Median Intake Research Articles

Partial weight reduction protocols in cats lead to better weight outcomes, compared with complete protocols, in cats with obesity.

To date, there have been no studies comparing outcomes of cats with obesity following either complete or partial weight reduction protocols. Fifty-eight cats participated in this non-randomized observational cohort study, including 46 (79%) and 12 (21%) that underwent complete or partial weight reduction protocols, respectively. Weight loss outcomes, body composition changes and essential nutrient intake were compared between cats in the two groups. All cats remained healthy, and those on a complete weight reduction protocol lost a median of 23% (range 10-39%) of starting body weight (SBW) over 294 days (113-967 days), whereas those undergoing partial restriction lost 25% (10-41%) over 178 days (54-512 days). Neither duration nor percentage weight loss differed between groups, but those that followed a partial weight reduction protocol lost weight at a faster rate (0.81% per week) and required fewer visits (4-19) than those that followed a complete weight reduction protocol (0.61% per week, p = 0.028; 11, 4-40 visits, p = 0.009). Further, lean tissue mass declined in cats on a complete weight reduction protocol (pre: 4.20 kg, 2.64-5.72 kg; post: 3.90 kg, 2.76-5.24 kg, p < 0.001), whereas lean tissue mass was unchanged in cats on partial weight reduction protocols (pre: 3.45 kg, 2.79-4.71 kg; post: 3.41 kg, 2.90-4.59 kg, p = 0.109). In 33 (57%) cats, median intake of selenium per day was less than NRC AI and RA recommendations, whilst intake was under FEDIAF recommendation in 42 (72%) cats. Median intake of choline per day was less than NRC MR and RA recommendations in 22 (38%) and 53 (91%) cats, respectively, whereas it was under the FEDIAF recommendation in 51 (88%) cats. In a small proportion (12-14%) of cats, phenylalanine/tyrosine and potassium were under recommendations; besides these, no other essential nutrient deficiencies were seen, and there were no differences between cats undergoing complete and partial weight reduction. Partial weight reduction protocols in cats lead to quicker average weight loss, with the possibility that lean tissue loss might be minimized. Such protocols might be more suitable for older cats and those with marked obesity.

Dietary ω-3 fatty acids and the incidence of atrial fibrillation in the Million Veteran Program

BackgroundAlthough recent large randomized clinical trials have reported an increased risk of atrial fibrillation (AF) with marine ω-3 fatty acid supplements, it is unclear whether dietary marine ω-3 fatty acids assessed through food frequency questionnaires are associated with AF risk. ObjectivesWe sought to test the hypothesis that dietary eicosapentaenoic acid/docosahexaenoic acid/docosapentaecnoic acid (EPA/DHA/DPA) is associated with a higher risk of AF in a large prospective cohort of US Veterans. MethodsWe analyzed data from Million Veteran Program participants who completed self-reported food frequency questionnaires. We used multivariable Cox regression to estimate the HRs of AF across quintiles of ω-3 fatty acid consumption and a cubic spline analysis to assess the dose–response relations between ω-3 fatty acids and AF. ResultsOf the 301,294 veterans studied, the median intake of ω-3 fatty acids (EPA/DHA/DPA) was 219 mg/d (IQR: 144–575), and the mean age was 64.9 y (SD: 12.0); 91% were men, and 84% were White. Consumption of EPA/DHA/DPA exhibited a nonlinear inverse relation with incident AF characterized by an initial decline to 11% at 750 mg/d of marine ω-3 fatty acid intake followed by a plateau. ConclusionsContrary to our hypothesis, dietary EPA/DHA/DPA was not associated with a higher risk of AF but was inversely related to AF risk in a nonlinear manner.

Dietary Intake and Nutritional Status in Diabetic and Nondiabetic Patients With Chronic Kidney Disease Stage 4-5 (NutriDiab Study)

The aim of the present study was to assess the dietary intake and nutritional status of patients with chronic kidney disease (CKD) stage 4-5 according to the presence of diabetes. This observational and cross-sectional study included adult patients with CKD stage 4-5 referred to a nephrology unit, between October 2018 and March 2019. Daily dietary intake was evaluated by 24-hour dietary inquiry and urine excretion. Nutritional status was assessed by measuring body composition using bioimpedance analysis and muscle function using handgrip strength. Undernutrition was considered using the protein energy wasting score. A total of 75 CKD patients were included, 36 (48%) of whom had diabetes; median age (interquartile range) was 71 (60-80) years. The median weight-adjusted dietary energy intake (DEI) was 22.6 (19.1-28.2) kcal/kg/day and the mean weight-adjusted dietary protein intake (DPI) was 0.86±0.19g/kg/day. There was no significant difference in DEI and DPI between patients with diabetes and those without, except for weight-adjusted DPI which was significantly lower in diabetic patients (P=.022). In univariate analysis, diabetes was associated with weight-adjusted DPI (coefficient [95% confidence interval] -0.237 [-0.446; -0.004] kcal/kg/day; P=.040), but this association did not remain significant in multivariate analysis. Nutritional status did not differ significantly between diabetic and nondiabetic patients except for lean tissue mass, which was lower in diabetic patients (P=.046). The proportion of patients with protein energy wasting was not significantly different between diabetic and nondiabetic patients (13.9% vs. 10.2%, respectively). In the present cohort, DPI and DEI were not significantly different between diabetic and nondiabetic CKD patients. Diabetes was not found to be associated with dietary intakes in CKD stage 4-5 patients.

Dairy products and kidney function decline after myocardial infarction: A prospective analysis in the Alpha Omega Cohort

Population-based studies have shown both beneficial and neutral associations between dairy consumption and kidney function outcomes. We investigated the association between dairy products and kidney function decline in drug-treated post-myocardial infarction (MI) patients. We analysed data of 2169 post-MI patients (aged 60-80 years, 81% male) of the Alpha Omega Cohort. Dietary data were collected at baseline (2002-2006) using a validated 203-item food frequency questionnaire. The 2021 Chronic Kidney Disease Epidemiology (CKD-EPI) equation was used to estimate 40-months change in creatinine-cystatin C based glomerular filtration rate (eGFRcr-cysC, mL/min per 1.73m2). Beta coefficients and 95% confidence intervals (CIs) for dairy products in relation to annual eGFRcr-cysC change were obtained from multivariable linear regression, adjusted for age, sex, energy intake, and other lifestyle and dietary factors. Baseline energy-adjusted median intakes were 64g/day for total milk, 20g/day for hard cheeses, 18g/day for plain yogurt, and 70g/day for dairy desserts. Mean±SD eGFRcr-cysC was 84±20 (13% with CKD), and annual eGFRcr-cysC change was-1.71±3.85. In multivariable models, high vs. low intakes of total milk, cheese, and dairy desserts were not associated with annual eGFRcr-cysC change (βtotal milk:-0.21 [-0.60; 0.19], βcheese:-0.08 [-0.52; 0.36], βdairy desserts:-0.24 [-0.72; 0.24]). High vs. low intake of yogurt was adversely associated with annual eGFRcr-cysC change (βtotal yogurt:-0.50 [-0.91;-0.09]), but subsequent spline analyses showed no clear dose-response association. Intakes of milk, cheese or dairy desserts were not associated with a delayed kidney function decline after MI. The observed adverse association for yogurt should be interpreted with caution. Our findings require confirmation in other cohorts of coronary heart disease patients.

Associations of diet with survival of patients (pts) with metastatic cancer of the urothelium (mUC) and renal cell carcinoma (mRCC) on immune checkpoint blockade (ICB).

4598 Background: The gut microbiome is an emerging modifiable predictor of ICB efficacy. Diet impacts the gut microbiome and fiber intake is associated with longer progression-free survival (PFS) in advanced melanoma treated with ICB. Whether diet impacts ICB benefit in mUC or mRCC remains unknown. Methods: Using a prospective cohort design, baseline dietary data were collected from pts with mUC or mRCC initiating ICB at Memorial Sloan Kettering Cancer Center using the extensively validated Harvard Willett Food Frequency Questionnaire. Tumor mutational burden (TMB) was estimated by next generation sequencing (MSK-IMPACT). The primary endpoint was radiologist assessed PFS, with secondary endpoint of overall survival (OS). Fiber intake was stratified as high or low using the median intake in our cohort. Associations between fiber intake and clinical outcomes were assessed using Kaplan-Meier curves plus univariable (UV) and multivariable (MV) Cox proportional hazards regression. Models were adjusted for prior ICB exposure. Models for mUC controlled for TMB and Bellmunt risk factors. Models for mRCC controlled for histology (clear vs non-clear cell) and IMDC risk score. Results: From 2/2021-6/2022, 88 pts eligible for analysis were enrolled with median follow-up of 10.1 months (mo) (mUC n = 40; mRCC n = 48). Median fiber intake was 17.5 g/day (interquartile range 12.5-24.5). Among pts with mUC, high fiber intake (≥17.5 g/day) was associated with longer PFS (UV hazard ratio [HR] 0.56, 95% CI 0.26-1.19, p = .13; MV HR 0.39, 95% CI 0.16-0.93, p = .03). Similar trends were observed for mRCC. In subgroup analyses, PFS was numerically longer with high fiber intake among mUC pts on maintenance avelumab (median PFS 6.1 vs 3.0 mo, n = 14) and in pts with mRCC treated with first-line (1L) ipilimumab + nivolumab (median PFS 18.0 vs 5.7 mo, n = 14) and 1L ICB + tyrosine kinase inhibitor (median PFS not reached vs 5.1 mo, n = 21). Among pts with mUC on non-maintenance ICB, pts with high fiber intake had numerically higher PFS at 6 mo (38% vs 14%, n = 26). Conclusions: This pilot study indicates that high fiber intake is associated with longer PFS among pts with mUC on ICB. Trends towards longer PFS and OS with high fiber intake were observed among pts with mRCC. Analyses of the gut microbiome are underway to investigate mechanisms of action. [Table: see text]

Iodine Intake From Diet and Supplements and Urinary Iodine Concentration in a Cohort of Pregnant Women in the United States

BackgroundThe DRI Estimated Average Requirement (EAR) in pregnancy for Iodine (I), an essential nutrient for fetal neurodevelopment, is 160 μg/d. Supplementation with 150 μg/d I/day is recommended during pregnancy, however, neither dietary intake or the combination of diet and supplement intake has been reported in US pregnant women. ObjectiveDetermine iodine intake from diet and supplements and iodine status in pregnancy by urinary iodine concentration in a large cohort of pregnant women. DesignPregnant women (n=750) completed the Diet History Questionnaire 2.0 from the National Institute of Cancer or multiple 24-hour recalls at baseline and identified their prenatal supplement(s). Dietary iodine intake was estimated using the USDA, FDA and ODS-NIH Database for the Iodine Content of Common Foods at enrollment, supplemental iodine intake throughout the study using content databases, and urinary iodine concentration (UIC) by the modified Sandell-Kolthoff reaction in samples collected between 14-20 weeks gestation (n=966). ResultsThe median intake of iodine from diet was 108.8 μg/d, and 63% (473/750) were below the Estimated Average Requirement (EAR). Furthermore, 65% (529/818) took a supplement containing iodine, however, only 32% (259/818) took ≥150 μg/d. Median intake increased to 188.5 μg/d with the inclusion of I from supplements, however , 41% (380/925) remained below the EAR even after supplementation suggesting inadequate intake in nearly half of the cohort. A similar 48% (467/966) had UIC ≤150 μg/L. ConclusionsAssessment of iodine status by UIC and intake of iodine from diet and supplements support a high prevalence of iodine insufficiency during pregnancy in this large cohort of US women.

Estimated dietary intake of polyphenols from cereal foods and associated lifestyle and demographic factors in the Melbourne Collaborative Cohort Study

Cereal foods are consumed globally and are important sources of polyphenols with potential health benefits, yet dietary intakes are unclear. We aimed to calculate the dietary intakes of polyphenols from cereal foods in the Melbourne Collaborative Cohort Study (MCCS), and describe intakes by demographic and lifestyle factors. We estimated intakes of alkylresorcinols, lignans and phenolic acids in n = 39,892 eligible MCCS participants, using baseline dietary data (1990–1994) from a 121-item FFQ containing 17 cereal foods, matched to a polyphenol database developed from published literature and Phenol-Explorer Database. Intakes were estimated within groups according to lifestyle and demographic factors. The median (25th–75th percentile) intake of total polyphenols from cereal foods was 86.9 mg/day (51.4–155.8). The most consumed compounds were phenolic acids, with a median intake of 67.1 mg (39.5–118.8), followed by alkylresorcinols of 19.7 mg (10.8–34.6). Lignans made the smallest contribution of 0.50 mg (0.13–0.87). Higher polyphenol intakes were associated with higher relative socio-economic advantage and prudent lifestyles, including lower body mass index (BMI), non-smoking and higher physical activity scores. The findings based on polyphenol data specifically matched to the FFQ provide new information on intakes of cereal polyphenols, and how they might vary according to lifestyle and demographic factors.

Fluorinated liquid-crystal monomers in paired breast milk and indoor dust: A pilot prospective study

Fluorinated liquid-crystal monomers (FLCMs), one class of emerging persistent, bioaccumulative and toxic (PBT) compounds, are widely used in liquid-crystal displays (LCDs). As a result, they have been found in the environment and serum from occupational workers. However, little is known about their occurrence in non-occupational exposing populations. Herein, we provided an evaluation of the health risks of FLCMs for infants based on breastfeeding exposure and dust ingestion. The detection frequencies (DF) of FLCMs in indoor dust and breast milk was 100 %, with median concentrations of 12.00 ng/g dry weight (dw) and 133.40 ng/g lipid weight (lw), respectively. 1-butoxy-2,3-difluoro-4-(trans-4-propylcyclohexyl)benzene (BDPrB) was the predominant pollutant in indoor dust and human breast milk. Significant positive correlations were observed between the dust concentrations of seven FLCMs including BDPrB, and their breast milk concentrations (r = 0.275–0.660, P < 0.05). Further, associations were also found in some demographic and behavioral factors and concentrations of some FLCMs (P < 0.05). The highest EDI of ∑FLCMs was observed for infants who were < 1 month of age, with a median breast milk intake of 700.35 ng/kg bw/day, in which 1-ethoxy-2,3-difluoro-4-(trans-4-propylcyclohexyl)benzene (EDPrB), BDPrB, and 4′-[(trans, trans)-4′-butyl[1,1′-bicyclohexyl]-4-yl]-3,4-difluoro-1,1′-biphenyl (BBDB) collectively contributed 94.4 % of the total EDIs. Notably, the lactational intake of FLCMs was higher than that of some environmental pollutants (EPs). Overall, our results suggest higher exposure risks for infants and breastfeeding is the predominant exposure route for daily intake of FLCMs for infants.

Dietary Iodine Intake and Related Factors among Secondary School Students in Macao.

Iodine is a crucial micronutrient that is indispensable for optimal physical growth and cognitive maturation. However, the dietary iodine intake status of Macao's population is unknown. Therefore, a cross-sectional study was conducted to assess the dietary iodine intake of Macao secondary school students. Four hundred and twenty-four students filled in a self-developed, 61-item, iodine-specific food frequency questionnaire (I-FFQ). The dietary iodine intake was calculated based on the I-FFQ and food composition database. The median daily iodine intake of the students was 74.4 µg, which is lower than the 150 µg recommended by the World Health Organization (WHO). The intake frequency of dried seaweed and kelp was also low, with 49.3% and 64.2% of students consuming these foods infrequently over a month. In conclusion, the dietary iodine intake of secondary school students in Macao was inadequate. It is recommended that individuals should take the initiative to gain iodine-related knowledge. Students are advised to eat a variety of iodine-rich foods, such as seaweed and seafood, as part of a healthy, balanced diet to ensure sufficient iodine intake. Furthermore, it will be necessary to measure urinary iodine for the iodine status assessment of the Macao population in future.

Folate and vitamin B12 usual intake and biomarker status by intake source in United States adults aged ≥19 y: NHANES 2007–2018

BackgroundFolate and vitamin B12 are important biomarkers of nutritional status of populations. ObjectivesThis study aims to estimate folate and vitamin B12 usual intakes among United States adults and examine folate and vitamin B12 biomarker status by intake source. MethodsWe analyzed data for United States adults aged ≥19 y from National Health and Nutrition Examination Survey 2007–2018 (n = 31,128), during which time voluntary corn masa flour (CMF) fortification was started. Usual intake was estimated using the National Cancer Institute method. Folate intake included folate from natural foods and folic acid from 4 sources: enriched cereal grain products (ECGPs), CMF, ready-to-eat cereals (RTEs), and folic acid–containing supplements (SUP). Vitamin B12 intake was mainly from food and supplements. ResultsThe median natural food folate intake (222 μg dietary folate equivalents (DFE)/d) was below the estimated average requirement (EAR) of 320 μg DFE/d. The proportions of those who consumed folic acid from ECGP/CMF only, ECGP/CMF + RTE, ECGP/CMF + SUP, and ECGP/CMF + RTE + SUP were 50%, 18%, 22%, and 10%, respectively. Median usual folic acid intakes (μg/d) were 236 (IQR: 152, 439) overall and 134, 313, 496, and 695 in the ECGP/CMF only, ECGP/CMF + RTE, ECGP/CMF + SUP, and ECGP/CMF + RTE + SUP folic acid consumption groups, respectively. Overall, 2.0% (95% CI: 1.7%, 2.3%) of adults, all of whom used folic acid supplements, consumed greater than the tolerable upper intake level (UL) of 1000 μg/d folic acid. The median usual vitamin B12 intake (μg/d) was 5.2 for vitamin B12 supplement nonusers and 21.8 for users. Consumption of RTE and/or supplements with folic acid was associated with higher serum and red blood cell folate concentrations. Vitamin B12 supplement users had significantly higher serum vitamin B12 concentrations. ConclusionsFolic acid fortification plays a critical role in helping United States adults meet the folate EAR. At current fortification levels, United States adults who do not consume supplements do not have the usual folic acid intake exceeding the UL.

Long-term treatment with teduglutide: a 48-week open-label single-center clinical trial in children with short bowel syndrome

BackgroundShort bowel syndrome (SBS) is the main cause of intestinal failure in children. ObjectivesThis single-center study evaluated the safety and efficacy of teduglutide in pediatric patients with SBS–associated intestinal failure (SBS-IF). MethodsChildren with SBS followed at our center with ≥2 y on parenteral nutrition (PN) and with small bowel length <80 cm who had reached a plateau were consecutively included in the study. At baseline, participants underwent a clinical assessment including a 3-d stool balance analysis, which was repeated at the end of the study. Teduglutide was administered subcutaneously 0.05 mg/kg/d for 48 wk. PN dependence was expressed as the PN dependency index (PNDI), which is the ratio PN non-protein energy intake/REE. Safety endpoints included treatment-emergent adverse events and growth parameters. ResultsMedian age at inclusion was 9.4 y (range: 5–16). The median residual SB length was 26 cm (IQR: 12–40). At baseline, the median PNDI was 94% (IQR: 74–119), (median PN intake: 38.9 calories/kg/d, IQR: 26.1–48.6). At week 24, 24 (96%) children experienced a reduction of >20% of PN requirements with a median PNDI = 50% (IQR: 38–81), (PN intake: 23.5 calories/kg/d IQR: 14.6–26.2), P < 0.01. At week 48, 8 children (32%) were weaned completely off PN. Plasma citrulline increased from 14 μmol/L (IQR: 8–21) at baseline to 29 μmol/L (IQR: 17–54) at week 48 (P < 0.001). Weight, height, and BMI z-scores remained stable. The median total energy absorption rate increased from 59% (IQR: 46–76) at baseline to 73% (IQR: 58–81) at week 48 (P = 0.0222). Fasting and postprandial endogenous GLP-2 concentrations increased at weeks 24 and 48 compared with baseline. Mild abdominal pain at the early phase of treatment, stoma changes, and redness at the injection site were commonly reported. ConclusionsIncreased intestinal absorption and PN dependency reduction were observed with teduglutide treatment in children with SBS-IF. Trial registrationClinicalTrials.gov NCT03562130. https://clinicaltrials.gov/ct2/show/NCT03562130?term=NCT03562130&draw=2&rank=1

Fluid overload in newborns undergoing abdominal surgery: a retrospective study

Background Fluid management in newborns undergoing surgery can be challenging due to difficulties in accurately assessing volume status in context of high fluid needs perioperatively and postoperative third-space fluid loss. Fluid overload can be associated with an increase in neonatal morbidity and mortality. Objective Our objective was to determine the burden of fluid overload and to evaluate their associations with adverse effects among infants undergoing abdominal surgery at a tertiary perinatal center. Methods Patients from our Neonatal Intensive Care Unit who underwent abdominal surgery from January 2017 to June 2019 were included in this retrospective cohort study. Fluid balance was assessed based on the maximum percentage change in body weight at 3- and 7-postoperative days. Results Sixty infants were included, with a median [interquartile range] gestational age (GA) of 29 [25–36] weeks and birth weight of 1240 [721–2871] grams. The median daily actual fluid intake was significantly higher than the prescribed fluid intake in the first 7 postoperative days (163 vs. 145 mL/kg, p < .01). The median maximum change of body weight by postoperative days 3 and 7 were 6% [3–13] and 11% [5–17], respectively. A 1% increase in weight within the first 3 postoperative days was associated with a 0.6-day increase for invasive ventilatory support (p = .012). The correlation was still significant after adjusting for GA (p = .033). Conclusion Fluid overload within the first 3 postoperative days was associated with an increase in ventilator support among infants. Careful attention to fluid management may affect the optimization of outcomes for newborns undergoing abdominal surgery.

Association of Women Leading Land Use with Energy and Nutrient Intakes Among Children Aged 6 to 59 Months in Oromia, Ethiopia

Nutrition-specific interventions alone will not help countries to end child malnutrition; nutrition-sensitive interventions such as women empowerment are also needed. Therefore, this cross sectional study was conducted to assess the association of women leading land use with nutrient intakes among children aged 6 to 59 months in Oromia, Ethiopia. Three hundred thirty-two caregivers participated in the study. A pretested questionnaire was used to collect data on background characteristics of child caregivers, women leading land use status, and caregivers’ exposure to mass media. Dietary assessment for nutrients intake was collected using a 24-hour recall. The survey data was analyzed using SPSS software version 25. Descriptive statistics were presented in frequency and percentages and in the form of mean ± SD. The nutrient intakes were compared with recommended dietary allowances to analyze the gap between the intakes and the recommendations were presented as percentages. Any difference in the variables was compared, based on women leading land use, using Chi square test and Mann Whitney u test, depending on the type of data. Results were considered statistically significant at P<0.05. Starchy staples were consumed by more than 90% of the children; close to ¾ of the children consumed legumes and nuts; animal source foods consumption was below 20% except dairy products (84%). Vitamin A rich fruits and vegetables were consumed by 33% of the children on average; and the minimum dietary diversity score was achieved by 48% of the children. The median energy intakes for children aged above a year and calcium intakes during the second half of the first year were more than 90%. On the other hand, the intakes of energy, at the stage of the second 6 months, fat, the calcium (>1 year) and the ascorbic acid intake were below 90%. Intake of Fat and Ascorbic acid was very low. Interestingly, iron intake for the children of 6-12 months age was more than 100%. However, there was statistical difference (p<0.05) in the proportion children of women with land leading power and without land leading power who consumed starchy staples, legumes and nuts, dairy products as well as ascorbic acid. Women empowerment in deciding land use issues affect about their child feeding practices and ultimately nutritional outcome and therefore, Women empowerment should be ensured for better child feeding practices and nutrients intake.

Iodine intake assessment in the staff of a Porto region university (Portugal): the iMC Salt trial

PurposeIodine deficiency disorder (IDD) is an ongoing worldwide recognized problem with over two billion individuals having insufficient iodine intake. School-aged children and pregnant women are often target groups for epidemiological studies, but there is a lack of knowledge on the general adult population. The aim of this study was to assess the iodine status among a Portuguese public university staff as a proxy for the adult working population.MethodsThe population study covered 103 adults within the iMC Salt randomized clinical trial, aged 24–69 years. Urinary iodine concentration was measured spectrophotometrically using the Sandell–Kolthoff reaction. Iodine food intake was assessed using a 24-h dietary recall. The contribution of discretionary salt to the iodine daily intake was assessed through 24-h urinary sodium excretion (UIE) and potentiometric iodine determination of household salt.ResultsThe mean urine volume in 24 h was 1.5 L. The median daily iodine intake estimated from 24-h UIE was 113 µg/day, being lower among women (p < 0.05). Only 22% of participants showed iodine intake above the WHO-recommended cutoff (150 µg/day). The median daily iodine intake estimated from the 24-h dietary recall was 58 µg/day (51 and 68 µg/day in women and men, respectively). Dairy, including yoghurt and milk products, were the primary dietary iodine source (55%). Iodine intake estimated from 24-h UIE and 24-h dietary recall was moderately correlated (Spearman rank correlation coefficient r = 0.34, p < 0.05). The average iodine concentration in household salt was 14 mg I/kg, with 45% of the samples below the minimum threshold preconized by WHO (15 mg I/kg). The contribution of discretionary salt to the daily iodine intake was around 38%.ConclusionThis study contributes new knowledge about iodine status in Portuguese working adults. The results revealed moderate iodine deficiency, particularly in women. Public health strategies and monitoring programs are needed to ensure iodine adequacy in all population groups.

Leptin levels in childhood tuberculosis and its correlation with body mass index, IFN-γ, and TNF-α in an Indonesian population

BackgroundLeptin plays a key role in the regulation of energy and inflammation in tuberculosis (TB). However, its correlation in children with TB remains unclear. Therefore, this study aimed to evaluate the correlations between body mass index, IFN-γ, TNF-α, and leptin levels in children with TB. MethodsThis was a cross-sectional study of children aged 2–14 years with TB. Sputum examination, chest radiography, and tuberculin skin test findings and clinical symptoms were considered for TB diagnosis. Data on body weight; height; mid-upper arm circumference (MUAC); body mass index (BMI); food intake; and IFN-γ, TNF-α, and leptin levels were collected and analyzed. ResultsOf the 64 diagnosed TB subjects, 2 subjects had positive bacteriological results. The median age was 6 (2–14) years, body weight was 17.7 (9.45–55) kg, height was 114 ± 21.46 cm, and Z score BMI was −0.85 ± 1.14 kg/m2. Malnourished was observed in 17.2% of the subjects. The median calorie intake was 1448.5 (676–4674) kcal, carbohydrate intake was 182.5 (63–558) g, protein intake was 57.9 (15.8–191.0) g, and fat intake was 81.6 (23.6–594.1) g. The median leptin level was 1.2 (0.2–59) ng/mL, IFN-γ was 2.5 (0.9–161) pg/mL, and TNF-α was 13.0 (5.7–356) pg/mL. Correlations were observed between leptin and MUAC (r = 0.251, p = 0.02), Z score (r = 0.453, p = 0.00), and IFN-γ (r = 0.295, p = 0.018). ConclusionThere were positive correlations between BMI and leptin levels, whereas IFN-γ and MUAC showed weak correlations.

Indices of Mediterranean diet adherence and breast cancer risk in a community-based cohort.

A Mediterranean-style dietary pattern is believed to have cancer-protective effects. We compared the prospective associations between adherence to four established Mediterranean diet indices and breast cancer risk (including total, postmenopausal, and hormone receptor positive cases) in women in the Framingham Offspring Study. The four indices used two different approaches to measuring adherence to a Mediterranean diet: (a) scores based on the population-specific median intakes of Mediterranean diet-related foods in a given population (i.e., alternate Mediterranean Diet (aMED) index and Mediterranean Diet Score (MDS) index), and (b) scores based on compliance with recommended intakes of relevant foods from the Mediterranean diet pyramid [i.e., Mediterranean Diet (MeDiet) index and Mediterranean Style Dietary Pattern (MSDP) index]. Dietary data were derived from semiquantitative food frequency questionnaires collected in 1991-95. Participants included 1579 women aged ≤ 30 years who were free of prevalent cancer. Women were followed through 2014, and Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for various confounders. During a median follow-up of approximately 18 years, 87 breast cancer cases were documented. Women in the highest (vs. lowest) score category of the pyramid-based scores (i.e., MeDiet or MSDP) had approximately 45% statistically significantly lower breast cancer risks. These effects were even stronger for any hormone receptor positive cases using the MeDiet index (highest vs. lowest score categories: HR = 0.45, 95% CI: 0.22-0.90). Neither of the median intake-based scores (i.e., aMED, MDS) was associated with breast cancer risk. Our results suggest that the methodology and the composition of Mediterranean diet indices influence their ability to assess conformity to this specific diet pattern and predict breast cancer risk.

Dietary Intake in Older Patients with Dementia Prior to and After the Onset of Coronavirus Disease 2019

This was an observational study of hospitalized patients with dementia who developed COVID-19. The disease course, dietary intake, and disease severity (mild/severe) were evaluated. Twenty-nine patients with a median age of 84 years, with both mild (18) and severe conditions, (11) were evaluated. Mild group had decreased food intake from the day of symptom onset. In the severe group, the decline began the day before symptom onset. On day 30 of the disease, the median food intake of the mild group returned to levels observed prior to symptom onset, in contrast to those in the severe group.

Biomarkers of seafood intake during pregnancy – Pollutants versus fatty acids and micronutrients

Intake of fish and seafood during pregnancy may have certain beneficial effects on fetal development, but measurement of intake using questionnaires is unreliable. Here, we assessed several candidate biomarkers of seafood intake, including long-chain omega 3 fatty acids (n-3 LCPUFA), selenium, iodine, methylmercury, and different arsenic compounds, in 549 pregnant women (gestational week 29) in the prospective birth cohort NICE (Nutritional impact on Immunological maturation during Childhood in relation to the Environment). Proportions of the fatty acids eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) in erythrocytes were measured using gas chromatography with flame ionization detector. Selenium was measured in blood plasma and erythrocytes, mercury and arsenic in erythrocytes, and iodine and several arsenic compounds in urine, using inductively coupled plasma mass spectrometry, arsenic compounds after first being separated by ion exchange high-performance liquid chromatography (HPLC). Each biomarker was related to intake of total seafood and to intake of fatty and lean fish, and shellfish in third trimester, estimated from a semi-quantitative food frequency questionnaire filled out in gestational week 34. The pregnant women reported a median total seafood intake of 184 g/week (5th-95th percentiles: 34–465 g/week). This intake correlated most strongly with erythrocyte mercury concentrations (rho = 0.49, p < 0.001), consisting essentially of methylmercury, followed by total arsenic in erythrocytes (rho = 0.34, p < 0.001), and arsenobetaine in urine (rho = 0.33, p < 0.001), the main form of urinary arsenic. These biomarkers correlated well with intake of both fatty fish, lean fish, and shellfish. Erythrocyte DHA and plasma selenium correlated, although weakly, mainly with fatty fish (rho = 0.25 and 0.22, respectively, both p < 0.001). In conclusion, elevated concentrations of erythrocyte mercury and urinary arsenobetaine can be useful indicators of seafood intake, more so than the n-3 LCPUFAs. However, the relative importance of the biomarkers may differ depending on the type and amount of seafood consumed.

Intake of soy products and soy isoflavones in relation to ovarian reserve

To investigate the association between intake of soy food and isoflavone with ovarian reserve. Previous studies suggest on the relationship between soy intake and human fertility are inconsistent. Some clinical studies suggest that soy and phytoestrogens may not be deleterious to reproduction and may even be beneficial in couples undergoing infertility treatment. However, no studies have evaluated the relationship between soy or isoflavone intake with markers of ovarian reserve other than follicle-stimulating hormone (FSH). Cross-sectional study. An academic fertility center. Patients presenting to an academic fertility center between 2007 and 2019 were invited to participate in the Environment and Reproductive Health Study. Six hundred and sixty seven participants reported their soy food intake and had an antral follicle count (AFC) assessment. Intake of 15 soy-based foods during the previous 3 months was obtained at baseline and intake of isoflavone was estimated. Participants were divided into 5 groups based on soy food and isoflavone intake considering those who did not consume soy as the reference group. Ovarian reserve was assessed using AFC as the primary outcome measure, with antimüllerian hormone (AMH) and FSH as secondary outcome measures. The AFC was measured on the third day of the menstrual cycle. Moreover, FSH and AMH levels were measured in blood samples obtained on the third day and the follicular phase of the menstrual cycle. To evaluate the association between soy intake and ovarian reserve, we used Poisson regression models for AFC and quantile regression models for AMH and day 3 FSH levels by adjusting for confounders. Participants had a median age of 35.0 years. The median intake of soy was 0.09 servings/day and isoflavones was 1.78 mg/day. Moreover, AFC, AMH, and FSH were unrelated to soy intake in crude analyses. We found no association between soy food intake with AFC or day 3 FSH level in multivariable models. However, participants in the highest category of soy food intake had significantly low AMH levels (-1.16, 95% confidence interval: -1.92, -0.41). Soy intake had no association with AFC, AMH, or FSH in sensitivity analyses that included using different cutoff points of soy intake, excluding participants in the highest 2.5 percentile of intake, and additional statistical adjustment for dietary patterns. The results of this study are not consistent with a strong positive or inverse association of soy or isoflavone intakes within the observed range of intake, which substantially overlaps with that in the general population of the United States as well as the ovarian reserve among individuals presenting to fertility centers.

The long-term clinical course of protein-losing enteropathy combined with iron deficiency anemia in Korean toddlers: Possible association with cow's milk protein.

Protein-losing enteropathy (PLE), a rare condition with excessive gastrointestinal protein loss, presents with hypoalbuminemia, edema, or ascites. Several cases of PLE combined with severe iron deficiency anemia (IDA) have been reported in infants and toddlers that were considered to result from excessive cow's milk consumption, although the mechanism has not been clearly established. We retrospectively reviewed the clinical, laboratory, endoscopic, and radiologic characteristics of patients diagnosed and treated for PLE with IDA between 2015 and 2021. Long-term outcomes were analyzed according to dietary intervention during the follow-up period. A total of 10 patients aged 7.0-26.7 months were enrolled in the study and the median follow-up duration of them was 9.4 months (range, 1.3-18.0). Six of them were fed powdered formula, while two were fed whole cow's milk, and their median daily intake was 700mL (range, 300-900). The times to normalization of hemoglobin, albumin, and eosinophil count were shorter in patients with dietary elimination of cow's milk protein immediately after diagnosis compared to those with reduced intake or no dietary change. Early complete elimination of cow's milk protein should be considered, especially if the laboratory parameters are not normalized with adequate iron supplementation even though the clinical symptoms show improvement. We would like to draw attention to the possibility of the cow's milk protein in the pathogenesis of the condition through the non-IgE-mediated immune reactions.