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: 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 supplementation in early life supports adequate growth, increased serum gangliosides concentration and improves some measures of cognitive development in Chinese infants.
Background and Objectives: The role of maternal vitamin D in infantile growth remains unclear. Methods and Study Design: Serum 25-hydroxyvitamin D [25(OH)D] concentrations were examined for pregnancies who visited the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from January 2016 to December 2017. Anthropometric measurements of corresponding offspring were performed from birth to 2 to 3 years old. Infantile body mass index (BMI) was transformed into age-, sex- and height- normalized Z-scores, and Latent Class Growth Mixture (LCGM) model was used to identify trajectories of BMI-Z. Results: Among the 329 included pregnancy women, 109 (33.13 %), 190 (57.75%) and 30 (9.12%) were defined as vitamin D deficiency [25(OH)D <30 nmol/L], insufficiency [30 nmol/L≤25(OH)D<50 nmol/L] and sufficiency [25(OH)D ≥50 nmol/L], respectively. When compared with vitamin D sufficiency, maternal vitamin D deficiency was not associated with preterm birth [odds ratio (OR)=2.69, 95% confidence interval (95% CI) =0.57-12.80], small for gestation age (OR=0.99, 95% CI=0.29-3.46), and low birth weight (OR=1.69, 95% CI=0.34-8.51). Similarly, no significant relationships were found between maternal vitamin D concentrations and anthropometric indices (such as weight, length, BMI) during 0 to 3 years old. Furthermore, LCGM model identified two patterns of offspring growth: stable moderate BMI-Z and early transient BMI-Z groups. Maternal vitamin D levels were higher in the former group than the latter (p=0.037); however, maternal vitamin D status appeared to be unrelated with offspring BMI-Z trajectories in multivariable logistic regression models. Conclusions: Maternal vitamin D deficiency may not be related to adverse pregnancy outcomes as well as offspring growth.
Background and Objectives: To evaluate the effect of oral nutritional supplements (ONS) on community elderly people with malnutrition or risk of malnutrition. Methods and Study Design: A single arm intervention trial for 3 months was conducted. Whole nutrient powder was given to all the participants. Dietary intakes were measured by 3-day diet record. Nutritional status was evaluated using body weight, body mass index (BMI), calf circumference (CC), and Mini Nutritional Assessment Short-Form (MNA-SF) scores. Muscle mass was measured by bioimpedance analysis (BIA). All these parameters as well as muscle strength, physical function, and quality of life were measured at both the baseline and the end. Results: Compared with the baseline, ONS increased protein intake (58.32±16.67 vs 41.90±18.49 g/d, p<0.001), body weight (57.03±8.31 vs 56.68±8.23 kg, p<0.05), BMI (22.16±2.13 vs 22.02±2.08 kg/m2, p<0.05), CC (34.21±2.53 vs 33.80±2.53 cm, p<0.001), MNA-SF scores (12.61±1.43 vs 10.48±0.99, p<0.05), hand grip strength (24.54±8.05 vs 23.27±7.74 kg, p<0.001), and 6-m gait speed (1.11±0.33 vs 0.96±0.28 m/s, p<0.001). Moreover, SF-36 scores of the overall subjects have been improved in all dimensions (p<0.05). Conclusions: The study demonstrated that ONS can effectively increase protein intake and improve nutritional status, muscle strength, physical function and quality of life of the elderly with malnutrition or malnutrition risk in communities.
Surgical resection is the primary and most effective treatment for cancer patients. While such a traumatic intervention often accompanies different degrees of postoperative risk largely depending on the patient’s health status. Due to the high prevalence of malnutrition or low cardiorespiratory fitness in elderly cancer patients, prehabilitation is an optimal program to reduce postoperative complications and enhance recovery from surgical trauma. An increasing body of evidence suggests that improving nutrition and taking aerobic exercise or strength training prior to major surgery can help reduce postoperative morbidity, mortality, or length of stay. However, there are still controversies regarding the manner, intensity, or duration of preoperative nutrition and exercise training in elderly patients, as well as the impact on delaying cancer treatment. This article reviews the impact of prehabilitation on improving postoperative outcomes in the multi-modal or single-modal pathway, aiming to maximize its effectiveness and increase medical practitioners’ attention on enhancing the physical condition of the elderly cancer patients preoperatively.