Asieh Mansour, Sayed Mahmoud Sajjadi-Jazi, Maryam Mirahmad
et al.
Abstract Background Less is known whether the amino acid composition of dietary protein sources effects on long-term health outcomes. We aimed to evaluate the association between dietary amino acid composition and all-cause and cause-specific mortality. Methods This study used data from the Golestan Cohort Study, which was performed in the Golestan Province of Iran from January 2004 to June 2008. Mortality, which was the primary outcome, was ascertained through September 2022. The Cox proportional hazards regression models were used to determine the adjusted hazard ratios (HR) and 95% confidence intervals (CI) for mortality according to the quintiles of amino acid consumption, taking the third quintile as the reference. Results A total of 47,337 participants (27,293 [57.7%] women) with a mean (standard deviation) age of 51.9 (8.9) years were included. During a median follow-up of 15 years, 9,231 deaths were documented. Regarding essential amino acid intakes, the HRs of all-cause mortality were 1.16 (95% CI, 1.07–1.26) in the first quintile, compared with the reference group (P for non-linear trend < 0.001). Similarly, non-linear associations were observed between risk of all-cause mortality and intake of branched-chain, aromatic, sulfur-containing, or non-essential amino acids (P for non-linear trend < 0.001 for all comparisons), with higher HRs for participants in the first quintiles. There was an age interaction for the associations between dietary amino acids and mortality (P for interaction ˂0.05). While high amino acid diets were detrimental in middle-aged adults (< 65 years), increased hazards of mortality were observed among older adults (≥ 65 years) with low amino acid intake. Conclusions This study showed the non-linear trend between amino acids intake and risk of mortality in the middle-aged and older Iranian population. Overall, our findings suggest that diets lower in amino acids were associated with increased hazards of mortality, particularly among older adults.
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases
Abstract Background Modifying diet is crucial for diabetes and complication management. Numerous studies have shown that adjusting eating habits to align with the circadian rhythm may positively affect metabolic health. However, eating midpoint, eating duration, and their associations with diabetic kidney disease (DKD) are poorly understood. Methods The National Health and Nutrition Examination Survey (2013–2020) was examined for information on diabetes and dietary habits. From the beginning and ending times of each meal, we calculated the eating midpoint and eating duration. Urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and/or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 were the specific diagnostic criteria for DKD. Results In total, details of 2194 subjects with diabetes were collected for analysis. The overall population were divided into four subgroups based on the eating midpoint quartiles. The prevalence of DKD varied noticeably (P = 0.037) across the four categories. When comparing subjects in the second and fourth quartiles of eating midpoint to those in the first one, the odds ratios (ORs) of DKD were 1.31 (95% CI, 1.03 to 1.67) and 1.33 (95% CI, 1.05 to 1.70), respectively. And after controlling for potential confounders, the corresponding ORs of DKD in the second and fourth quartiles were 1.42 (95% CI, 1.07 to 1.90) and 1.39 (95% CI, 1.04 to 1.85), respectively. Conclusions A strong correlation was found between an earlier eating midpoint and a reduced incidence of DKD. Eating early in the day may potentially improve renal outcomes in patients with diabetes.
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases
Abstract
Objective:
To compare the agreement and cost of two recall methods for estimating children’s minimum dietary diversity (MDD).
Design:
We assessed child’s dietary intake on two consecutive days: an observation on day one, followed by two recall methods (list-based recall and multiple-pass recall) administered in random order by different enumerators at two different times on day two. We compared the estimated MDD prevalence using survey-weighted linear probability models following a two one-sided test equivalence testing approach. We also estimated the cost-effectiveness of the two methods.
Setting:
Cambodia (Kampong Thom, Siem Reap, Battambang, and Pursat provinces) and Zambia (Chipata, Katete, Lundazi, Nyimba, and Petauke districts).
Participants:
Children aged 6–23 months: 636 in Cambodia and 608 in Zambia.
Results:
MDD estimations from both recall methods were equivalent to the observation in Cambodia but not in Zambia. Both methods were equivalent to the observation in capturing most food groups. Both methods were highly sensitive although the multiple-pass method accurately classified a higher proportion of children meeting MDD than the list-based method in both countries. Both methods were highly specific in Cambodia but moderately so in Zambia. Cost-effectiveness was better for the list-based recall method in both countries.
Conclusion:
The two recall methods estimated MDD and most other infant and young child feeding indicators equivalently in Cambodia but not in Zambia, compared to the observation. The list-based method produced slightly more accurate estimates of MDD at the population level, took less time to administer and was less costly to implement.
Public aspects of medicine, Nutritional diseases. Deficiency diseases
Chronic energy deficiency can impair the hypothalamic-pituitary-gonadal (HPG) axis and lead to hypothalamic anovulation in underweight women. This review presents the syndromes related to underweight status that are associated with infertility, the summarizes the underlying mechanisms, and reviews the available treatment options. Eating disorders, such as anorexia nervosa (AN), constitute the most common cause of infertility in underweight women, who, in addition, experience miscarriages, and sexual dysfunction. The relative energy deficiency in sports (REDS; former terminology: athlete's triad) involves menstrual dysfunction due to low energy availability, which results in anovulation. Moreover, lipodystrophies, malnutrition, starvation, systematic illnesses (malignancies, endocrinopathies, infectious diseases, advanced chronic diseases, neurologic illnesses), and the utilization of drugs can cause excessive weight loss. They may result in fertility problems due to the loss of adipose tissue and the subsequent hormonal disturbances. Each of these conditions requires multidisciplinary management. Nutritional counseling should target the restoration of energy balance by increasing intake and reducing output. Medical treatment, recommended only for patients who did not respond to standard treatment, may include antipsychotics, antidepressants, or leptin administration. Finally, psychiatric treatment is considered an integral part of the standard treatment.
Asia represents rich traditional dietary diversity. The rapid diet transition in the region is leading to a high prevalence of non-communicable diseases. The aim of this exploratory study was to document traditional foods and beverages and associated traditional knowledge that have potential positive health impacts, from selected countries in the region. The study also focused on identifying their importance in the prevention and management of lifestyle-related diseases and nutritional deficiencies as well as for the improvement of the overall health and wellbeing. This was conducted in selected locations in Indonesia, Thailand, Malaysia and Nepal through a qualitative method with a pre-tested documentation format. Through a detailed documentation of their health benefits, the study tries to highlight the significance of traditional foods in public health as well as their relevance to local market economies towards sustainable production and consumption and sustainable community livelihoods.
Abstract Background This study aimed to explore the association of adherence to the Mediterranean diet (MD), osteopenia and the risk of all-cause mortality in general population. Methods This retrospective cohort study included 5452 participants ≥ 50 years from the National Health and Nutrition Examination Survey (NHANES). The associations of osteopenia and adherence to the MD with all-cause mortality, as well as the interaction and moderating effects between the osteopenia and adherence to the MD on the all-cause mortality, were explored via univariate and multivariable Cox proportional hazards models. Results The follow-up was from October 1, 2006, to December 31, 2019. The median survival time of patients was 81 months. In total, 4724 people were survived and 728 were dead. Osteopenia was associated with increased risk of all-cause mortality in people [hazards ratio (HR) = 1.57, 95% confidence interval (CI) 1.23–1.99]. No significant risk of all-cause mortality was found in people with high adherence to the MD compared with those with low adherence to the MD (P > 0.05). Compared to subjects with no osteopenia who had high adherence to the MD, osteopenia people who had high adherence to the MD (HR = 1.52, 95% CI 1.17–1.98) or low adherence to the MD (HR = 1.81, 95% CI 1.23–2.66) were at increased risk of all-cause mortality after adjusting for confounding factors. The relationship between osteopenia and the risk of all-cause mortality was decreased in those with high adherence to the MD (HR = 1.57, 95% CI 1.17–2.11) compared with those with low adherence to the MD (HR = 1.62, 95% CI 1.08–2.41) after adjusting for confounding factors. Conclusion The adherence to the MD regulated the association between osteopenia and the risk of all-cause mortality, which suggested the importance of adherence to the MD in those with osteopenia, and the MD could be advocated in general people.
Nutritional diseases. Deficiency diseases, Public aspects of medicine
Helda Tutunchi, Sina Naghshi, Mohammad Naemi
et al.
Abstract
Objectives:
To quantify the dose–response relation between yogurt consumption and risk of mortality from all causes, CVD and cancer.
Design:
Systematic review and meta-analysis.
Setting:
We conducted a comprehensive search of PubMed/Medline, ISI Web of Science and Scopus databases through August 2022 for cohort studies reporting the association of yogurt consumption with mortality from all causes, CVD and cancer. Summary relative risks (RR) and 95 % CI were calculated with a random-effects model.
Participants:
Seventeen cohort studies (eighteen publications) of 896 871 participants with 75 791 deaths (14 623 from CVD and 20 554 from cancer).
Results:
High intake of yogurt compared with low intake was significantly associated with a lower risk of deaths from all causes (pooled RR 0·93; 95 % CI: 0·89, 0·98, I2 = 47·3 %, n 12 studies) and CVD (0·89; 95 % CI: 0·81, 0·98, I2 = 33·2 %, n 11), but not with cancer (0·96; 95 % CI: 0·89, 1·03, I2 = 26·5 %, n 12). Each additional serving of yogurt consumption per d was significantly associated with a reduced risk of all-cause (0·93; 95 % CI: 0·86, 0·99, I2 = 63·3 %, n 11) and CVD mortality (0·86; 95 % CI: 0·77, 0·99, I2 = 36·6 %, n 10). There was evidence of non-linearity between yogurt consumption and risk of all-cause and CVD mortality, and there was no further reduction in risk above 0·5 serving/d.
Conclusion:
Summarising earlier cohort studies, we found an inverse association between yogurt consumption and risk of all-cause and CVD mortality; however, there was no significant association between yogurt consumption and risk of cancer mortality.
Public aspects of medicine, Nutritional diseases. Deficiency diseases
Abstract Background Systemic factors can strongly affect how tumour cells behave, grow, and communicate with other cells in breast cancer. Lipid metabolic reprogramming is a systemic process that tumour cells undergo; however, the formation and dynamics of lipids associated with the tumour immune microenvironment (TIME) remain unclear. The investigation of the sophisticated bidirectional crosstalk of tumour cells with cancer metabolism, gene expression, and TIME could have the potential to identify novel biomarkers for diagnosis, prognosis, and immunotherapy. This study aimed to construct a prognostic signature to detect the bicrosstalk between the lipid metabolic system and the TIME of breast cancer. Methods To detect the expression of LRGs and execute GO/KEGG analysis, the R program was chosen. Considering the clinical information and pathological features, a prognostic gene signature was constructed by LASSO Cox regression analysis. TMB, MSI, and immune infiltration analyses were performed, and consensus cluster analysis of LRGs was also performed. Results These 16 lipid metabolism-related genes (LRGs) were mainly involved in the process of lipid metabolism and fatty acid binding in breast cancer. Prognosis analysis identified the prognostic value of FABP7(Fatty acid binding protein 7) and NDUFAB1(NADH:ubiquinone oxidoreductase subunit AB1) in breast cancer patients. The prognostic gene signature constructed with FABP7 and NDUFAB1 was significantly related to immune cell infiltration and could predict the overall survival rate with above average correctness of breast cancer patients. FABP7 and NDUFAB1 were proven to have relevance in immune cell infiltration and tumour mutation burden (TMB). Consensus cluster analysis identified that the upregulated mRNAs were mostly related to the oncogenesis process, while the downregulated mRNAs were associated with immune-related signalling pathways. Conclusion A comprehensive analysis was performed to evaluate the lipid metabolic system and identified a signature constructed by two prognostic genes for immunotherapies in breast cancer. The results also revealed evidence of vulnerabilities in the interplay between the lipid metabolic system and the TIME in breast cancer. Further data with clinical studies and experiments are warranted.
Abstract Background We investigated the association of anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and hip circumference (HC) with the risk of incident sudden cardiac death (SCD) among Iranian population with and without type 2 diabetes mellitus (T2DM). Methods The study population included 9,089 subjects without and 1,185 subjects with T2DM, aged ≥ 20 years. Participants were recruited in 1999–2001 or 2001–2005, and followed for incident SCD annually, up to 20 March 2018. Multivariate Cox proportional hazard models, adjusted for traditional risk factors of cardiovascular disease, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of anthropometric indices (as continuous and categorical variables). Results During a follow-up of over 15 years, 144 (1.58%) and 86 (7.26%) incident SCD occurred in non-T2DM and T2DM groups, respectively. Among non-T2DM group, a 1 standard deviation (SD) increase in WHtR was associated with higher risk of incident SCD by a HR of 1.23 (95% CI: 1.00–1.50) in the multivariable model. From the first quartile to the fourth quartile of WHtR, the trend of SCD risk was significant in age- and sex-adjusted analysis (P-value for trend: 0.041). Other indices did not show significant associations with SCD. Among T2DM group, a 1 SD increase in WHR had a HR of 1.36 (1.05–1.76) in the multivariable model. Considering WHR as categorical variables, the trend of SCD risk across quartiles of WHR was significant. Furthermore, a 1 SD increase in HC led to reduced risk of incident SCD with a HR of 0.75 (0.58–0.97) in multivariable analysis; this lower risk remained significant even after adjustment for WC. Compared to the first quartile, the fourth quartile of HC also showed a HR of 0.50 (0.25–0.99) (P-value for trend = 0.018). BMI, WC, and WHtR did not have significant associations with incident SCD. Conclusion In our long-term population-based study, we demonstrated central but not general obesity (as assessed by WHR in participants with T2DM, and WHtR in participants without T2DM) as a herald of incident SCD. Moreover, HC can have an inverse association with SCD among participants with T2DM.
As the GFR loss aggravates, the disturbed mineral metabolism worsens the bone microstructure and remodelling ‐ scenario, which is known as CKD‐mineral bone disease (MBD). CKD‐MBD is characterized by : (i) abnormal metabolism of calcium, phosphorus, parathyroid hormone (PTH), or vitamin D; (ii) abnormalities in bone turnover, mineralization, volume linear growth or strength; (iii) soft‐tissue calcifications, either vascular or extra‐osseous. Uremic vascular calcification and osteoporosis are the most common complications related to CKD‐MBD. Disregulated bone turnover by uremic toxin or secondary hyperparathyroidism disturbed bone mineralization and makes it difficult for calcium and inorganic phosphate to enter into bone, resulting in increased serum calcium and inorganic phosphate. Vascular calcification worsens by hyperphosphatemia and systemic inflammation. Since vitamin D deficiency plays an important role in renal osteodystrophy, supplement of nutritional vitamin D is important in treating uremic osteoporosis and vascular calcification at the same time. Its pleotropic effect improves the bone remodeling initiated by osteoblast and alleviates the risk factors for vascular calcification with less hypercalcemia than vitamin D receptor analogs. Therefore, nutritional vitamin D should be considered in managing CKDMBD.
Introduction: skin ulcers can generate serious complications in people with diabetes, which can lead to partial or total amputation of the compromised limb. Platelet-rich gel is being used frequently to promote the healing of a skin ulcer. However, the clinical outcomes in healing are often variable because the factors that influence this procedure are not yet fully understood.
Objective: to evaluate the effect of the platelet-rich xenogenic gel on the healing of an induced skin ulcer in a model in rats with type 2 diabetes (T2D).
Materials and methods: 12 Sprague dawley rats were used and divided into 3 groups of 4 rats with an induced 15mm skin ulcer each. Group 1 (with T2D): platelet-rich xenogenic gel was applied. Group 2 (rats with T2D) and group 3 (rats without T2D) applied saline and a dressing. The wound surface was measured on days 0, 20, 29 and 33 using a digital micrometer and photographs.
Nutritional diseases. Deficiency diseases, Diseases of the endocrine glands. Clinical endocrinology
Ayodeji Awoyemi, Marius Trøseid, Harald Arnesen
et al.
Abstract Background Metabolic syndrome (MetS) is a cluster of conditions that conjoined represents a 1.5–2.5 fold increased risk of developing cardiovascular disease (CVD). Recent studies have reported that gut dysbiosis and leakage of bacterial components, may contribute to the metabolic disturbances and systemic inflammation observed in subjects with MetS. Chronic exposure to lipopolysaccharide (LPS) has been shown to induce features of MetS in experimental studies. LPS interacts with the innate immune system, facilitated through LPS-binding protein (LBP) and the co-receptor CD14, both regarded as markers of gut leakage. Purpose We investigated whether circulating levels of LBP and sCD14 are associated with the presence of MetS and its components, and further any association with systemic inflammation. Methods We examined 482 men, aged between 65 and 75 years, all at high CVD risk. MetS criteria’s according to the US National Cholesterol Education Program Adult Treatment Panel III were met in 182 subjects (38%). Results Levels of LBP and sCD14 did not differ between individuals with and without MetS. However, a trend towards increased risk of MetS through quartiles of LBP was observed (p = 0.05). Individuals in the highest quartile (Q4), had an increased risk of MetS (OR = 1.76, 95% CI (1.04–3.00), compared to the lowest quartile (Q1) (p = 0.04). With regard to the separate constituents of MetS, patients who met the waist circumference criterion had significant higher concentration of LBP compared to those who did not (p = 0.04). We also found a weak, but significant correlation between LBP and waist circumference (r = 0.10, p = 0.03). Moderate, yet significant correlations were observed between both LBP and sCD14 and several markers of systemic inflammation (r = 0.1–0.23; p < 0.001–0.04). Conclusion The trend for increased prevalence of MetS observed with increasing quartiles of LBP seems to be mainly driven by central obesity in our male cohort. The associations between LBP, sCD14 and systemic inflammation, indicate a potential role of the innate immune system in MetS. Trial registration CLINICALTRIALS.GOV, NCT00764010. Registered 01 October 2008—retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT00764010?term=NCT00764010&rank=1