24-h Intake Research Articles

Microplastics in stools and their influencing factors among young adults from three cities in China: A multicenter cross-sectional study

The mass concentration of microplastics in stools and influencing factors remain unclear. The aim was to investigate the types and mass concentrations of microplastics in the stools of young college students and to explore potential influencing factors. Twenty-six participants were recruited from colleges in each city using stratified simple sampling, including Changsha, Shanghai, and Changchun. Participants’ dietary and fluid intake behavior was recorded using the 3-day 24-h dietary questionnaire and the 7-day 24-h fluid intake record, respectively. Lifestyle factor information related to microplastic exposure was collected through a microplastic exposure questionnaire. Stools were collected and detected using pyrolysis gas chromatography–mass spectrometry (Py-GCMS) method. Eventually, 78 participants completed the study. The detection rate of microplastics, including polyethylene (PE), polyvinyl chloride (PVC), polystyrene (PS), polypropylene (PP) and polyethylene terephthalate (PET), in stools was 98.7%, with a total mass concentration of 54.7 (10.1–102.7) μg/g. There were differences in the total mass concentrations of microplastics in the stools of participants in three cities, namely Changsha, Shanghai, and Changchun, which decreased sequentially (χ2 = 47.819, P < 0.05). Participants with a relatively high frequency of takeaway food consumption had higher total mass concentrations of microplastics mass concentrations in stools (χ2 = 7.390, P < 0.05). Participants with a relatively high frequency of consuming reheated food had a greater mass concentration of PET microplastics (χ2 = 6.117, P < 0.05). The total mass concentration of microplastics, as well as the mass concentrations of PE, PVC, PP, and PA66, in the bottled water intake group were greater than those in the nonintake group (all P < 0.05). Overall, the total mass concentration of microplastics in stools was related to residential city, consumption of reheated food, and bottled water intake (all P < 0.05). Young college students generally experience microplastic exposure, with the main types being PE, PVC, PS, PP, PET, and PA66. Living location, reheated food consumption, and bottled water intake were factors influencing microplastic exposure.

Non-modifiable and Modifiable Risk Factors in Vascular Ageing Extremes: The African-PREDICT Study

BackgroundCardiovascular risk factors accelerate vascular ageing beyond chronological age, hence early vascular ageing (EVA). Carotid to femoral pulse wave velocity (cfPWV) is a measure of vascular ageing and is used to identify EVA and supernormal vascular ageing (SUPERNOVA). Vascular ageing is not completely understood in African populations. Therefore, we aimed to phenotype young South African adults stratified by cfPWV extremes in terms of non-modifiable and modifiable risk factors. This study included 1133 young adults (mean age: 24.5 years). We measured cfPWV using applanation tonometry. Body composition measures, self-reported 24-h dietary intake, smoking and alcohol consumption were included. Fasting blood samples were analysed for biochemical risk factors. Three groups based on cfPWV percentiles were compared and included SUPERNOVA (≤ 10th percentile), average vascular ageing (AVA, between 10 to 90th percentile) and EVA (≥ 90th percentile).ResultsChronological age, male sex, smoking, alcohol use, and blood pressure were incrementally higher across PWV groups (all p trend ≤ 0.007). Black ethnicity was higher (p = 0.038) in the SUPERNOVA group. In exploratory factor analysis, a factor pattern including mean arterial pressure and fasting glucose showed beneficial odds (OR 0.62, p = 0.002) for SUPERNOVA and higher likelihood (OR 2.10, p < 0.001) for EVA. Another factor pattern of socio-economic status and total dietary fat showed lower odds (OR 0.64, p = 0.003) for EVA.ConclusionPoor lifestyle behavioural risk factors seem detrimental in the EVA group conferring a possible higher risk of future CVD.

The test-retest reliability and validity of food photography and food diary analyses.

To assess test-retest reliability of both food photography and food diary methods and validity of these data against known values derived from food labels. Test-retest reliability analyses of food diary and food photography were compared using single foodstuffs using intra-class correlation coefficients, coefficients of variation, and limits of agreement. For food diaries, 24-h test-retest reliability was also examined. Validity was assessed against weighed analyses. As part of habitual intake, a single foodstuff (randomly allocated from 14 common foods) was consumed by 26 participants over 24-h. On two occasions (14 days apart), single-blind dietary analyses allowed estimation of foodstuff-specific energy and macronutrient content and 24-h intakes. For food diaries, test-retest reliability was acceptable (weight, energy, carbohydrate, protein, and fat: all intra-class correlation coefficients: >0.990, coefficient of variation percentage: <0.1%, limits of agreements: <0.1 to <0.1, p > 0.05, and effect size: <0.01). For food photography, test-retest reliability was acceptable for weight, energy, carbohydrate, and protein (all intra-class correlation coefficients: >0.898, coefficient of variation percentage: 3.6%-6.2%, limits of agreements: 1.1 to - 44.9, and effect size: 0.01-0.12). Food photography validity was worse than food diaries for all variables (percentage difference: 8.8%-15.3%, coefficient of variation percentage: 7.5%-13.8%, all p ≤ 0.05, and effect size: 0.001-0.11). Greater reliability and validity occurred in food diaries versus food photography. These findings suggest that using food photography may lead to an underestimation of energy and macronutrient content, which may have implications for dietary interventions and nutritional strategies.

Habitual water intake impacted the body composition of young male athletes in free-living conditions: a cross-sectional study.

The study aimed to explore the associations between water intake and body composition and differences of body composition in different water itake and hydration statuses among young male athletes. A cross-sectional study was conducted among 111 young male athletes in Beijing, China. Total drinking fluids (TDF) and water from food were assessed using a 7-day, 24-h fluid intake record questionnaire and the duplicate portion method, respectively. The osmolality of 24-hour urine and blood samples was tested. Body composition was measured using a bioelectrical impedance analyzer twice at 5-min intervals. Participants were divided into two groups based on the recommendations of total water intake (TWI) and TDF in China, as well as into three groups based on 24-h urine osmolality. Pearson's correlation coefficients were calculated to determine the relationship between water intake and body composition. Chi-square tests and Student's t-tests were used to compare differences. A total of 109 participants completed the study. TDF (r = 0.230, p = 0.016; r = 0.234, p = 0.014; r = 0.242, p = 0.011) and TWI (r = 0.275, p = 0.004; r = 0.243, p = 0.011; r = 0.243, p = 0.011) were positively correlated with total body water (TBW), intracellular water (ICW), and extracellular water (ECW). TBW/body weight (BW) was positively associated with TDF percentage of BW (TDF/BW) (r = 0.267, p = 0.005), water from food percentage of BW (r = 0.217, p = 0.024), and TWI percentage of BW (TWI/BW) (r = 0.316, p = 0.001). Participants who met the TDF recommendation of China had 1.3 kg higher skeletal muscle mass (SMM), 0.9 kg higher ICW, and 0.5% higher TBW/BW than those who did not (all p < 0.05), with fat-free mass (FFM) and TBW being higher (p = 0.051; p = 0.050). Those who met the TWI recommendation of China had 1.3 kg higher SMM, 2.4 kg higher FFM, 1.1 kg higher ICW, 0.6 kg higher ECW, and 1.7 kg higher TBW than their counterparts (all p < 0.05). Moderate associations were found between water intake and body composition. No significant differences were observed among participants in three hydration statuses (all p > 0.05). Participants who met the TWI or TDF recommendations had better body composition distribution than their counterparts. Thus, habitual water intake, not hydration status, affects body composition among athletes in free-living conditions.

The association between integrating echocardiography use in the management of septic shock patients and outcomes in the intensive care unit: a systematic review and meta-analysis.

Septic shock in critically ill patients can increases morbidity and mortality. We aimed to study the effect on outcomes when integrating point of care (POC) echocardiography in the management of septic shock patients in the Intensive Care Unit (ICU) who are being treated according to the Surviving Sepsis Campaign (SSC) guidelines. An electronic search of MEDLINE through PubMed, clinical trials.gov and google scholar was conducted for the period from January 1990-January 2024 to identify studies of septic shock adult and pediatric patients in the ICU managed according to SSC guidelines with or without POC echocardiography. Three reviewers extracted data independent of each other. Cochrane collaboration tool was used for bias assessment. Random effect meta-analysis used to pool data. A total of 1701 articles identified. Seven studies included in the final report with a total of 3885 patients. POC echocardiography guided septic shock management was associated with lower in-hospital and 28-day mortality (sOR = 0.82 [95%CI: 0.71-0.95], p = 0.01), more frequent initiation of inotropic support (sOR = 2.42 [95%CI 1.92-3.03], p < 0.0001) and shorter time to achieve lactate clearance (SMD = - 0.87h [95%CI - 1.23h to - 0.51h], p < 0.0001). Summary estimates did not achieve significance for effect of POC echocardiography on 24-h fluid intake (SMD = - 2.11ml [95%CI - 5.93ml to 1.72ml], p = 0.28) on mechanical ventilation-free days (SMD = 0.03days [95%CI - 0.04 to 0.10], p = 0.94). Shock reversal time analysis was less meaningful due to the small number of studies reporting outcome. POC echocardiography guided management in septic shock patients in the ICU can lead to a decrease in mortality, increase in initiation of inotropic support, and a decrease in lactate clearance time. Larger cohort studies and data collection and analysis are needed for further understanding and optimizing standardization of protocols for POC echocardiography use in septic shock patients in the ICU.

Association between dietary inflammatory index and all-cause mortality in US adults with dermatitis: a population-based cohort study.

While dermatitis management is primarily symptomatic, the role of diet in symptom exacerbation and improvement is increasingly recognized. The dietary inflammatory index (DII), a quantitative assessment tool for dietary inflammatory potential, has been associated with various chronic diseases but remains understudied in dermatitis. This cohort study investigated the association between DII scores and all-cause mortality among patients with dermatitis. The study included 1,074 patients with dermatitis and complete dietary intake records from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. The DII scores were calculated using two 24-h dietary recalls and dietary supplement intakes and the consumption of 28 foods with known pro- or anti-inflammatory properties. All-cause mortality information was from the National Death Index, censored on December 31, 2019. Multivariable Cox hazards regression models, restricted cubic spline (RCS) models, and subgroup analyses were employed to evaluate the association of DII with all-cause mortality, adjusting for potential confounders. The 1,074 patients were divided into DII tertiles (T1: n = 358, median age 40 years, DII -3.91, 0.06; T2: n = 296, median age 40 years, DII 0.06, 1.88; T3: n = 237, median age 39 years, DII 1.88, 4.39). The study revealed a positive correlation between higher DII scores and increased all-cause mortality risk among patients with dermatitis (fully-adjusted model, HR = 1.13, 95% CI 1.02, 1.27, p = 0.026). This association was more pronounced in adults over 45 years, with the highest DII tertile indicating a 2.42-fold increased mortality risk (95% CI 1.15, 5.07, p = 0.019) compared with the lowest tertile. The RCS model confirmed a linear dose-response trend (p for non-linear = 0.183), validating the relationship. Elevated DII scores are associated with an increased risk of all-cause mortality in patients with dermatitis, suggesting that the dietary inflammatory potential may impact health outcomes in this population. The findings underscore the importance of dietary interventions in dermatitis management, especially for middle-aged and older adults. Future research with larger cohorts and a longer follow-up is warranted to validate the findings.

Cross-context equivalence and agreement of healthy diet metrics for national and global monitoring: a multicountry analysis of cross-sectional quantitative 24-hour dietary intake studies

BackgroundDespite national and global commitments to improve nutrition, there are no universally accepted indicators for at-scale monitoring of diets. Several metrics have been proposed and used, but they vary in their comprehensiveness and validity in capturing the properties of healthy diets and, potentially, their interpretability across contexts. ObjectiveThe objective of this study was to assess the cross-context equivalence and agreement of healthy diet metrics. DesignQuantitative 24-h dietary intake data from 57,456 nonpregnant females (15–49 y) in 21 countries were used to construct the food group diversity score (FGDS) and Minimum Dietary Diversity for Women indicator; the Global Diet Quality Score (GDQS) and its submetrics: GDQS+ and GDQS−; the Global Dietary Recommendations (GDR) score and its submetrics: noncommunicable disease (NCD)-Protect and NCD-Risk scores; and the All-5 indicator. Associations between (standardized) measures and indicators were quantified by fitting linear and logistic mixed-effect models across World Bank country income classifications, respectively. The levels of agreement between measures were assessed using Bland–Altman plots of z-scores, whereas rank correlations were assessed using Spearman’s ρ. ResultsThe consumption of healthy food groups was positively associated with concurrent intakes of unhealthy food groups, in particular in high-income countries. Hence, metrics constructed using both healthy and unhealthy food groups (i.e., GDR score and GDQS) showed relatively less discriminatory capacity across country income classifications than their respective submetrics or FGDS. Standardized metrics of healthy (e.g., FGDS and GDQS+) and unhealthy food group consumption (i.e., NCD-Risk and GDQS−) exhibited strong agreement and correlations. ConclusionComposite metrics weighting both healthy and unhealthy food groups have limited cross-context equivalence, because a wide range of diets can theoretically return similar scores. Healthy food group (sub)metrics performed comparably, likely indicating strong underlying construct validity (i.e., dietary diversity and nutrient adequacy). For national and global monitoring, refinement and validation of unhealthy food group metrics (i.e., moderation) is recommended to complement healthy food group metrics.

Associations between dietary potassium intake and urinary potassium excretion: a protocol for systematic review and meta-analysis

BackgroundWhile numerous studies have reported associations between low dietary potassium intake and adverse clinical outcomes, methods to estimate potassium intake, mainly self-reported dietary measures and urinary potassium excretion, entail certain limitations. Self-reported measures are subject to underreporting and overreporting. Urinary potassium excretion is affected by multiple factors including renal function. Revealing the degree of bias inherent in these measures would help accurately assess potassium intake and its association with disease risk. We aim to summarize evidence on the strength of the associations between potassium intake estimated from 24-h urinary potassium excretion and potassium intake estimated from self-reported dietary measures or objective quantification methods in populations with different kidney function levels and age groups. We also aim to identify factors that affect the association strength.MethodsWe will search for potentially eligible studies that examined associations between self-reported potassium intake, 24-h urinary potassium excretion, and objectively quantified potassium intake, using MEDLINE (PubMed), Embase, Web of Science, and Scopus. Studies on children, adolescents, adults, and the elderly are eligible. Studies of patients on dialysis will be excluded. Collective study results, including a meta-analysis, will be synthesized if an adequate number of studies examining similar dietary potassium intake estimation methods are found. Analyses will be performed separately according to age groups and renal function. For the meta-analysis, fixed-effects or random-effect models will be employed depending on the degree of study heterogeneity to combine across studies the correlation coefficient, ratio, or standardized mean difference for potassium intake, comparing dietary potassium intake based on self-reported or objectively quantified methods and intake based on 24-h urinary potassium excretion. The degree of heterogeneity among included studies will be examined by calculating I2 statistics. To investigate sources of study heterogeneity, random-effects meta-regression analyses will be performed.DiscussionRevealing the strength of the association between dietary and urinary measures in populations with different levels of kidney function and age groups will enhance researchers’ and clinicians’ ability to interpret studies that utilize these measures and help establish a more solid evidence base for the role of potassium intake in changing chronic disease risk. Identifying factors that modify the associations between these measures may aid in developing predictive models to estimate actual potassium intake.Systematic review registrationPROSPERO CRD42022357847.

Dietary pattern and diversity analysis using DietDiveR in R: a cross-sectional evaluation in the National Health and Nutrition Examination Survey

BackgroundThere are few resources available for researchers aiming to conduct 24-h dietary record and recall analysis using R. ObjectivesWe aimed to develop DietDiveR, which is a toolkit of functions written in R for the analysis of recall or record data collected with the Automated Self-Administered 24-h Dietary Assessment Tool or 2-d 24-h dietary recall data from the National Health and Nutrition Examination Survey (NHANES). The R functions are intended for food and nutrition researchers who are not computational experts. MethodsDietDiveR provides users with functions to 1) clean dietary data, 2) analyze 24-h dietary intakes in relation to other study-specific metadata variables, 3) visualize percentages of energy intake from macronutrients, 4) perform principal component analysis or k-means clustering to group participants by similar data-driven dietary patterns, 5) generate foodtrees based on the hierarchical food group information for food items consumed, 6) perform principal coordinate analysis taking food grouping information into account, and 7) calculate diversity metrics for overall diet and specific food groups. DietDiveR includes a self-paced tutorial on a website (https://computational-nutrition-lab.github.io/DietDiveR/). As a demonstration, we applied DietDiveR to a demonstration data set and data from NHANES 2015–2016 to derive a dietary diversity measure of nuts, seeds, and legumes consumption. ResultsAdult participants in the NHANES 2015–2016 cycle were grouped depending on the diversity in their mean consumption of nuts, seeds, and legumes. The group with the highest diversity in nuts, seeds, and legumes consumption had 3.8 cm lower waist circumference (95% confidence interval: 1.0, 6.5) than those who did not consume nuts, seeds, and legumes. ConclusionsDietDiveR enables users to visualize dietary data and conduct data-driven dietary pattern analyses using R to answer research questions regarding diet. As a demonstration of this toolkit, we explored the diversity of nuts, seeds, and legumes consumption to highlight some of the ways DietDiveR can be used for analyses of dietary diversity.

Estimation of dietary intake of sodium, potassium, phosphorus and protein in healthy Indian population and patients with chronic kidney disease.

Poor nutritious diet is a major risk element for non-communicable diseases (NCD), which are of considerable public health concern. Given the diverse dietary patterns in India, precise determination of nutrient consumption is crucial for disease management. The present study assessed the dietary intake of sodium, potassium, protein, and phosphorus among North Indians. This cross-sectional study included healthy adults and adults with stage 2 to 4 chronic kidney disease (CKD). We analysed sodium, protein, potassium and phosphorus intakes using one-time 24-h urinary excretion. Dietary intake was also analysed in subgroups based on sex, body mass index, blood pressure and abdominal obesity. We evaluated the performance of various equations available to estimate sodium intake using a spot urine sample with respect to the sodium excretion measured in a 24-h urine sample. Descriptive statistics was used along with t-test for statistical significance. A total of 404 subjects (182 adult healthy subjects and 222 adults with CKD) with a mean age of 47.01 ± 11.46 years were studied. Mean dietary intakes of sodium, salt, potassium, protein and phosphorus were 2.94 ± 1.68 g/day, 7.42 ± 4.24 g/day, 1.43 ± 0.59 g/day, 47.67 ± 14.73 g/day and 0.86 ± 0.39 g/day, respectively. There were no differences in nutrient consumption between adults who were healthy and those with CKD. Consumption of sodium, salt, protein, potassium, and phosphorus among healthy population vs. those with CKD were 2.81 ± 1.60 vs. 3.05 ± 1.73 g/day (p = 0.152), 7.08 ± 4.04 vs. 7.70 ± 4.37 g/day (p = 0.143), 47.16 ± 14.59 vs. 48.08 ± 14.86 g/day (p = 0.532), 1.38 ± 0.59 vs. 1.48 ± 0.58 g/day (p = 0.087) and 0.86 ± 0.41 vs. 0.87 ± 0.37 g/day (p = 0.738), respectively. Men had higher consumption of these nutrients than women. Compared to non-hypertensives, hypertensive subjects had higher consumption of salt (8.23 ± 4.89 vs. 6.84 ± 3.59 g/day, p = 0.002) and potassium (1.51 ± 0.63 vs. 1.38 ± 0.55 g/day, p = 0.024), however, no difference were found in protein and phosphorus intakes. In terms of performance of equations used to estimate 24-h sodium intake from spot urinary sodium concentration against the measured 24-h urinary sodium excretion, INTERSALT 2 equation exhibited the least bias [1.08 (95% CI, -5.50 to 7.66)]. The study shows higher-than-recommended salt and lower-than-recommended potassium intake in the north Indian population compared to those recommended by guidelines. The dietary protein intake is below the recommended dietary allowance. These findings help the development of targeted policies for dietary modification to reduce the risk of the development and progression of CKD.

Mechanism of multi-organ compensation under different iodine intake in pregnant rats: results from a repeated-measures study of iodine metabolism.

This study aimed to explore the differences in iodine metabolism and expression of NIS and Pendrin in pregnant rats under different iodine nutritional status. Female Wistar rats were divided into four groups: low iodine (LI), normal iodine (NI), tenfold high iodine (10HI), and fifty fold high iodine (50HI). The intervention began after one week of adaptive feeding. Iodine metabolism experiments were performed beginning on the 15th day of pregnancy. 24-h iodine intake and excretion were calculated. The concentrations of iodine in urine, fecal, thyroid, and placenta were measured by ICP-MS. PCR and Western Blot were used to detect the mRNA levels and cell membrane protein of sodium/iodide symporter (NIS) and Pendrin in the small intestine, thyroid, kidney, and placenta. Fecal iodine excretion (FIE) and urinary iodine excretion (UIE) in the 50HI group were significantly higher than those in the NI group (P < 0.05). The NIS protein and mRNA in the kidney and small intestine have an upward trend in iodine deficiency and a downward trend in iodine excess. Thyroid and placental iodine storage in the 50HI group were significantly higher than those in the NI group (P < 0.05). NIS, Pendrin protein, and mRNA in the thyroid and placenta tend to increase when iodine is deficient and decrease when there is excess. Iodine excretion and iodine stores in the placenta and thyroid gland are positively correlated with iodine intake. NIS and Pendrin are also regulated by iodine intake.

Therapeutic effects of mitoquinol during an acute heat stress challenge in growing gilts.

Study objectives were to evaluate the effects of mitoquinol (MitoQ) on production parameters, gastrointestinal tract (GIT; stomach and small and large intestines) weight, and circulating leukocytes during a 24-h acute heat stress (HS) challenge. Crossbred gilts [n = 32; 49.1 ± 2.4kg body weight (BW)] were blocked by BW and randomly assigned to 1 of 4 environmental-therapeutic treatments: 1) thermoneutral (TN) control (n = 8; TNCON), 2) TN and MitoQ (n = 8; TNMitoQ), 3) HS control (n = 8; HSCON), or 4) HS and MitoQ (n = 8; HSMitoQ). Pigs were moved into individual pens and allowed to acclimate for 6 d. The study consisted of 2 experimental periods (P). During P1 (2 d), all pigs remained in TN conditions (20.6 ± 1.5 °C) and were fed ad libitum. During P2 (24h), pigs were fed ad libitum and exposed to either TN or constant HS (37.3 ± 1.3 °C). Mitoquinol (40mg/d) was orally administered twice daily (0700 and 1800 hours) during P1 and P2. As expected, pigs exposed to HS had increased rectal temperature, skin temperature, and respiration rate (+1.5 °C, +8.7 °C, and +86 bpm, respectively; P < 0.01) compared to their TN counterparts. Compared to TN, HS pigs had decreased feed intake (67%; P < 0.01) and significant BW loss (+1.5 vs. -1.9kg, respectively; P < 0.01). Total GIT weight was decreased in HS relative to TN pigs (P < 0.01), and this was influenced by decreased luminal contents (2.43 vs. 3.26kg, respectively; P < 0.01) and reduced empty GIT mass (3.21 vs. 3.48kg, respectively; P = 0.03). Stomach contents remained similar between TN and HS pigs (P > 0.54) but tended to increase in MitoQ relative to CON pigs (0.90 vs. 0.63kg, respectively; P = 0.08). Stomach content as a percentage of the previous 24h feed intake was increased in HS compared to the TN controls (93% vs. 31%; P < 0.01). In contrast, small and large intestinal contents were decreased in HS compared to TN pigs (23% and 49%, respectively; P < 0.01). Liver weight decreased in HS relative to TN pigs (1.15 vs. 1.22kg, respectively; P = 0.02), and was decreased in MitoQ compared to CON pigs (1.13 vs. 1.24kg; P < 0.01). Circulating lymphocytes tended to be decreased in HS relative to TN pigs (16%; P = 0.07). In summary, acute HS increased all body temperature indices, negatively influenced animal performance, and differentially altered GIT motility as evidenced by decreased gastric emptying and increased intestinal transit. However, MitoQ supplementation did not appear to ameliorate these effects.

No change in 24-h sodium intake estimated from spot urine in Norwegian adults from 2006 to 2019: the population-based Trøndelag Health Study (HUNT).

Monitoring time trends in salt consumption is important for evaluating the impact of salt reduction initiatives on public health outcomes. There has so far not been available data to indicate if salt consumption in Norway has changed during the previous decade. We aimed to assess whether average 24-h salt intake estimated from spot urine samples in the adult population of mid-Norway changed from 2006-2008 to 2017-2019 and to describe variations by sex, age and educational level. Repeated cross-sectional studies. The population-based Trøndelag Health Study (HUNT). In each of two consecutive waves (HUNT3: 2006-2008 and HUNT4: 2017-2019), spot urine samples were collected from 500 men and women aged 25-64 years, in addition to 250 men and women aged 70-79 years in HUNT4. Based on spot urine concentrations of Na, K and creatinine and age, sex and BMI, we estimated 24-h Na intake using the International Cooperative Study on Salt and Blood Pressure (INTERSALT) equation for the Northern European region. Mean (95 % CI) estimated 24-h salt intakes in men were 11·1 (95 % CI 10·8, 11·3) g in HUNT3 and 10·9 (95 % CI 10·6, 11·1) g in HUNT4, P = 0·25. Corresponding values in women were 7·7 (95 % CI 7·5, 7·9) g and 7·7 (95 % CI 7·5, 7·9) g, P = 0·88. Mean estimated salt intake in HUNT4 decreased with increasing age in women, but not in men, and it did not differ significantly across educational level in either sex. Estimated 24-h salt intake in adult men and women in mid-Norway did not change from 2006-2008 to 2017-2019.

Machine learning-based prognostic model for in-hospital mortality of aortic dissection: Insights from an intensive care medicine perspective.

Aortic dissection (AD) is a severe emergency with high morbidity and mortality, necessitating strict monitoring and management. This retrospective study aimed to identify prognostic factors and establish predictive models for in-hospital mortality among AD patients in the intensive care unit (ICU). We retrieved ICU admission records of AD patients from the Medical Information Mart for Intensive Care (MIMIC)-IV critical care data set and the eICU Collaborative Research Database. Functional data analysis was further applied to estimate continuous vital sign processes, and variables associated with in-hospital mortality were identified through univariate analyses. Subsequently, we employed multivariable logistic regression and machine learning techniques, including simple decision tree, random forest (RF), and eXtreme Gradient Boosting (XGBoost) to develop prognostic models for in-hospital mortality. Given 643 ICU admissions from MIMIC-IV and 501 admissions from eICU, 29 and 28 prognostic factors were identified from each database through univariate analyses, respectively. For prognostic model construction, 507 MIMIC-IV admissions were divided into 406 (80%) for training and 101 (20%) for internal validation, and 87 eICU admissions were included as an external validation group. Of the four models tested, the RF consistently exhibited the best performance among different variable subsets, boasting area under the receiver operating characteristic curves of 0.870 and 0.850. The models highlighted the mean 24-h fluid intake as the most potent prognostic factor. The current prognostic models effectively forecasted in-hospital mortality among AD patients, and they pinpointed noteworthy prognostic factors, including initial blood pressure upon ICU admission and mean 24-h fluid intake.

Differential dietary intake and contribution of ultra-processed foods during pregnancy according to nutritional status.

Frequent consumption of ultra-processed foods (UPFs) during pregnancy is linked to excess intake of added sugar, fat, and sodium and inadequacy of several micronutrients. Diet quality during pregnancy should be maximized as inadequate levels of key nutrients and excessive intake of energy and added sugar might influence mother-child health. We aimed to estimate the contribution (% of total calories) of ultra-processed products to the total energy intake by pre-gestational body mass index (BMI) categories and Hb status during pregnancy in participants from the MAS-Lactancia Cohort. Pre-gestational weight, hemoglobin levels, 24-h dietary intake recall interviews, and sociodemographic data were collected during the second and third trimesters of pregnancy. Reported consumed foods were categorized using the NOVA classification, and the contribution of calories from each NOVA category was estimated using the Mexican Food Database. We estimated medians and interquartile ranges (p25 and p75) for dietary intake and energy contributions. The comparison of intake between the second and third trimesters was done using the Wilcoxon test. In addition, a quantile regression model with an interaction between pre-gestational BMI and Hb levels status in tertiles over the percentage of energy from UPFs was adjusted by age and socioeconomic status. The contribution to total energy intake from UPFs was 27.4% in the second trimester and 27% in the third trimester (with no statistical difference). The percentage of energy intake from UPFs was higher in women who started pregnancy with obesity and presented the lowest levels of Hb (1st tertile), 23.1, 35.8, and 44.7% for the 25th, 50th, and 75th percentiles, respectively, compared to those with normal BMI and the highest tertile of Hb levels: 18, 29.0, and 38.6% for the 25th, 50th, and 75th percentiles, respectively. In conclusion, UPF intake in pregnant women is similar to the general population and was higher for those with pre-gestational obesity and the lowest tertile of Hb levels. UPF contributes also to sugar, saturated fat, and sodium, which may adversely affect the health of mothers and their offspring.

#5372 THE ASSOCIATION BETWEEN POTASSIUM INTAKE AND RISK OF CHRONIC KIDNEY DISEASE

Abstract Background and Aims High potassium intake is closely related to lower risk of cardiovascular disease. However, the association between potassium intake and chronic kidney disease (CKD) development in the general population is uncertain. Method From UK biobank cohort, we included 317,162 participants without CKD between 2006 and 2010. The main predictor was spot urine potassium-to-creatinine ratio (KCR) as a surrogate of potassium intake. The primary outcome was incident CKD, defined based on ICD-10 and OPCS-4 codes. For secondary analysis, we included 141,180 participants who completed 24-h dietary recall questionnaire and dietary potassium intake was an additional predictor. Results At baseline, individuals with higher KCR had lower levels of blood pressure, BMI, and inflammation, and were less likely to have diabetes and hypertension than those with lower KCR. During a median follow-up of 11.9 years, the primary outcome events occurred in 15,255 (4.8%) participants. In competing risk model, adjusted hazard ratio (aHR) per 1-SD increase in KCR for incident CKD was 0.90 (95% confidence interval [CI], 0.89-0.92). In addition, compared with quartile 1 of KCR, the aHRs (95% CIs) for second, third, and fourth quartile were 0.98 (0.94–1.02), 0.90 (0.86–0.95), and 0.80 (0.76–0.84), respectively. In secondary analysis, higher potassium consumption was also inversely associated with risk of CKD. Compared with quartile 1 of dietary potassium intake, the corresponding aHRs (95% CIs) for each quartile were 0.85 (0.78–0.92), 0.73 (0.67–0.81), and 0.67 (0.60–0.75), respectively. Conclusion Higher urinary potassium excretion and potassium intake were associated with lower risk of incident CKD.

Plasma amino acid signatures define types of pediatric diabetes

Metabolic biomarkers with pathophysiological relevance is lacking in pediatric diabetes. We aimed to identify novel metabolic biomarkers in pediatric type 1 (T1D) and type 2 diabetes (T2D). We hypothesized that (1) targeted plasma metabolomics, focused on plasma amino acid concentrations, could identify distinctively altered patterns in children with T1D or T2D, and (2) there are specific changes in concentrations of metabolites related to branch chain amino acids (BCAA) and arginine metabolism in children with T2D. In a pilot study, we enrolled children with T1D (n=15) and T2D (n=13), and healthy controls (n=15). Fasting plasma amino acid concentrations were measured by ultra-performance liquid chromatography, and compared between the groups after adjustment for confounding factors. The mean age (SD) of participants was 16.4 (0.9) years. There were no group differences in age, gender, race/ethnicity, or 24-h protein intake. Mean BMI percentile was higher in the T2D than the T1D group or controls (p<0.001). The T2D group had lower arginine, citrulline, glutamine, glycine, phenylalanine, methionine, threonine, asparagine and symmetric dimethylarginine (SDMA) but higher aspartate than controls, after adjusting for BMI percentiles (all p<0.05). Children with T2D also had lower glycine but higher ornithine, proline, leucine, isoleucine, valine, total BCAA, lysine and tyrosine than those with T1D after adjusting for confounding factors (all p<0.05). Children with T1D had lower phenylalanine, methionine, threonine, glutamine, tyrosine, asymmetric dimethylarginine (ADMA) and SDMA than controls (all p<0.05). Children with T2D and T1D have distinct fasting plasma amino acid signatures that suggest varying pathogenic mechanisms and could serve as biomarkers for these conditions.

Low-intake dehydration prevalence in non-hospitalised older adults: Systematic review and meta-analysis

Low-intake dehydration amongst older people, caused by insufficient fluid intake, is associated with mortality, multiple long-term health conditions and hospitalisation. The prevalence of low-intake dehydration in older adults, and which groups are most at-risk, is unclear. We conducted a high-quality systematic review and meta-analysis, implementing an innovative methodology, to establish the prevalence of low-intake dehydration in older people (PROSPERO registration: CRD42021241252). We systematically searched Medline (Ovid), Cochrane CENTRAL, Embase (Ovid), CINAHL and Proquest from inception until April 2023 and Nutrition and Food Sciences until March 2021. We included studies that assessed hydration status for non-hospitalised participants aged ≥65 years, by directly-measured serum/plasma osmolality, calculated serum/plasma osmolarity and/or 24-h oral fluid intake. Inclusion, data extraction and risk of bias assessment was carried out independently in duplicate. From 11,077 titles and abstracts, we included 61 (22,398 participants), including 44 in quality-effects meta-analysis. Meta-analysis suggested that 24% (95% CI: 0.07, 0.46) of older people were dehydrated (assessed using directly-measured osmolality >300 mOsm/kg, the most reliable measure). Subgroup analyses indicated that both long-term care residents (34%, 95% CI: 0.09, 0.61) and community-dwelling older adults (19%, 95% CI: 0.00, 0.48) were highly likely to be dehydrated. Those with more pre-existing illnesses (37%, 95% CI: 0.14, 0.62) had higher low-intake dehydration prevalence than others (15%, 95% CI: 0.00, 0.43), and there was a non-significant suggestion that those with renal impairment (42%, 95% CI: 0.23, 0.61) were more likely to be dehydrated than others (23%, 95% CI: 0.03, 0.47), but there were no clear differences in prevalence by age, sex, functional, cognitive or diabetic status. GRADE quality of evidence was low as to the exact prevalence due to high levels of heterogeneity between studies. Quality-effects meta-analysis estimated that a quarter of non-hospitalised older people were dehydrated. Widely varying prevalence rates in individual studies, from both long-term care and community groups, highlight that dehydration is preventable amongst older people. One in every 4 older adults has low-intake dehydration. As dehydration is serious and prevalent, research is needed to better understand drinking behaviour and assess effectiveness of drinking interventions for older people.

RAASi Therapy Attenuates the Association between 24-h Urinary Potassium Excretion and Dietary Potassium Intake in CKD Patients.

The aim of this study was to evaluate urinary potassium (K) excretion as a reliable marker of dietary K intake, in a cohort of CKD patients with or without Renin-Angiotensin-Aldosterone System (RAAS) inhibitor therapy. One hundred and thirty-eight consecutive out-patients (51 f and 87 m) aged 60 ± 13 years and affected by CKD stage 3-4, who were metabolically and nutritionally stable, entered the study between November 2021 and October 2022. No difference was observed between patients with (n = 85) or without (n = 53) RAAS inhibitor therapy, regarding dietary intakes, blood biochemistry, and 24-h urine excretion parameters. Considering all patients, urinary K showed a weak relationship with eGFR (r = 0.243, p < 0.01), and with dietary K intake (r = 0.184, p < 0.05). Serum K was not associated with dietary K intake, but an inverse relationship was observed with eGFR (r = -0.269, p < 0.01). When patients were examined depending on whether they were receiving RAAS inhibitor therapy, the weak inverse relationship between serum K and eGFR was maintained in both groups. Conversely, urinary K excretion remained positively associated with dietary K intake only in the no RAAS inhibitor group. In conclusion, 24-h urine K excretion may be used as a surrogate of K intake, but RAAS inhibitor therapy reduces the association between 24-h urine K excretion and dietary K intake in CKD patients.

28 Effects of low-dose electrolyte supplementation to university horses in light to moderate exercise

Electrolyte supplementation is a frequent practice in human and equine athletes, as exercise in hot and humid weather can exacerbate electrolyte and fluid losses. Previous equine electrolyte research has focused on supplementation of horses in heavy or very heavy workloads with limited research in horses in light to moderate workloads. The objective of this research was to determine if a low-dose electrolyte supplement would benefit university horses in light to moderate exercise during hot and humid weather, with the intention to elucidate information regarding electrolyte supplementation to other lesson programs or horse owners. The study covered 5 consecutive weekdays during mid-September in Murfreesboro, Tennessee, with record high temperatures (33 to 37°C) and humid weather. Eleven mature stock-type horses from the Middle Tennessee State University teaching and research herd were selected for the study, with 5 horses assigned to the treatment group and 6 horses assigned to the control group. Treatment horses received a low-dose oral electrolyte supplement daily for 5 d comprised of 0.07g NaCl/kg of body weight (BW) and 0.02g KCl/kg BW, and control horses received 0.09g/kg BW granulated sugar as a placebo. All horses received their normal diet of Purina Strategy concentrate and prairie grass hay. Measurementsincluded 24-h water intake, fasted blood glucose, and plasma concentrations of sodium, potassium, and chloride. Throughout the week studied, each horse was ridden daily. Riders for each horse were blinded to treatments and completed a Qualtrics survey following each ride to assess their perceptions of horse performance and willingness to work. Data were analyzed using a mixed model with repeated measures or a GLM procedure when appropriate (SAS 9.4) with significance set at P < 0.05. Rider-perceived horse fatigue (P = 0.23) and willingness (P = 0.47) were not different between treatments. Day had an effect on water consumption (P < 0.01), with average water consumption peaking at 37L on d 3 with the highest ambient temperature (37°C), while treatment did not affect water consumption (P = 0.94). Treatment did not affect horse weight (P = 0.66), or serum levels of sodium (P = 0.18), potassium (P = 0.92), and chloride (P = 0.26). Average blood glucose tended to be higher in control animals (P = 0.06), however they were receiving granulated sugar as a placebo. These results suggest that horses in light to moderate work receiving a commercial concentrate may not require additional low-dose electrolyte supplementation.