BACKGROUND AND OBJECTIVES:The gestational weight gain (GWG) range during mid-to-late pregnancy associated with the lowest combined risk of adverse birth outcomes in women with gestational diabetes mellitus (GDM) remains unclear. This study aims to examine the associations between GWG and adverse birth out-comes among women with GDM. METHODS AND STUDY DESIGN:This study included a cohort of 1,673 pregnant women with GDM. GWG was defined as weight gain from pre-pregnancy to a measurement between 24 and 32 gestational weeks, residualized for gestational age and standardized as z-scores. Multivariable logistic regression models were used to assess associations between GWG z-scores (per 1-SD increase and categories: <-1, -1 to 1 [reference], and ≥1) and small for gestational age (SGA), large for gestational age (LGA), and preterm birth. Restricted cubic splines were fitted to explore nonlinear associations. RESULTS:Each 1-SD higher in GWG z-score was associated with lower odds of SGA (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.43-0.71) and higher odds of LGA (1.48; 1.29-1.70). Compared with the reference group, women with GWG z-scores <-1 had higher odds of SGA and lower odds of LGA, whereas those with z-scores ≥1 showed the opposite pattern. No significant association was observed with preterm birth. Spline analyses indicated that a GWG z-score of approximately -0.07 (equal to 8.2 kg at 28 weeks) was associated with the lowest combined odds of SGA and LGA. CONCLUSIONS:Among women with GDM, both insufficient and excessive mid-to-late pregnancy GWG were associated with adverse size-for-gestational-age outcomes.
BACKGROUND AND OBJECTIVES:This study aims to investigate the impact of ultra-processed food (UPF) intake and the Chinese Diet Balance Index for Pregnancy (DBI-P) index on cesarean section rates and neonatal weight among women with gestational diabetes mellitus (GDM). METHODS AND STUDY DESIGN:This study was a retrospective cohort study involving 279 GDM patients. We have collected dietary data, pregnancy information, and calculated UPF intake and the Chinese Diet Balance Index for Pregnancy (DBI-P) index. The impact of UPF exposure and dietary factors on low birth weight and macrosomia was analyzed using logistic regression. RESULTS:This study revealed widespread insufficient consumption of several food groups among the GDM population. Specifically, compared with the UPF non-exposed group, the UPF-exposed group had a significantly higher rate of insufficiency in vegetables (Z = -4.94, p <0.001) and dairy products (Z = -2.28, p = 0.007), but a lower intake of plant oils (Z = -2.16, p = 0.03). After adjusting for several factors, the logistic regression results showed that UPF exposure was a risk factor for cesarean section (OR = 1.74, p = 0.046). Moreover, GDM patients who were overweight or obese before pregnancy faced a higher risk of a cesarean section when exposed to UPFs (OR = 4.13, 95%CI(1.35, 12.6)). CONCLUSIONS:Patients with GDM showed an unbalanced dietary intake pattern, which was more pronounced in the group with higher exposure to UPFs. However, prenatal UPF exposure did not significantly affect the patients' oral glucose tolerance test (OGTT) results. Nonetheless, excessive UPF consumption during pregnancy may increase the risk of cesarean section.
BACKGROUND AND OBJECTIVES:This cross-sectional study investigated the association between equivalent income and energy and nutrient intake among nursery school children. METHODS AND STUDY DESIGN:A total of 761 preschool children aged 3 to 6 years participated. Energy and nutrient intakes were calculated using four-day food records consisting of two non-consecutive weekdays and two non-consecutive weekend days, collected between October and December in 2019 and 2020. Equivalent income was calculated by dividing household income by the square root of the number of household members. Nutrient inadequacy was evaluated using the DRIs for Japanese (2020). Analysis of covariance was used to compare intakes among equivalent income groups, and χ2 tests were used to compare the prevalence of nutrient inadequacy. Analyses were conducted separately by sex, with significance set at p <0.05. RESULTS:Children in the low equivalent income group had a lower percentage of energy from protein, a higher percentage from carbohydrates, and lower intakes of several nutrients. Evaluations based on the DRIs showed higher prevalence of nutrient inadequacy including vitamin A, calcium and iron in the low equivalent income group. CONCLUSIONS:These findings suggest a significant association between household economic status and dietary intake among preschool children in Japanese nursery schools. Collaboration among families, dietitians and local governments is essential to promote healthy eating habits in early childhood.
BACKGROUND AND OBJECTIVES:Background and Objectives: This study explored the association between the dietary inflammatory index (DII) and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and the potential mediating role of blood inflammatory markers. METHODS AND STUDY DESIGN:In this cross-sectional study of 507 patients with AECOPD, dietary intake was assessed through 24-hour dietary recalls, and the DII was determined. Generalized linear models, logistic regression and mediation analysis were used to evaluate associations between DII, inflammatory markers [white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI)], and lung function [forced expiratory volume in one second (FEV1), forced vital capacity (FVC)]. RESULTS:DII was 2.81and showed a significant negative linear correlation with FVC (p <0.05) and with FEV1 (p <0.05). After adjusting for confounding factors, each unit increase in DII was associated with a decrease of 0.053 L in FEV1 and 0.078 L in FVC. Additionally, FEV1 showed negative associations with SII, SIRI, NLR, PLR, and WBC (all p <0.05). Mediation analysis revealed that WBC exerted a statistically significant mediating effect between DII and FEV1 (ACME = -7.54 × 10⁻³, p <0.05). CONCLUSIONS:It was indicated that a pro-inflammatory diet is associated with reduced lung function in AECOPD patients, with lung function showing a significant negative correlation with inflammatory markers. WBC serves as a key mediator between the DII and FEV1.
BACKGROUND AND OBJECTIVES:Sarcopenia and malnutrition are highly prevalent among older adults with advanced-stage cancers. Although the SARC-F is a simple and widely used screening tool for sarcopenia, its extended prognostic value remains under investigation. This study aimed to evaluate the relationship between SARC-F scores, nutritional status, inflammatory biomarkers, and short-term mortality in hospitalized older adults with advanced solid organ malignancies. METHODS AND STUDY DESIGN:We conducted a retrospective cross-sectional analysis on 72 patients with advanced-stage solid tumors and 52 age and sex matched controls. Nutritional status was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF), Nutrition Risk Screening (NRS-2002), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Functional and frailty assessments included Activities of Daily Living (ADL), Instrumental ADL (IADL), and the FRAIL scale. Laboratory markers of inflammation were also collected. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were used to identify predictors of mortality. RESULTS:A total of 124 participants were included (72 patients with advanced-stage cancer and 52 controls). The mean age was 74.3±9.4 years, and 58.1% were male. Mortality rates at 1, 3, and 6 months were 41.9%, 59.7%, and 65.3%, respectively. In multivariate analysis, calcium levels were independently associated with increased mortality risk (OR: 4.59, p <0.001). The SARC-F score demonstrated moderate discriminative ability for mortality prediction (AUC: 0.675), with high specificity (96.2%) but low sensitivity (30.6%) at a cut-off of ≥4. CONCLUSIONS:The SARC-F score serves as a multidimensional indicator reflecting sarcopenia risk, nutritional deficits, functional impairment, and short-term mortality. Its prognostic utility improves when combined with clinical and laboratory markers. This study proposes a novel prognostic model incorporating SARC-F, GLIM criteria, and serum calcium to enhance short-term mortality prediction in older adults with advanced cancer.
BACKGROUND AND OBJECTIVES:The convergence of genomic science and culinary arts has led to a new paradigm in wellness tourism: nutrigenomic retreats. These programs merge genetic insights with tailored diets, immersive culinary education, and holistic wellness practices. While nutrigenomics and personalized nutrition are advancing rapidly, translation of gene-diet knowledge into structured, real-world experiential models remains underexplored. This paper proposes a conceptual and translational framework for nutrigenomic retreats, integrating scientific advances in personalized nutrition with gastronomy-driven wellness experiences. METHODS AND STUDY DESIGN:A narrative review of peer-reviewed literature was conducted, focusing on nutrigenomics, culinary medicine, functional foods, and wellness tourism. Insights from nutritional genomics databases and publicly available transcriptomic resources are used illustratively to highlight gene-diet interactions relevant to retreat settings. Conceptual models, including retreat agendas, gene-informed dietary personalization, and culinary education formats, are presented. RESULTS:Nutrigenomic retreats are proposed as a multidisciplinary platform for health optimization by combining: interpretation of common genetic variants associated with nutrient metabolism and dietary response (e.g., FTO, MTHFR, CYP1A2); personalized menus aligned with gene-diet interactions; culinary instruction emphasizing nutrient-dense, culturally diverse, functional foods; and complementary wellness interventions such as mindfulness, physical activity, and biofeed-back. These illustrative elements may enhance scientific literacy, empowering participants to better understand individual nutritional variability and adopt sustainable health behaviors. CONCLUSIONS:Nutrigenomic retreats represent a novel fusion of science, culinary innovation, and wellness culture. As interest in personalized health continues to expand, this model may offer an experiential pathway for preventive health education and functional gastronomy, while fostering public engagement with genomics.
BACKGROUND AND OBJECTIVES:In this multicentre prospective observational study, we aimed to investigate changes in energy intake and nutritional indices, including cardiovascular, cerebrovascular, respiratory, and musculoskeletal conditions, among older adults hospitalised in general hospitals who required long-term rehabilitation. METHODS AND STUDY DESIGN:This study included patients aged ≥65 years who were admitted to 41 National Hospital Organization hospitals between September 2019 and March 2020 with cardiovascular, cerebrovascular, respiratory, or musculoskeletal diseases. Physical measurements, blood test values, energy intake, and activities of daily living were evaluated at admission and discharge. RESULTS:The analysis includ-ed 222 patients (125 men, 97 women; mean age, 78.9 years). On admission, 75.7% of patients were malnourished or at risk of malnutrition based on the Mini Nutritional Assessment-Short Form score, with the highest prevalence (84.1%) observed in patients with respiratory disease. Although energy intake significantly increased during hospitalisation in all disease groups, only 31.1% of patients met the estimated energy requirements at discharge, and their body mass index and nutritional indices decreased. Logistic regression analysis showed that older age, female sex, higher energy intake at admission, and lower inflammation were associated with sufficient energy intake at discharge. Energy intake at admission was consistently associated with sufficient energy intake at discharge regardless of disease category, whereas other associated factors dif-fered by disease. CONCLUSIONS:Nutritional management in general hospitals may be inadequate for older adults requiring long-term rehabilitation. These findings suggest the need for early individualised nutritional management in hospitalised older adults undergoing long-term rehabilitation.
BACKGROUND AND OBJECTIVES:As the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) rises, identifying reliable biomarkers for risk prediction is essential. This study assessed baseline triglyceride glucose (TyG) index and TyG-derived parameters as predictors of future MASLD risk in older adults. METHODS AND STUDY DESIGN:We analyzed data from 2,757 Chinese adults (60-91 years) undergoing annual health checks (2017-2023). Incident MASLD was detected using ultrasound after excluding baseline cases. Cox proportional hazards models (with parameters in quartiles) and time-dependent ROC curves quan-tified associations and time-varying predictive performance among TyG-related parameters. The predictive performance of TyG-BMI was also compared with the hepatic steatosis index (HSI) in ROC analysis. RESULTS:Over a median six-year follow-up, 584 incident MASLD cases occurred. TyG-derived parameters showed stronger associations than TyG index. Specifically, triglyceride glucose-body mass index (TyG-BMI) demon-strated the highest risk, with an adjusted hazard ratio of 6.42 (95% CI: 5.33-7.73) for the highest versus lowest quartile. This association remained robust in sensitivity analysis. TyG-BMI demonstrated numerically higher AUC values than the HSI (Men: TyG-BMI 0.758 vs. HSI 0.747; Women: TyG-BMI 0.759 vs. HSI 0.756), with overlapping confidence intervals. Time-dependent ROC analysis confirmed TyG-BMI's superior predictive accuracy over time. The optimal TyG-BMI cut-offs were 187.97 for men and 191.33 for women. CONCLUSIONS:TyG-BMI demonstrated superior predictive performance compared to TyG index itself, other TyG-derived parameters, and the HSI, supporting its utility as a practical screening tool in primary care.
BACKGROUND AND OBJECTIVES:Tart cherry products have been proposed to lower serum uric acid and reduce gout risk, but clinical findings are inconsistent. This study evaluated the effect of tart cherry intake on serum uric acid concentration and explored possible mechanisms. METHODS AND STUDY DESIGN:Randomized controlled trials comparing tart cherry intake with placebo or usual diet and reporting serum uric acid concentration were identified from electronic databases. A random effects meta analysis was used to pool standardized mean differences between groups. In parallel, bioactive compounds in tart cherry were retrieved from public databases, and their potential targets related to serum uric acid and gout were investigated using network based analyses and molecular docking. RESULTS:Four randomized trials (eight comparisons; 392 participants) were included. Tart cherry intake was associated with a modest reduction in serum uric acid concentration compared with control (standardized mean difference -0.22; 95% confidence interval -0.43 to -0.01), with substantial heterogeneity. Network and docking analyses suggested that anthocyanins and other polyphenols may act on inflammatory, oxidative stress and metabolic pathways. CONCLUSIONS:Tart cherry intake may modestly lower serum uric acid concentration, but evidence is limited in quantity and consistency. Larger, rigorously designed randomized trials are needed.
BACKGROUND AND OBJECTIVES:Non-communicable diseases (NCDs), including diabetes, cardiovascular diseases, and obesity, remain major global health challenges largely driven by suboptimal dietary patterns. The Food Exchange List (FEL) is a structured dietary planning tool originally developed for diabetes management to support balanced nutrient intake. Although FELs are widely used across diverse cultural and clinical contexts, evidence regarding their direct role in NCD prevention and management is limited. This scoping review examines the historical development, core principles, and global applications of FELs, with a focus on their use in dietary planning and NCD control, aiming to identify gaps in the existing literature. METHODS AND STUDY DESIGN:Following Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR checklist, four databases (PubMed, ProQuest, Web of Science, and Cochrane Library) were searched between November 18, 2024, and January 2, 2026, to identify primary research published from 1990 to 2026. Of 500 records screened, 38 studies met the inclusion criteria. Notably, 60% (n = 24) focused exclusively on FEL development without evaluating clinical or behavioral outcomes. RESULTS:Findings from randomized and quasi-experimental studies, as well as small pilot interventions, suggest that FELs can support meal planning, nutritional adequacy, and attainment of specific dietary targets. However, their cognitive complexity may negatively affect adherence and contribute to higher dropout rates. Evidence for FEL effectiveness in NCD management remains limited, particularly among low-literacy populations. CONCLUSIONS:Overall, there is a clear need for long-term studies evaluating culturally adapted and simplified FELs and their independent effects on clinical outcomes, including glycemic control, cardiovascular risk, quality of life, and medication use.
BACKGROUND AND OBJECTIVES:Current evidence suggests that gut microbiota dysbiosis accelerates aging and aging-related diseases through pro-inflammatory pathways. This study aimed to evaluate dietary quality in relation to inflammation and gut microbiota, and to explore their relationship with chronic diseases among urban Chinese adults aged 40-69 years. METHODS AND STUDY DESIGN:A cross-sectional study was conducted among urban Chinese adults aged 40-69 years. Dietary quality was assessed by dietary intake, dietary inflammation index (DII), and dietary index for gut microbiota (DI-GM). Log-binomial regression was per-formed to examine the associations between DII, DI-GM and chronic diseases. RESULTS:An excessive energy proportion from fat (37.4%) and an insufficient contribution from carbohydrates (44.7%) indicated an imbalance in macronutrient intake. The medians and interquartile ranges for DII and DI-GM of the participants were 1.3 (0.2, 2.5) and 3.0 (2.0,5.0), respectively, suggesting a pro-inflammatory and gut microbiota-unfavorable dietary tendency. Livestock contributed most to dietary inflammation in the population (standardized β = 0.251), whereas vegetables showed the strongest inverse effect (standardized β = -0.500). A higher DI-GM score was suggested to be a protective factor against self-reported dysglycemia (OR = 0.311; 95%CI: 0.118, 0.818). CONCLUSIONS:The participants exhibited an imbalance in macronutrient intake and a dietary tendency that was pro-inflammatory and unfavorable to gut microbiota. Notably, this study revealed a negative relationship between DI-GM and dysglycemia in middle-aged and elderly population, which under-scores the potential of targeting gut microbiota through diet for chronic disease prevention in this population.
BACKGROUND AND OBJECTIVES:Uric acid to high-density lipoprotein cholesterol ratio (UHR) plays a significant role in metabolic and inflammatory responses. However, the association between UHR and osteoporosis (OP) remains unclear in type 2 diabetes mellitus (T2DM) with metabolic dysfunction-associated steatotic liver disease (MASLD). This study aims to investigate this association and identify potential biomarkers for early OP screening. METHODS AND STUDY DESIGN:A total of 420 T2DM patients with MASLD aged ≥50 years were en-rolled in this retrospective study. All subjects underwent dual energy X-ray absorptiometry (DXA) examination to measure bone mineral density (BMD) and were divided into three groups according to UHR tertiles, and the differences in BMD levels and OP prevalence among the three groups were compared. Logistic regression was used to analyze the relationship between UHR and OP. RESULTS:Patients in the highest tertile of UHR group (UHR >363.46) had lower BMD and a higher incidence of OP than those in the lower tertiles. In the UHR >363.46 group, UHR was negatively correlated with lumbar spine, whole body, and femoral neck BMD (p <0.05). After adjusting for confounding factors, UHR >363.46 was associated with a significantly increased risk of OP compared to UHR ≤312.35 (OR = 3.341, 95%CI: 1.129-9.887, p = 0.029). ROC curve indicated that UHR combined with Age, HOMA-IR and 25(OH)D had a high predictive value for OP, with an area under the curve of 0.837 (p <0.001). CONCLUSIONS:Increased UHR is significantly associated with higher risk of OP, suggesting that clinical monitoring of UHR is valuable for early detection of OP in T2DM with MASLD.
BACKGROUND AND OBJECTIVES:The Nutrition Self-Assessment App (APP), a novel smartphone-based tool, was developed to enable users of oral nutritional supplements (ONSs) to self-assess total energy expenditure (TEE) and identify energy deficits, providing personalized ONS recommendations. By integrating step-count track-ing and dietary intake reporting, the app estimates physical activity levels and energy deficits. However, validation against clinician assessments is essential prior to large-scale implementation. METHODS AND STUDY DESIGN:In this multicenter cross-sectional study (October-November 2023), TEE and deficits were evaluated using both the app and clinician assessments. Statistical analyses included paired t-tests, intraclass correlation coefficients (ICC), and Bland-Altman plots. Clinician satisfaction was measured via a 5-point Likert scale. RESULTS:Among 423 ONS users, no significant differences were found between clinician- and app-derived estimates for TEE (1606.2 ± 287.2 vs. 1541.6 ± 300.5 kcal/day, p >0.05) or energy deficits (610.4 ± 376.9 vs. 600.1 ± 384.6 kcal/day, p >0.05). Agreement was moderate for TEE (ICC = 0.66) and excellent for deficits (ICC = 0.94). Bland-Altman analysis showed 93.9% (397/423) of deficit differences within 95% limits of agreement. Clinicians rated the app as "very satisfied" (46.1%) or "fairly satisfied" (37.1%) for most participants. CONCLUSIONS:The app demonstrated moderate agreement with clinician assessments for TEE estimation, while showing high agreement in energy deficit estimation. These findings validate its potential reliabil-ity as a supportive tool for ONS management. Its integration of activity tracking and dietary monitoring supports scalable implementation to improve ONS adherence.
BACKGROUND AND OBJECTIVES:Severe community-acquired pneumonia (CAP) is one of the most common di-agnoses in the medical intensive care unit. The objective of this study is to seek an effective and clinically tolerable dosage of ω-3 (EPA+DHA) fatty acids (FA) in enterally fed patients with severe pneumonia. METHODS AND STUDY DESIGN:A total of 84 patients were randomly assigned to a control group or two experimental groups from January 2022 to June 2024, each receiving 3.50g and 8.75g of ω-3 FA daily for 7 days, and clinical outcomes and tolerance parameters were collected. RESULTS:ω-3 FA supplementation significantly reduced mechanical ventilation (MV) duration, hospital expenses, and daily hospital costs. Mechanistically, the anticipated anti-inflammatory effect was not observed but a trend of immune enhancement was noted. The addition of 3.50g and 8.75g of ω-3 FA daily was relatively well-tolerated in patients with severe pneumonia. CONCLUSIONS:In this pilot study, ω-3 FA supplementation at 3.50-8.75 g/day to enterally fed patients with severe pneumonia for 7 days was relatively well-tolerated, shortened days of MV, and decreased hospital cost. Further investigation with adequate statistical power and larger sample size is warranted to confirm these clin-ical benefits and establish the optimal dosage for this supplementation strategy.
BACKGROUND AND OBJECTIVES:This study aimed to evaluate the safety and efficacy of a fish oil-enriched food for special medical purposes (FSMP, ProSure) compared to an oncology-specific enteral nutrition product (TPF-T). METHODS AND STUDY DESIGN:This multicenter, randomized, open-label, non-inferiority phase III trial (NCT05301556) included patients with gastrointestinal tumors scheduled for surgery and at high risk for malnutrition. Participants were randomized 1:1 to receive either FSMP or TPF-T as a sole nutritional source from 4±2 days before surgery to 9±3 days postoperatively. The primary endpoint was the change in serum pre-albumin levels from baseline to 9±3 days post-surgery (non-inferiority margin: 20.807 mg/L). RESULTS:Of the 325 patients randomized (FSMP: n = 162; TPF-T: n = 163), FSMP demonstrated non-inferiority to TPF-T in maintaining serum pre-albumin levels in the perioperative patients (least square [LS] mean differ-ence: 6.9 mg/L, 95% CI: -5.0 to 18.8). FSMP showed a greater reduction in serum triglycerides (LS mean difference: -0.133 mmol/L, 95% CI: -0.239 to -0.027, p = 0.014), while comparable changes in other lipid parameters, serum albumin, body weight, or grip strength from baseline to 9±3 days post-surgery, and the length of hospital stay were observed between groups (all p >0.05). The most common treatment-emergent adverse events were gastrointestinal disorders, including abdominal distension (FSMP: 17.3% vs. TPF-T: 18.4%), di-arrhea (21.0% vs. 11.0%), and nausea (6.8% vs. 5.5%). CONCLUSIONS:ProSure, an FSMP, when used as a sole nutritional source, is not inferior to TPF-T in maintaining perioperative nutritional status in patients with gastrointestinal tumors, demonstrating comparable efficacy and safety.
BACKGROUND AND OBJECTIVES:Postprandial hyperglycaemia is a modifiable risk factor, even in healthy adults, and dietary strategies to attenuate postprandial glycaemic excursions are of clinical interest. This study investigated whether mulberry leaf and water chestnut husk tea (MW tea) attenuates postprandial and second-meal glycaemic responses in adults. METHODS AND STUDY DESIGN:This randomised, double-blind, placebo-controlled crossover study with a washout period of at least one week examined the effects of MW tea consumption on postprandial and second-meal glycaemic responses. Twenty healthy adults consumed MW or placebo tea in a randomised crossover sequence before breakfast. Interstitial glucose levels were continuously monitored using flash glucose monitoring (FreeStyle Libre Pro). The primary outcome was the incremental area under the curve (ΔIAUC) of interstitial glucose after breakfast, and the secondary outcome was the ΔIAUC after lunch (second meal). RESULTS:Significant intervention-by-time interactions were observed after both breakfast and lunch (second meal). The IAUC of interstitial glucose after breakfast (primary outcome) and lunch (secondary outcome) differed between the MW and placebo tea conditions. Compared with placebo tea, MW tea was associated with attenuated postprandial interstitial glucose responses after both breakfast and lunch, as quantified by ΔIAUC, with effect sizes ranging from moderate to large and achieved statistical power (1-β) generally in the moderate-to-high range. CONCLUSIONS:These findings suggest that a single intake of MW tea may attenuate postprandial and second-meal glycaemic responses in healthy adults. These findings should be interpreted with caution and require further confirmation.
BACKGROUND AND OBJECTIVES:Evidence regarding macronutrients and body composition remains limited. This study examined the relationship in Chinese college students. METHODS AND STUDY DESIGN:498 Beijing college students aged 18-31 years were included. Dietary intake was assessed using a food frequency questionnaire, and body composition was measured by bioelectrical impedance. Linear and logistic regression analyses examined correlations between macronutrients intake and body composition. RESULTS:Obesity-related indicators including waist and hip circumference, waist-hip ratio, body mass index, body fat mass, fat mass index and body fat percentage, and muscle-related indicators including soft lean mass, fat free mass, fat-free mass index, skeletal muscle mass, skeletal muscle index were negatively correlated with the propor-tion of protein intake (p <0.05), and were positively correlated with the proportion of fat intake (p <0.05). All body composition parameters, except waist-hip ratio, were negatively correlated with the proportion of car-bohydrate intake (p <0.05). The risk of thinness increased progressively with higher proportion of protein in-take (OR: 4.48, 4.57, 7.43; p <0.05). However, higher proportion of protein intake was associated with a reduced risk of overweight (OR :0.41, 0.39; p <0.05) and obesity (OR = 0.09, p = 0.007). Increased risk of overweight (OR = 2.29, p = 0.044) and obesity (OR = 4.42, p = 0.030) were observed in the fourth quartile group of fat intake proportion compared to the first. CONCLUSIONS:Further studies are warranted to clarify the relationship between body muscle and fat distribution and macronutrients intake composition.
BACKGROUND AND OBJECTIVES:There has been a debate regarding appropriate nutrition support during the ear-ly stages of intensive care unit (ICU) admission. This study investigated nutrition support implementation and its relationship with clinical outcomes based on nutrition status. METHODS AND STUDY DESIGN:We performed a retrospective cohort study of 595 critically ill adults receiving invasive mechanical ventilation. Patients were assessed by Global Leadership Initiative on Malnutrition criteria. Stages following ICU admission were cate-gorized as early acute phase (days 1-3), late acute phase (days 4-6), and recovery phase (days 7-10). Patients were divided into energy intake categories (<10, 10-20, and >20 kcal/kg/day) and protein intake cate-gories (<0.8, 0.8-1.2, and >1.2 g/kg/day). We examined differences in 90-day mortality at each stage using Cox proportional hazards analyses for total cohort, well-nourished, and malnourished groups. RESULTS:Mortality was not associated with nutrition intakes during the early and late acute phases. However, higher energy intake during the recovery phase was associated with lower mortality in total cohort (p = 0.002). Significant associations between energy intake and mortality during the recovery phase were observed in both well-nourished and malnourished patients (p = 0.007 and p = 0.05, respectively). Additionally, protein intake during the recovery phase was associated with mortality, specifically in malnourished patients (p = 0.007), but not in well-nourished patients. CONCLUSIONS:Energy intake after 7 days in ICU was associated with mortality in both nutrition status groups, while protein intake showed benefit only in malnourished patients. Therefore, phase-dependent nutrition intake depending on nutrition status may be applicable for optimizing ICU nutri-tion support strategies.
BACKGROUND AND OBJECTIVES:This study aimed to evaluate the effects of intermittent fasting (IF) on glycated hemoglobin (HbA1c), fasting blood glucose (FBG), body weight (BW), and body mass index (BMI) in pa-tients with type 2 diabetes mellitus (T2DM) and prediabetes. METHODS AND STUDY DESIGN:A systematic search of PubMed, Cochrane Library, Embase, Scopus, and Web of Science was conducted for randomized controlled trials on IF in T2DM and prediabetes published before September 30, 2025. Meta-analysis was performed using RevMan 5.3 and Stata 17.0. RESULTS:Fourteen studies (sixteen arms), involving 899 patients, were included. Four studies (five arms) compared IF with ad libitum diet (316 patients), and ten studies (eleven arms) compared IF with continuous energy restriction diets (CERD) (583 patients). Meta-analysis showed that IF was more effective than the ad libitum diet in reducing HbA1c, BW, BMI and FBG (Standard-ized Mean Difference (SMD) (Hedges's g) -0.64, 95% Confidence Interval (CI) -1.04, -0.24; p <0.05), (SMD (Hedges's g) -0.30, 95% CI -0.55, -0.05; p <0.05), (SMD (Hedges's g) -0.26, 95% CI -0.51, 0.00; p = 0.05), (SMD (Hedges's g) -0.39, 95% CI -0.64 to -0.15; p <0.05). IF demonstrated effects similar to CERD (p <0.05) in terms of HbA1c, BW, BMI, and FBG. Among 14 studies, dropout rates were 21.5% (IF), 26.2% (CERD), and 15.9% (ad libitum). CERD showed a significantly higher dropout rate than ad libitum, whereas no significant differences were observed between IF and CERD or between IF and ad libitum. CONCLUSIONS:Intermit-tent fasting is a effective dietary approach for patients with T2DM and prediabetes.
BACKGROUND AND OBJECTIVES:Weekly iron-folic acid (IFA) supplementation has been implemented in Indonesia to reduce the prevalence of anaemia in adolescent girls. This study aimed to assess the prevalence of anaemia and adherence to weekly IFA supplementation and their associated factors among adolescent girls in senior high schools in two high-stunting-prone areas of Ambon City, Indonesia. METHODS AND STUDY DESIGN:This cross-sectional study was conducted in August-September 2023, involving 645 adolescent girls enrolled at five senior high schools in two high-stunting-prone areas of Ambon City, namely Poka-Rumah Tiga and Laha Village. The dependent variables were anaemia (i.e., haemoglobin level <12 g/dL) and adherence to weekly IFA supplementation (i.e., consumption of one IFA tablet per week). Factors associated with anaemia and adherence to weekly IFA supplementation were examined using logistic regression. RESULTS:Of 645 ado-lescent girls surveyed, 19.7% had anaemia, and 19.5% consumed weekly IFA tablets. The likelihood of developing anaemia was associated with respondents with a high level of awareness of anaemia (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.16-2.57). Adherence to taking weekly IFA tablets increased in those with a high level of awareness of IFA supplementation (aOR = 3.88, 95%CI: 2.46-6.10). CONCLUSIONS:Our study showed that anaemia among adolescent girls represents a moderate to high public health problem, accompanied by low adherence to weekly IFA supplementation among adolescent girls in these areas. Strengthening school-based supplementation, parental engagement, and supply monitoring could enhance programme effectiveness and inform local health policies in Ambon City and other similar settings in Indonesia.
