Socioeconomic status is significantly associated with the dietary intakes of folate and depression scales in Japanese workers (J-HOPE Study)

The Hidden Hunger among Nepalese Non-Pregnant Women Aged 15-49 Years: The Role of Individual, Household, and Community-Level Factors

Micronutrient deficiencies remain a public health burden among non-pregnant women in developing countries, including Nepal. Hence, this study examined micronutrient deficiencies among non-pregnant Nepalese women aged 15-49 using the 2016 Nepal National Micronutrient Status Survey (NNMSS). Data for 2143 non-pregnant women was extracted from the 2016 NNMSS. The study analysed the levels of ferritin, soluble transferrin receptor (sTfR), red blood cell (RBC) folate, and zinc of the participants. Multivariable logistic analysis was carried out to assess factors associated with micronutrient deficiencies. The prevalence of ferritin, sTfR, folate, and zinc was observed to be 19%, 13%, 16%, and 21%, respectively. Non-pregnant women from the Janajati region were significantly less prone to high levels of ferritin [adjusted odds ratio (AOR): 0.45; 95% confidence interval (CI): 0.25, 0.80], and those who had body mass index (BMI) of 25 kg/m2 or higher had significantly elevated ferritin levels [AOR: 2.69; 95% CI: 1.01, 7.17]. Non-pregnant women aged 35-49 years were significantly less predisposed to folate deficiency [AOR: 0.58; 95% CI: 0.40, 0.83], and the odds of zinc deficiency were significantly lower among non-pregnant women from wealthier households [AOR: 0.48; 95% CI: 0.31, 0.76]. This study provides further insight into screening high-risk subgroups and instituting public health interventions to address the prevailing micronutrient deficiencies among non-pregnant Nepalese women.

Evaluating the potential role of determinants of health on encephalocele patient outcomes - a combined retrospective study and systematic review

INTRODUCTION

To evaluate the outcomes and demographics of encephalocele patients who were born and received treatment in our neonatal ICU and conduct a PRISMA literature review.

METHODS

An Institutional Review Board (IRB)-approved retrospective cohort study was undertaken to investigate the results of treating encephalocele patients at Jackson Memorial Hospital (JMH) from 1998 to 2022. The study focused on assessing outcomes and the impact of maternal socioeconomic factors, such as religion, age, and education, along with the timing of diagnosis, in connection with a systematic review.

RESULTS

A total of 20 encephalocele patients were identified (13 females and 7 males), with 15 having available medical records for review. Most of these cases involved occipital encephaloceles (73.3%). Maternal ages at the time of delivery ranged from 15 to 42 years, with a mean age of 27.3 years. The average gestational age at birth was 37 weeks. Ten cases had a prenatal diagnosis documented, occurring between 12 and 24.5 weeks of gestation. Three of the surviving patients had records of prenatal counseling that included discussions about termination. No infections were reported. Among the 15 cases, 11 patients (73.3%) were alive at the last follow-up, with a mean age at follow-up of 4.12 years, ranging from 6 weeks to 15 years post-birth. Hydrocephalus was noted in 26.7%. Only 1 mother had completed high school. Most mothers were either on Medicaid (9 patients) or uninsured (3 patients), with only 3 having commercial insurance. Religious affiliations varied among the mothers, with 14 out of 15 identifying with a particular religion. The systematic review identified 22 articles from various countries, with 11 articles meeting the inclusion criteria for qualitative analysis. These articles revealed potential maternal risk factors for encephaloceles, including low-nutrient diets, inadequate folic acid intake, young maternal age, advanced maternal age, low socioeconomic status, and limited educational attainment.

CONCLUSIONS

In the twenty-first century, there is a positive trend in the survival rates of children born with encephalocele. However, maternal factors such as low socioeconomic status and limited educational attainment remain prominent, affecting their ability to access timely prenatal care and impacting follow-up medical care for these children.

Effects of chronic folate deficiency and sex differences on depression‑like behavior in mice

Although previous studies have reported that serum folate levels are negatively associated with depression in women but not men, it remains unclear whether folate deficiency can directly lead to depression and whether sex difference serves a role in this condition, since the potential mechanism remains elusive. Therefore, the present study aimed to investigate whether folate deficiency results in differences in parameters associated with depression between males and females. CD-1 mice received either a standard control diet or a folate-deficient diet from 10 to 38 weeks of age, following which behavioral assays, such as an open field test, sucrose preference test and forced swim test were performed throughout week 38. Serum and cerebral cortex samples were subsequently collected for assessment. Serum folate, homocysteine, estradiol (E2) and testosterone levels were measured using chemiluminescence, enzymatic cycling assay and electrochemiluminescence immunoassays. The cerebral cortex was used for western blot analysis, to detect the expression levels of estrogen receptor β (ERβ), PI3K/AKT pathway and caspase-3. The results revealed that compared with those in female mice that received standard control diet, female mice that received folate-deficient diet exhibited lower E2 concentrations, lower sucrose preferences (as determined through the sucrose preference test), longer durations of immobility (as determined in the forced swim test) and less time spent in the central areas of the open field test. Western blotting demonstrated that the expression levels of ERβ and the phosphorylation levels of PI3K and AKT were decreased, whilst the expression levels of cleaved caspase-3 were increased, in the cerebral cortex of female mice that received folate-deficient diet. However, no differences in E2 concentration, behavioral assay parameters or protein levels of ERβ, phosphorylated (p-)PI3K, p-AKT and cleaved caspase-3 could be observed in male mice regardless of whether they received standard control or folate-deficient diets. Collectively, these results revealed that folate deficiency only led to depression-like behavior in female mice. This may be associated with reduced E2 levels, which may inhibit the PI3K/AKT pathway and upregulate the expression of cleaved caspase-3 to promote neuronal apoptosis.

Household income and the risk of incident hypertension in employees at multiple workplaces in Japan: J-HOPE

This cohort study aimed to investigate the association between household income and incident hypertension in a Japanese employed population. During 2012, a total of 4314 normotensive daytime employees (3153 men and 1161 women) were included in this study. Participants had a wide range of occupations and were employed at one of 12 workplaces from various economic sectors in Japan. After a 2-year follow-up, incident hypertension was compared among groups according to household income: <5.0, 5.0-7.9, 8.0-9.9, and ≥10.0 million Japanese yen (¥)/year. A Cox proportional hazard model was used to calculate the hazard ratio for incident hypertension in each household income group, compared with the group earning <5.0 million ¥/year. The hazard ratios for men were 1.52 (95% confidence interval, 1.08-2.18) for 5.0-7.9 million ¥/year, 1.49 (0.98-2.27) for 8.0-9.9 million ¥/year, and 1.92 (1.23-3.01) for ≥10.0 million ¥/year after adjusting for age, baseline systolic blood pressure, worksite, type of occupation, number of family members, and smoking status. This positive relationship was attenuated but remained significant after further adjustment for alcohol consumption and body mass index, both of which were higher among men with higher household income. Conversely, there was no significant difference for women in the risk of incident hypertension among household income groups, although those with higher household income tended to have a lower risk of incident hypertension. Household income is positively associated with the onset of hypertension in Japanese employed men working daytime hours.

Association between Biomarkers of Cardiovascular Diseases and the Blood Concentration of Carotenoids among the General Population without Apparent Illness

Several studies have demonstrated that carotenoid-rich vegetables are useful against cardiovascular diseases (CVDs). However, it is still unclear when a healthy population should start eating these vegetables to prevent CVDs. In this study, we evaluated the role of carotenoids in CVD markers in healthy subjects using age-stratified analysis. We selected 1350 subjects with no history of apparent illness who were undergoing health examinations. We then evaluated the relationship between the serum concentrations of six major carotenoids as well as their total, and nine CVD markers (i.e., body mass index (BMI), pulse wave velocity (PWV), systolic blood pressure (SBP), diastolic blood pressure (DBP), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), blood insulin, fasting blood glucose (FBG), triglycerides (TGs), and high-density lipoprotein (HDL) cholesterol) using multiple regression analysis. It was found that the total carotenoid level was significantly associated with seven markers other than BMI and FBG in males and with eight markers other than DBP in females. Many of these relationships were independent of lifestyle habits. Many significant relationships were found in young males (aged 20-39) and middle-aged females (aged 40-59). These findings can be used as lifestyle guidance for disease prevention although the causal relationships should be confirmed.

Association between Serum Vitamin Levels and Depression in U.S. Adults 20 Years or Older Based on National Health and Nutrition Examination Survey 2005⁻2006

Depression is one of the leading causes of disability around the world. Although several studies have been conducted to analyze the association between vitamins and depression, the results have been inconsistent. Based on the database of National Health and Nutrition Examination Survey (NHANES) (2005–2006), a cross-sectional analysis was conducted to uncover the correlations between serum vitamin concentrations and depression in 2791 participants over 20 years of age. Vitamin concentrations in serum were measured by high performance liquid chromatography (HPLC), a standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS) or radioassay kit method. A nine-item Patient Health Questionnaire (PHQ-9) was used to assess depression symptoms. The binary logistic regression model was applied to analyze the association between vitamins and depression. In the whole population, negative associations were discovered between folate concentrations (p for trend = 0.02), trans-β-carotene (p for trend = 0.01) and depression, while positive associations were found among vitamin B12 concentrations (p for trend = 0.008), vitamin A concentrations (p for trend = 0.01) and depression. In order to evaluate the influence of gender on the pathogenesis of depression of vitamins exposure, we performed gender-stratified analysis. In females, folate concentrations (p for trend = 0.03) and vitamin B12 concentrations (p for trend = 0.02) were correlated with depression. In males, no significant association was found between depression and serum vitamin concentrations. The correlation of vitamins with depression deserves further investigation in larger and diverse populations, especially in females.

Giving social support to outside family may be a desirable buffer against depressive symptoms in community-dwelling older adults: Japan gerontological evaluation study

Background

Depression is the leading cause of impaired quality of life and burden upon societies. Social supports can buffer against depressive symptoms effectively. The aim of this study is to determine the type of social support to have a positive relationship with depressive symptoms in healthy population.

Methods

11,869 male and 12,763 female residents within the age range of 65–100 were analyzed cross-sectionally with regard to depressive symptoms (evaluated by the Japanese version of the 15-item Geriatric Depression Scale), social supports (four dimensions: giving or receiving, emotional or instrumental), and covariates utilizing data collected by the Japan Gerontological Evaluation Study. Analyzed　participants were GDS scores ≤ 10 and independence in ADL, who could give and receive supports well. Multiple linear models were applied for the analysis.

Results

All supports between husband and wife were significantly associated with lower depressive degrees. In comparison with the differences between receiving and giving supports in predictive effects on depressive degrees, giving social supports to outside family, emotional or instrumental, were associated with fewer depressive symptoms.

Conclusions

There is a possibility that not only supports between husband and wife but giving social supports to outside family accounts for psychological benefits against depression, in addition to supports between husband and wife.

Predictors of folate status among pregnant Japanese women: the Hokkaido Study on Environment and Children’s Health, 2002–2012

The International Clearinghouse for Birth Defects, Surveillance and Research reports a rise in the prevalence rate of spina bifida in Japan. We determined first-trimester folate status of Hokkaido women and identified potential predictors. Participants were 15 266 pregnant women of the Hokkaido Study on Environment and Children’s Health Cohort. Data were extracted from self-reported questionnaires and biochemical assay results. Demographic determinants of low folate status were younger maternal age (adjusted OR (AOR) 1·48; 95 % CI 1·32, 1·66), lower educational level (AOR 1·27; 95 % CI 1·17, 1·39) and lower annual income (AOR 1·11; 95 % CI 1·01, 1·22). Plasma cotinine concentrations of 1·19–65·21 nmol/l increased the risk of low folate status (AOR 1·20; 95 % CI 1·10, 1·31) and concentrations >65·21 nmol/l further increased the risk (AOR 1·91; 95 % CI 1·70, 2·14). The most favourable predictor was use of folic acid (FA) supplements (AOR 0·19; 95 % CI 0·17, 0·22). Certain socio-demographic factors influence folate status among pregnant Japanese women. Modifiable negative and positive predictors were active and passive tobacco smoking and use of FA supplements. Avoiding both active and passive tobacco smoking and using FA supplements could improve the folate status of Japanese women.

Interactions between psychological stress and drinking status in relation to diet among middle-aged men and women: a large-scale cross-sectional study in Japan

The aim of this study was to investigate the interaction between psychological stress (PS) and drinking status in relation to diet among middle-aged Japanese men and women in a large-scale cross-sectional study. The study population included 5,587 middle-aged Japanese men and 2,718 middle-aged Japanese women who underwent annual health checkups. The subjects were divided into 2 groups (non-drinkers and drinkers) and classified as having low, moderate, or high self-reported PS levels. Energy-adjusted food and nutrient consumption was assessed with a validated food frequency questionnaire. Using a general linear model, food and nutrient consumption was estimated for each self-reported PS level in the 2 groups (non-drinkers and drinkers) and the interactions between self-reported PS levels and drinking status were calculated. In men, pork and beef; squid, octopus, shrimp, and clams; eggs; mushrooms; Japanese-style sweets; ice cream; bread; Chinese noodles; coffee; and soda as foods and protein, animal protein, fat, animal fat, carbohydrate, monounsaturated fatty acid, polyunsaturated fatty acid (PUFA), n-3 PUFA, n-6 PUFA, cholesterol, vitamin D, vitamin B2, vitamin B6, vitamin B12, niacin, pantothenic acid, magnesium, phosphorus, and zinc as nutrients significantly interacted with self-reported PS levels and drinking status (p for interaction <0.05 for all). No specific interactions were found in women. These findings suggest interactions between PS levels and drinking status with consumption of some foods and nutrients, especially macronutrient intake, in men but not in women.

Change in psychological distress following change in workplace social capital: results from the panel surveys of the J-HOPE study

PURPOSE

Research on the longitudinal association of workplace social capital and mental health is limited. The purpose of the present study was to investigate the prospective association of social capital in the workplace with mental distress, measured by K6, adjusting for individuals factors as well as workplace-related factors among employees in Japan.

METHODS

The participants included 6387 men and 1825 women from 12 private companies in Japan. Questionnaires, inquiring about workplace social capital, K6, job strain and effort-reward imbalance were administered at the baseline survey between October 2010 and December 2011 (response rate=77.4%). At 1-year follow-up, social capital and K6 were assessed again (follow-up rate=79.5%), and a generalised linear model was used to estimate the association between changes in workplace social capital and change in K6.

RESULTS

After adjusting for baseline demographic characteristics and workplace-related factors (Job Content Questionnaire (JCQ), Effort-Reward Imbalance Questionnaire (ERIQ)), increased workplace social capital between waves was associated with improved psychological distress (β=-0.2327, p<0.0001). An inverse association was found in both men and women, all age groups, and among employees with high or low baseline mental health. The association was stronger among those who reported higher stress at baseline.

CONCLUSIONS

Boosting workplace social capital may promote mental health in the workplace.

A prospective study of shortened vitamin supplementation prior to cisplatin-pemetrexed therapy for non-small cell lung cancer

BACKGROUND

Prior supplementation with folic acid and vitamin B12 is required to reduce pemetrexed therapy toxicity; the recommended lead-in time is at least 7 days. On the basis of previous pharmacokinetic and clinical studies, we hypothesized that the lead-in time could be shortened to 24 hours, enabling earlier commencement of standard chemotherapy; thus, we planned the first prospective trial of this regimen.

METHODS

Patients with advanced nonsquamous non-small cell lung cancer who had not previously received cytotoxic chemotherapy were enrolled. After measurement of homocysteine concentrations, the patients received 1,000 μg of vitamin B12 by intramuscular injection and began taking 350-500 μg of oral folic acid daily. Starting 24-48 hours after the vitamin B12 injection, the patients received intravenous 500 mg/m(2) pemetrexed and 75 mg/m(2) cisplatin for 4 cycles at 3 weekly intervals. The primary endpoint was the proportion of patients who developed neutropenia grade ≥3.

RESULTS

Thirty patients received chemotherapy starting within 48 hours of the vitamin B12 injection. No treatment-related deaths or grade 4 toxicity occurred. Neutropenia grade ≥3, other laboratory toxicities grade ≥3, and nonlaboratory toxicities grade ≥3 occurred in 6.7%, 13%, and 13% of patients, respectively. The baseline homocysteine concentrations were not higher in patients with grade ≥3 toxicities than in the remainder of the cohort (mean values, 8.6 and 10.7 μmol/L, respectively). The response rate to chemotherapy was 43%.

CONCLUSION

The shortened vitamin supplementation was well tolerated and retained antitumor efficacy. Analysis of baseline homocysteine concentrations confirmed the efficacy of short-term vitamin supplementation.