was higher than each alone (AUC=0.711, 95%CI: 0.642-0.779). Conclusions: In post-PCI patients with NSTE-ACS, the TyG index and GNRI are significant predictors of MACEs, with the TyG index indicating higher risk and GNRI lower risk. Their combined use may enhance the predictive accuracy for MACEs in this patient population.
Background and Objectives: Consuming a diet that ensures adequate nutrient intake is essential to address all forms of malnutrition. In Japan, a meal combining staple food, main dish, and side dish is considered a balanced diet. This study was conducted to investigate the frequency of meals combining staple food, main dish, and side dish associated with nutrient adequacy. Methods and Study Design: This cross-sectional study included 6,264 adults. All data were obtained from the 2015 Health and Nutrition Survey in Shiga prefecture. Staple food, main dish, and side dish were each defined as a dish with primary ingredients of ≥50 g. Regarding the frequency, participants were divided into ≥2 and <2 times/d groups. The nutrient adequacy evaluated using the Dietary Reference Intakes for Japanese 2020 (DRIs–J) score is based on the reference values provided in the DRIs–J. The t-test was used to evaluate nutrient adequacy between the 2 groups. Results: Of the total participants, only 1,423 (22.7%) were classified into the ≥2 times/d group, and they had significantly higher DRIs–J scores than participants in the <2 times/d group (p < 0.001). The adequacy percentage of all nutrients except saturated fatty acid, particularly dietary fiber and most micronutrients, was >1.5-fold higher in the ≥2 times/d group than in the <2 times/d group (p < 0.001). Conclusions: This study provides important information that meals combining staple food, main dish, and side dish at least twice a day is effective in maintaining a diet with high nutrient adequacy.
Background and Objectives: To explore the nutritional challenges and its influencing factors of adults aged 40-69 living in Chinese cities. Methods and Study Design: This cross-sectional study involved 300 subjects from 29 cities in China. Questionnaires were used to collect demographic information, presence of chronic disease, and the use of nutritional supplements and fortified foods. 24-hour food intake was recorded using the Eat-Right Assistant, a validated digital service. Results: Fiber (56.7%), calcium (66.3%) and selenium (67.0%) were the nutrients with the highest insufficient intake. The foods with the highest inadequate consumption were dairy products (91%), fruits (84.3%), tubers (76.3%), soybeans and nuts (70%), and whole grains (65%). Even though 95.7% of the study population showed medium-high level of dietary diversity, dietary imbalance was present among 99% of the subjects. Higher socioeconomic status, passive health awareness, or the use of nutritional supplements or fortified foods, showed positive influence on nutrient intake and dietary quality. Conclusions: This research provided insights into the dietary intake status and its influencing factors of 300 urban residents aged 40-69. The adult population still face a challenge of inadequate nutrient intake and imbalanced diet. In addition, this study supported the feasibility of using a digital service in research. Further studies with a larger sample size are needed to confirm current findings. This will help to clarify the unmet nutritional needs of adults in China and thus help to achieve healthy aging.
Cow’s milk protein allergy is an adverse immune reaction to proteins found in cow’s milk, primarily casein and whey, affecting artificially fed, breastfed and mixed-fed infants. The immunological mechanisms involved lead to diverse clinical presentations, most commonly impacting the digestive and respiratory systems, as well as the skin. Diagnosis relies primarily on clinical evaluation due to the absence of specific diagnostic tests, making accurate identification crucial to prevent misdiagnosis or underdiagnosis. Treatment requires strict avoidance of cow’s milk proteins in both children’s and breastfeeding mothers’ diets, with close monitoring of nutritional status during long-term management. Recent advancements in treatment, including the use of probiotics, provide new options for improving clinical outcomes. This narrative review aims to provide clinicians with evidence to standardise diagnosis and treatment, improve food allergy management by non-allergy specialists and develop accurate feeding recommendations.
Background and Objectives: This study aimed to analyze the relationship between thyroid volume (TVOL) and physical development of children, and explore the suitable TVOL correction methods. Methods and Study Design: 1500 children aged 8-10 years from Gansu Province northwest China were selected. The height (H), weight (W), urine iodine of children was measured and their thyroid was examined by ultrasound. Body mass index (BMI), body surface area (BSA) and TVOL were calculated (BSA was calculated by three formulas), and the relationship between TVOL and age, sex, physical development was analyzed. The applicability of TVOL correction methods including BMI corrected volume (BMIV), BSA corrected volume (BSAV), weight and height corrected volume indicator (WHVI) and height corrected volume indicator (HVI) were compared. Results: Median urinary iodine concentrations of children aged 8, 9, 10 years were 166.6 μg/L, 167.2 μg/L and 178.8 μg/L respectively. The rate of iodine deficiency was 20.3%, the rate of thyroid goiter was 3.2%. The physical development indexes (height, weight, BMI and BSA) and TVOL increased with age. The physical development indexes (height, weight, BMI and BSA) of boys were higher than girls (p <0.05). Only BSAV1 had no correlation with all physical development indexes (p >0.05). The TVOL P97 (97th percentile) of children aged 8, 9, 10 years were 4.4 ml, 4.9 ml, 6.5 ml, the values were 4.6 mL, 4.7 mL, 5.9 mL after BSAV1 corrected. The difference between TVOL and BSAV1 ranges from -0.37% to 0.36%. Conclusions: The thyroid volume is not only affected by age, but it is also affected by physical development. Thyroid goiter should be assessed based on age and physical development. The formula BSAV1=TVOL/ (W0.425×H0.725×71.84×10-4) was a suitable TVOL correction method.
Background and Objectives: Exploring the effects of circulating micronutrients on Graves' disease (GD) through observational research or randomized controlled trials has drawn more attention. In order to investigate the putative causal inference, we provide an illustrative estimate of two-sample Mendelian randomization (MR) study. Methods and Study Design: Inverse-variance weighted (IVW) method was employed as the primary approach to determine the causal relationships between micronutrients level and GD. Several complementary sensitivity analyses were also undertaken to evaluate the impact of potential violations of MR assumptions. In addition, we utilized cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) to analyze the differences in the prevalence of GD among participants with different levels of trace nutrient concentrations. Results: In terms of vitamins, IVW MR analysis revealed a suggestive relationship between each standard deviation decrease in vitamin D level and increased risk of GD (OR=1.28, 95% CI: 1.04-1.59, p = 0.0212). A nominally significant association was also noted for genetically predicted vitamin B-6 concentration and higher risk of GD (OR=1.56, 95% CI: 1.08-2.25, p = 0.0171). Genetically predicted concentrations of other vitamins level and 6 minerals levels were not in association with GD susceptibility. The causal estimates from other complementary MR approaches were consistent with these findings. Additionally, we found that participants from NHANES with vitamin D and VB-6 deficiency had a higher prevalence of GD. Conclusions: Our study provides an obvious unidirectional causality of circulating vitamin B-6 and vitamin D with GD. Dietary supplementation with micronutrients may be a complement to classical therapies for preventing and treating GD.
Background and Objectives: Patients with gastrointestinal (GI) malignancies are at high risk for malnutrition because of reduced food intake, poor digestion, and altered absorption. Methods and Study Design: In a retrospective review of medical records for patients admitted to urban hospitals in an Asian nation for GI tumor surgery (gastric, colon, or anorectal cancers), we found that malnutrition was common yet often overlooked. Our review identified records for 349 adult GI-tumor surgery patients. The Nutrition Risk Screening-2002 (NRS-2002) was the most frequently used screening instrument. In further review, we compared outcomes for malnourished GI tumor surgery patients given daily oral nutritional supplements (ONS) to outcomes for patients who were not given ONS. Results: Review of results revealed that only 20% of patients in our sample underwent nutritional screening or assessment on admission. Of those who did, nearly 60% were malnourished. Although due to small sample sizes, no statistically significant differences were observed, malnourished patients who received ONS had fewer complications and shorter lengths of stay by 1-day. Such findings reveal many missed opportunities to improve patient outcomes and to avert excess healthcare costs for treatment of complications, slowed recovery, longer hospital stays, and readmissions. Conclusions: Based on our findings, nutritional training for professionals is necessary to address the serious problems of under-recognition and inadequate treatment of malnutrition in hospitalized patients.
Background and Objectives: Obese and diabetic individuals tend to have insulin resistance, but are less likely to develop osteoporosis. The association of triglyceride-glucose (TyG) related indices with osteoporosis remains controversial, and longitudinal evidence exploring the male osteoporosis (MOP) is limited. This study aims to examine TyG, TyG-body mass index (TyG-BMI) and the metabolic score for insulin resistance (METS-IR) with osteoporosis risk among older men. Methods and Study Design: A cohort study based on 1622 middle-aged and older men in 2015 was conducted, and followed up until 2022. Participants with osteoporosis and admittedly secondary risk factors were excluded. TyG, TyG-BMI, METS-IR and corresponding quantiles were calculated. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence interval (CI). Receiver operating characteristic (ROC) curve was applied to estimate their performance in osteoporosis screening. Results: 72 of 1622 participants were newly developed OP during the 9317 person-years. The adjusted HRs of TyG, TyG-BMI, and METS-IR for MOP were 0.573 (95%CI 0.336-0.976), 0.991(95%CI 0.984-0.999) and 0.929 (95%CI 0.892-0.968), respectively, and presented at linear dose-response relationships. Subgroup analysis showed that the estimated benefit for MOP incidence was consistent among participants aged more than 70 years and related to BMI and eating mount of milk, fresh fruit and vegetables. No difference was found in the area under ROC curve for screening osteoporosis, ranging from 0.585 to 0.617. Conclusions: TyG and relevant indices were associated with the incidence of osteoporosis in the senile men, and the relationship was thought to correlate with BMI and nutritional behaviors.
Background and Objectives: Protein-energy wasting (PEW) is common among maintenance hemodialysis (MHD) patients and is strongly associated with mortality and adverse outcomes. This study aimed to assess the effects of low-protein energy supplements on the nutritional status of MHD patients with PEW. Methods and Study Design: We conducted a prospective randomized controlled trial in 68 MHD patients suffering from PEW. Patients randomized to the intervention group received dietary counseling along with daily low-protein supplements containing 212 kcal of energy and 2.4 g of protein every day for 3 months. The control group received dietary counseling only. Dietary data, nutritional assessments, anthropometric measurements, bioelectrical impedance analysis and blood analysis were collected at baseline and after three months from both groups. Results: Fifty-nine MHD patients completed the study. Patients in the intervention group showed an increase in energy intakes (p < 0.001). A significant decrease in the Malnutrition Inflammation Score (MIS) (p < 0.001) and Nutrition Risk Screening 2002 (p < 0.001) were found in the intervention group compared with the control group. Moreover, significant improvements in mid-upper arm circumference (p < 0.001), mid-arm muscle circumference (p < 0.001), albumin (p = 0.003), and prealbumin (p = 0.033) were observed in the intervention group compared with the control group. Conclusions: The combination of oral low-protein supplements and dietary counseling for three months was more effective than dietary counseling alone in terms of improving the nutritional status of MHD patients with PEW.