Low Intake Group Research Articles

Exploring the Impact of Niacin Intake on Cardiovascular Outcomes: A Comprehensive Analysis Using NHANES Data (2003-2018).

The relationship between cardiovascular outcomes and niacin consumption levels remains unclear. This study aimed to examine the correlation between niacin intake and the incidence of cardiovascular disease, as well as the mortality rates associated with cardiovascular disease and other causes. From 2003 to 2018, we continually investigated updated information from the National Health and Nutrition Examination Survey. Based on the quartiles of niacin intake levels, four distinct categories of participants were established: Q1 (<14.646 mg), Q2 (14.646-21.302 mg), Q3 (21.302-30.401 mg), and Q4 (>30.401 mg). Baseline variable differences were assessed employing the Chi-Square and Student's t-tests. A weighted logistic regression with multiple variables was used to determine the association between niacin intake and cardiovascular disease prevalence. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause death and cardiovascular disease were determined utilising hazard regression models. Kaplan-Meier curves were used to compare survival probability between the high and low niacin intake groups, and dose-response linear relationships were evaluated with restricted cubic splines. The cohort analysis included 80,312 participants for the assessment of niacin intake. Comparing the Q1 dataset to the Q4 dataset in the overall population, weighted Cox regression analysis showed a negative association with all-cause mortality (95% CI: 0.71-0.96, HR: 0.82) and mortality owing to cardiovascular disease (95% CI: 0.67-0.96, odds ratio (OR): 0.80). Sex-based subgroup analysis revealed a detrimental correlation between niacin use and overall mortality in females (Q4 cohort: 95% CI: 0.62-0.97, HR: 0.78) but not in males. Additionally, the Q3 (95% CI: 0.59-0.94, HR: 0.75) and Q4 (95% CI: 0.51-0.97, HR: 0.7) groups exhibited a negative association with female cardiovascular disease mortality compared to the Q1 group. Niacin intake was not significantly correlated with prevalence, all-cause mortality, or death from cardiovascular disease in males. Higher niacin consumption was correlated with a decreased risk of cardiovascular disease and death from all causes across the entire study population. Nevertheless, only females, and not males, exhibited a beneficial effect on mortality.

The effect of dietary magnesium intake on cognitive decline related to olfactory impairment in older adults: a cross-sectional study from the NHANES database.

Olfactory impairment in the elderly has been shown to be associated with an increased risk of cognitive decline, and oxidative stress may be involved in this process. Dietary magnesium (Mg), as an antioxidant dietary nutrient, has been reported to be associated with cognitive decline. This study aimed to explore the effect of dietary Mg intake on cognitive decline related to olfactory impairment in older adults. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) database 2013-2014. Information on dietary Mg intake was obtained from 24-hour interview. Assessment of cognitive decline included four evaluation dimensions: the Consortium to Establish a Registry for Alzheimer's Disease (including immediate and delayed), an animal fluency test, and a digit symbol substitution test. Weighted univariable and multivariable linear regression models were utilized to explore the effect of Mg on cognitive decline related to olfactory impairment, using β values and 95% confidence intervals (CIs). Subgroup analyses based on gender, history of diabetes, cardiovascular disease (CVD) and depression were further assessed. In total, 1,388 elderly people were included, of whom 319 (22.98%) had olfactory impairment. After adjusting for all covariates, there was an inverse relationship between high Mg intake and cognitive decline (β=-0.21, 95%CI: -0.37 to -0.04), and olfactory impairment was positively associated with cognitive decline (β=0.53, 95%CI: 0.28 to 0.77). Among the elderly with olfactory impairment, the odds of cognitive decline were reduced in the high Mg intake group (β=0.37, 95%CI: 0.04 to 0.71) compared to the low Mg intake group (β=0.67, 95%CI: 0.39 to 0.96), especially among the elderly who were female (β=0.53, 95%CI: 0.09 to 0.98), with diabetes (β=0.72, 95%CI: 0.46 to 0.99), and without CVD (β=0.33, 95%CI: 0.05 to 0.61) and depression (β=0.38, 95%CI: 0.06 to 0.70). Adequate dietary Mg intake may provide potential beneficial effects, improving cognitive function, among elderly patients with olfactory impairment, which should be confirmed by scale-large prospective studies.

The influence of the daily salt-intake on the antihypertensive action and atrial natriuretic peptide level in patietns with angiotensin receptor neprilysin inhibition

Abstract Background The angiotensin receptor–neprilysin inhibitor (ARNI) is a drug which acts through angiotensin receptor blocking effect and the increase in atrail natriuretic peptide (ANP) through neprilysin inhibitor in hypertension (HT). These combined effects result in a reduced risk of hospitalization for heart failure or death from cardiovascular causes. ANP is also known for its various cardioprotective effects including vasodilator and natriuretic action. Acording to Guyton's pressure-natriuresis curve, the efficacy of angiotensin receptor blocker drugs is diminished in HT cases with high daily salt inatke. However, whether the effect of ARNI on HT is attenuated in patients with high daily salt intake remains unclear. Purpose The present study investigated the influence of a daily salt intake on the antihypertensive action and ANP level in patients with ARNI. Methods Fourty-four consecutive essential HT patients on ARNI were enrolled. Blood pressure and ANP level were measured at baseline (before taking ARNI) and 3 weeks later. ARNI (200mg) was prescribed and maintained during the study. In addtion, the daily salt intake was calculated using creatinine and natrium levels in urine, age, and body weight according to Japanese hypertensive guideline at baseline and 3 weeks later. Results The average age was 70±8 years old. About 50% (N=23) was male. The mean sytolic and diastolic blood pressure was 148±14mmHg and 89±10mmHg, respectively. The mean daily salt intake was 9.5±2.2 g/day at baseline. The mean ANP level was 529±300pg/ml. At follow up (3 weeks later), the mean systolic and diastolic blood pressure significanly went down to 132± 18 mmHg and 70± 9 mmHg, respectively (p=0.03). ANP level also increased from 529±300pg/ml to 793±580pg/ml. However, the mean daily salt intake was almost same as the baseline at 9.4±3.2 g/day. The patients were divided into 2 groups; high daily salt intake (N=20 with mean daily salt intake 10.5±1.7g/day)) and low daily salt intake (N=24 with 8.4±3.1g/day) groups compared to the baseline. The absolute and percentage changes in systolic blood pressure were almost same in the high and low daily salt intake groups (-12.7±15.8mmHg vs -13.7±14.2mmHg, p=0.75; -5.8±6.5% vs.-7.0±9.6%, p=0.58, respectively). However, the change rate in ANP level was significantly higer in the high daily salt intake group than in the low daily salt intake group (155±63 vs. 12±16%, p=0.01). Conclusion ARNI demonstrates effectiveness in lowering the blood pressure even in patients with higher salt intake, unlike angiotensin receptor blocker. In cases with high salt intake, the notable increase in ANP levels may contribute to decreasing blood pressure through vasodilator and natriuretic action.

The association between early postoperative food intake and postoperative hospital length of stay in patients undergoing cardiac surgery: A retrospective observational single-center study

Background & AimsPerioperative nutritional status is critical during the postoperative recovery process in patients undergoing cardiac surgery. Several studies on patients undergoing cardiac surgery have reported low energy intake in early postoperative food intake via oral nutrition; however, no study has shown an association of low energy intake with postoperative hospital length of stay (LOS). This study aimed to determine whether early postoperative low food intake was associated with prolonged postoperative hospital LOS in patients undergoing cardiac surgery. MethodsThis was a retrospective, observational, single-center study conducted in patients aged ≥18 years undergoing elective cardiac surgery from January 1, 2020, to May 31, 2023. Patients were categorized by food intake as food intake < 50% (low food intake group) and ≥ 50% (adequate food intake group) at lunch on postoperative day (POD) 3. The primary outcome of this study was the postoperative hospital LOS. A generalized linear model was used to examine the association between food intake and postoperative hospital LOS using the following explanatory variables: age, European System for Cardiac Operative Risk Evaluation (EuroSCORE) II value, preoperative risk of malnutrition, activities of daily living status, Sequential Organ Failure Assessment score, and C-reactive protein level. ResultsOf the 315 patients, 104 (33.0%) had a food intake of <50% on POD3. There were no significant differences in age, sex, EuroSCORE II value, and comorbidities between the two groups. Patients in the low-food intake group had a significantly lower Barthel Index (6.7% vs. 1.4%, p = 0.017) and a higher malnutrition risk according to the Mini Nutritional Assessment Short Form score (40.4% vs. 28.2%, p = 0.043). Food intake of <50% on POD3 was associated with prolonged postoperative hospital LOS (β = 1.135 [95% confidence interval: 1.004–1.262], p = 0.018). ConclusionsLow food intake on POD3 is associated with prolonged postoperative hospital LOS in patients undergoing elective cardiac surgery. Early postoperative food intake should be closely monitored in patients after elective cardiac surgery.

The relationship between Fruit and vegetable intake and frailty: Data from NHANES 2007–2018

BackgroundPrevious studies have indicated a certain relationship between the intake of fruits and vegetables and frailty. However, there is currently a lack of research on the association between fruit and vegetable intake and frailty. ObjectiveThis study aims to explore the potential correlation between fruit and vegetable intake and frailty. Additionally, we seek to investigate the relationship between fruit intake and frailty across different demographic characteristics and subgroups. MethodsInitially, participant information from the NHANES database (2007–2018) was extracted, including age, gender, race, education level, and other relevant factors. Subsequently, a comprehensive adjustment of multiple variables was carried out using a logistic regression model to analyze the relationship between vegetable and fruit intake and frailty. We also conducted subgroup analyses for variables showing significant differences in the regression model, exploring the relationship between vegetable and fruit intake and frailty in different demographic subgroups. Finally, we employed Restricted Cubic Splines (RCS) to explore the relationship between vegetable and fruit intake and frailty. ResultsIn our study of 13,935 participants, 2224 were classified as frail, while 11,711 were non-frail. Significant differences were observed between the frail and non-frail groups in variables such as gender, race, marital status, education level, and BMI. Weighted logistic regression analysis revealed a significant association between the intake of fruits (including f_other, f_whole, f_juice, f_total) and vegetables (including v_redor_total, v_total) and a reduced risk of frailty (p for trend <0.05, OR < 1). Notably, in the f_other group, both the medium and high intake groups had a significantly lower risk of frailty compared to the low intake group (ORs of 0.70 and 0.68, p < 0.001, respectively). Subgroup analysis indicated significant interactions between fruit and vegetable intake and frailty across different gender, income, alcohol intake, education level, and racial groups (p for interaction <0.05). Restricted cubic spline analysis showed that while an increase in fruit and vegetable intake reduced the risk of frailty within a certain range, the risk gradually increased beyond that range. ConclusionThis study provides preliminary evidence supporting a close association between vegetable and fruit intake and frailty, laying the foundation for future in-depth investigations into the dietary links with frailty. These findings also offer new nutritional intervention strategies for frailty prevention, emphasizing the crucial role of diet in maintaining overall health. However, further clinical and epidemiological research is needed to validate these associations and provide detailed explanations for the specific mechanisms through which fruit and vegetable intake impact frailty.

Exploring the relationship between live microbe intake and obesity prevalence in adults

Obesity has become a global health problem. In recent years, the influence of dietary microbes in the obese population has attracted the attention of scholars. Our study aimed to investigate the link between live microbe intake and obesity in adults. Participants (aged over 20 years) for this study were from the 1999–2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorised into low, medium and high dietary live microbe intake groups. Linear regression was used to analyse the link between live microbe intake and body mass index (BMI) and waist circumference (WC). Logistic regression was used to analyse the link between live microbe intake and obesity and abdominal obesity prevalence. Restricted cubic spline curves (RCS) were used to check whether there was a non-linear relationship between live microbe intake and obesity. A total of 42,749 participants were included in this study and the number of obese reached 15,463. We found that live microbe intake was negatively linked to BMI and WC. In models adjusted for all confounders, the high live microbe intake group had lower obesity (OR = 0.812, 95%CI: 0.754–0.873) and abdominal obesity prevalence (OR = 0.851, 95%CI: 0.785–0.923) than the lowest intake group. Upon further quantification of live microbe intake, we found similar results. RCS analyses showed that live microbe intake was nonlinearly negatively correlated with BMI, WC, obesity, and abdominal obesity prevalence (P for non-linearity < 0.05). This study preliminarily reveals a negative link between live microbe intake and obesity in adults.

Metabolomics Profiling of Serum and Urine from Chuanzang Black Pigs with Different Residual Feed Intake.

This study was conducted to evaluate associations of blood variables and urine variables with different residual feed intakes (RFIs) in growing Chuanzang black (CB) pigs. A total of 228 growing CB boars from 99 days were used. The same basal diet was offered ad libitum and individual feed intake and body weight were measured over a period of 181 d. The CB pigs were categorized based on their residual feed intake values, with six individuals each from the high and low ends selected and divided into two groups: the low residual feed intake group (LS) and the high residual feed intake group (HS). Serum and urine samples were collected at the end of the experiment for determination of metabolomics profiling. Results showed that there were significantly different metabolites in serum and urine of different RFI groups (fold-change, FC > 2.0 or FC < 0.5, and p < 0.05), and 21 metabolites were identified in serum and 61 in urine. Cluster analysis showed that 20 metabolites were up-regulated and one metabolite was down-regulated in serum; 44 metabolites were up-regulated and 17 metabolites were down-regulated in urine. Kyoto Encyclopedia of Genes and Genomes analysis showed that the differential metabolites of serum were enriched in linoleic acid metabolism, and the differential metabolites of urine were enriched in steroid hormone biosynthesis, taurine and hypotaurine metabolism, and primary bile acid biosynthesis. The correlations between serum metabolites and urine metabolites indicated a significant positive correlation between all fatty acyls in serum metabolites and L-glutamate in urine. However, no compelling genetic or blood biomarkers have been found to explain the differences in RFI, suggesting multiple approaches to effective feed use in pigs. This study provides new insights into the subsequent assessment of RFI by metabolomics profiling, as well as the development of novel feed additives for the factors that will facilitate future research directions in CB pigs.

Effects of Adult Men’s Lifestyle on Scalp Health

Purpose: This study aims to investigate the association of dietary habits and general characteristics of adult Korean men with scalp conditions.Methods: Statistical Package for the Social Sciences version 25.0 was used for data analysis, with a &lt;i&gt;p&lt;/i&gt;-value of 0.05 indicating significance. Frequency analysis was conducted to investigate participants’ general characteristics. Exploratory factor analysis was conducted to validate the measurement tool and Cronbach’s α coefficient verified reliability. Cross-tabulation was used to explore dietary habits and differences by general characteristics. Independent sample &lt;i&gt;t&lt;/i&gt;-test and one-way analysis of variance were utilized to investigate scalp condition following general characteristics and dietary habits, with the Scheffe test used for post-hoc analysis.Results: Statistically significant differences were observed in dietary habits (&lt;i&gt;p&lt;/i&gt;&lt;0.05), with the low-intake group demonstrating relatively higher scalp conditions than the high-intake group (M=2.27 vs. M=2.10). Analysis by general characteristics revealed significant differences in age, marital status, occupation, stress, sleep, exercise, shampoo type, and frequency (&lt;i&gt;p&lt;/i&gt;&lt;0.05).Conclusion: Individuals with healthier dietary habits exhibited better scalp conditions. Poorer scalp conditions were associated with older age, higher stress levels, shorter sleep duration, and poor exercise habits. Balanced dietary habits, effective stress management, improved sleep quality, and regular exercise are required for maintaining a healthy scalp. Further investigation on systematic management is warranted.

Association between fatty acid intake and age-related macular degeneration: a meta-analysis.

The association of age-related macular degeneration (AMD) with the intake of high and low fatty acids (FAs), respectively, remains controversial. To this end, we performed a comprehensive meta-analysis of all the existing studies on the association of various intake levels of FA subtypes with AMD to determine these associations. A systematic search of PubMed, Web of Science, Cochrane Library, and EMBASE databases was conducted from inception to September 2023. To compare the highest and lowest groups, odds ratio (OR) with 95% confidence intervals (CIs) was analyzed with a random-effects model/fixed-effects model. A high intake of omega-3 LCPUFAs (OR:0.67; 95%CI:[0.51, 0.88]; p = 0.004), DHA (OR:0.80; 95%CI:[0.70, 0.90]; p < 0.001), EPA (OR:0.91; 95%CI:[0.86, 0.97]; p = 0.004), and simultaneous intake of DHA and EPA (OR:0.79; 95%CI:[0.67, 0.93]; p = 0.035) significantly reduced the risk of overall AMD. Conversely, a high intake of trans-FAs (OR: 2.05; 95%CI: [1.29, 3.25]; p = 0.002) was significantly related to an increased risk of advanced AMD compared to the low-intake group. The subgroup analysis results are shown in the articles. Increasing dietary intake of omega-3 LCPUFAs, specifically DHA, and EPA, or the simultaneous intake of DHA and EPA, is significantly associated with a reduced risk of overall AMD. Various subtypes of omega-3 also have a significant association with a reduced risk of different stages of AMD. The high intake of trans-fatty acids (TFAs) is significantly and positively correlated with the risk of advanced AMD. This could further support the idea that consuming foods rich in omega-3 LCPUFAs and reducing consumption of foods rich in TFAs may prevent AMD. https://www.crd.york.ac.uk/prospero/, identifier CRD42023467227.

Effects of sodium intake, age, gender, blood sampling time on distribution of plasma aldosterone, renin activity, deoxycorticosterone, cortisol, cortisone, and 24 h urinary aldosterone levels in normotensive individuals based on LC-MS/MS.

This study aims to analyze the distribution of plasma aldosterone, renin activity, deoxycorticosterone (DOC), cortisol, cortisone, and 24 h urinary aldosterone (24 h-uAld) levels based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Plasma and 24 h urine were collected from 129 healthy volunteers in Northeast China. The effect of sodium intake, age, gender, blood sampling time on plasma aldosterone concentration (PAC), plasma renin activity (PRA), PAC to PRA ratio (ARR), DOC, cortisol, cortisone, cortisol to cortisone ratio, and 24 h-uAld were investigated by nonparametric test, multiple linear regression and Harris-Boyd's standard deviate test. There was no significant difference observed in 24 h-uAld, PAC (AM), PRA(AM), ARR (AM), DOC (AM), cortisol (AM), cortisone (AM), and cortisol to cortisone (AM) between high and low sodium intake group. Significant differences were observed between morning and afternoon sampling groups in terms of PAC, ARR, DOC, cortisol, and cortisone. Reference intervals (RIs) of 24 h-uAld, PAC (AM) were recommended to be partitioned by gender. RI of PRA was recommended age stratification. We recommend that the same reference interval could be used regardless of sodium intake. Gender is the main influence factor for 24 h-uAld, PAC, and ARR. Age is key influence factor for PRA.

Exploratory analysis on the association of dietary live microbe and non-dietary prebiotic/probiotic intake with serum cotinine levels in the general adult population.

Previous research has indicated the potential involvement of the microbiota in smoking-related processes. The present study seeks to examine the relationship between dietary live microbes, as well as probiotic or prebiotic consumption, and serum cotinine levels. This study used data from the National Health and Nutrition Examination Survey 1999-2018. Dietary intake information and probiotic/prebiotic intake data was collected through self-reported questionnaires. Participants were stratified into low, medium, and high intake groups according to their consumption of foods with varying microbial content. Multiple linear models were applied to explore the relationships of dietary live microbes, probiotic or prebiotic use with the serum cotinine level. A total of 42,000 eligible participants were included in the final analysis. The weighted median serum cotinine level was 0.05 (0.01, 10.90) ng/ml. Participants with low, medium, and high dietary microbe intake represented 35.4, 43.6, and 21.0% of the cohort, respectively. Furthermore, participants were stratified into three groups based on their overall consumption of foods with variable microbe contents. The association between dietary live microbe intake and serum cotinine levels remained robust across all models, with medium intake as the reference (Model 2: β = -0.14, 95% CI: -0.20, -0.07; High: β = -0.31, 95% CI: -0.39, -0.22). Moreover, both prebiotic and probiotic use exhibited an inverse relationship with serum cotinine levels (Prebiotic: β = -0.19, 95% CI: -0.37, -0.01; Probiotic: β = -0.47, 95% CI: -0.64, -0.30). Subgroup analyses revealed no discernible interactions between dietary live microbe, prebiotic, probiotic use, and serum cotinine levels. Our findings suggest a negative correlation between dietary live microbe intake, as well as non-dietary prebiotic/probiotic consumption, and serum cotinine levels.

#1620 Association of dietary live microbe intake with chronic kidney disease based on baseline characteristics of national population: NHANES 2011-2018

Abstract Background and Aims The gut microbiota plays a crucial role in a variety of diseases, including chronic kidney disease (CKD). The gut-kidney axis is mediated through metabolism dependent pathways. The relationship between CKD and the dietary consumption of live microbes has not been explicitly studied. Probiotic food intake may play a beneficial role in human health including the gut microbiota. However, in addition to probiotic foods, live micro-organisms are also found in other food products, such as raw vegetables and fruits. In this study, we adjusted for the potential association between dietary live microbiome intake and chronic kidney disease (CKD) in different baseline characteristics, including kidney function status. Method A total of 22,039 subjects were included in the study. We used data from the US National Health and Nutrition Examination Survey 2011-2018. Based on a 2-day 24-hour dietary recall, the dietary intake of the live microbiome was adjusted and the participants were categorized into three groups: low (&amp;lt;104 CFU/g), medium (104–107 CFU/g), or high (&amp;gt;107 CFU/g) dietary intake of live microbes, according to the classification system for the dietary intake of live microbes and participants’ 24-hour dietary recall data. Low intake was used as a reference. Stage 3 CKD with high risk of progression was defined by a combination of estimated glomerular filtration rate (GFR-EPI &amp;lt;60 mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (uACR &amp;gt;30 mg/g was defined as microalbuminuria). CKD was defined by a combination of GFR-EPI &amp;lt;60 mL/min/1.73 m2 or uACR, &amp;gt;30 mg/g. Albuminuria was defined as uACR &amp;gt;300 mg/g. The analyses used weighted logistic regression models (crude model and first, adjusted for age, gender, race, education and second, adjusted for hypertension, diabetes, total cholesterol level, BMI, hemoglobin level, total calorie intake, GFR and serum creatinine level). Results After model adjustment (Model 2, p&amp;lt; 0.0001), women in the medium dietary live microbe intake group had a low prevalence of stage 3 CKD with high risk of progression in contrast to those in the low dietary live microbiome intake group (OR: 0.913, 95% Cl: 0.63-1.32, p&amp;lt; 0.01), between high and low group (OR: 0.333, 95% Cl: 0.13-0.86, p&amp;lt; 0.01). However there was no significant association in men. In model 2, patients in the medium dietary live microbiome intake group had a low prevalence of microalbuminuria in contrast to those in the low dietary live microbiome intake group (OR: 0.789, 95% Cl: 0.63-0.98, p&amp;lt; 0.05). In model 2, we also found the significant association with albuminuria between high and low (OR 0.784, 95% Cl: 0.63-0.98, p&amp;lt; 0.05), medium and low (OR: 0.572, 95% Cl: 0.33-0.98, p&amp;lt; 0.05) dietary live microbiome intake patient groups. In model 2, those in the medium dietary live microbe intake group had a low prevalence of CKD in contrast to those in the low dietary live microbiome intake group (OR: 0.896, 95% Cl: 0.82-0.98) p&amp;lt; 0.01), but there was no significant association between the high and low dietary live microbiome intake groups. Conclusion In this study, a medium or high dietary live microbiome intake was associated with a low prevalence of stage 3 CKD with ahigh risk of progression in women. A medium dietary live microbiome intake was associated with a low prevalence of chronic kidney disease or microalbuminuria in the population. A medium or high dietary live microbiome intake was associated with a low prevalence of albuminuria. A medium dietary live microbiome intake was associated with a low prevalence of microalbuminuria.

#2106 Higher daily protein intake can reduce the risk of infections in kidney transplant recipients during the early post-transplant period

Abstract Background and Aims Kidney transplantation (KT) is considered the most effective treatment for end-stage renal disease (ESRD), and it significantly contributes to enhancing the quality of life and extending the survival of patients with ESRD. After kidney transplantation, the early and heavy use of immunosuppressants and glucocorticoids can affect the recipients' immune status to varying degrees, increasing the risk of postoperative infections caused by a wide range of pathogens. Thus, the prevention and management of infectious diseases are major factors contributing to improved outcomes in kidney transplantation. Protein-energy wasting (PEW) is commonly observed in uremic patients, and it may persist even after they have undergone kidney transplantation (KT). And PEW is a significant factor in the progression of chronic kidney disease (CKD). Providing appropriate dietary guidance and intervention is essential for enhancing the immune status of recipients, promoting a positive nitrogen balance in the body, minimizing infections, and safeguarding graft function. This study aimed to investigate the relationship between daily protein intake (DPI) and postoperative infections at 3 months post-transplant, which may establish a foundation for the early postoperative protein intake regimen, reducing the incidence of postoperative infections, and improving the early prognosis of kidney transplantation. Method This is a retrospective observational study. 176 kidney transplant recipients (KTRs) who underwent kidney transplant in West China Hospital from December 2021 to June 2022 were included and followed up regularly. 24-hour urine urea data were collected at months 1 and 3 post-transplant to calculate their DPI. These KTRs were further divided into two groups according to the recommended DPI for KTRs by the 2021 Practice Guidelines for the Nutritional Management of Chronic Kidney Disease, namely high intake group (Group 1, with DPI ≥ 1.4 g/kg·d, n = 66) and low intake group (Group 2, with DPI &amp;lt; 1.4 g/kg·d, n = 110). Occurrence of hospitalization and postoperative infections within 3 months were recorded. Multiple logistic regression was utilized to analyze the association between DPI and early postoperative infections at 3 months post-transplant. Results Mean DPI levels at month 1 post-transplant were 1.58 ± 0.22 g/kg·d in Group 1 and 1.02 ± 0.31 g/kg·d in Group 2, respectively (P &amp;lt; 0.05), this huge difference in DPI between the two groups continued to month 3. There was no significant difference in age, gender, pre-transplant body mass index (BMI), dialysis type and time, donor type, or the ratio of delayed graft function (DGF) between the two groups. There was a statistically significant difference in the percentage of hospitalization between the two groups during the postoperative period of 3 months (P = 0.027). Pneumonia was the most common reason of hospitalization after transplantation, followed by urinary tract infection. The results of multiple logistic regression analysis showed that higher DPI in the early post-transplant period was a protective factor for infection after kidney transplantation. Conclusion In the early post-transplant period, consuming higher levels of dietary protein may reduce the risk of infections and complications, and help preserve the function of the transplanted kidney.

#2736 Higher daily protein intake can reduce the risk of infections in kidney transplant recipients during the early post-transplant period

Abstract Background and Aims Kidney transplantation (KT) is considered the most effective treatment for end-stage renal disease (ESRD), and it significantly contributes to enhancing the quality of life and extending the survival of patients with ESRD. After kidney transplantation, the early and heavy use of immunosuppressants and glucocorticoids can affect the recipients' immune status to varying degrees, increasing the risk of postoperative infections caused by a wide range of pathogens. Thus, the prevention and management of infectious diseases are major factors contributing to improved outcomes in kidney transplantation. Protein-energy wasting (PEW) is commonly observed in uremic patients, and it may persist even after they have undergone kidney transplantation (KT). And PEW is a significant factor in the progression of chronic kidney disease (CKD). Providing appropriate dietary guidance and intervention is essential for enhancing the immune status of recipients, promoting a positive nitrogen balance in the body, minimizing infections, and safeguarding graft function. This study aimed to investigate the relationship between daily protein intake (DPI) and postoperative infections at 3 months post-transplant, which may establish a foundation for the early postoperative protein intake regimen, reducing the incidence of postoperative infections, and improving the early prognosis of kidney transplantation. Method This is a retrospective observational study. 176 kidney transplant recipients (KTRs) who underwent kidney transplant in West China Hospital from December 2021 to June 2022 were included and followed up regularly. 24-hour urine urea data were collected at month 3 post-transplant to calculate their DPI. These KTRs were further divided into two groups according to the recommended DPI for KTRs by the 2021 Practice Guidelines for the Nutritional Management of Chronic Kidney Disease, namely high intake group (Group 1, with DPI ≥ 1.4 g/kg·d, n = 66) and low intake group (Group 2, with DPI &amp;lt; 1.4 g/kg·d, n = 110). Occurrence of postoperative infections events within 3 months were recorded. Multiple logistic regression was utilized to analyze the association between DPI and early postoperative infections at 3 months post-transplant. Results Mean DPI levels at month 3 post-transplant were 1.75 ± 0.56 g/kg·d in Group 1 and 0.98 ± 0.24 g/kg·d in Group 2, respectively. There was no significant difference in age, gender, pre-transplant body mass index (BMI), dialysis type and time, donor type, or the ratio of delayed graft function (DGF) between the two groups. There was a statistically significant difference in the percentage of hospitalization for infections between the two groups during the postoperative period of 3 months (P = 0.027). Pneumonia was the most common reason of rehospitalization after transplantation, followed by urinary tract infection. The results of multiple logistic regression analysis showed that higher DPI in the early post-transplant period was a protective factor for infection after kidney transplantation. Conclusion In the early post-transplant period, consuming higher levels of dietary protein can reduce the risk of infections and complications, and help preserve the function of the transplanted kidney.

#676 Correlation between dietary live microbe intake and all-cause mortality based on baseline characteristics: results from NHANES 2011-2018

Abstract Background and Aims The gut microbiome plays a beneficial role in human health, including kidney function and chronic kidney disease progression. Potential therapeutic strategies for CKD and hypertension that target the gut microbiota include dietary interventions, mainly probiotic, prebiotic, synbiotic modulation. In addition to probiotic foods, live micro-organisms are also found in other food products, such as raw vegetables and fruits. In this study, we evaluated the potential impact of dietary live microbiome intake on all-cause mortality in different baseline characteristics, including kidney function status. Method A total of 20 627 subjects were included in the study. We used data from the US National Health and Nutrition Examination Survey 2011-2018. Based on a 2-day 24-hour dietary recall, the dietary intake of the live microbiome was adjusted and the participants were categorized into three groups: low (&amp;lt;104 CFU/g), medium (104–107 CFU/g), or high (&amp;gt;107 CFU/g) dietary intake of live microbes, according to the classification system for the dietary intake of live microbes and participants’ 24-hour dietary recall data. Low intake was used as a reference. Baseline characteristics included kidney function by estimated glomerular filtration rate (GFR-EPI &amp;lt;60 mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (uACR &amp;gt;30 mg/g). We used a multivariate Cox proportional hazards model to identify the impact of dietary live microbiome intake on all-cause mortality. In subgroups, we adjusted the Hazard Ratio (aHR) of the additional factors in the models. Results The risk for all-cause mortality was significantly decreased in subjects included in the medium dietary live microbiome intake (HR: 0.82, 95% Cl: 0.73-0.93, p &amp;lt; 0.004). In subgroup analysis (N = 3302), medium dietary intake of the live microbiome decreased mortality in subjects with eGFR &amp;lt;60 mL/min/1.73 m2 or uACR &amp;gt;30 mg/g and BMI &amp;gt;25 (aHR: 0.86, 95% CI: 0.75-0.99, p&amp;lt;0.05) as compared to low dietary intake of the live microbiome group after adjustment for hypertension, diabetes, BMI, total calorie intake, laboratory results (hemoglobin, creatinine, total cholesterol, estimated glomerular filtration rate). However, there was no significance to the risk for all-cause mortality in the subgroup with CKD between the high and low dietary live microbiome intake groups. Conclusion In this study, low dietary live microbial intake significantly increased all-cause mortality in the population. The medium dietary intake of live microbiome significantly decreased all-cause mortality in overweight or obese patients with CKD or microalbuminuria.

Association of dietary selenium intake and all-cause mortality of Parkinson’s disease and its interaction with blood cadmium level: a retrospective cohort study

BackgroundParkinson’s disease (PD) is a slowly progressive neurodegenerating disease that may eventually lead to disabling condition and pose a threat to the health of aging populations. This study aimed to explore the association of two potential risk factors, selenium and cadmium, with the prognosis of Parkinson’s disease as well as their interaction effect.MethodsData were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 to 2015–2016 and National Death Index (NDI). Participants were classified as Parkinson’s patients by self-reported anti-Parkinson medications usage. Cox regression models and restricted cubic spline models were applied to evaluate the association between PD mortality and selenium intake level as well as blood cadmium level. Subgroup analysis was also conducted to explore the interaction between them.ResultsA total of 184 individuals were included. In full adjusted cox regression model (adjusted for age, gender, race, hypertension, pesticide exposure, smoking status and caffeine intake), compared with participants with low selenium intake, those with normal selenium intake level were significantly associated with less risk of death (95%CI: 0.18–0.76, P = 0.005) while no significant association was found between low selenium intake group and high selenium group (95%CI: 0.16–1.20, P = 0.112). Restricted cubic spline model indicated a nonlinear relationship between selenium intake and PD mortality (P for nonlinearity = 0.050). The association between PD mortality and blood cadmium level was not significant (95%CI: 0.19–5.57, P = 0.112). However, the interaction term of selenium intake and blood cadmium showed significance in the cox model (P for interaction = 0.048). Subgroup analysis showed that the significant protective effect of selenium intake existed in populations with high blood cadmium but not in populations with low blood cadmium.ConclusionModerate increase of selenium intake had a protective effect on PD mortality especially in high blood cadmium populations.

Dietary vitamin intake and cancer risk in patients with chronic kidney disease: results from the National Health and Nutrition Examination Survey (2007-2018).

The relationship between vitamin intake and cancer risk in the chronic kidney disease (CKD) population is unknown. For this reason, we investigated the relationship between dietary vitamin intake and cancer risk in CKD patients and looked for effective vitamin dietary patterns. This study included 3518 CKD patients from 2007 to 2018 National Health and Nutrition Examination Survey database. All participants were categorized into four groups based on vitamin intake by K-mean clustering. The data were collected and analyzed from June 2023 to December 2023. A total of 3518 CKD patients with a mean age of (61.8 ± 16.3) years were included in the study. During a median follow-up of 7.3years, 137 participants died of cancer. In the multivariate adjusted cox proportional hazards model for single vitamin intake, vitamin E Q4 intake (reference Q1) reduced cancer mortality (HR (95% CI) = 0.45 (0.24-0.87), P = 0.018). Further plotting of the restricted cubic spline curve revealed a linearly decreasing relationship between vitamin E intake and cancer mortality (Poverall = 0.010 Pnon-linear = 0.163). In the multivariate adjusted cox proportional hazards model for multivitamin co-intake, the vitamin C/K intake group reduced cancer mortality compared to the low vitamin intake group (HR (95% CI) = 0.42 (0.20-0.88), P = 0.022). Increased vitamin C intake was independently associated with reduced cancer risk in CKD patients, and a vitamin dietary pattern with high vitamin C/K intake was also effective in reducing cancer risk.

Potassium affects the association between dietary intake of vitamin C and NAFLD among adults in the United States.

Although the association between nonalcoholic fatty liver disease (NAFLD) and vitamin C has been well studied, the effects of dietary potassium intake on this relationship are still unclear. Thus, this study aimed to determine the effects of dietary potassium intake on the association between vitamin C and NAFLD. We performed a cross-sectional learn about with 9443 contributors the usage of 2007-2018 NHANES data. Multiple logistic regression evaluation has been utilized to check out the affiliation of dietary vitamin C intake with NAFLD and advanced hepatic fibrosis (AHF). Subsequently, we plotted a smoothed match curve to visualize the association. Especially, the analysis of AHF was conducted among the NAFLD population. In addition, stratified evaluation used to be developed primarily based on demographic variables to verify the steadiness of the results. Effect amendment by way of dietary potassium intake used to be assessed via interplay checks between vitamin C and NAFLD in the multivariable linear regression. In this cross-sectional study, we found that vitamin C was negatively related to NAFLD and AHF. The relationship between vitamin C and NAFLD was different in the low, middle and high potassium intake groups. Furthermore, potassium intake significantly modified the negative relationship between vitamin C and NAFLD in most of the models. Our research showed that potassium and vitamin C have an interactive effect in reducing NAFLD, which may have great importance for clinical medication.

The impact of guideline recommended protein intake on mortality and length of intensive care unit and hospital stay in critically ill adults: A systematic review

International guidelines recommend a target protein intake of ≥1.2 g/kg/day to all critically ill patients for optimal outcomes. There are however various conflicting data related to this recommendation. The primary objective of this review was to compare a protein intake group (≥1.2 g/kg/day) with a lower protein intake group (<1.2 g/kg/day) in critically ill adult patients on mortality, length of intensive care unit (ICU) and hospital stay. Secondly, the effect of protein intake on length of mechanical ventilation, adverse nutrition-related events and muscle mass and strength parameters were investigated. Sixteen randomised controlled trials (RCTs) of adult patients admitted to an intensive or high care unit and receiving nutrition support in the form of enteral- and/or parenteral nutrition were selected against prespecified eligibility criteria. Two independent reviewers extracted relevant data and assessed the risk of bias of the included studies. Review Manager 5.4.1 was used to analyse data and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was used to evaluate the certainty of the evidence. The higher protein group, when compared to the lower protein group, probably results in little to no difference in mortality (risk ratio [RR] 1.01; 95% confidence interval [CI]: 0.89 to 1.14; moderate-certainty evidence); with a probable slight increase in length of ICU stay (mean difference [MD] 0.33; 95% CI -0.57 to 1.23; moderate-certainty) and length of hospital stay (MD 1.72; 95% CI -0.58 to 4.01; moderate-certainty evidence), on average. For secondary outcomes, it was found that the higher protein group probably does not reduce the length of mechanical ventilation (MD 0.08; 95% CI -0.38 to 0.53; moderate-certainty evidence). Higher protein group probably reduces the occurrence of diarrhoea and high gastric residual volume and may reduce the occurrence of constipation. It may also increase nitrogen balance (MD 3.66; 95% CI 1.81 to 5.51; low-certainty evidence). Importantly, there does not seem to be harm associated with the higher protein group, though it should be mentioned that for many of the adverse events in this study, the certainty of evidence was low or very low.

Abstract P254: Association Between Protein Intake and Prevalence of Sarcopenia in Japanese Community-Dwelling Older Adults

Background and Aim: To determine the protein intake associated with the prevalence of sarcopenia, we conducted a cross-sectional study of 1251 community-dwelling older Japanese aged 60 years and older. Methods: The mean age of the participants was 68.8 years, and the percentage of women was 56.7%. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 by low muscle mass (skeletal muscle mass), muscle strength (grip strength), and physical performance (gait speed). Protein and energy intake were assessed using a food frequency questionnaire (FFQ). Logistic regression models were used to estimate the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (95%CIs) of the prevalence of sarcopenia according to gender-specific tertiles of protein intake as a percentage of total energy. Corresponding analyses were done also for protein intake per day and for protein intake per kg of body weight, separately, instead of protein intake as a percentage of total energy. Results: The prevalence of sarcopenia was 8.0% (100/1251). The median protein intake as a percentage of total energy, protein intake per day, and protein intake per body weight by gender were, in order, 11.8%E, 59.2 g/day, and 0.9 g/kg/day for males and 14.1%E, 54.7 g/day, and 1.0 g/kg/day for females. Since there was no gender interaction in the association between each protein intake and the prevalence of sarcopenia, we performed the analysis for males and females combined. The multivariable adjusted ORs (95%CI) of the prevalence of sarcopenia was lower in the high protein intake as a percentage of total energy (&gt;12.6%E in males and &gt;15.2%E in females, respectively) group (0.47 (0.27-0.83)) than in the low intake (&lt;11.1%E in males and &lt;13.4%E in females, respectively) group; the linear trend was significant (p =0.009). Similarly, we found a significantly inverse association for sarcopenia prevalence at protein intakes higher than 54.4 g/day for males and 50.6 g/day for females, compared to those with lower intakes. However, there was no association between protein intake per body weight and the prevalence of sarcopenia. We obtained similar results when the participants were restricted to those 65 years and older as a sensitivity analysis. Conclusion: Significant inverse associations were found between the prevalence of sarcopenia and protein intake in community-dwelling older Japanese. However, we should consider that protein intake assessed by the FFQ is often underestimated when discussing absolute protein intake for sarcopenia prevention.