BackgroundLow estrogen levels affect bone mineral density and bone microarchitecture, increasing the risk of osteoporosis. This hormonal change can also contribute to the loss of strength, muscle mass, and physical performance.AimTo investigate associations between the components of sarcopenia and bone microarchitecture in postmenopausal women.MethodsA cross-sectional study was conducted with 98 women ≥ 50 years of age. Data were collected on sociodemographic, lifestyle, and clinical characteristics. Measurements were performed of height, body mass, calf circumference adjusted for BMI, grip strength, and physical performance using the Timed Up and Go test. The appendicular skeletal muscle mass index (ASMI) and bone mineral density were estimated by dual energy X-ray absorptiometry. Bone microarchitecture was determined by the trabecular bone score. The association between ASMI and bone microarchitecture was tested using multivariate linear regression analysis with adjusted models.ResultsThe participants were predominantly between 60.0 and 69.9 years of age (62.3%), lived with a partner (51.0%), declared themselves to be non-White (59.2%), had low or no education (67.3%), were sufficiently active (52.0%), and did not consume alcohol (87.8%) or smoke (94.9%). ASMI was associated with bone microarchitecture after the adjustment of the models (β = 0.047; 95% CI: 0.009–0.084; p = 0.015).ConclusionThe positive association found between skeletal muscle mass and bone microarchitecture indicates that maintaining muscle mass may play a significant role in bone health among postmenopausal women.

BackgroundDietary supplements are widely used by athletes and sportspersons; however, little is known about protein supplement intake among university students undertaking strength training in gyms in the United Arab Emirates (UAE).PurposeThe purpose of this study was to examine the consumption, knowledge, perceptions, and use of protein supplementation, alone or in association with other supplements, among university students attending fitness centers in the UAE.MethodA cross-sectional study was conducted among university students in the UAE using a previously validated, self-administered online survey.ResultA total of 402 adults participated in the study. Approximately 260 (64%) of the participants visited fitness centers, with a higher percentage of males (154/207, 74.4%) than females (106/195, 54.4%). Those who frequented gyms consumed more protein supplements (91/260, 35.0%) compared with nonattendees (8/142, 5.6%). Significant gender differences were observed regarding the benefits and risks of protein supplementation. Among all the participants, 123 (31%) thought that the greatest benefit was building muscle mass, while 141 (35%) believed there was no risk involved. Among protein supplement users, 65 of 109 (59.6%) experienced some type of side effect. Additionally, 57 (14.2%) reported that friends or family encouraged them to take protein supplements.ConclusionThere is an urgent need to educate university students about the responsible use of protein supplements and the potential risks associated with their misuse. This can be achieved by providing reliable information through university health centers, academic tutors, nutritionists, and awareness campaigns conducted by student wellness services.

Roasted coffee's bioactive compounds may affect human glucose metabolism. This pilot clinical trial investigated the impact of coffee roast level, coffee timing, and carbohydrate (CHO) type on blood glucose responses. Healthy participants (15 female and 4 male) completed this six-week, randomized, single-blinded study. Treatments comprised combinations of roast levels (light, medium, or dark), coffee timings (pre-, co-, or post-CHO ingestion), and CHO types: oral glucose tolerance test (OGTT) beverages or a standardized breakfast designated as PreO, PreB, CoO, CoB, PostO, and PostB. Subjects consumed 300 mL of test beverages and provided 10 capillary blood samples over 4 h. Coffees were analyzed for caffeine, 3, 4, and 5 chlorogenic acids (CGA), trigonelline, total phenols, color, °Brix, and total dissolved solids (TDS). Significant (p < 0.05) differences in 3CQA, 5CQA, and trigonelline, but not caffeine and 4CQA, were observed across roast levels. Prior to CHO, coffee did not increase blood glucose, but potentiated increases after CHO. PreO and PreB treatments produced the highest peak glucose values (160 mg/dL). This was not observed for co- or posttreatments. In the CoO combination, AUC values were significantly (p < 0.05) lower than placebo only for medium roast. In posttreatments, peak glucose levels were higher following OGTT than breakfast, but AUCs did not differ. Light roast coffee yielded the lowest AUC for PreO and the highest peak at 3 h in the CoO combination. Medium roast resulted in the lowest AUC across all time points in CoO, while both medium and dark roasts elevated AUC in PreO. Only dark roast increased AUC in the PreB condition. Three AUC main effects (CHO type, coffee roast, and timing) and two interactions (timing × roast; timing × CHO × roast) were highly significant (p < 0.002). These findings may benefit those desiring temporary blood glucose elevations for exercise performance and recovery versus those seeking to moderate glucose.Trial Registration: ClinicalTrials.gov identifier: NCT05119153

Background: Dysregulated lipid metabolism has been implicated in breast cancer pathogenesis; however, the causal nature of these associations remains unclear. This study aimed to investigate the causal relationships between circulating lipid metabolites and the risk of estrogen receptor–positive (ER+) and ER-negative (ER−) breast cancer using a bidirectional Mendelian randomization (MR) approach.Methods: We evaluated 386 circulating lipid metabolites as exposures in two-sample MR analyses, with ER+ and ER− breast cancer as outcomes. Genetic instruments were selected based on genome-wide significance (p < 1 × 10−5) and linkage disequilibrium clumping (R2 < 0.01 within a 1000 kb window). The inverse variance weighted method was used as the primary analytical approach. Sensitivity analyses—including MR-Egger regression, Cochran's Q test, and leave-one-out analyses—were conducted to assess pleiotropy and heterogeneity. Validation analyses were performed using an independent genome-wide association study (GWAS) dataset for ER+ breast cancer. Reverse MR analysis was also conducted to evaluate potential reverse causality.Results: Among the 386 lipid metabolites analyzed, 24 and 23 exhibited nominal associations (p < 0.05) with ER+ and ER− breast cancer, respectively. After applying false discovery rate (FDR) correction (FDR < 0.05), three metabolites—myristoleate (14:1n5), tricosanoyl sphingomyelin (d18:1/23:0), and 5α-androstan-3β, 17β-diol monosulfate (2)—remained significantly associated with an increased risk of ER+ breast cancer. In contrast, none of the associations with ER− breast cancer remained significant after FDR correction. Sensitivity analyses indicated no evidence of horizontal pleiotropy or heterogeneity, and the associations remained robust in leave-one-out analyses. These findings were further validated in an independent GWAS dataset. Moreover, reverse MR analysis found no evidence supporting a causal effect of ER+ breast cancer on the levels of the three identified lipid metabolites.Conclusions: This study provides robust genetic evidence supporting a causal role for specific lipid metabolites in the development of ER+ breast cancer. These metabolites may serve as potential biomarkers for early detection and targets for preventive interventions.

Background: Malnutrition is associated with increased morbidity and mortality in patients with head and neck cancer (HNC) undergoing surgery. The ability to identify patients who are malnourished with an objective measure is currently a barrier to prompt screening and interventions. Recognizing the need for a screening tool, we used the geriatric nutritional risk index (GNRI) to assess the prevalence of malnutrition and the association between postoperative complications and GNRI scores.Methods: A retrospective review of medical records was conducted at a tertiary care academic hospital. A total of 49 HNC patients undergoing surgery with a serum albumin obtained within 6 months of surgery were included in this study. GNRI was calculated as follows: (1.487 × serum albumin [g/L] + (41.7 × current weight/ideal body weight [kg]). Analyses were conducted using univariate statistical methods.Results: 49 patients were included in the study, 32 men (65%) and 17 women (35%), with a mean age of 63 + 12 years. Malnutrition was defined by a GNRI score of < 97.5 and was present in 24% of patients (n = 12). Malnourished patients had significantly higher rates of postoperative complications and discharge to a skilled nursing facility (SNF) compared to controls.Conclusions: A low GNRI score appears to be a predictor of increased complications after head and neck surgery. The GNRI is a simple tool that requires serum albumin, current body weight, and ideal body weight to objectively assess nutrition status. Further studies are needed to assess the utility of using GNRI to assess malnutrition and identify patients who are at high risk for complications during the postoperative course.

This study investigated the prevalence and severity of premenstrual syndrome (PMS) among adult females and its relationship with the dietary inflammatory index (DII), which measures the inflammatory potential of a person's diet. The study employed a cross-sectional design, with participants recruited through convenience sampling. A structured questionnaire, including the Arabic Premenstrual Syndrome Scale, was used to assess the prevalence and severity of PMS. A self-administered food frequency questionnaire was used to assess dietary intakes and depict the DII of the participant's intakes. A total of 305 adult females participated; of these, 93% reported at least one PMS symptom, with a prevalence of 33.7% for PMS, primarily characterized by mild to moderate symptoms. The mean DII score was 2.52 ± 6.28, indicating a generally proinflammatory diet among participants. Multiple logistic regression analyses revealed that higher DII scores, particularly in Tertile 3, were significantly associated with increased PMS severity (p=0.001). These findings highlight the importance of dietary modifications that aim to reduce inflammation as a potential strategy for mitigating the severity of PMS. Future research should focus on longitudinal studies to establish causality and explore the effectiveness of anti-inflammatory dietary interventions in managing PMS symptoms.

Background: According to the last national survey in 1998, the prevalence of vitamin A deficiency (VAD) was as high as 61% in the Democratic Republic of the Congo (DRC), leading to the implementation of the vitamin A supplementation (VAS) programme. The available data are outdated and require situation analysis and vitamin A status data. While these data are missing, the relevance of the VAS programme is currently at the centre of debate, and it is important to understand how policymakers and programme planners perceive VAS. This study aims to explore the insights of policymakers and programme planners regarding its relevance and justification.Methods: This study used an exploratory qualitative design. Data were collected using key informant interviews with policymakers and programme planners at the national, provincial and health zone levels, including a total of 25 participants. Data were analysed using thematic analysis.Results: The participants recognised the relevance of VAS in reducing morbidity and mortality, especially in children. However, they identified challenges in communication and delivery mechanisms, such as insufficient supplement supply and a lack of provider motivation. The participants' opinions diverged regarding the justification of the VAS programme. Some participants perceived VAS as an essential strategy due to its benefits, while others advocated for alternative, cost-effective approaches, such as improving vitamin A dietary intake through fortification.Conclusion: Although VAS was considered important, our findings highlight the need to investigate alternative approaches, such as promoting affordable vitamin A–rich foods. There is an urgent need for more objective information regarding vitamin A status in the child population, and further research on VAD is necessary to evaluate the impact of the VAS programme.

Objectives: Waist-to-height ratio (WHtR) is an alternative index to evaluate metabolic health and predict the risk of estimating the impact of adiposity on cardiometabolic diseases. Despite the significance, the diagnostic performance of WHtR has not been extensively investigated in large epidemiological studies in Indonesia. Therefore, this study aimed to investigate anthropometric indexes (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], and WHtR) with the best clinically accurate and diagnostic performance in detecting the prevalence of diabetes mellitus (DM) and hypertension (HTN) in the Indonesian population.Methods: This study used a cross-sectional method to analyze big data of 7699 individuals from the Indonesian Family Life Survey. The diagnostic performance of each anthropometric index was analyzed using the receiver operating characteristics (ROC) curve model in the SPSS and MedCalc applications. Furthermore, the associations of anthropometric indexes with DM and HTN were evaluated using logistic regression adjusted for sociodemographic confounders.Results: WHtR showed the highest area under the curve (AUC) for detecting DM in men (0.731 [0.679–0.784]), as well as HTN in both men (0.650 [0.629–0.671]) and women (0.615 [0.598–0.633]). Although often negligible, the discrepancies had overlapping 95% confidence intervals with other indexes. WHtR also showed the strongest association with both DM (AOR [95% CI]: 3.166 [2.416–4.150]) and HTN (1.938 [1.703–2.206]). Lower cutoffs for BMI (22.72 kg/m2) and WC (83.35 cm) enhanced sensitivity for DM and HTN detection, particularly in men.Discussion: WHtR outperformed BMI, WC, and WHR in detecting DM and HTN in the Indonesian population. Additionally, lower cutoffs for overall (BMI) and abdominal obesity (WC) should be considered to enhance the sensitivity of anthropometric indexes in screening for cardiometabolic diseases in the population.

Zinc (Zn) is an essential dietary nutrient metal that functions as a cofactor for numerous enzymes involved in diverse cellular processes, including energy metabolism. In humans, Zn deficiency afflicts an estimated one-third of the global population and is a prominent risk factor for numerous diseases, including the development of obesity and diabetes. It is known that severe Zn deficiency leads to impaired growth and development in animals, suggesting that this dietary micronutrient is required for the maintenance of organismal energy balance. However, the impact of Zn restriction on energy balance, specifically energy intake versus expenditure, remains incompletely described in existing murine models of Zn deficiency. Here, we characterized the impact of a prolonged Zn-restricted diet on animal growth, energy balance, and glucose metabolism using metabolic cage analysis and oral glucose tolerance tests in adult mice. While we demonstrated dietary Zn-dependent reductions in body weight with concomitant decreases in energy expenditure and energy intake, we found no significant alterations in energy balance. Furthermore, we observed modest sex-dependent impacts on glucose tolerance. Collectively, these data highlight that prolonged, severe Zn restriction in adult mice does not elicit significant changes in metabolic parameters such as overall energy balance and glucose clearance. These findings indicate that other factors lead to the changes in body weight and composition in Zn-deficient mice.

Background: Malnutrition is the leading cause of morbidity and mortality among children under five, with significant regional disparities, particularly in Ethiopia, being very high. This study aims to use Geographic Information Systems (GIS) to identify hotspot areas and associated factors for stunting and wasting among children under five in Oromia Regional State, Ethiopia. Methods: A community-based cross-sectional study was conducted. Data were obtained from the 2019 Ethiopian Demographic and Health Survey (EDHS). A total of 653 children under five years old were included in this study. The data were collected using a multistage sampling technique to select the study participants. ArcGis Version 10.7 was used for geospatial analysis. A Bayesian logistic regression model was used to determine the associated factors for undernutrition. A p value < 0.05 was considered statistically significant. Results: Overall, the prevalence of stunting and wasting was 36.29% and 4.9%, respectively. In hotspot analysis, both Guji Zone and East Hararge were at high risk of stunting among children under 5 years. Eastern Guji (Gora Dola) and Eastern Hararge (Goro Muti and Meta) areas were at high risk for wasting children under 5 years old. In the adjusted model, being rural residents, mothers who had attended a secondary/above school, children aged 24-35 and 36-47 months, a preceding birth interval > 48 months, using a protected water source, and wealth index were significantly associated with stunting among children under five years. Similarly, mothers aged 25-35 years, rural residents, married women, preceding birth intervals > 48 months, and having more than three children were significantly associated with wasting among children under 5 years. Conclusion: The prevalence of stunting and wasting among children under 5 years remains high in the study setting. These findings suggest that a multifaceted approach addressing education, water access, socioeconomic conditions, and targeted health interventions for high-risk populations is essential to reducing stunting and wasting among children under 5 years old in Oromia Regional State.