Lower Energy Intake Research Articles

Legume Consumption and Blood Pressure Control in Individuals with Type 2 Diabetes and Hypertension: Cross-Sectional Findings from the TOSCA.IT Study

Background: Our aims were to evaluate the relationship of habitual legume consumption with blood pressure (BP) control in a large cohort of people with T2D and hypertension, and to investigate whether specific nutritional components of legumes or other foods may contribute to regulate BP levels. Methods: We studied 1897 participants with T2D and hypertension. Dietary habits were assessed through a validated food frequency questionnaire. Sex-specific quartiles of legume consumption were created. Results: Higher legume consumption was associated with a lower intake of energy, carbohydrates, glycaemic load, alcohol, and sodium, and a significantly greater intake of proteins, fat, monounsaturated, polyunsaturated, fibre, potassium, and polyphenols. Significantly lower systolic and diastolic BP values were observed in the highest vs. lowest quartile of legume consumption (132.9 ± 6.7 vs. 137.3 ± 7.0 mmHg, p < 0.001; 78.9 ± 4.1 vs. 81.0 ± 4.2 mmHg, p = 0.002; respectively), as well as the proportion of people meeting the treatment targets (61.3% vs. 37.4% and 71.3% vs. 52.4%, respectively, p < 0.01). This association was independent from other foods whose consumption is associated with the high legume intake. Conclusions: In people with T2D and hypertension, three servings of legumes per week are associated with significantly better BP control. This gives further support to current dietary guidelines in recommending the frequent consumption of legumes, as a “ready-to-use” dietary strategy to achieve optimal BP control.

#4964 ASSOCIATION OF DIETARY INTAKE WITH SERUM LEVELS OF PHOSPHORUS AND POTASSIUM IN THE ELDERLY HEMODIALYSIS PATIENTS IN KOREA

Abstract Background and Aims Dietary management of elderly (>60 years old) hemodialysis(HD) patients is very important for solving health problems and improving quality of life. Hyperphosphatemia and hyperkalemia in elderly HD patients are closely related to intake of dietary phosphorus and potassium from Koreans’ unique eating patterns. It is very difficult to manage the diet of hemodialysis patients due to the unique eating patterns of elderly Koreans. In the daily meal pattern, sodium and potassium contents are high in grain-based foods, soups, stews, and seasoned vegetables. And, there are various recipes for meals using a range of condiments, which increase serum phosphorus level. For this reason, it is necessary to educate dietary management using real-time Apps for the elderly in Korea. This study was designed to provide the base data for the development of a self-dietary management App for Korean elderly HD patients. Method This study was conducted on 237 elderly HD patients (149 males and 88 females) at nationwide 18 university hospitals. We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 23 food meal items based on the Korean usual diets. For this dietary status evaluation, a newly constructed potassium and phosphorus content DB was used. Results The average age of the patients was 69.7± 11.6 years for men and 69.2±6.9 years for women and the duration of HD was 5.4 ± 4.9 years for men and 5.5±4.2 for women. The mean body mass index (BMI) was 23.24 ± 2.99 kg/m2, mean serum phosphorus level was 5.03 ± 9.59 mg/dl, and mean serum potassium level was 5.41 ± 8.58 mEqL. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of the subjects, and hyperkalemia(> 5.0 mEq/L) in 35.4%. Energy and protein were significantly lower than recommended intakes of HD patients(P = .027, P = .015). Lower intake of energy and protein was more significant in women. The intake of sodium and potassium was significantly higher than recommendation(P = .014, P = .021), which was more excessive in men. Serum phosphorus levels showed positive correlation with intake frequency of mixed grains rice (P = .011), noodle without broth(P = .000), vegetable soup(P = .039), and roasted beef(P = .047) in male patients. In case of female patients, intake of sweet potatoes was correlated with hyperphosphatemia (P = .047). Serum potassium levels showed a positive correlation with intake of Kimchi(P = .000), noodle without broth(P = .000), and ham(P = .018) in men. In women, sweet potatoes(P = .027) and medium-potassium fruits(P = .047) were correlated with serum potassium level. On the other hand, intake of white rice showed negative correlation with serum potassium levels(P = .037) in both sex. Conclusion Dietary management along with medical treatment is essential for maintaining serum phosphorus and potassium levels within acceptable ranges because the composition of the daily routine diet is very unique and varies in Korea. The results of this study showed that the intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels in the elderly Korean HD patients. In addition, limiting intake of sweet potatoes, medium and high potassium vegetables & fruits to under three servings per week is recommended. Therefore, customized dietary management needs to be regulated according to each individual's dietary pattern for the Korean elderly HD patients. Major variables found in this study can be used in the development of new App for customized self-dietary management.

#3784 DIETARY BEHAVIOR OF CKD PATIENTS BEFORE AND AFTER THE COVID-19 PANDEMIC PERIOD

Abstract Background and Aims As the COVID-19 infection went global pandemic in 2020, many governments around the world have carried out social lockdown policies. It resulted in changes in lifestyles such as diet, physical activity, and social interaction. This study aimed to investigate the changes of lifestyles focusing on diet, especially in patients with chronic kidney disease (CKD) during the COVID-19 pandemic period. Method We compared data from 2019 and 2020 of the Korea National Health and Nutrition Examination Survey (KNHANES) before and after COVID-19, because COVID-19 was first detected in January 2020 in South Korea. CKD was defined as albumin to creatinine ratio >30 mg/g or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. CKD was categorized into two groups, CKD stage 1–2 and CKD 3–5; eGFR over 60 with albuminuria and eGFR below 60 mL/min/1.73 m2. We compared changes in diet behavior, nutrients, and food intake between 2019 and 2020 in normal, CKD stage 1–2, and CKD stage 3–5 groups. Results This analysis included a total of 5,084 and 4,338 participants from 2019 and 2020. When compared to normal group in the post-COVID-19, CKD group showed lower energy intake (p = 0.038), but the proportion of carbohydrates, proteins, and lipids did not differ. In the pre-COVID-19, CKD stage 3–5 group ate significantly lower sodium (1612.3 ± 62.1 mg/1000kcal) compared to normal (1809.1 ± 17.3 mg/1000kcal) and CKD stage 1–2 group (1856.3 ± 44.9 mg/1000kcal) (p = 0.007). However, post-COVID-19 period, sodium intake significantly increased only in CKD stage 3–5 group (1893.5 ± 109.2 mg/1000kcal, p = 0.015), and the urine Na/Cr ratio also increased (from 19.5 ± 1.4 to 26.0 ± 1.5, p = 0.001). The main source food of sodium was kimchi in every group, but the proportion changed in the post-COVID-19 period. In CKD stage 3–5 group, compared to the pre-COVID-19 period, the intake of noodles and Ramen increased 35% and 91%, respectively. Interestingly, the potassium intake increased from pre-COVID-19 to post-COVID-19 in all three groups. Conclusion The COVID-19 pandemic affects CKD patients' diets in terms of sodium intake. We need to pay attention to diet and nutritional education for CKD stage 3–5 patients.

In critically ill adult patients with COVID-19, lower energy and higher protein intake are associated with fewer mechanical ventilation and antibiotic days but not with ICU length of stay.

Coronavirus disease 2019 (COVID-19) nutrition management guidelines recommend hypocaloric, high-protein feeding in the acute phase of critical illness. This study aimed to determine, among critically ill adults with COVID-19, whether nutrition support affects outcomes in nonobese patients when providing a mean energy intake of ≥20 kcal/kg/day vs <20 kcal/kg/day and protein intake of ≥1.2 g/kg/day vs <1.2 g/kg/day, using actual body weight, and in patients with obesity when providing ≥20 kcal/kg/day vs <20 kcal/kg/day and a protein intake of ≥2 g/kg/day vs <2 g/kg/day using ideal body weight. This retrospective study included adults with COVID-19 on mechanical ventilation (MV) admitted to the intensive care unit (ICU) from 2020 to 2021. Clinical and nutrition parameters were recorded the first 14 days of ICU stay. One hundred four patients were included: 79 (75.96%) were male and had a median age of 51 years and body mass index of 29.65 kg/m2 . ICU length of stay (LOS) was not affected by nutrition intake, but patients receiving <20 kcal/kg/day had fewer MV days (P = 0.029). In a subgroup analysis, MV days were lower in the nonobese group receiving <20 kcal/kg/day (P = 0.012). In the obese group, those receiving higher protein intake had fewer antibiotic days (P = 0.013). In critically ill patients with COVID-19, lower energy and higher protein intake were respectively associated with fewer MV days and, in patients with obesity, fewer antibiotic days, but they had no effect on ICU LOS.

Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs.

Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.

Analysis of dietary patterns on cardiovascular risks in children: from a cross-sectional and a longitudinal study

ObjectivesDiet is one of the main risk factors for cardiovascular disease (CVD), while the evidence about the relationship between dietary pattern (DP) and CVD in children is scarce. This study aims to explore the association between DP and CVD risk in children. Study designThis was a cross-sectional and longitudinal study. MethodsThis research was conducted among 4351 children aged 6–12 years old in 2014, then the subgroup children in 2014 were followed up in 2019. Dietary intakes were assessed using a food frequency questionnaire. DP was clustered based on 15 food items, and finally, four main DPs were obtained. ResultsFour major DPs were identified: (1) low intake of nuts and algae pattern, (2) low-energy intake pattern, (3) high-energy intake pattern, and (4) regular DP. Compared with the regular diet pattern, the low intake of nuts and algae pattern was associated with the increased risk of higher systolic blood pressure (107.71 mm Hg vs 105.78 mm Hg, P < 0.001), diastolic blood pressure (64.98 mm Hg vs 63.91 mm Hg, P = 0.0056), hypertension (odds ratio [OR]:1.44, 95% confidence interval [CI]: 1.10, 1.88; P = 0.0036), dyslipidemia (OR: 2.41, 95% CI: 1.28, 4.52; P = 0.0194), and obesity (OR: 1.48, 95% CI: 1.16, 1.89; P = 0.0003) in children from a cross-sectional aspect in 2014 and it was also found associated with an increased risk of hypertension (OR: 2.67, 95% CI: 1.45, 4.92; P = 0.0017) in 2019. ConclusionsLow nuts and algae intake combinations in children seemed associated with increased CVD risk. Such findings are imperative for national development of dietary recommendation for the prevention of CVDs.

Macronutrients intake and physical frailty in Korean older adults: A cohort-based cross-sectional study.

To investigate the relationship of energy and macronutrients with physical frailty in Korean older individuals who had a high proportion of energy intake from carbohydrates. This study included 954 adults aged 70 to 84 years and used baseline data from the Korean Frailty and Aging Cohort Study (KFACS) collected in 2016. The relationship between energy or macronutrients and frailty was evaluated using multivariable logistic regression models and multivariable nutrient density models. A high carbohydrate intake was related to a higher prevalence of frailty (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.03-3.93). In the participants who had low energy intake, replacement of 10% energy from fats with isocaloric carbohydrates was related to a higher prevalence of frailty (10%, OR = 1.59, 95% CI = 1.03-2.43). Regarding proteins, we found no evidence for a relationship between the replacement of the energy of carbohydrates or fats with isocaloric protein and the prevalence of frailty in older adults. This study showed that the optimal proportion of energy intake from macronutrients may be an important nutritional intervention factor for reducing the risk of frailty among people who are likely to have low energy intake. Geriatr Gerontol Int 2023; 23: 478-485.

Fatty liver index relationship with biomarkers and lifestyle: result from RaNCD cohort study

BackgroundLifestyle intervention can effectively treat patients with non-alcoholic fatty liver disease (NAFLD). The present study aimed to investigate the association between lifestyle factors with fatty liver index (FLI) in Iranian adults.MethodsThis study enrolled 7114 subjects from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in western Iran. To compute the FLI score, anthropometric measures, and a few non-invasive liver status indicators were used. Binary logistic regression models examined the association between FLI score and lifestyle.ResultsParticipants with FLI < 60 had a lower daily energy intake compared to those with FLI ≥ 60 (2740.29 vs. 2840.33 kcal/day, P = < 0.001). The risk of NAFLD in males with high socioeconomic status (SES) was 72% higher than in those with low SES (OR: 1.72; 95% CIs 1.42–2.08). An adjusted logistic regression model showed a significantly negative association between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-value < 0.001 and OR: 0.54, p-value < 0.001, respectively). The odds of NAFLD in female participants with depression were 71% higher than in non-depressed participants (OR: 1.71, 95% CI: 1.06–2.64). Dyslipidemia and high visceral fat area (VFA) were also associated with a significant increase in the risk of NAFLD (P < 0.05).ConclusionIn our study, we found that good SES, high VFA, and dyslipidemia were associated with an increased risk of NAFLD. Conversely, high physical activity reduces the risk of NAFLD. Therefore, lifestyle modification may help improve liver function.

Intermittent Energy Restriction Combined with a High-Protein/Low-Protein Diet: Effects on Body Weight, Satiety, and Inflammation: A Pilot Study

Intermittent energy restricted (IER) diets have become popular as a body weight management approach. In this pilot study, we investigated if an IER diet would reduce systemic inflammation and if maintaining an elevated protein level while on an IER diet would enhance satiety. Six healthy women, aged 33–55 years with a BMI of 27–33 kg/m2, were randomized to first adhere to either a low- or high-protein IER diet using whole foods for three weeks. They then returned to their regular diets for a week, after which they adhered to the second diet for three weeks. Each test diet consisted of three low-energy intake days followed by four isocaloric energy intake days. The diets differed only in protein content. High-sensitivity C-reactive protein (hs-CRP), glucose, satiety, body weight, and waist circumference were measured at the beginning and end of each dietary intervention. Most participants showed reductions in hs-CRP levels from baseline on both IER diets but reported greater satiety when adhering to the higher protein IER diet. Overall, the IER diets reduced body weight and appeared to decrease inflammation in these overweight women, and the higher protein version enhanced satiety, which may lead to greater long-term dietary adherence.

Trends in energy and macronutrient intake among Taiwanese older adults in 1999–2000, 2005–2008 and 2013–2016 periods

BackgroundThis study aimed to explore trends, in 3 periods, in the intake of energy and macronutrients among Taiwanese older adults.MethodsStudy subjects were those aged ≥65 years in the Nutrition and Health Survey in Taiwan 1999–2000 as well as the surveys in 2005–2008 and 2013–2016. Twenty-four-hour dietary recall data were obtained. This study used the 3 nutrition survey datasets for 1999–2000, 2005–2008, and 2013–2016, including data on the questionnaire, physical examination, and dietary intakes. Each nutrition survey involved the face-to-face household interview, and individual’s dietary intake of carbohydrate, fat, and protein (% of energy) was estimated. Subsequently, intake statuses of the three macronutrients were classified into below, meeting, and above intake categories.ResultsIn the 2013–2016 survey, approximately 40% of the older adults had a low intake of energy. The prevalence of older adults with a meeting intake of carbohydrate, fat, and protein have increased from the 1999–2000 to 2013–2016 periods. The prevalence of people having a low intake of carbohydrate declined from the 1999–2000 period to the 2013–2016 period. The prevalence of high fat intake in 2013–2016 was approximately 5% higher than that in 1999–2000. In the 2013–2016 period, the prevalence of low intake of carbohydrate, fat, and protein were 25.9, 24.5, and 4.9%, respectively; moreover, the prevalence of high intake of the aforementioned macronutrients were 38.7, 36.2, and 17.6%, respectively.ConclusionsOur study provides important evidence on the dietary patterns, as well as their changes over time among Taiwanese older adults. Such information would be useful for health policy makers about the burden of unbalanced diet and for nutrition educators on planning nutrition promotion interventions about well-balanced dietary for the older persons.

The association of dietary inflammatory potential with sarcopenia in Chinese community-dwelling older adults

BackgroundDietary-induced inflammation is potentially associated with sarcopenia. Nevertheless, few studies have investigated the structure of the inflammatory diet and its correlation with muscle function and performance in both the upper and lower limbs. This study was performed to explore the association of the dietary inflammatory index (DII) with sarcopenia and its diagnostic parameters.MethodsWe conducted a cross-sectional survey on a sample of 515 Chinese community-dwelling older adults selected through multistage cluster sampling from three districts in Shanghai. DII scores were calculated using a validated food frequency questionnaire. Sarcopenia and its diagnostic parameters were determined based on the definition set by the Asian Working Group on Sarcopenia (AWGS).ResultsThe mean age of study participants was 71.31 ± 4.71 years. The prevalence of sarcopenia in the cohort was 12.4%. Older adults in the highest DII quartile had a 3.339 times increased risk of sarcopenia compared to those in the lowest quartile (OR Quartile4vs1:3.339, 95%CI: 1.232, 9.052, p-trend: 0.004) after adjusting for confounding factors. Additionally, a more pro-inflammatory diet was associated with lower appendicular skeletal muscle index (ASMI) (OR Quartile4vs1: 3.005, 95%CI: 1.275, 7.318, p-trend: 0.005), a higher 5-times sit-stand test time score (OR Quartile4vs1: 4.942, 95%CI: 1.745, 13.993, p-trend: 0.005), and lower gait speed (OR Quartile4vs1: 2.392, 95%CI: 1.104, 5.185, p-trend: 0.041) after adjusting for confounding factors. However, there was no significant association between DII, handgrip strength, and Short Physical Performance Battery (SPPB) score in either the unadjusted or adjusted model.ConclusionThis study found that the association between consuming a more pro-inflammatory diet and sarcopenia in Chinese community-dwelling older adults was mainly due to underlying low intakes of dietary energy, protein, and anti-inflammatory foods, and not due to the high intake of pro-inflammatory foods. Meanwhile, DII was more highly correlated with lower limb muscle strength and performance compared to upper limb muscle strength.

Young Japanese Underweight Women with “Cinderella Weight” Are Prone to Malnutrition, including Vitamin Deficiencies

Undernutrition among young women at “Cinderella weight” is socially important in Japan. To determine the nutritional status of Cinderella-weight women, we conducted an exploratory cross-sectional study on the health examination results of employees aged 20 to 39 (n = 1457 and 643 for women and men, respectively). The percentage of underweight women was found to be much higher than that of men (16.8% vs. 4.5%, respectively). In underweight women (n = 245), handgrip strength (22.82 ± 5.55 vs. 25.73 ± 5.81 kg, p &lt; 0.001), cholesterol level (177.8 ± 25.2 vs. 194.7 ± 31.2 mg/dL, p &lt; 0.05), and lymphocyte count (1883 ± 503 vs. 2148 ± 765/μL, p &lt; 0.001) were significantly lower than in overweight women (n = 116). Then, the BMI &lt; 17.5 group (n = 44) was referred to the outpatient nutrition evaluation clinic. Lower prealbumin, cholesterol, and lymphocyte levels were also observed in 34%, 59%, and 32% of the patients, respectively. Regarding dietary characteristics, 32% of the underweight women in this study skipped breakfast, and 50% had low dietary diversity scores. Lower total energy intake, carbohydrate and fiber intake, and Ca and Fe intake were also observed in 90% of the patients. Deficiencies in vitamin B1, B12, D, and folate were diagnosed in 4.6%, 25%, 14%, and 98% of the patients, respectively. Thus, young underweight women may be prone to malnutrition.

Association of Sociodemographic, Socioeconomic and Lifestyle Characteristics with Low Protein and Energy Intake in the Healthy Swiss Population

A balanced diet has the goal of providing adequate amounts of different nutrients to promote and maintain physical and psychological health. Our aim was to study the association between different sociodemographic, socioeconomic and lifestyle factors and low energy or protein intake among the Swiss population. This is a cross-sectional cohort study based on the national nutritional survey “MenuCH”, which is the first representative, detailed assessment of dietary habits in the adult Swiss population conducted in 2014/2015. We compared the mean protein and caloric intake based on two 24 h recall nutritional assessments with current recommendations based on resting metabolic rate calculation and DACH guidelines. A total of 1919 participants with a median age of 46 years and 53% females were included. Overall, 10.9% and 20.2% of participants had an energy and protein intake, respectively, below the dietary reference values. However, a high income (&gt;9000 CHF per month) reduced the risk of low energy intake (OR 0.49 [0.26–0.94], p = 0.032), obesity (OR 6.55 [3.77–11.38], p &lt; 0.01), and living in a household with children (OR 2.1 [1.15–3.85], p = 0.016) was associated with higher risk. Regarding low protein intake, the most important risk factors were an age group of 65–75 years (OR 2.94 [1.57–5.52], p = 0.001) and female gender (OR 1.73 [1.15–2.6], p = 0.008). Regular meat consumption reduced the risk of low protein intake (OR of 0.23 (0.1–0.53), p = 0.001). Within this survey, several socio-economic and lifestyle factors were associated with low energy and protein intake in the healthy Swiss population. A bunderstanding of these factors may help to reduce the risk of malnutrition.

The Influence of Relative Reinforcing Value of Food, Sensitization, Energy Intake and Diet Quality on zBMI Change over Two Years in Adolescents: A Longitudinal Cohort Study

The relative reinforcing value (RRV) of food and sensitization are associated with zBMI and zBMI change over time, but the mechanisms underlying these relationships is unknown. The purpose of this study was to test the hypothesis that greater RRV and sensitization to HED food is associated with lower diet quality and greater energy intake at baseline and again at 24 months and that these relationships result in greater zBMI gain. The RRV of HED and LED food and dietary intake were measured at baseline and again after 24 months in a cohort of 202 boys and girls of 12–14 years old. The baseline RRV of HED food was associated with lower diet quality and lower energy intake at 24 months. zBMI gain was positively associated with the baseline energy intake but not baseline RRV of HED food or diet quality. However, diet quality moderated the relationship between baseline energy intake and zBMI change, with no difference in zBMI change as a function of energy intake when diet quality was high but significant and opposite relationships with energy intake when diet quality was low. This study suggests that high diet quality can reduce the negative impact of greater energy intake on zBMI change in adolescents.

Regionalized analysis of gut barrier components in the small intestine of BALB/c mice following chronic immobilization stress.

Microbiota and tight junction proteins (TJPs) are components of the gut barrier, and are considered stress targets that have deleterious effects on intestinal homeostasis. This study aimed to evaluate the effects of chronic immobilization stress on selected small intestine homeostasis parameters. Female BALB/c mice were divided into a stress group that underwent short-term immobilization for 2 h per day for 4 consecutive days, and a non-stressed control group (n = 6 per group). Proximal and distal small intestine samples were excised to assess colony-forming units per gram (CFU/g) of total bifidobacteria in selective agar plates, luminal albumin was assessed using immune-enzymatic assay, pro-inflammatory cytokines were evaluated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and TJPs (pore-forming, claudin (Cld)-2; pore-sealing, Cld-4; ambiguous, Cld-7, -12 and -15) were assessed with RT-qPCR and western blotting. Compared with the control group, the stress group had lower body weight and energy intake. In the distal region, the stressed mice had lower bifidobacteria count and messenger ribonucleic acid (mRNA) expression of Cld-2, Cld-4 and Cld-12, though they had more albumin and higher interleukin (IL)-6 mRNA expression. Within the proximal region, the stressed mice had higher mRNA expression of tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), IL-6, Cld-7, Cld-12, and Cld-15, along with lower levels of IL-10 and Cld-4. However, mRNA and protein expression of TJPs were discordant. These findings indicate divergent stress-induced outcomes in the small intestine, evidenced by the elicitation of a pro-inflammatory response and decreased anti-inflammatory response in the duodenum, and by increased albumin transudation and decreased bifidobacterial growth in the distal region.

Association of breakfast skipping with habitual dietary intake and BMI in female rotating shift workers.

Higher BMI, lower quality of diet and a higher percentage of breakfast-skippers have been reported among rotating shift (RS) workers compared with day shift (DS) workers. As such, this study examined the association between breakfast skipping, habitual food consumption and BMI in RS workers. Japanese nurses were studied using a self-administered questionnaire that assessed the height, weight, breakfast consumption habits, dietary consumption, physical activity, sleep habits, chronotype and demographic characteristics of the participants. A cross-sectional study was conducted in a population of nurses in Japan. Dietary and health-related questionnaires were mailed to 5536 nurses aged 20-59 years, working at 346 institutions. A total of 3646 nurses at 274 institutions responded to the questionnaire. After removing those who met the exclusion criteria, 2450 participants were included in the statistical analysis. The RS breakfast-skippers had lower total energy intake, diet quality and higher BMI than DS workers, whereas the RS breakfast-consumers had a higher total energy intake and BMI than the DS workers. In the RS workers, breakfast skipping on the days of DS and the end days of evening/night shift was associated with a poorer diet quality. Additionally, breakfast skipping on the days of DS was positively associated with BMI, independent of the total energy intake and diet quality. Breakfast skipping on workdays may contribute to a difference in dietary intake and BMI between RS workers and DS workers and may increase BMI in RS workers, independent of dietary intake.

Change in carbohydrate intake one year after Roux-en-Y gastric bypass: A prospective study.

Background and objectives: To investigate the effect of carbohydrate intake before laparoscopic Roux-en-Y gastric bypass (LRYGB) on body weight, body composition and glycaemic status after surgery. Methods: In a tertiary centre cohort study, dietary habits, body composition and glycaemic status were evaluated before and 3, 6 and 12 months after LRYGB. Detailed dietary food records were processed by specialized dietitians on the basis of a standard protocol. The study population was subdivided according to relative carbohydrate intake before surgery. Results: Before surgery, 30 patients had a moderate relative carbohydrate intake (26%-45%, M-CHO), a mean body mass index (BMI) of 40.4 ± 3.9 kg/m² and a mean glycated haemoglobin A1c (A1C) of 6.5 ± 1.2% compared to 20 patients with a high relative carbohydrate intake (> 45%, H-CHO), mean BMI of 40.9 ± 3.7 kg/m² (non-significant, NS) and a mean A1C of 6.2% (NS). One year after surgery, body weight, body composition and glycaemic status were similar in the M-CHO (n = 25) and H-CHO groups (n = 16), despite less caloric intake in the H-CHO group (1317 ± 285 g vs. 1646 ± 345 g in M-CHO, p < 0.01). Their relative carbohydrate intake converged to 46% in both groups, but the H-CHO group reduced the absolute total carbohydrate consumption more than the M-CHO group (190 ± 50 g in M-CHO vs. 153 ± 39 g in H-CHO, p < 0.05), and this was especially pronounced for the mono- and disaccharides (86 ± 30 g in M-CHO vs. 65 ± 27 g in H-CHO, p < 0.05). Conclusion: A high relative carbohydrate intake before LRYGB, did not influence the change in body composition or diabetes status after surgery, despite a significantly lower total energy intake and less mono- and disaccharide consumption after surgery.

Nutritional Status of Patients with Facioscapulohumeral Muscular Dystrophy

In patients with facioscapulohumeral muscular dystrophy (FSHD), a rare genetic neuromuscular disease, reduced physical performance is associated with lower blood levels of vitamin C, zinc, selenium, and increased oxidative stress markers. Supplementation of vitamin C, vitamin E, zinc, and selenium improves the quadriceps' physical performance. Here, we compared the nutritional status of 74 women and 85 men with FSHD. Calorie intake was lower in women with FSHD than in men. Moreover, we assessed vitamin C, vitamin E, zinc, copper, and selenium intakes in diet and their concentrations in the plasma. Vitamin E, copper, and zinc intake were lower in women with FSHD than in men, whereas plasma vitamin C, copper levels, and copper/zinc ratio were higher in women with FSHD than in men. The dietary intake and plasma concentrations of the studied vitamins and minerals were not correlated in both sexes. A well-balanced and varied diet might not be enough in patients with FSHD to correct the observed vitamin/mineral deficiencies. A low energy intake is a risk factor for suboptimal intake of proteins, vitamins, and minerals that are important for protein synthesis and other metabolic pathways and that might contribute to progressive muscle mass loss. Antioxidant supplementation and higher protein intake seem necessary to confer protection against oxidative stress and skeletal muscle mass loss.

Optimizing health promotion through visual media innovation for youth soccer athletes

Background: The inconsistency of performance for adolescent soccer athletes is caused by inappropriate nutrition practices. The study on U-14 to U-18 soccer athletes showed 20% of athletes lacked fluid intake and 87% of athletes had low energy and protein intake. Objective: This study aims to develop health promotion media for youth soccer athletes. Methods: This study assessed the feasibility of the developed media which consists of two stages. The first stage is the media feasibility assessment conducted by experts who focused on developing health promotion media. Results: The feasibility of sports nutrition pyramid poster, meal plate poster, and infographic is 3.2; 3.4; and 3.3. The sports nutrition pyramid poster has scores of 3 (layout); 3.5 (design); 3.2 (content). The meal plate poster has scores of 3.25 (layout); 3 (design); 3.7 (content). The infographic has scores of 3 (layout); 3 (design); 3.7 (content). There was an increase in the athlete's knowledge score from 65 to 79 (p=0.001). Conclusion: All media are feasible to be used as athletes’ health promotion media.

Nutritional Assessment in Chronic Kidney Disease Patients in the Bundelkhand Region (Uttar Pradesh), India

Introduction This research aimed to assess the nutritional intake and anthropometry of patients presenting with CKD in a hospital clinic. Methods The study was carried out on 100 CKD patients who were on maintenance hemodialysis at Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India. The patient’s file was inspected to get the relevant anthropometric and biochemical data. The information was gathered using a pre-designed proforma. Results The study included 100 CKD patients with a mean age of 45.74 ± 14.93 years. Males outnumber females, with a male-to-female ratio of 6.69:1. The mean calorie and protein given to the CKD patients (according to body weight) are 1657.60 ± 240.179 and 71.75 ± 77.165, respectively. The mean weight, BMI, and MUAC of the CKD patient were 57.371±6.22, 21.56 ± 1.705, and 23.86 ± 1.709, respectively. After 3 months of nutritional assessment, the patient’s mean weight, BMI, and MUAC were increased. The mean cholesterol, Triglyceride, HDL, VLDL, and RBS levels of the CKD patient were 163.90 ± 29.75, 139.76 ± 35.72, 49.46 ± 6.29, 28.488 ± 7.114, and 117.65 ± 21.46, respectively. After three months of the nutritional assessment, the patient’s mean cholesterol, Triglyceride, HDL, and VLDL levels increased while RBS level decreased. The CKD patient’s mean S. creatinine and S. albumin levels were 9.97 ± 3.453 and 3.285 ± 0.531, respectively. After 3 months of nutritional assessment, the patient’s mean S. creatinine and S. albumin levels increased to 10.4231 ± 3.420 and 4.056 ± 5.6389, respectively. Conclusion The nutritional diet influences body weight, BMI, and biochemical indicators. Low energy and protein intake was reported; hence, educating patients, co-patients, and families about the essential foods that fulfill the recommended intake for CKD patients is required. Follow-up patients showed better nutritional knowledge as compared with baseline patients.