Inadequate Dietary Intake Research Articles

Causes of Nutritional Anemia in Adolescent Children

Amaç: Anemi çocukluk döneminde en sık 6 ay–2 yaş ile adolesan dönemde görülmektedir. Adolesan yaş grubunda anemi en sık hızlı büyüme ve diyet ile yetersiz alım nedeni ile gelişmekte olup, beslenme ile ilişkili anemi toplumumuzda sık görülmektedir. Çalışmamızda adolesan yaş grubunda nutrisyonel aneminin nedenlerini saptamayı amaçladık.Materyal ve Metot: Dokuz Eylül Üniversitesi Pediatri Anabilim Dalı'nda 01.01.2014-01.07.2015 tarihleri ​​arasında, nutrisyonel anemi tanısı alan 90 çocuk çalışmaya dȃhil edildi. Olgular 10-18 yaş aralığındaydı. Tüm olguların hastane arşiv dosyaları taranarak yaş, cinsiyet, boy, ağırlık, boya göre ağırlık (W/H) ölçümleri hasta veri kayıt formlarına kaydedildi. Ayrıca tanı sonrası olgulara eğitim durumu, anne ve babalarının eğitim durumu, semptomları ve muayene bulguları, kırmızı et, tavuk, balık, meyve, kuru baklagil, yumurta, yeşil yapraklı sebze gibi besinleri tüketim sıklığını içeren bir anket doldurtuldu. Bulgular: Veriler uygun istatistik testler kullanılarak değerlendirildi. Çalışmaya 10-18 yaşları arasında 90 olgu dȃhil edildi. 87 olguda demir eksikliği anemisi saptandı. 3 olguda B12 eksikliği anemisi saptandı. Hastaların yeterli miktarda demirden zengin yiyecek almadığı görüldü. Özellikle kırmızı et tüketiminde %91’inin yetersiz olduğu tespit edildi. Sonuç: Adolesanların izlemde mutlaka nutrisyonel anemi riski açısından değerlendirilmesi gerektiği ve koruyucu hekimlik uygulamalarına da yer verilmesi gerektiği düşünülmüştür.

The Impact of Serum Zinc Levels on Abdominal Fat Mass in Hemodialysis Patients.

Background: Zinc deficiency is highly prevalent and is caused by inadequate dietary intake, malabsorption and removal by treatment in hemodialysis patients. This study investigated the relationship between serum zinc levels and nutritional status in hemodialysis patients. Methods: A cross-sectional study examining 87 hemodialysis patients was performed. The serum concentrations of zinc were studied to evaluate their association with nutritional status, which was assessed by measuring abdominal muscle and fat areas with computed tomography. Results: Serum zinc levels were significantly and positively correlated with subcutaneous and visceral fat areas (r = 0.299, p < 0.01, and r = 0.298, p < 0.01, respectively), but not abdominal muscle areas. Multiple regression analyses demonstrated that serum zinc levels were a significant independent predictor of visceral fat areas (p < 0.01), but not subcutaneous fat areas (p = 0.631). Conclusions: Our findings suggest that serum zinc levels could play a crucial role in determining abdominal fat mass in hemodialysis patients.

Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease.

Nutrient deficiencies are well recognized as secondary consequences of celiac disease (CD) and closely related to the clinical presentation of affected patients. Despite their clinical significance, consensus is lacking on the pattern and frequency of nutrient deficiencies in CD, the usefulness of their assessment at the time of diagnosis and during follow-up. This review aims to provide an overview of nutrient deficiencies among pediatric and adult CD patients at diagnosis and on a gluten-free diet (GFD), and their potential causes in CD. Secondly, we review their impact on CD management strategies including the potential of nutrient supplementation. A search of Medline, Pubmed and Embase until January 2019 was performed. Despite a high variability between the reported deficiencies, we noted that nutrient deficiencies occur frequently in children and adults with CD at diagnosis and during treatment with a GFD. Both inadequate dietary intake and/or diminished uptake due to intestinal dysfunction contribute to nutrient deficiencies. Most deficiencies can be restored with (long-term) treatment with a GFD and/or supplementation. However, some of them persist while others may become even more prominent during GFD. Our results indicate a lack of comprehensive evidence on the clinical efficacy of nutrient supplementation in CD management highlighting the need for further studies.

Carnitine Profile Changes in Pediatric Hematopoietic Stem Cell Transplant: New Role for Carnitine?

Carnitine is an essential cofactor for mitochondrial import and oxidation of fatty acids. High-dose chemotherapy and radiation, often required for hematopoietic stem cell transplant (HSCT), leads to tissue damage, mitochondrial dysfunction, and alterations in carnitine metabolism. The aim of this pilot cohort study was to describe plasma and urinary carnitine profiles during pediatric HSCT and their relationships with clinical outcomes. Plasma and urinary carnitine samples were collected from 22 pediatric patients before and through day 180 post-HSCT. Associations were observed between graft-versus-host disease and an elevated plasma total carnitine (P=0.019), and also increased plasma acyl:free carnitine ratio with veno-occlusive disease (P=0.016). Mortality was observed in those with their highest urinary total carnitine losses on day 0 (P=0.005), and in those with an abnormal day 28 plasma ratio either above or below the reference range (P=0.007). Changes in carnitine profiles were more reflective of metabolic stress and negative outcomes than of inadequate dietary intake. Associations observed direct larger studies to assess the validity of carnitine profiles as a prognostic indicator and also to assess whether prophylactic carnitine supplementation pre-HSCT could reduce mitochondrial injury and urinary losses and help mitigate inflammatory and metabolic comorbidities of HSCT.

Nutritional adequacy and dietary disparities in an adult Caribbean population of African descent with a high burden of diabetes and cardiovascular disease.

The Caribbean island of Barbados has a high burden of diabetes and cardiovascular disease. Dietary habits were last described in 2005. A representative population‐based sample (n = 363, aged 25–64 years) provided two nonconsecutive 24‐hr dietary recalls in this cross‐sectional study. Mean daily nutrient intakes were compared with the Dietary Guidelines for Americans. Subgroup differences by age, sex, and educational level were examined using logistic regression. High sugar intakes exist for both sexes with 24% (95% CIs 18.9, 30.0) consuming less than the recommended <10% of energy from added sugars (men 22%; 15.0, 31.6; women 26%; 18.9, 33.7). Sugar‐sweetened beverages provide 43% (42.2%, 44.4%) of total sugar intake. Inadequate dietary fiber intakes (men 21 g, 18.2, 22.8; women 18 g, 16.7, 18.9) exist across all age groups. Inadequate micronutrient intake was found in women for calcium, folate, thiamine, zinc, and iron. Older persons (aged 45–64 years) were more likely to report adequacy of dietary fiber (OR = 2.7, 1.5, 4.8) and iron (OR = 3.0, 1.7, 5.3) than younger persons (aged 25–44). Older persons (aged 45–64 years) were less likely to have an adequate supply of riboflavin (OR = 0.4, 0.2, 0.6) than younger persons. Men were more likely to have adequate intakes of iron (OR = 13.0, 6.1, 28.2), folate (OR = 2.4, 1.3, 4.6), and thiamine (OR = 3.0, 1.5, 5.0) than women. Education was not associated with nutrient intake. The Barbadian diet is characterized by high sugar intakes and inadequate dietary fiber; a nutrient profile associated with an increased risk of obesity, type 2 diabetes, and related noncommunicable diseases.

Effect of L-Carnitine on Amino Acid Metabolism in Elderly Patients Undergoing Regular Hemodialysis

Introduction: Among patients regularly undergoing hemodialysis, hypocarnitinaemia often develops as a consequence of inadequate dietary intake, reduced synthesis in the body, and considerable losses during hemodialysis. Objectives: To evaluate the effects of L-carnitine supplementation on patients with end-stage kidney disease (ESKD) who underwent hemodialysis. Methods: Thirty-one patients with ESKD, comprising 18 men and 13 women, with a median age of 72 (range 58–89) years, who underwent regular hemodialysis received treatment with L-carnitine for 1 year. The total and free carnitine, acylcarnitine, and amino acids (AA) levels before and after L-carnitine treatment were analyzed, and the blood biochemistry results and clinical profiles of the subjects were compared before and after treatment. Results: The median (interquartile range [IQR]) serum total and free carnitine and acylcarnitine levels significantly increased from 34.5 (28.2–44.3), 20.9 (15.8–27.6), and 14.1 (11.2–17.6) µmol/L, respectively to 407.4 (371.6–493.5), 270.2 (228.3–316.0), and 155.0 (136.1–168.5) µmol/L, respectively, after treatment (all p < 0.001). The median (IQR) blood valine, tyrosine, phenylalanine, and citrulline levels increased from 0.94 (0.80–1.09), 0.45 (0.39–0.55), 0.61 (0.56–0.79), and 1.04 (0.79–1.26) mg/dL, respectively to 1.24 (1.13–1.54), 0.76 (0.62–0.85), 0.90 (0.70–1.04), and 1.22 (0.92–1.39) mg/dL, respectively, following L-carnitine treatment (p < 0.001, p < 0.001, p = 0.002, and p = 0.030, respectively); however, the median (IQR) blood arginine level decreased from 0.20 (0.13–0.24) to 0.09 (0.06–0.14) mg/dL after treatment (p < 0.001). The median (IQR) percentage fractional shortening (41.5 vs. 41.9%; p = 0.012) and left ventricular ejection fraction (65.2 vs. 67.3%; p = 0.036) increased significantly following treatment. Conclusions: L-Carnitine increased the blood acylcarnitine levels, enhanced fatty acid metabolism, and affected AAs metabolism; this may be beneficial for energy production within the cardiac and skeletal muscles.

A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection.

Immune support by micronutrients is historically based on vitamin C deficiency and supplementation in scurvy in early times. It has since been established that the complex, integrated immune system needs multiple specific micronutrients, including vitamins A, D, C, E, B6, and B12, folate, zinc, iron, copper, and selenium, which play vital, often synergistic roles at every stage of the immune response. Adequate amounts are essential to ensure the proper function of physical barriers and immune cells; however, daily micronutrient intakes necessary to support immune function may be higher than current recommended dietary allowances. Certain populations have inadequate dietary micronutrient intakes, and situations with increased requirements (e.g., infection, stress, and pollution) further decrease stores within the body. Several micronutrients may be deficient, and even marginal deficiency may impair immunity. Although contradictory data exist, available evidence indicates that supplementation with multiple micronutrients with immune-supporting roles may modulate immune function and reduce the risk of infection. Micronutrients with the strongest evidence for immune support are vitamins C and D and zinc. Better design of human clinical studies addressing dosage and combinations of micronutrients in different populations are required to substantiate the benefits of micronutrient supplementation against infection.

Knowledge and awareness of folic acid usage in Saudi pregnant women in Riyadh city from 2019-2020.

Background:Folic acid (FA) supplementation is an important intervention to avoid nutritional deficiencies during pregnancy and later on will have an effect on mother and fetus. Inadequate dietary intake will lead to nutritional deficiency which further requires to depend on supplementation. FA is one of the vital nutrients which is mandatory for improving pregnancy outcomes. Previous studies have documented the pregnant women who know about supplementation of FA but not consuming during pregnancy will lead to complications in their neonates. This study aimed to inspect the knowledge and awareness about supplementation of FA in Saudi pregnant women and to compare present study results with other prior studies carried out in the Saudi population.Methods:In this study, we have opted 406 Saudi pregnant women with the age range of 18–65 years of age through questionnaire-based research, was further assessed for FA supplementation usage during the pregnancy. Involved pregnant women have filled questionnaire and signed the consent form.Results:The results of this study showed 38% of women were pregnant during 31–40 years of the age range. Almost 96% of pregnant women have awareness about FA supplementation during pregnancies, and 5.9% of women had histories for not using FA supplementation and had abnormal offspring. The current study questionnaire survey confirms 55.7% of pregnant women have information about FA supplementations. Nearly 89% of women have used FA in their previous pregnancies.Conclusion:Saudi pregnant women has good knowledge and awareness about the usage of FA supplementation during pregnancy. Limited efforts should be implemented national wide in all the hospitals and clinics to improve the awareness about maternal nutrition during pregnancy. Nutritional counselling should be conducted in remote areas to get a perception in Saudi Arabia.

A landscape of micronutrient status in women through the reproductive years: Insights from seven regions in Asia.

Optimal micronutrient status is critical to the health of women, particularly during their reproductive years. A woman’s health and nutritional status during the preconception stage thus has significant implications for pregnancy outcomes and her offspring’s health later in life. In this review, we evaluated micronutrient intakes and status (iron, folate, and vitamin B12) of women in their reproductive years and during pregnancy, along with associated health consequences and dietary causes, across seven regions in Asia, namely, Hong Kong, Indonesia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. A structured literature search, targeting peer-reviewed publication databases, as well as data from international and national sources in the public domain, was conducted. Our review of the nutritional landscape demonstrates that micronutrient deficiency–related conditions, especially anemia and its associated health consequences, are common among Asian women of reproductive age, yet the dietary causes are poorly studied. Inadequate or borderline dietary intake of micronutrients and low consumption of micronutrient supplements were evident, despite existing recommendations, food fortification, and supplementation strategies. Evaluation of current programs through nutrition monitoring and improvement of supplementation strategies, such as supplementing with multiple micronutrients, alongside food-based programs, will help better support the health of women through their reproductive years.

Nutritional risk markers among stroke out-patients at the neurology clinic of a teaching hospital in Ghana.

Introductionstroke survivors are at risk of malnutrition due to inadequate dietary intake, as a result of neurological disorders causing dysphagia, depression and impaired ability to self-feed. There is paucity of information on nutritional status of stroke survivors after discharge from hospital care, hence, this study sought to determine the nutritional risk markers among stroke out-patients at the Neurology Clinic of Komfo Anokye Teaching Hospital, Kumasi, Ghana.Methodsa cross-sectional study was conducted among 106 stroke survivors at Komfo Anokye Teaching Hospital, Kumasi, Ghana. Nutritional status of stroke survivors was assessed, using body mass index (BMI) and mid upper arm circumference (MUAC). Biochemical and haematological nutrition indicators including total serum protein, serum albumin, total lymphocyte count, uric acid and haemoglobin were also determined. Independent t-test and ANOVA were used to test differences between mean values.Resultsthe mean age of study participants was 58.47±14.2 years, with 56% being females. Overall, 96 (88.7%) of the participants had malnutrition, of whom 66 (68.8%) were undernourished, while 30 (31.2%) had overnutrition. It was also found that 38.7% of the participants were anaemic, based on haemoglobin levels. Using mean BMI, stroke survivors who had been discharged over five years were significantly overweight (p = 0.010).Conclusionthere was high level of malnutrition among stroke out-patients in this study. The most common nutrition-related problem in the stroke survivors studied was anaemia. Findings from this study suggest the need for nutrition intervention strategies to address the high burden of malnutrition among the stroke survivors.

Association between antioxidant vitamins and oxidative stress among patients with a complete hydatidiform mole

OBJECTIVES:This study aimed to evaluate the potential relationship between oxidative stress, dietary intake, and serum levels of antioxidants in patients with a complete hydatidiform mole (CHM) compared with controls.METHODS:This was an observational cross-sectional study conducted in Rio de Janeiro, Brazil. A total of 140 women were enrolled in this study and divided into four groups: 43 patients with CHM, 33 women who had had an abortion, 32 healthy pregnant women, and 32 healthy non-pregnant women. All participants underwent blood sampling, assessment using a semiquantitative food frequency questionnaire, and anthropometric measurement. Blood samples were collected after overnight fasting (10-12 h). Vitamin levels (A, C, and E) were determined by ultra-performance liquid chromatography, and gamma-glutamyl transferase levels were assessed using an automated quantitative analysis system (Dimension®, Siemens).RESULTS:Although all groups showed sufficient serum vitamin A and E levels, the participants had inadequate dietary intake of these vitamins. Conversely, all groups had an insufficient serum level of vitamin C, despite adequate intake. The gamma-glutamyl transferase values did not differ significantly among the groups. However, elevated serum levels of this enzyme were observed in several patients.CONCLUSIONS:All groups exhibited high levels of oxidative stress, as evaluated by gamma-glutamyl transferase levels, and had inadequate intake of antioxidant vitamins. Therefore, the high exposure to oxidative stress found in our study, even in healthy pregnant and non-pregnant women, may increase the incidence of CHM in this region.

Modifiable Behavioral Risk Factors Associated with Biological Risk Factors in Subjects at Risk of Type 2 Diabetes in Benin: PREDIBE Study

Introduction: Type 2 diabetes is a major public health problem worldwide. This study aimed at identifying modifiable behavioral risk factors associated with biological factors in people at risk of type 2 diabetes which could be targeted in the design and implementation of appropriate interventions to prevent the disease. Methods: 180 subjects at risk of type 2 diabetes (aged 15 - 60 years) were identified and selected at random during a preliminary survey conducted in two groups of villages in northeastern Benin. The study took part on August 2017. Questionnaires were administered to consenting subjects; anthropometric measurements taken and blood samples withdrawn. Blood samples were subjected to biochemical testing according to standard protocols. Results: Data was obtained from 180 subjects at risk of type 2 diabetes. The average age of the subjects was 42.76 ± 11.30 years. Multivariate analysis showed inadequate dietary intake score, low physical activity and tobacco use as behavioral factors significantly associated with high waist circumference, high blood sugar, low HDL cholesterol, high triglyceride levels and high body fat percentage. Conclusion: There is a possible association between biological and behavioral risk factors.

Influence of food consumption in the glycemic profile of children and adolescents with type 1 diabetes Mellitus

ABSTRACT Objective To review the dietary intake of children and adolescents with type 1 diabetes Mellitus and its association with the glycemic profile. Methods Longitudinal observational study. Dietary intake was measured using a three-day dietary record and the glycemic profile with a continuous glucose monitoring (range between 70 and 180mg/dL) and serum glycated hemoglobin levels (ideal &lt;7.5%). Anthropometric data, insulin therapy, and carbohydrate counting were collected. Results The sample included 34 individuals with type 1 diabetes Mellitus aged 13.6±2.1 years. The majority of the population was eutrophic (76.4%). The entire sample used the basal-bolus insulin regimen, with mean insulin dose of 1.0±0.2U/kg/day; for 44.1% of the sample the carbohydrate counting method was used. Macronutrients intake was adequate in only 8.8% of the individuals, the highest frequency of inadequacy was related to carbohydrates (p=0.07). Inadequate glycemic control with hyperglycemia episodes and high mean glycated hemoglobin (9.7%) was observed in all individuals (61.3±18.5%). Carbohydrate counting was responsible for maintaining the percentage of time that the patient had interstitial blood glucose values within the range &gt;40% (p&lt;0.001) and maintaining the percentage of time in hyperglycemia &lt;50% (p&lt;0.001). Conclusion The majority of individuals were eutrophic, but presented inadequate dietary intake and glycemic control. The method of counting carbohydrates positively influenced the glycemic profile.

Assessment of Dietary Behavior of Children Aged between 3-12 Years Suffering from Thalassemia Visiting Tertiary Care Hospitals, Lahore

Thalassemia is a hereditary blood disorder passed down through families in which the body makeshemoglobin in an abnormal form. Nutritional deficiencies in thalassemia children results in anemia andother medical complications. Objective: To assess dietary behavior of children aged between 3-12 yearssuffering from thalassemia. Methods: A cross-sectional study was carried out in the outdoor patientdepartment of thalassemia at Sir Ganga Ram Hospital, Lahore for 4 months.100 patients were selectedthrough non probability sampling technique. Data was tabulated and analyzed by SPSS version 21.0.Results: Thalassemia was more prevalent in the age group of 8-12 years. Nutritional deficiencies inthalassemia patients caused anemia as it was evident from results that 74% of thalassemic children hadpale skin. As far as dietary intake was concerned only 4% of thalassemia children were consuming meatand meat products.58% of thalassemia children consumed milk on daily basis. Only 8% took green leafyvegetables on daily basis as it contains high amount of iron. Micro nutrient deficiencies as vitamin A, Cwere common among thalassemia patients as only 30% were consuming fruits on daily basis.Conclusions: Most of the thalassemiacchildren were found to be malnourished due to inadequatedietary intake. The caregivers and parents should be counseled to create awareness

Selenium deficiency risk in central Kenya highlands: an assessment from the soil to the body.

Selenium (Se) deficiency is associated with increased risk of clinical disorders. Yet, it has not been considered as an important public health issue in Africa. The health burden of this 'hidden hunger' remains largely unknown. Using a case study of central Kenya highlands, a cross-sectional survey assesses Se status of agricultural soils, foods, hair, and actual average dietary Se intake of the local population and investigates the soil-food Se concentration and Se intake-individual Se status relationships. The survey examines eight locations characterized by different agricultural soil types and assesses average dietary Se intake among 159 children and 111 women based on 24-h dietary recall data. Soil Se concentration does not explain Se concentration in foods, which instead is associated with soil's pH, organic matter, and P and Fe content. Cereal grains, beans and potato/green banana form a large portion of the local diet while intake of animal-based foods is limited. This results in Se intake of 15 and 33µgp-1d-1 for children and women, respectively. On average, 87% of children and 97% of women have inadequate average daily dietary Se intake, and the hair Se concentration of 92% children and 94% women is below the reference values. Soil's characteristics contribute to variation in Se concentration in foods and consequently the dietary Se intake. A low diversified diet is a key contributing factor to inadequate dietary Se intake in the region. These findings call for the need to investigate potential intervention measure and the health burden of Se deficiency.

Meal patterns in relation to energy and protein intake in older adults in home health care

Inadequate dietary intake is common in frail elderly people, however knowledge of meal patters and their relation to dietary intake is scarce, but is important for planning meals and nutritional prevention and interventions. The aim of this study was to describe meal patterns and the relation to energy and protein intake in elderly people in home health care. In this cross-sectional study, 69 men and women ≥65 years old with a lasting need for home health care were included. A 24-hour recall was used to analyse meal patterns as well as intake of energy and protein. Meal patterns were analysed in terms of number of eating occasions, time of the first, and the last meal each day, length of the overnight fast, timing of the energy and protein intake, energy content and time for the largest meal of the day, and classification as an early or late eater. In this population, 77% had four or five eating occasions per day. The median length of the overnight fast was 13h and 87% of participants had an overnight fast of >11h. Regarding the timing of the energy and protein intake, there were three peaks: in the morning, mid-day and in the evening. The mid-day meal was the most important eating occasion regarding total energy intake; mid-day was also the time of the day when most participants had a protein intake >20g. The majority (60%) of participants were categorized as early eaters. Neither the number of eating occasions nor the length of the overnight fast was correlated with energy or protein intake; however, a large energy intake from the largest meal of the day was significantly correlated with an increased total energy and protein intake, indicating that daily energy intake is stimulated by at least one large meal per day. This study showed that one large meal a day had more impact on daily energy and protein intake than did several eating occasions or a short overnight fast in elderly people in home health care. Further research is needed to elucidate how to stimulate large energy intake at main meals to stimulate daily energy and protein intake.

Dietary intakes and biomarker patterns of folate, vitamin B6, and vitamin B12 can be associated with cognitive impairment by hypermethylation of redox-related genes NUDT15 and TXNRD1

BackgroundB vitamins in the one-carbon metabolism pathway (folate, vitamin B6, and vitamin B12) have been implicated in DNA methylation, and their deficiency may contribute to cognitive decline through increased homocysteine (Hcy) levels and subsequent oxidative damage. The aim of this study was to investigate whether B vitamin deficiency and increased Hcy could interact with DNA methylation of oxidative-related genes and exacerbate cognitive impairment.MethodsParticipants were selected from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer’s disease (EMCOA) study. We included 2533 participants who completed a selection of comprehensive cognitive tests and a semiquantitative food frequency questionnaire (FFQ) and were followed for an average of 2.3 years. The longitudinal effects of B vitamin intake on cognitive decline were examined using linear mixed-effect models. Seven mild cognitive impairment (MCI) patients, in the predementia stage of Alzheimer’s disease (AD), and fivev healthy controls were selected for the discovery of genome-wide differentially methylated CpG sites. Candidate oxidative stress-related genes significantly correlated with serum levels of B vitamins were selected for validation in 102 MCI patients and 68 controls. The correlations between DNA methylation levels and serum concentrations of B vitamins and oxidative biomarkers were analyzed with Spearman’s correlation. The interactive effects of DNA methylation and B vitamins on cognitive performance were further evaluated by multiple linear regression.ResultsIn the prospective analysis, inadequate dietary intake of vitamin B12 was significantly associated with accelerated cognitive decline, whereas adequate folate, vitamin B6, and vitamin B12 intakes were significantly associated with better cognitive reserve. In the case-control analysis, the DNA methylation levels of NUDT15 and TXNRD1 were examined, and significantly hypermethylated sites were identified in MCI patients. Significant correlations of hypermethylated sites with serum levels of folate, homocysteine (Hcy), and oxidative biomarkers were observed, and interactive effects of B vitamins and hypermethylated sites were significantly associated with cognitive performance.ConclusionAdequate dietary folate at baseline predicted a better cognitive reserve, while decreased serum levels of B vitamins may contribute to cognitive impairment by affecting methylation levels of specific redox-related genes.Trial registrationEMCOA, ChiCTR-OOC-17011882, Registered 5th, July 2017-Retrospectively registered, http://www.medresman.org/uc/project/projectedit.aspx?proj=2610Graphical

A physiological dose of oral vitamin B-12 improves hematological, biochemical-metabolic indices and peripheral nerve function in B-12 deficient Indian adolescent women.

BackgroundVitamin B-12 deficiency is often considered synonymous with pernicious anemia, a rare condition in which severe malabsorption of the vitamin requires high-dose parenteral treatment. In developing countries such as India, inadequate dietary intake of B-12 due to socio-cultural factors leads to widely prevalent asymptomatic low B-12 status. In this scenario, lower doses of oral B-12 may be effective, safer and more affordable.ObjectiveTo examine the effects of oral B-12 treatment at physiological doses on hematological and biochemical indices and peripheral nerve function in B-12 deficient rural Indian adolescent women.MethodsThirty-nine women with B-12 deficiency who were excluded from a community based B-12 supplementation trial (Pune Rural Intervention in Young Adolescents (PRIYA)) received oral B-12 2μg/day, either alone (n = 19) or with multiple micronutrients (UNIMAPP formula + 20gm milk powder, n = 20) for 11 months. Hematological indices, nutrients (B-12, folate), metabolites (homocysteine) and peripheral nerve function (SUDOSCAN, Impetomedical, Paris and sensory nerve conduction velocity (NCV) of median and sural nerves) were assessed at baseline and after 11 months of B-12 treatment.ResultsResults were similar in the two treatment allocation groups, which were therefore combined. At baseline, all women had B-12 concentration <100pmol/L, 79% were anemic and 33% had macrocytosis, but none had neuropathy. After 11 months of treatment, B-12 levels increased, while folate did not change. The prevalence of anemia fell to 59% and mean corpuscular volume (MCV) and plasma homocysteine concentrations decreased. Sudomotor nerve function in the feet improved by an average of 14.7%, and sensory conduction velocity in median and sural nerves increased by 16.2% and 29.4% respectively.ConclusionWe document clinically beneficial effects of supplementation with a physiological dose of oral B-12 in asymptomatic rural Indian adolescent women with very low B-12 status. These findings support a public health approach to tackle the widely prevalent low B-12 status in young Indians.

Periodontitis and intake of thiamine, riboflavin and niacin among Korean adults.

Adequate intake of vitamin B complex could be prerequisite to health. However, few studies have been reported on the association of thiamine (vit B1 ), riboflavin (vit B2 ) and niacin (vit B3 ) with periodontal health. This study described the association between periodontal health and dietary vit B1 , vit B2 and vit B3 intake in the Korean population. A total of 12750 adults aged over 19years were selected for this study as a sub-sample of the national data set from Korean National Health and Nutrition Examination Survey (IV and V). Periodontitis and gingivitis were defined as Community Periodontal Index (CPI) scores of 3-4 and 1-2, respectively. Information on dietary vit B1 , vit B2 and vit B3 intake was from 24-hour dietary recall method. Multivariable complex logistic regression analyses estimated association between vit B1 , vit B2 and vit B3 intakes and periodontal health after adjusting for various potential confounders. Stratified analyses by age, sex, dyslipidemia and total energy intake were also undertaken. The overall estimated prevalence of periodontitis (CPI 3-4) and gingivitis (CPI 1-2) was 29.9% and 46.6%, respectively. Our data showed none of the inadequate intake of vit B1 , vit B2 and B3 showed significant association with gingivitis after adjusting for potential confounders. Inadequate intake of vit B3 showed higher prevalence odds of periodontitis by 1.25 times (adjusted odds ratio=1.25, 95% CI=1.07-1.46). The association of vit B3 with periodontitis was stronger in females and participants aged 40-59years. Inadequate dietary intake of vit B3 was associated with periodontitis.

1808P - Taste and smell alterations (TSAs) in patients (pts) with stage II-III colon cancer (CC): A pilot within the PROTECT study

BackgroundTSAs are common side effects among cancer pts undergoing chemotherapy and may lead to inadequate dietary intake and reduced quality of life. Here, we investigate the incidence of multiple components of self-reported TSAs and its etiological determinants in a homogeneous group of pts with stage II-III CC. MethodsWe used data collected in an ongoing observational study within the Prospective Dutch Colorectal Cancer Cohort, designed to study nutritional factors and oncological outcomes. Pts receive questionnaires on dietary intake by food-frequency questionnaire (past month average intake), dietary supplement use and TSAs at diagnosis (T0), and at 6, 12, 24 months post-diagnosis. Here, we selected pts with stage II-III CC, with completed T6 questionnaires and available clinical data. ResultsWe included 87/468 pts for analysis (updated for ESMO) with a mean age 64.0±7.6 years, 70% male and 70% current/former smokers. Adjuvant chemotherapy (ACT), received by 52% of pts, consisted of CAPOX (90%), FOLFOX (5%), or CAP (5%) as initial regimen. TSAs were reported at T0 (4% of pts) and at T6 (32% of pts). TSA presence was significantly related to receiving ACT (RR 13.8, 95%CI: 3.5-54.3), but not to age, sex, education and smoking status. ACT treated pts more often reported a change in taste ability (49%, p<0.001), change in taste perception (51%, p<0.001), dry mouth (29%, p<0.001), bad taste (38%, p<0.001), and metallic taste (18%, p=0.006), compared to pts who did not receive ACT. Pts with TSAs did not significantly differ from pts without TSAs in terms of caloric intake at T6 (p=0.69). Caloric intake was low (no-TSA (n=59) 1772kCal and TSA (n=28) 1809kCal) and was below the ESPEN guidelines on nutrition in cancer patients for both groups. ConclusionsTSAs are more prevalent in CC pts who received ACT compared to pts who did not, with taste more affected than smell. Pts had caloric intake below guideline recommendations at T6. The influence of TSAs on caloric intake appears to be limited when caloric intake is already insufficient. More pts, follow-up, and data on macronutrients and quality of life are needed to confirm and enrich these preliminary findings and ultimately help improve supportive care. Legal entity responsible for the studyUniversity Medical Center Utrecht. FundingProvince of Utrecht, The Netherlands. DisclosureB. Dorresteijn: Full / Part-time employment: Danone Nutricia Research. M. Jourdan: Full / Part-time employment: Danone Nutricia Research. All other authors have declared no conflicts of interest.