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Poon SWY, Brown RM, Sumithran P. Comparison of the Nutritional Adequacy of Current Food-Based Very Low Energy Diets: A Review and Nutritional Analysis. Nutrients 2024; 16:2993. [PMID: 39275308 PMCID: PMC11396843 DOI: 10.3390/nu16172993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
Very low energy diets (VLEDs) contain <800 kcal/day and typically comprise formulated meal replacement products with adequate protein and micronutrients. Food-based VLEDs are an alternative approach, but it is uncertain whether they can provide adequate nutrition within an 800 kcal/day restriction. This analysis aimed to assess the nutritional adequacy of food-based VLEDs compared with formula VLEDs. A systematized literature review was conducted to identify balanced food-based VLEDs by searching five scientific databases from inception to 23 March 2023 and online sources between 1 and 7 May 2023. Ultimately, nine diets were analyzed for nutritional content and compared with Codex Alimentarius standards for formula foods, and Australian estimated average requirement and adequate intake (AI) for adults 19-50 years. Optifast® was used as a comparator. None of the VLEDs met all nutritional benchmarks. Three food-based diets had nutrient profiles similar to formula VLEDs, with one being adequate for all nutrients except thiamine, magnesium and zinc in men and iron in women. All VLEDs, including Optifast®, did not meet AI for dietary fiber, except one. In general, food-based VLEDs offered more fiber than Optifast®. In conclusion, food-based VLEDs were inadequate in certain micronutrients but offered more dietary fiber than formula VLEDs. These nutritional deficits do not preclude food-based VLEDs from being recommended, provided they are addressed.
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Affiliation(s)
- Shirley Wing Yan Poon
- Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Fitzroy, VIC 3065, Australia
- School of Agriculture, Food and Ecosystem Sciences, Faculty of Science, University of Melbourne, Parkville, VIC 3010, Australia
| | - Robyn Mary Brown
- Department of Pharmacology and Biochemistry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Priya Sumithran
- Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Fitzroy, VIC 3065, Australia
- Department of Surgery, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC 3004, Australia
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Almandoz JP, Wadden TA, Tewksbury C, Apovian CM, Fitch A, Ard JD, Li Z, Richards J, Butsch WS, Jouravskaya I, Vanderman KS, Neff LM. Nutritional considerations with antiobesity medications. Obesity (Silver Spring) 2024; 32:1613-1631. [PMID: 38853526 DOI: 10.1002/oby.24067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 06/11/2024]
Abstract
The improved efficacy and generally favorable safety profile of recently approved and emerging antiobesity medications (AOMs), which result in an average weight reduction of ≥15%, represent significant advancement in the treatment of obesity. This narrative review aims to provide practical evidence-based recommendations for nutritional assessment, management, and monitoring of patients treated with AOMs. Prior to treatment, clinicians can identify preexisting nutritional risk factors and counsel their patients on recommended intakes of protein, dietary fiber, micronutrients, and fluids. During treatment with AOMs, ongoing monitoring can facilitate early recognition and management of gastrointestinal symptoms or inadequate nutrient or fluid intake. Attention should also be paid to other factors that can impact response to treatment and quality of life, such as physical activity and social and emotional health. In the context of treatment with AOMs, clinicians can play an active role in supporting their patients with obesity to improve their health and well-being and promote optimal nutritional and medical outcomes.
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Affiliation(s)
- Jaime P Almandoz
- Division of Endocrinology, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Thomas A Wadden
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Colleen Tewksbury
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Caroline M Apovian
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Jamy D Ard
- Department of Epidemiology and Prevention and Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Zhaoping Li
- Center for Human Nutrition, University of California Los Angeles, Los Angeles, California, USA
| | - Jesse Richards
- Department of Internal Medicine, University of Oklahoma School of Medicine, Tulsa, Oklahoma, USA
| | - W Scott Butsch
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Lisa M Neff
- Eli Lilly and Company, Indianapolis, Indiana, USA
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Monge-Rojas R, Vargas-Quesada R, Previdelli AN, Kovalskys I, Herrera-Cuenca M, Cortés LY, García MCY, Liria-Domínguez R, Rigotti A, Fisberg RM, Ferrari G, Fisberg M, Gómez G. A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition. Food Nutr Bull 2024; 45:S11-S25. [PMID: 38112070 DOI: 10.1177/03795721231215267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
BACKGROUND Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.
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Affiliation(s)
- Rafael Monge-Rojas
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Rulamán Vargas-Quesada
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | | | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Marianella Herrera-Cuenca
- Universidad Central de Venezuela, Caracas, Venezuela
- Framingham State University, Framingham, MA, USA
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Xue N, Du Y. Nutritional Knowledge, Attitudes, and Needs Among Community Residents of Beijing: A Cross Sectional Study. Int J Gen Med 2024; 17:3319-3327. [PMID: 39081672 PMCID: PMC11288351 DOI: 10.2147/ijgm.s462260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
Background Community health education is essential in combating obesity and cardiovascular diseases by addressing nutritional knowledge gaps and promoting healthier dietary habits in China. The aim of this study was to investigate the nutritional knowledge, attitudes, and needs of residents at Beijing Fengtai District. Methods This cross-sectional study was conducted between October 2021 and January 2022, residents from 31 communities of the Fengtai District were given an online questionnaire, which was designed to assess their nutritional knowledge, attitudes, and needs. Results From 420 distributed surveys, a total of 416 participants were enrolled for an effective recovery rate of 99.05%. Among them, 317 participants (76.20%) scored 80% or higher on the nutritional knowledge questionnaire, participants with higher nutritional knowledge scores were more likely to be aged over 60 years (OR = 0.21, 95% CI 0.06-0.76, p = 0.02), female (OR = 0.40, 95% CI 0.22-0.73, p < 0.01) and employed (OR = 2.31, 95% CI 1.04-5.12, p = 0.04). While many community residents expressed a desire to receive guidance on dietary guidance (n = 303, 72.84%) dietary matching (n = 303, 72.84%), and preventive health care (n = 286, 68.75%). Residents were familiar with nutritional care clinics (55.05%) and believed that the nutritional care clinics should be increased (59.86%). In addition, 345 residents (83.41%) wanted nutritional care clinics to provide consultation on nutritious meal planning. Conclusion Beijing residents need additional access to clinical nutritional resources as their needs are not fulfilled despite a relatively strong knowledge of nutrition.
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Affiliation(s)
- Ningning Xue
- Emergency Department of Beijing Tiantan Hospital, Capital Medical University, Beijing, 100007, People’s Republic of China
| | - Yue Du
- Emergency Department of Beijing Tiantan Hospital, Capital Medical University, Beijing, 100007, People’s Republic of China
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Brown J, Huybrechts K, Straub L, Heider D, Bateman B, Hernandez-Diaz S. Use of Real-World Data and Machine Learning to Screen for Maternal and Paternal Characteristics Associated with Cardiac Malformations. RESEARCH SQUARE 2024:rs.3.rs-4490534. [PMID: 38947037 PMCID: PMC11213223 DOI: 10.21203/rs.3.rs-4490534/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Effective prevention of cardiac malformations, a leading cause of infant morbidity, is constrained by limited understanding of etiology. The study objective was to screen for associations between maternal and paternal characteristics and cardiac malformations. We selected 720,381 pregnancies linked to live-born infants (n=9,076 cardiac malformations) in 2011-2021 MarketScan US insurance claims data. Odds ratios were estimated with clinical diagnostic and medication codes using logistic regression. Screening of 2,000 associations selected 81 associated codes at the 5% false discovery rate. Grouping of selected codes, using latent semantic analysis and the Apriori-SD algorithm, identified elevated risk with known risk factors, including maternal diabetes and chronic hypertension. Less recognized potential signals included maternal fingolimod or azathioprine use. Signals identified might be explained by confounding, measurement error, and selection bias and warrant further investigation. The screening methods employed identified known risk factors, suggesting potential utility for identifying novel risk factors for other pregnancy outcomes.
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Sun Y, Zhang H, Qi G, Tian W. Nutrient deficiency patterns and all-cause and cardiovascular mortality in older adults with hypertension: a latent class analysis. BMC Public Health 2024; 24:1551. [PMID: 38853236 PMCID: PMC11163810 DOI: 10.1186/s12889-024-19003-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 05/30/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Previous researches examining the impact of dietary nutrition on mortality risk have mainly focused on individual nutrients, however the interaction of these nutrients has not been considered. The purpose of this study was to identify of nutrient deficiencies patterns and analyze their potential impact on mortality risk in older adults with hypertension. METHODS We included participants from the National Health and Nutrition Examination Survey (NHANES) study. The latent class analysis (LCA) was applied to uncover specific malnutrition profiles within the sample. Risk of the end points across the phenogroups was compared using Kaplan-Meier analysis and Cox proportional hazard regression model. Multinomial logistic regression was used to determine the influencing factors of specific malnutrition profiles. RESULTS A total of 6924 participants aged 60 years or older with hypertension from NHANES 2003-2014 was followed until December 31, 2019 with a median follow-up of 8.7 years. Various nutrients included vitamin A, vitamin B1, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K, fiber, folate, calcium, magnesium, zinc, copper, iron, and selenium, and LCA revealed 4 classes of malnutrition. Regarding all-cause mortality, "Nutrient Deprived" group showed the strongest hazard ratio (1.42 from 1.19 to 1.70) compared with "Adequate Nutrient" group, followed by "Inadequate Nutrient" group (1.29 from 1.10 to 1.50), and "Low Fiber, Magnesium, and Vit E" group (1.17 from 1.02 to 1.35). For cardiovascular mortality, "Nutrient Deprived" group showed the strongest hazard ratio (1.61 from 1.19 to 2.16) compared with "Adequate Nutrient" group, followed by "Low Fiber, Magnesium, and Vit E" group (1.51 from 1.04 to 2.20), and "Inadequate Nutrient" group (1.37 from 1.03 to 1.83). CONCLUSIONS The study revealed a significant association between nutrients deficiency patterns and the risk of all-cause and cardiovascular mortality in older adults with hypertension. The findings suggested that nutrients deficiency pattern may be an important risk factor for mortality in older adults with hypertension.
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Affiliation(s)
- YuJiao Sun
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China
| | - HuanRui Zhang
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China
| | - GuoXian Qi
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China
| | - Wen Tian
- Department of Geriatric, The First Hospital of China Medical University, 155 Nanjing North Street, Heping Ward, Shenyang, 110001, NO, China.
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Côté M, Pelletier L, Nadeau M, Bouvet-Bouchard L, Julien F, Michaud A, Biertho L, Tchernof A. Micronutrient status 2 years after bariatric surgery: a prospective nutritional assessment. Front Nutr 2024; 11:1385510. [PMID: 38807643 PMCID: PMC11132185 DOI: 10.3389/fnut.2024.1385510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/17/2024] [Indexed: 05/30/2024] Open
Abstract
Background Among commonly performed bariatric surgeries, biliopancreatic diversion with duodenal switch (BPD-DS) provides greater weight loss than Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), with sustained metabolic improvements. However, the risk of long-term nutritional deficiencies due to the hypoabsorptive component of BPD-DS hinders its widespread use. Objective The aim of the study was to examine nutritional status over 2 years after BPD-DS, RYGB or SG. Methods Patients were recruited in the REMISSION trial (NCT02390973), a single-center, prospective study. Out of 215 patients, 73, 48 and 94, respectively, underwent BPD-DS, RYGB or SG. Weight loss, micronutrient serum levels (including iron, calcium, parathormone, vitamins A, B12 and D), and nutritional supplementation were assessed over 2 years. Patients were supplemented according to the type of surgery and individual micronutrient level evolution. Results At baseline, BPD-DS patients were younger than SG patients (p = 0.0051) and RYGB patients had lower body mass index (p < 0.001). Groups had similar micronutrient levels before surgery, with vitamin D insufficiency as the most prevalent nutritional problem (SG: 38.3%, RYGB: 39.9%, BPD-DS: 54.8%, p = 0.08). BPD-DS patients showed lower levels of iron, calcium and vitamin A than SG patients at 24 months. Groups had similar levels of vitamin D at 24 months. Prevalence of vitamin D, calcium, iron, vitamin A and vitamin B12 deficiency was similar among groups at 24 months. Rates of vitamin D insufficiency and iron deficiency were lower at 24 months than at baseline. Micronutrient intake was consistent with recommendations in groups post-surgery, but most BPD-DS patients took vitamin A and vitamin D supplement doses above initial recommendations. Conclusion With appropriate medical and nutritional management, all surgeries led to similar rates of vitamin D, calcium, iron, vitamin A and vitamin B12 deficiencies at 24 months. However, initial vitamin A and vitamin D supplementation recommendations for BPD-DS patients should be revised upwards.
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Affiliation(s)
- Marianne Côté
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- School of Nutrition, Faculty of Agricultural and Food Sciences, Laval University, Québec, QC, Canada
| | - Laurence Pelletier
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- School of Nutrition, Faculty of Agricultural and Food Sciences, Laval University, Québec, QC, Canada
| | - Mélanie Nadeau
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
| | - Léonie Bouvet-Bouchard
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- Department of Surgery, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - François Julien
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- Department of Surgery, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Andréanne Michaud
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- School of Nutrition, Faculty of Agricultural and Food Sciences, Laval University, Québec, QC, Canada
| | - Laurent Biertho
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- Department of Surgery, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - André Tchernof
- Quebec Heart and Lung Institute – Laval University, Québec, QC, Canada
- School of Nutrition, Faculty of Agricultural and Food Sciences, Laval University, Québec, QC, Canada
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Guma E, Chakravarty MM. Immune Alterations in the Intrauterine Environment Shape Offspring Brain Development in a Sex-Specific Manner. Biol Psychiatry 2024:S0006-3223(24)01260-5. [PMID: 38679357 DOI: 10.1016/j.biopsych.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/20/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
Exposure to immune dysregulation in utero or in early life has been shown to increase risk for neuropsychiatric illness. The sources of inflammation can be varied, including acute exposures due to maternal infection or acute stress, or persistent exposures due to chronic stress, obesity, malnutrition, or autoimmune diseases. These exposures may cause subtle alteration in brain development, structure, and function that can become progressively magnified across the life span, potentially increasing the likelihood of developing a neuropsychiatric conditions. There is some evidence that males are more susceptible to early-life inflammatory challenges than females. In this review, we discuss the various sources of in utero or early-life immune alteration and the known effects on fetal development with a sex-specific lens. To do so, we leveraged neuroimaging, behavioral, cellular, and neurochemical findings. Gaining clarity about how the intrauterine environment affects offspring development is critically important for informing preventive and early intervention measures that may buffer against the effects of these early-life risk factors.
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Affiliation(s)
- Elisa Guma
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institute of Mental Health, Bethesda, Maryland; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.
| | - M Mallar Chakravarty
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
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Luan F, Wang J, Liu L, Liu B, Li F, Zhao J, Lai J, Jiang F, Xu W, Zhang Z, Ran P, Shu Y, Yang Z, Fu G. Serum iron element: A novel biomarker for predicting PD-1 immunotherapy efficacy. Int Immunopharmacol 2024; 131:111823. [PMID: 38508094 DOI: 10.1016/j.intimp.2024.111823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
This study aims to explore the relationship between serum iron by inductively coupled plasma-mass spectrometry (ICP-MS) and the efficacy of immune checkpoint inhibitors (ICIs) and potential mechanism. Totally 113 patients from 233 patients with advanced metastatic lung cancer, esophageal cancer, gastric cancer and colorectal cancer who treated with immunotherapy in Shandong Provincial Hospital were divided into training group (n=68) and validation group (n=45), whose patients were divided into clinical benefit response (CBR) and non-clinical benefit (NCB) by RECIST (v1.1) respectively. We found for the first time that high serum iron level (>1036 μg/L) was a novel biomarker of better PFS (10.13 months vs 7.37 months; p = 0.0015) and OS(16.00 months vs 11.00 months; p = 0.0235) by ROC curve (sensitivity: 78.13 %; Specificity: 80.56 %; p < 0.0001) of CBR (n=32) and NCB (n=36) patients in training group. Interestingly, consistently stable and high serum iron level predicted better efficacy during immunotherapy. Noteworthy, the predictive efficacy of PD-L1 expression was significantly inferior than serum iron (accuracy:63.49% vs 79.41%, p=0.0432), while serum iron detected by spectrophotometry did not predict the efficacy of immunotherapy (p=0.0671) indicating higher sensitivity of ICP-MS. Bioinformatics analysis showed that serum iron could enhance innate immunity and cytokine release and was verified by proteomics that KEGG and GO analysis enriched innate immune and cytokine signaling pathways. Flow cytometry showed that IL-17 (p=0.0002) increased and IL-6 (p=0.0112) decreased after immunotherapy. Based on this, Nomogram with better prediction was constructed by multiple clinical and independent factors. Our results revealed that serum iron is positively associated with ICIs efficacy by enhancing innate immunity and cytokine release in advanced metastatic cancers, and can be a biomarker for predicting ICIs response.
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Affiliation(s)
- Fang Luan
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Jingliang Wang
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250002, China; Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Lei Liu
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China; Department of Oncology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250102, China
| | - Bin Liu
- Department of Biomedical Engineering, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Fuxia Li
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Jing Zhao
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Jingjiang Lai
- Innovative Institute of Chinese Medicine, Shandong University of Traditional Chinese 24 Medicine, Jinan 250002, China
| | - Fengxian Jiang
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250002, China; Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Wei Xu
- Department of Oncology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250012, China
| | - Zhizhao Zhang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Pancen Ran
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250002, China; Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Yang Shu
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250002, China; Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Zhe Yang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Guobin Fu
- The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250002, China; Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China; The Third Affiliated Hospital of Shandong First Medical University, Jinan 250031, China.
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Tan X, Tan PY, Gong YY, Moore JB. Overnutrition is a risk factor for iron, but not for zinc or vitamin A deficiency in children and young people: a systematic review and meta-analysis. BMJ Glob Health 2024; 9:e015135. [PMID: 38599666 PMCID: PMC11015307 DOI: 10.1136/bmjgh-2024-015135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION Traditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can coexist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A (VA) status and weight status (both underweight and overweight) in children and young people. METHODS Ovid Medline, Ovid Embase, Scopus and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum or plasma levels of iron, zinc or VA biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood meta-analyses were performed. RESULTS After screening, 83 observational studies involving 190 443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28 and 27 studies reporting data for iron, zinc and VA status, respectively. Synthesising 16 records of OR from seven eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (ID) (OR (95% CI): 1.51 (1.20 to 1.82), p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 (1.33 to 2.43), p<0.0001, I2=20.6%) in comparison to those with overweight (1.31 (0.98 to 1.64), p<0.0001, I2=40.5%), although between group differences were not significant (p=0.08). CONCLUSIONS Overnutrition is associated with increased risk of ID, but not zinc or VA deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of ID may well be under-recognised, particularly in children and young people living with overnutrition. PROSPERO REGISTRATION NUMBER CRD42020221523.
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Affiliation(s)
- Xiaomian Tan
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
| | - Pui Yee Tan
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
| | - Yun Yun Gong
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
| | - J Bernadette Moore
- School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, UK
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Livzan MA, Lyalyukova EA, Druk IV, Safronova SS, Khalashte AA, Martirosian KA, Petrosian VY, Galakhov YS. Obesity: current state of the problem, multidisciplinary approach. (based on the consensus of the World Gastroenterological Organization “Obesity 2023” and the European guideline on obesity care in patients with gastrointestinal and liver diseases, 2022). EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2024:5-47. [DOI: 10.31146/1682-8658-ecg-218-10-5-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Obesity is the largest pandemic in the world, and its prevalence continues to increase. The purpose of the presented publication is to raise awareness of doctors about modern methods of diagnosing obesity and approaches to therapy, using an interdisciplinary team approach similar to that used in other chronic diseases, such as diabetes, heart disease and cancer. The article presents data from the World Gastroenterological Organization (2023) and the European Guidelines for the Treatment of Obesity in patients with diseases of the gastrointestinal tract and liver (2022). According to modern approaches, obesity should be considered as a chronic recurrent progressive disease, the treatment of which requires a comprehensive interdisciplinary approach involving psychologists and psychiatrists, nutritionists/nutritionists, therapists, endoscopists and surgeons, including lifestyle changes, a well-defined diet and exercise regimen, drug therapy, endoscopic or surgical methods of treatment. Conclusions. In order to stop the growing wave of obesity and its many complications and costs, doctors, insurance companies and health authorities should make systematic efforts to raise public awareness of both the adverse health risks associated with obesity and the potential reduction of risks through a comprehensive approach to therapy.
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12
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Lian S, Huang Y, Li J, Nie J, Li M, Zhou J, He J, Liu C. Combined effects of pre-pregnancy BMI and gestational weight gain on preterm birth: comparison between spontaneous and ART conception. J Assist Reprod Genet 2024; 41:673-681. [PMID: 38277112 PMCID: PMC10957804 DOI: 10.1007/s10815-024-03024-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Inappropriate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are both linked to preterm birth (PTB); however, which one plays a dominant role in PTB risk is not yet sure. We aimed to evaluate the combined effect of pre-pregnancy BMI and GWG on the risk of PTB in singleton pregnancies conceived both spontaneously and through assisted reproductive technology (ART). METHODS The data included all mothers (n = 17,540,977) who had a live singleton birth from the US National Vital Statistics System (NVSS) 2015-2019. Logistic regression models, quantile-g-computation, and generalized additive model were used to analyze the combined association of pre-pregnancy BMI and GWG with PTB. RESULTS The singleton PTB rate was significantly higher in ART pregnancies (11.5%) than in non-ART pregnancies (7.9%). When compared to those women with pre-pregnancy normal weight and GWG within Institute of Medicine (IOM) guidelines, the highest PTB risk was observed in non-ART women with pre-pregnancy underweight and GWG below IOM guidelines (aOR 2.56; 95% CI 2.53-2.60) and in ART women with pre-pregnancy obese and GWG below IOM guidelines (aOR 2.56; 95%CI 2.36-2.78). GWG dominated the combined effect with its joint effect coefficient of - 0.281 (P < 0.05) in non-ART women and - 0.108 (P < 0.05) in ART women. CONCLUSIONS Inappropriate GWG played a dominant role in increasing the risk of PTB in both non-ART and ART populations. Counseling regarding pre-pregnancy BMI and especially GWG appears to be even more crucial for pregnancies conceived via ART, given their impact on PTB.
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Affiliation(s)
- Shaoyan Lian
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Ying Huang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jieying Li
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jiaying Nie
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Meilin Li
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jiaxin Zhou
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jiang He
- Department of Mathematics and Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Chaoqun Liu
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China.
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13
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Berger MM, Amrein K, Barazzoni R, Bindels L, Bretón I, Calder PC, Cappa S, Cuerda C, D'Amelio P, de Man A, Delzenne NM, Forbes A, Genton L, Gombart AF, Joly F, Laviano A, Matthys C, Phyo PP, Ravasco P, Serlie MJ, Shenkin A, Stoffel NU, Talwar D, van Zanten ARH. The science of micronutrients in clinical practice - Report on the ESPEN symposium. Clin Nutr 2024; 43:268-283. [PMID: 38104489 DOI: 10.1016/j.clnu.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/27/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND & AIMS The European Society for Clinical Nutrition and Metabolism published its first clinical guidelines for use of micronutrients (MNs) in 2022. A two-day web symposium was organized in November 2022 discussing how to apply the guidelines in clinical practice. The present paper reports the main findings of this symposium. METHODS Current evidence was discussed, the first day being devoted to clarifying the biology underlying the guidelines, especially regarding the definition of deficiency, the impact of inflammation, and the roles in antioxidant defences and immunity. The second day focused on clinical situations with high prevalence of MN depletion and deficiency. RESULTS The importance of the determination of MN status in patients at risk and diagnosis of deficiencies is still insufficiently perceived, considering the essential role of MNs in immune and antioxidant defences. Epidemiological data show that deficiencies of several MNs (iron, iodine, vitamin D) are a global problem that affects human health and well-being including immune responses such as to vaccination. Clinical conditions frequently associated with MN deficiencies were discussed including cancer, obesity with impact of bariatric surgery, diseases of the gastrointestinal tract, critical illness, and aging. In all these conditions, MN deficiency is associated with worsening of outcomes. The recurrent problem of shortage of MN products, but also lack of individual MN-products is a worldwide problem. CONCLUSION Despite important progress in epidemiology and clinical nutrition, numerous gaps in practice persist. MN depletion and deficiency are frequently insufficiently searched for in clinical conditions, leading to inadequate treatment. The symposium concluded that more research and continued education are required to improve patient outcome.
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Affiliation(s)
- Mette M Berger
- Lausanne University, Faculty of Biology & Medicine, 1005 Lausanne, Switzerland.
| | - Karin Amrein
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Laure Bindels
- Faculty of Pharmacy and Biomedical Sciences, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
| | - Irene Bretón
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Stefano Cappa
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies (IUSS-Pavia), 27100 Pavia, Italy.
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Patrizia D'Amelio
- Service de gériatrie et réadaptation gériatrique, Département de Médecine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Angélique de Man
- Department of Intensive Care Medicine, Research VUMC Intensive Care, Amsterdam Cardiovascular Science, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands.
| | - Nathalie M Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
| | - Alastair Forbes
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
| | - Laurence Genton
- Clinical Nutrition Unit, Department of Endocrinology, Geneva University Hospitals, Geneva, Switzerland.
| | - Adrian F Gombart
- Linus Pauling Institute, Department of Biochemistry and Biophysics, Oregon State University, Corvallis, OR 97331, USA.
| | - Francisca Joly
- Beaujon Hospital, APHP, Clichy, University of Paris VII, France.
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, University La Sapienza, Rome, Italy.
| | | | - Pyi Pyi Phyo
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Copenhagen, Denmark.
| | - Paula Ravasco
- Coordinator of the Curricular Units Diabetes, Obesity and Lifestyle, Digestion and Defence, University of Lisbon - Católica Medical School, Lisbon, Portugal.
| | - Mireille J Serlie
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Switzerland; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
| | - Dinesh Talwar
- Department of Biochemistry, Glasgow Royal Infirmary, Glasgow, UK.
| | - Arthur R H van Zanten
- Gelderse Vallei Hospital, Ede and Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
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Radtke MD, Steinberg FM, Scherr RE. Methods for Assessing Health Outcomes Associated with Food Insecurity in the United States College Student Population: A Narrative Review. Adv Nutr 2024; 15:100131. [PMID: 37865221 PMCID: PMC10831897 DOI: 10.1016/j.advnut.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.
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Affiliation(s)
- Marcela D Radtke
- Propel Postdoctoral Fellow, Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Palo Alto, CA, USA 94305
| | | | - Rachel E Scherr
- Family, Interiors, Nutrition & Apparel Department, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, USA, 94132; Scherr Nutrition Science Consulting, San Francisco, CA, 94115.
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Hatch-McChesney A, Smith TJ. Nutrition, Immune Function, and Infectious Disease in Military Personnel: A Narrative Review. Nutrients 2023; 15:4999. [PMID: 38068857 PMCID: PMC10708187 DOI: 10.3390/nu15234999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
Consuming a diet that meets energy demands and provides essential nutrients promotes a healthy immune system, while both under- and over-nutrition have been associated with immune dysfunction. Military personnel comprise a unique population who frequently endure multi-stressor environments, predisposing them to immune decrements. Additionally, 49% and 22% of active duty U.S. military personnel are classified as overweight and obese, respectively. A literature search on PubMed was conducted to identify studies, reports, review papers, and references within those sources relevant to the topic area. Military personnel experiencing either under- or over-nutrition can suffer from degraded health, readiness, and performance. Insufficient intake of nutrients during military operations increases infection risk and negatively impacts infection recovery. Energy, protein, iron, zinc, and vitamins C and D are nutritional areas of concern that may impact immune competence in a multi-stressor environment. Over-nutrition can promote accretion of excess body fat and obesity, which contributes to a chronic inflammatory state that coincides with immune impairments. Prioritizing efforts to optimize nutrient intake is one approach for reducing disease burden and improving readiness. This review discusses nutritional concerns concomitant to multi-stressor environments that impact immune function, and the relevance of obesity to infectious disease risk in the military population.
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Affiliation(s)
| | - Tracey J. Smith
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA 01760, USA;
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16
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Bradley M, Melchor J, Carr R, Karjoo S. Obesity and malnutrition in children and adults: A clinical review. OBESITY PILLARS (ONLINE) 2023; 8:100087. [PMID: 38125660 PMCID: PMC10728708 DOI: 10.1016/j.obpill.2023.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 12/23/2023]
Abstract
Background In the U.S., children and adults are consuming more low-nutrient foods with added sugar and excess fats as compared to healthy, high-quality calories and micronutrients. This diet is increasing the prevalence of malnutrition and nutritional deficiencies, despite high calorie intake. This is a review of the common micronutrient deficiencies, the risk factors for malnutrition, dietary plans, and the health consequences in children and adults with obesity in the U.S. Methods This clinical review of literature was performed on the MEDLINE (PubMed) search engine. A total of 1391 articles were identified and after review, a total of 130 were found to be most pertinent. Discussion The most common micronutrient deficiencies found in patients with obesity were vitamin A, thiamine (B1), folate (B9), cobalamin (B12), vitamin D, iron, calcium, and magnesium, especially prior and after bariatric surgery. Diets that produced the most weight reduction also further puts these individuals at risk for worsening malnutrition. Malnutrition and micronutrient deficiencies can worsen health outcomes if not properly managed. Conclusion Adequate screening and awareness of malnutrition can improve the health outcomes in patients with obesity. Physiologic changes in response to increased adiposity and inadequate intake increase this population's risk of adverse health effects. Malnutrition affects the individual and contributes to worse public health outcomes. The recommendations for screening for malnutrition are not exclusive to individuals undergoing bariatric procedures and can improve the health outcomes of any patient with obesity. However, clearly, improved nutritional status can assist with metabolism and prevent adverse nutritional outcomes post-bariatric surgery. Clinicians should advise on proper nutrition and be aware of diets that worsen deficiencies.
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Affiliation(s)
- Morgan Bradley
- Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL, 32304, USA
| | - Julian Melchor
- Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL, 32304, USA
| | - Rachel Carr
- Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL, 32304, USA
| | - Sara Karjoo
- Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL, 32304, USA
- Johns Hopkins All Children's Hospital, 601 5th St. S. Suite 605, St. Petersburg, FL, 33701, USA
- University of South Florida Morsani College of Medicine, 560 Channelside Drive MDD 54, Tampa, FL, 33602, USA
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17
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Steenackers N, Van der Schueren B, Augustijns P, Vanuytsel T, Matthys C. Development and complications of nutritional deficiencies after bariatric surgery. Nutr Res Rev 2023; 36:512-525. [PMID: 36426645 DOI: 10.1017/s0954422422000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The clinical effectiveness of bariatric surgery has encouraged the use of bariatric procedures for the treatment of morbid obesity and its comorbidities, with sleeve gastrectomy and Roux-en-Y gastric bypass being the most common procedures. Notwithstanding its success, bariatric procedures are recognised to predispose the development of nutritional deficiencies. A framework is proposed that provides clarity regarding the immediate role of diet, the gastrointestinal tract and the medical state of the patient in the development of nutritional deficiencies after bariatric surgery, while highlighting different enabling resources that may contribute. Untreated, these nutritional deficiencies can progress in the short term into haematological, muscular and neurological complications and in the long term into skeletal complications. In this review, we explore the development of nutritional deficiencies after bariatric surgery through a newly developed conceptual framework. An in-depth understanding will enable the optimisation of the post-operative follow-up, including detecting clinical signs of complications, screening for laboratory abnormalities and treating nutritional deficiencies.
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Affiliation(s)
- Nele Steenackers
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Bart Van der Schueren
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Augustijns
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Tim Vanuytsel
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
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18
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Cordon IM, Doerr C, Whetstone L. California's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Be Better social marketing campaign: mothers' fruit and vegetable consumption and facilitation of children's healthy behaviours. Public Health Nutr 2023; 26:2514-2525. [PMID: 37424282 DOI: 10.1017/s1368980023001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
OBJECTIVE Evaluation of California Department of Public Health's three-year social marketing campaign (Be Better) to encourage healthy eating and water consumption among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) California mothers. Andreasen's social marketing framework was used to outline the development and evaluation of the campaign. DESIGN Quantitative, pre-post cross-sectional study with three cohorts nested within survey years. Generalised estimating equation modeling was used to obtain population estimates of campaign reach and changes in mothers' fruit and vegetable (FV) consumption and facilitative actions towards their children's health behaviours. SETTING CalFresh Healthy Living (California's SNAP-Ed). PARTICIPANTS Three separate cohorts of SNAP mothers were surveyed (pre, post) between 2016 and 2018 inclusive. A total of 2229 mothers (ages 18-59) self-identified as White, Latina, African American or Asian/Pacific Islander participated. RESULTS Approximately 82 percent of surveyed mothers were aware of the campaign as assessed by measures of recall and recognition. Ad awareness was positively associated with mothers' FV consumption (R2 = 0·45), with the proportion of FV on plates and with behaviours that facilitate children's FV consumption and limit unhealthy snacks and sugary drinks (βs ranged from 0·1 to 0·7). CONCLUSIONS The campaign successfully reached 82 percent of surveyed mothers. Positive associations between California's Be Better campaign and targeted health behaviours were observed, although the associations varied by year and media channel (i.e. television, radio, billboards and digital). Most associations between ad awareness and outcomes were noted in years two and three of the campaign, suggesting that more than 1 year of campaign exposure was necessary for associations to emerge.
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Affiliation(s)
- Ingrid M Cordon
- California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Ave, Sacramento, CA95814, USA
| | - Celeste Doerr
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, Sacramento, CA95814, USA
| | - Lauren Whetstone
- California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Ave, Sacramento, CA95814, USA
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19
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Amerikanou C, Gioxari A, Kleftaki SA, Valsamidou E, Zeaki A, Kaliora AC. Mental Health Component Scale Is Positively Associated with Riboflavin Intake in People with Central Obesity. Nutrients 2023; 15:4464. [PMID: 37892539 PMCID: PMC10609858 DOI: 10.3390/nu15204464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Micronutrient deficiencies are a well-established fact in obesity. However, few studies exist on the relationship between micronutrient intake and mental health. In this study, we investigated the associations between daily intakes of vitamins and minerals and scoring items that measure mental health in people living with central obesity. One hundred males and females with central obesity and metabolic abnormalities were included in the study. Demographic, clinical, anthropometric, and biochemical data were collected. Mental health statuses were assessed with validated questionnaires, and daily micronutrient intakes were assessed with food diaries and Nutritionist ProTM software v7.9. The mental component score (MCS-12) positively correlated with vitamin A (Rho = 0.249, p = 0.038), vitamin C (Rho = 0.293, p = 0.014), riboflavin (Rho = 0.264, p = 0.026), and folate (Rho = 0.238, p = 0.046). Rosenberg Self-Esteem Scale (RSES) correlated with sodium (Rho = 0.269, p = 0.026), and the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) correlated with chromium (Rho = 0.313, p = 0.009). In the regression analysis, after potential confounders were adjusted for, only riboflavin was positively associated with the MCS-12 log (beta ± SD = 0.047 ± 0.023, p = 0.044). Our study provides evidence of the link between dietary riboflavin and mental health in people with obesity, and it highlights the importance of monitoring both nutritional status and mental health when managing obesity.
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Affiliation(s)
- Charalampia Amerikanou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70 El. Venizelou Ave., 17676 Athens, Greece; (C.A.); (S.-A.K.); (E.V.); (A.Z.)
| | - Aristea Gioxari
- Department of Nutritional Science and Dietetics, School of Health Sciences, University of the Peloponnese, Antikalamos, 24100 Kalamata, Greece;
| | - Stamatia-Angeliki Kleftaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70 El. Venizelou Ave., 17676 Athens, Greece; (C.A.); (S.-A.K.); (E.V.); (A.Z.)
| | - Evdokia Valsamidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70 El. Venizelou Ave., 17676 Athens, Greece; (C.A.); (S.-A.K.); (E.V.); (A.Z.)
| | - Antonia Zeaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70 El. Venizelou Ave., 17676 Athens, Greece; (C.A.); (S.-A.K.); (E.V.); (A.Z.)
| | - Andriana C. Kaliora
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 70 El. Venizelou Ave., 17676 Athens, Greece; (C.A.); (S.-A.K.); (E.V.); (A.Z.)
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20
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DiVito D, Wellik A, Burfield J, Peterson J, Flickinger J, Tindall A, Albanowski K, Vishnubhatt S, MacMullen L, Martin I, Muraresku C, McCormick E, George-Sankoh I, McCormack S, Goldstein A, Ganetzky R, Yudkoff M, Xiao R, Falk MJ, R Mascarenhas M, Zolkipli-Cunningham Z. Optimized Nutrition in Mitochondrial Disease Correlates to Improved Muscle Fatigue, Strength, and Quality of Life. Neurotherapeutics 2023; 20:1723-1745. [PMID: 37723406 PMCID: PMC10684455 DOI: 10.1007/s13311-023-01418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 09/20/2023] Open
Abstract
We sought to prospectively characterize the nutritional status of adults ≥ 19 years (n = 22, 27% males) and children (n = 38, 61% male) with genetically-confirmed primary mitochondrial disease (PMD) to guide development of precision nutritional support strategies to be tested in future clinical trials. We excluded subjects who were exclusively tube-fed. Daily caloric requirements were estimated using World Health Organization (WHO) equations to predict resting energy expenditure (REE) multiplied by an activity factor (AF) based on individual activity levels. We developed a Mitochondrial Disease Activity Factors (MOTIVATOR) score to encompass the impact of muscle fatigue typical of PMD on physical activity levels. PMD cohort daily diet intake was estimated to be 1,143 ± 104.1 kcal in adults (mean ± SEM, 76.2% of WHO-MOTIVATOR predicted requirement), and 1,114 ± 62.3 kcal in children (86.4% predicted). A total of 11/22 (50%) adults and 18/38 (47.4%) children with PMD consumed ≤ 75% predicted daily Kcal needs. Malnutrition was identified in 16/60 (26.7%) PMD subjects. Increased protein and fat intake correlated with improved muscle strength in those with insufficient daily Kcal intake (≤ 75% predicted); higher protein and fat intake correlated with decreased muscle fatigue; and higher protein, fat, and carbohydrate intake correlated with improved quality of life (QoL). These data demonstrate the frequent occurrence of malnutrition in PMD and emphasize the critical need to devise nutritional interventions to optimize clinical outcomes.
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Affiliation(s)
- Donna DiVito
- Clinical Nutrition Department, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amanda Wellik
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jessica Burfield
- Clinical Nutrition Department, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - James Peterson
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jean Flickinger
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alyssa Tindall
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kimberly Albanowski
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shailee Vishnubhatt
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Laura MacMullen
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Isaac Martin
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colleen Muraresku
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth McCormick
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ibrahim George-Sankoh
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shana McCormack
- Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Amy Goldstein
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca Ganetzky
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marc Yudkoff
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rui Xiao
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marni J Falk
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Maria R Mascarenhas
- Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zarazuela Zolkipli-Cunningham
- Department of Pediatrics, Division of Human Genetics, Mitochondrial Medicine Frontier Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Kinshella MLW, Pickerill K, Bone JN, Prasad S, Campbell O, Vidler M, Craik R, Volvert ML, Mistry HD, Tsigas E, Magee LA, von Dadelszen P, Moore SE, Elango R. An evidence review and nutritional conceptual framework for pre-eclampsia prevention. Br J Nutr 2023; 130:1065-1076. [PMID: 36484095 PMCID: PMC10442797 DOI: 10.1017/s0007114522003889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 10/31/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
Pre-eclampsia is a serious complication of pregnancy, and maternal nutritional factors may play protective roles or exacerbate risk. The tendency to focus on single nutrients as a risk factor obscures the complexity of possible interactions, which may be important given the complex nature of pre-eclampsia. An evidence review was conducted to compile definite, probable, possible and indirect nutritional determinants of pre-eclampsia to map a nutritional conceptual framework for pre-eclampsia prevention. Determinants of pre-eclampsia were first compiled through an initial consultation with experts. Second, an expanded literature review was conducted to confirm associations, elicit additional indicators and evaluate evidence. The strength of association was evaluated as definite relative risk (RR) < 0·40 or ≥3·00, probable RR 0·40-0·69 or 1·50-2·99, possible RR 0·70-0·89 or 1·10-1·49 or not discernible RR 0·90-1·09. The quality of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluation. Twenty-five nutritional factors were reported in two umbrella reviews and twenty-two meta-analyses. Of these, fourteen were significantly associated with pre-eclampsia incidence. Higher serum Fe emerged as a definite nutritional risk factors for pre-eclampsia incidence across populations, while low serum Zn was a risk factor in Asia and Africa. Maternal vitamin D deficiency was a probable risk factor and Ca and/or vitamin D supplementation were probable protective nutritional factors. Healthy maternal dietary patterns were possibly associated with lower risk of developing pre-eclampsia. Potential indirect pathways of maternal nutritional factors and pre-eclampsia may exist through obesity, maternal anaemia and gestational diabetes mellitus. Research gaps remain on the influence of household capacities and socio-cultural, economic and political contexts, as well as interactions with medical conditions.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Kelly Pickerill
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Jeffrey N. Bone
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Sarina Prasad
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Olivia Campbell
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Rachel Craik
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
| | - Marie-Laure Volvert
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
| | - Hiten D. Mistry
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
| | | | - Laura A. Magee
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
| | - Peter von Dadelszen
- Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
| | - Sophie E. Moore
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
- MRC Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rajavel Elango
- Department of Pediatrics, BC Children’s and Women’s Hospital, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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22
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Renzetti S, Gennings C, Calza S. A weighted quantile sum regression with penalized weights and two indices. Front Public Health 2023; 11:1151821. [PMID: 37533534 PMCID: PMC10392701 DOI: 10.3389/fpubh.2023.1151821] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/02/2023] [Indexed: 08/04/2023] Open
Abstract
Background New statistical methodologies were developed in the last decade to face the challenges of estimating the effects of exposure to multiple chemicals. Weighted Quantile Sum (WQS) regression is a recent statistical method that allows estimating a mixture effect associated with a specific health effect and identifying the components that characterize the mixture effect. Objectives In this study, we propose an extension of WQS regression that estimates two mixture effects of chemicals on a health outcome in the same model through the inclusion of two indices, one in the positive direction and one in the negative direction, with the introduction of a penalization term. Methods To evaluate the performance of this new model we performed both a simulation study and a real case study where we assessed the effects of nutrients on obesity among adults using the National Health and Nutrition Examination Survey (NHANES) data. Results The method showed good performance in estimating both the regression parameter and the weights associated with the single elements when the penalized term was set equal to the magnitude of the Akaike information criterion of the unpenalized WQS regression. The two indices further helped to give a better estimate of the parameters [Positive direction Median Error (PME): 0.022; Negative direction Median Error (NME): -0.044] compared to the standard WQS without the penalization term (PME: -0.227; NME: 0.215). In the case study, WQS with two indices was able to find a significant effect of nutrients on obesity in both directions identifying sodium and magnesium as the main actors in the positive and negative association, respectively. Discussion Through this work, we introduced an extension of WQS regression that improved the accuracy of the parameter estimates when considering a mixture of elements that can have both a protective and a harmful effect on the outcome; and the advantage of adding a penalization term when estimating the weights.
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Affiliation(s)
- Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stefano Calza
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
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23
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Zavros A, Andreou E, Aphamis G, Bogdanis GC, Sakkas GK, Roupa Z, Giannaki CD. The Effects of Zinc and Selenium Co-Supplementation on Resting Metabolic Rate, Thyroid Function, Physical Fitness, and Functional Capacity in Overweight and Obese People under a Hypocaloric Diet: A Randomized, Double-Blind, and Placebo-Controlled Trial. Nutrients 2023; 15:3133. [PMID: 37513551 PMCID: PMC10386647 DOI: 10.3390/nu15143133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Evidence of the effectiveness of zinc (Zn) and selenium (Se) on resting metabolic rate (RMR) and physical function parameters in people with overweight and obesity is scarce, while the effects of zinc and selenium on thyroid function and body composition are still a topic of debate and controversy. The aim of this randomized, double-blind, and placebo-controlled trial was to examine the effects of a hypocaloric diet and Se-Zn co-supplementation on RMR, thyroid function, body composition, physical fitness, and functional capacity in overweight or obese individuals. Twenty-eight overweight-obese participants (mean BMI: 29.4 ± 4.7) were randomly allocated (1:1) to the supplementation group (n = 14, 31.1 ± 5.5 yrs, 9 females) and the placebo group (n = 14, 32.1 ± 4.8 yrs, 6 females). The participants received Zn (25 mg of zinc gluconate/day) and Se (200 mcg of L-selenomethionine/day) or placebo tablets containing starch for eight weeks. The participants of both groups followed a hypocaloric diet during the intervention. RMR, thyroid function, body composition, cardiorespiratory fitness (VO2max), and functional capacity (sit-to-stand tests, timed up-and-go test, and handgrip strength) were assessed before and after the intervention. A significant interaction was found between supplementation and time on RMR (p = 0.045), with the intervention group's RMR increasing from 1923 ± 440 to 2364 ± 410 kcal/day. On the other hand, no interaction between supplementation and time on the thyroid function was found (p > 0.05). Regarding the effects of Zn/Se co-administration on Se levels, a significant interaction between supplementation and time on Se levels was detected (p = 0.004). Specifically, the intervention group's Se serum levels were increased from 83.04 ± 13.59 to 119.40 ± 23.93 μg/L. However, Zn serum levels did not change over time (90.61 ± 23.23 to 89.58 ± 10.61 umol/L). Even though all body composition outcomes improved in the intervention group more than placebo at the second measurement, no supplement × time interaction was detected on body composition (p > 0.05). Cardiorespiratory fitness did not change over the intervention. Yet, a main effect of time was found for some functional capacity tests, with both groups improving similarly over the eight-week intervention period (p < 0.05). In contrast, a supplement x group interaction was found in the performance of the timed up-and-go test (TUG) (p = 0.010), with the supplementation group improving more. In conclusion, an eight-week intervention with Zn/Se co-supplementation combined with a hypocaloric diet increased the RMR, TUG performance, and Se levels in overweight and obese people. However, thyroid function, Zn levels, body composition, and the remaining outcomes of exercise performance remained unchanged.
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Affiliation(s)
- Antonis Zavros
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Eleni Andreou
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - George Aphamis
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Gregory C Bogdanis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Giorgos K Sakkas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Zoe Roupa
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - Christoforos D Giannaki
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
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24
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Sadhai P, Coetzee A, Conradie-Smit M, Greyling CJ, van Gruting R, du Toit I, Lubbe J, van de Vyver M, Conradie M. Nutritional deficiency in South African adults scheduled for bariatric surgery. Front Endocrinol (Lausanne) 2023; 14:1120531. [PMID: 37293490 PMCID: PMC10246427 DOI: 10.3389/fendo.2023.1120531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/20/2023] [Indexed: 06/10/2023] Open
Abstract
Background Globally, there is a rising trend in obesity, known to increase morbidity and mortality. Metabolic surgery and adequate weight loss decrease mortality but may worsen pre-existing nutrient deficiencies. Most data on pre-existing nutritional deficiencies in the population undergoing metabolic surgery is from the developed world, where an extensive micronutrient assessment is achievable. In resource-constrained environments, the cost of a comprehensive micronutrient assessment must be weighed against the prevalence of nutritional deficiencies and the potential harm if one or more nutritional deficiencies are missed. Methods This cross-sectional study investigated the prevalence of micronutrient and vitamin deficiencies in participants scheduled to undergo metabolic surgery in Cape Town, South Africa, a low-middle income country. 157 participants were selected and 154 reported on; who underwent a baseline evaluation from 12 July 2017 to 19 July 2020. Laboratory measurements were conducted, including vitamin B12 (Vit B12), 25-hydroxy vitamin D (25(OH)D), folate, parathyroid hormone (PTH), thyroid-stimulating hormone (TSH), thyroxine (T4), ferritin, glycated haemoglobin (HbA1c), magnesium, phosphate, albumin, iron, and calcium. Results Participants were predominantly female, aged 45 years (37-51), with a preoperative BMI of 50.4 kg/m2 (44.6-56.5). A total of 64 individuals had Type 2 diabetes mellitus (T2D), with 28 undiagnosed cases at study entry (18% of study population). 25(OH)D deficiency was most prevalent (57%), followed by iron deficiency (44%), and folate deficiency (18%). Other deficiencies (vitamin B12, calcium, magnesium, phosphate) were rarely encountered and affected ≤1% of participants. Folate and 25(OH)D deficiency were related to obesity classification, with a higher prevalence in participants with a BMI ≥40 kg/m2 (p <0.01). Conclusion A higher prevalence of some micronutrient deficiencies was noted compared with data from similar populations in the developed world. The minimum baseline/preoperative nutrient evaluation in such populations should include 25(OH)D, iron studies, and folate. Additionally, screening for T2D is recommended. Future efforts should seek to collate broader patient data on a national scale and include longitudinal surveillance after surgery. This may provide a more holistic picture of the relationship between obesity, metabolic surgery and micronutrient status inform more appropriate evidence-based care.
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Affiliation(s)
- Prabash Sadhai
- Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ankia Coetzee
- Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marli Conradie-Smit
- Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - C. J. Greyling
- Specialist Physician & Endocrinologist, Durbanville Mediclinic and Kuilsriver Netcare Hospital, Cape Town, South Africa
| | - Rutger van Gruting
- Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Inge du Toit
- Department of Surgical Sciences, Division of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jeanne Lubbe
- Department of Surgical Sciences, Division of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Mari van de Vyver
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Magda Conradie
- Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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25
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de Azevedo Muner Ferreira B, Fonseca DC, Sala P, Alves JTM, Prudêncio APA, Machado NM, Marques M, Barcelos S, Ishida RK, Guarda IFMS, De Moura EGH, Sakai P, Santo MA, de Miranda Torrinhas RSM, Waitzberg DL. Roux-en-Y gastric bypass affects the expression of genes related to the intestinal folate metabolism pathway in obese women. Nutrition 2023; 112:112054. [PMID: 37224573 DOI: 10.1016/j.nut.2023.112054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/10/2023] [Accepted: 04/03/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Roux-en-Y gastric bypass (RYGB) promotes sustained weight loss, and the resulting new gastrointestinal anatomy can contribute to nutritional depletions. Folate deficiency is one of the most frequently observed nutritional deficiencies after RYGB. The aim of this study was to assess whether RYGB affects the expression of genes related to the intestinal folate metabolism pathway as an additional molecular mechanism contributing to its postoperative deficiency. METHODS Biopsies from the duodenum, jejunum, and ileum of 20 obese women were collected before and 3 mo after RYGB. The expression of genes involved in intestinal folate metabolism was assessed by microarray and reverse transcriptase polymerase chain reaction (RT-qPCR). Folate intake (7-d food record) and plasma levels (electrochemiluminescence) also were measured. RESULTS Compared with the preoperative phase, transcriptomic alterations were observed in all intestinal segments studied after RYBG, mainly marked by decreased expression of genes encoding folate transporters/receptors and increased expression of genes involved in folate biosynthesis (P < 0.05). Reduced folate intake and plasma folate levels were also observed simultaneously (P < 0.05). Plasma folate concentrations correlated inversely with intestinal FOLR2 and SHMT2 genes (P < 0.001). CONCLUSION The present findings suggested that impaired expression of genes related to intestinal folate metabolism may contribute to the early systemic deficiency after RYGB and highlight a potential transcriptomic reprogramming of the intestine in response to RYGB to compensate for folate depletion induced by this surgical technique.
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Affiliation(s)
- Beatriz de Azevedo Muner Ferreira
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Danielle Cristina Fonseca
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscila Sala
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Departmento de Nutrição, Centro Universitário São Camilo, Sao Paulo, Brazil
| | - Juliana Tepedino Martins Alves
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula Aguiar Prudêncio
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Natasha Mendonça Machado
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mariane Marques
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Samira Barcelos
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Paulo Sakai
- Hospital das Clínicas, HCFMUSP, São Paulo, Brazil
| | | | - Raquel Susana Matos de Miranda Torrinhas
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Dan Linetzky Waitzberg
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Aaseth JO, Alexander J. Postoperative Osteoporosis in Subjects with Morbid Obesity Undergoing Bariatric Surgery with Gastric Bypass or Sleeve Gastrectomy. Nutrients 2023; 15:nu15061302. [PMID: 36986032 PMCID: PMC10057453 DOI: 10.3390/nu15061302] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
Obesity has become a worldwide epidemic accompanied by adverse health effects. The limited efficiency of traditional weight reduction regimens has led to a substantial increase in the use of bariatric surgery. Today, sleeve gastrectomy (SG) and Roux-en-Y-gastric bypass (RYGB) are the most used procedures. The present narrative review focuses on the risk of developing postoperative osteoporosis and summarizes some of the most relevant micronutrient deficiencies associated with RYGB and SG. Preoperatively, the dietary habits of obese individuals might lead to precipitated deficiencies in vitamin D and other nutrients affecting bone mineral metabolism. Bariatric surgery with SG or RYGB can aggravate these deficiencies. The various surgical procedures appear to affect nutrient absorption differently. Being purely restrictive, SG may particularly affect the absorption of vitamin B12 and also vitamin D. In contrast, RYGB has a more profound impact on the absorption of fat-soluble vitamins and other nutrients, although both surgical methods induce only a mild protein deficiency. Despite adequate supplementation of calcium and vitamin D, osteoporosis may still occur after the surgery. This might be due to deficiencies in other micronutrients, e.g., vitamin K and zinc. Regular follow-ups with individual assessments and nutritional advice are indispensable to prevent osteoporosis and other adverse postoperative issues.
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Affiliation(s)
- Jan O. Aaseth
- Department of Research, Innlandet Hospital Trust, P.O. Box 104, N-2381 Brumunddal, Norway
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, N-2418 Elverum, Norway
- Correspondence: ; Tel.: +47-9959-6960
| | - Jan Alexander
- Norwegian Institute of Public Health, P.O. Box 222, N-0213 Oslo, Norway
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27
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Vrieling F, Stienstra R. Obesity and dysregulated innate immune responses: impact of micronutrient deficiencies. Trends Immunol 2023; 44:217-230. [PMID: 36709082 DOI: 10.1016/j.it.2023.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/28/2023]
Abstract
Obesity is associated with the development of various complications, including diabetes, atherosclerosis, and an increased risk for infections, driven by dysfunctional innate immune responses. Recent insights have revealed that the availability of nutrients is a key determinant of innate immune cell function. Although the presence of obesity is associated with overnutrition of macronutrients, several micronutrient deficiencies, including Vitamin D and zinc, are often present. Micronutrients have been attributed important immunomodulatory roles. In this review, we summarize current knowledge of the immunomodulatory effects of Vitamin D and zinc. We also suggest future lines of research to further improve our understanding of these micronutrients; this may serve as a stepping-stone to explore micronutrient supplementation to improve innate immune cell function during obesity.
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Affiliation(s)
- Frank Vrieling
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Rinke Stienstra
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands; Department of Internal Medicine, RadboudUMC, Nijmegen, The Netherlands.
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28
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Seifu CN, Fahey PP, Atlantis E. Micronutrient deficiencies and anaemia associated with body mass index in Australian adults: a cross-sectional study. BMJ Open 2022; 12:e061442. [PMID: 36521896 PMCID: PMC9809261 DOI: 10.1136/bmjopen-2022-061442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIM To estimate the prevalence of micronutrient deficiencies and anaemia, and their association with body mass index (BMI) categories among Australian adults. METHOD We analysed data from the 2011-2013 Australian Health Survey from 3539 participants aged 18 years and over (without known pregnancy) with measured weight and height, and nutrient biomarkers. To address complex sampling, survey weights were used when estimating the prevalence of micronutrient deficiencies (vitamin B12 deficiency; serum vitamin B12<145 pmol/L; iron deficiency; ferritin<30 µg/L and vitamin D deficiency; 25-hydroxyvitamin D<50 nmol/L) and anaemia (haemoglobin <120 g/L for females and <130 g/L for males) and when assessing associations with logistic regression models with adjusted ORs (AORs) for BMI categories: healthy weight (BMI 18.5 to <25.0 kg/m2), reference; overweight (BMI 25.0 to <30.0 kg/m2), obesity class I (BMI 30.0 to <35.0 kg/m2), obesity class II/III (BMI 35.0 kg/m2 or more). RESULT The prevalence of vitamin B12 deficiency (range 0.9%─2.8%) and anaemia (range 3.9%─6.7%) were variable across BMI groups. The prevalence of iron deficiency in the obesity class I group was 12.0 percentage points lower than healthy weight group with an AOR of 0.50 (95% CI 0.30 to 0.83). The prevalence of vitamin D deficiency in the obesity class II/III group was 7.9 percentage points higher than the healthy weight group with an AOR of 1.62 (95% CI 1.01 to 2.60). Vitamin B12 deficiency and anaemia were not consistently associated with BMI groups. CONCLUSION We found a consistent association between severe obesity and vitamin D deficiency in Australian adults. We also found obesity class I was negatively associated with iron deficiency, whereas there was no consistent association between BMI groups and vitamin B12 deficiency and anaemia. Public health strategies are needed to prevent vitamin D deficiency in this high-risk population.
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Affiliation(s)
- Canaan Negash Seifu
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Paul Patrick Fahey
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Evan Atlantis
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Discipline of Medicine, Faculty of Medicine and Health, Nepean Clinical School, The University of Sydney, Sydney, New South Wales, Australia
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Guardiola-Márquez CE, Santos-Ramírez MT, Segura-Jiménez ME, Figueroa-Montes ML, Jacobo-Velázquez DA. Fighting Obesity-Related Micronutrient Deficiencies through Biofortification of Agri-Food Crops with Sustainable Fertilization Practices. PLANTS (BASEL, SWITZERLAND) 2022; 11:3477. [PMID: 36559589 PMCID: PMC9784404 DOI: 10.3390/plants11243477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Obesity is a critical medical condition worldwide that is increasingly involved with nutritional derangements associated with micronutrient deficiencies, including iron, zinc, calcium, magnesium, selenium, and vitamins A, C, D, and E. Nutritional deficiencies in obesity are mainly caused by poor-quality diets, higher nutrient requirements, alterations in micronutrient metabolism, and invasive obesity treatments. The current conventional agricultural system is designed for intensive food production, focusing on food quantity rather than food quality, consuming excessive agricultural inputs, and producing nutrient-deficient foods, thus generating severe health and environmental problems; agricultural food products may worsen obesity-related malnutrition. Therefore, modern agriculture is adopting new biofortification technologies to combat micronutrient deficiencies and improve agricultural productivity and sustainability. Biofertilization and nanofertilization practices are increasingly used due to their efficiency, safety, and reduced environmental impact. Biofertilizers are preparations of PGP-microorganisms that promote plant growth by influencing plant metabolism and improving the nutrient uptake, and nanofertilizers consist of synthesized nanoparticles with unique physicochemical properties that are capable of increasing plant nutrition and enriching agricultural products. This review presents the current micronutrient deficiencies associated with obesity, the modern unsustainable agri-food system contributing to obesity progression, and the development of bio- and nanofertilizers capable of biofortifying agri-food crops with micronutrients commonly deficient in patients with obesity.
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Affiliation(s)
| | - María Teresa Santos-Ramírez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - M. Eugenia Segura-Jiménez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Melina Lizeth Figueroa-Montes
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Daniel A. Jacobo-Velázquez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
- Tecnologico de Monterrey, The Institute for Obesity Research, Ave. General Ramon Corona 2514, Zapopan 45201, Jalisco, Mexico
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In vitro effects of vitamins C and E on adipocyte function and redox status in obesity. PHARMANUTRITION 2022. [DOI: 10.1016/j.phanu.2022.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Raposeiras-Roubín S, Abu-Assi E, Lizancos Castro A, Barreiro Pardal C, Melendo Viu M, Cespón Fernández M, Blanco Prieto S, Rosselló X, Ibáñez B, Filgueiras-Rama D, Íñiguez Romo A. Nutrition status, obesity and outcomes in patients with atrial fibrillation. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:825-832. [PMID: 35279417 DOI: 10.1016/j.rec.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES A paradoxical protective effect of obesity has been previously reported in patients with atrial fibrillation (AF). The aim of this study was to determine the impact of nutritional status and body mass index (BMI) on the prognosis of AF patients. METHODS We conducted a retrospective population-based cohort study of patients with AF from 2014 to 2017 from a single health area in Spain. The CONUT score was used to assess nutritional status. Cox regression models were used to estimate the association of BMI and CONUT score with mortality. The association with embolism and bleeding was assessed by a competing risk analysis. RESULTS Among 14 849 AF patients, overweight and obesity were observed in 42.6% and 46.0%, respectively, while malnutrition was observed in 34.3%. During a mean follow-up of 4.4 years, 3335 patients died, 984 patients had a stroke or systemic embolism, and 1317 had a major bleeding event. On univariate analysis, BMI was inversely associated with mortality, embolism, and bleeding; however, this association was lost after adjustment by age, sex, comorbidities, and CONUT score (HR for composite endpoint, 0.98; 95%CI, 0.95-1.01; P=.719). Neither obesity nor overweight were predictors of mortality, embolism, and bleeding events. In contrast, nutritional status-assessed by the CONUT score-was associated with mortality, embolism and bleeding after multivariate analysis (HR for composite endpoint, 1.15; 95%CI, 1.14-1.17; P<.001). CONCLUSIONS BMI was not an independent predictor of events in patients with AF in contrast to nutritional status, which showed a strong association with mortality, embolism, and bleeding. The study was registered at ClinicalTrials.gov (Identifier: NCT04364516).
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Affiliation(s)
- Sergio Raposeiras-Roubín
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain; Grupo de Investigación Cardiovascular, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain; Laboratorio Traslacional para la Imagen y Terapia Cardiovascular, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - Emad Abu-Assi
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain; Grupo de Investigación Cardiovascular, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain
| | - Andrea Lizancos Castro
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | - María Melendo Viu
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - María Cespón Fernández
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Sonia Blanco Prieto
- Grupo de Investigación Cardiovascular, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain
| | - Xavier Rosselló
- Laboratorio Traslacional para la Imagen y Terapia Cardiovascular, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Servicio de Cardiología, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Grupo de Investigación Cardiovascular, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Balearic Islands, Spain
| | - Borja Ibáñez
- Laboratorio Traslacional para la Imagen y Terapia Cardiovascular, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Servicio de Cardiología, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - David Filgueiras-Rama
- Laboratorio Traslacional para la Imagen y Terapia Cardiovascular, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
| | - Andrés Íñiguez Romo
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain; Grupo de Investigación Cardiovascular, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain
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B1 Vitamin Deficiency After Bariatric Surgery, Prevalence, and Symptoms: a Systematic Review and Meta-analysis. Obes Surg 2022; 32:3104-3112. [PMID: 35776243 DOI: 10.1007/s11695-022-06178-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
B1 deficiency is a very prevalent complication of bariatric surgery. This study reviews prevalence and symptoms of B1 vitamin deficiency after bariatric surgery. PubMed, Scopus, and Web of Science published were searched up to 10 Feb 2022, with the following keywords: Roux-en-Y gastric bypass, one anastomosis gastric bypass, Omega bypass, Mini bypass, Bariatric surgery OR Bariatric surgery, metabolic surgery, Weight loss surgery, Classic gastric bypass, Loop gastric bypass, Gastric Bypass, thiamine OR thiamin, beriberi, B1. A total of 11 studies examining 1494 patients were included in this meta-analysis. Twenty-seven percent of patients who underwent bariatric surgeries experience vitamin B1 deficiency. Thiamine supplements should be prescribed for the patients for the rest of their lives, and also standard post-surgery follow-ups are necessary in terms of monitoring dietary factors.
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Jeong J, Cho Y, Cho IY, Ahn J. Association between Obesity and Anemia in a Nationally Representative Sample of South Korean Adolescents: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:1055. [PMID: 35742105 PMCID: PMC9222758 DOI: 10.3390/healthcare10061055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/28/2022] [Accepted: 06/01/2022] [Indexed: 12/10/2022] Open
Abstract
Anemia is associated with physical, cognitive, and developmental problems. Given that there are limited studies on anemia prevalence among obese Asian adolescents and that past evidence is controversial, this study investigated the relationship between obesity and anemia in a nationally representative sample of South Korean adolescents. Data were obtained from the 2007-2019 Korea National Health and Nutrition Examination Survey. Overall, 10,231 subjects were included in the analysis. Multiple logistic regression was performed to determine the relationship between obesity and anemia. Compared with the non-obesity group, the adjusted odds ratio (OR; 95% confidence interval [CI]) of anemia was 1.00 (0.66-1.50) in the obesity group. However, in the early adolescent subgroup of 10-13 years (adjusted OR, 2.88; 95% CI, 1.20-6.95), the risk of anemia was significantly higher in the obese group than in the non-obese group. Obesity was associated with an increased risk of anemia in early adolescents. Obese adolescents aged 10-13 require special care, especially through regular examination and management for anemia.
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Affiliation(s)
- Jaehoon Jeong
- Department of Medical Care, Jeju Correctional Institution, Jeju 63147, Korea;
| | - Younghoon Cho
- Yeoncheon-gun Public Health and Medical Center, Jeongok-eup, Yeoncheon-gun 11017, Korea;
| | - In-Young Cho
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Joonho Ahn
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea
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Georgiou K, Belev NA, Koutouratsas T, Katifelis H, Gazouli M. Gut microbiome: Linking together obesity, bariatric surgery and associated clinical outcomes under a single focus. World J Gastrointest Pathophysiol 2022; 13:59-72. [PMID: 35720165 PMCID: PMC9157685 DOI: 10.4291/wjgp.v13.i3.59] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/21/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity is increasingly prevalent in the post-industrial era, with increased mortality rates. The gut microbiota has a central role in immunological, nutritional and metabolism mediated functions, and due to its multiplexity, it is considered an independent organ. Modern high-throughput sequencing techniques have allowed phylogenetic exploration and quantitative analyses of gut microbiome and improved our current understanding of the gut microbiota in health and disease. Its role in obesity and its changes following bariatric surgery have been highlighted in several studies. According to current literature, obesity is linked to a particular microbiota profile that grants the host an augmented potential for calorie release, while limited diversity of gut microbiome has also been observed. Moreover, bariatric surgery procedures represent effective interventions for sustained weight loss and restore a healthier microbiota, contributing to the observed fat mass reduction and lean mass increase. However, newer evidence has shown that gut microbiota is only partially recovered following bariatric surgery. Moreover, several targets including FGF15/19 (a gut-derived peptide), could be responsible for the favorable metabolic changes of bariatric surgery. More randomized controlled trials and larger prospective studies that include well-defined cohorts are required to better identify associations between gut microbiota, obesity, and bariatric surgery.
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Affiliation(s)
- Konstantinos Georgiou
- The First Propaedeutic Surgical Unit, Hippocrateion Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Nikolay A Belev
- Medical Simulation Training Center, Research Institute of Medical University of Plovdiv, and UMPHAT “Eurohospital”, Medical University of Plovdiv, Plovdiv 4002, Bulgaria
| | - Tilemachos Koutouratsas
- Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Hector Katifelis
- Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Maria Gazouli
- Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Zavros A, Giannaki CD, Aphamis G, Roupa Z, Andreou E. The Effects of Zinc and Selenium Supplementation on Body Composition and Thyroid Function in Individuals with Overweight or Obesity: A Systematic Review. J Diet Suppl 2022:1-29. [PMID: 35532055 DOI: 10.1080/19390211.2022.2072044] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
People with obesity have been found to have lower zinc (Zn) and selenium (Se) circulatory levels and abnormal thyroid function than people with normal weight. Studies about the effects of Zn and Se supplementation on body composition and thyroid function of overweight-obese people showed inconsistent results. A systematic review of randomized controlled trials was conducted to determine the effects of Ζn supplementation, Se supplementation, and their combination on body composition and thyroid function of individuals with overweight or obesity. Databases of PubMed, ScienceDirect, and Cochrane, were searched from inception to February 27, 2022, to identify relevant articles. For the assessment of the methodological quality of the studies, the Jadad scale was used. After screening the articles, thirteen studies were finally included and were analyzed using the strength of the evidence approach. Regarding the effectiveness of Zn supplementation on body composition, moderate evidence was found, while the effects of Se were found to be mixed. Zn supplementation was found to affect the thyroid function of people with overweight or obesity by increasing their free triiodothyronine (FT3) levels. However, this result is based only on one study among hypothyroid patients. At this point, the effectiveness of Zn, Se, and their combination, on the body composition and the thyroid function of people with overweight or obesity cannot safely be determined because of the controversial results, small number, and the limitations of the identified studies. The results of this systematic review must be interpreted with caution due to the limitations detected.
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Affiliation(s)
- Antonis Zavros
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | | | - George Aphamis
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Zoe Roupa
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Eleni Andreou
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
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36
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Estado nutricional, obesidad y eventos en pacientes con fibrilación auricular. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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37
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Mirrafiei A, Jabbarzadeh B, Hosseini Y, Djafarian K, Shab-Bidar S. No association between dietary magnesium intake and body composition among Iranian adults: a cross-sectional study. BMC Nutr 2022; 8:39. [PMID: 35484632 PMCID: PMC9052595 DOI: 10.1186/s40795-022-00535-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/05/2022] [Indexed: 08/30/2023] Open
Abstract
PURPOSE Obesity is becoming more prevalent worldwide. Magnesium (Mg) intake may play a role in the regulation of energy metabolism and body weight. Therefore, in this cross-sectional study, we aimed to investigate the association between dietary Mg intake and body composition among healthy adults. METHODS A total of 778 adult men and women aged 18-59 years who attended health care centers in Tehran, Iran, entered the final analysis. Dietary intake was assessed with a validated and reliable food frequency questionnaire with 168 items and the dietary Mg intake was estimated using Nutritionist IV software. Anthropometric measurements and blood samples were collected and body composition was evaluated employing the Body Mass Index (BMI), A Body Shape Index (ABSI), Body Adiposity Index (BAI), Body Roundness Index (BRI), Visceral Adiposity Index (VAI), Lipid Accumulation Index (LAP), and Triglyceride-Glucose index (TyG). Multiple linear regression analysis was used to determine the association of the dietary Mg intake with body composition indices. RESULTS The mean daily dietary Mg intake was 294 ± 140 mg in men and 262 ± 112 mg in women. Unadjusted linear regression showed that dietary magnesium intake is significantly associated with a waist to hip ratio (WHR) and total cholesterol (TC) in men, and hip circumference (HC) in women. After adjusting for potential confounders including age, education, marriage, occupation and smoking, total energy intake, and activity score, there remained no significant association between dietary Mg intake and any of the body composition indices including BMI, ABSI, BAI, BRI, VAI, LAP, and TyG neither in men nor women. CONCLUSION Higher Mg intake was not associated with anthropometric indices in Iranian adults, according to our findings. Additional observational studies would be beneficial in clarifying the existing findings.
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Affiliation(s)
- Amin Mirrafiei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, 14167-53955, Iran
| | - Bahareh Jabbarzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, 14167-53955, Iran
| | - Yasaman Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, 14167-53955, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, 14167-53955, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, 14167-53955, Iran.
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38
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Seyni-Boureima R, Zhang Z, Antoine MMLK, Antoine-Frank CD. A review on the anesthetic management of obese patients undergoing surgery. BMC Anesthesiol 2022; 22:98. [PMID: 35382771 PMCID: PMC8985303 DOI: 10.1186/s12871-022-01579-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/27/2022] [Indexed: 12/01/2022] Open
Abstract
There has been an observed increase in theprevalence of obesity over the past few decades. The prevalence of anesthesiology related complications is also observed more frequently in obese patients as compared to patients that are not obese. Due to the increased complications that accompany obesity, obese patients are now more often requiring surgical interventions. Therefore, it is important that anesthesiologists be aware of this development and is equipped to manage these patients effectively and appropriately. As a result, this review highlights the effective management of obese patients undergoing surgery focusing on the preoperative, perioperative and postoperative care of these patients.
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Affiliation(s)
- Rimanatou Seyni-Boureima
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China
| | - Zongze Zhang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China.
| | - Malyn M L K Antoine
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China
| | - Chrystal D Antoine-Frank
- Department of Anatomical Sciences, St. George's University, True Blue,Grand Anse, West Indies, St. George, Grenada
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Novak JR, Robinson LP, Korn LE. What MFTs should know about nutrition, psychosocial health, and collaborative care with nutrition professionals. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:502-522. [PMID: 34264531 DOI: 10.1111/jmft.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Despite sufficient evidence on the role of nutrition in psychosocial health, Marriage and Family Therapists lack the knowledge for sufficient assessment and referrals in treatment. The purpose of this article is to orient MFTs to human metabolism and the effects of various nutrients, or lack thereof, on the psychosocial health in their clients. The roles of several micronutrients and macronutrients will be described as well as the effects of eating patterns and overall metabolic health on mental health. Finally, implications for MFTs as sole practitioners, domains for assessment and psychoeducation, and recommendations for collaborating with nutrition professionals will be discussed.
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Affiliation(s)
- Josh R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Lindsey P Robinson
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Leslie E Korn
- Private practice and specializing in mental health nutrition, Olympia, WA, USA
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40
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Salaheldin Y, El Ansari W, Aljaloudi E, Elhag W. Third reported case of rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-En-Y gastric bypass: case report and literature review. Eat Weight Disord 2022; 27:1235-1241. [PMID: 34061321 PMCID: PMC8964611 DOI: 10.1007/s40519-021-01154-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/16/2021] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency. CASE REPORT We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). CONCLUSION Bariatric teams should screen patients before bariatric surgery for nutritional deficiencies and continue surveillance of their nutritional status after surgery. They should maintain a high index of suspicion for zinc deficiency in patients with skin rash after bariatric surgery. LEVEL OF EVIDENCE Level V, case report.
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Affiliation(s)
- Yassmin Salaheldin
- Department of Bariatric Surgery/Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical, Doha, State of Qatar. .,College of Medicine, Qatar University, Doha, State of Qatar. .,School of Health and Education, University of Skövde, Skövde, Sweden.
| | - Esraa Aljaloudi
- Department of Family Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
| | - Wahiba Elhag
- Department of Bariatric Surgery/Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
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41
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Abstract
The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the 'patient voice'. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.
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Voland L, Le Roy T, Debédat J, Clément K. Gut microbiota and vitamin status in persons with obesity: A key interplay. Obes Rev 2022; 23:e13377. [PMID: 34767276 DOI: 10.1111/obr.13377] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 12/28/2022]
Abstract
There are numerous factors involved in obesity progression and maintenance including systemic low-grade inflammation, adipose tissue dysfunction, or gut microbiota dysbiosis. Recently, a growing interest has arisen for vitamins' role in obesity and related disorders, both at the host and gut bacterial level. Indeed, vitamins are provided mostly by food, but some, from the B and K groups in particular, can be synthesized by the gut bacterial ecosystem and absorbed in the colon. Knowing that vitamin deficiency can alter many important cellular functions and lead to serious health issues, it is important to carefully monitor the vitamin status of patients with obesity and potentially already existing comorbidities as well as to examine the dysbiotic gut microbiota and thus potentially altered bacterial metabolism of vitamins. In this review, we examined both murine and human studies, to assess the prevalence of sub-optimal levels of several vitamins in obesity and metabolic alterations. This review also examines the relationship between vitamins and the gut microbiota in terms of vitamin production and the modulation of the gut bacterial ecosystem in conditions of vitamin shortage or supplementation. Furthermore, some strategies to improve vitamin status of patients with severe obesity are proposed within this review.
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Affiliation(s)
- Lise Voland
- Inserm, Sorbonne University, Nutrition and obesities: systemic approaches (NutriOmics), Paris, France
| | - Tiphaine Le Roy
- Inserm, Sorbonne University, Nutrition and obesities: systemic approaches (NutriOmics), Paris, France
| | - Jean Debédat
- Inserm, Sorbonne University, Nutrition and obesities: systemic approaches (NutriOmics), Paris, France
| | - Karine Clément
- Inserm, Sorbonne University, Nutrition and obesities: systemic approaches (NutriOmics), Paris, France.,Public hospital of Paris, Nutrition department, Pitié-Salpêtrière Hospital, Paris, France
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Dashti HS, Miranda N, Cade BE, Huang T, Redline S, Karlson EW, Saxena R. Interaction of obesity polygenic score with lifestyle risk factors in an electronic health record biobank. BMC Med 2022; 20:5. [PMID: 35016652 PMCID: PMC8753909 DOI: 10.1186/s12916-021-02198-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genetic and lifestyle factors have considerable effects on obesity and related diseases, yet their effects in a clinical cohort are unknown. This study in a patient biobank examined associations of a BMI polygenic risk score (PRS), and its interactions with lifestyle risk factors, with clinically measured BMI and clinical phenotypes. METHODS The Mass General Brigham (MGB) Biobank is a hospital-based cohort with electronic health record, genetic, and lifestyle data. A PRS for obesity was generated using 97 genetic variants for BMI. An obesity lifestyle risk index using survey responses to obesogenic lifestyle risk factors (alcohol, education, exercise, sleep, smoking, and shift work) was used to dichotomize the cohort into high and low obesogenic index based on the population median. Height and weight were measured at a clinical visit. Multivariable linear cross-sectional associations of the PRS with BMI and interactions with the obesity lifestyle risk index were conducted. In phenome-wide association analyses (PheWAS), similar logistic models were conducted for 675 disease outcomes derived from billing codes. RESULTS Thirty-three thousand five hundred eleven patients were analyzed (53.1% female; age 60.0 years; BMI 28.3 kg/m2), of which 17,040 completed the lifestyle survey (57.5% female; age: 60.2; BMI: 28.1 (6.2) kg/m2). Each standard deviation increment in the PRS was associated with 0.83 kg/m2 unit increase in BMI (95% confidence interval (CI) =0.76, 0.90). There was an interaction between the obesity PRS and obesity lifestyle risk index on BMI. The difference in BMI between those with a high and low obesogenic index was 3.18 kg/m2 in patients in the highest decile of PRS, whereas that difference was only 1.55 kg/m2 in patients in the lowest decile of PRS. In PheWAS, the obesity PRS was associated with 40 diseases spanning endocrine/metabolic, circulatory, and 8 other disease groups. No interactions were evident between the PRS and the index on disease outcomes. CONCLUSIONS In this hospital-based clinical biobank, obesity risk conferred by common genetic variants was associated with elevated BMI and this risk was attenuated by a healthier patient lifestyle. Continued consideration of the role of lifestyle in the context of genetic predisposition in healthcare settings is necessary to quantify the extent to which modifiable lifestyle risk factors may moderate genetic predisposition and inform clinical action to achieve personalized medicine.
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Affiliation(s)
- Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. .,Broad Institute, Cambridge, MA, USA. .,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Nicole Miranda
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Brian E Cade
- Broad Institute, Cambridge, MA, USA.,Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Tianyi Huang
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Elizabeth W Karlson
- Mass General Brigham Personalized Medicine, Mass General Brigham HealthCare, Boston, MA, USA.,Department of Medicines, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Broad Institute, Cambridge, MA, USA.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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44
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Mayasari NR, Hu TY, Chao JCJ, Bai CH, Chen YC, Huang YL, Chang CC, Wang FF, Hadi H, Nurwanti E, Chang JS. Associations of the pre-pregnancy weight status with anaemia and the erythropoiesis-related micronutrient status. Public Health Nutr 2021; 24:6247-6257. [PMID: 34120669 PMCID: PMC11148615 DOI: 10.1017/s1368980021002627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The coexistence of underweight (UW) and overweight (OW)/obese (OB) at the population level is known to affect iron deficiency (ID) anaemia (IDA), but how the weight status affects erythropoiesis during pregnancy is less clear at a population scale. This study investigated associations between the pre-pregnancy BMI (pBMI) and erythropoiesis-related nutritional deficiencies. DESIGN Anthropometry, blood biochemistry and 24-h dietary recall data were collected during prenatal care visits. The weight status was defined based on the pBMI. Mild nutrition deficiency-related erythropoiesis was defined if individuals had an ID, folate depletion or a vitamin B12 deficiency. SETTING The Nationwide Nutrition and Health Survey in Taiwan (Pregnant NAHSIT 2017-2019). PARTICIPANTS We included 1456 women aged 20 to 45 years with singleton pregnancies. RESULTS Among these pregnant women, 9·6 % were UW, and 29·2 % were either OW (15·8 %) or OB (13·4 %). A U-shaped association between the pBMI and IDA was observed, with decreased odds (OR; 95 % CI) for OW subjects (0·6; 95 % CI (0·4, 0·9)) but increased odds for UW (1·2; 95 % CI (0·8, 2·0)) and OB subjects (1·2; 95 % CI (0·8, 1·8)). The pBMI was positively correlated with the prevalence of a mild nutritional deficiency. Compared to normal weight, OB pregnant women had 3·4-fold (3·4; 95 % CI (1·4, 8·1)) higher odds for multiple mild nutritional deficiencies, while UW individuals had lowest odds (0·3; 95 % CI (0·1, 1·2)). A dietary analysis showed negative relationships of pBMI with energy, carbohydrates, protein, Fe and folate intakes, but positive relationship with fat intakes. CONCLUSION The pre-pregnancy weight status can possibly serve as a good nutritional screening tool for preventing IDA during pregnancy.
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Affiliation(s)
- Noor Rohmah Mayasari
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Tzu-Yu Hu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi Chun Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
| | - Ya Li Huang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fan-Fen Wang
- Department of Internal Medicine, Yangming Branch, Taipei City Hospital, Taipei, Taiwan
| | - Hamam Hadi
- Alma Ata Graduate School of Public Health, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Esti Nurwanti
- Department of Nutrition, Faculty of Health Sciences, University of Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei11031, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei, Taiwan
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Cena H, Fiechtner L, Vincenti A, Magenes VC, De Giuseppe R, Manuelli M, Zuccotti GV, Calcaterra V. COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior. A Narrative Review. Nutrients 2021; 13:4255. [PMID: 34959805 PMCID: PMC8707175 DOI: 10.3390/nu13124255] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/17/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, social isolation, semi-lockdown, and "stay at home" orders were imposed upon the population in the interest of infection control. This dramatically changes the daily routine of children and adolescents, with a large impact on lifestyle and wellbeing. Children with obesity have been shown to be at a higher risk of negative lifestyle changes and weight gain during lockdown. Obesity and COVID-19 negatively affect children and adolescents' wellbeing, with adverse effects on psychophysical health, due in large part to food choices, snacking between meals, and comfort eating. Moreover, a markable decrease in physical activity levels and an increase in sedentary behavior is associated with weight gain, especially in children with excessive weight. In addition, obesity is the most common comorbidity in severe cases of COVID-19, suggesting that immune dysregulation, metabolic unbalance, inadequate nutritional status, and dysbiosis are key factors in the complex mechanistic and clinical interplay between obesity and COVID-19. This narrative review aims to describe the most up-to-date evidence on the clinical characteristics of COVID-19 in children and adolescents, focusing on the role of excessive weight and weight gain in pediatrics. The COVID-19 pandemic has taught us that nutrition education interventions, access to healthy food, as well as family nutrition counselling should be covered by pediatric services to prevent obesity, which worsens disease outcomes related to COVID-19 infection.
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Affiliation(s)
- Hellas Cena
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; (H.C.); or (M.M.)
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | - Lauren Fiechtner
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA 02114, USA;
- Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA 02114, USA
- Center for Pediatric Nutrition, Harvard Medical School, Boston, MA 02115, USA
| | - Alessandra Vincenti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | | | - Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | - Matteo Manuelli
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; (H.C.); or (M.M.)
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (G.V.Z.)
- “L. Sacco” Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (G.V.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Kobylińska M, Antosik K, Decyk A, Kurowska K. Malnutrition in Obesity: Is It Possible? Obes Facts 2021; 15:19-25. [PMID: 34749356 PMCID: PMC8820192 DOI: 10.1159/000519503] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) classifies malnutrition as the biggest threat to public health worldwide, and this condition is observed in 20-60% of hospitalized patients. Malnutrition is a state of the body in which due to insufficient supply or incorrect absorption of essential nutrients, the body composition changes and the body's functions are impaired. Malnutrition is associated not only with reduced body mass index but also with obesity. SUMMARY Obesity is defined as a paradoxical state of malnutrition, which despite excessive energy consumption is associated with a shortage of individual microelements. Deficiency or lack of homeostasis of essential micronutrients can significantly affect daily performance, intellectual and emotional state, but also the physical state of the body. Food deficiency can also contribute to further weight gain or the development of other metabolic diseases. Micronutrient deficiency may include not only incorrect dietary choices and insufficient access to nutrient-rich foods but also changes in the absorption, distribution or excretion of nutrients, and altered micronutrient metabolism resulting from systemic inflammation caused by obesity. An effective therapy method recommended for people with morbid obesity is bariatric surgery aimed at both weight loss and improving quality of life. Unfortunately, the effects of these treatments are often medium- and long-term complications associated with micronutrient deficiency as a result of reduced consumption or absorption. Therefore, the use of bariatric surgery in patients with extreme obesity can affect the metabolism of microelements and increase the risk of nutritional deficiencies. Key Messages: Studies by many authors indicate a higher incidence of food deficiency among people with excessive body weight, than in people with normal body weight of the same age and same sex. Monitoring the concentration of minerals and vitamins in blood serum is a good practice in the treatment of obesity. The proper nutritional status of the body affects not only the state of health but also the effectiveness of therapy. The aim of the review was to present the issue of malnutrition in the context of obesity.
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Affiliation(s)
| | - Katarzyna Antosik
- Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce, Poland
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47
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Vitamins as Possible Cancer Biomarkers: Significance and Limitations. Nutrients 2021; 13:nu13113914. [PMID: 34836171 PMCID: PMC8622959 DOI: 10.3390/nu13113914] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022] Open
Abstract
The Western-style diet, which is common in developed countries and spreading into developing countries, is unbalanced in many respects. For instance, micronutrients (vitamins A, B complex, C, D, E, and K plus iron, zinc, selenium, and iodine) are generally depleted in Western food (causing what is known as ‘hidden hunger’), whereas some others (such as phosphorus) are added beyond the daily allowance. This imbalance in micronutrients can induce cellular damage that can increase the risk of cancer. Interestingly, there is a large body of evidence suggesting a strong correlation between vitamin intake as well as vitamin blood concentrations with the occurrence of certain types of cancer. The direction of association between the concentration of a given vitamin and cancer risk is tumor specific. The present review summarized the literature regarding vitamins and cancer risk to assess whether these could be used as diagnostic or prognostic markers, thus confirming their potential as biomarkers. Despite many studies that highlight the importance of monitoring vitamin blood or tissue concentrations in cancer patients and demonstrate the link between vitamin intake and cancer risk, there is still an urgent need for more data to assess the effectiveness of vitamins as biomarkers in the context of cancer. Therefore, this review aims to provide a solid basis to support further studies on this promising topic.
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48
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Zang XD, Hu QH, Liu XX, Da M, Yang ZC, Qi JR, Mo XM. Serum vitamin E concentration is negatively associated with body mass index change in girls not boys during adolescence. World J Pediatr 2021; 17:517-526. [PMID: 34468958 DOI: 10.1007/s12519-021-00454-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/11/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Vitamin E is the most abundant lipid-soluble antioxidants present in plasma; however, the relationship between serum vitamin E and change in body mass index (BMI)-for-age Z scores in adolescents has not been well described. METHODS This study is a cross-sectional study. Data were analyzed from 4014 adolescents who participated in the National Health and Nutrition Examination Survey. The nutritional status was calculated by BMI Z scores and was classified into normal weight, overweight, and obese. Multivariable-adjusted logistic regression was used to examine the association between serum vitamin E levels with overweight/obesity. Besides, the interaction effects between potential confounders and vitamin E on obesity were further evaluated. RESULTS After adjusting potential confounders, serum vitamin E levels were negatively associated with overweight/obesity in girls but not in boys. Per standard deviation increment in vitamin E concentrations was associated with a 92% decreased risk of obesity in females. Besides, lower quartiles of serum vitamin E were associated with a higher risk of overweight/obesity in girls. Moreover, the inverse association between serum vitamin E levels and obesity was also found in most subgroups through subgroup analysis. CONCLUSIONS Our study supports the negative association between serum vitamin E levels and overweight/obesity in adolescents. A higher serum vitamin E level may be associated with a reduced probability of obesity in girls, but not in boys.
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Affiliation(s)
- Xiao-Dong Zang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China.,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Qing-Hui Hu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Xiao-Xu Liu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Min Da
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Zhao-Cong Yang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Ji-Rong Qi
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Xu-Ming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China.
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Prado A, Brito RO, Pereira ECA, Correa JL, Neto MG, Dayyeh BKA, Negri M, Svidzinski TIE. First Study of Naturally Formed Fungal Biofilms on the Surface of Intragastric Balloons. Obes Surg 2021; 31:5348-5357. [PMID: 34570305 DOI: 10.1007/s11695-021-05730-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intragastric balloon (IGB) is a medical device used in the endoscopic treatment of pre-obesity and obesity. The involvement of IGB with biofilms has been previously reported; however, little is still known. We determine the frequency of biofilms naturally formed on the external surface of IGB, as well as some variables related to IGB types and patients features, species of fungi involved, and biofilm evidence. METHODS A retrospective study was conducted based on endoscopies and medical records of patients with explanted IGB between 2015 and 2018, which had masses strongly adhered to the surface of the balloon, suspecting the presence of a biofilm. From 2018, the samples of those masses were investigated seeking biofilm characterization based on mycological and structural aspects. RESULTS A total of 149 endoscopies were surveyed; 27 IGBs (18.12%) showed signs suggesting biofilm formation. There was no significant difference between biofilm involvement in IGB and the anthropometric and demographic profile of the patients. On the other hand, there was a significant difference regarding the IGB type, 24.05% of the adjustable IGB were compromised by biofilm, while in non-adjustable IGB, it was 11.43% (p = 0.04; OR 2.45; 95% CI, 0.98-6.12). Candida glabrata was the most isolated fungal species from the well-organized fungal biofilm. CONCLUSIONS The frequency of fungal biofilm naturally formed on the external surface of IGB was elevated. The risk of biofilm formation was increased for the adjustable IGB, but it did not relate to the demographic data and anthropometric patient profile.
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Affiliation(s)
- Andressa Prado
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Rubens O Brito
- Department of Diagnostic and Therapeutic Endoscopy, Mgastro Digestive Tract Medical Center, Maringa, Brazil
| | - Elton C A Pereira
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Jakeline L Correa
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Manoel G Neto
- Division of Gastrointestinal Endoscopy, ABC Medical School, São Paulo, Brazil
| | - Barham K A Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Melyssa Negri
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil
| | - Terezinha I E Svidzinski
- Medical Mycology Laboratory, Laboratory for Teaching and Research in Clinical Analysis, State University of Maringa, Maringa, Brazil.
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50
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Calzza JI, Muza LS, Gasparin AA, Xavier RM, Monticielo OA. Nutritional aspects and cardiovascular risk in systemic lupus erythematosus. ACTA ACUST UNITED AC 2021; 67:656-660. [PMID: 34550252 DOI: 10.1590/1806-9282.20200817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/06/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients with systemic lupus erythematosus present with a higher number of classic risk factors for coronary diseases and a higher prevalence of metabolic syndrome resulting from the disease itself. To evaluate the nutritional indicators of the cardiovascular risk of patients with systemic lupus erythematosus by analyzing eating habits, anthropometry, laboratory data, and disease activity and to describe the prevalence of patients fulfilling the criteria for metabolic syndrome. METHODS Anthropometric measurements including waist circumference, food recall, and laboratory tests. RESULTS The population presented an insufficient daily intake of micronutrients. Anthropometry revealed that 37.5% of the patients were classified with degree II obesity by body mass index and 76.8% by abdominal obesity. Regarding metabolic syndrome, 18 patients (16%) fulfilled the diagnostic criteria. CONCLUSIONS Individuals with systemic lupus erythematosus presented with increased risk factors, as determined using anthropometric measurements and laboratory tests, for cardiovascular disease, indicating the need for nutritional guidance in this population to reduce cardiovascular risk, increase the quality of life, and increase survival of these patients.
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Affiliation(s)
- Joana Isabelli Calzza
- Universidade Federal do Rio Grande do Sul, Departamento de Nutrição - Porto Alegre (RS), Brazil
| | - Letícia Souza Muza
- Universidade Federal do Rio Grande do Sul, Departamento de Nutrição - Porto Alegre (RS), Brazil
| | - Andrese Aline Gasparin
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia - Porto Alegre (RS), Brazil
| | - Ricardo Machado Xavier
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia - Porto Alegre (RS), Brazil
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