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Nutrients, Volume 13, Issue 4 (April 2021) – 345 articles

Cover Story (view full-size image): This original article provides evidence for the protective effect of coffee consumption, particularly caffeinated coffee, on total and cancer mortality in an adult Mediterranean population. Coffee is one of the most consumed beverages worldwide, and recent evidence supports that coffee has been associated with lower incidence of some chronic diseases such as type 2 diabetes and cardiovascular disease (CVD). A recent meta-analysis based on 40 studies with 3,852,651 subjects from different countries has also shown a protective effect of usual coffee consumption on mortality from all-cause, CVD and cancer mortality, with the lowest mortality observed for the consumption of 2–3.5 cups per day. However, few studies have examined the role of coffee consumption on mortality in Mediterranean populations with high life expectancy and healthy diets; this study adds new evidence in this sense. View this paper
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19 pages, 1073 KiB  
Review
Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?
by Lorenzo Bertani, Davide Giuseppe Ribaldone, Massimo Bellini, Maria Gloria Mumolo and Francesco Costa
Nutrients 2021, 13(4), 1387; https://doi.org/10.3390/nu13041387 - 20 Apr 2021
Cited by 20 | Viewed by 7360
Abstract
Nutrition has an important impact on inflammatory bowel diseases (IBD). In particular, several studies have addressed its role in their pathogenesis, showing how the incidence of IBD significantly increased in recent years. Meanwhile, nutrition should be considered a component of the treatment of [...] Read more.
Nutrition has an important impact on inflammatory bowel diseases (IBD). In particular, several studies have addressed its role in their pathogenesis, showing how the incidence of IBD significantly increased in recent years. Meanwhile, nutrition should be considered a component of the treatment of the disease, both as a therapy itself, and especially in the perspective of correcting the various nutritional deficiencies shown by these patients. In this perspective, nutritional suggestions are very important even in the most severe forms of IBD, requiring hospitalization or surgical treatment. Although current knowledge about nutrition in IBD is increasing over time, nutritional suggestions are often underestimated by clinicians. This narrative review is an update summary of current knowledge on nutritional suggestions in IBD, in order to address the impact of nutrition on pathogenesis, micro- and macro-nutrients deficiencies (especially in the case of sarcopenia and obesity), as well as in hospitalized patients. Full article
(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)
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12 pages, 744 KiB  
Article
The Association of Healthy Aging with Multimorbidity: IKARIA Study
by Alexandra Foscolou, Christina Chrysohoou, Kyriakos Dimitriadis, Konstantina Masoura, Georgia Vogiatzi, Viktor Gkotzamanis, George Lazaros, Costas Tsioufis and Christodoulos Stefanadis
Nutrients 2021, 13(4), 1386; https://doi.org/10.3390/nu13041386 - 20 Apr 2021
Cited by 10 | Viewed by 6127
Abstract
The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled [...] Read more.
The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension; hypercholesterolemia; diabetes; obesity; cancer; CVD; osteoporosis; thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman’s rho = −0.127, p < 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan. Full article
(This article belongs to the Section Nutrition and Public Health)
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13 pages, 743 KiB  
Article
Sodium Content and Labelling Completeness of Packaged Foods and Beverages in Kenya
by Rhoda Ndanuko, Damian Maganja, Alex Kibet, Daisy H. Coyle, Judith Kimiywe, David Raubenheimer, Matti Marklund and Jason H. Y. Wu
Nutrients 2021, 13(4), 1385; https://doi.org/10.3390/nu13041385 - 20 Apr 2021
Cited by 5 | Viewed by 3564
Abstract
Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. Nutrition information on packaged foods can help guide consumers toward products with less sodium, however the availability of nutrition information on foods sold in [...] Read more.
Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. Nutrition information on packaged foods can help guide consumers toward products with less sodium, however the availability of nutrition information on foods sold in Kenya is currently unknown. The aims of this study were to estimate the proportion of packaged foods and beverages displaying nutrition information for sodium and determine the amount of sodium in packaged foods available for sale in Kenya. Data was collected in 2019 from five retail supermarkets in Nairobi. The availability of sodium information provided on packaged products and the sodium content were recorded. As secondary analyses, we compared sodium content labelling of products in Kenya by manufacturing location and the sodium content of products available in Kenya and South Africa. A total of 6003 packaged products in 56 food categories were identified. Overall, 39% of products displayed sodium content, though the availability of labelling varied widely between food categories, with coverage in main categories ranging from 0% (yoghurts and yoghurt drinks) to 86% (breakfast cereals). Food categories with the highest median sodium content were herbs and spices (9120 mg/100 g), sauces (1200 mg/100 g) and meat alternatives (766 mg/100 g) although wide variabilities were often observed within categories. Imported products were more likely to provide information on sodium than locally produced products (81% compared to 26%) and reported higher median sodium levels (172 mg/100 g compared to 96 mg/100 g). Kenyan products reported a higher median sodium content than South African products in six categories while South African products had higher median sodium in 20 categories, with considerable variation in median sodium content between countries in some categories. These findings highlight considerable potential to improve the availability of sodium information on packaged products in Kenya and to introduce reformulation policies to reduce the amount of sodium in the Kenyan food supply. Full article
(This article belongs to the Section Nutrition and Public Health)
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12 pages, 287 KiB  
Article
COVID-19-Related Stress and Anxiety, Body Mass Index, Eating Disorder Symptomatology, and Body Image in Women from Poland: A Cluster Analysis Approach
by Kamila Czepczor-Bernat, Viren Swami, Adriana Modrzejewska and Justyna Modrzejewska
Nutrients 2021, 13(4), 1384; https://doi.org/10.3390/nu13041384 - 20 Apr 2021
Cited by 21 | Viewed by 5242
Abstract
To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety [...] Read more.
To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety which may contribute to the emergence or worsening of symptoms of eating disorders and the development of negative body image. Therefore, in this study, we aimed to: (1) classify different conditions associated with COVID-19-related stress, COVID-19-related anxiety, and weight status; and (2) analyze and compare the severity of dimensions typically related to eating disorders symptomatology and body image in individuals with different COVID-19-related stress, COVID-19-related anxiety, and weight status. Polish women (N = 671, Mage = 32.50 ± 11.38) completed measures of COVID-19-related stress and anxiety along with body dissatisfaction, drive for thinness, and bulimia symptomatology subscales of the Eating Disorders Inventory, and the appearance evaluation, overweight preoccupation, and body areas satisfaction subscales of the Multidimensional Body-Self Relations Questionnaire. The following four clusters were identified through cluster analysis: (a) Cluster 1 (N = 269), healthy body weight and low COVID-related stress (M = 3.06) and anxiety (M = 2.96); (b) Cluster 2 (N = 154), healthy body weight and high COVID-related stress (M = 5.43) and anxiety (M = 5.29); (c) Cluster 3 (N = 127), excess body weight and high COVID-related stress (M = 5.23) and anxiety (M = 5.35); (d) Cluster 4 (N = 121), excess body weight and low COVID-related stress (M = 2.69) and anxiety (M = 2.83). Our results showed that Clusters 3 and 4 had significantly greater body dissatisfaction and lower appearance evaluation and body areas satisfaction than Clusters 1 and 2. Cluster 3 also had a significantly higher level of drive for thinness, bulimia, and overweight preoccupation than Clusters 1 and 2. These preliminary findings may mean that the COVID-19 pandemic and attendant anxiety and stress caused by the pandemic are exacerbating symptoms of eating disorders and negative body image, with women with excess weight particularly at risk. Full article
(This article belongs to the Section Nutrition in Women)
15 pages, 7648 KiB  
Review
The Effects of Bariatric Surgery on Vitamin B Status and Mental Health
by Amna Al Mansoori, Hira Shakoor, Habiba I. Ali, Jack Feehan, Ayesha S. Al Dhaheri, Leila Cheikh Ismail, Marijan Bosevski, Vasso Apostolopoulos and Lily Stojanovska
Nutrients 2021, 13(4), 1383; https://doi.org/10.3390/nu13041383 - 20 Apr 2021
Cited by 14 | Viewed by 9211
Abstract
Diet is a modifiable factor that ensures optimal growth, biochemical performance, improved mood and mental functioning. Lack of nutrients, notably vitamin B, has an impact on human health and wellbeing. The United Arab Emirates is facing a serious problem of micronutrient deficiencies because [...] Read more.
Diet is a modifiable factor that ensures optimal growth, biochemical performance, improved mood and mental functioning. Lack of nutrients, notably vitamin B, has an impact on human health and wellbeing. The United Arab Emirates is facing a serious problem of micronutrient deficiencies because of the growing trend for bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy. People undergoing bariatric surgery are at high risk of developing neurological, cognitive, and mental disabilities and cardiovascular disease due to deficiency in vitamin B. Vitamin B is involved in neurotransmitter synthesis, including γ-aminobutyric acid, serotonin, dopamine, and noradrenaline. Deficiency of vitamin B increases the risk of depression, anxiety, dementia and Alzheimer’s disease. In addition, vitamin B deficiency can disrupt the methylation of homocysteine, leading to hyperhomocysteinemia. Elevated homocysteine levels are detrimental to human health. Vitamin B deficiency also suppresses immune function, increases the production of pro-inflammatory cytokines and upregulates NF-κB. Considering the important functions of vitamin B and the severe consequences associated with its deficiency following bariatric surgery, proper dietary intervention and administration of adequate supplements should be considered to prevent negative clinical outcomes. Full article
(This article belongs to the Section Clinical Nutrition)
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9 pages, 3055 KiB  
Article
Maternal Dietary Carbohydrate Intake and Newborn Aortic Wall Thickness
by Kirsty M. Mckenzie, Reeja Nasir, Yang Kong, Hasthi U. Dissanayake, Rowena McMullan, Adrienne Gordon, Alice Meroni, Melinda Phang and Michael R. Skilton
Nutrients 2021, 13(4), 1382; https://doi.org/10.3390/nu13041382 - 20 Apr 2021
Cited by 1 | Viewed by 2535
Abstract
Evidence from animal models indicates that maternal diet during pregnancy affects offspring cardiometabolic health. Improving carbohydrate quality during high-risk pregnancies reduces aortic intima-medial thickness; a marker for early atherosclerosis; in the infant offspring. We sought to determine whether maternal carbohydrate quantity and quality [...] Read more.
Evidence from animal models indicates that maternal diet during pregnancy affects offspring cardiometabolic health. Improving carbohydrate quality during high-risk pregnancies reduces aortic intima-medial thickness; a marker for early atherosclerosis; in the infant offspring. We sought to determine whether maternal carbohydrate quantity and quality are associated with newborn aortic intima-medial thickness in healthy pregnancies. Maternal diet throughout pregnancy was evaluated in 139 mother–child dyads using a validated food frequency questionnaire. Carbohydrate intake was expressed as quantity (% total energy), quality (fibre, glycaemic index), and glycaemic burden (glycaemic load). Aortic intima-medial thickness was measured by high-frequency ultrasound of the neonatal abdominal aorta. Neither quantity nor quality of maternal carbohydrate intake during pregnancy was associated with meaningful differences in offspring maximum aortic intima-medial thickness with the exception of fibre intake in women with overweight or obesity which was inversely associated (−8 μm [95% CI −14, −1] per g fibre, p = 0.04). In healthy pregnancy, the quantity and quality of maternal carbohydrate intake is likely not a meaningful modifiable lifestyle factor for influencing offspring vascular health. The effect of carbohydrate quality may only be evident in high-risk pregnancies, consistent with previous findings. These findings may be confirmed in prospective dietary trials in pregnancy. Full article
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10 pages, 923 KiB  
Article
Effects of Periconceptional Multivitamin Supplementation on Folate and Homocysteine Levels Depending on Genetic Variants of Methyltetrahydrofolate Reductase in Infertile Japanese Women
by Keiji Kuroda, Takashi Horikawa, Yoko Gekka, Azusa Moriyama, Kazuki Nakao, Hiroyasu Juen, Satoru Takamizawa, Yuko Ojiro, Koji Nakagawa and Rikikazu Sugiyama
Nutrients 2021, 13(4), 1381; https://doi.org/10.3390/nu13041381 - 20 Apr 2021
Cited by 3 | Viewed by 4761
Abstract
Methylenetetrahydrofolate reductase (MTHFR) has various polymorphisms, and the effects of periconceptional folic acid supplementation for decreasing neural tube defects (NTDs) risk differ depending on the genotypes. This study analyzed the effectiveness of multivitamin supplementation on folate insufficiency and hyperhomocysteinemia, depending on MTHFR polymorphisms. [...] Read more.
Methylenetetrahydrofolate reductase (MTHFR) has various polymorphisms, and the effects of periconceptional folic acid supplementation for decreasing neural tube defects (NTDs) risk differ depending on the genotypes. This study analyzed the effectiveness of multivitamin supplementation on folate insufficiency and hyperhomocysteinemia, depending on MTHFR polymorphisms. Of 205 women, 72 (35.1%), 100 (48.8%) and 33 (16.1%) had MTHFR CC, CT and TT, respectively. Serum folate and homocysteine levels in women with homozygous mutant TT were significantly lower and higher, respectively, than those in women with CC and CT. In 54 women (26.3% of all women) with a risk of NTDs, multivitamin supplementation containing folic acid and vitamin D for one month increased folate level (5.8 ± 0.9 to 19.2 ± 4.0 ng/mL, p < 0.0001) and decreased the homocysteine level (8.2 ± 3.1 to 5.8 ± 0.8 nmol/mL, p < 0.0001) to minimize the risk of NTDs in all women, regardless of MTHFR genotype. Regardless of MTHFR genotype, multivitamin supplements could control folate and homocysteine levels. Tests for folate and homocysteine levels and optimal multivitamin supplementation in women with risk of NTDs one month or more before pregnancy should be recommended to women who are planning a pregnancy. Full article
(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)
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14 pages, 1185 KiB  
Review
Diet Quality of Malaysians across Lifespan: A Scoping Review of Evidence in a Multi-Ethnic Population
by Amutha Ramadas, Su Ming Tham, Shehzeen Alnoor Lalani and Sangeetha Shyam
Nutrients 2021, 13(4), 1380; https://doi.org/10.3390/nu13041380 - 20 Apr 2021
Cited by 7 | Viewed by 7583
Abstract
Malaysia is a rapidly developing economy experiencing a nutrition transition. It suffers from a double burden of over- and undernutrition, making it essential to understand diet quality in the population. In this scoping review, we have collated the existing literature on Malaysian diet [...] Read more.
Malaysia is a rapidly developing economy experiencing a nutrition transition. It suffers from a double burden of over- and undernutrition, making it essential to understand diet quality in the population. In this scoping review, we have collated the existing literature on Malaysian diet quality, including factors that influence it, and the association between diet quality and health outcomes across the lifespan of Malaysians. Overall, diet quality was poor in all age groups studied. The Healthy Eating Index (HEI) and its iterations were predominantly used in urban and clinical settings to evaluate diet-chronic disease relationships. These indices were significantly associated with cardio-metabolic and disease risks in adults. The Diet Diversity Score (DDS) and Food Variety Score (FVS) were used to gauge diet quality in maternal and child nutrition studies and were associated with appropriate growth and caloric intake. Deficiencies were found in fruit, vegetable, legumes, and dairy intake. Meat, salt, and sugar intake were found to be excessive in many studies. The findings can inform policies to improve diet quality in this population. The review also identified knowledge gaps that require further investigation. Full article
(This article belongs to the Special Issue Diet and Wellbeing across the Life Course)
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9 pages, 250 KiB  
Article
Increasing Egg Consumption at Breakfast Is Associated with Increased Usual Nutrient Intakes: A Modeling Analysis Using NHANES and the USDA Child and Adult Care Food Program School Breakfast Guidelines
by Yanni Papanikolaou and Victor L. Fulgoni III
Nutrients 2021, 13(4), 1379; https://doi.org/10.3390/nu13041379 - 20 Apr 2021
Cited by 9 | Viewed by 4292
Abstract
The objective of the current modeling analysis was three-fold: (1) to examine usual nutrient intakes in children when eggs are added into dietary patterns that typically do not contain eggs; (2) to examine usual nutrient intakes with the addition of eggs in the [...] Read more.
The objective of the current modeling analysis was three-fold: (1) to examine usual nutrient intakes in children when eggs are added into dietary patterns that typically do not contain eggs; (2) to examine usual nutrient intakes with the addition of eggs in the Child and Adult Care Food Program (CACFP) school breakfast; and (3) to examine nutrient adequacy when eggs are included in routine breakfast patterns and with the addition of eggs to the CACFP school breakfast program. Dietary recall data from the National Health and Nutrition Examination Survey 2011–2016 (children aged 1–18 years-old; n = 9254; CACFP n = 159) were used in the analysis. The usual intakes of pantothenic acid, riboflavin, selenium, and vitamin D increased ≥10 percent (relative to the baseline values) with the addition of one egg at breakfast. The usual intakes of protein and vitamin A at breakfast were also increased by more than 10 percent compared to the baseline values with the addition of two eggs. Similar outcomes were observed with the addition of eggs to the CACFP school breakfast. The percent of children above the adequate intake for total choline increased to 43.6 and 57.8% with one and two eggs, respectively, compared to 22.6% at the baseline. The addition of eggs at breakfast can contribute to nutrient intakes and overall dietary adequacy and play a role in public health initiatives aimed at increasing the intake of under-consumed nutrients and nutrients of concern. Full article
13 pages, 988 KiB  
Review
Sarcopenia and Vitamin D Deficiency in Patients with Crohn’s Disease: Pathological Conditions That Should Be Linked Together
by Francesco Palmese, Rossella Del Toro, Giulia Di Marzio, Pierluigi Cataleta, Maria Giulia Sama and Marco Domenicali
Nutrients 2021, 13(4), 1378; https://doi.org/10.3390/nu13041378 - 20 Apr 2021
Cited by 7 | Viewed by 3352
Abstract
Sarcopenia is a prevalent condition in patients with Crohn’s disease (CD), representing an independent predictor factor for the development of major postoperative complications. Thus, a proper assessment of the muscle strength, by using different validated tools, should be deemed an important step of [...] Read more.
Sarcopenia is a prevalent condition in patients with Crohn’s disease (CD), representing an independent predictor factor for the development of major postoperative complications. Thus, a proper assessment of the muscle strength, by using different validated tools, should be deemed an important step of the clinical management of these patients. Patients with CD are frequently malnourished, presenting a high prevalence of different macro- and micro-nutrient deficiencies, including that of vitamin D. The available published studies indicate that vitamin D is involved in the regulation of proliferation, differentiation, and regeneration of muscle cells. The relationship between vitamin D deficiency and sarcopenia has been extensively studied in other populations, with interesting evidence in regards to a potential role of vitamin D supplementation as a means to prevent and treat sarcopenia. The aim of this review was to find studies that linked together these pathological conditions. Full article
(This article belongs to the Special Issue Nutritional Intake in Patients with Crohn’s Disease)
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11 pages, 1026 KiB  
Article
Unveiling the Correlation between Inadequate Energy/Macronutrient Intake and Clinical Alterations in Volunteers at Risk of Metabolic Syndrome by a Predictive Model
by Francesca Danesi, Carlo Mengucci, Simona Vita, Achim Bub, Stephanie Seifert, Corinne Malpuech-Brugère, Ruddy Richard, Caroline Orfila, Samantha Sutulic, Luigi Ricciardiello, Elisa Marcato, Francesco Capozzi and Alessandra Bordoni
Nutrients 2021, 13(4), 1377; https://doi.org/10.3390/nu13041377 - 20 Apr 2021
Cited by 3 | Viewed by 3174
Abstract
Although lifestyle-based interventions are the most effective to prevent metabolic syndrome (MetS), there is no definitive agreement on which nutritional approach is the best. The aim of the present retrospective analysis was to identify a multivariate model linking energy and macronutrient intake to [...] Read more.
Although lifestyle-based interventions are the most effective to prevent metabolic syndrome (MetS), there is no definitive agreement on which nutritional approach is the best. The aim of the present retrospective analysis was to identify a multivariate model linking energy and macronutrient intake to the clinical features of MetS. Volunteers at risk of MetS (F = 77, M = 80) were recruited in four European centres and finally eligible for analysis. For each subject, the daily energy and nutrient intake was estimated using the EPIC questionnaire and a 24-h dietary recall, and it was compared with the dietary reference values. Then we built a predictive model for a set of clinical outcomes computing shifts from recommended intake thresholds. The use of the ridge regression, which optimises prediction performances while retaining information about the role of all the nutritional variables, allowed us to assess if a clinical outcome was manly dependent on a single nutritional variable, or if its prediction was characterised by more complex interactions between the variables. The model appeared suitable for shedding light on the complexity of nutritional variables, which effects could be not evident with univariate analysis and must be considered in the framework of the reciprocal influence of the other variables. Full article
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14 pages, 3196 KiB  
Article
Assessment and Imaging of Intracellular Magnesium in SaOS-2 Osteosarcoma Cells and Its Role in Proliferation
by Concettina Cappadone, Emil Malucelli, Maddalena Zini, Giovanna Farruggia, Giovanna Picone, Alessandra Gianoncelli, Andrea Notargiacomo, Michela Fratini, Carla Pignatti, Stefano Iotti and Claudio Stefanelli
Nutrients 2021, 13(4), 1376; https://doi.org/10.3390/nu13041376 - 20 Apr 2021
Cited by 3 | Viewed by 2913
Abstract
Magnesium is an essential nutrient involved in many important processes in living organisms, including protein synthesis, cellular energy production and storage, cell growth and nucleic acid synthesis. In this study, we analysed the effect of magnesium deficiency on the proliferation of SaOS-2 osteosarcoma [...] Read more.
Magnesium is an essential nutrient involved in many important processes in living organisms, including protein synthesis, cellular energy production and storage, cell growth and nucleic acid synthesis. In this study, we analysed the effect of magnesium deficiency on the proliferation of SaOS-2 osteosarcoma cells. When quiescent magnesium-starved cells were induced to proliferate by serum addition, the magnesium content was 2–3 times lower in cells maintained in a medium without magnesium compared with cells growing in the presence of the ion. Magnesium depletion inhibited cell cycle progression and caused the inhibition of cell proliferation, which was associated with mTOR hypophosphorylation at Serine 2448. In order to map the intracellular magnesium distribution, an analytical approach using synchrotron-based X-ray techniques was applied. When cell growth was stimulated, magnesium was mainly localized near the plasma membrane in cells maintained in a medium without magnesium. In non-proliferating cells growing in the presence of the ion, high concentration areas inside the cell were observed. These results support the role of magnesium in the control of cell proliferation, suggesting that mTOR may represent an important target for the antiproliferative effect of magnesium. Selective control of magnesium availability could be a useful strategy for inhibiting osteosarcoma cell growth. Full article
(This article belongs to the Special Issue Magnesium in Human Health and Disease)
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7 pages, 231 KiB  
Article
Evaluation of Serum Zinc Status of Pregnant Women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015
by Xiao-Bing Liu, Jia-Xi Lu, Li-Juan Wang, Yi-Chun Hu, Rui Wang, De-Qian Mao, Jian Huang, Li-Yun Zhao, Xiao-Guang Yang and Li-Chen Yang
Nutrients 2021, 13(4), 1375; https://doi.org/10.3390/nu13041375 - 20 Apr 2021
Cited by 7 | Viewed by 2475
Abstract
Objective: The purpose of this study was to evaluate serum zinc status of pregnant women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) in 2015–2016. Methods: A total of 7147 apparently healthy pregnant women were randomly selected in 302 national monitoring [...] Read more.
Objective: The purpose of this study was to evaluate serum zinc status of pregnant women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) in 2015–2016. Methods: A total of 7147 apparently healthy pregnant women were randomly selected in 302 national monitoring sites. Information on age, race, residence region, education, pregnancy, and family income per annum was collected, and the concentration of serum zinc was determined. The evaluation of serum zinc status was further performed according to the recommendations by the International Zinc Nutrition Consultative Group (IZiNCG). Results: The median concentration of serum zinc was 858.9 μg/L with an interquartile range (IQR) of 712.9 μg/L and 1048.9 μg/L, while the overall prevalence of zinc deficiency was 3.5% with a 95% confidence interval (CI) of 3.0% and 3.9%. Serum zinc status of pregnant women changed greatly in the different categories, particular in pregnancy and family income per annum (p < 0.05), but no significant difference was observed in the prevalence of zinc deficiency (p > 0.05). Conclusions: The lower prevalence of zinc deficiency generally indicated a better zinc status for pregnant women in the CACDNS in 2015–2016. However, a well-designed evaluation system of zinc status for pregnant women should be continually optimized and improved by inducing more parameters such as biochemical, dietary, or functional indicators. Full article
(This article belongs to the Section Nutrition and Public Health)
12 pages, 1137 KiB  
Article
Hydration Status, Fluid Intake, Sweat Rate, and Sweat Sodium Concentration in Recreational Tropical Native Runners
by Juthamard Surapongchai, Vitoon Saengsirisuwan, Ian Rollo, Rebecca K. Randell, Kanpiraya Nithitsuttibuta, Patarawadee Sainiyom, Clarence Hong Wei Leow and Jason Kai Wei Lee
Nutrients 2021, 13(4), 1374; https://doi.org/10.3390/nu13041374 - 20 Apr 2021
Cited by 10 | Viewed by 4867
Abstract
Aim: The purpose of this study was to evaluate hydration status, fluid intake, sweat rate, and sweat sodium concentration in recreational tropical native runners. Methods: A total of 102 males and 64 females participated in this study. Participants ran at their self-selected pace [...] Read more.
Aim: The purpose of this study was to evaluate hydration status, fluid intake, sweat rate, and sweat sodium concentration in recreational tropical native runners. Methods: A total of 102 males and 64 females participated in this study. Participants ran at their self-selected pace for 30–100 min. Age, environmental conditions, running profiles, sweat rates, and sweat sodium data were recorded. Differences in age, running duration, distance and pace, and physiological changes between sexes were analysed. A p-value cut-off of 0.05 depicted statistical significance. Results: Males had lower relative fluid intake (6 ± 6 vs. 8 ± 7 mL·kg−1·h−1, p < 0.05) and greater relative fluid balance deficit (−13 ± 8 mL·kg−1·h−1 vs. −8 ± 7 mL·kg−1·h−1, p < 0.05) than females. Males had higher whole-body sweat rates (1.3 ± 0.5 L·h−1 vs. 0.9 ± 0.3 L·h−1, p < 0.05) than females. Mean rates of sweat sodium loss (54 ± 27 vs. 39 ± 22 mmol·h−1) were higher in males than females (p < 0.05). Conclusions: The sweat profile and composition in tropical native runners are similar to reported values in the literature. The current fluid replacement guidelines pertaining to volume and electrolyte replacement are applicable to tropical native runners. Full article
(This article belongs to the Special Issue Hydration and Fluid Needs during Physical Activity)
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7 pages, 1420 KiB  
Article
Stiff Person Syndrome and Gluten Sensitivity
by Marios Hadjivassiliou, Panagiotis Zis, David S. Sanders, Nigel Hoggard and Ptolemaios G. Sarrigiannis
Nutrients 2021, 13(4), 1373; https://doi.org/10.3390/nu13041373 - 20 Apr 2021
Cited by 2 | Viewed by 10909
Abstract
Stiff person syndrome (SPS) is a rare autoimmune disease characterised by axial stiffness and episodic painful spasms. It is associated with additional autoimmune diseases and cerebellar ataxia. Most patients with SPS have high levels of glutamic acid decarboxylase (GAD) antibodies. The aetiology of [...] Read more.
Stiff person syndrome (SPS) is a rare autoimmune disease characterised by axial stiffness and episodic painful spasms. It is associated with additional autoimmune diseases and cerebellar ataxia. Most patients with SPS have high levels of glutamic acid decarboxylase (GAD) antibodies. The aetiology of SPS remains unclear but autoimmunity is thought to play a major part. We have previously demonstrated overlap between anti-GAD ataxia and gluten sensitivity. We have also demonstrated the beneficial effect of a gluten-free diet (GFD) in patients with anti-GAD ataxia. Here, we describe our experience in the management of 20 patients with SPS. The mean age at symptom onset was 52 years. Additional autoimmune diseases were seen in 15/20. Nineteen of the 20 patients had serological evidence of gluten sensitivity and 6 had coeliac disease. Fourteen of the 15 patients who had brain imaging had evidence of cerebellar involvement. Twelve patients improved on GFD and in seven GFD alone was the only treatment required long term. Twelve patients had immunosuppression but only three remained on such medication. Gluten sensitivity plays an important part in the pathogenesis of SPS and GFD is an effective therapeutic intervention. Full article
(This article belongs to the Special Issue Gluten-Related Disorders: Time to Move from Gut to Brain)
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3 pages, 204 KiB  
Editorial
Diet, Nutrition and Chronic Degenerative Diseases
by Laura Di Renzo, Paola Gualtieri and Antonino De Lorenzo
Nutrients 2021, 13(4), 1372; https://doi.org/10.3390/nu13041372 - 20 Apr 2021
Cited by 28 | Viewed by 7627
Abstract
Chronic degenerative diseases (CDDs), represented mainly by obesity, cardiovascular disease (CVD), diabetes, chronic kidney disease (CKD), inflammatory bowel diseases, osteoporosis, sarcopenia, neurodegenerative diseases such as Huntington’s disease (HD), rheumatoid arthritis (RA), chronic respiratory diseases, and many cancers, have been, up to now, the [...] Read more.
Chronic degenerative diseases (CDDs), represented mainly by obesity, cardiovascular disease (CVD), diabetes, chronic kidney disease (CKD), inflammatory bowel diseases, osteoporosis, sarcopenia, neurodegenerative diseases such as Huntington’s disease (HD), rheumatoid arthritis (RA), chronic respiratory diseases, and many cancers, have been, up to now, the most frequent causes of prolonged disability and death worldwide [...] Full article
(This article belongs to the Special Issue Diet, Nutrition and Chronic Degenerative Diseases)
16 pages, 938 KiB  
Article
Assessment of Factors Related to Diminished Appetite in Hemodialysis Patients with a New Adapted and Validated Questionnaire
by Elihud Salazar-Robles, Abel Lerma, Martín Calderón-Juárez, Armando Ibarra, Héctor Pérez-Grovas, Luis A. Bermúdez-Aceves, Lilian E. Bosques-Brugada and Claudia Lerma
Nutrients 2021, 13(4), 1371; https://doi.org/10.3390/nu13041371 - 19 Apr 2021
Cited by 3 | Viewed by 4704
Abstract
Appetite loss is a common phenomenon in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (HD). We aimed to (i) adapt and validate a Spanish language version of the Council on Nutrition Appetite Questionnaire (CNAQ) and (ii) to identify psychological and biological factors [...] Read more.
Appetite loss is a common phenomenon in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (HD). We aimed to (i) adapt and validate a Spanish language version of the Council on Nutrition Appetite Questionnaire (CNAQ) and (ii) to identify psychological and biological factors associated with diminished appetite. We recruited 242 patients undergoing HD from four hemodialysis centers to validate the Spanish-translated version of the CNAQ. In another set of 182 patients from three HD centers, the Appetite and Diet Assessment Tool (ADAT) was used as the gold standard to identify a cut-off value for diminished appetite in our adapted questionnaire. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Distorted Thoughts Scale (DTS), Dialysis Malnutrition Score (DMS), anthropometric, values and laboratory values were also measured. Seven items were preserved in the adapted appetite questionnaire, with two factors associated with flavor and gastric fullness (Cronbach’s alpha = 0.758). Diminished appetite was identified with a cut-off value ≤25 points (sensitivity 73%, specificity 77%). Patients with diminished appetite had a higher proportion of females and DMS punctuation, lower plasmatic level of creatinine, blood urea nitrogen, and phosphorus. Appetite score correlated with BDI score, BAI score and DTS. Conclusions: This simple but robust appetite score adequately discriminates against patients with diminished appetite. Screening and treatment of psychological conditions may be useful to increase appetite and the nutritional status of these patients. Full article
(This article belongs to the Section Nutritional Epidemiology)
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17 pages, 3727 KiB  
Article
Prolonged Changes in Hepatic Mitochondrial Activity and Insulin Sensitivity by High Fructose Intake in Adolescent Rats
by Arianna Mazzoli, Cristina Gatto, Raffaella Crescenzo, Luisa Cigliano and Susanna Iossa
Nutrients 2021, 13(4), 1370; https://doi.org/10.3390/nu13041370 - 19 Apr 2021
Cited by 7 | Viewed by 2647
Abstract
Persistence of damage induced by unhealthy diets during youth has been little addressed. Therefore, we investigated the impact of a short-term fructose-rich diet on liver metabolic activity in adolescent rats and the putative persistence of alterations after removing fructose from the diet. Adolescent [...] Read more.
Persistence of damage induced by unhealthy diets during youth has been little addressed. Therefore, we investigated the impact of a short-term fructose-rich diet on liver metabolic activity in adolescent rats and the putative persistence of alterations after removing fructose from the diet. Adolescent rats were fed a fructose-rich diet for three weeks and then switched to a control diet for further three weeks. Body composition and energy balance were not affected by fructose-rich diet, while increased body lipids and lipid gain were found after the rescue period. Switching to a control diet reversed the upregulation of plasma fructose, uric acid, lipocalin, and haptoglobin, while plasma triglycerides, alanine aminotransferase, lipopolysaccharide, and tumor necrosis factor alpha remained higher. Hepatic steatosis and ceramide were increased by fructose-rich diet, but reversed by returning to a control diet, while altered hepatic response to insulin persisted. Liver fatty acid synthase and stearoyl-CoA desaturase (SCD) activities were upregulated by fructose-rich diet, and SCD activity remained higher after returning to the control diet. Fructose-induced upregulation of complex II-driven mitochondrial respiration, peroxisome proliferator-activated receptor-gamma coactivator 1 alpha, and peroxisome proliferator activated receptor α also persisted after switching to control diet. In conclusion, our results show prolonged fructose-induced dysregulation of liver metabolic activity. Full article
(This article belongs to the Special Issue Diet, Liver, Oxidative Stress and Metabolic Syndrome)
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13 pages, 5361 KiB  
Article
Global Trends (1961–2017) in Human Dietary Potassium Supplies
by Diriba B. Kumssa, Edward J. M. Joy and Martin R. Broadley
Nutrients 2021, 13(4), 1369; https://doi.org/10.3390/nu13041369 - 19 Apr 2021
Cited by 19 | Viewed by 3142
Abstract
Background: Potassium (K) is an essential mineral and major intracellular electrolyte involved in the regulation of blood pressure, muscle contraction and nerve transmission in humans. Major dietary sources of K include fruits and vegetables, starchy roots and tubers, and whole grains. The aim [...] Read more.
Background: Potassium (K) is an essential mineral and major intracellular electrolyte involved in the regulation of blood pressure, muscle contraction and nerve transmission in humans. Major dietary sources of K include fruits and vegetables, starchy roots and tubers, and whole grains. The aim of this study was to assess and report: (i) the sufficiency of K in national food systems globally, (ii) to quantify the contribution from food groups, and (iii) to explore spatial and temporal trends in the period of 1961–2017. Methods: Food supply and demography (1961–2017), K composition and K requirement data were combined to estimate per capita human dietary supplies of potassium (DSK), adequate intake of K (AIK) and K sufficiency ratio (KSR) at national, regional, continental and global levels. Results and Discussion: Globally, the mean ± SD. DSK (mg capita−1 d−1) increased from 2984 ± 915 in 1961 to 3796 ± 1161 in 2017. There was a wide range in DSK between geographical regions and across years, with particularly large increases in east Asia, where DSK increased from <3000 to >5000 mg capita−1 day−1. Roots and tubers contributed the largest dietary source of K, providing up to 80% of DSK in most regions. At the global level, throughout the 57-year period, the population-weighted KSR was <1 based on the 2006 Institute of Medicine AIK recommendation, while it was >1 based on the 2019 National Academies of Science and the 2016 European Union AIK recommendation. While KSR ≥ 1 shows sufficiency of DSK, KSR < 1 does not indicate K deficiency risk. Conclusion: Due to the absence of a Recommended Daily Allowance (RDA) for K, this study used the ratio of DSK:AIK (i.e., KSR) to assess dietary K sufficiency. Estimates of dietary K sufficiency are, therefore, highly sensitive to the AIK reference value used and this varied greatly based on different institutions and years. To quantify the risk of dietary K deficiency, bridging the data gap to establish an RDA for K should be a global research priority. Full article
(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)
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15 pages, 1685 KiB  
Article
Effects of Lactobacillus plantarum CJLP55 on Clinical Improvement, Skin Condition and Urine Bacterial Extracellular Vesicles in Patients with Acne Vulgaris: A Randomized, Double-Blind, Placebo-Controlled Study
by Mi-Ju Kim, Kun-Pyo Kim, Eunhye Choi, June-Hyuck Yim, Chunpil Choi, Hyun-Sun Yun, Hee-Yoon Ahn, Ji-Young Oh and Yunhi Cho
Nutrients 2021, 13(4), 1368; https://doi.org/10.3390/nu13041368 - 19 Apr 2021
Cited by 22 | Viewed by 6214
Abstract
Lactobacillus plantarum CJLP55 has anti-pathogenic bacterial and anti-inflammatory activities in vitro. We investigated the dietary effect of CJLP55 supplement in patients with acne vulgaris, a prevalent inflammatory skin condition. Subjects ingested CJLP55 or placebo (n = 14 per group) supplements for 12 [...] Read more.
Lactobacillus plantarum CJLP55 has anti-pathogenic bacterial and anti-inflammatory activities in vitro. We investigated the dietary effect of CJLP55 supplement in patients with acne vulgaris, a prevalent inflammatory skin condition. Subjects ingested CJLP55 or placebo (n = 14 per group) supplements for 12 weeks in this double-blind, placebo-controlled randomized study. Acne lesion count and grade, skin sebum, hydration, pH and surface lipids were assessed. Metagenomic DNA analysis was performed on urine extracellular vesicles (EV), which indirectly reflect systemic bacterial flora. Compared to the placebo supplement, CJLP55 supplement improved acne lesion count and grade, decreased sebum triglycerides (TG), and increased hydration and ceramide 2, the major ceramide species that maintains the epidermal lipid barrier for hydration. In addition, CJLP55 supplement decreased the prevalence of Proteobacteria and increased Firmicutes, which were correlated with decreased TG, the major skin surface lipid of sebum origin. CJLP55 supplement further decreased the Bacteroidetes:Firmicutes ratio, a relevant marker of bacterial dysbiosis. No differences in skin pH, other skin surface lipids or urine bacterial EV phylum were noted between CJLP55 and placebo supplements. Dietary Lactobacillus plantarum CJLP55 was beneficial to clinical state, skin sebum, and hydration and urine bacterial EV phylum flora in patients with acne vulgaris. Full article
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11 pages, 1090 KiB  
Article
Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment
by Katrine S. Duus, Caroline Moos, Peder Frederiksen, Vibeke Andersen and Berit L. Heitmann
Nutrients 2021, 13(4), 1367; https://doi.org/10.3390/nu13041367 - 19 Apr 2021
Cited by 6 | Viewed by 2642
Abstract
This register-based national cohort study of 206,900 individuals investigated whether prenatal exposure to small extra doses of vitamin D from fortified margarine prevented inflammatory bowel disease (IBD) later in life; whether the risk of IBD varied according to month or season of birth; [...] Read more.
This register-based national cohort study of 206,900 individuals investigated whether prenatal exposure to small extra doses of vitamin D from fortified margarine prevented inflammatory bowel disease (IBD) later in life; whether the risk of IBD varied according to month or season of birth; and finally, whether there was an interaction between exposure to extra D vitamin and month or season of birth. Fortification of margarine with vitamin D was mandatory in Denmark from the mid-1930s until 1st June 1985, when it was abolished. Two entire birth cohorts, each including two years, were defined: one exposed and one unexposed to the fortification policy for the entire gestation. All individuals were followed for 30 years from the day of birth for an IBD diagnosis in Danish hospital registers. Logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Odds for IBD was lower among those exposed to extra D vitamin compared to those unexposed, OR = 0.87 (95% CI: 0.79; 0.95). No association with month or season of birth was found. However, estimates suggested that particularly children born during autumn may have benefitted from the effect of small extra doses of vitamin D. This is, to our knowledge, the first study to explore if prenatal exposure to vitamin D from fortification influenced the risk of IBD. Our results suggest that prenatal exposure to small amounts of extra vitamin D from food fortification may protect against the development of IBD before 30 years of age. Full article
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15 pages, 2816 KiB  
Article
The Tryptophan/Kynurenine Pathway: A Novel Cross-Talk between Nutritional Obesity, Bariatric Surgery and Taste of Fat
by Arnaud Bernard, Cédric Le May, Aurélie Dastugue, Audrey Ayer, Claire Blanchard, Jean-Charles Martin, Jean-Paul Pais de Barros, Pascaline Delaby, Cindy Le Bourgot, Séverine Ledoux and Philippe Besnard
Nutrients 2021, 13(4), 1366; https://doi.org/10.3390/nu13041366 - 19 Apr 2021
Cited by 8 | Viewed by 3973
Abstract
Diet-induced obesity (DIO) reduces the orosensory perception of lipids in rodents and in some humans. Although bariatric surgery partially corrects this alteration, underlying mechanisms remain poorly understood. To explore whether metabolic changes might explain this fat taste disturbance, plasma metabolome analyses, two-bottle choice [...] Read more.
Diet-induced obesity (DIO) reduces the orosensory perception of lipids in rodents and in some humans. Although bariatric surgery partially corrects this alteration, underlying mechanisms remain poorly understood. To explore whether metabolic changes might explain this fat taste disturbance, plasma metabolome analyses, two-bottle choice tests and fungiform papillae (Fun) counting were performed in vertical sleeve gastrectomized (VSG) mice and sham-operated controls. An exploratory clinic study was also carried out in adult patients undergone a VSG. In mice, we found that (i) the VSG reduces both the plasma neurotoxic signature due to the tryptophan/kynurenine (Trp/Kyn) pathway overactivation and the failure of fat preference found in sham-operated DIO mice, (ii) the activity of Trp/Kyn pathway is negatively correlated to the density of Fun, and (iii) the pharmacological inhibition of the Kyn synthesis mimics in non-operated DIO mice the positive effects of VSG (i.e., decrease of Kyn synthesis, increase of Fun number, improvement of the fat taste perception). In humans, a reduction of the plasma Kyn level is only found in patients displaying a post-surgery improvement of their fat taste sensitivity. Altogether these data provide a plausible metabolic explanation to the degradation of the orosensory lipid perception observed in obesity. Full article
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12 pages, 288 KiB  
Article
Gastric Cancer and the Daily Intake of the Major Dish Groups Contributing to Sodium Intake: A Case-Control Study in Korea
by Jung-Hyun Kwak, Chang-Soo Eun, Dong-Soo Han, Yong-Sung Kim, Kyu-Sang Song, Bo-Youl Choi and Hyun-Ja Kim
Nutrients 2021, 13(4), 1365; https://doi.org/10.3390/nu13041365 - 19 Apr 2021
Cited by 6 | Viewed by 3435
Abstract
Studies on the association between gastric cancer (GC) and the intake of soup-based dish groups (noodles and dumplings, soups, and stews), which are sodium-contributing foods, in Korea are insufficient, and the results of studies on the intake of pickled vegetables such as kimchi [...] Read more.
Studies on the association between gastric cancer (GC) and the intake of soup-based dish groups (noodles and dumplings, soups, and stews), which are sodium-contributing foods, in Korea are insufficient, and the results of studies on the intake of pickled vegetables such as kimchi are inconsistent. This study aimed to determine the association between the incidence of GC and the daily intake of high-sodium dish groups (noodles and dumplings, soups, stews, and pickled vegetables) and whether these associations differ depending on behavioral risk factors for GC. In this case-control study, subjects aged 20–79 years were recruited from two hospitals between December 2002 and September 2006. A total of 440 cases and 485 controls were recruited, of which 307 pairs were matched and included for the analysis. In our results, a higher intake of noodles and dumplings was associated with a significantly increased incidence of GC. In the participants who consumed past or current alcohol, a higher intake of noodles and dumplings was associated with a significantly increased incidence of GC. Our results suggest that efforts to reduce the daily sodium intake from noodles and dumplings are needed to prevent and reduce the incidence of GC. Full article
(This article belongs to the Section Clinical Nutrition)
22 pages, 3597 KiB  
Article
The Structure of Relationships between the Human Exposome and Cardiometabolic Health: The Million Veteran Program
by Kerry L. Ivey, Xuan-Mai T. Nguyen, Daniel Posner, Geraint B. Rogers, Deirdre K. Tobias, Rebecca Song, Yuk-Lam Ho, Ruifeng Li, Peter W. F. Wilson, Kelly Cho, John Michael Gaziano, Frank B. Hu, Walter C. Willett and Luc Djoussé
Nutrients 2021, 13(4), 1364; https://doi.org/10.3390/nu13041364 - 19 Apr 2021
Cited by 4 | Viewed by 3384
Abstract
The exposome represents the array of dietary, lifestyle, and demographic factors to which an individual is exposed. Individual components of the exposome, or groups of components, are recognized as influencing many aspects of human physiology, including cardiometabolic health. However, the influence of the [...] Read more.
The exposome represents the array of dietary, lifestyle, and demographic factors to which an individual is exposed. Individual components of the exposome, or groups of components, are recognized as influencing many aspects of human physiology, including cardiometabolic health. However, the influence of the whole exposome on health outcomes is poorly understood and may differ substantially from the sum of its individual components. As such, studies of the complete exposome are more biologically representative than fragmented models based on subsets of factors. This study aimed to model the system of relationships underlying the way in which the diet, lifestyle, and demographic components of the overall exposome shapes the cardiometabolic risk profile. The current study included 36,496 US Veterans enrolled in the VA Million Veteran Program (MVP) who had complete assessments of their diet, lifestyle, demography, and markers of cardiometabolic health, including serum lipids, blood pressure, and glycemic control. The cohort was randomly divided into training and validation datasets. In the training dataset, we conducted two separate exploratory factor analyses (EFA) to identify common factors among exposures (diet, demographics, and physical activity) and laboratory measures (lipids, blood pressure, and glycemic control), respectively. In the validation dataset, we used multiple normal regression to examine the combined effects of exposure factors on the clinical factors representing cardiometabolic health. The mean ± SD age of participants was 62.4 ± 13.4 years for both the training and validation datasets. The EFA revealed 19 Exposure Common Factors and 5 Physiology Common Factors that explained the observed (measured) data. Multivariate regression in the validation dataset revealed the structure of associations between the Exposure Common Factors and the Physiology Common Factors. For example, we found that the factor for fruit consumption was inversely associated with the factor summarizing total cholesterol and low-density lipoprotein cholesterol (LDLC, p = 0.008), and the latent construct describing light levels of physical activity was inversely associated with the blood pressure latent construct (p < 0.0001). We also found that a factor summarizing that participants who frequently consume whole milk are less likely to frequently consume skim milk, was positively associated with the latent constructs representing total cholesterol and LDLC as well as systolic and diastolic blood pressure (p = 0.0006 and <0.0001, respectively). Multiple multivariable-adjusted regression analyses of exposome factors allowed us to model the influence of the exposome as a whole. In this metadata-rich, prospective cohort of US Veterans, there was evidence of structural relationships between diet, lifestyle, and demographic exposures and subsequent markers of cardiometabolic health. This methodology could be applied to answer a variety of research questions about human health exposures that utilize electronic health record data and can accommodate continuous, ordinal, and binary data derived from questionnaires. Further work to explore the potential utility of including genetic risk scores and time-varying covariates is warranted. Full article
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9 pages, 416 KiB  
Article
Unhealthy Diet Pattern Mediates the Disproportionate Prevalence of Obesity among Adults with Socio-Economic Disadvantage: An Australian Representative Cross-Sectional Study
by Canaan Negash Seifu, Paul Patrick Fahey and Evan Atlantis
Nutrients 2021, 13(4), 1363; https://doi.org/10.3390/nu13041363 - 19 Apr 2021
Cited by 7 | Viewed by 4899
Abstract
The role of unhealthy dietary pattern in the association between socio-economic factors and obesity is unclear. The aim was to examine the association between socio-economic disadvantage and obesity and to assess mediation effect of unhealthy dietary pattern defined using the Mediterranean diet criteria. [...] Read more.
The role of unhealthy dietary pattern in the association between socio-economic factors and obesity is unclear. The aim was to examine the association between socio-economic disadvantage and obesity and to assess mediation effect of unhealthy dietary pattern defined using the Mediterranean diet criteria. The data source was the Australian National Nutrition and Physical Activity Survey. The study sample included 7744 participants aged 18 years and over, 28% of whom had obesity. We used the Australian Socio-Economic Indexes for Areas (SEIFA) classification system for categorizing socio-economic disadvantage; calculated the Mediterranean Diet Score (MDS) using standard criteria; and used measured body mass index to define obesity. We conducted a mediation analysis using log–binomial models to generate the prevalence ratio for obesity and the proportion mediated by the MDS. The most disadvantaged group was associated with higher level of obesity after controlling for covariates (1.40, 95% CI 1.25, 1.56) compared to the least disadvantaged group, and in a dose–response way for each decreasing SEIFA quintile. The relationship between socio-economic disadvantage and obesity was mediated by the MDS (4.0%, 95% CI 1.9, 8.0). Public health interventions should promote healthy dietary patterns, such as the Mediterranean diet, to reduce obesity, especially in communities with high socio-economic disadvantage. Full article
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24 pages, 985 KiB  
Perspective
Precision Nutrition for Alzheimer’s Prevention in ApoE4 Carriers
by Nicholas G. Norwitz, Nabeel Saif, Ingrid Estrada Ariza and Richard S. Isaacson
Nutrients 2021, 13(4), 1362; https://doi.org/10.3390/nu13041362 - 19 Apr 2021
Cited by 33 | Viewed by 29028
Abstract
The ApoE4 allele is the most well-studied genetic risk factor for Alzheimer’s disease, a condition that is increasing in prevalence and remains without a cure. Precision nutrition targeting metabolic pathways altered by ApoE4 provides a tool for the potential prevention of disease. However, [...] Read more.
The ApoE4 allele is the most well-studied genetic risk factor for Alzheimer’s disease, a condition that is increasing in prevalence and remains without a cure. Precision nutrition targeting metabolic pathways altered by ApoE4 provides a tool for the potential prevention of disease. However, no long-term human studies have been conducted to determine effective nutritional protocols for the prevention of Alzheimer’s disease in ApoE4 carriers. This may be because relatively little is yet known about the precise mechanisms by which the genetic variant confers an increased risk of dementia. Fortunately, recent research is beginning to shine a spotlight on these mechanisms. These new data open up the opportunity for speculation as to how carriers might ameliorate risk through lifestyle and nutrition. Herein, we review recent discoveries about how ApoE4 differentially impacts microglia and inflammatory pathways, astrocytes and lipid metabolism, pericytes and blood–brain barrier integrity, and insulin resistance and glucose metabolism. We use these data as a basis to speculate a precision nutrition approach for ApoE4 carriers, including a low-glycemic index diet with a ketogenic option, specific Mediterranean-style food choices, and a panel of seven nutritional supplements. Where possible, we integrate basic scientific mechanisms with human observational studies to create a more complete and convincing rationale for this precision nutrition approach. Until recent research discoveries can be translated into long-term human studies, a mechanism-informed practical clinical approach may be useful for clinicians and patients with ApoE4 to adopt a lifestyle and nutrition plan geared towards Alzheimer’s risk reduction. Full article
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13 pages, 570 KiB  
Article
Social Distancing in Chronic Migraine during the COVID-19 Outbreak: Results from a Multicenter Observational Study
by Vincenzo Di Stefano, Raffaele Ornello, Andrea Gagliardo, Angelo Torrente, Elisa Illuminato, Valeria Caponnetto, Ilaria Frattale, Raffaella Golini, Chiara Di Felice, Fabiola Graziano, Maria Caccamo, Davide Ventimiglia, Salvatore Iacono, Gabriella Matarazzo, Francesco Armetta, Giuseppe Battaglia, Alberto Firenze, Simona Sacco and Filippo Brighina
Nutrients 2021, 13(4), 1361; https://doi.org/10.3390/nu13041361 - 19 Apr 2021
Cited by 32 | Viewed by 3861
Abstract
Background: The restrictions taken to control the rapid spread of COVID-19 resulted in a sudden, unprecedented change in people’s lifestyle, leading to negative consequences on general health. This study aimed to estimate the impact of such changes on migraine severity during 2020 March–May [...] Read more.
Background: The restrictions taken to control the rapid spread of COVID-19 resulted in a sudden, unprecedented change in people’s lifestyle, leading to negative consequences on general health. This study aimed to estimate the impact of such changes on migraine severity during 2020 March–May lockdown. Methods: Patients affected by migraine with or without aura, diagnosed by expert physicians, completed a detailed interview comprehensive of: assessment of migraine characteristics; measure of physical activity (PA) levels; measure of the intake frequency of main Italian foods; the Insomnia Severity Index (ISI) questionnaire investigating sleep disorders. Results: We included 261 patients with a mean age of 44.5 ± 12.3 years. During social distancing, 72 patients (28%) reported a headache worsening, 86 (33%) an improvement, and 103 (39%) a stable headache frequency. A significant decrease of the PA levels during COVID-19 quarantine in the whole study sample was observed (median total metabolic equivalent task (METs) decreased from 1170 to 510; p < 0.001). Additionally, a significant difference was reported on median ISI scores (from 7 to 8; p < 0.001), which were increased in patients who presented a stable or worsening headache. Conclusions: Our study confirmed that the restrictions taken during the pandemic have affected the practice of PA levels and sleep quality in migraine. Hence, PA and sleep quality should be assessed to find strategies for an improvement in quality of life. Full article
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16 pages, 765 KiB  
Article
Analysis of the Effects of Nutrient Intake and Dietary Habits on Depression in Korean Adults
by Hyeonseo Yun, Dong-Wook Kim, Eun-Joo Lee, Jinmyung Jung and Sunyong Yoo
Nutrients 2021, 13(4), 1360; https://doi.org/10.3390/nu13041360 - 19 Apr 2021
Cited by 9 | Viewed by 3962
Abstract
While several studies have explored nutrient intake and dietary habits associated with depression, few studies have reflected recent trends and demographic factors. Therefore, we examined how nutrient intake and eating habits are associated with depression, according to gender and age. We performed simple [...] Read more.
While several studies have explored nutrient intake and dietary habits associated with depression, few studies have reflected recent trends and demographic factors. Therefore, we examined how nutrient intake and eating habits are associated with depression, according to gender and age. We performed simple and multiple regressions using nationally representative samples of 10,106 subjects from the Korea National Health and Nutrition Examination Survey. The results indicated that cholesterol, dietary fiber, sodium, frequency of breakfast, lunch, dinner, and eating out were significantly associated with depression (p-value < 0.05). Moreover, depression was associated with nutrient intake and dietary habits by gender and age group: sugar, breakfast, lunch, and eating out frequency in the young women’s group; sodium and lunch frequency among middle-age men; dietary fibers, breakfast, and eating out frequency among middle-age women; energy, moisture, carbohydrate, lunch, and dinner frequency in late middle-age men; breakfast and lunch frequency among late middle-age women; vitamin A, carotene, lunch, and eating out frequency among older age men; and fat, saturated fatty acids, omega-3 fatty acid, omega-6 fatty acid, and eating out frequency among the older age women’s group (p-value < 0.05). This study can be used to establish dietary strategies for depression prevention, considering gender and age. Full article
(This article belongs to the Special Issue Diet and Wellbeing across the Life Course)
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9 pages, 393 KiB  
Article
Managing Obesity in Lockdown: Survey of Health Behaviors and Telemedicine
by Noga C. Minsky, Dafna Pachter, Galia Zacay, Naama Chishlevitz, Miriam Ben-Hamo, Dana Weiner and Gabriella Segal-Lieberman
Nutrients 2021, 13(4), 1359; https://doi.org/10.3390/nu13041359 - 19 Apr 2021
Cited by 16 | Viewed by 4273
Abstract
Since the outbreak of COVID-19, billions of people have gone into lockdown, facing pandemic related challenges that engender weight gain, especially in the obese. We report the results of an online survey, conducted during Israel’s first quarantine, of 279 adults treated in hospital-based [...] Read more.
Since the outbreak of COVID-19, billions of people have gone into lockdown, facing pandemic related challenges that engender weight gain, especially in the obese. We report the results of an online survey, conducted during Israel’s first quarantine, of 279 adults treated in hospital-based obesity clinics with counseling, medications, surgery, endoscopic procedures, or any combination of these for weight loss. In this study, we assessed the association between changes in dietary and lifestyle habits and body weight, and the benefits of receiving weight management care remotely through telemedicine during lockdown. Compared to patients not receiving obesity care via telemedicine, patients receiving this care were more likely to lose weight (OR, 2.79; p = 0.042) and also to increase participation in exercise (OR, 2.4; p = 0.022). While 40% of respondents reported consuming more sweet or salty processed snacks and 33% reported less vegetables and fruits, 65% reported more homemade foods. At the same time, 40% of respondents reported a reduction in exercise and 52% reported a decline in mood. Alterations in these eating patterns, as well as in exercise habits and mood, were significantly associated with weight changes. This study highlights that lockdown affects health behaviors associated with weight change, and advocates for the use of telemedicine to provide ongoing obesity care during future quarantines in order to promote weight loss and prevent weight gain. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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4 pages, 202 KiB  
Editorial
Dietary Intake and Chronic Disease Prevention
by Annalisa Noce, Annalisa Romani and Roberta Bernini
Nutrients 2021, 13(4), 1358; https://doi.org/10.3390/nu13041358 - 19 Apr 2021
Cited by 23 | Viewed by 5233
Abstract
Non-communicable diseases (NCDs) are non-infectious chronic pathologies [...] Full article
(This article belongs to the Special Issue Dietary Intake and Chronic Disease Prevention)
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