Background:Iodine is an essential micronutrient required for thyroid hormone synthesis and fetal brain development, making pregnant women particularly vulnerable to iodine deficiency. Despite implementation of universal salt iodization in Ethiopia, adequate iodine intake remains suboptimal due to gaps in knowledge, utilization practices, and household availability of adequately iodized salt. These challenges are more pronounced in pastoral settings such as the Afar Region, where contextual factors may influence access to and use of iodized salt. Therefore, this study assessed knowledge, utilization practices, the availability of adequately iodized salt, and associated factors among pregnant women in Awash Sebat Administrative City using a Bayesian logistic regression approach. Methods:A community-based cross-sectional study was conducted among 411 pregnant women (response rate: 97.39%) in Awash Sebat Administrative City, Afar Region, Ethiopia, from December 1 to 30, 2024. Participants were selected using simple random sampling from health extension workers' registration lists of pregnant women. Data were collected using a structured interviewer-administered questionnaire and household salt iodine testing. Bayesian logistic regression was used to identify factors associated with knowledge, utilization practices, and the availability of adequately iodized salt. Results:Overall, 80.78% of pregnant women had good knowledge of iodized salt, and 62.8% demonstrated good utilization practices. Adequately iodized salt was found in nearly two-thirds of households (62.5%). Higher odds of good knowledge of iodized salt were observed among pregnant women with college-level or higher education (OR = 1.77; 95% CrI: 1.22-5.45), urban residence (OR = 2.48; 95% CrI: 1.57-6.32), and high wealth index (OR = 2.27; 95% CrI: 1.07-4.35). Good utilization practice was significantly associated with college-level or higher education among pregnant women (OR = 5.08; 95% CrI: 2.70-8.03), Christian religion (OR = 2.87; 95% CrI: 1.52-4.77), and urban residence (OR = 4.58; 95% CrI: 3.43-11.52), while husband-only decision-making was associated with lower odds (OR = 0.21; 95% CrI: 0.11-0.53). Women with good knowledge of iodized salt had higher odds of good utilization practice (OR = 5.06; 95% CrI: 3.88-33.45). The availability of adequately iodized salt was associated with college-level or higher education (OR = 2.13; 95% CrI: 1.10-4.20), urban residence (OR = 1.80; 95% CrI: 1.18-3.39), and a high household wealth index (OR = 2.05; 95% CrI: 1.53-4.88), whereas households with ≥ 4 members had lower odds (OR = 0.64; 95% CrI: 0.35-0.91). Conclusion:This study found that although a considerable proportion of pregnant women in Awash Sebat Administrative City had good knowledge of iodized salt, utilization practices and the availability of adequately iodized salt remained comparatively lower. Higher education, urban residence, and household wealth were consistently associated with better knowledge, utilization practices, and adequate household iodized salt. Good knowledge was positively associated with appropriate utilization practices, highlighting the importance of health education in promoting behavioral change. These findings underscore the need to strengthen community-based nutrition education, improve access to adequately iodized salt in pastoral settings, reinforce the implementation and monitoring of universal salt iodization policies, and promote women's participation in household decision-making to improve iodine nutrition among pregnant women.
Background:Optimal nutrition in infancy supports growth, development and long-term health. Commercial complementary foods are widely used in Australia, yet concerns persist regarding their iron, sugar and sodium content. This study examines their nutritional composition. Methods:In 2024, nutrition information was collected for complementary foods labelled from 6 months of age across four major retailers in Melbourne. Products for infants under 6 months and dairy-only products were excluded. Nutrient composition was analysed for iron, energy, fat, protein, carbohydrate, total sugar and sodium. Added sugars and free sugars were identified from ingredient lists. Results:A total of 266 products were identified. Snacks had the highest average energy (1692.7 ± 257.3 kJ/100 g), protein (7.8 ± 4.6 g/100 g), fat (9.1 ± 7.5 g/100 g), carbohydrates (69.4 ± 12.7 g/100 g), sodium (82.1 ± 109.9 mg/100 g) and iron (8.2 ± 10.9 mg/100 g), with some products containing up to 38 mg/100 g. Only 19.2% of all products were iron-fortified, and 10 of these products did not declare iron on the label. Iron-fortification was limited to grain-based products, most commonly breakfast cereals (58.8%) and snacks (37.3%). No fruit purees or main meals were iron-fortified. Fruit purees had high sugar content (9.7 g/100 g). Free sugars were present in 24.1% of products, most commonly snacks (46.4%). Conclusions:Most commercial complementary foods provided little iron, and fortified products did not consistently declare iron content. Snacks were the most energy-, sugar- and sodium-dense category. Stronger standards and clearer labelling may better support infant feeding.
Undernutrition remains highly prevalent among children and adolescents in Cameroon, while increasing rates of overweight and obesity reflect an ongoing nutrition transition and a growing double burden of disease. This systematic review aimed to provide a comprehensive overview of research conducted on nutritional status, dietary intake, and nutrition-related practices in nursery, primary, and secondary schools in Cameroon. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (PubMed, ScienceDirect, Google Scholar, and ResearchGate) were searched for studies published between January 2000 and February 2024. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. A total of 32 studies met the inclusion criteria. Most studies were conducted in urban areas, particularly in Yaoundé (21.8%), Douala (15.3%), and Bamenda (15.3%), while no studies were identified in the South, East, and Far North Regions. Among primary school children, the prevalence of malnutrition ranged from 9.25% to 30.2%. The highest prevalence of overweight and obesity (38.4%) was observed among secondary school students. Stunting was the most common form of malnutrition among nursery and primary school children. Dietary patterns were characterized by low consumption of fruits and vegetables, with up to 57.3% of children reporting no fruit intake over a 7-day period. These findings highlight significant regional disparities and the coexistence of undernutrition and overnutrition among school-aged children in Cameroon. Strengthening nutrition education, improving food environments, and implementing context-specific interventions are essential to address the double burden of malnutrition without exacerbating existing health risks.
Cardiovascular diseases remain a major global health burden, with myocardial infarction (MI) being a leading cause of mortality and long-term disability. Kefir, a fermented milk beverage rich in probiotic and bioactive compounds, has demonstrated cardioprotective effects in experimental models of hypertension. However, its effects in MI induced by coronary artery ligation remain poorly understood. This study investigated the impact of chronic kefir administration on cardiac function and remodeling in female Wistar rats subjected to MI. Animals were allocated to three groups: sham-operated (S), infarct vehicle-treated (IV), and infarct kefir-treated (IK). Treatments were administered daily for 60 days. Hemodynamic parameters, infarct area, collagen deposition, oxidative stress markers, and morphometric changes were evaluated. Chronic kefir treatment significantly reduced left ventricular end-diastolic pressure (LVEDP), infarct area, and collagen deposition in infarcted animals. Kefir also improved hemodynamic parameters by reducing systolic, diastolic, and mean arterial pressures while increasing heart rate. In addition, oxidative stress was attenuated, as evidenced by lower levels of advanced oxidation protein products (AOPP). No evidence of systemic toxicity or organ hypertrophy was observed. These findings suggest that milk-derived kefir exerts cardioprotective effects by improving hemodynamic function, attenuating adverse cardiac remodeling, and reducing oxidative stress. Collectively, the results support the potential of kefir as an adjunctive strategy for improving cardiac recovery following MI.
Introduction:Anemia is one of the most widespread diseases, with one in four people affected by anemia worldwide. In sub-Saharan Africa, anemia in preschool children is considered a severe public health problem. This study aimed to assess the prevalence of anemia and its associated factors among 6-59-month-old children in Ayder Comprehensive Specialized Referral Hospital, Tigray, Northern Ethiopia. Methods:A hospital-based cross-sectional study was conducted among systematically selected 423 6-59-month-old children who were seeking service at Ayder Comprehensive Specialized Referral Hospital. Data were collected using a structured questionnaire. Four mL of venous blood from the finger was collected and analyzed using a Sysmex machine (model XP-300). Anemia in children was defined as a hemoglobin level below 11 g/dL. Data were entered and analyzed using SPSS Version 21. Variables with a p value of < 0.2 in the bivariable analysis were selected for multivariable logistic regression, and statistical significance was declared at p value < 0.05 and CI of 95%. Results:The prevalence of anemia among children aged 6-59 months was 57.1% (95% confidence interval: 52.2%-62.1%); of this magnitude, mild, moderate, and severe anemia was 27.1%, 20.9%, and 9.1%, respectively. Morphological, microcytic hypochromic anemia was the most common type of anemia. Children aged 6-23 months (adjusted odds ratio = 2.374; 95% confidence interval: 1.428-3.945), stunting (adjusted odds ratio = 2.543; 95% confidence interval: 1.503-4.302), underweight (adjusted odds ratio = 6.660; 95% confidence interval: 3.046-14.566), and intestinal parasite infection (adjusted odds ratio = 2.803; 95% confidence interval: 1.242-6.322) were factors associated with anemia. Conclusion:The prevalence of anemia shows that it is a severe public health problem. Our findings underscore the need for nutrition counseling, deworming, growth monitoring, and promotion to minimize stunting, underweight, and intestinal parasite infection among children.
Introduction:Advanced Glycation End (AGE) Product is produced by atypical metabolism when food is cooked at high temperatures in a short time, such as roasted foods, or when chemicals are added as in processed foods. Research on the association between AGE and breast cancer (BC) has been inconclusive. Methods:This multicenter case-control study investigated the relationship between serum AGE (sAGE), tissue AGE (tAGE), and dietary AGE (dAGE) and BC, considering physical activity (PA). The study included 44 hormone receptor-positive premenopausal BC patients and 42 controls. Data on diet and PA were collected using validated Persian questionnaires. sAGE and tAGE were measured using blood and tissue samples. Results:The dAGE was 16,104.98 ± 6542.04 and 15,084.53 ± 5827.69 kilo-units/day, while PA was significantly lower in cases than controls (773.64 ± 829.92 vs. 1920.95 ± 2999.91 MET-minutes/week, p = 0.02). The mean sAGE was 626.11 ± 695.00 ng/mL in cases and 713.93 ± 829.67 in controls. tAGE was positive in 34.1% and 28.6% of cases and controls. Conclusion:We found no association between dAGE and BC or dAGE and sAGE or tAGE. PA was less in the BC group but unrelated to sAGE and dAGE. As we accounted for all relevant variables, our negative findings provide strong evidence against an association between AGEs in diet, PA, and BC.
Background:This cross-sectional case-control study aimed to investigate the association between germline and sporadic variations in the Insulin Receptor (INSR) gene, risk factors, and the differential expression of circulating miRNA-21 and miRNA-146a in the onset of Type 2 diabetes mellitus (T2DM). Method:A total of 800 T2DM patients and 600 nondiabetic age- and gender-matched individuals participated in single nucleotide polymorphism (SNPs) screening in the INSR gene via polymerase chain reaction (PCR), followed by Sanger sequencing. Transcriptional expression was quantified using reverse transcriptase PCR (RT-PCR). Relative expression levels of circulating miRNAs were determined by real-time PCR. Results:A significant (p < 0.05) association of Exon 17 INSR SNPs with T2DM, including a single base substitution mutation at Codon 115 (rs1799817; CAC > CAT) and Codon 83 (rs1799816; GGT > GAT), was found. However, a deletion mutation at Codon 186 (rs1052371; delT) showed no significant association with the disease. Linkage disequilibrium analysis (r 2 > 0.8) indicated a strong correlation among these SNPs and T2DM. INSR and miRNA-21 levels were significantly downregulated in T2DM patients, while circulating miRNA-146a was upregulated, as shown by relative expression analysis. ROC curve analysis indicated that miRNA-21 and miRNA-146a exhibited high diagnostic efficacy for T2DM. Furthermore, combined detection of these miRNAs showed greater potential as biomarkers for insulin resistance and metabolic complications in T2DM, particularly in this study population. Conclusion:This study highlights a significant association between SNPs in Exon 17 of INSR and the differential expression of circulating miRNAs in T2DM.
Aim:This study aimed to investigate the association between estimated 24-h urinary sodium (24 h-UNa) excretion and metabolic syndrome (MetS) prevalence and its components in adults. Methods:This cross-sectional study (2015-2017) included 2057 men and women (mean age: 45.5 ± 14.8 years; 45.5% men). Anthropometric assessments and biochemical measurements were conducted according to standard protocols. Na intake was estimated from second-void morning urine specimens using the Tanaka formula, which incorporates spot UNa, potassium (UK), and creatinine (UCr) levels. MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria, encompassing hyperglycemia (G), hypertriglyceridemia (T), low high-density lipoprotein cholesterol (HDL-C) (H), hypertension (B), and abdominal obesity (W). Multivariable logistic regression, adjusted for age, sex, estimated glomerular filtration rate (eGFR), physical activity level (PAL), and smoking status, was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for MetS and its components across tertiles of 24 h-UNa (< 124, 124-162, and ≥ 162 mmol/day). Results:The overall MetS prevalence was 37.6%, with a mean estimated 24 h-UNa excretion of 3491 ± 1020 mg/day. After multivariable adjustment, high UNa excretion was independently associated with increased odds of MetS (OR = 1.49, 95% CI = 1.16-1.92), abdominal obesity (OR = 2.70, 95% CI = 2.09-3.49), and hypertriglyceridemia (OR = 1.48, 95% CI = 1.16-1.89). However, no significant association was observed between high UNa excretion and hypertension (OR = 1.13, 95% CI = 0.86-1.48). Furthermore, the prevalence of specific MetS phenotypes was significantly elevated in the highest compared to the lowest 24 h-UNa tertile (e.g., WBH [13.3% vs. 11.1%, p = 0.018], WBT [18.5% vs. 14.1%, p = 0.033], BHT [11.3% vs. 10.5%, p = 0.028], WHT [22.1% vs. 17.7%, p = 0.006], and WBHT [10.4% vs. 9.3%, p = 0.019]). Conclusion:Elevated estimated 24 h-UNa excretion is independently associated with a higher likelihood of MetS and its key components, particularly abdominal obesity and hypertriglyceridemia. These findings suggest that high dietary Na intake may be an independent risk factor for MetS, and that dietary salt reduction could play a vital role in the primary prevention of MetS.
Background:Insulin resistance and obesity are critical determinants of low muscle mass. The main goal was to determine whether the reduced muscle mass in people without diabetes is correlated with the insulin resistance index and obesity indicators. Method:The data from NHANES 2011 to 2018 were analyzed to explore how the TyG index and obesity indices relate to low muscle mass. Associations were conducted using weighted logistic regression, RCS analysis, sensitivity analyses, and subgroup evaluations. In addition, the prediction capability of these indices was evaluated using ROC curve analysis and the AUC. Result:The TyG index (OR = 1.86, 95% CI: 1.31-2.63, p = 0.001), TyG-WC (OR = 7.53, 95% CI: 5.49-10.30, p < 0.001), TyG-WHtR (OR = 10.40, 95% CI: 7.56-14.30, p < 0.001), and TyG-WWI (OR = 4.74, 95% CI: 3.41-6.57, p < 0.001) turned out to show a positive relationship with low muscle mass in nondiabetic adults. TyG-WHtR's higher discriminative performance has been proven by its AUC, which was 0.831 (95% CI: 0.814-0.848). The most appropriate threshold values were 4.932 for men and 5.031 for women aged ≥ 40 years, and 4.628 for men and 4.674 for women aged < 40 years. Conclusion:The risk of insufficient muscle mass is increased in nondiabetic adults with higher values of TyG-obesity indicators (TyG-WC, TyG-WHtR, and TyG-WWI). TyG-WHtR possessed the best discriminative ability than other indicators.
Problem considered:Hemodialysis patients with end-stage renal disease (ESRD) frequently experience impaired health-related quality of life (HRQoL) due to multifactorial influences, including comorbidities, environmental stressors, and lifestyle factors. Hence, this study aimed at evaluating the determinants of HRQoL of hemodialysis patients, with a focus on the roles of comorbidities, cigarette smoking, environmental exposure, and residential setting. Methods:A cross-sectional observational study of 84 adult (ranging in age from 18 to 65 years) patients undergoing maintenance hemodialysis was conducted at Hehia Hospital in Egypt for one year, extending from May 2024 to May 2025. The study sample consisted predominantly of middle-aged to older adults (mean age 55.33 ± 12 years), with a majority being male (64.3%), having primary education or less (46.4%), and residing in rural areas (83.3%). The HRQoL was assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF). Sociodemographic, clinical, and environmental data were collected. Univariate and multivariate regression analyses were conducted to identify significant predictors of the overall QoL of hemodialysis patients with ESRD. Results:Multivariate analysis revealed that educational attainment (β = -0.295, p = 0.002), presence of comorbid conditions (β = 0.178, p = 0.043), occupational exposure to excessive climate (β = -0.183, p = 0.039), smoking status (β = 0.204, p = 0.021), perceived stress (β = 0.180, p = 0.039), and pain intensity (β = 0.322, p = 0.001) were significant predictors of the HRQoL of the hemodialysis patients with ESRD. These predictors, together, explained 45.5% of the variance in the QoL scores of the patients (R 2 = 0.455). Notably, smokers had significantly lower HRQoL scores than the nonsmokers. Conclusion:The HRQoL of hemodialysis patients is adversely affected by smoking, pain, stress, educational background, comorbid diseases, and climate exposure. These findings underscore the need for holistic, patient-centered interventions that incorporate smoking cessation, psychosocial support, and environmental adaptations to improve the well-being of this vulnerable population.
Background:Maternal overweight (OW) and obesity are increasingly prevalent worldwide and have been linked to adverse pregnancy and delivery outcomes. This study aims to evaluate maternal and neonatal outcomes in pregnancies stratified according to pregestational body mass index (BMI) in a tertiary care setting in Italy. Methods:This retrospective study included all singleton live births between 2022 and 2024 at the IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Women were classified into four groups based on pregestational BMI: (1) underweight (UW, BMI < 18.5 kg/m2, n = 1796); (2) normal weight (NW, BMI 18.5-24.9 kg/m2, n = 11,710); (3) OW (BMI ≥ 25.0 kg/m2, n = 2313); and (4) obese (OB, BMI ≥ 30.0 kg/m2, n = 976). Delivery outcomes were compared among groups using binary logistic regression and generalized linear models adjusted for confounding factors. Results:Inclusion criteria were met by a population of 17,813 singleton pregnancies. Multivariate models confirmed that OB women were independently associated with virtually all adverse delivery outcomes, including higher odds of preterm birth (aOR 1.48), labor induction (aOR 1.69), emergency cesarean delivery (aOR 1.42), postpartum hemorrhage (aOR 1.40), APGAR score at 5 min lower than 6 (aOR 2.77), and admission to neonatal intensive care unit (aOR 2.05) compared to NW controls. OW women were at higher risk of emergency cesarean delivery and postpartum hemorrhage, while UW women showed largely comparable outcomes to NW women, with the sole exception of reduced birthweights and higher odds of episiotomy use. Conclusions:Maternal OW and OB are associated with increased maternal and neonatal morbidity, highlighting the complex obstetric challenges in this population. These findings underscore the need for a BMI-tailored obstetric care and preventive public health strategies targeting women of reproductive age.
Background:Ethiopia ranks among the countries with the highest tuberculosis (TB) burden globally. Weight gain during the intensive treatment phase is a reliable indicator of successful TB treatment outcomes; however, evidence on its magnitude and its determinants in Northwest Ethiopia, particularly, in East Gojjam Zone, remains limited. Objective:This study aimed to determine the magnitude of weight gain and its determinants among adult TB patients during the first two months of the intensive treatment phase in East Gojjam Zone public health institutions, Northwest Ethiopia, 2025. Methods:An institution-based cross-sectional study design was conducted from June 4 to August 4, 2025. Using proportional simple random sampling, 619 adult TB patients aged 18+ years under follow-up at public at 31 health institutions were enrolled. Data were collected via interviewer-administered questionnaires and medical record reviews. Binary logistic regression identified determinants factors; variables with p < 0.25 in bivariable analysis were entered into multivariable logistic regression analysis. Results:Weight gain was achieved by 428 (69.1%) of TB patients (95% CI: 65.4, 72.7) during the intensive phase treatment. Six factors were independently associated with weight gain: completed drug adherence (AOR: 4.12, 95% CI: 3.12-5.71), illness duration ≤ 30 days prior to treatment initiation (AOR: 3.51, 95% CI: 2.17-5.13), supplementary food provision (AOR: 3.03, 95% CI: 1.90-4.83), meal frequency ≥ 3 times/day (AOR: 3.85, 95% CI: 2.41-6.14), good TB knowledge (AOR: 3.19, 95% CI: 2.19-4.05), and favorable attitude toward treatment (AOR: 2.41, 95% CI: 1.13-3.79). Conclusion:Approximately seven in ten adult TB patients achieved weight gain during the intensive treatment phase. Promoting drug adherence, early treatment initiation, nutritional supplementation, adequate meal frequency, and health education targeting TB knowledge and patient attitude are essential strategies for improving weight recovery and treatment outcomes.
Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease (CVD); however, its etiology-particularly its relationship with dietary factors-remains poorly understood. The study aimed to investigate the relationship between dietary glycemic index (GI) and glycemic load (GL) with carotid intima-media thickness (cIMT) and proatherogenic inflammatory markers in patients with MetS. This cross-sectional study was conducted among 185 subjects (80 males and 105 females) aged 20-50 years. Dietary intake was assessed using a validated food frequency questionnaire, and dietary GI and GL were calculated. Main outcomes were cIMT as well as serum levels of malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin. There was a significant trend indicating that higher GI and GL were associated with elevated serum levels of MDA, TNF-α, and VCAM-1. In addition, a significant trend was observed indicating an increase in cIMT across higher tertile categories of both GI and GL. However, dietary GI and GL were not associated with serum levels of hs-CRP, ICAM-1, and E-selectin. Higher dietary GI and GL are associated with increased cIMT, elevated oxidative stress, and proatherogenic inflammatory markers in patients with MetS. These findings suggest that diets high in GI and GL may contribute to the progression of atherosclerosis in this population. Therefore, low-GI and low-GL diets may help reduce the risk of CVD and should be considered in dietary recommendations for these patients.
Age-related renal function decline may contribute to other physiological alterations. This study aimed to examine the associations of kidney function, assessed by estimated glomerular filtration rate (eGFR), and nutritional factors with homocysteine levels in community-dwelling older adults. This cross-sectional study enrolled participants aged ≥ 65 years. Demographic characteristics were collected using questionnaires. Biochemical parameters, including homocysteine, folic acid, vitamin B12, and metabolic disorder indicators, were measured, and eGFR was calculated and categorized into three groups. Homocysteine concentrations were significantly higher in the low and moderate eGFR groups compared with the high eGFR group (median: 16.9 vs. 11.9 vs. 9.3 μM, p < 0.01). Regression analyses indicated that each 1-unit decrease in eGFR was associated with higher homocysteine (β = -0.13, p < 0.01). Conversely, higher folic acid (β = -0.29, p < 0.01) and vitamin B12 (β = -0.003, p < 0.01) levels were significantly associated with lower homocysteine concentrations. These associations remained significant after mutual adjustment, indicating distinct effects of renal function and nutritional factors on homocysteine levels. Moreover, homocysteine levels were positively correlated with waist circumference (r = 0.38, p < 0.01) and triglycerides (r = 0.18, p < 0.05) and inversely correlated with high-density lipoprotein cholesterol (r = -0.27, p < 0.01). The results suggest that renal function and nutritional status are independently associated with homocysteine levels and may contribute to metabolic risk profiles in older adults.
This manuscript describes the design and baseline findings of the POI trial, a school-based, cluster-randomized intervention aimed at the prevention of childhood obesity in the Canary Islands, Spain. Childhood obesity prevalence in this region is among the highest in Europe, with 40.6% of children aged 6-9 years classified as overweight or obese. Early, multidisciplinary, school-based interventions integrating nutrition and physical activity are therefore a public health priority. Methods:The POI trial is a cluster-randomized controlled study conducted in primary schools in Gran Canaria, enrolling children aged 6-10 years. The intervention integrates nutrition education, physical activity promotion, and family engagement, supported by both paper-based and digital educational materials. Teachers played a central role in intervention delivery within the classroom setting. Schools served as the unit of randomization and implementation. Baseline assessments included standardized anthropometric measurements, objectively measured physical activity, and selected metabolic parameters (fasting glucose and lipid profile). Dietary intake outcomes will be reported separately; this manuscript focuses on the nutrition education framework and baseline nutrition-related metabolic indicators. Results:A total of 557 children from 13 schools were included (298 intervention participants from 5 schools and 259 controls from 8 schools). Significant differences in overweight and obesity prevalence were observed by school type, with the highest prevalence in public schools (48.6%), followed by partially subsidized (33.2%) and private schools (28.3%) (p = 0.001). Among participants with available blood samples (n = 237), elevated fasting glucose was detected in 21 children and hypercholesterolemia in 24 children. Conclusions:These baseline findings highlight substantial socioeconomic disparities in childhood overweight and obesity and demonstrate the presence of early metabolic risk in school-aged children. The POI trial provides a scalable, school-based model integrating nutrition education and physical activity for obesity prevention, with the potential to inform public health strategies in high-prevalence settings. Trial Registration: ClinicalTrials.gov identifier: NCT06607159.
Background:Xerophthalmia during pregnancy is a major public health problem, associated with an increased risk of morbidity and mortality among pregnant women. Studies indicated that Ethiopia is a country with the highest rates of xerophthalmia. However, most studies emphasize biochemical deficiency or night blindness rather than the full clinical spectrum. This study was intended to assess all clinical forms of xerophthalmia. Objective:The study assessed the prevalence and associated factors of xerophthalmia among pregnant women attending antenatal care in general and referral public hospitals of the Tigray Region, Ethiopia, in 2024. Methods:Using an institution-based cross-sectional design, a total of 1387 pregnant women were selected using a systematic random sampling technique to assess for xerophthalmia. The data collection was conducted from February 2024 to July 2024. Results were presented as adjusted odds ratios (AORs) with 95% CI and significance level p value (< 0.05), which expresses the magnitude of the effect of each category on the outcome relative to the reference category. Results:Out of the total 1387 selected pregnant women, 1355 participated, yielding a response rate of 97.83%. The prevalence of xerophthalmia was 25% (95% CI: 22.7%-27.3%). Factors significantly associated with xerophthalmia include inadequate sanitation (AOR = 2.369; 95% CI: 1.335-4.202), not taking iron supplementation (AOR = 2.577; 95% CI: 1.551-4.284), fewer antenatal care follow-ups (AOR = 3.462; 95% CI: 2.203-5.441), not owning livestock (AOR = 9.528; 95% CI: 5.666-16.023), history of miscarriage (AOR = 7.984; 95% CI: 4.361-14.614), alcohol consumption during pregnancy (AOR = 8.045; 95% CI: 3.94-16.425), consuming inadequate vegetables (AOR = 1.68; 95% CI: 1.18-2.40), and mid-upper arm circumference < 23 cm (AOR = 2.20; 95% CI: 1.58-3.08). Conclusions:Xerophthalmia among pregnant women in the Tigray Region indicates a critical public health concern. Inadequate sanitation, alcohol consumption during pregnancy, history of miscarriage, not owning livestock, low ANC attendance, inadequate vegetable consumption, undernutrition, and lack of iron supplementation during pregnancy were significantly associated with xerophthalmia. Therefore, we recommend adequate sanitation, avoiding alcohol consumption during pregnancy, preventing miscarriage, owning livestock in the household, ANC attendance, consuming vegetables, preventing acute malnutrition, and iron supplementation during pregnancy as effective interventions.
Background:Citrus oils (COs) are consumed as herbal tea in traditional medicine to ameliorate the obesity-induced consequences. Citrus limon oil (CLO), C. aurantiifolia oil (CAO), and C. japonica oil (CJO) are widely dispersed for their medicinal properties. However, it is yet unknown how these oils work to reduce obesity. This work investigates the potential beneficial effects of the nanoemulsions (NEs) of Citrus essential oils (EOs) on hepatic steatosis and cardiac and pancreatic injury in high-fat diet (HFD)-induced obese rats and the mechanisms behind these effects. Methods:EOs were formulated as NEs using the ultrasonic emulsification method. The three NEs (150 mg/kg) were orally and separately administered along with the standard metformin (500 mg/kg) for 30 days after prior induction of obesity by HFD for a period of 12 weeks. Results:Treatments with NEs improved HFD-induced obesity with different potentials. The NE of CJO represented more cytoprotective and antisteatotic activities. It resulted in a preferential reduction of body weight and serum levels of glucose and lipids, as well as tissue injury and oxidative stress biomarkers that were accompanied by improved tissue architectures. At the molecular level, it upregulated the antioxidants Nrf2, HO-1, and SIRT1. It also increased the levels of adiponectin while decreasing visfatin. Furthermore, it downregulated the apoptotic executor, active caspase-3. Conclusions:The CJO NEs have shown strong promise in lowering obesity-induced hepatic steatosis and mitigating cardiac and pancreatic injury via hypoglycemic, antidyslipidemic, cytoprotective, antioxidant, and antiapoptotic activities. These beneficial effects are collectively associated with modulating the adiponectin/SIRT1/Nrf2 signaling cascade.
Introduction:Alzheimer's disease (AD), a major neurodegenerative disorder, is characterized by progressive cognitive decline and the accumulation of amyloid-beta and tau proteins in the brain. Intermittent fasting (IF) is being explored as a dietary intervention to mitigate AD-related effects, possibly by modulating factors such as reelin and α-synuclein, which are involved in synaptic function and AD pathology. Methods:The study included six groups of rats: Ctrl, Ctrl.ADF, Ctrl.TRF, AD, AD.TRF, and AD.ADF. AD was induced by bilateral ICV injections of 5 μL Aβ. To prove fasting, blood glucose levels were assessed with a glucometer. Memory and learning were assessed using the Morris Water Maze (MWM) test, and hippocampal reelin and α-synuclein concentrations were quantified via ELISA. Electrophysiological recordings were analyzed using eProbe software. Results:TRF was more effective than ADF in improving cognitive function in AD rats, as indicated by a significant increase in TSGQ [F (5,40) = 5.590, p < 0.01] and swimming speed [F (3,21) = 114.3, p < 0.01], along with a significant reduction in latency time and path length (p < 0.001). Both TRF and ADF significantly increased reelin concentration and neuronal firing rate (p < 0.01), whereas only TRF led to a significant decrease in α-synuclein levels. Discussion:These findings suggest that TRF may enhance spatial memory and reduce α-synuclein accumulation in AD rats, possibly through mechanisms associated with synaptic plasticity and neuroprotection.
Dietary nucleic acids exert physiological effects beyond serving as substrates for nucleic acid synthesis; however, their exact molecular forms that are absorbed in the small intestine remain unclear. In this study, we investigated the absorption forms of food-derived DNA by comprehensively quantifying 31 nucleic acid monomers that permeated the intestinal membrane after oral administration, using LC-MS/MS. Hydrolyzed Oncorhynchus milt DNA (HD-omDNA; mainly 1-4-mer nucleotides), deoxyribonucleotides (dNTs), and deoxyribonucleosides (dNSs) were orally administered to mice, and blood samples were collected from the tail vein, aorta, and portal vein. Intestinal permeation was also assessed using the Ussing chamber method. Oral administration of HD-omDNA, dNTs, or dNSs increased the plasma levels of pyrimidine dNSs-such as thymidine, deoxyuridine, and deoxycytidine-identifying them as the major forms of high-molecular-weight DNA absorbed into systemic circulation. Portal vein concentrations of these pyrimidine dNSs were elevated compared with vehicle controls, confirming their intestinal absorption. In contrast, purine nucleic acid monomers were metabolized to uric acid, as indicated by elevated portal vein concentrations of its precursors, hypoxanthine, and xanthine upon co-administration with the xanthine oxidase inhibitor febuxostat. Notably, dinucleotides were also detected in portal vein plasma in vivo and on the basolateral side in Ussing chamber experiments, suggesting that dinucleotides are a previously unrecognized absorption form of HD-omDNA. Collectively, these findings demonstrate that dietary DNA permeates the intestine mainly as pyrimidine dNSs, whereas dinucleotides are also an absorption form, revealing unique absorption characteristics of dietary deoxyribonucleotides and oligodeoxyribonucleotides.
Background:For children to grow and develop to their full potential, the first 2 years of life are critical. Infectious disease incidence and associated mortality can be reduced by optimal complementary feeding practices. Studies on these practices and determinants, however, are few in this field. The purpose of this study is to close this information gap. Methods:Between January 15 and February 15, 2021, 565 mothers of children ages 6 to 23 months participated in a community-based comparative cross-sectional study in Durame town and Kedida Gamela district. Structured questionnaires were used to gather data through in-person interviews, and SPSS Version 25 was used for analysis. Determinants of complementary feeding practices were identified through bivariate and multivariable logistic regression, utilizing adjusted odds ratios with a 95% confidence interval p value 0.05. Results:Complementary feeding practice magnitudes in rural and urban areas were 13.1% and 25.1%, respectively. The mother's knowledge of good complementary feeding (AOR = 5.13, 95% CI: 1.68, 15.65) and household food insecurity (AOR = 3.5, 95% CI: 1.4, 8.75) was associated with optimal complementary feeding practices in rural areas, while child age (AOR = 3.57, 95% CI: 1.08, 11.805), postnatal care (AOR = 2.58, 95% CI: 1.28, 5.16), and the mother's awareness about complementary feeding practices (AOR = 4.5, 95% CI: 1.13, 14.17) were associated with good complementary feeding practices in urban settings. Conclusion and Recommendation:In comparison with rural areas, the magnitude of optimal complementary feeding practice is significantly higher in urban areas. Integration of nutrition education and infant and young child feeding into maternal and child health services is essential to improving child feeding practices.
