Dietary nutrition plays an essential role in the progression of chronic obstruc-tive pulmonary disease (COPD). This study aimed to use Chinese Healthy Eating Index (CHEI) to evaluate dietary quality in COPD patients and investigate the relationship between dietary quality and COPD disease severity. A total of 525 COPD inpatients were collected from December 1st, 2022, to December 1st, 2023. The dietary intake was collected through food frequency questionnaires (FFQ), and diet quality was assessed by the CHEI. Modified Medical Research Council Dyspnea Scale (mMRC), the COPD assessment test (CAT), and Global Initiative for Obstructive Lung Disease (GOLD) stage were used to assess disease severity. Multivariable logistic regression was used to analyze the association between the total CHEI score, and its component scores and COPD disease severity. The CHEI score with COPD pa-tients is 56.75±8.89. The CAT score of the low CHEI group was significantly higher than that of the high CHEI group (p <0.05). Ordinal logistic regression analysis indicated that the group with higher CHEI total scores was significantly associated with the low grade of mMRC (OR: 0.982, 95%CI: 0.964, 1.000, p <0.05). And the higher intake of tubers, whole grains and mixed beans, and fish and seafood were all associated with lower mMRC grades (p <0.05). COPD patients have poor dietary quality. High CHEI scores were associated with the low mMRC grades. Patients with COPD should be encouraged to maintain a good quality diet to reduce the risk of disease exacerbation.

The aim of this study was to investigate the effect of dietary iron and zinc in-take on the risk of preterm labor before and during different trimesters, and to assess whether there is an interaction between iron and zinc intake and the risk of preterm labor. The study was a nested case-control study of 880 cases and 8017 controls in Lanzhou City, northwest China. Unconditional logistic regression was used to determine the association between dietary iron/zinc intake and the risk of preterm labor and its clinical subtypes. Multivariable-adjusted restricted cubic spline (RCS) modeling was used to explore the non-linear relationship between dietary iron/zinc intake levels and the risk of preterm birth. Lower iron/zinc intake before and during pregnancy was associated with a higher risk of preterm labor and some of its subtypes, and there was a non-linear trend between iron/zinc intake and risk of preterm labor (p non-linear <0.05). A synergistic effect of low iron and zinc intake on the risk of preterm labor was also observed. We observed a significant increase in the risk of preterm labor in women with low dietary zinc intake before and during pregnancy, with a dose-response relationship. Similarly, there was a significant negative association between lower dietary iron intake during pregnancy and preterm labor. In addition, there was a multiplicative interaction between low dietary iron and zinc intake and preterm delivery before pregnancy and during three different periods of pregnancy. Higher dietary intake of iron and zinc before and during pregnancy may reduce the risk of preterm labor. Low intakes of iron and zinc during pregnancy appear to have a synergistic effect on the risk of preterm labor.

Evidence suggests that bioactive components present in plant foods have beneficial effects. Fenugreek is commonly used in Indian culinary practices and can help to keep blood sugar levels under control. The objective of this study was to assess the efficacy of defatted fenugreek seed flakes (FenuflakesTM) on the 24-hour glycaemic response (Incremental Area Under the Curve, iAUC), variability (Mean Amplitude Glycaemic Excursion assessed by Continuous Glucose Monitoring system) in participants with type 2 diabetes. Twenty-one type 2 diabetes participants, aged 42 to 50 years, were provided with 5-day cyclic iso-caloric diets for 14 days without (control diet) and with 30 g of FenuflakesTM (test diet) in a randomized crossover trial. The Abbott Pro sensor recorded interstitial glucose concentration every 15 minutes consecutively for 14 days in the participants. Additionally, fasting plasma glucose and glycated hemoglobin (HbA1c) were assessed at the baseline and end of the study. 15 out of 21 participants completed the randomized control and test diet feeding periods as per protocol. There was a significant reduction in 24-hour iAUC (p=0.02) and mean amplitude glycemic excursions (p=0.006) in the test diet as compared to control diet. Furthermore, within the test diet, there was a significant reduction in fasting plasma glucose and HbA1c (p<0.05) at the end of the 14-day intervention period. The results suggest that the inclusion of FenuflakesTM, into regular dietary practices may effectively reduce glucose levels and enhance glycemic control in Asian Indian adults with type 2 diabetes.

The presence and accumulation of inflammation may exacerbate the develop-ment of dyslipidemia. Therefore, this study aimed to explore the relationship between blood inflammatory markers and the dietary inflammatory index (DII) in American adults as well as their association with dyslipidemia. This cross-sectional study included participants with complete data on lipid levels, dietary intake, and blood inflammatory markers. The associations between dyslipidemia and two sets of exposures-blood inflammatory markers and the DII-were analysed using weighted univariate and multivariate logistic regression models. Among the 9,441 participants (2009-2018), 6,689 (70.9%) had dyslipidemia. Logistic regression analysis revealed that higher DII quartiles were significantly associated with an increased risk of dyslipidemia, with the fourth quartile exhibiting an odds ratio of 1.33 (95% CI: 1.10-1.62; p < 0.001). Furthermore, DII combined with various blood inflammatory markers was consistently associated with an increased dyslipidemia risk (all OR > 1.0, all p < 0.05). A non-linear relationship was observed between the systemic immune-inflammation index (SII) and dyslipidemia risk, which became significant when the SII exceeded 434.65. DII and blood inflammation markers showed a positive association with dyslipidemia. Nonetheless, these findings still offer valuable insights to public health policymakers for developing evidence-based strategies to prevent dyslipidemia and potentially reduce inflammation-associated dyslipidemia risk.

Children with developmental disabilities commonly experience feeding problems; however, tools to assess the nature and extent of these difficulties are not available in Arabic. This study aims to validate the Arabic version of the Screening Tool for Feeding Problems (STEP) and evaluate its factorial structure in children with developmental disabilities. This cross-sectional study involved 167 children with developmental disabilities, recruited from nine disability centers and schools in Madinah, Saudi Arabia. Data were collected from caregivers using a paper version of the Arabic version of STEP, which was sent home with the child along with a consent form for signature. The English-to-Arabic translation of the tool was conducted by a bilingual professional using the forward-backward translation method. Confirmatory factor analysis was performed to evaluate the factorial structure of the Arabic version of STEP using two models. Model 1 included all 23 items; Model 2 excluded six items with low factor loadings, resulting in a 17-item version. Model 2 demonstrated improved goodness of fit indices, supporting a modified five-factor structure. Reliability analysis showed acceptable internal reliability for the total scale in both models, with Cronbach's alpha of 0.80 and McDonald's omega of 0.79 for Model 1, and alpha of 0.83 and omega of 0.82 for Model 2. Internal consistency for individual factors ranged from 0.31 to 0.70. The Arabic version of STEP demonstrates satisfactory psychometric properties and appears to be a valid and reliable tool for screening feeding difficulties in children with developmental disabilities in the Saudi Arabian context.

Chronic obstructive pulmonary disease (COPD) is a disease characterized by malnutrition, a catabolic process, and chronic inflammation; thus, vitamin deficiency may occur frequently. We aimed to evaluate the levels of micronutrients in stable COPD patients. There were 168 COPD patients from six pulmonology departments, with 36 healthy controls. The patients also performed pulmonary function tests and filled out the St. George's Respiratory Questionnaire (SGRQ). Serum vitamin B-12 and folate levels were measured using the chemiluminescence immunoassay (CLIA) method. Plasma 25-OH D3 levels were measured by high-performance liquid chromatography (HPLC). Our results revealed vitamin D deficiency in 68.9% (mild: 59.6%, intermediate: 25.7%, severe: 14.7%), vitamin B-12 deficiency in 21.7%, and folic acid deficiency in 50% of COPD patients. There was a significant difference between the COPD and healthy control groups regarding vitamin D deficiency (68.9% vs. 16.6%; p <0.001). Mean plasma 25-OH-D level was significantly lower in COPD patients (p <0.01). There was a positive correlation of plasma 25-OH-D level with the SGRQ impact score (r = 0.174, p = 0.028) and a negative correlation with age and number of exacerbations (respectively; r = -0.248, p = 0.002, and r = -0.160, p = 0.044). Vitamin D, B-12, and folate deficiencies frequently occur in COPD patients. Low plasma levels of 25-OH-D may be associated with advanced age and a higher number of exacerbations in patients with COPD. COPD patients with low vitamin D and folate may experience a decrease in quality of life.

Stunting is a global health challenge, especially in developing countries like Indonesia, where its prevalence reached 21.6% in 2022. This condition stems from malnutrition, recurrent infections, and inadequate care during the first 1,000 days of life. Maternal nutrition is critical for fetal growth, as deficiencies can lead to low birth weight and short birth length, increasing the risk of stunting. This study evaluates the potential of fortified tempeh as a nutritional intervention to improve birth outcomes. A quasi-experimental study with a quantitative approach was conducted to compare the effects of regular and fortified tempeh on BW and BL among pregnant women in Kuningan Regency. Participants were divided into two groups: one receiving fortified tempeh and the other regular tempeh. BW and BL were measured at birth and statistically analyzed for differences. The results showed no statistically significant differences in BW and BL between the two groups. However, the fortified tempeh group exhibited a positive trend, with an average BW of 2.92 kg and an average BL of 49.1 cm, compared to the regular tempeh group. Fortified tempeh demonstrates potential as a cost-effective, locally sourced intervention to support fetal growth and reduce stunting risks. Its integration into public health programs could enhance maternal nutrition and improve birth outcomes in Indonesia.

Type 2 diabetes mellitus (T2DM) has emerged as a significant global public health concern. Multiple studies have shown that traditional nutraceuticals are potential to treat T2DM and its complications. This review will explore traditional nutraceuticals with antidiabetic properties with a focus on traditional Asian nutraceuticals and their antioxidant effects on gene expression associated to T2DM. Literature searching was conducted in Pubmed, Scopus, and Science Direct using the keywords "nutraceutical", "antidiabetic", "insulin resistance", "Diabetes Mellitus", "herbal medicine", "mechanism", "pathway", "traditional food", "functional food", "antioxidant", "clinical", "preclinical", "animal studies", and "Asian" combined with Boolean operators "OR". Nutraceuticals sourced from traditional Indonesian herbal beverages, including Galohgor, Bir Pletok, and Wedang Uwuh, have shown potential efficacy in reducing hyperglycemia, oxidative stress, and obesity in T2DM. Furthermore, multiple Asian plants and their bioactive compounds, such as curcumin, kaempferol, cinnamon, saponin, quercetin, myricetin, anthocyanin, terpenoid, alkaloid, and gallic acid, have been shown to beneficially influence glucose ho-meostasis, insulin sensitivity, and problems associated with diabetes. Moreover, bioactive compounds of these traditional nutraceuticals have been proven in modulating gene expression associated with β-cell function, insulin signaling pathway, and antioxidant activity, which may offer a new therapeutic target. This review highlights the increasing scientific evidence on the role of traditional nutraceuticals for the prevention and management of diabetes mellitus, presenting promising alternatives to standard pharmacologi-cal therapy. Nonetheless, double-blind randomized clinical trials are required to validate these antidiabetic effects.

Malnutrition is a crucial factor affecting the prognosis of various diseases, especially among elderly, surgical and critically ill patients. With the implementation of Diagnosis Related Groups (DRGs) and Diagnosis-Intervention Packet (DIP) in China, accurate diagnosis and treatment of malnutrition is essential for enhancing clinical decision-making and patient prognosis. These guidelines were developed by multidisciplinary experts through a systematic review of evidence-based medical literature. They adopt the new international standard for malnutrition diagnosis from the Global Leadership Initiative on Malnutrition (GLIM) proposed by the Global Nutrition Organization and categorize evidence levels, providing recommendations tailored to the Chinese population's data and characteristics. The guidelines cover the entire process of malnutrition diagnosis in adult patients, including definition, epidemiology, nutrition risk screening, multi-level nutrition assessment, and diagnostic procedures. They also propose individualized diagnostic strategies for specific patient groups, such as obese or critically ill patients, and establish a standardized process for malnutrition diagnosis. At last, the guidelines form 27 questions, 38 recommendations, in order to improve the practical capac-ity of malnutrition diagnosis in China.

This study aims to investigate the association between dietary patterns and cognitive function among older adults with lower educational backgrounds living in China. We analyzed data from the 2018 Health Survey of individuals aged over 50 in Chengyang, Qingdao, China. Questionnaires were used to collect information on the behaviors and lifestyles of the elderly. The Montreal Cognitive Assessment (MoCA) was administered to evaluate cognition, with a total score of less than 19 indicating cognitive impairment for participants with low educational attainment. Using Principal Component Analysis, we identified three dietary patterns: Shellfish, Fruit, and Red Meat. Cross-sectional data regarding dietary intake, cognition, and demographics from 964 participants was analyzed using multivariate regression models to explore the relationship between dietary patterns and cognitive function. Our findings indicated that the 'Shellfish-based' dietary pattern ("Shellfish" DP) was significantly associated with cognitive function in both the third quartile (Q3: Odds Ratio = 0.58, 95% CI: 0.36-0.93, p <0.05) and the fourth quartile (Q4: OR = 0.54, 95% CI: 0.33-0.87, p <0.05). Furthermore, stratified analysis based on specific covariates revealed that significant results among individuals with a BMI of less than 25 kg/m² (OR = 0.57, 95% CI: 0.33-0.99, p <0.05). No significant interaction effects were observed between shellfish dietary intake and various subgroups (all interaction p >0.05). Our research demonstrates that "Shell-fish" DP is negatively correlated with cognitive decline among the elderly population. This correlation is particularly significant in individuals with BMI < 25kg/m2, as well as among women and under the age of 65. However, no interaction was observed between the shellfish DP and the various subgroups. These findings can effectively guide older adults in optimizing their dietary structures, thereby safeguarding their cognition.