Food Intake Research Articles

Annual Prize Lecture 2024: Endogenous physiological mechanisms as basis for the treatment of obesity and type 2 diabetes

AbstractIn 1964, it was proven that postprandial insulin secretion is largely regulated by gut hormones and, in 1973, it was proposed that a gut hormone would also regulate appetite and food intake. Several gut hormones were tested for metabolic actions with disappointing results until the discovery of the proglucagon derivative, glucagon‐like peptide‐1 (GLP‐1). This peptide from the distal intestine has preserved activity on insulin secretion in people with type 2 diabetes and turned out to regulate both secretion and motility in the gastrointestinal tract and importantly, appetite and food intake, thus functioning as an efficient ‘ileal brake’ hormone. However, the natural hormone acts predominantly via sensory afferent systems and is extremely rapidly removed from the circulation by enzymatic degradation and renal elimination, and increasing the doses merely results in nausea and vomiting. Lipidation of analogs turned out to provide both stability and limit renal elimination, and very slow up‐titration of dosing improves tolerance. Indeed, the most recent agonists may near‐normalize glycaemic control in type 2 diabetes, may cause weight losses of up to 25% of body weight, and significantly reduce cardiovascular risk, effects that resemble those of bariatric surgery. Thus, a solution to one of the most serious health problems of modern civilization, the increased morbidity and mortality of the metabolic syndrome, may be addressed by mobilization of one of the body's own regulatory mechanisms. image

Hepatic vagal afferents convey clock-dependent signals to regulate circadian food intake

Circadian desynchrony induced by shiftwork or jet lag is detrimental to metabolic health, but how synchronous or desynchronous signals are transmitted among tissues is unknown. We report that liver molecular clock dysfunction is signaled to the brain through the hepatic vagal afferent nerve (HVAN), leading to altered food intake patterns that are corrected by ablation of the HVAN. Hepatic branch vagotomy also prevents food intake disruptions induced by high-fat diet feeding and reduces body weight gain. Our findings reveal a homeostatic feedback signal that relies on communication between the liver and the brain to control circadian food intake patterns. This identifies the hepatic vagus nerve as a potential therapeutic target for obesity in the setting of chronodisruption.

Rhythmic liver drives feeding behavior

The hepatic vagal nerve mediates the impact of circadian disruption on food intake in mice

Weight loss in patients with severe obesity after bariatric surgery–the potential role of the chrono-nutrition, chronotype and the circadian misalignment: A study protocol of the ChronoWise prospective cohort

Background Despite the potential effectiveness of bariatric surgery in promoting weight loss, a considerable proportion of patients still face the challenge of achieving optimal post-surgery outcomes. The timing of eating, in addition to the content of what is eaten, as well as chronotype and social jetlag (a marker of circadian misalignment), have been implicated in weight regulation. However, the current understanding of these chrono-related behaviours in individuals undergoing bariatric surgery is still scarce. Thus, this study aims to evaluate the role of chrono-nutrition, chronotype, and circadian misalignment in the weight-loss trajectory among individuals living with severe obesity who underwent bariatric surgery. Methods The ChronoWise project is a prospective single-centre cohort study designed to follow patients experiencing bariatric surgery at the Santo António Local Health Unit (ULSSA), Porto, Portugal. Participants will be recruited and evaluated at pre-surgery and followed-up over 3 and 6 months after surgery. The baseline evaluation will be conducted face-to-face during the hospital stay and by telephone or video call on the subsequent evaluations, following standard procedures. Data collection includes sociodemographics, food intake, chrono-nutrition behaviours, sleep time behaviour, sleep quality, screen time, physical activity and exercise behaviours, anthropometric measurements, and biochemical parameters. The ‘Munich Chronotype Questionnaire’ will be used to assess chronotype and social jet lag. Chrono-nutrition dimensions will be measured by the ‘Chrononutrition Profile—Questionnaire’ in all evaluations. Weight and height will be self-reported and retrieved from medical registries. trajectories of weight-loss will be obtained. Discussion This study will add important evidence on the role of chrono-nutrition, chronotype and social jetlag profile in weight-loss outcomes after bariatric surgery. Identifying novel approaches to change the paradigm of post-surgical weight management towards a tailored treatment aligned with circadian rhythm may be useful to strengthen the existing treatments and improve patients’ response to bariatric surgery.

Maladaptive Restrictive Food Choice Behavior in Adolescents With Anorexia Nervosa

ABSTRACTObjectiveIndividuals with anorexia nervosa persistently restrict their food intake while often severely underweight. This maladaptive food choice behavior and related decision‐making processes have mainly been investigated in adults. It is unknown whether the same decision‐making processes drive food choices in adolescents, given their more favorable treatment outcomes. This study investigated maladaptive food choice behavior in adolescents with AN and examined whether they display the same decision‐making processes as adults.MethodAdolescents with AN (n = 42) and age‐matched controls (n = 42) completed a computer‐based food choice task, rating food images for healthiness and tastiness before choosing between two food items.ResultsAdolescents with AN chose high‐fat foods less frequently than controls, with food choices more influenced by their perceived “healthiness” and less by their “tastiness” than they did among controls. Relative to controls, adolescents with AN also reported lower overall tastiness ratings and greater habit strength of restrictive eating, which was, however, not related to food choices.DiscussionAdolescents with AN display the same maladaptive food choice behavior as adults, namely the persistent restriction of high‐fat food choices. Their choices were more strongly influenced by the perceived healthiness of a food item, compared to the choices of controls.

Nutritional status of Saudi obese patients undergoing laparoscopic sleeve gastrectomy, one-year follow-up study

Abstract Bariatric surgery has significantly increased globally as an effective treatment for severe obesity. Nutritional deficits are common among candidates for bariatric surgery, and follow-up of nutritional status is critically needed for post-surgery healthcare management. This observational prospective study was conducted at King Khalid University Hospital in Riyadh. Samples were collected pre- and post-laparoscopic sleeve gastrectomy (LSG), with the visit intervals divided into four visits: pre-surgery (0M), 3 months (3M), 6 months (6M) and 12 months (12M). Food intake and eating patterns significantly changed during the first year (P < 0·001). The mean energy intake at 3M post-surgery was 738·3 kcal, significantly lower than the pre-surgery energy intake of 2059 kcal. Then, it increased gradually at 6M and 12M to reach 1069 kcal (P < 0·00). The intake of Fe, vitamin B12 and vitamin D was below the dietary reference intake recommendations, as indicated by the 24-hour dietary recall. The prevalence of 25 (OH) vitamin D deficiency improved significantly from pre- to post-surgery (P < 0·001). Vitamin B12 deficiency was less reported pre-LSG and improved steadily towards a sufficient post-surgery status. However, 35·7 % of participants were deficient in Fe status, with 28·6% being female at higher levels than males. While protein supplementation decreased significantly over the 12M follow-up, the use of vitamin supplements dramatically increased at 3 and 6M before declining at 12M. Fe and vitamin B12 were the most popular supplements after vitamin D. This study confirms the necessity for individualised dietary plans and close monitoring of candidates’ nutritional status before and after bariatric surgery.

ReNeu: A Pivotal, Phase IIb Trial of Mirdametinib in Adults and Children With Symptomatic Neurofibromatosis Type 1-Associated Plexiform Neurofibroma

PURPOSE Pharmacologic therapies for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PNs) are limited; currently, none are US Food and Drug Administration–approved for adults. METHODS ReNeu is an open-label, multicenter, pivotal, phase IIb trial of mirdametinib in 58 adults (≥18 years of age) and 56 children (2 to 17 years of age) with NF1-PN causing significant morbidities. Patients received mirdametinib capsules or tablets for oral suspension (2 mg/m 2 twice daily, maximum 4 mg twice daily), regardless of food intake, in 3 weeks on/1 week off 28-day cycles. The primary end point was confirmed objective response rate (ORR; proportion of patients with a ≥20% reduction of target PN volume from baseline on consecutive scans during the 24-cycle treatment phase) assessed by blinded independent central review (BICR) of volumetric magnetic resonance imaging. RESULTS Twenty-four of 58 adults (41%) and 29 of 56 children (52%) had a BICR-confirmed objective response during the 24-cycle treatment phase; in addition, two adults and one child had confirmed responses during long-term follow-up. Median (range) target PN volumetric best response was –41% (−90 to 13) in adults and –42% (−91 to 48) in children. Both cohorts reported significant and clinically meaningful improvement in patient- or parent proxy-reported outcome measures of worst tumor pain severity, pain interference, and health-related quality of life (HRQOL) that began early and were sustained during treatment. The most commonly reported treatment-related adverse events were dermatitis acneiform, diarrhea, and nausea in adults and dermatitis acneiform, diarrhea, and paronychia in children. CONCLUSION In ReNeu, the largest multicenter NF1-PN trial reported to date, mirdametinib treatment demonstrated significant confirmed ORRs by BICR, deep and durable PN volume reductions, and early, sustained, and clinically meaningful improvement in pain and HRQOL. Mirdametinib was well-tolerated in adults and children.

Assessing Fears of Negative Consequences in Children With Symptoms of Avoidant Restrictive Food Intake Disorder

ABSTRACTObjectiveFear of Aversive Consequences (FOAC), such as choking or vomiting, is an important associated feature of Avoidant/Restrictive Food Intake Disorder (ARFID). However, the manifestation of FOAC in young children is poorly understood. This study aimed to describe the fears of children with ARFID symptoms and examine the concordance between parent and child ratings of fear.MethodChild‐reported FOAC was assessed using an interview designed for children between 6 and 10 years old, the Gustatory Avoidance and Gastrointestinal Stress Symptoms (GAGSS). Parents were administered a semi‐structured diagnostic interview regarding their child's symptoms, the Pica, ARFID, and Rumination Interview.ResultsAmong 68 children with ARFID diagnoses or symptoms (41.2% female, 85.3% White, mean age = 8.2 years, SD = 1.1 years; range 5.2–9.9 years), 91.2% of children endorsed at least one fear relative to 26.5% of parents. Among parent–child dyads, 36.8% disagreed about the child's fear of stomach pain (κ = 0.12) and 48.5% disagreed about the child's fear of vomiting, (κ = 0.08), both indicating low inter‐rater reliability. On average, children endorsed 4.3 (SD = 2.3) fears out of 9 options. The most frequently endorsed fears were that food will “taste bad,” (n = 43, 63.2%), “make you gag” (n = 37, 54.4%), and “look disgusting” (n = 36, 52.9%).DiscussionFindings highlight ways in which fear may manifest in children with ARFID that are not easily discernable by adults. Greater precision in depicting childhood fears may facilitate the earlier detection of problematic eating behaviors.

Improving Enhanced Recovery after Surgery (ERAS): The Effect of a Patient-Centred Mobile Application and an Activity Tracker on Patient Engagement in Colorectal Surgery

Background The Enhanced Recovery After Surgery (ERAS) protocol improved perioperative colorectal care. Although the protocol is firmly implemented across hospital settings, there are benefits to gain by actively involving patients in their recovery. The main objective of this study was to investigate whether compliance with selected items in the ERAS protocol could further improve by using a patient-centred mobile application. Method This multicentre, randomised controlled trial was conducted between October 2019 and September 2022. Patients aged 18 years or older who underwent elective colorectal surgery, and in possession of a smartphone were included. The intervention group used a mobile application combined with an activity tracker to be guided and supported through the ERAS pathway. The control group received standard care and wore an activity tracker to monitor their daily activities. The primary outcome was overall compliance with selected active elements of the ERAS protocol. Results In total, 140 participants were randomised to either the intervention (n = 72) or control group (n = 68). The use of the ERAS App demonstrated a significant improvement in overall compliance by 10%, particularly in early solid food intake by 42% and early mobilization by 27%. Postoperative or patient reported outcomes did not differ between groups. Conclusion The smartphone application ‘ERAS App’ is able to improve adherence to the active elements of the ERAS protocol for colorectal surgery. This is an important step towards optimizing perioperative care for colorectal surgery patients and enabling patients to optimize being in control of their own recovery. Trial registration: ERAS APPtimize, NTR7314 ( https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON29410 ).

Impact of Sleeve Gastrectomy on Body Weight and Food Intake Regulation in Diet-Induced Obese Mice

The epidemic of obesity has increased worldwide and is associated with comorbidities such as diabetes and cardiovascular disease. In this context, strategies that modulate body weight and improve glycemic metabolism have increased, and bariatric surgeries such as Sleeve Gastrectomy (SG) have been highlighted in obesity treatment. However, the mechanism by which SG reduces body weight and improves glycemic control remains unknown. Thus, in this study, we aimed to evaluate food intake and the expression of hypothalamic genes involved with the regulation of this process in diet-induced obese mice submitted to SG. For this, we used C57BL/6 mice submitted to a 10-week high-fat diet protocol and submitted to SG. Food intake, fed and fasted glycemia, as well as hypothalamic anorexigenic and orexigenic gene expression were evaluated 4 weeks after the surgical procedure. First, we observed that SG reduces body weight (44.19 ± 0.47 HFD, 43.51 ± 0.71 HFD-SHAM, and 38.22 ± 1.31 HFD-SG), fasting glycemia (115.0 ± 4.60 HFD, 122.4 ± 3.48 HFD-SHAM, and 93.43 ± 4.67 HFD-SG), insulinemia (1.77 ± 0.15 HFD, 1.92 ± 0.27 HFD-SHAM, and 0.93 ± 0.05 HFD-SG), and leptinemia (5.86 ± 1.38 HFD, 6.44 ± 1.51 HFD-SHAM, and 1.43 ± 0.35 HFD-SG) in obese mice. Additionally, SG reduces food (5.15 ± 0.18 HFD, 5.49 ± 0.32, HFD-SHAM, and 3.28 ± 0.26 HFD-SG) and total (16.88 ± 0.88 HFD, 17.05 ± 0.42, HFD-SHAM, and 14.30 ± 0.73 HFD-SG) calorie intake without alterations in anorexigenic and orexigenic gene expression. In conclusion, these data indicate that SG improves obesity-associated alterations at least in part by a reduction in food intake. This effect is not associated with the canonical food intake pathway in the hypothalamus, indicating the involvement of non-canonical pathways in this process.

Genetic and functional analyses of CTBP2 in anorexia nervosa and body weight regulation

AbstractThe C-terminal binding protein 2 (CTBP2) gene (translational isoforms: CTBP2-L/S, RIBEYE) had been identified by a cross-trait analysis of genome-wide association studies for anorexia nervosa (AN) and body mass index (BMI). Here, we did a mutation analysis in CTBP2 by performing polymerase chain reactions with subsequent Sanger-sequencing to identify variants relevant for AN and body weight regulation and ensued functional studies. Analysis of the coding regions of CTBP2 in 462 female patients with AN (acute or recovered), 490 children and adolescents with severe obesity, 445 healthy-lean adult individuals and 168 healthy adult individuals with normal body weight detected 24 variants located in the specific exon of RIBEYE. In the initial analysis, three of these were rare non-synonymous variants (NSVs) detected heterozygously in patients with AN (p.Arg72Trp - rs146900874; p.Val289Met -rs375685611 and p.Gly362Arg - rs202010294). Four NSVs and one heterozygous frameshift variant were exclusively detected in children and adolescents with severe obesity (p.Pro53Ser - rs150867595; p.Gln175ArgfsTer45 - rs141864737; p.Leu310Val - rs769811964; p.Pro397Ala - rs76134089 and p.Pro402Ser - rs113477585). Ribeye mRNA was detected in mouse hypothalamus. No effect of fasting or overfeeding on murine hypothalamic Ribeye expression was determined. Yet, increased Ribeye expression was detected in hypothalami of leptin-treated Lepob/ob mice. This increase was not related to reduced food intake and leptin-induced weight loss. We detected rare and frequent variants in the RIBEYE specific exon in both patients with AN and in children and adolescents with severe obesity. Our data suggest RIBEYE as a relevant gene for weight regulation.

Changes in per capita and aggregate apparent consumption of livestock-derived foods in Canada from 1960–2020

Abstract Food systems are a major driver of resource depletion and environmental degradation globally, with livestock-derived food production accounting for a disproportionate fraction of these impacts. At the same time, meat, eggs, and dairy products are important sources of protein, energy, and micronutrients in human diets. Higher rates of red and processed meat consumption has, however, also been linked to increased heath risks in high-income countries. Given the important role that livestock-derived foods play in both planetary and human health, it is important to understand patterns in their consumption and how these have changed over time. Here, we report and assess changes in Canadian apparent consumption of livestock-derived foods, as both mass of edible unprocessed products and total contained protein, between 1960 and 2020. We used Statistics Canada food availability data, as it is the closest available proxy for historical consumption data. The animal foods included are dairy, eggs, and chicken, turkey, pork, and beef meat, with results expressed in kilograms of boneless meat, shell-less eggs, and total milk solids per capita per year. Total national apparent livestock food consumption was also calculated, by multiplying annual per capita availability by national population, for each year included in this analysis. Results indicate that, over the last six decades, apparent per capita consumption of livestock-derived foods in Canada has remained surprisingly constant, peaking in the 1970s at 108 kg/person/year, and varying narrowly between 91–101 kg/person/year for the most recent 35 years. The composition of Canadians’ livestock-derived food intake, however, does appear to have changed markedly, with apparent consumption of beef declining since its zenith in the late 1970s, while the apparent consumption of chicken meat has grown rapidly. Substantial reductions in the consumption of livestock foods in Canada are required to stay within planetary boundaries.

Nanowire-like phosphorus modulated carbon-based iron nanozyme with oxidase-like activity for sensitive detection of choline and dye degradation

Choline is mainly supplemented through food intake, lack of choline would result in diseases like liver cirrhosis, hardening of the arteries, or neurodegenerative disorders. The accurate detection of choline is important for human health. Herein, a novel nanowire-like phosphorus/nitrogen co-doped carbon-based iron nanozyme (Fe-NPC) with outstanding oxidase-like activity was synthesized, and the influence of phosphorus doping on oxidase-like activity was explored. Proper phosphorus doping was found to enhance the oxidase-like activity of Fe-NPC by increasing surface defects, promoting iron loading, and modulating chemical environment of central site. The oxidase-like activity of Fe-NPC was successfully applied to colorimetric-fluorescent dual mode detection of choline, and good linear relationship in the ranges of 3–200 μM were achieved with LODs of 1.95 and 1.50 μM, respectively. The fluorescent detection was constructed based on the fluorescence quenching of silicon quantum dots (Si QDs) by quinone-imine. The quenching mechanism was attributed to FRET due to the large spectra overlap, reduced fluorescence lifetime and proper donor−acceptor distance. The successful application to the detection of choline in milk proved the practicability of the proposed sensing method. The oxidase-like properties of Fe-NPC was further used in the degradation of cationic dye methyl blue, high degradation efficiency of 74 % was achieved within 5 min under optimal conditions, proving the enormous potential of Fe-NPC for application in environment protection.

Effect of school feeding program on dietary folate intake among school adolescent girls in Sidama region, southern Ethiopia

BackgroundEthiopia recently initiated a school feeding program (SFP) that provides nutritious meals to vulnerable students during school to combat malnutrition and improve their nutrition. However, there is limited evidence regarding the program’s impact on dietary folate intake among adolescent girls. Improving folate status in adolescent girls is important to prevent neural tube defect and anemia This study was aimed at assessing the effect of the SFP on dietary folate intake among school adolescent girls in the Sidama Region, Southern Ethiopia.MethodsThis school-based cross-sectional study compared dietary folate intake among adolescent girls enrolled in schools with (n = 290) and without (n = 290) SFP. Multistage sampling method was used to select adolescent girls from 12 schools. The multiple pass 24-h dietary recall method was used to estimate the dietary intake of adolescent girls. Dietary diversity in the preceding day of the survey was assessed with the standard nine-food group score. Nutrient inadequacy was defined as a proportion of adolescents with dietary value of nutrient intake less than the recommended daily allowance (RDA). The dietary folate intake was compared between two groups using multilevel mixed effects linear regression model adjusted for potential confounders.ResultsThe result showed significantly higher mean (±SD) dietary folate intake in SFP beneficiaries (421.12 ± 78.60 μg/day) than the non-beneficiaries (393.26 ± 74.57 μg/day; β = 27.19, p < 0.001). SFP beneficiary girls had a significantly higher mean (±SD) dietary diversity score (5.24 ± 1.35) compared to non-beneficiary girls (4.83 ± 1.54; β = 0.40, p = 0.001). The prevalence of inadequate folate intake was significantly higher among no-beneficiaries (47.4%) compared to beneficiaries (36.9%; p = 0.01).ConclusionThe SFP in Sidama region improved folate intake and dietary diversity of adolescent girls. The evidence from this study supports the expansion of the program to enhance dietary intake of nutrients of adolescent girls in the region.

Sex-specific dietary habits and their association with weight change in healthy adults

BackgroundDietary intake plays a pivotal role in the prevalence and management of obesity. While women and men exhibit differences in dietary habits and food-related behaviors, sex-based weight loss recommendations are lacking. This study aims to examine the impact of specific foods and food categories on weight reduction in men and women over a two-year period.MethodsA total of 8,548 participants from the 10K cohort, from 2019 to 2023, were included in the analysis (53.1% women, mean age 51.7 years). Anthropometric measurements and laboratory results were collected at baseline and at the two-year follow-up visit. Dietary assessment was based on daily food intake digitally logged through an application for at least 3 consecutive days at both timepoints. We compared intake of macronutrients, micronutrients, food groups and daily energy consumption between sex and body mass index (BMI) categories at baseline and weight change categories at follow-up. Using linear regression, we assessed the associations between food categories or specific foods and BMI at baseline as well as weight change percentage at follow-up.ResultsDietary habits varied by BMI and sex. Women and men living with obesity (BMI > 30 kg/m2) reported a greater intake of animal-based protein and lower intake of plant-based proteins and fats at baseline, as compared to participants with normal weight. In linear regression models predicting two-year weight change, including age, income, and baseline weight, the explained variance was 5.6% for men and 5.8% for women. Adding food categories and specific foods increased the explained variance to 20.6% for men and 17.5% for women. Weight reduction in men was linked to daily consumption of an egg (1.2% decrease) and beef (1.5% decrease), while in women, the most pronounced reductions were associated with an apple (1.2% decrease) and cashew nuts (3.4% decrease). Notably, total energy intake changes significantly impacted weight outcomes only in women.ConclusionsSex-specific dietary habits significantly influence weight change over time. In men, weight loss was primarily associated with the addition of animal-based protein, while in women, it was linked to caloric deficit and plant-based fat, suggesting that sex-based nutritional interventions may demonstrate greater efficacy.Trial registrationNCT05817734 (retrospectively registered January 31, 2023).

A Food Intake Estimation System Using an Artificial Intelligence-Based Model for Estimating Leftover Hospital Liquid Food in Clinical Environments: Development and Validation Study.

Medical staff often conduct assessments, such as food intake and nutrient sufficiency ratios, to accurately evaluate patients' food consumption. However, visual estimations to measure food intake are difficult to perform with numerous patients. Hence, the clinical environment requires a simple and accurate method to measure dietary intake. This study aims to develop a food intake estimation system through an artificial intelligence (AI) model to estimate leftover food. The accuracy of the AI's estimation was compared with that of visual estimation for liquid foods served to hospitalized patients. The estimations were evaluated by a dietitian who looked at the food photo (image visual estimation) and visual measurement evaluation was carried out by a nurse who looked directly at the food (direct visual estimation) based on actual measurements. In total, 300 dishes of liquid food (100 dishes of thin rice gruel, 100 of vegetable soup, 31 of fermented milk, and 18, 12, 13, and 26 of peach, grape, orange, and mixed juices, respectively) were used. The root-mean-square error (RMSE) and coefficient of determination (R2) were used as metrics to determine the accuracy of the evaluation process. Corresponding t tests and Spearman rank correlation coefficients were used to verify the accuracy of the measurements by each estimation method with the weighing method. The RMSE obtained by the AI estimation approach was 8.12 for energy. This tended to be smaller and larger than that obtained by the image visual estimation approach (8.49) and direct visual estimation approach (4.34), respectively. In addition, the R2 value for the AI estimation tended to be larger and smaller than the image and direct visual estimations, respectively. There was no difference between the AI estimation (mean 71.7, SD 23.9 kcal, P=.82) and actual values with the weighing method. However, the mean nutrient intake from the image visual estimation (mean 75.5, SD 23.2 kcal, P<.001) and direct visual estimation (mean 73.1, SD 26.4 kcal, P=.007) were significantly different from the actual values. Spearman rank correlation coefficients were high for energy (ρ=0.89-0.97), protein (ρ=0.94-0.97), fat (ρ=0.91-0.94), and carbohydrate (ρ=0.89-0.97). The measurement from the food intake estimation system by an AI-based model to estimate leftover liquid food intake in patients showed a high correlation with the actual values with the weighing method. Furthermore, it also showed a higher accuracy than the image visual estimation. The errors of the AI estimation method were within the acceptable range of the weighing method, which indicated that the AI-based food intake estimation system could be applied in clinical environments. However, its lower accuracy than that of direct visual estimation was still an issue.

Gut Hormones in Heart Failure.

Heart failure (HF) is a syndrome affecting all organ systems. While some organ interactions have been studied intensively in HF (such as the cardiorenal interaction), the endocrine gut has to some degree been overlooked. However, there is growing evidence of direct cardiac effects of several hormones secreted from the gastrointestinal tract. For instance, GLP-1 (glucagon-like peptide-1), an incretin hormone secreted from the distal intestine following food intake, has notable effects on the heart, impacting heart rate and contractility. GLP-1 may even possess cardioprotective abilities, such as inhibition of myocardial ischemia and cardiac remodeling. While other gut hormones have been less studied, there is evidence suggesting cardiostimulatory properties of several hormones. Moreover, it has been reported that patients with HF have altered bioavailability of numerous gastrointestinal hormones, which may have prognostic implications. This might indicate an important role of gut hormones in cardiac physiology and pathology, which may be of particular importance in the failing heart. We present an overview of the current knowledge on gut hormones in HF, focusing on HF with reduced ejection fraction, and discuss how these hormones may be regulators of cardiac function and central hemodynamics. Potential therapeutic perspectives are discussed, and knowledge gaps are highlighted herein.

Synergistic impact of Composite Dietary Antioxidant Index and physical activity on fatty liver disease

BackgroundThe relationship between dietary antioxidants and fatty liver disease remains a topic of debate. This study aimed to examine the association between the Composite Dietary Antioxidant Index (CDAI) and nonalcoholic fatty liver disease (NAFLD)/metabolic-associated fatty liver disease (MAFLD).MethodsThe study analyzed data from the 2003–2018 cycles of the National Health and Nutrition Examination Survey. The study included 16,321 individuals aged 20–85 years. Food and nutrient intake data were based on the 24-h recall method. Multivariate logistic regression models were employed to examine the relationship between CDAI and NAFLD/MAFLD.ResultsIn the fully adjusted multivariate logistic regression model, CDAI demonstrated a significant negative correlation with NAFLD and MAFLD. Mediation analysis showed that inflammatory factors partially mediated the relationship between CDAI and NAFLD/MAFLD prevalence. The combination of high CDAI levels with effective physical activity was associated with a greater reduction in NAFLD/MAFLD prevalence than high CDAI levels alone.ConclusionOur study highlighted a negative association between CDAI and NAFLD/MAFLD, mediated by inflammatory factors. Additionally, participants with characteristics of active physical activity and high levels of CDAI were more strongly correlated with the reduced prevalence of NAFLD/MAFLD. Further research in clinical cohorts should be conducted to comprehensively investigate the impact of CDAI on NAFLD/MAFLD prevalence.

Pediatric Hospital Utilization During Medical Stabilization for Patients With Eating Disorders.

Few studies have examined pediatric hospital utilization across the spectrum of eating disorder (ED) diagnoses among hospitalized patients. We describe sociodemographic and clinical characteristics, hospital utilization, and enteral tube feeding and examine factors associated with hospital utilization among patients with EDs. Using data from the Pediatric Health Information System, we included patients aged 4 to 20 years with primary ED diagnoses hospitalized from 2018 to 2022. We examined sociodemographic factors, length of stay, costs, and enteral tube feeding by ED diagnosis. Adjusted regression models compared hospital utilization by diagnosis, adjusting for sociodemographic and clinical factors. Among N = 10 279 hospitalizations from 49 hospitals, anorexia nervosa (AN) was most common (70.9%), followed by avoidant restrictive food intake disorder (ARFID) (15.6%). Mean age was 15.1 years (SD = 2.5), and most were female (86.6%), of white non-Hispanic race (70.9%), with private insurance (70.1%), with 63.9% occurring after the coronavirus disease 2019 pandemic onset. Median (interquartile range) length of stay was 8.0 days (7.0), and hospital costs were $18 099 ($15 592). A total of 18.8% received enteral tube feeding, with significant hospital variation. In adjusted models, compared with AN, ARFID, binge disorders, and unspecified feeding and ED had shorter stays, whereas hospital costs were lower for binge disorders, and enteral feeding was more likely for ARFID. Our findings indicate long and costly hospitalizations, especially for AN, with implications for hospital and treatment capacity, highlighting the need for earlier diagnosis and treatment to prevent the need for hospitalization.

Neuroprotective component of outpatient rehabilitation of patients with lumbosciatica and depression

The aim of the study was to investigate the effectiveness of including cytoflavin in complex outpatient rehabilitation therapy for patients suffering from lumboschialgia and depression .Material and methods. 86 patients (38 men and 48 women, average age — 53.2 ± 5.9 years) with lumboschialgia and depression were examined. All patients underwent dynamic somatic and neurological status examination (before and after therapy), laboratory and instrumental studies were performed. To assess the neurological profile, the following were used: digital rating scale (DRS) of pain, Oswestry questionnaire (version 2.1a), hospital anxiety and depression scale (HADS), CGI-S scale, DN4 and SF-36 questionnaires. All patients underwent dynamic diagnostics of spinal mobility using the following parameters: Thomayer test (spinal flexion, distance floor – fingers (FF)), distance fingers legs (FL), backward bend while standing and lying on the stomach. In addition to standard treatment, patients in the main group (n = 44) were prescribed cytoflavin: 2 tablets 2 times a day regardless of food intake, 30-day course. The subjects from the control group (n = 42) received only standard treatment.Results. Inclusion of cytoflavin in the regimens contributed to a more pronounced reduction in pain syndrome compared to the control group: by 5 times according to the Oswestry questionnaire (version 2.1a), by 1.7 times versus 1.3 times according to the DN4 questionnaire, respectively (p &lt; 0.05). The disappearance or significant reduction of pain syndrome contributed to the expansion of motor activity due to the increase in mobility in the spine — a more pronounced positive dynamics in terms of extension: 34.2 % and 22.9% in the main group versus 15.9% and 17.7% in the control group (p &lt; 0.05). The inclusion of the drug contributed to a more significant reduction in neurological symptomatology disorders than in patients in the control group: anxiety indicators (according to the HADS scale) in the control group decreased by 5.3 times, while in the control group they decreased only by 1.75 times (p &lt; 0.05); signs of depression — by 2 and 1.5 times, respectively (p &lt; 0.05). At the same time, the subjects to a greater extent noted a decrease in fatigue, an improvement in night sleep, an increase in activity and performance. The effectiveness of the presented outpatient rehabilitation scheme was confirmed by the positive dynamics of the patients’ quality of life indicators on all SF-36 scales: the most significant increase on the scales of “role functioning due to physical condition” and “pain intensity” — on average by 25.9 points in the control and 26.3 points in the main, respectively (p ≥ 0.05).Conclusion. The inclusion of cytoflavin in the complex treatment of patients with this pathology helps to reduce the intensity of pain, increase spinal mobility and eliminate the neuropathic component, which improves the quality of life of patients. The results obtained can serve as a basis for further research in this area.