Association of serum vitamin D concentration with the final course of hospitalization in patients with COVID-19

Background

Vitamin D deficiency is a substantial public health problem. The present study evaluated the association between vitamin D concentration and hospitalization and mortality risk in patients with coronavirus disease 19 (COVID-19).

Methods

This study used the COronavirus in LOwer Silesia (COLOS) dataset collected between February 2020 and June 2021. The medical records of 474 patients with confirmed severe acute respiratory syndrome 2 (SARS-CoV-2) infection, and whose vitamin D concentration was measured, were analyzed.

Results

We determined a significant difference in vitamin D concentration between discharged patients and those who died during hospitalization (p = 0.0096). We also found an effect of vitamin D concentration on the risk of death in patients hospitalized due to COVID-19. As vitamin D concentration increased, the odds ratio (OR) for death slightly decreased (OR = 0.978; 95% confidence interval [CI] = 0.540-0.669). The vitamin D concentration cutoff point was 15.40 ng/ml. In addition, patients with COVID-19 and serum 25-hydroxyvitamin D (25(OH)D) concentrations < 30 ng/ml had a lower survival rate than those with serum 25(OH)D ≥ 30 ng/ml (log-rank test p = 0.0018). Moreover, a Cox regression model showed that patients with an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2 and higher vitamin D concentrations had a 2.8% reduced risk of mortality (hazard ratio HR = 0.972; CI = 0.95-0,99; p = 0.0097).

Conclusions

The results indicate an association between 25(OH)D levels in patients with COVID-19 and the final course of hospitalization and risk of death.

A High-Quality Diet, as Measured by the DASH Score, Is Associated with a Lower Risk of Metabolic Syndrome and Visceral Obesity

The current study was designed to examine the relationship between diet quality, as measured by the Dietary Approaches to Stop Hypertension (DASH) score, and the prevalence of metabolic syndrome (MetS) and its components. The study was cross-sectional in design and enrolled 535 people, including 215 with MetS and 320 without MetS. Using a validated food frequency questionnaire, the DASH diet quality score was counted. The mean age of the MetS group and control subjects was 58.48 ± 14.65 and 58.33 ± 9.26 years, respectively. The study showed that the MetS group had a significantly lower mean total DASH score than the control group (23.13 ± 5.44 vs. 24.62 ± 5.07, p = 0.0023). In addition, it was found that an increase in the total DASH score was associated with a lower risk of MetS (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.91-0.99, p = 0.009). In the correlation analysis of the total population, a better-quality diet (higher DASH score) was positively correlated with high-density lipoprotein cholesterol (HDL-c), and negatively correlated with triglyceride (TG) concentration and waist circumference. It was also found that an increase in the total DASH score was associated with a lower risk of abdominal obesity (OR = 0.93, 95% CI = 0.88-0.99, p = 0.017). The results from the analyzed data highlight the potential benefits of following a healthy diet such as DASH.

Metabolic Syndrome Is Associated with Low Diet Quality Assessed by the Healthy Eating Index-2015 (HEI-2015) and Low Concentrations of High-Density Lipoprotein Cholesterol

Presenting diet quality of patients with metabolic syndrome (MetS), using a holistic approach is more useful than investigating dietary individual components, but there is still a small amount of research in this area. The aim of this study assessed the diet quality, as measured by the HEI-2015, of MetS patients compared to healthy individuals. The study and control group consisted of 215 patients with MetS and 320 people without MetS, respectively. A nutritional analysis using a semi-quantitative food frequency questionnaire was used to evaluate the nutritional habits in the study and control group. Total HEI-2015 scores were significantly lower in MetS subjects than in those in the control group (65.04 ± 9.71 vs. 66.75 ± 8.88) and the quality of women’s diets was better than the quality of men’s diet (66.83 ± 8.99 vs. 64.75 ± 9.57). We also observed that low HDL-c concentration increased the risk of MetS in the general population the most. Across the population, there was a weak positive correlation between HDL-c concentrations and total HEI-2015 scores and a weak negative correlation between mean waist circumference values and total HEI-2015 scores. HDL-c concentrations may be a key factor in the prevention of MetS and appropriate therapeutic management to increase HDL-c levels may be of key importance in patients diagnosed with MetS.

Usefulness of the C2HEST Score in Predicting the Clinical Outcomes of COVID-19 in Diabetic and Non-Diabetic Cohorts

BACKGROUND

Diabetes mellitus is among the most frequent comorbidities worsening COVID-19 outcome. Nevertheless, there are no data regarding the optimal risk stratification of patients with diabetes and COVID-19. Since individual C₂HEST components reflect the comorbidities, we assumed that the score could predict COVID-19 outcomes.

MATERIAL AND METHODS

A total of 2184 medical records of patients hospitalized for COVID-19 at the medical university center were analyzed, including 473 diabetic patients and 1666 patients without any glucose or metabolic abnormalities. The variables of patients' baseline characteristics were retrieved to calculate the C₂HEST score and subsequently the diabetic and non-diabetic subjects were assigned to the following categories: low-, medium- or high-risk. The measured outcomes included: in-hospital mortality; 3-month and 6-month all-cause mortality; non-fatal end of hospitalization (discharged home/sudden-deterioration/rehabilitation) and adverse in-hospital clinical events.

RESULTS

A total of 194 deaths (41%) were reported in the diabetic cohort, including 115 in-hospital deaths (24.3%). The 3-month and 6-month in-hospital mortality was highest in the high-risk C₂HEST stratum. The C₂HEST score revealed to be more sensitive in non-diabetic-group. The estimated six-month survival probability for high-risk subjects reached 0.4 in both cohorts whereas for the low-risk group, the six-month survival probability was 0.7 in the diabetic vs. 0.85 in the non-diabetic group-levels which were maintained during whole observation period. In both cohorts, receiver operating characteristics revealed that C₂HEST predicts the following: cardiogenic shock; acute heart failure; myocardial injury; and in-hospital acute kidney injury.

CONCLUSIONS

We demonstrated the usefulness and performance of the C₂HEST score in predicting the adverse COVID-19 outcomes in hospitalized diabetic subjects.

Energy exchangers with LCT as a precision method for diet control in LCHADD

Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) is a rare genetic disease. The LCHADD treatment is mainly based on special diet. In this diet, energy from long-chain triglycerides (LCT) cannot exceed 10%, however energy intake from the consumption of medium-chain triglycerides (MCTs) should increase. The daily intake of energy should be compatible with energy requirements and treatment should involve frequent meals including during the night to avoid periods of fasting. In fact, there are no recommendations for total content of LCT in all of the allowed food in the LCHADD diet. The aim of the study was to present a new method of diet composition in LCHADD with the use of blocks based on energy exchangers with calculated LCT content. In the study, the diet schema was shown for calculating the energy requirements and LCT content in the LCHADD diet. How to create the diet was also shown, based on a food pyramid developed for patients with LCHADD. The blocks will make it possible, in a quick and simple way, to create a balanced diet which provides adequate energy value, essential nutrients and LCT content. This method can be used by doctors and dietitians who specialize in treating rare metabolic diseases. It can also be used by patients and their families for accurate menu planning with limited LCT content.

Prevalence of Diet Atherogenicity and Coexistence of Lipid Disorders and Arterial Hypertension among 50-year-old Inhabitants of Wroclaw, Poland

OBJECTIVE

The incorrect composition of a diet, its atherogenicity, is conducive to the occurrence of lipid disorders, arterial hypertension (HTN), diabetes, and metabolic syndrome (MetS). The aim of the study was to evaluate the prevalence of incorrect anthropometric and biochemical parameters as well as diet atherogenicity.

METHODS

The study group included 1,520 adults (880 women, 640 men). The nutritional status evaluation was based on respondents' BMI and waist circumference. The diet atherogenicity was estimated using Keys Index (KI) and P/S ratio. Total cholesterol (TCh), LDL cholesterol as well as triglycerides (TG) concentration in blood serum were also evaluated.

RESULTS

In 56.8% of women and 60.8% of men waist circumference exceeded referential values. The diets of 71.4% of women and 87.3% of men were atherogenic. HTN was observed in 64.1% of the study population. Hypercholesterolaemia was found in approximately 72% of the respondents. The increased LDL cholesterol concentration were found in 57.5% of women and 64.5% of men. Abnormal concentration of HDL cholesterol occurred among approximately 20% of respondents. Hypertriglyceridaemia was recognised in 26% of women and 44% of men. In the group of women and men with HTN, mean values, i.e. BMI, waist circumference and TG (with TCh concentration additionally noted in men) were found as significant. Normal lipid profile and arterial pressure values were observed in 6.6% of the population.

CONCLUSIONS

In the diets of men with HTN were observed higher values of KI compared to group without HTN. No significant differences were found in the frequency of occurrence of the analysed parameters either among the group of women with HTN or without it. In the group of men with HTN, the abnormal BMI, waist circumference and TG occurred more frequently.

Comparison of nutritional value of „fruit and vegetables” and “western” dietary patterns identified in a group of cancer patients

BACKGROUND

Dietary patterns (DPs) are defined as the amounts, types and combinations of various food products in habitual diets and the frequency of their consumption. Dietary pattern analysis is usually performed in order to assess the combined effect of consumed food products on health

OBJECTIVE

The aim of the study was to assess and compare the nutritional value of dietary patterns identified in a group of patients staying on the oncological ward

MATERIAL AND METHODS

The study group consisted of 100 patients (51 women and 49 men) aged 19-83 years. Dietary intake was assessed using a food frequency questionnaire (FFQ) validated for the population of Lower Silesian Voivodeship

RESULTS

Factor analysis identified two main dietary patterns explaining 25.6% of variance. The “fruit and vegetables” DP consisted of vegetables, fruits, juices, unrefined grains and nuts, seeds and raisins. Instead, the “Western” DP was characterized by the consumption of high-fat and processed meat and poultry, fried fish, refined grains, honey and sugar, fats, sweets, beverages and chips. While higher scores for “fruit and vegetables” pattern were associated with increased intake of dietary fiber, antioxidant vitamins, folic acid and decreased glycemic load per 1000 kcal and sodium intake, for “Western” pattern observed relationships were opposite. Women were more likely to have higher factor scores for “fruit and vegetables” DP and lower factor scores for “Western” DP than men

CONCLUSIONS

Dietary patterns identified in the study group differed in terms of nutritional value, in spite of similar macronutrient content in the diet. “Western” DP was characterized by lower nutritional value than “fruit and vegetables” dietary pattern.

Glycemic load and carbohydrates content in the diets of cancer patients

BACKGROUND

Glycemic load (GL) is used to evaluate how various food products affect blood sugar level. According to some studies, high dietary GL may increase the risk of cancer development and recurrence.

OBJECTIVE

The aim of the study was to assess dietary glycemic load and intake of carbohydrates derived from various food products by patients staying on an oncological ward.

MATERIAL AND METHODS

The study group included 100 cancer patients aged 19-83 years (59.6 ± 11.3 years). GL, energy and nutrient intake was estimated based on the data from the Food Frequency Questionnaire (FFQ). The correlations between dietary GL and consumption of 18 groups of products were assessed.

RESULTS

The average GL per 1000 kcal was 61.0 ± 8.6 g in the diets of men and 56.2 ± 9.5 g in the diets of women. High GL (>120 g) was observed in 76% of analyzed diets. The diets of men had higher GL, energy and sucrose content than the diets of women. Men, in comparison to women, consumed more refined grain products (144.1 ± 78.2 g vs. 95.5 ± 67.8 g), beverages (236.4 ± 344.7 g vs. 69.2 ± 173.0 g), honey and sugar (28.0 ± 22.2 g vs. 16.7 ± 18.0 g), dark chocolate (4.5 ± 4.5 g vs. 3.9 ± 6.7 g), sweets (66.1 ± 56.6 g vs. 38.8 ± 39.5 g) and soups (313.3 ± 105.3 g vs. 260.8 ± 160.3 g).

CONCLUSIONS

Analyzed diets were characterized by high GL and simple sugars content. Men consumed more refined and sweetened products than women. The improvement of knowledge about proper nutrition is needed in studied group of cancer patients.

Assessment of glycemic load and intake of carbohydrates in the diet of Wroclaw Medical University students (Poland)

BACKGROUND

Glycemic Load (GL) is one of the indicators that can be used to assess the nutritional value of the diet. The results of numerous studies have shown that high glycemic index and/or high GL diets were associated with increased risk for type 2 diabetes, cardiovascular disease and cancer.

OBJECTIVES

The aim of the study was to evaluate dietary GL, intake of food products which are source of carbohydrates and contribution of particular carbohydrates in students' diets.

MATERIAL AND METHODS

The study group consisted of 140 female students from Wroclaw (Poland) aged 21±1.6 years. The dietary assessment was performed using food frequency-questionnaire. The GL of daily food ration (DFR) was considered low for values <80 g, medium for values between 80-120 g and high for values >120 g.

RESULTS

The mean GL of the diets was 120.7±42 g. DFR of 12.1% of the students had low GL, 46.6% - medium, and 39.3% - high. Diets in the 4th quartile of GL were characterized by the highest energy value, total carbohydrate, sucrose, starch and fiber content and energy contribution from carbohydrates when compared with lower quartiles. Higher percentage of energy from protein and fats in the diets was related with lower dietary GL. The highest correlation coefficient between GL and weight of the consumed food was observed for sweets (r=0.67), cereal products (r=0.52), juices and sweetened beverages (r=0.50), vegetables (r=0.45) and fruits (r=0.44). In the study, cereal products, fruits, sweets, vegetables and juices and sweetened beverages consumed by the female subjects constituted respectively 26.6%, 12.8%, 11.4%, 9.1% and 8.8% of the total dietary GL.

CONCLUSIONS

Lower dietary GL in the female students participating in the study can be achieved by limiting the intake of sweets and sweet beverages as well as consuming cereal products with a low GI.

KEY WORDS

glycemic index, glycemic load, carbohydrates, students, diet.

[The role of diet in multiple sclerosis]

Multiple sclerosis is a demyelinating disease of the central nervous system, occurs most commonly in adults between 20 and 40 years of age. Etiology of this disease is still not known, and one of the analyzed environmental factors is food. In this study, based on literature, discusses the impact of dietary intake of food on the occurrence and development of the disease. This study demonstrated that patients with multiple sclerosis less than healthy people ate bread and cereal products, fish, some vegetables and fruits. While patients often consumed an animal products, whole milk and sweets. It also discusses Swank's diet, which suggest that the severity of symptoms disease may be responsible food of animal origin, which is rich in saturated fatty acids. The author found that patients who comply a diet, after 34 years of application, the risk of death due to multiple sclerosis was three times lower than in those who have not complied with all the dietary recommendations. Moreover, research demonstrated a correlation between deficiency of omega-3, vitamin D, B12, antioxidant vitamins and folic acid in diet, and the development and exacerbation of symptoms of multiple sclerosis. Results of research concerning the relationship between dietary factors and the occurrence and development of this disease are inconclusive why the need is greater the amount thereof in this field. Patients may consider using a diet or supplements, if pharmacotherapy and other alternative and complementary methods do not bring expected effects.

Evaluation of fatty acids daily intake and diets atherogenicity of dietetics students of Wroclaw Medical University

BACKGROUND

Dietary and lifestyle risk factors play an important role in the pathogenesis of cardiovascular disease (CVD). The excessive intake of products that could affect atherogenic effect and are rich sources of saturated fatty acids (SFA) and cholesterol conductive the occurrence of lipid metabolism disturbances in the body.

OBJECTIVE

Evaluation of fatty acids dietary intake and assessment of the students' diets atherogenicity in the aspect of the CVD risk.

MATERIAL AND METHODS

The study was conducted in 2011-2012. The study group included 100 females, dietetic students of the Wroclaw Medical University. The average age of the students was 21 years. Dietary habits were evaluated by the 3-day diet record method including one weekend day.

RESULTS

Average energy intake was 1673.9 kcal per day. The average daily total fat intake was 65.4 g and provided 34.5% of total energy intake. The percentage of energy from SFA in the diets of 82% students exceeded the recommended 10% and averaged 13.1%. The average percentage of energy from monounsaturated fatty acids (MUFA) in the students diets was 12.9% and in the diets of 5% students did not exceeded recommended 10%. The average percentage of energy from polyunsaturated fatty acids (PUFA) was 5.7% and in the diets of 66% students did not fulfilled the recommended 6-10%. About 80% of the students consumed less than recommended 2 g of C 18:3 per day. Insufficient intake of EPA and DHA was observed in 71% students' diets. The average n-6/n-3 PUFA ratio was 7.2 and in the 76% of female diets exceeded the recommended value of 4:1. The diets of 80% of students were considered as atherogenic, because of elevated value of Keys score. The ratio between PUFA and SFA in the female diets was incorrect and amounted to 0.52 (recommended value > 1.0).

CONCLUSIONS

Incorrect energy intake from daily diet and improper dietary intake of selected fatty acids in the diets of students may contribute to the development of CVD.

Fatty acid profile of the fat in selected smoked marine fish

BACKGROUND

Fish and marine animals fat is a source of unique long chain polyunsaturated fatty acids (LC-PUFA): eicosapentaenoic (EPA), docosahexaenoic (DHA) and dipicolinic (DPA). These compounds have a beneficial influence on blood lipid profile and they reduce the risk of cardiovascular diseases, atherosclerosis and disorders of central nervous system. The proper ratio of n-6/n-3 fatty acids in diet is necessary to maintain a balance between the effects of eicosanoids synthesized from these acids in the body.

OBJECTIVE

The aim of this study was the evaluation of total fat and cholesterol content and percentage of fatty acids in selected commercial smoked marine fish.

MATERIAL AND METHODS

The studied samples were smoked marine fish such as: halibut, mackerel, bloater and sprat. The percentage total fat content in edible muscles was evaluated via the Folch modified method. The fat was extracted via the Bligh-Dyer modified method. The enzymatic hydrolysis was used to assesses cholesterol content in samples. The content of fatty acids, expressed as methyl esters, was evaluated with gas chromatography.

RESULTS

The average content of total fat in 100 g of fillet of halibut, mackerel, bloater and sprat amounted respectively to: 14.5 g, 25.7 g, 13.9 g and 13.9 g. The average content of cholesterol in 100 g of halibut, mackerel, bloater and sprat was respectively: 54.5 mg, 51.5 mg, 57.5 mg and 130.9 mg. The amount of saturated fatty acids (SFA) was about 1/4 of total fatty acids in the analyzed samples. The oleic acid (C18:1 n-9) was the major compound among monounsaturated fatty acids (MUFA) and amounted to 44% of these fatty acids. The percentage of polyunsaturated fatty acids (PUFA) in halibut, mackerel, bloater and sprat was respectively: 31.9%, 45.4%, 40.8% and 37.0%. The percentage of n-3 PUFA in mackerel and bloater was 30.1% and 30.2%, while in halibut and sprat was lower and amounted to 22.5% and 25.6%, respectively.

CONCLUSIONS

In terms of nutritional magnitude the meat of mackerel and herring, compared to the meat of sprat and halibut has a much better n-3 PUFA content, while relatively low content of cholesterol.

The influence of components of diet on the symptoms of ADHD in children

In most children with ADHD the cause of the disease is not exactly known, and its etiology is multifactorial. The conventional treatment is based on the combination of behavioral and psychological therapy and the pharmacotherapy. The pharmacotherapy has a high effectiveness in ADHD treatment, but it is often associated with undesirable side effects, such as: loss of appetite and weight, growth inhibition, abdominal pain, headaches, sleeping problems and increased blood pressure. In the recent years, much attention was devoted to the issue of an appropriate diet in this disease, especially when the standard pharmacotherapy is not effective. The diet of pregnant and lactating woman, and child may have an impact on the development and deepening of the hyperkinetic syndrome. There is much evidence to indicate that it is linked to nutritional factors. Chronic deficiencies of certain minerals such as zinc, iron, magnesium and iodine and insufficient dietary intake of long-chain polyunsaturated fatty acids may have a significant impact on the development and deepening of the symptoms of ADHD in children. A crucial role in the diet of pregnant and lactating women, and child plays also polyunsaturated omega-3 fatty acids, mainly DHA, which are necessary for proper development and function of brain. Their chronic deficiency may contribute to increase risk of ADHD in children. The authors of several studies also demonstrated the positive impact of the elimination food products containing synthetic food additives, like artificial food dyes and preservatives on the behavior of children with ADHD. The beneficial effects brought also the elimination of food products, that are rich in salicylates. It was found that the intake of food products with a low glycemic index helps to reduce symptoms in some hyperactive children. Providing an appropriate supply of nutrients and minerals and elimination of certain food products from diet is especially important during intensive growth and development of the child. In this article the issues concerning the role of the diet in treatment of the children with diagnosed ADHD and the importance of deficiency of certain minerals and long-chain polyunsaturated fatty acids in pregnancy and child growth was discussed. There is a need for further studies in this area to evaluate the potential effectiveness of the diet in treating the symptoms of ADHD.