Background and Objectives: Human milk fat globule membrane (MFGM) has multifunctional health benefits. We evaluated neurodevelopment and growth of healthy term infants fed bovine milk-derived MFGM-enriched formula (MF) over 12 months. Methods and Study Design: A prospective, multi-centre, double-blind, randomized trial was conducted in Fuzhou, China. Healthy term infants (n=212), aged <14 days, were assigned
randomly to be fed MF or a standard formula (SF) for 6 months and then switched to stage 2 MF and SF formula until 12 months. A reference group (n=206) contained healthy breastfed infants (BFR). Neurodevelopment was assessed with Bayley-III Scales. Results: At 12 months, the composite social emotional (+3.5) and general adaptive behaviour (+5.62) scores were significantly higher in MF than SF (95% CIs 0.03 to 6.79 and 1.78 to 9.38; p=0.048 and 0.004, respectively). Mean cognitive (+2.85, 95% CIs -1.10 to 6.80, P = 0.08), language (+0.39, 95% CIs -2.53 to 3.30, p=0.87) and motor (+0.90, 95% CIs -2.32 to 4.13, p=0.49) scores tended to be higher in MF than SF, but the differences between the two groups were not significant. BFR scored higher on Bayley-III than either MF or SF at 6 and 12 months.
Cognitive scores were significantly higher in BFR than SF (95% CI 0.05 to 7.20; p=0.045), but not MF (p=0.74) at 6 months. Short-term memory was significantly higher in MF than SF at 12 months (95% CI 1.40 to 12.33; p=0.008). At 4 months, serum gangliosides were significantly higher in MF and BFR than SF (95% CI 0.64 to 13.02; p=0.025). Milk intake,
linear growth, body mass and head circumference were not significantly different between formula-fed groups. Conclusions: MFGM upplementation in early life supports adequate growth, increased serum gangliosides concentration and improves some measures of cognitive development in Chinese infants.
Background and Objectives: This study aimed to evaluate the application of the improved B-ultrasound method (hereafter referred to as B method) for measuring the antral section to evaluate gastric motility in guiding EN for patients with sepsis. Methods and Study Design: In this single-center, non-blinded, randomized controlled trial, 64 patients with sepsis were randomly enrolled from January 2018 to December 2019. The improved B method (study group) and physicians’ clinical experience (control group) were used to guide EN. The two groups patients were separated randomly both. Results: Compared with the control group, the study group had a significantly shorter EN start time, faster initial rate of EN, lower incidence of EN interruption, and shorter Tmax (p<0.05,95% confidence intervals.) and exhibited lower incidences of adverse reactions (p<0.05). Kaplan–Meier survival analysis demonstrated that the study group exhibited significantly fewer adverse EN complications (p=0.029), shorter MV duration, and decreased ICU stay and in-hospital mortality (p<0.05). Conclusions: The improved B method could perform real-time monitoring of gastric function. Additionally, compared with the physician’s personal clinical experience, the improved B method exhibits a better effect in guiding EN for patients with sepsis.
Background and Objectives: This study evaluated the association of physical prefrailty with the prevalence of inadequate nutrients among community-dwelling Japanese elderly women. Methods and Study Design: This cross-sectional study included 120 older women (age range, 65–79 years) at an elders college. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study (J-CHS). Participants were classified as either prefrailty (1–2 deficits) or nonfrailty (0 deficits) based on set criteria. Both groups were compared in terms of physical function, exercise time, nutrient intake, and food group intake estimated by Food Frequency Questionnaire Based on Food Groups (FFQg), and estimated prevalence of
inadequate nutrient intake, which was evaluated using each dietary reference value, set as the estimated average requirement (EAR) and dietary goal (DG), based on the Dietary Reference Intakes (DRIs) for Japanese, 2020. Results: Of the participants, 45.0% exhibited physical
prefrailty. Binary logistic regression analysis identified that vitamin C intake below EAR (OR, 7.12; 95% CI, 1.47-34.41, p=0.014) was the only factor associated with physical prefrailty. Conclusions: In addition to measuring physical function, dietary surveys and evaluation of nutritional adequacy by DRIs are expected to be useful for the early prevention of physical prefrailty by linking to nutrition education among community-dwelling Japanese elderly adults.
Background and Objectives: We evaluated the effectiveness of a 24-week nutritional ingestion program involving essential amino acid and tea catechin intake after performing resistance exercise in increasing the skeletal muscle mass, physical performance, and quality of life of healthy older people. Methods and Study Design: An open-label randomized controlled trial involving 84-healthy older individuals (age ≥65 years) without sarcopenia, diabetes, and kidney disease, was conducted. They were allocated to the exercise (n=28), exercise and essential amino acid ingestion (n=28), and exercise, essential amino acid, and tea catechin ingestion groups (n=28). The participants underwent a 24-week program of resistance exercise (performed twice per week) along with essential amino acid and tea catechin intake (3,000 and 540 mg, respectively). Results: Six participants could not complete the intervention after randomization. After the 24-week intervention period, the exercise, essential amino acid, and tea catechin ingestion groups showed an increase in the skeletal muscle mass index, one-legged balance test, and physical quality of life score (skeletal muscle mass index, p=0.004; one-legged balance test, p=0.045; physical quality of life, p=0.020). After the 24-week intervention period, the exercise and essential amino acid ingestion group showed an increase in the skeletal muscle mass index and physical quality of life score (skeletal muscle mass index, p=0.014; physical quality of life, p=0.041). However, the exercise group did not show an increase in the skeletal muscle mass index. Conclusions: These results suggested that resistance exercise, essential amino acid, and tea catechin intake in healthy older people could improve physical performance.
Background and Objectives: To assess the causality of potentially modifiable factors, including lifestyle, nutrients, lipids, anthropometric traits, and inflammatory factors of Parkinson’s disease (PD), genetic instruments for modifiable factors were identified from genome-wide association studies (GWAS), with a total of 38 potentially modifiable factors being included. Methods and Study Design: Genetic associations for PD (1,239 cases and 451,025 matched controls) were extracted from the UK Biobank GWAS summary statistics. The causal effects of modifiable factors on the risk of PD were estimated using the multiplicative random-effects inverse variance weighted method (IVW). Results: In the IVW analysis, a decreased risk for PD was causally associated with genetically predicted smoking cessation (odds ratio 0.41, [95% confidence interval]0.32 to 0.78; p=6.52×10-4), higher bone mineral density (0.43, 0.38, 0.71; p=2.31×10-5), and higher concentrations of vitamin B-12 (0.56, 0.43 to 0.91; p=4.15×10-6), docosahexenoic acid (0.52, 0.37 to 0.71; p=2.58×10-4), and sIL-6R (0.69, 0.58 to 0.75; p=3.17×10-6). A one standard deviation increase in apolipoprotein
(a) isoform size was found to be associated with a 67% increase in PD risk (1.67, 1.36 to 1.71; p=1.59×10-4). Being a genetically morning person (2.18, 1.12 to 4.72; p=3.51×10-5) was associated with a higher risk for PD, while a higher cigarette smoking number was associated with higher odds of PD (1.05, 1.01 to 1.08; p=1.34×10-4). Conclusions: In conclusion, our findings provide new evidence for the potential positive causal association of cigarette smoking number and apolipoprotein (a) isoform size and the inverse causal association of vitamin B-12, docosahexaenoic acid, smoking cessation, and soluble interleukin-6 receptor with PD, which contributes to the development of new interventions for PD.
Background and Objectives: This study aimed to explore the correlation between population-based iodine intake from iodized salt (iodine-IS) and thyroid cancer (TC) incidence. Methods and Study Design: The TC incidence data were collected from the annual reports issued by China’s National Central Cancer Registry. The iodine-IS data were extracted from the National Iodized Salt Surveys and National IDD Surveys (NIDDs). The time lag effect of iodine-IS on TC incidence was examined by using a polynomial distributed lag (PDL) model. Results: Iodine-IS consumption peaked in 1999, declined to approximately 60% of 1999 in 2018, but remained close to 142.2 μg/person/day. After 2000, TC incidence increased notably on an annual basis. Iodine-IS and the age-standardized rate adjusted to the world population of TC incidence were significantly negatively correlated (p<0.05). The PDL model revealed that iodine-IS had a significant 6-year time lag effect on TC incidence (p<0.05). Conclusions: Iodine nutrition, as indicated by iodine-IS, exhibited a steady decline. The population-based iodine-IS was adequate, however, TC incidence continued increasing. Although the 6-year cumulative effect of iodine-IS was considered, a negative correlation between iodine-IS and TC incidence was observed. Iodine-IS may not be a major risk factor for TC because universal salt iodization is maintaining adequate iodine nutrition in the population. The increasing TC incidence may reduce public willingness to consume iodized salt.
Background and Objectives: This study aimed to explore the associations of postpartum dietary quality and behavioral practices with maternal health in Guangzhou China. Methods and Study Design: We conducted a cross-sectional study among puerperal women in urban and suburban areas in Guangzhou, China (n=2013). Data for postpartum dietary and behavioral practices and health conditions were collected by a standardized questionnaire. Dietary balance index (DBI) was calculated to assess an individual’s dietary quality. Logistic regression analysis was used to identify the factors related to women’s health. Results: 75.5% of women reported at least one postpartum disease, and the most common problems were prolonged duration of lochia (70.0%) and backache (43.0%), followed by constipation (23.6%), insufficient milk secretion (19.2%), breast swelling (18.5%) and hemorrhoids (13.8%). Average postpartum weight retention was 3.5 kg. Logistic regression analysis revealed that 12-18 h/d of bed rest time, breastfeeding, doing postpartum exercise, basking, getting out of bed within 2 days after delivery, higher intake of fish and shrimp, fruits,
vegetable, milk were protective factors for at least one out of these health problems or weight retention (p<0.05). Bed rest time for more than 18 h/d or less than 12 h/d, ginger vinegar intake, doing housework, cesarean section, and excessive and inadequate intake of cereals had an adverse association (p<0.05). Conclusions: Some features of a traditional Chinese
postpartum diet and behaviour are related to maternal morbidity during the puerperium. Further studies are needed to assess whether postpartum diet and behavioral intervention improve maternal health during the postpartum period.
Background and Objectives: Ketogenic diet (KD), a well-known nonpharmacologic treatment of intractable epilepsy, could adversely affect growth and nutritional status; however, such data are limited in Thailand. This study aimed to assess growth and nutritional status of Thai children treated with KD together with dietary adherence and its related factors. Methods and Study Design: The records of children treated with KD for more than 1 month between January 2009 to September 2020 were reviewed. Weight, height, and biochemical indices were retrieved at baseline, 1,3,6,12,18, and 24 months. Type of KDs, compliance and adverse effects were extracted. Results: Forty-eight patients (21 male) were enrolled. Median age was 3.5 years (IQR 0.9, 10.1). There was no significant decrease in weight-for-age z score (WAZ) despite a trend toward minimal reduction in WAZ at 3 months. Median followup time was 13 months (IQR 7, 29.5). Height-for-age z-score (HAZ) significantly decreased at 12 months [median -1.55 (IQR -3.35, -0.43) vs baseline median -0.6 (IQR -2.07, 0.29)]. Adherence of KD in tube feeding patients was better than oral feeding. Thirty seven percent (18/48) of the patients continued the diet beyond 2 years. Early discontinuation before 6 months was mostly due to poor compliance from patients and families (6/11, 55%). Common adverse effects were GI problems (77%), dyslipidemia (64%) and hypercalciuria (29%). Conclusions: Under close monitoring, KD can be administered in Thai children with minimal adverse effects on growth and nutritional status. Adherence depends on route of feeding, clinical response, and cooperation of the families.
Background and Objectives: Observational studies have associated lifestyle, dietary, adiposity, biochemical and clinical measures with heart failure. Whether the associations are causal remains unclear. We aimed to determine the causal associations between modifiable risk factors and incidence or mortality of heart failure. Methods and Study Design: Using single-nucleotide polymorphism (SNP) as genetic instruments, we conducted a two-sample Mendelian randomization (MR) analysis to estimate the causal effects of 27 modifiable risk factors on incident heart failure (2526 cases; 20926 participants) and mortality of heart failure (1798 deaths; 2828 patients). Results: None of 27 modifiable risk factors were significantly associated with incidence or mortality of heart failure after the Bonferroni correction (p<0.0019). However, there was suggestive evidence for genetically predicted educational attainment (odds ratio [OR] per educational year increase: 0.57, 95% CI 0.33-0.99, p=0.049), circulating mono-unsaturated fatty acid concentrations (OR per 1-SD increase [ORSD] : 1.50, 1.10-2.04, p=0.011), C-reactive protein (CRP) (1.53, 1.04-2.25, p=0.031), high-density lipoprotein (HDL) (0.84, 0.72-0.99, p=0.036), triglycerides (1.24, 1.00-1.52, p=0.045), and systolic blood pressure (SBP) (1.06, 1.01-1.11, p=0.017) with incident heart failure. Conclusions: Our findings provide supporting evidence for prioritizing certain modifiable risk factors such as education, lipids, and blood pressure for primary prevention of heart failure, suggesting important clues for further mechanism research.
Background and Objectives: To present a new method of text-modified food management for patients with dysphagia that integrates the idea of food exchange. In addition to prioritizing nutrition in each recipe, the diet plan emphasizes straightforward preparation methods that balance nutrition and palatability. Methods and Study Design: On the basis of the recommended intake in the Expert Consensus, the design of the texture-modified food incorporates the concept of equivalent food exchange. The plan consists of a staple food, a meat, a vegetable, a snack, and a fruit as the base units, and the volume and nutrient density of each unit is modified to meet the needs of patients with dysphagia. Results: Five categories of standard portions were established, the standard portion of staple foods, milk should be used instead of water during preparation, and carbohydrate components (dextrin) should be added so that each portion provides approximately 200 Kcal of energy. The standard portion of meat,
protein components (90% whey) should be added to provide approximately 14 g of protein and 150 Kcal of energy per portion. Two types of standard snacks are recommended, each serving provides 250 Kcal of energy. Vegetables and fruits provide 70 Kcal and 90 Kcal of energy. We compiled 19 recipes representative of the food exchange system and our recipe design priorities (texture modification, sufficient nutrition, color, fragrance and taste). Conclusions: The method is combined theory and practice and can be applied to clinical nutrition work to promote the nutritional intake of patients with dysphagia.
Background and Objectives: Frailty and malnutrition are overlapping geriatric syndromes and leads to poor clinical outcomes in older patients. This study determined whether Malnutrition Universal Screening Tool (MUST) can predict frailty in older hospitalised patients. Methods and Study Design: This prospective study recruited 243 patients ≥65 years in a tertiary-teaching hospital in Australia. Frailty assessment was performed by use of the Edmonton-Frail-Scale (EFS), while malnutrition-risk was determined by use of the MUST. Patients with an EFS score >8 were classified as frail, while patients with a MUST score of 1 as at moderate malnutrition-risk and ≥2 as at high malnutrition-risk. Multivariable logistic regression determined whether malnutrition-risk predicts frailty after adjustment for various co-variates. Results: The mean (SD) age was 83.9 (6.5) years) and 126 (51.9%) were females. One-hundred and forty-nine (61.3%) patients were classified as frail, while 66 (27.2%) were found to be at high malnutrition-risk according to the MUST. Frail patients were more likely to be older with a higher Charlson-index and on polypharmacy than non-frail patients. Patients who were at high malnutrition-risk were more likely to be living alone and on vitamin D supplementation than those at low malnutrition-risk. Patients who were at a high malnutrition-risk but not those who were at moderate malnutrition-risk, were more likely to be deemed frail (aOR 2.6, 95% CI 1.2–5.5, p=0.015) when compared to those who were at low alnutrition-risk. Conclusions: Only patients who were classified as at high malnutrition-risk according to the MUST are more likely to be deemed frail.
Background and Objectives: Diabetes mellitus (DM) leads to nearly 3-fold higher risk of pulmonary tuberculosis (TB), indicating an increasing challenge to public health in low-to middle income countries. Till now, the risk factor is still uncertain. We carried out this study with the main purpose to identify the risk factors of having TB in DM patients. Methods and Study Design: A hospital-based matched case-control study was conducted in Qingdao, China from March, 2016 to January, 2018. Cases were DM patients with concurrent TB (DMTB). Each case was matched with two controls, patients with DM only of similar age, sex and DM course. Cox regression of conditional logistic analysis was used to define the risk factors
for having TB in DM, and then sensitivity analysis was carried out. Results: We identified 315 patients, including 105 cases and 210 controls. Smokers had a higher risk of having TB with a multivariable adjusted odds ratio (aOR) of 12.45 than non-smokers. Poor glycemic control (aOR=2.66), frequency of DM re-examination <1 time/year (aOR=3.39), as well as
TB contact history was also independently related with higher risk, while BMI ≥24 (aOR=0.42), education level ≥ college (aOR=0.11) showed a negative association. Conclusions: Poor glycemic control, smoking, low frequency of reexamination was associated with higher risk of having TB in DM, while overweight and obesity, high education levels showed a negative association. These findings provide clues to target DM populations prone to TB, which may be of help to halt the epidemic of TB in high burden countries.
Background and Objectives: Research has produced inconsistent findings on the association between dietary patterns and cognitive function. In the present study, we examined the association between dietary patterns and cognitive function among rural China’s older adults and aimed to identify major dietary patterns. Methods and Study Design: This cross-sectional study included 1176 individuals aged 65–85 years. Dietary intake was assessed using a food frequency questionnaire. Factor analysis and the Chinese Dietary Balance Index were respectively employed to determine dietary patterns and assess dietary quality. Cognitive function was evaluated using the Mini-Mental State Examination, and logistic regression analysis was performed to examine the relationship between dietary patterns and cognitive decline. Results: Three main dietary patterns were identified and named on the basis of foods with high content: a “healthy dietary pattern,” a “multigrain dietary pattern,” and a “snack dietary pattern.” With the increase in the score of the healthy dietary pattern, the Mini-Mental State Examination total score exhibited a significant downward trend (p<0.001). Moreover, we observed a prominent negative association between the healthy dietary pattern and mild cognitive impairment (4th to 1st quartile, OR=0.36; 95%CI, 0.24–0.54; p<0.001). After we adjusted for potential covariates, the negative correlation remained (4th to 1st quartile, OR=0.48; 95%CI, 0.28–0.81; p=0.006). However, no relation was observed between mild cognitive impairment and either the multigrain or snack dietary patterns. Conclusions: The healthy dietary pattern, which is based on the consumption of rice and flour, red meat, chicken, vegetables, seafood, and fruits, protects against cognitive dysfunction.
Background and Objectives: Sleep disturbance is a common health problem in the elderly population. We examined the association between dietary variety and subjective sleep quality in community-dwelling elderly Japanese women. Methods and Study Design: This cross-sectional study recruited 160 community-dwelling elderly women aged ≥65 years. Subjective sleep quality and dietary variety were assessed by Pittsburg Sleep Quality Index (PSQI) and dietary variety score (DVS), respectively. DVS was calculated from the eating frequency of 10 food groups. Sleep disturbance was defined as PSQI score of ≥6. Results: The DVS in subjects with sleep disturbance was significantly lower than that of those without the disturbance (4.1±2.1 vs 5.3±2.1, p<0.01). In the multivariable regression model, the PSQI score was negatively correlated with the DVS score in age-adjusted model (standardized coefficient; −0.234, p<0.01). In the further adjusted model that included depression levels, the negative association between PSQI score and DVS score was retained (standardized coefficient; −0.211, p<0.05). Among 10 food groups comprising DVS, the eating frequency of soybean and soybean products was the determinant of sleep disturbance in the stepwise liner regression analysis. In the further model that contained DVS, DVS was the independent determinant of sleep disturbance, while the eating frequency of soybean and soybean products was excluded. Conclusions: A worse sleep quality was associated with lower DVS in elderly Japanese women. Diet comprising various food groups was better for sleep quality than consuming only a particular food in the elderly.
Background and Objectives: To date, few studies have comprehensively explored the association between milk and dairy product intake and dental caries. Therefore, this study aimed to simultaneously assess the associations between whole milk, low-fat milk, skim milk, yogurt, milk desserts, cheese, creams, and total fluid milk intake and the risk of dental caries in children and adolescents. Methods and Study Design: Data were from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Two 24-hour dietary recall interviews measured dietary milk and dairy product intake. Primary teeth caries was diagnosed by the dfs (decayed or filled primary tooth surfaces) index, and permanent teeth caries was diagnosed by the DMFS (decayed, missing, or filled permanent tooth surfaces) index. We used logistic regression to explore the associations between milk and dairy product intake and the risk of dental caries. Results: A total of 6885 individuals aged 2-17 years were included in this study. In the fully adjusted model, the odds ratios (95% confidence intervals) of dental caries were 0.66 (0.47-0.93) for intake ≥ 122.50 g/day of yogurt and 0.82 (0.69-0.98) for intake < 22.58 g/day of cheese, as compared with non-consumers. Conclusions: Our study indicates that high yogurt and low cheese intake is associated with a decreased risk of dental caries among American children and adolescents. These findings may be applied to update and supplement the evidence that informs public health policies on milk and dairy products and the prevention of dental caries.
Background and Objectives: Malnutrition is implicated as a key modifiable risk factor for sarcopenia. As such, a dietary pattern analysis, rather than an analysis of single food items or nutrients, may provide insights into the comprehensive contribution of diet and nutrition to the risk of sarcopenia. Accordingly, the aim of this study was to evaluate the relationships between main dietary patterns and sarcopenia. Methods and Study Design: A total of 591 participants aged over 40 years were included in this cross-sectional study. A validated foodfrequency questionnaire was used to assess their dietary intake, and principal component analysis (PCA) was used to identify the main dietary patterns. A multivariate logistic regression model was used to explore the associations between their main dietary patterns and
the risk of sarcopenia. Results: This study identified 56 cases of sarcopenia, equating to an overall detection rate of 9.48%. The PCA revealed four major dietary patterns among the participants: “coarse cereals and vegetables”; “beverages and animal organs”; “poultry, fish and shrimp”; and “fruits and pasta”. After adjusting for age, sex, physical activity and smoking, individuals with the “coarse cereals and vegetables” dietary pattern had a 63.0% reduction in the risk of sarcopenia. Conclusions: The “coarse cereals and vegetables” dietary pattern is negatively correlated with sarcopenia, and may reduce the risk of sarcopenia.
Background and Objectives: It is important to evaluate the swallowing function of patients with acute cerebral infarction. The effects of nutritional intervention after an early assessment by a flexible endoscopic evaluation of swallowing (FEES) were evaluated. Methods and Study Design: This retrospective study included 274 patients who were hospitalized for acute
cerebral infarction and underwent a FEES between 2016 and 2018. The effects of early nutritional intervention after an assessment by a FEES within 48 h from admission were evaluated. The patients were divided into a shorter hospital stay group (<30 days) and a longer group (≥30 days). A multivariate analysis was performed to identify the predictive factors for a shorter hospital stay. Results: The overall patient characteristics were as follows: 166 men; median age, 81 years old; and median body mass index (BMI), 21.1 kg/m2. No significant differences in the age, sex, or BMI were found between the shorter and longer hospital stay groups. A FEES within 48 h of admission (odds ratio [OR], 2.034; 95% confidence interval [CI], 1.121–3.691; p=0.02), FILS level ≥6 at admission (OR, 2.309; 95% CI, 1.197–4.457; p=0.013), and an administered energy dose of ≥18.5 kcal/kg on hospital day 3 (OR, 2.345; 95% CI, 1.178–4.668; p=0.015) were independently associated with a hospital stay <30 days. Conclusions: Patients with acute cerebral infarction are more likely to have a shorter hospital stay (<30 days) if they undergo a FEES early after admission and receive optimal nutritional intervention.
Background and Objectives: Through Zero Hunger Strategic Reviews, national governments articulate how they can achieve the second Sustainable Development Goal targets of zero hunger and zero malnutrition by 2030. To suggest how such strategic reviews might accelerate progress towards those goals, an in-depth critical assessment was undertaken of Zero Hunger Strategic Reviews carried out between 2015 and 2019 in 13 countries in Asia and the Pacific. The appraisal focused on the conceptual frameworks used to guide the content of the processes and, secondly, on how well those involved understood the factors that drive or block policy change in their respective countries. Methods and Study Design: The
qualitative study involved a desk review of: (1) all reports produced for the 13 strategic reviews; (2) guidance notes for their implementation; and (3) conceptual frameworks pertinent to them. Results: More explicit use of globally accepted conceptual frameworks would strengthen the national strategic reviews. More importantly, none considered closely the challenges that would arise as efforts are made to obtain approval for policy reforms and increased allocations of public resources to address hunger and malnutrition more effectively. Conclusions: Any recommendations from such strategic reviews will need to be assessed against competing development priorities and then planned, coordinated, and implemented
effectively. While accurate technical understanding is necessary to take strategic action, the best plans to eliminate hunger and malnutrition will flounder if efforts are not also made to advocate for policy change, to build political leadership, and to hold accountable those responsible for the actions required.
Background and Objectives: To investigate the effects of oral preoperative regimens on gastric emptying time in relation to BMI in Chinese adults. Methods and Study Design: The enrolled 56 adults were divided into three groups (normal-weight, underweight, and overweight) and completed a regimen of two drinks after a 2-week interval. After drinking a carbohydrate regimen (CD, 50 g carbohydrates) or a carbohydrate glutamine regimen (CGD, 44 g carbohydrates and 6 g glutamine) labelled with 99mTc-DTPA (99mTcdiethylenetriaminepentaacetic acid), gastric emptying times T50 and T90 were measured using a curve derived from scintigraphic images. Results: T50 and T90 had no significant difference between the CD and CGD regimens. T50 was significantly delayed in the
underweight participants (BMI <18.5 kg/m2, as Chronic Energy Deficiency, CED) compared with the normal-weight participants after drinking CD (p=0.003) or CGD (p=0.002), as well as T90 after CD (p=0.019). There was no difference in glucose concentrations between the three groups. There are negative correlations between body weight and gastric emptying time
T50 (r=-0.461, p=0.016) or T90 (r=-0.553, p=0. 003) after drinking CD, as well as T50 (r=-0.553, p=0.003) after drinking CGD. Conclusions: Underweight adults should be careful to take oral preoperative regimens 2 hours before surgery and consider reducing the volume because of a slower gastric emptying rate.