Dietary Intake and Chronic Disease Prevention

Human Intervention Study: Alkylresorcinol Metabolites as Potential Biomarkers for Grain Intake and the Occurrence of Alkylresorcinols in Commonly Consumed Foods in the German Retail Sector

Grains are one of the primary nutrients and are associated with many health benefits. To reflect the intake of grain-based products, two promising potential biomarkers are alkylresorcinol (AR) metabolites 3,5-dihydroxybenzoic acid (3,5-DHBA) and 3-(3,5-dihydroxyphenyl)-propanoic acid (3,5-DHPPA). The aim of this study was to validate the occurrence of AR in food samples and investigate the suitability of their metabolites as potential biomarkers in human intervention studies. In the first step, the AR content in different grain products from the German retail sector was analyzed by GC-MS. ARs were found in higher concentrations in whole grain products and in moderate contents in refined grains and quinoa. Based on these results, human intervention studies were performed in the next step, and the AR metabolites 3,5-DHBA and 3,5-DHPPA were analyzed by LC-MS/MS in urine samples. The intake of only whole grain products leads to an increasing level of both potential biomarkers, while a refined grain diet shows decreasing levels of the AR metabolites. The excretion of 3,5-DHBA after a whole grain-rich diet differs significantly (p = 0.043) from no grain intake.

Effect of metacognitive therapy on depression in patients with chronic disease: a protocol for a systematic review and meta-analysis

BACKGROUND

Chronic diseases have a high prevalence worldwide, and patients with chronic diseases often suffer from depression, leading to a poor prognosis and a low quality of life. Metacognitive therapy is a transdiagnostic psychotherapy intervention focused on thinking patterns, with the advantages of reliable implementation effect, short intervention period and low cost. It can help patients change negative metacognition, alleviate depression symptoms, and has a higher implementation value compared with other cognitive interventions. Therefore, metacognitive therapy may be an effective way to improve the mental health of patients with chronic diseases.

METHODS AND ANALYSIS

CNKI, Wanfang Database, VIP Database for Chinese Technical Periodicals, Sinomed, PubMed, SCOPUS, Embase, The Cochrane Library, Web of Science and PsycINFO will be used to select the eligible studies. As a supplement, websites (eg, the Chinese Clinical Registry, ClinicalTrials.gov) will be searched and grey literature will be included. The heterogeneity and methodological quality of the eligible studies will be independently screened and extracted by two experienced reviewers. All the data synthesis and analysis (drawing forest plots, subgroup analysis and sensitive analysis) will be conducted using RevMan 5.4.1.

ETHICS AND DISSEMINATION

This article is a literature review that does not include patients' identifiable information. Therefore, ethical approval is not required in this protocol. The findings of this systematic review and meta-analysis will be published in a peer-reviewed journal as well as presentations at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42023411105.

Dietary Behavior and Determinants of Diet Quality among Primary Health Care Patients in Poland

BACKGROUND

The aim of the present research was to determine the factors influencing the prevalence of eating behaviors, diet quality, and unhealthy eating among primary healthcare patients in Poland.

METHODS

The cross-sectional study included 896 adult primary care patients in Łódź. The study was conducted from January 2020 to December 2021 among thirty-four primary healthcare facilities. A survey recorded the sociodemographic data of the respondents as well as data regarding their health condition and diet.

RESULTS

The majority of the respondents (57.6%) had average dietary habits, while 40% had unhealthy eating habits. The univariable logistic regression found that primary care patients with medium/secondary education had a 1.5 times greater risk of unhealthy eating habits, and those with post-secondary vocational education had a 1.75 times greater risk of unhealthy eating habits than those with higher education (OR = 1.46; 95% CI: 1.08-1.97, p ≤ 0.01, and OR = 1.75; 95% CI: 1.04-2.94, p ≤ 0.05). The multivariable logistic regression confirmed that the level of education had a significant impact on dietary habits: for medium/secondary education, OR = 1.40; 95% CI: 1.03-1.91 (p ≤ 0.01); for post-secondary vocational education, OR = 1.69; 95% CI: 1.0-2.85 (p ≤ 0.05).

CONCLUSIONS

The education level was significantly correlated with the prevalence of unhealthy eating behaviors in the studied population. This factor should be considered in the promotion of healthy eating behaviors and nutritional counseling interventions conducted by family physicians in primary health care.

The Future for the Children of Tomorrow: Avoiding Salt in the First 1000 Days

It is widely known that optimal nutrition in the first 1000 days of life positively impacts the child's development throughout adulthood. In this setting, salt should not be added to complementary feeding. In developed countries, salt intake is generally higher than recommended for children. Excessive salt intake is the major determinant of hypertension and is associated with several cardiovascular outcomes. Therefore, pediatricians have a key role in raising awareness among parents to avoid salt consumption in the first 1000 days of life to ensure better health for their children. Starting from a review of the literature published in PubMed/MedLine regarding the short- and long-term consequences of salt consumption during the first 1000 days of life, our comprehensive review aims to analyze the beneficial effects of avoiding salt at such a vulnerable stage of life as the first 1000 days. Obesity, hypertension, increased salt sensitivity, high sweet drink consumption, increased mortality, and morbidity persisting in adult age represent the principal consequences of a higher salt intake during the first 1000 days of life.

An Update on Recent Studies Focusing on the Antioxidant Properties of Salvia Species

Nutrition has crucial effects and a significant role in disease prevention. Recently, nutraceuticals have attracted much attention in scientific research due to their pleiotropic effects and relatively non-toxic behavior. Among the biological effects displayed by plants belonging to the Lamiaceae family, such as antibacterial, anticancer, anti-inflammatory, and anticholinesterase, sage is well known for its antioxidant properties and is a rich source of numerous compounds that are biologically active, amongst them polyphenols, with more than 160 types identified. In this review we summarized some of the significant studies published in the last decade reporting the most employed extraction methods and the different assays that are useful for establishing the antioxidant properties of some sage species. Even though the scientific literature contains plenty of data regarding the antioxidant properties of many sage species, further studies are needed in order to gain a deeper understanding of the mechanism of action and the compounds responsible for their antioxidant activity. Finally, it should be taken into account that the data on the antioxidant properties of sage extracts are often difficult to compare with each other, since a series of variables in the extraction procedures, the type of assay used, and standardization may affect the final result.

Cumulative Stress Exposure and Cognitive Function Among Older Adults: The Moderating Role of a Healthy Lifestyle

OBJECTIVES

Although chronic stress is a risk factor for poor age-related cognitive health, there is limited research that has examined how cumulative stress across the lifespan affects cognitive aging. There may also be resilience factors that minimize the effects of cumulative stress on cognitive health. Engaging in a healthy lifestyle is protective against cognitive decline and may therefore interact with cumulative stress to buffer the stress-cognition relationship. The objective of the current study was to examine the moderating role of a healthy lifestyle, comprised of physical activity, social engagement, and sleep quality, in the relationship between cumulative stress exposure (CSE) and baseline and change in cognitive performance (global cognition, episodic memory, executive function) over 9 years among 1,297 older adults in the Midlife in the United States cohort (Mage = 69.0 ± 6.4, 57.8% female).

METHODS

CSE and healthy lifestyle behaviors were indexed using self-reported questionnaires at baseline, and cognitive function was assessed using a battery of standardized neuropsychological tests at baseline and follow-up.

RESULTS

Controlling for age, sex, education, race, marital status, employment status, hypertension, diabetes, and depression, higher CSE was associated with poorer baseline performance and slower decline over time in global cognition and executive function, but not episodic memory. A healthy lifestyle did not significantly moderate the relationship between cumulative stress and cognitive function. Exploratory analyses showed a significant cumulative stress-cognition relationship among females only.

DISCUSSION

This study lends support for a lifespan model of cognitive aging and suggests that the cognitive health consequences of stress extend beyond immediate timescales.

Microbiota-accessible carbohydrates (MACs) as novel gut microbiome modulators in noncommunicable diseases

The gut microbiota has a significant role in human health and is affected by many factors. Diet and dietary components have profound impacts on the composition of the gut microbiome and largely contribute to the change in bacterial flora. A high-fiber diet increased dietary fiber (DF) fermentation and the production of short-chain fatty acids (SCFAs), which increased the number of microorganisms. Microbiota-accessible carbohydrates (MACs), a subgroup of fermentable carbohydrates such as DF, are defined as indigestible carbohydrates metabolized by microbes. These carbohydrates are important components to sustain the microbial environment of the complicated digestive tract and avoid intestinal dysbiosis. Each MAC has a unique property and can therefore be used as a sensitive output microbiota modulator to support host homeostasis and modulate health. In addition to the overall health-developing effects, MACs are thought to have a promising effect on the prevention of non-communicable diseases (NCDs), which are major health problems worldwide. The aim of the manuscript was to describe microbiota-accessible carbohydrates and summarize their effects on gut modulation and NCDs.

The association of dietary macronutrient quality indices with depression and anxiety symptoms and quality of life in Iranian adults: The LipoKAP study

BACKGROUND

Macronutrients' quality may impact differently on mental health and quality of life (QOL). This study aimed to investigate the potential relationship between the carbohydrate quality index (CQI), fat quality index (FQI), protein quality index (PQI), the affective mental symptoms and QOL among Iranian adults.

METHODS

The LipoKAP is a cross-sectional study, conducted with 2456 adults in Iran. A validated food frequency questionnaire was used to evaluate usual dietary intakes. A validated Iranian version of the Hospital Anxiety and Depression Scale was used to assess the severity of anxiety and depression. QOL was assessed by EQ-5D.

RESULT

In the fully adjusted model, participants in the highest tertile of CQI had lower QOL than those in the lowest tertile (OR = 1.35; 95 % CI: 1.06, 1.73). Individuals in the top tertile of FQI (OR = 0.71; 95 % CI: 0.55, 0.91) and PQI (OR = 0.78; 95 % CI: 0.60; 1.01) were less likely to report lower QOL than those in the bottom tertile. An inverse association was found between PQI and depressive symptoms (OR = 0.72, 95 % CI: 0.55, 0.95), but not for CQI and FQI.

LIMITATIONS

The cross-sectional design of the study and the use of a memory-based dietary tool may limit the generalizability of our findings.

CONCLUSION

Higher PQI was associated with lower risk of depressive symptoms and having a low-quality life. Although CQI and FQI were not related to depressive and anxiety symptoms, higher values of FQI were associated with better QOL, while CQI showed an inverse association.

The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases

Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.

Psychosocial Factors and Psychological Characteristics of Personality of Patients with Chronic Diseases Using Artificial Intelligence Data Mining Technology and Wireless Network Cloud Service Platform

It was to explore the application value of health cloud service platform based on data mining algorithm and wireless network in the analysis of psychosocial factors and psychological characteristics of personality of patients with chronic diseases. Based on the demand analysis of cloud service platform for chronic diseases, a health cloud service platform including three modules was established: support layer, application layer, and interaction layer; and K-means algorithm and Apriori algorithm were used to mine and process data. The changes of pulse wave and EEG signal of epileptic seizures before and after processing by wireless network health cloud service platform were analyzed. 42 patients with idiopathic generalized epilepsy were selected as the research subjects, and 40 volunteers with normal physical examination during the same period were selected as the control group. The differences in the basic clinical characteristics data, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Symptom Checklist 90 (SCL-90), and Eysenck Personality Questionnaire-Revision Short Scale for Chinese (EPQ-RSC) were compared between the two groups. It was found that the initial EEG signals of epileptic patients had noise pollution before and after the seizure, and the noise in the EEG signals was filtered out after digital technology processing in the cloud service platform. The maximum number of epileptic patients aged 18∼30 years was 17 (40.48%), and the mean scores of HAMD and HAMA scales in the epileptic group were significantly higher than those in the control group (P < 0.001). The total score of SCL-90, somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychosis in the epilepsy group were obviously higher than those in the control group (P < 0.01). The mean value of EPQ-RSC and neuroticism (N) was clearly higher (P < 0.05), the mean value of extroversion (E) was significantly lower (P < 0.01), and the mean value of Lie Scale was significantly higher (P < 0.05) in the epileptic group in contrast with those in the control group. It indicates that the cloud service platform for chronic diseases based on artificial intelligence data mining technology and wireless network has potential application value. Epilepsy patients with chronic diseases should be paid more attention to their psychosocial factors and psychological characteristics of personality in the treatment process.

Greenhouse gas emissions in the food system: Current and alternative dietary scenarios

BACKGROUND: There is a growing interest in diets due to the high contribution to greenhouse gas emissions (GHGE). OBJECTIVE: The study was aimed to estimate the impact on GHGE of replacing the current diet with eight alternative diets, which would be associated with GHGE, to contribute to the discussion of how dietary changes affect the GHGE. METHODS: The latest National Nutrition and Health Survey was utilized to determine the nutrient composition of Turkey’s current diet, with eight dietary scenarios designed to meet the National Dietary Guidelines. RESULTS: The current diet had the highest GHGE with 3254.50 g CO2eq/person/day with beef, lamb, and cheese products accounting for the majority of emissions (18.61%, 17.15%, and 10.89%, respectively). The Model diet had a GHGE of 2994.18 g CO2eq/person/day, whereas vegetarian diets had the lowest (lacto-ovo vegetarian diet with 1944.95 g CO2eq/person/day and vegan diet with 1166.80 g CO2eq/person/day). Low energy efficiencies were associated with high diet-related GHGE levels. CONCLUSION: When evaluating future dietary guidelines for a sustainable diet, our study highlighted the need of integrating both health and environmental aspects. The present study found that dietary changes would significantly contribute to lowering GHGE. These findings will be beneficial in informing Turkey’s nutrition, agriculture, and public policymakers.

Effect of Online Home-Based Training on Functional Capacity and Strength in Two CKD Patients: A Case Study

Chronic kidney disease (CKD) is a clinical condition characterized by the loss of kidney function over time, as well as several complications affecting gastrointestinal, cardiovascular, and musculoskeletal systems. Physical exercise seems to induce positive adaptations in CKD patients, without side effects. Usually, these patients show a reduced physical activity and physical performance. The aim of this case-report was to evaluate the effects of an online training protocol on functional capacity and on muscle mass, in CKD stage III patients. Methods: Two CKD (stage III according to KDIGO guidelines) participants (1 female, Patient A; 1 male, Patient B) were enrolled and they performed an online tailored-supervised combined training lasting 12 weeks, including multi-joint strength exercises using TheraBand and an aerobic session at 65–70% of the patients' heart rate reserve. Results: Both patients showed an improving trend on functional capacity (6 minutes walking test: Patient A = +3%; Patient B = +5.3%) and on strength of the upper arms (handgrip strength test-right: Patient A = +13.4%; Patient B = +19.1%; handgrip strength test-left: Patient A = +42.8%; Patient B= +12.9%), as well as a reduction in inflammation and oxidative stress biomarkers. The protocol was feasible, and no side effects were evidenced. These case studies suggest that the online combined training can produce beneficial effects in CKD patients under conservative therapy, by reducing the CKD-related complications and improving the adherence to exercise of this population of patients, overcoming logistic barriers such as transportation, availability of facilities, and working and personal-life schedule.

Do environmental pollutants carrier to COVID-19 pandemic? A cross-sectional analysis

The coronavirus disease (COVID-19) is a highly transmitted disease that spreads all over the globe in a short period. Environmental pollutants are considered one of the carriers to spread the COVID-19 pandemic through health damages. Carbon emissions, PM2.5 emissions, nitrous oxide emissions, GHG, and other GHG emissions are mainly judged separately in the earlier studies in different economic settings. The study hypothesizes that environmental pollutants adversely affect healthcare outcomes, likely to infected people by contagious diseases, including coronavirus cases. The subject matter is vital to analyze the preventive healthcare theory by using different environmental pollutants on the COVID-19 factors: total infected cases, total death cases, and case fatality ratio, in a large cross-section of 119 countries. The study employed the generalized least square (GLS) method for robust inferences. The results show that GHG and CO2 emissions are critical factors likely to increase total coronavirus cases and death rates. On the other hand, nitrous oxide, carbon, and transport emissions increase the case fatality ratio through healthcare damages. The study concludes that stringent environmental policies and improving healthcare infrastructure can control coronavirus cases across countries.

Circulating Inflammatory Markers May Mediate the Relationship between Healthy Plant-Based Diet and Metabolic Phenotype Obesity in Women: A Cross-Sectional Study

BACKGROUND

It has been posited that both metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) could be emergent from diet and inflammatory markers. Thus, we sought to investigate the influence of plant-based diet on MHO and MUHO phenotypes mediated by inflammatory markers in overweight and obese women.

METHODS

This cross-sectional study was conducted on 289 women aged ≥18 years, with a body mass index (BMI) ≥25 kg/m². Dietary intake was measured using 147 item food frequency questionnaire, as well as anthropometrics and biochemistry panel, in all participants. Metabolic health phenotypes were considered using Karelis score, while plant-based diet indices (PDI) were evaluated based on 18 food groups, where healthy and unhealthy PDI were identified.

RESULTS

Accordingly, 26.9% of women had MHO and 73.1% had MUHO phenotypes. After adjusting for potential confounders, TGF-β1 had a significant inverse association with hPDI (β: -0.28; 95% CI: 452.99, -85.25; P: 0.004). Moreover, we found that women with higher hPDI had lower odds of MUHO (OR: 0.95; 95% CI: 0.39, 2.30; P: 0.03). Regarding the mediatory effect of the inflammatory markers, TGF-β1 (P: 0.73), IL-β1 (P: 0.14), and MCP1 (P: 0.51) played a role in decreasing the odds of MUHO among hPDI tertiles.

CONCLUSION

There was a significant inverse relationship between adherence to hPDI and MUHO phenotype in overweight and obese Iranian women. This association appeared to be mediated by TGF-β1, IL-β1, and MCP1.

The relationship between sugar-sweetened beverages, sleep disorders, and diabesity

BACKGROUND

Diabetes and obesity in adults are global issues. Obesity and type 2 diabetes mellitus (T2DM) are increasingly categorized under the umbrella term "diabesity." Health risk factors (HRFs), which include altering sleep habits and reducing sugar-sweetened beverages (SSBs) consumption, have emerged as relatively novel and crucial strategies for preventing and treating diabetes.

OBJECTIVE

We aimed to explore: 1) whether SSBs could affect diabesity in China's community; 2) whether HRFs could moderate this relationship; and 3) whether a three-way interaction exists between HRFs, SSBs, and diabesity.

METHODS

On December 10, 2018, we investigated diabetes complications in four cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire. The primary exposure was SSBs and outcomes were body mass index (BMI) and waist circumference (WC), while glycated hemoglobin (HbA1c) and sleep patterns (including duration and disorders) were considered moderators.

RESULTS

Overall, 1920 participants were enrolled, and those who did not complete the questionnaire were excluded. Finally, this study included 1765 participants, with a response rate of 92.0%. The mean age was (57.10 ± 10.0) years. Patients with lower educational levels were more likely to have a lower prevalence of WC (χ ² = 2.73) and BMI (χ ² = 3.47), and some HRFs were positively correlated with WC and BMI. Additionally, SSBs were significantly associated with BMI (β = 1.29) and WC (β = 2.97), and there was also differences based on sex, some HRFs, such as HbA1c, FBG and TG, showed higher levels in male participants, whereas TC level was higher in female participants. In the moderation analysis, sleep patterns were also associated with total cholesterol, triglyceride, and BMI. Furthermore, there were three-way interaction effects among HbA1c, sleep patterns, and SSBs on total cholesterol, triglyceride, BMI, and WC. Moreover, sensitivity analysis demonstrated that our results were robust.

CONCLUSION

SSBs positively correlated with patterns dose-dependently. Moreover, SSBs could also be associated with sleep patterns, and blood glucose levels were correlated with diabesity. A three-way interaction effect was discovered between SSBs, sleep patterns, blood glucose levels, and patterns. Therefore, understanding the diabesity caused by SSBs and other HRFs can help prevent its occurrence.