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: Metabolically unhealthy obesity is characterized by the presence of cardiovascular metabolic risks such as hypertension, dyslipidemia, and hyperglycemia. Research has shown a correlation between remnant cholesterol (RC) concentrations and abdominal obesity in children. However, the effect of RC concentration on metabolically unhealthy obesity remains unclear. Methods and Study Design: This study included 3114 Chinese adolescents who received health check-ups. We used logistic regression models and receiver operating characteristic analysis to evaluate the correlation between RC concentration and metabolically unhealthy obesity in a cross-sectional design. Results: After controlling for possible confounding variables, we found that individuals in the top and fourth quintiles of RC concentrations had a significantly higher likelihood of developing metabolically unhealthy obesity compared to those in the bottom quintile (ORs, 4.810 and 1.836; 95% CIs, 3.209–7.212 and 1.167–2.890, respectively). The risk of metabolically unhealthy obesity tended to increase with RC concentration (ptrend<0.001). In addition, boys showed positive associations between RC concentration and both BMI (r = 0.305, p<0.001) and waist circumference (r = 0.306, p<0.001). According to the analysis, the predictive accuracy of metabolically unhealthy obesity was 0.736 (95% CI, 0.690–0.781) for boys and 0.630 (95% CI, 0.573–0.687) for girls. The ideal prediction threshold was 0.66 for boys and 0.59 for girls. Conclusions: Our findings indicate that elevated RC concentration is linked to a higher likelihood of developing metabolically unhealthy obesity in young individuals, regardless of other known risk factors.
Background and Objectives: This study aimed to evaluate the effects of milk and banana given as a bedtime to patients with primary insomnia on sleep parameters and some biochemical parameters such as brain-derived neurotrophic factor, leptin, and ghrelin. Methods and Study Design: Study was conducted with 21 patients with insomnia who met the inclusion criteria. The patients were divided into 3 parallel groups: banana, milk and control. The intervention group were given at bedtime just 1 portion of banana or just 200 mL of whole-fat milk. Control group did not consume any non-routine food. Baseline and after the study, venous blood samples were taken from the patients to measure brain-derived neurotrophic factor, leptin and ghrelin concentrations, and sleep quality and architecture were determined by polysomnography and Pittsburg Sleep Quality Index. Results: Pittsburg Sleep Quality Index scores of the banana and milk group were found to be lower after the intervention (p<0.05). In terms of polysomnography, the total sleep time of the milk group was found to be significantly higher than baseline. Serum ghrelin concentration of the milk group decreased significantly compared to the baseline. Conclusions: Bedtime milk or banana intake was effective for dealing with insomnia. Foods rich in tryptophan, such as banana and milk, given bedtime, may improve sleep parameters and appetite hormones.
Background and Objectives:Malnutrition is associated with a higher risk of osteoporosis. We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men. Methods and Study Design:This is a nested case-control study from a prospective cohort enrolled 1109 individuals who were followed for seven years. Demographic data, medical history, signs and symptoms, and laboratory parameters were collected and analysed. Nutritional status and Geriatric Nutritional Risk Index (GNRI) were assessed. The nutrition-related indexes predictive value for osteopenia development was analyzed through multivariate Cox regression analysis and by creating a receiver operating characteristic curve (ROC), calculating the area under the curve (AUC). Kaplan–Meier (K–M) method was further used to find the nutritional status level in the elderly men. Results:The ALB and GNRI correlated with the risk of osteopenia in Chinese elderly men. After adjusting for all covariates, people with higher ALB level (HR: 0.821; 95% CI: 0.790–0.852) and higher GNRI score (HR: 0.889; 95% CI: 0.869–0.908) had a smaller risk of osteopenia. ROC analysis showed that the AUC for ALB was 0.729 (p＜0.05) and for the GNRI score was 0.731 (p＜0.05). K-M curve indicated a significant difference in ALB level (p＜0.001) and GNRI score (p＜0.001) in the respective subgroups. Conclusions:This study found that lower ALB level and lower GNRI score are associated with a higher prevalence of osteopenia among elderly men in China.
Background and Objectives: The precise impact of tea consumption on the risk of depression remains unclear. This study aimed to explore the relationship between the consumption patterns of tea and the likelihood of depression onset, utilizing a two-sample Mendelian randomization (MR) methodology. Methods and Study Design: We utilized available genome-wide association study (GWAS) datasets on tea intake and depressive disorders. To investigate the causal relationship between tea consumption and depression, we employed a set of two-sample Mendelian Randomization (MR) methods. These included the inverse-variance weighted (IVW) analysis, weighted median approach, and MR-Egger regression. Additionally, we utilized MR-PRESSO and the MR-Egger intercept test for the detection of pleiotropic effects. To ensure the robustness and consistency of our findings, a sensitivity analysis was carried out, applying the 'leave-one-out' strategy. The Bayesian weighted Mendelian randomization (BWMR) was employed to conduct additional testing on the obtained results. Results: The study's outcomes revealed a causal association between elevated tea intake and an increased risk of depression (Inverse-Variance Weighted Analysis: Odds Ratio [OR] = 1.029, 95% Confidence Interval [CI]: 1.003–1.055, p = 0.027). This was observed despite variations in instrumental variables and the nonexistence of horizontal pleiotropy. Further, the robustness of our Mendelian Randomization investigation was affirmed through the implementation of the 'leave-one-out' method in our sensitivity analysis. The findings from BWMR were in line with those obtained from IVW (BWMR: OR=1.030, 95% CI: 1.003–1.057, p = 0.029). Conclusions: The results from this study indicate a substantial and positive causal link between the regularity of tea drinking and the risk of depression onset.
Background and Objectives: Parkinson disease (PD), which is a neurodegenerative disorder, includes several gastrointestinal symptoms that are similar to those of Celiac disease (CD). However, the presence of celiac antibodies in PD patients has not yet been studied. Our aim in this study is to compare anti-transglutaminase (ATA) and antigliadin antibodies (AGA) as well as gastrointestinal symptoms and nutrition habits, between patients with Parkinson’s disease (PD) and healthy controls. Methods and Study Design: Serum AGA IgG and IgA and the ATA antibodies IgA and IgG were studied in 102 PD patients and 91 healthy controls. Gastrointestinal symptoms, specifically constipation, were investigated using the gastrointestinal system rating scale (GSRS) and the constipation rating scale (CRS). Dietary habits were also investigated and compared between the groups. Results: No significant differences were found between the two groups in terms of celiac antibodies. As expected, the hypokinetic GSRS and CRS scores were significantly higher in the PD group (p<0.001). Dietary habits, especially carbohydrate-rich diets, had a negative impact on gastrointestinal symptoms in the PD patients. Conclusions: Studies have suggested a connection between PD and CD, which infers a probable non-celiac gluten intolerance and the need to offer PD patients an elimination diet. However, the results of our study did not support any link between celiac antibodies and PD. Notwithstanding, the negative impact of a carbohydrate-rich diet in PD patients still leaves a question regarding gluten sensitivity in these patients.
Background and Objectives: To examine the effects of nutritional therapy in adult patients with severe burns. Methods and Study Design: Sixty adult patients with severe burns were enrolled. Data on nutritional intake through enteral nutrition (EN) or parenteral nutrition (PN) on days 7, 14, 21, and 28 post-injury were collected. Patients were divided into target and non-target groups according to whether their energy or protein intake reached the target. Patient age, length of ventilation, and total bilirubin (TBIL), albumin (ALB), prealbumin (pALB), and C-reactive protein (CRP) concentrations were recorded. Results: The percentage of protein targets with protein delivery was lower than that of energy target with energy delivery. The ratio of PN protein to total protein was lower than that of PN energy to total energy on days 7, 14, 21, and 28 (p<0.001, p<0.001, p=0.001, and p=0.003, respectively). Compared to the non-target group on day 21, the target group was younger, had lower TBIL on day 7, higher ALB and pALB on day 21, and lower CRP on day 14 (p=0.025, p=0.021, p=0.028, p=0.029, and p=0.049, respectively). Multivariate logistic regression analysis showed that older age and longer ventilation were independent risk factors in patients who did not meet the nutritional target on day 21 (p=0.026 and p=0.043, respectively). Conclusions: The protein intake of adult patients with severe burns was low. Compared to the non-target group, the target group had better laboratory test results. Older age and longer ventilation were independent risk factors for patients not meeting the nutritional target.
Background and Objectives: Gastric cancer (GC) is the fourth leading cause of cancer death worldwide. Patients with GC have higher nutritional risk. To construct a nomogram model for predicting preoperative nutritional risk in patients with GC in order to more precisely assess preoperative nutritional risk in patients. Methods and Study Design: Patients diagnosed with GC and undergoing surgical treatment were included in this study. Data was collected through clinical information, laboratory testing, and radiomics-derived characteristics. The use of the least absolute shrinkage selection operator (LASSO) regression analysis and multi-variable logistic regression is employed to construct a clinical prediction model, which takes the form of a logistic nomogram. The effectiveness of the nomogram model was evaluated using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Results: A total of three predictors, namely body mass index (BMI), hemoglobin (Hb) and radiomics characteristic score (Radscore) were identified by LASSO regression analysis from a total of 18 variables studied. The model constructed using these three predictors displayed medium prediction ability. The area under the ROC curve was 0.895 (95% CI 0.844-0.945) in the training set, with a cutoff value of 0.651, precision of 0.957, and sensitivity of 0.718. In the validation set, it was 0.880 (95% CI 0.806-0.954), with a cutoff value of 0.655, precision of 0.930, and sensitivity of 0.698. DCA also confirmed the clinical benefit of the combined model. Conclusions: This simple and dependable nomogram model for clinical prediction can assist physicians in assessing preoperative nutritional risk in GC patients in a time-efficient and accurate manner to facilitate early identification and diagnosis.
Background and Objectives: Women are more prone to iron deficiency (ID) anemia when pregnant. The diagnostic use of mean reticulocyte volume (MRV) in identifying ID anemia during pregnancy has not been thoroughly investigated. The objective of study is to evaluate the effectiveness of MRV in diagnosing ID in pregnant women. Methods and Study Design: At first, the MRV of 20 healthy female volunteers (healthy group) was measured on specific days throughout one month. Subsequently, clinical data from 724 pregnant women were thoroughly examined. These women were divided into two groups: 282 with ID (research group) and 442 without ID (control group). Parameters such as MRV, reticulocyte hemoglobin equivalent (RHE), red blood cell volume distribution width-standard deviation (RDW-SD), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), reticulocyte count (RET), MRV/MCV ratio, and serum ferritin (SF) were analyzed and compared. Results: The MRV remained consistent over a month for 20 healthy individuals. In addition, there were significant differences in MRV, RHE, RDW-SD, MCV, MCH, MCHC, HCT, RET, and MRV/MCV between the research group and control group. The receiver operating characteristic (ROC) analysis showed that the areas under the curve (AUCs) for these measures were as follows: 0.840, 0.837, 0.676, 0.654, 0.639, 0.602, 0.571, 0.550, and 0.816, respectively. Ultimately, there was a substantial disparity in MRV prior to and following therapy with oral iron treatments. Conclusions: In healthy women, MRV remains stable and reliably diagnoses ID, while assessing oral iron treatment effectiveness during pregnancy.
Background and Objectives: Study aim was to determine the levels of and barriers of the Nutrition Care Process (NCP), a practical method of individualized nutrition support. Methods and Study Design: The delegate of registered dieticians (RDs) from acute-care hospitals answered our nationwide web-based questionnaire (April-June, 2023) to determine the implementation status of Screening, Assessment, Intervention (including Planning), and Monitoring (components of the NCP). Results: Of 5,378 institutions contacted, 905 (16.8%) responded. For the Screening, 80.0% screened all inpatients: the primary personnel in charge, RDs (57.6%); the most used screening tool, the Subjective Global Assessment (SGA) (49.2%). For the Assessment, 66.1% assessed all inpatients: most evaluated, food intake (93.3%); least evaluated, muscle mass and strength (13.0%, 8.8%). For the Intervention, 43.9% did so within 48 hours of hospital admission: the most often RDs’ intervention, oral nutritional supplement (92.9%); less intervention, parenteral nutrition (29.9%). For the Monitoring, 18.5% of institutions had it ≥ 3 times/week and 23.0% had it less than once a week for severely malnourished patients: most monitored, energy and protein intake (93.7%, 84.3%); less monitored, lipid dose (30.1%). Conclusions: The barriers of NCP were inefficient staffing systems and unsuitable tools in Screening, inaccurate patient targeting and lack of important evaluation items in Assessment, delayed timing and incomplete contents in Intervention, and inadequate frequency and lack of important evaluation items in Monitoring. An increase in RDs’ staffing in acute-care general wards, widespread NCP instruction manuals, and education about the tools and evaluation items in nutritional management were the possible solutions.
Background and Objectives: There is no evidence on rich-antioxidants diet in preventing hypertension in heat-exposed workers. We aimed to evaluate the effects of formula supplemented with vitamin C (VC) and hawthorn beverage on reducing blood pressure (BP) and oxidative stress levels in heat-exposed workers. Methods and Study Design: In the 40-day cluster-randomized controlled trial, four heat-exposed shift-teams were enrolled and randomly assigned to the intervention and control groups. The intervention group was given one VC tablet with 130.0 mg VC and a 500 mL hawthorn beverage with 278.7 mg flavonoids per day, the control group was given 500 mL of slightly salted water per day, and both groups were given healthy diet education. BP and creatinine-corrected urinary 8-isoprostane-prostaglandin F2α (8-iso-PGF2α/Cr) concentrations were assessed at baseline, Day 17 (only BP) and Day 41, respectively. Results: Compared with the control group, the systolic BP (SBP), diastolic BP (DBP), and log10-transformed 8-iso-PGF2α/Cr in the intervention group decreased by 7.41 mmHg, 7.93 mmHg and 0.232, respectively, from baseline to day 41 (all p<0.05). When considering baseline BP levels, compared with the control group, DBP in the intervention group was reduced by 5.46 mmHg (p<0.05) among participants with lower baseline BP, and SBP and DBP experienced reductions of 9.74 and 9.22 mmHg among participants with higher baseline BP (both p<0.05). Conclusions: The intervention involving the supplementation of VC and hawthorn beverage rich in flavonoids to heat-exposed workers had prevented the elevated BP caused by heat exposure and this might through its inhibition of oxidative stress.