Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) has recently been renamed as metabolic dysfunction-associated fatty liver disease (MAFLD) by the Asian Pacific Association for the Study of the Liver (APASL) to reflect metabolic dysfunction. Vitamin D regulates free fatty acid flux from the periphery to the liver. The association MAFLD and vitamin D has been controversial. We investigated the association of MAFLD, nutrient intake, and vitamin D status in South Korean adults. Methods and Study Design: We analyzed patient responses from the Korea National Health and Nutrition Examination survey (KNHANES) 2010-2011. The disease group was selected as per the latest guidelines. Steatosis was evaluated by the fatty liver index (FLI). Frequency analysis was performed on general characteristics. We compared differences in nutritional status using complex sample adjusted chi-square tests and generalized linear models. After adjusting for age, complex sample logistic regression analysis was used to examine the relationship between MAFLD and vitamin D. Results: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), LDL, triglyceride, creatinine, glucose, nutrient intake, and serum 25(OH)D concentrations were significantly elevated while HDL was reduced in the disease group than in the control group. The OR for 25(OH)D was 1.015 (95% CI: 1.004-1.026, p<0.0001). However, MAFLD presented no significant association with vitamin D concentration (OR 1.010, 95% CI: 0.985-1.037, p=0.431) after adjusting for age. Conclusions: We found no significant relationship between MAFLD and serum vitamin D concentration in South Korean adults.
Background and Objectives: Genetic and dietary factors are important contributors to the development of dental fluorosis (DF). This study investigated the association between DF and dietary carotenoids, and explored whether the association was modified by polymorphisms of the antioxidant enzyme superoxide dismutase 2 (SOD2 rs11968525) in Guizhou, China. Methods and Study Design: A cross-sectional study with a total of 899 adults aged 18-75 years were enrolled in the study. Face-to-face interviews were conducted to assess dietary habits using a validated 75 item food frequency questionnaire (FFQ). Sociodemographic and lifestyle information, and blood and urine samples were also collected. Genotypes were evaluated using TaqMan single nucleotide polymorphism (SNP) Genotyping Assay. Results: There were significant dose-dependent inverse associations of the prevalence of DF with intake of α-carotene, β-carotene, lutein/zeaxanthin, lycopene and total carotenoids (p-trend ranged from<0.001–0.004). The odds ratios (ORs) and 95% confidence intervals (CIs) of DF comparing the highest against lowest quartile were 0.56 (0.35, 0.92) for α-carotene, 0.53 (0.35, 0.81) for β-carotene, 0.44 (0.27, 0.74) for lycopene, 0.35 (0.21, 0.58) for lutein/zeaxanthin in combination and 0.42 (0.25, 0.69) for total carotenoids (all p-trend<0.005). Intake of β-cryptoxanthin was not found to be related to DF. The inverse association of DF with dietary intake of α-carotene and β-carotene was more evident in individuals with the AG+AA genotype (p-interaction<0.05). Conclusions: Higher dietary carotenoids were associated with a lower occurrence of DF, polymorphisms in SOD2 (rs 11968525) modified the associations between dietary intake of carotene and DF. These findings provide evidence for precision prevention of fluorosis.
Background and Objectives: Accumulating evidence suggests that vitamin D may be involved in the pathogenesis of type 2 diabetes (T2D). Group specific component (GC) gene is the most important transporter of vitamin D and plays a regulatory role in vitamin D metabolism. We aimed to evaluate the association of GC gene polymorphisms with T2D susceptibility and vitamin D status in the Chinese rural population. Methods and Study Design: A total of 1372 subjects were eligible in this cross-sectional study. Three SNPs of the GC gene (rs7041, rs4588, and rs2282679) were genotyped by TaqMan probe assays. Logistic regression and Kruskal-Wallis one-way analysis were performed to determine the possible risk genotype for T2D and vitamin D metabolite concentrations, respectively. Results: The serum 25-hydroxyvitamin D3 [25(OH)D3] and vitamin D binding protein (DBP) concentrations were significantly lower in the T2D group than the non-T2D group. GG genotype carriers of rs7041 (T>G) were more likely to have T2D compared with AA carriers (OR=2.00, 95% CI: 1.19-3.37). Variants of rs4588 (C>A) and rs2282679 (A>C) were associated with a lower risk of T2D under the dominant inheritance model (OR=0.65, 95% CI: 0.48-0.88; OR=0.66, 95% CI: 0.49-0.90, respectively). We further found that non-T2D subjects with AA genotype of rs4588 had significantly higher 25(OH)D3 concentrations than the CC genotype (p=0.022). In contrast, the T2D cases with the CC genotype of rs2282679 had lower DBP concentrations compared to the AA genotype (p=0.020). Conclusions: Our study indicates a potential role for GC gene polymorphisms in T2D susceptibility and vitamin D metabolite concentrations in the Chinese rural population.
Background and Objectives: To investigate the prevalence of vitamin A and vitamin D deficiency and the associated factors in hospitalized neonates in Xi’an, China. Methods and Study Design: A total of 524 hospitalized neonates were collected in this study. Serum vitamin A and D concentrations were detected in neonates within two weeks of birth. Results: Serum vitamin A and D concentrations of hospitalized neonates were 0.55±0.21 μmol/L and 42.0±20.6 nmol/L, respectively. They were greater in full-term neonates than in preterm neonates, greater in rural neonates than in urban, and greater in single than in twin (all p<0.001). The prevalence of vitamin A and D deficiency were 14.9% and 33.0%, the prevalence of marginal vitamin A deficiency was 64.7%, and vitamin D insufficiency was 35.1%. Neonatal serum vitamin A and D concentrations were all positively correlated with birth weight and gestational age. Neonatal serum vitamin D concentration was also positively correlated with maternal serum vitamin D concentration. Additionally, neonatal vitamin A concentration was positively correlated with neonatal serum vitamin D concentration. Conclusions: Vitamin A and vitamin D statuses are compromised in hospitalized neonates in Xi’an, especially in premature neonates, low birth weight neonates, twins, and those born in urban areas. Individualized supplementation with vitamin A and vitamin D in neonates should be a clinical consideration.
Background and Objectives: This study evaluated the relationship between dietary inflammatory index (DII) and metabolic health in the Chinese elderly. Methods and Study Design: A total of 6,730 participants from the “Community-based Cardiovascular and Health Promotion Study” (CoCHPS) cohort were included in this study. The DII scores were acquired using a validated 125-item food-frequency questionnaire (FFQ) (ranged −5.84 to 3.90). The correlation of DII with metabolic health indexes was evaluated with logistic regression and multivariable cox regression using SPSS and R software. Results: Compared with low DII scores, subjects in the highest DII score quartiles had higher odds of metabolic dysfunction (OR=1.36, 95% CI: 1.07–1.68, p trend=0.023). In the subgroup analyses, the effect of a pro-inflammatory diet on metabolic dysfunction was particularly evident among people with hyperglycaemia (HR=1.58, 95% CI: 1.35–2.14), hypertension (HR=1.48, 95% CI: 1.07–2.09), dyslipidemia (HR=1.45, 95% CI: 1.24–1.87), abdominal obesity (HR=2.16, 95% CI: 1.57–2.96), and ≥60 years old (HR=1.32, 95% CI: 1.04–1.56) or who were women (HR=1.35, 95% CI: 1.08–1.67). Conclusions: DII score was associated with metabolic health. Further studies are needed to deepen our understanding of dietary parameters and different populations.
Background and Objectives: To evaluate whether cardio-metabolic risk data in obese postmenopausal women are affected by adherence to the Mediterranean diet. Methods and Study Design: This cross-sectional study was conducted in 89 pre-obese and obese postmenopausal women (PMW) aged 40-75 years with a Body Mass Index (BMI) value ≥ 25 kg/m2. Demographic characteristics, health status, anthropometric measurements, physical activity status, nutritional habits, lipid profile, some biochemical results and cardiovascular risk predictor (CVRP) data were collected by face-to-face interviews. Results: In this study, a negative correlation was found between CVRP and a Mediterranean diet score (MEDI-LITE) scores in pre-obese and obese PMW (p=0.008, p=0.02, respectively). Total cholesterol levels of the obese women were found to be negatively correlated with MEDI-LITE scores (p=0.002). VLDL-cholesterol (p=0.04, p=0.008, respectively) and triglyceride levels (p=0.002, p=0.003, respectively) of the pre-obese and obese women were negatively correlated with MEDI-LITE scores. According to the logistic regression analysis, the variables affecting CVRP negatively in our study were age, smoking, and salt use, while the variables affecting CVRP positively were MEDI-LITE score and omega 3 fatty acid consumption. Conclusions: In this study, it was observed that the increase in the Mediterranean diet (MedDiet) adherence score of the pre-obese and obese women in the postmenopausal period had favourable effect on lipid profile and CVRP. It is considered that adhering to the MedDiet in pre-obese and obese PMW can be recommended as an effective strategy to prevent the increased risk of cardiovascular disease due to advanced age, menopause, and high BMI values.
Background and Objectives: Although the association between dietary protein intake and inflammatory bowel disease (IBD) risk has been investigated, the results are inconsistent. Therefore, we conducted a meta-analysis to reassess the relationship between dietary protein intake and IBD risk. Methods and Study Design: The PubMed, Web of Knowledge, and
Wanfang databases were searched for pertinent studies through January 31, 2020. Relative risks (RRs) with 95% confidence intervals (CIs) were derived using a random-effect model. Subgroup analyses according to disease type, geographic location, and sex; sensitivity analysis; and publication bias analysis were performed. Results: The current report includes 8 articles consisting of 12 studies with 1069 cases and 330,676 participants. The pooled RR (95% CI) of the highest vs. the lowest categories of dietary protein intake for the IBD risk was 1.561 (0.384-6.347) in cohort studies and 1.060 (0.663-1.694) in case-control studies. Evidence of heterogeneity was found both in cohort studies (I2=86.4%, p=0.007) and in case control studies (I2=49.0%, p=0.039). However, the association was significant among Asian populations (RR=1.675, 95% CI=1.096-2.559) but not in other populations. We did not find any relationship of dietary protein intake with the risk of either Crohn’s disease or ulcerative colitis. Conclusions: Based on limited information, the highest dietary protein intakes among Asians may increase the risk of IBD, undifferentiated for ulcerative colitis or Crohn’s disease. This may reflect dietary patterns for which protein is a marker rather than implicate protein itself.
Background and Objectives: There is emerging scientific evidence of the health benefits of traditional food plants at both molecular and folk remedy levels; however, epidemiological observations are limited. The Amami island region of Japan has a variety of unique traditions conserved till today, where a cohort study was conducted in 2005. The objective of this study was to investigate the associations between the intake of common and local vegetables and the risk of mortality and cancer incidence in Amami. Methods and Study Design: Participants were enrolled from the general population of Amami as part of the Japan Multi-institutional Collaborative Cohort (J-MICC) Study. In total, 5,015 participants (2,053 men and 2,962 women) aged 35-69 years were enrolled in this study. They were followed up to obtain information on movement, death, and cancer incidence. The hazard ratios (HRs) and 95% CIs were estimated using the Cox proportional hazard model after adjusting for potential confounding factors. Results: A significant inverse association was observed between cabbage intake and the HRs for overall mortality (p for trend=0.046) and lung cancer incidence (p=0.016). Intake of handama and togan as local vegetables was associated with decreased HRs for overall mortality (p=0.019 and 0.036, respectively). Conclusions: While the molecular and biochemical reasoning and residual confounding factors behind this association remain unclear, the findings of this study suggest that the dietary lifestyle in Amami has a positive impact on the residents, which can significantly decrease mortality risk.
Background and Objectives: Our objective is to study the efficacy and safety of parenteral nutrition (PN) with iron sucrose to prevent anemia in preterm infants. Methods and Study Design: We performed a randomized, double-blind controlled trial in which preterm infants were divided into five groups randomly: a control group (PN without iron sucrose, namely group Iron-0), and intervention groups (PN with iron sucrose 100 μg/kg/d, 200 μg/kg/d, 300 μg/kg/d and 400 μg/kg/d, namely group Iron-1, 2, 3, and 4, respectively). The indicators were red blood cell (RBC) parameters, iron storage and oxidant stress. Results: One hundred infants completed this study. Excepting the RBC count in Iron-2, the value of erythrocyte parameters in intervention groups decreased less than that in the control group. And the decrease of RBC count in Iron-1 (-0.6×1012/L vs -0.9×1012/L, p=0.033), hemoglobin in Iron-4 (-26.0 g/L vs -41.0 g/L, p=0.03) and hematocrit in Iron-1(-9.5% vs -14.0%, p=0.014) was significantly less than in the control group. The change of ferritin in Iron-4 was significantly higher than in the control group (280.2 ng/ml vs 117.5 mg/ml, p=0.04). There was no difference in serum iron in intervention groups when compared to the control group (p>0.05). Except for the change of Malondialdehyde (MDA) in Iron-1, the increase in other intervention groups was higher than in the control group (p>0.05). Conclusions: PN with iron sucrose for prevention of anemia in preterm infants is safe and efficacious to some extent.
Background and Objectives: Adiposity at birth is a predictor of childhood obesity. Abdominal circumference (AC) at birth has been shown to correlate well with visceral adipose tissue and abdominal subcutaneous adipose tissue. Adiposity differs according to ethnicity and geography. The aim of this study was to describe the anthropometry derived adiposity phenotype in neonates from Colombo, Sri Lanka and compare it with global data. Methods and Study Design: Birth anthropometry was performed within 12-24 hours by the same investigator as part of a prospective cohort study on healthy term babies, at a tertiary care hospital in Colombo, Sri Lanka, 2015-2019. The anthropometry derived adiposity phenotype was indicated by skinfold thickness, AC and upper arm fat area (UFA) derived from the mid-upper arm circumference (MUAC). Results: Sri Lankan neonates had a significantly lower weight with significantly higher AC (n=337, 2.9±0.4 kg, 30.6±2.3 cm) compared to Canadian (n=389, 3.5±0.02 kg, 29.9±2.1 cm; p<0.001) and Australian (n=1270, 3.4±0.4 kg, 28.5±1.9 cm; p<0.001) neonates. Anthropometry derived adiposity at birth showed a significant correlation with weight and BMI of both mother and father (p<0.05) as opposed to their income or education (p>0.05). Conclusions: Healthy neonates from Colombo, Sri Lanka demonstrated significantly higher AC despite significantly lower weight, indicating increased abdominal adiposity compared to neonates from high-income countries as well as Indian neonates with the thin-fat phenotype.
Background and Objectives: Previous study reported that high proportion of Chinese cancer patients practice food avoidance behaviour for fear of cancer recurrence. The present study aims at documenting the degree of food avoidance behaviours and its association with nutrient intake and diet quality among Chinese cancer patients. Methods and Study Design: Cross-sectional face-to-face interviews were conducted with 245 patients suffering from nasopharyngeal and colorectal cancer to investigate their FAB. Participant’s nutrient intake was assessed by 3-day diet record. Diet quality was measured by Diet Quality Index – International (DQI-I). Results: As many as 86% cancer participants reported practicing food avoidance behaviours. The nutrients to which less than half of the participants met its daily requirement include vitamin D (0%), vitamin E (0.4%), calcium (7.8%), zinc (26.1%) and vitamin B1 (32.2%). Among all participants, only 47.8% met their daily energy requirement. Those reported having high degree of food avoidance behaviours are more likely to have low intake of protein, zinc and iron. However, there was no association between FAB and overall diet quality although the Variety subscale of DQI-I showed that food avoidance behaviours negatively link to participant’s dietary sources of protein. Conclusions: Degree of practicing food avoidance behaviour is negatively associated with nutrients of animal origin, in particular protein. However, the overall diet quality was not affected by such. The study results provided important information to frontline clinical workers who are dealing with cancer patients practising non-mainstream diet.
The prevalence of the double burden of malnutrition in society is well known with the coexistence of undernutrition with an increase in overweight/obesity; this has been increasing globally with nutritional imbalances and infectious diseases being the major etiological factors. However, there is also the coexistence of inappropriate adiposity or metabolic dysfunction in an individual who appears currently undernourished by anthropometric standards (stunted or underweight); this is the intraindividual double burden of malnutrition. It could also occur in temporal sequence, as anthropometric overweight in an individual who has previously endured childhood undernutrition. IIDBM has increased the risk for diet-related non-communicable diseases over the past few decades, as it tracks into adulthood, warranting an urgent need for intervention and prevention. While gut dysbiosis has been associated with various forms of malnutrition, the early life gut microbiome composition and its related metabolites and regulatory factors, are possibly linked to the development of inflammatory and metabolic conditions in IIDBM. The possible underlying physiological mechanisms are reviewed here, working through host dietary influences, gut microbial metabolites, host inflammation and metabolic dysregulation. When validated experimentally and tested through appropriately designed randomised, controlled trials, these mechanistic insights will likely lead to development of preventive strategies.
Background and Objectives: Poor nutritional status is a common finding in pulmonary tuberculosis (TB) patients with and without type 2 diabetes mellitus (T2DM), thiamin (VB-1) and riboflavin (VB-2) are coenzymes important for the activation of many enzymes involved in improving nutritional status. We aimed to investigate enzymatic activities and the associations between VB-1 and VB-2, and their relations to nutritional status in TB and TB+T2DM patients. Methods and Study Design: This was a cross-sectional study that prospectively enrolled TB 40 patients with or without T2DM respectively from the Chest Hospital of Qingdao and 76 healthy controls with similar age and gender distributions were recruited from the medical center of the affiliated hospital of Qingdao Medical College. The erythrocyte transketolase activation coefficient (ETKac, for VB-1 deficiency), the glutathione reductase activation coefficient (EGRac, for VB-2 deficiency), and metabolic enzyme activities were analyzed. Results: VB-1 and VB-2 deficiency rates were higher, and enzyme activities were lower in TB and TB+T2DM relative to control group. ETKac and EGRac were negatively correlated with enzyme activities, either with body mass index (BMI), while enzyme activities were positively associated with BMI. Conclusions: VB-1 and VB-2 concentrations were lower in TB patients with or without T2DM relative to controls, with concomitant reductions in the activity levels of key metabolic enzymes. Significant correlations were observed between VB-1 and VB-2 concentrations and the activity of these metabolic enzymes, they all correlated with nutrition status (BMI). VB-1 and VB-2 concentrations may thus impact metabolic enzyme activity and thereby influence nutritional status.