Abstract Objective This study aimed to investigate the effects of low-carbohydrate diets (LCD) and low-fat diets (LFD) on sarcopenia, as well as the source and quality of nutrients, to provide strong support for the development of a more scientifically based dietary guidance scheme. Methods The data of this study came from the National Health and Nutrition Examination Survey (NHANES). LCD and LFD scores were calculated based on macronutrient energy proportions. Logistic regression, isoenergetic substitution models were used to evaluate associations with sarcopenia, defined by dual-energy X-ray absorptiometry (DXA). Results A total of 1,745 participants were included in this study, with a mean age of 38.71 ± 0.46 years and a mean body mass index (BMI) of 28.87 ± 0.26 kg/m². After adjusting for covariates, the highest tertiles of overall LCD and healthful LCD scores were associated with a significantly lower risk of sarcopenia, with odds ratios (OR) of 0.48 (95% CI: 0.24–0.96) and 0.51 (95% CI: 0.32–0.81), respectively, compared with the lowest tertiles. In comparison, the highest tertile of the total LFD was associated with a 78% higher risk of sarcopenia (OR = 1.78; 95% CI: 1.03–3.11). Furthermore, replacing 5% of energy from carbohydrates with protein or fat, and with plant protein or unsaturated fat, was associated with reduced sarcopenia risk, with OR of 0.86 (95% CI: 0.74–0.99) and 0.80 (95% CI: 0.65–0.99), respectively. Conclusion In this cross-sectional study, higher overall and healthful LCD scores are associated with a lower risk of sarcopenia, whereas higher overall and unhealthful LFD scores are associated with an increased risk. These findings suggest that the relationships between LCD, LFD, and sarcopenia may depend not only on the quantity of macronutrients but also on their dietary sources.
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases
Santiago De Loredo, Ana Schindler, Carolina Gómez Martin
et al.
En los últimos años se han registrado avances significativos tanto en el tratamiento farmacológico como en el quirúrgico de la obesidad y la diabetes mellitus (DM). Nuevos agentes terapéuticos demostraron eficacia en la reducción ponderal, el control glucémico y la prevención de eventos cardiovasculares. En simultáneo, el perfeccionamiento de las técnicas quirúrgicas amplió las opciones disponibles ofreciendo abordajes cada vez más seguros y eficaces. El presente documento surge de una revisión bibliográfica desarrollada por un equipo de graduados de la Sociedad Argentina de Diabetes con la supervisión de referentes nacionales en la materia. Su objetivo es actualizar las perspectivas actuales sobre el manejo y el tratamiento de la “diabesidad”.
El abordaje de la obesidad y la DM como una entidad conjunta exige un cambio de paradigma por parte del equipo de salud promoviendo una actitud proactiva. Existen opciones terapéuticas farmacológicas y quirúrgicas seguras, pero su adecuada selección requiere de una actualización constante de la evidencia científica, una evaluación interdisciplinaria de las alternativas disponibles y un enfoque individualizado centrado en la persona con DM.
Nutritional diseases. Deficiency diseases, Diseases of the endocrine glands. Clinical endocrinology
A. A. Zabolotneva, O. P. Shatova, J. A. Agapova
et al.
Obesity, type 2 diabetes mellitus (T2DM), and related metabolic disorders occupy the leading positions on the lists of diseases worldwide. It is not surprising that the efforts of many scientific groups and clinicians are aimed at finding effective therapeutic strategies to treat these diseases. In recent decades, the involvement of the intestinal microbiota in the pathogenesis of metabolic, immune, and other disorders in humans has become increasingly obvious. In this regard, attempts are made to modulate the composition and functional activity of the microbiota as a primary or adjuvant way of treating various disorders. The purpose of this review was to highlight and analyse the results of clinical studies in recent years devoted to the study of various methods of modulating the intestinal microbial community for the treatment of obesity, metabolic syndrome, and T2DM. To achieve this goal, we conducted a systematic search using electronic databases, including Scopus, Medline, and PubMed, limiting the publication period from 2019 to 2024. The conducted analysis showed that the therapeutic success of various methods of modulating intestinal microbiota, on the one hand, indicates the need to take into account the characteristics of the microbial composition of the intestines of patients and direct therapeutic actions to correct dysbiosis; on the other hand, it provides grounds for the widespread introduction of pharmacological or other approaches to correcting the microbiotic composition of the intestine as an effective method of treating obesity and associated metabolic disorders.
Abstract Background Women’s physical activity varies across the adult lifespan. However, changes in physical activity among mid-aged women are not well understood. We analysed 21 years of data from women born in 1946–51 to identify: (1) trajectories of physical activity in the transition from mid- to old-age and (2) determinants of different physical activity trajectories. Methods Data were from the 1946–51 cohort of the Australian Longitudinal Study on Women’s Health (N = 10,371). Surveys were mailed at three-year intervals from 1998 (age 47–52) to 2019 (age 68–73) to collect data on physical activity, sociodemographic factors (country of birth, area of residence, educational attainment, marital status, income management, paid work hours, living with children age < 18, providing care), health indicators (menopause status, BMI, physical and mental health, chronic conditions), and health behaviours (smoking, alcohol status). Group-based trajectory modelling was used to identify trajectories of physical activity. Multinomial logistic regression models were used to examine the determinants of physical activity trajectories. Results Five trajectories were identified: Low-stable (13.3% of participants), Moderate-stable (50.4%), Moderate-increasing (22.2%), High-declining (7.7%), and High-stable (6.6%). Sociodemographic characteristics (area of residence, education, income management, living with children, and providing care) were determinants of physical activity trajectories, but the strongest factors were BMI, physical and mental health. Women who were overweight/obese and had poor physical and mental health were less likely to be in the High-stable group than in any other group. Changes in these variables (increasing BMI, and declining physical and mental health) and in marital status (getting married) were positively associated with being in trajectories other than the High-stable group. Conclusions Although most women maintained physical activity at or above current guidelines, very low physical activity levels in the Low-stable group, and declining levels in the High-declining group are concerning. The data suggest that physical activity promotion strategies could be targeted to these groups, which are characterised by socioeconomic disadvantage, high (and increasing) BMI, and poor (and worsening) physical and mental health. Removing barriers to physical activity in these women, and increasing opportunities for activity, may reduce chronic disease risk in older age.
Nutritional diseases. Deficiency diseases, Public aspects of medicine
Abstract Background Obesity affects approximately 800 million people worldwide and may contribute to various diseases, especially cardiovascular and cerebrovascular conditions. Fat distribution and content represent two related yet distinct axes determining the impact of adipose tissue on health. Unlike traditional fat measurement indices, which often overlook fat distribution, the Chinese visceral adiposity index (CVAI) is a novel metric used to assess visceral fat accumulation and associated health risks. Our objective is to evaluate its association with the risk of cardiovascular and cerebrovascular diseases. Methods A nationwide longitudinal study spanning 9 years was conducted to investigate both the effects of baseline CVAI levels (classified as low and high) and dynamic changes in CVAI over time, including maintenance of low CVAI, transition from low to high, transition from high to low, and maintenance of high CVAI. Continuous scales (restricted cubic spline curves) and categorical scales (Kaplan-Meier curves and multivariable Cox regression analyses) were utilized to evaluate the relationship between CVAI and cardiovascular and cerebrovascular diseases. Furthermore, subgroup analyses were conducted to investigate potential variations. Results Totally 1761 individuals (22.82%) experienced primary outcomes among 7717 participants. In the fully adjusted model, for each standard deviation increase in CVAI, there was a significant increase in the risk of primary outcomes [1.20 (95%CI: 1.14–1.27)], particularly pronounced in the high CVAI group [1.38 (95%CI: 1.25–1.54)] compared to low CVAI group. Regarding transition patterns, individuals who consistently maintained high CVAI demonstrated the highest risk ratio compared to those who consistently maintained low CVAI [1.51 (95%CI: 1.31–1.74)], followed by individuals transitioning from low to high CVAI [1.22 (95% CI: 1.01–1.47)]. Analysis of restricted cubic spline curves indicated a positive dose-response relationship between CVAI and risk of primary outcomes (p for non-linear = 0.596). Subgroup analyses results suggest that middle-aged individuals with high CVAI face a notably greater risk of cardiovascular and cerebrovascular diseases in contrast to elderly individuals [1.75 (95% CI: 1.53–1.99)]. Conclusion This study validates a significant association between baseline levels of CVAI and its dynamic changes with the risk of cardiovascular and cerebrovascular diseases. Vigilant monitoring and effective management of CVAI significantly contribute to early prevention and risk stratification of cardiovascular and cerebrovascular diseases.
Donya Firoozi, Seyed Jalil Masoumi, Seyed Mohammad-Kazem Hosseini Asl
et al.
Abstract Background The regulation of the circadian clock genes, which coordinate the activity of the immune system, is disturbed in inflammatory bowel disease (IBD). Emerging evidence suggests that butyrate, a short-chain fatty acid produced by the gut microbiota is involved in the regulation of inflammatory responses as well as circadian-clock genes. This study was conducted to investigate the effects of sodium-butyrate supplementation on the expression of circadian-clock genes, inflammation, sleep and life quality in active ulcerative colitis (UC) patients. Methods In the current randomized placebo-controlled trial, 36 active UC patients were randomly divided to receive sodium-butyrate (600 mg/kg) or placebo for 12-weeks. In this study the expression of circadian clock genes (CRY1, CRY2, PER1, PER2, BMAl1 and CLOCK) were assessed by real time polymerase chain reaction (qPCR) in whole blood. Gene expression changes were presented as fold changes in expression (2^-ΔΔCT) relative to the baseline. The faecal calprotectin and serum level of high-sensitivity C-reactive protein (hs-CRP) were assessed by enzyme-linked immunosorbent assay method (ELIZA). Moreover, the sleep quality and IBD quality of life (QoL) were assessed by Pittsburgh sleep quality index (PSQI) and inflammatory bowel disease questionnaire-9 (IBDQ-9) respectively before and after the intervention. Results The results showed that sodium-butyrate supplementation in comparison with placebo significantly decreased the level of calprotectin (-133.82 ± 155.62 vs. 51.58 ± 95.57, P-value < 0.001) and hs-CRP (-0.36 (-1.57, -0.05) vs. 0.48 (-0.09-4.77), P-value < 0.001) and upregulated the fold change expression of CRY1 (2.22 ± 1.59 vs. 0.63 ± 0.49, P-value < 0.001), CRY2 (2.15 ± 1.26 vs. 0.93 ± 0.80, P-value = 0.001), PER1 (1.86 ± 1.77 vs. 0.65 ± 0.48, P-value = 0.005), BMAL1 (1.85 ± 0.97 vs. 0.86 ± 0.63, P-value = 0.003). Also, sodium-butyrate caused an improvement in the sleep quality (PSQI score: -2.94 ± 3.50 vs. 1.16 ± 3.61, P-value < 0.001) and QoL (IBDQ-9: 17.00 ± 11.36 vs. -3.50 ± 6.87, P-value < 0.001). Conclusion Butyrate may be an effective adjunct treatment for active UC patients by reducing biomarkers of inflammation, upregulation of circadian-clock genes and improving sleep quality and QoL.
AIM: The primary purpose of our study was to understand the damage in the peripheral nerves of patients with diabetes and to determine the change in patients’ reaction rates and perceptions by the age groups, duration of diabetes, fasting plasma glucose and HbA1c values, and compare these with those of the healthy individuals.METHODS: This study was carried out at the Baskent University Hospital Endocrinology and Metabolic Diseases Outpatient Clinic. A total of 64 patients diagnosed with type 2 diabetes and 64 healthy controls were included in the study. Finger tapping, visual, and auditory reaction time tests were performed on the subjects, respectively. The subjects’ fasting plasma glucose and HbA1c levels, and the duration of their diabetes were recorded. Analyses were performed using the SPSS version 25. Differences were considered statistically significant when the p-value is <0.05.RESULTS: It was observed that the participants in the control group between the ages of 18-34 showed a faster reaction in all tests (p=0.01), but the difference in reaction rates in both groups decreased as the age increased. There were positive correlations between the duration of type 2 diabetes and the visual and auditory examination results (r= 0.69, p<0.05, r=0.52, p<0.05, respectively). There was also a positive correlation between the HbA1c (%) and the visual (r=0.97, p<0.05) examination results.CONCLUSIONS: As the patients’ HbA1c levels and the time spent with type 2 diabetes increased, their reaction rate and perception skills decreased. Especially in the early stages of the disease, cognitive decline was observed to be rapid. It is thought that early diabetic control is significant.
Abstract Background Body mass index (BMI) and A Body Shape Index (ABSI) are current independent risk factors for non-alcoholic fatty liver disease (NAFLD). The aim of this study was to explore the value of combining these two most common obesity indexes in identifying NAFLD. Methods The subjects in this study were 14,251 individuals from the NAfld in the Gifu Area, Longitudinal Analysis (NAGALA) cohort who underwent routine health examination. We integrated BMI with WC and with ABSI to construct 6 combined obesity indicators—obesity phenotypes, the combined anthropometric risk index (ARI) for BMI and ABSI, optimal proportional combination OBMI+WC and OBMI+ABSI, and multiplicative combination BMI*WC and BMI*ABSI. Several multivariable logistic regression models were established to evaluate the relationship between BMI, WC, ABSI, and the above six combined indicators and NAFLD; receiver operating characteristic (ROC) curves were drawn to compare the ability of each obesity indicator to identify NAFLD. Results A total of 2,507 (17.59%) subjects were diagnosed with NAFLD. BMI, WC, ABSI, and all other combined obesity indicators were significantly and positively associated with NAFLD in the current study, with BMI*WC having the strongest correlation with NAFLD in female subjects (OR per SD increase: 3.13) and BMI*ABSI having the strongest correlation in male subjects (OR per SD increase: 2.97). ROC analysis showed that ARI and OBMI+ABSI had the best diagnostic performance in both sexes, followed by BMI*WC (area under the curve: female 0.8912; male 0.8270). After further age stratification, it was found that ARI and multiplicative indicators (BMI*WC, BMI*ABSI) and optimal proportional combination indicators (OBMI+WC, OBMI+ABSI) significantly improved the NAFLD risk identification ability of the basic anthropometric parameters in middle-aged females and young and middle-aged males. Conclusion In the general population, BMI combined with ABSI best identified obesity-related NAFLD risk and was significantly better than BMI or WC, or ABSI. We find that ARI and the multiplicative combined indicators BMI*WC and BMI*ABSI further improved risk prediction and may be proposed for possible use in clinical practice.
The combination of African leaf nanoparticle hydrogel (Vernonia amygdalina) and Papuan honey in modern dressing to heal wound in grade II diabetic patients can reduce the care day length and amputation risk for upper or lower extremity areas that are often affected and wounded in the event of hyperglycemia. Wound care is performed every 3 days for 20 days based on the physiological process in the proliferative phase of wound healing. The diabetic wound was assessed using the Bates Jensen Wound Assessment Tool (BWAT). The research was experimental with pre- and post-test control group design. The results showed that the 20-day wound care with this combination could reduce the BWAT score by 5.2, a sign of its effectiveness as compared to the control group reduction by 4.33. Conclusively, performing a modern dressing using this combination for 30-45 minutes every 3 days for 20 days was effective in accelerating the healing process of grade II diabetic wounds.
Soheila Ranjbaran, Davoud Shojaeizadeh, Tahereh Dehdari
et al.
Abstract Background Diabetes is a major cause of worldwide morbidity and mortality. Diet and medication non-adherence are common among individuals with diabetes, making glycemic control difficult to attain. This study aimed to evaluate an intervention designed based on Health Action Process Approach (HAPA) to improve adherence to diet and medication among patients with type 2 diabetes in Tehran, Iran. Methods The study was a randomized controlled trial. A total of 248 patients with type 2 diabetes who had low diet and medication adherence were randomly allocated into two intervention (n = 124) and control (n = 124) groups. Intervention group received educational intervention during three months. HAPA constructs, diet and medication adherence, and Hemoglobin A1c (HbA1c) levels were assessed at baseline, one month and six months after the intervention. Mixed Model Analysis was used to compare between and within group changes in the outcomes. Results There was a statistically significant improvement in HbA1c levels after six months (7.77 ± 1.36% vs. 8.07 ± 1.52%, 95% CI, p < 0.001). Diet and medication adherence, intention, task self-efficacy, coping self-efficacy, recovery self-efficacy, action and coping planning, barriers, benefits and perceived social support were significantly improved one month and six months after the intervention (p < 0.001). Conclusion Our intervention designed based on health action process approach led to improvements in diet and medication adherence, and HbA1c among the patients within one and six months. Trial registration: IRCT, IRCT20151208025431N4. Registered 10 March 2018, https://fa.irct.ir
Zinc oxide is often used as a dietary supplement because zinc is an important dietary and trace element that contributes immensely to the body's functions. Iron and zinc deficiencies are the most common in the world. They often combine with phytate, which interferes with iron and zinc absorption. Nanoscale moieties improve the bioavailability of zinc and iron but also pose an unknown threat to human health. To render them biocompatible, we encapsulated ZnONPs in alginate/gum-acacia (SAGA ZnONPs) hydrocolloids and further conjugated them with iron oxide. The nanomatrices are stable and less than 100 nm in size as determined by transmission electron microscopy and biocompatible with human intestinal Caco-2 cells. Fe/SAGA ZnONPs release higher zinc at acidic pH (stomach) than in intestinal pH. We determined the effect of alginate/gum /iron oxide ZnONPs matrices on various digestive processes using the intestinal cells (Caco-2) on permeable support. Uptake efficiencies of Zn/Fe using Fe/SAGA ZnONPs are higher than bare ZnONPs. Our results demonstrated that alginate and gum acacia are promising polysaccharides for ZnONPs to protect them against harsh digestive milieu. Further conjugation with iron oxide is shown to be an efficient delivery system.
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases
Due to its volatility, the qualitative experience of menthol may be modulated by its preparation and combination with other compounds. One such method of preparation is dilution, with two dilution methods existing within the sport and exercise science literature, where menthol is used to impart feelings of oral cooling and improve thermal comfort and sensation during heat exposure. This study compared these two dilution methods; one using a solvent the other using temperature, via a randomized counterbalanced repeated measures design (<i>n</i> = 12; Height: 174.0 ± 8.5 cm Mass: 73.4 ± 13.3 kg Age: 28.7 ± 8.4 y; two exposures to each solution) to assess the effect of solution and heat exposure, upon thermal comfort, thermal sensation and associated physiological parameters in non-heat acclimated participants. Thermal comfort was significantly affected by solution (<i>p</i> = 0.041; η<sup>2</sup> = 0.017) and time (<i>p</i> < 0.001; η<sup>2</sup> = 0.228), whereas thermal sensation was significantly affected by time only (<i>p</i> = 0.012; η<sup>2</sup> = 0.133), as was tympanic temperature (<i>p</i> < 0.001; η<sup>2</sup> = 0.277). Small to moderate clear differences between solutions at matched time points were also observed. These trends and effects suggest that, depending upon the dilution method employed, the resultant perceptual effects are likely impacted; this also likely depends upon the timing of menthol administration within a heat exposure session.
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases
Abstract Background The triglyceride glucose (TyG) index is a noninsulin-based marker for insulin resistance (IR) in general practice. Although smoking and heavy drinking have been regarded as major risk factors for various chronic diseases, there is limited evidence regarding the combined effects of smoking and alcohol consumption on IR. This study aimed to investigate the relationship between the TyG index and smoking and alcohol consumption using two Korean population-based datasets. Methods This study included 10,568 adults in the Korean National Health and Nutrition Examination Survey (KNHANES) and 9586 adults in the Korean Initiatives on Coronary Artery Calcification (KOICA) registry datasets. Multivariate logistic analysis was conducted to explore the relationship between smoking and alcohol consumption and the TyG index. To assess the predictive value of smoking and alcohol consumption on high TyG index, the area under the curve (AUC) were compared and net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses were derived. Results The combined effect of smoking and alcohol consumption was an independent risk factor of a higher TyG index in the KNHANES (adjusted odds ratio: 4.33, P < .001) and KOICA (adjusted odds ratio: 1.94, P < .001) datasets. Adding smoking and alcohol consumption to the multivariate logistic models improved the model performance for the TyG index in the KNHANES (AUC: from 0.817 to 0.829, P < .001; NRI: 0.040, P < .001; IDI: 0.017, P < .001) and KOICA (AUC: from 0.822 to 0.826, P < .001; NRI: 0.025, P = .006; IDI: 0.005, P < .001) datasets. Conclusions Smoking and alcohol consumption were independently associated with the TyG index. Concurrent smokers and alcohol consumers were more likely to have a TyG index that was ≥8.8 and higher than the TyG indices of non-users and those who exclusively consumed alcohol or smoking tobacco.