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Objective: Micronutrient status, specifically vitamin D and iron, represent modifiable factors for optimizing military readiness. The primary purpose of this investigation was to determine associations between micronutrient deficiency (i.e., iron status and 25-hydroxy-vitamin D [25(OH)D]) and operationally relevant outcomes (i.e., skeletal health, musculoskeletal injury) at baseline and post-10 weeks of arduous military training. Methods: A total of 227 (177 men, 50 women) Marine Officer Candidates School (OCS) candidates who completed OCS training with complete data sets were included in this analysis. Vitamin D and iron status indicators were collected at two timepoints, pre (baseline) and post OCS. Musculoskeletal outcomes at the mid- and proximal tibial diaphysis were assessed via peripheral quantitative computed tomography. Results: Micronutrient status declined following OCS training in men and women and was associated with musculoskeletal outcomes including greater bone strength (strength strain index) at the mid-diaphysis site in those with optimal status (M = 38.26 mm3, SE = 15.59) versus those without (M = −8.03 mm3, SE = 17.27). In women (p =.037), endosteal circumference was greater in the deficient group (M = 53.26 mm, SE = 1.19) compared with the optimal group (M = 49.47 mm, SE = 1.31) at the proximal diaphysis. In men, greater baseline hepcidin concentrations were associated with an increased likelihood of suffering musculoskeletal injury during training. Conclusions: Vitamin D and iron status declined over the course of training, suggesting impaired micronutrient status. Differences in musculoskeletal outcomes by micronutrient group suggests optimal vitamin D and ferritin concentrations may exert beneficial effects on bone fatigability and fracture reduction during military training. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated sex differences in self-reported causes, symptoms, and recovery strategies associated with underperformance in endurance athletes. Methods: A total of 82 athletes (40 women) meeting the inclusion criteria (performance level ≥tier 3, used training diaries, and experienced 1 or more periods of underperformance during their career) completed an online questionnaire. The questionnaire encompassed inquiries regarding load monitoring and experiences with underperformance, focusing on causes, symptoms, and recovery strategies. Results: The most frequently reported symptoms associated with underperformance included psychological (31%), physiological (23%), and health-related (12%) symptoms. Notably, female athletes were more likely to report psychological symptoms associated with underperformance (38% vs 25%, P =.01) compared with male athletes. The leading causes of underperformance comprised illness (21%), mental/emotional challenges (20%), training errors (12%), lack of recovery (10%), and nutritional challenges (5%). Female athletes reported nutritional challenges more frequently as the cause of underperformance compared with males (9% vs 1%, P =.01), whereas male athletes more often attributed underperformance to training errors (15% vs 9%, P =.03). Overall, 67% of athletes reported recovering from underperformance, with a tendency for more male than female athletes to recover (76% vs 58%, P =.07). Furthermore, a higher proportion of male than female athletes reported implementing changes in the training process as a recovery strategy (62% vs 35%, P =.02). Conclusions: This study offers valuable insights into sex differences in experiences with underperformance in endurance athletes. The findings could inform coaches and athletes in both the prevention and treatment of such incidents. [ABSTRACT FROM AUTHOR]

Background: Frailty is a state of vulnerability to poor homeostatic resolution of after a stressful event. The prevalence of frailty in patients with chronic kidney disease (CKD) is more common than in the general population. Frailty is associated with a poor clinical prognosis, malnutrition, and cognitive impairment; however, studies on these factors in patients with CKD are lacking. Therefore, we aimed to evaluate the relationship between CKD and frailty, nutritional status, and cognitive impairment and their influence on clinical outcomes. Methods: We prospectively enrolled participants from June 2019 to December 2020 and divided them into three CKD groups according to kidney function (CKD G1-2, CKD G3-4, and CKD G5D). Clinical outcomes were defined as the composite outcomes of all-cause death, hospitalization, and cardiovascular outcomes, including nonfatal myocardial infarction, revascularization, or stroke. To calculate the relative risk of frailty, cognitive impairment, nutritional status, and clinical outcome, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis. Result: A total of 83 patients were included, of whom 31.3% had frailty and 18.1% had cognitive impairment. In the CKD G5D group, the prevalence of frailty (56.7%, n = 17) was significantly higher, and the nutritional quotient score was lower in the other groups. The Korean-Montreal Cognitive Assessment score was significantly lower in the CKD G5D group; however, cognitive impairment did not differ among the three groups. Frailty was significantly associated with cognitive impairment and CKD G5D group. Cognitive impairment was significantly associated with older age and higher BMI. Well-nourished status was significantly associated with BMI and CKD G5D group. Patients in the CKD G5D group were significantly more likely to have adverse clinical outcomes. Conclusions: The prevalence of frailty increased significantly as the CKD stage progressed. Particularly, CKD G5D group correlated with frailty and nutritional status, leading to poor clinical outcomes. [ABSTRACT FROM AUTHOR]

The Women empowerment in the livestock sector has been emerged globally for assessing empowerment to promote sustainable development. This study aims to conduct a comprehensive review of existing literature on the interconnections among women's empowerment in the livestock sector, child nutrition, and livestock interventions. Utilizing the PRISMA Protocol 2020, our research considers diverse factors such as nutritional status and interventions through livestock, in conjunction with women's empowerment. We utilized major accessible electronic databases, including Google Scholar, PubMed, and relevant article references, as our data sources. Employing the PICO criteria and Boolean search technique, our study synthesizes published works, explores key concepts, and evaluates the strengths and weaknesses of various studies. Our findings reveal that women's empowerment is context-specific, and many studies do not encompass all dimensions of WE in the livestock sector. While the Women's Empowerment in Agriculture Index is widely employed in various contexts, there remains a need to further explore WE in the livestock sector. Moreover, our review highlights a narrow focus on livestock interventions in the existing literature. Although some studies explore the relationship between nutritional status and empowerment, only a limited number of studies examine the nexus among child nutritional status, livestock intervention, and empowerment. However, due to the limited studies conducted, a strong connection among these variables could not be firmly established. Consequently, our review underscores the substantial potential for a more comprehensive understanding of these interconnections. By elucidating the concepts and linkages among women's empowerment, child nutrition, and livestock interventions, our study contributes to enhanced knowledge and identifies avenues for future research and policy implications. [ABSTRACT FROM AUTHOR]

The relationship between nutrient intake and osteoarthritis (OA) remains unclear. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) in a multi-cycle retrospective cohort study to explore the associations between the intake of six nutrients—carbohydrates, dietary fiber, protein, fat, folate, niacin and OA. This study performed a cross-sectional analysis using NHANES data from 1999 to 2018 to investigate the relationship between the intake of six nutrients and OA. Univariate and multivariate weighted logistic regression models, along with restricted cubic splines (RCS), were applied to assess the associations between nutrient intake and OA. A total of 32,484 participants were included in the study, of whom 1864 were diagnosed with OA, resulting in a prevalence rate of 5.74%. Multivariate weighted logistic regression consistently demonstrated that dietary fiber, folic acid, and nicotinic acid intake were negatively associated with the presence of OA, while protein intake exhibited a J-shaped relationship with OA, and carbohydrate or fat intake showed no significant association with OA. Compared with participants in the lowest quartile (Q1), those in the highest quartile (Q4) of dietary fiber, folic acid, and nicotinic acid intake had 27%, 28%, and 33% lower odds of having OA, respectively, after adjusting for potential confounding factors. RCS analysis revealed that dietary fiber and nicotinic acid intake had a nonlinear relationship with the presence of OA, folic acid intake had a linear relationship with OA, and protein intake followed a J-shaped curve with OA. These results suggest that higher intake of dietary fiber, folic acid, and nicotinic acid is associated with a reduced likelihood of OA, while protein intake follows a J-shaped curve, with moderate intake offering the greatest protection. These findings highlight the importance of balancing protein intake and optimizing the consumption of other nutrients for the prevention and management of OA. Further research is needed to confirm these findings and clarify the underlying mechanisms. [ABSTRACT FROM AUTHOR]

The health benefits of a plant-based diet may be outweighed by an increased consumption of ultra-processed foods (UPF) and plant-based alternatives. This study compares diet quality (intakes of protein, saturated fatty acids, sugar, fiber, and micronutrients) and nutritional status (prevalence of low holotranscobalamin and ferritin levels) among different dietary patterns: 22.5% vegans, 46.5% vegetarians, 31% omnivores in 142 first-year college students (20 ± 1.6 years, BMI 21.9 ± 3.1 kg/m², 83% female). Intakes of vitamin B12, folate, iron, zinc, and calcium were on average below reference values, especially in vegans and vegetarians. However, the prevalence of low holotranscobalamin and ferritin levels did not differ between the dietary groups, presumably due to supplementation. Irrespective of the diet, UPF contributed to 49% of daily energy intake. UPF exhibited a lower content of protein, fiber, vitamin B2, vitamin B12, folate, zinc and calcium compared to processed foods (all p < 0.001). Plant-based alternatives contained more fiber and less saturated fatty acids whereas the content of protein and micronutrients was lower compared with animal products (all p < 0.05). In conclusion, UPF consumption contributes to the inadequate intake of many micronutrients by young adults. This is further aggravated by plant-forward eating patterns including the consumption of plant-based alternatives. [ABSTRACT FROM AUTHOR]

Geriatric nutritional risk index (GNRI), a simple, objective index for evaluating nutritional status of elderly patients, is demonstrated to be associated with the prognosis of several diseases. This study aims to explore the association between GNRI and prognosis of elderly aneurysmal subarachnoid hemorrhage (aSAH) patients. A total of 168 patients older than 65 years old were included in this research. The modified Rankin Scale (mRS) was applied to assess the prognosis of patients. Favorable outcome was defined as mRS <3 and unfavorable outcome was defined as mRS ≥ 3. The GNRI, calculated by albumin, height, and weight, was used to evaluate the nutritional status of elderly patients. Multivariate logistic regression was performed to identify the association between GNRI and prognosis of elderly aSAH patients. Compared with unfavorable outcome groups, favorable outcome group had higher GNRI level. After adjusting for several important factors, multivariate logistics regression analysis showed that low GNRI was associated with higher risk of unfavorable outcome. The receiver operating curve (ROC) analysis demonstrated that the area under the curve (AUC) was 0.720, which meant GNRI might be a reliable prognostic predictor. A low GNRI was independently associated with unfavorable outcome of elderly aSAH patients. The registration number is NCT04785976 and the registration data is February 2021. [ABSTRACT FROM AUTHOR]

Objective: To promote the application of high-quality frailty risk prediction models in the field of debilitation among Chinese patients undergoing MHD, and to provide a basis for optimisation and improvement of future studies. Methods: A literature search was conducted in Chinese and English databases (PubMed, Web of Science, Cochrane Library, CINAHL, Embase, CNKI, Wanfang, VIP, SinoMed) and the cutoff date for which was April 30, 2024. Literature characteristics, types of studies, predictors, model construction methods and results were analysed and compared. Results: Ten studies met the inclusion criteria, and seven were focused on model development and validation. A total of 12 predictive models were included across these 10 studies; three of these were solely model development studies, while seven were both model development and validation. The area under the curve (AUC) for the subjects' operating characteristics was > 0.7 in all ten studies. The most frequently identified predictors in the models included age, nutritional status, the presence of multimorbidity, gender, and depression. While the overall applicability of the ten studies was deemed satisfactory, it is important to note that all studies exhibited a high risk of bias, particularly concerning the data analysis component. Conclusion: The frailty risk prediction models for patients undergoing maintenance hemodialysis have demonstrated satisfactory applicability; however, they are all associated with a significant risk of bias and lack comprehensive external validation. To develop more accurate and practical prediction models, future studies must rely on large-sample, multicenter prospective cohort studies and adhere to a rigorous study design. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Child malnutrition is a public health concern in developing countries including Ghana. Ensuring a child's minimum meal frequency is met is critical for preventing malnutrition and improving nutrient intake. However, minimum meal frequency and its context-specific determinants among children in the Kumbungu District of Ghana are yet to be investigated. This study therefore examined minimum meal frequency and its determinants among children aged 6 to 23 months in Kumbungu District, Ghana. Methods: An analytical cross-sectional study design was used and involved 395 mother-child pairs selected through systematic random sampling. A semi- structured questionnaire was used to obtain respondents' socio-demographic characteristics, maternal nutritional knowledge and feeding practices and anthropometric information of children. Multivariate binary logistic regression analysis was used to determine the determinants of minimum meal frequency. Results: Of the 395 children studied, about 51.4% of them were females, with about 25.8% and 74.2% of them aged 6–8 months and 9–23 months respectively. About 72.4% of the children met the minimum meal frequency. Children aged 9–23 months were 3.48 times more likely to meet the minimum meal frequency as compared to children aged 6–8 months [Adjusted odds ratio (AOR): 3.48, 95% CI: 1. 33-9.03, p = 0.011]. Moreover, children who met the minimum dietary diversity were 46.32 times more likely to achieve the minimum meal frequency as compared to those who did not meet the minimum dietary diversity [AOR: 46.32, 95% CI: 17.78-120.64, p < 0.001]. Conclusions: The proportion of children who received minimum meal frequency was high. Child age and minimum dietary diversity were significant determinants of minimum meal frequency. To achieve optimal minimum meal frequency for all children, mothers should be encouraged to practice age appropriate meal frequency, particularly, those with children aged 6–8 months as well as feed their children diversified diets. [ABSTRACT FROM AUTHOR]

Background: Serum Neurofilament Light chain (NfL) is a promising biomarker of neuronal damage, used to assess the extent of neuronal injury and neurodegeneration, and it is widely applied in the diagnosis of neurodegenerative disease and monitoring disease progression. This article aims to determine whether serum NfL associated with cognitive level. Methods: Using NHANES data, we conducted an analysis of cognitive test results for 450 adults aged 60 years and older and examined their correlation with serum NfL levels. When exploring the association between cognitive test scores and serum NfL levels, regression models and restricted cubic spline (RCS) regression models were employed to adjust for potential confounding factors. The least absolute shrinkage and selection operator (LASSO) regression was applied for identifying key cognitive impairment factors, which was then included in the establishment of a risk prediction nomogram model, with the receiver operating characteristic (ROC) curve being built to evaluate its discriminatory power for cognitive impairment. Results: It was found that there is a strong positive correlation between serum NfL levels and both low total cognitive function (total-CF) OR: 1.028 (95%CI = 1.015–1.041 p < 0.001) and low Digit Symbol Substitution Test (DSST) OR: 1.026 (95%CI = 1.003–1.050, p = 0.027). Furthermore, using the RCS model, we observed a linear trend in the relationship between NfL and low total-CF. The nomogram model based on NfL identified by LASSO regression displayed a considerable predicative value for low total-CF, with an area under the curve [AUC = 85.6% (81.6–89.3%)]. Conclusion: There is a strong correlation between serum NfL levels and cognitive function, especially DSST, which reflects attention and information processing abilities, as well as overall cognitive function, but not memory and language fluency. Thus, NfL may serve as a serum biomarker for dementia monitoring. [ABSTRACT FROM AUTHOR]

Background: Sepsis is a critical condition characterized by severe immune dysregulation, ranking among the leading causes of morbidity and mortality in intensive care and internal medicine units. Nutritional status plays a pivotal role in modulating these responses, as when inadequate it can compromise immune defenses, the body's ability to handle stress and inflammation, and the clinical course. Malnutrition is frequently observed in septic patients and is strongly associated with worse clinical outcomes, including increased mortality, prolonged hospital stays, and greater complication rates. In this context, nutritional scoring systems have emerged as valuable tools to evaluate patients' nutritional status and predict clinical trajectories. Objectives: Given the absence of a direct comparison of their performance in an internal medicine setting, this study aimed to assess the effectiveness of various nutritional scores as predictive tools for clinical outcomes in septic patients, emphasizing their application within the field of internal medicine. Methods and Results: A retrospective analysis was conducted on 143 patients diagnosed with sepsis or septic shock who were admitted to an internal medicine unit. Key variables included clinical and laboratory parameters, comorbidities, and nutritional scores at the time of diagnosis. The modified Glasgow Prognostic Score (mGPS), the Prognostic Nutritional Index (PNI), the Controlling Nutritional Status (CONUT) score, the modified Nutrition Risk in Critically Ill (mNUTRIC) score, and the blood urea nitrogen-to-albumin ratio (BAR) were evaluated in forecasting mortality and clinical outcomes in patients with sepsis. Among them, the mNUTRIC score emerged as the strongest independent predictor of in-hospital mortality, with a good performance and a reasonable threshold for risk stratification. Conclusions: The study highlights the mNUTRIC score's practicality and reliability in assessing nutritional and inflammatory risks in septic patients, particularly in non-ICU settings. These findings suggest its potential utility in guiding nutritional interventions and improving clinical outcomes, emphasizing the importance of integrating nutritional assessment into sepsis management. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition is a major contributor to poor treatment and survival outcomes in pancreatic cancer, yet nutritional assessment is not standardized or consistently implemented in the care of oncology patients. The Geriatric Nutritional Risk Index (GNRI), calculated from serum albumin and body weight, may be useful as a practical tool for identifying patients at risk of poor nutritional status. Purpose: To provide a preliminary analysis using a limited selection of variables to examine the association of the GNRI at diagnosis and the GNRI change over time with overall survival in patients with pancreatic cancer. Methods: This retrospective study included 314 patients aged ≥18 years with pancreatic cancer. The GNRI was calculated at diagnosis and ≥30 days later. Patients were categorized by the GNRI at diagnosis (no risk >98, any risk ≤98) and change in the GNRI over time (no change/increase, mild decrease, and severe decrease). Additional variables included were demographics and stage. Comparative analysis included t-tests, chi-square tests, and ANOVA. Survival was analyzed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazards modeling. Results: Median survival was significantly decreased in patients in the any-nutritional-risk group compared to the no-nutritional-risk group at diagnosis (442 vs. 1105 days), and those experiencing severe decreases in the GNRI scores compared to mild decreases and no change or increases (372.5 vs. 712 vs. 1791 days), respectively. Survival analysis stratified by the GNRI at diagnosis shows that both mild (HR 2.19, 95%, and CI 1.46–3.30) and severe decreases (HR 4.04, 95%, and CI 2.64–6.18) in the GNRI scores were independently associated with decreased survival versus no change or increase in the GNRI group after controlling for stage. Log-rank tests also show patients with any nutritional risk at diagnosis had significantly lower survival than those with no nutritional risk (p = 0.00052). Conclusions: Lower GNRI scores showing greater nutritional risk at diagnosis and decreasing GNRI scores over time were predictors of decreased survival in pancreatic cancer. Our findings indicate that the GNRI may be valid and effective for the early identification of patients with a high nutritional risk who require nutritional interventions to improve outcomes in pancreatic cancer. However, more research is needed using larger samples and a greater variety of variables to confirm the presence and strength of this relationship, examine the effect of patient factors known to be associated with survival and nutrition, and explore potential influential confounders. [ABSTRACT FROM AUTHOR]

Background/Objectives: The dietary changes experienced by residents in long-term care facilities (LTCFs) following an earthquake are poorly understood. This study aimed to examine variations in nutritional status among residents of an Integrated Facility for Medical and Long-term Care (IFMLC), a particular type of Japanese LTCF, after the 2024 Noto Peninsula Earthquake. Methods: This descriptive study was conducted at the single IFMLC. A total of 115 residents living at the facility on 1 January 2024, at the time of the earthquake, were recruited for the study. The focus was the body weight and skeletal muscle mass changes observed before and after the earthquake. The observation period lasted for three months following the earthquake. Results: Water outage persisted for over a month, making dishwashing impossible and leading to an extended reliance on disposable dishes with limited capacity. This situation consequently reduced the variety and volume of meal options and overall energy intake meals. Residents' body weight significantly decreased 3 months after the earthquake, and the prevalence of weight loss and skeletal muscle mass loss was particularly high in residents with normal swallowing function. To address nutritional deficiencies post-earthquake, the registered dietitian enhanced energy sufficiency through food fortification, oral nutritional supplements, and pre-prepared ready-to-hang liquid formulas. Conclusions: To prevent further weight and skeletal muscle mass reduction among IFMLC residents, providing ample water, and a disaster manual that can be used even with limited resources is essential. Furthermore, preparing for disasters by stockpiling foods and implementing strategies to enhance energy sufficiency is crucial. [ABSTRACT FROM AUTHOR]

Background: Malnutrition and muscle weakness are highly prevalent in critically admitted patients. To overcome sarcopenia and muscle weakness, physical activity and neuromuscular electric stimulation have been introduced with limited efficacy. Thus, several anabolic remedies have been introduced. An adequate increase in protein support according to indirect calorimetry and body composition and methyl hydroxybutyrate (HMB) is emerging. Therefore, we wanted to investigate the impact of HMB-enriched whey formula on the nutritional status, muscle weakness, and clinical course of critically ill patients undergoing nutritional status multimodal assessment and physical rehabilitation. Methods: We consecutively enrolled critically ill adult patients admitted to the intensive care unit (ICU) of "Santa Maria Hospital", Terni, Italy. All patients underwent preliminary anthropometric, laboratory tests, nutritional (bioimpedance vector analysis and indirect calorimetry), and ultrasound muscle assessment at admission (T0). Laboratory tests monitoring continued throughout the ICU stay. Nutritional and muscle strength assessment was taken weekly throughout the patient's ICU stay. All patients were enterally administered with a whey protein-enriched formula. Ten days after admission (during the physical rehabilitation period), patients were randomly administered a mixture of essential amino acids and methyl hydroxybutyrate (HMB). Results: We consecutively enrolled 54 ICU patients. At the baseline, survivors (n = 46) were significantly younger than non-survivors. The latter had a worse SAPS II score, nutritional status, and risk, with no significant difference in basal metabolism. Prealbumin values significantly correlated with improved nutritional status and metabolism. Starting from 10 days upon ICU admission, the pennation angle (used as a measure of muscle strength) significantly correlated with the improvement in nutritional status. Whey proteins were well tolerated. Its administration showed a tendency to improve the pennation angle. No specific effect of the mixture containing essential amino acids and methyl hydroxybutyrate was observed. Nutritional status improvement and the rise of basal metabolism were significantly correlated with the extubation time. On the other hand, the reduction in muscle weakness was not significantly correlated with the timing of extubation. Conclusions: Whey protein formula administration can significantly improve nutritional status and basal metabolism in ICU patients. This is reflected in improved muscle strength. Whey protein administration shows a tendency toward a rise in pennation angle. A similar and non-specific trend was observed upon HMB mixture add-one. Further prospective large-scale controlled studies are needed to confirm these promising results. [ABSTRACT FROM AUTHOR]

Background: The study aimed to investigate the association between fat body mass and bone mineral density (BMD) of the lumbar spine (L1–L4), femoral neck, and total body. Methods: We studied 95 patients with Crohn's disease (CD), 68 with ulcerative colitis (UC), and 40 healthy adults (control group—CG) aged 18–50 years old. The BMD of lumbar spine and femoral neck was assessed as well as body composition. Results: A lower fat mass percentage was observed in about 8% of CD, 13% of UC, and 3% of CG. An increased percentage of fat mass was common, and occurred above 50% of CD, 40% of UC, and about 60% of CG. Body fat mass and fat mass percentage were significantly lower among UC compared with the CG (p-value < 0.001) and CD (p-value < 0.01) in women. Body fat mass correlated positively with the BMD and T-score of L1–L4 and total body mass in men with UC. We found a positive correlation between the fat body mass and BMD and T-score of L1–L4, femoral neck, and total body in women with IBD. Among CG, positive correlations occurred between the fat body mass and BMD of L1–L4, BMD of total body, and T-score of total body, but only in men. CRP (C-reactive protein) correlated negatively with fat body mass only in men with CD. Conclusions: A higher fat mass percentage is common among IBD patients and healthy adults despite a normal body mass index. Body fat mass is a predictor of nutritional status and likely influences the course of the disease, as it correlated positively with BMD, T-score, and Z-score. The association between fat tissue and bone health appears to be stronger in women. Further studies are needed to investigate additional factors that may affect bone health in IBD. [ABSTRACT FROM AUTHOR]

The efficiency of biological control agents can be influenced by several factors, such as the quality of their herbivore hosts and the nutritional status of the host plants. This study focused on the parasitism capacity of Habrobracon hebetor (Hymenoptera: Braconidae) on Helicoverpa armigera (Lepidoptera: Noctuidae) reared on different nitrogen fertilized tomato plant cultivars. Four cultivars, namely Kingston, Early Urbana, Super strain-B, and Primo Early, with four nitrogen levels (0, 2.1, 3.0, 3.9 g/pot Nitrogen as Urea 46%), were used. The results showed that the net parasitism rate (C0) of H. hebetor varied from 9.50 to 11.04 and 10.3 to 12.34 host/parasitoid on H. armigera reared on four host plant cultivars with the lowest and highest N levels, respectively. The transformation rate (Qp) on treatments was close to 1. The total parasitism capacity of a stable population (ψ) ranged from 0.224 to 0.358 host/parasitoid. Moreover, the highest recorded values of the finite parasitism rate (ω) included 0.281, 0.390, 0.329 and 0.431 day−1 on the hosts reared on Early Urbana, Super strain-B, Primo Early and Kingston at the highest N levels, respectively. Based on the estimated biological attributes in the current study, the optimum performance for H. hebetor belonged to the hosts fed on Kingston and Super strain-B cultivars. Moreover, the parasitism capacity of the parasitoid was positively influenced by nitrogen fertilized treatments as an effective bottom-up factor. [ABSTRACT FROM AUTHOR]

Objectives: Food price is a determining factor in food choice which affect diet quality accordingly. However, the association between food price and diet quality has not been thoroughly discussed among Chinese adults. This study aimed to analyze the association of daily energy-adjusted dietary costs (CNY/2000 kcal) and diet quality among Chinese adults. Methods: A total of 680 Chinese adults aged above 25 years from Henan province were investigated in 2020. Three indices were adopted for evaluating diet quality: the nutrient-rich foods 9.2 (NRF 9.2) index for evaluating nutrient density, the mean adequacy ratio (MAR) for evaluating nutrient adequacy, energy density (ED) based on solid foods only for evaluating energy density. The daily energy-adjusted diet cost was calculated by dividing the estimated daily diet costs (CNY/day) by the energy intake per day (kcal/day) and multiplying the result by 2000. Results: Subjects who closely adhered to the NRF9.2, MAR, and ED paid ¥8.92, ¥13.17, and ¥14.34 more for daily food consumption, respectively, than those who weakly adhered to these dietary patterns did. Furthermore, multiple linear regression analysis adjusted covariance revealed that an increase in ¥1 of the energy-adjusted diet cost per day was associated with changes of 0.494 units (P < 0.001), 0.003 units (P < 0.001), and − 0.018 units (P < 0.001) in the NRF9.2, MAR, and ED, respectively. Conclusion: Higher energy-adjusted diet cost was associated with higher quality diets. This might be important for public health policies to develop strategies to promote healthy diets by regulating food supply and its costs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the synergistic effects of combined sleep interventions and enhanced nutritional support on postoperative recovery in colon cancer patients, with a focus on sleep quality, nutritional status, pain management, psychological well-being, and quality of life. Methods: This randomized controlled trial included 290 postoperative colon cancer patients admitted to the First Affiliated Hospital of Soochow University between May 2021 and May 2023. Participants were randomized into two groups: the intervention group, which received standard care supplemented with sleep and nutritional interventions, and the control group, which received standard care alone. Outcomes were assessed pre- and post-intervention, including the Pittsburgh Sleep Quality Index (PSQI), nutritional markers (serum albumin, prealbumin, body weight, etc.), Visual Analog Scale (VAS) for pain, Self-Rating Anxiety and Depression Scales (SAS, SDS), and EORTC QLQ-C30 quality of life scores. Results: The intervention group demonstrated significantly greater improvements across all assessed domains compared to the control group (P < 0.005 after Bonferroni correction). Sleep quality (PSQI: 7.81 vs. 10.43, d = 0.81) and nutritional markers (e.g., prealbumin: 230.19 mg/L vs. 188.01 mg/L, d = 1.21) improved markedly. Similarly, reductions in pain (VAS: 2.65 vs. 5.19,d = 1.09), anxiety (SAS: 42.03 vs. 49.45, d = 0.88), and depression (SDS: 38.17 vs. 49.77,d = 1.02) were observed. Quality of life scores significantly increased in the intervention group compared to the control group (EORTC QLQ-C30: 99.29 vs. 88.41, d = 0.92). Conclusion: The combined intervention of sleep enhancement and nutritional support significantly accelerated postoperative recovery in colon cancer patients, demonstrating synergistic effects that improved physical, psychological, and quality-of-life outcomes. These findings underscore the value of integrating multifaceted interventions into standard postoperative care to optimize recovery trajectories and overall well-being. [ABSTRACT FROM AUTHOR]

Background: Protein energy wasting (PEW) and undernutrition are highly prevalent in children with chronic kidney disease (CKD), but their impact on clinical outcomes is not well described. This prospective longitudinal study in children with CKD assessed the association of nutritional parameters with infection-related hospital admissions (IRHA). Methods: Children with CKD2–5D aged 2–18 years and infection-free for 1 month were recruited over 5 years. Evaluation for undernutrition by subjective global nutritional assessment and for PEW using paediatric criteria was undertaken and categorized as mild (>2 criteria), standard (>3 criteria) and modified PEW (>3 criteria with short stature). The IRHA (severe viral, bacterial or fungal infections) were recorded. Results: Among 137 children (45 on dialysis; age 123 ± 46 months; 70% males), undernutrition was seen in 60% and PEW in 52%. In over 38 ± 21 months follow-up, 107 (78%) required hospital admissions (67% IRHA). The incidence rate of IRHA in days per patient-year was higher in those with undernutrition compared to well-nourished children [1.74 (1.27, 2.31) vs. 0.65 (0.44, 0.92) p < 0.0001] and higher in those with PEW compared to no PEW [1.74 (1.30, 2.28) vs. 0.56 (0.36, 0.82) p < 0.0001] respectively. On adjusted analysis, independent risk factors for IRHA were undernutrition, low BMI, hypoalbuminemia and dialysis status with modified PEW [OR 5.34 (2.16, 13.1) p < 0.001] and raised CRP [OR 4.66 (1.56, 13.9) p = 0.006] having the highest risk. Additionally, modified PEW and BMI were noted to have a twofold risk for recurrent infections. Conclusion: In children with CKD2–5D, incidence rate of IRHA was significantly higher in those with undernutrition and PEW. While dialysis, poor nutritional status and inflammation were risk factors for IRHA, modified PEW and BMI were associated with recurrent infections. [ABSTRACT FROM AUTHOR]

Background: Food insecurity (FI) is prevalent among children with chronic kidney disease (CKD), but its impact on health outcomes, and feasibility of prescribed diet restrictions is unknown. Accordingly, this study aims to explore associations of FI and CKD outcomes, and understand its role in following prescribed kidney diet recommendations. Methods: We performed a mixed-methods single-center cohort study of children with advanced CKD or kidney failure. Demographics, socioeconomic status, and health outcomes were compared across FI status; associations between FI and CKD outcomes were explored using multivariable regression. A qualitative sub-analysis of de-identified caregiver interview transcripts was analyzed for themes around diet restrictions. Results: There was a trend that FI patients were more likely to be of Black race (33% vs. 20%); have public insurance (67% vs. 48%); need more blood pressure medications (2 [0.75,3] vs. 1 [0,3]); and have a higher likelihood of emergency department (42% vs. 25%) or intensive care unit encounters (25% vs. 14%). There were no associations of FI and outcomes of interest. Major themes that emerged from caregiver interviews include (1) understanding of the kidney diet focuses on foods to avoid; (2) adapting to suggested dietary restrictions requires changes in meal preparation; and (3) challenges to adherence include social stigma, growth, budget, and time. Conclusions: The impact of FI on children's medical needs with CKD remains inconclusive but trends suggest a higher risk. Regardless of FI status, adhering to prescribed diet restrictions in kidney disease involves significant dedication. Challenges involve food availability, a child's response to restrictions, and social stigma. [ABSTRACT FROM AUTHOR]

Some studies have demonstrated the involvement of high concentrations of copper in the manifestation of insulin resistance in individuals with obesity. The objective of this study was to evaluate the copper nutritional status and its relationship with parameters of glycemic control in women with obesity. An observational case–control clinical study involving 203 women aged between 20 and 50 years, divided into two groups: obese (n = 84) and eutrophic (n = 119). Body weight, height and waist, hip and neck circumferences, dietary copper intake, copper biomarkers, determine ceruloplasmin activity and glycemic control parameters were measured. It was observed that women with obesity had higher copper concentrations in plasma and lower concentrations in erythrocytes when compared to the control group. Analysis of glycemic control parameters revealed a statistically significant difference in fasting blood glucose (p < 0.05) between groups. The study identified a significant positive correlation between plasma copper and fasting insulin values and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index (p < 0.05). The results of this study demonstrate that obese women have high copper concentrations in plasma and lower concentrations in erythrocytes. Furthermore, the significant positive correlation between plasma copper and fasting insulin and HOMA-IR index suggests the influence of this mineral on glycemic control parameters in obese women. [ABSTRACT FROM AUTHOR]

Purpose: To develop a simple and convenient inflammation-nutrition-adiposity biomarker to complement the TNM staging system, further assess the prognosis of patients with colorectal cancer cachexia. Methods: This study was a multi-centre cohort study. The triceps skinfold thickness-albumin index (TA) was calculated by combining the triceps skinfold thickness (TSF) and serum albumin levels. Kaplan–Meier analysis and Cox proportional risk regression models were used to assess the relationship between the TA and all-cause mortality. Internal validation was carried out. Results: We included 1025 patients with colorectal cancer cachexia, 61.2% of whom were male, with a mean age of 58.91 (12.45) years. As the TA increased, overall mortality decreased in female patients (hazard ratio [HR], 0.95) but not in male patients (HR, 0.99). Multivariate Cox analysis showed that patients in the normal TA group had a significantly lower risk of death than those in the low TA group (HR, 0.53, 95% CI, 0.40–0.72). Patients with a normal TA had a lower risk of malnutrition, poor quality of life, and poor short-term prognosis than those with a low TA. Conclusions: TA index enables clinicians to assess the prognosis of patients as early as possible to improve the survival of patients with colorectal cancer cachexia. [ABSTRACT FROM AUTHOR]

Currently, the combination of atezolizumab and bevacizumab (Atez/Bev) is recommended as the first-line therapy for patients with advanced hepatocellular carcinoma (HCC). However, there is a lack of research on the levels of nutrient elements in advanced HCC patients receiving Atez/Bev treatment. In this study, data from 35 patients with advanced HCC and 37 healthy individuals of similar age and sex were included. The levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase were significantly increased in patients with HCC. These levels returned to the reference range after three rounds of Atez/Bev treatment. Additionally, the levels of blood urea nitrogen and creatinine (Cr) increased after Atez/Bev treatment. In HCC patients, the levels of calcium (Ca), iron (Fe), and copper (Cu) were significantly higher, while the levels of sodium (Na), magnesium (Mg), and zinc (Zn) were significantly lower compared to healthy individuals. These changes were reversed after Atez/Bev treatment. In conclusion, our findings indicate that treatment with Atez/Bev influences the levels of Ca, Fe, Cu, Na, Mg, and Zn in patients with HCC. The alterations in these elements caused by Atez/Bev treatment require mechanistic research in the future. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a prevalent global malignancy with substantial morbidity and mortality. Accurate prognostic evaluation is essential in CRC patient management. This study investigates the prognostic significance of red blood cell count (RBC) and Onodera's prognostic nutritional index (OPNI) in resectable CRC patients. Methods: A retrospective analysis of 210 CRC patients undergoing radical resection (January 2015–January 2017) assessed clinical and hematological factors, including RBC, albumin, hemoglobin, and OPNI. A novel comprehensive biomarker, R-OPNI, combining preoperative RBC with OPNI, was introduced. Correlations with patient survival were analyzed, and R-OPNI's independent prognostic value was assessed through univariate and multivariate Cox models. Predictive ability was compared to other factors using the receiver operating characteristic (ROC) method. Results: Higher RBC levels (≥ 3.9 × 1012/L) and elevated OPNI were associated with significantly improved overall survival. Lower R-OPNI scores (0 or 1) indicated notably poorer survival. Multivariate analysis confirmed R-OPNI's independent prognostic significance (HR: 0.273, 95% CI: 0.098–0.763, p = 0.013). R-OPNI (AUC = 0.732) demonstrated superior predictive value compared to individual prognostic factors. Conclusion: R-OPNI emerges as a robust, independent prognostic predictor for resectable CRC patients, emphasizing the importance of assessing preoperative nutritional status. [ABSTRACT FROM AUTHOR]

There are currently more than 3.3 million prostate cancer (PC) survivors in the United States. Conformance with national dietary guidelines and a good diet quality may lower the risk for Gleason grade progression in PC patients. Assessing the nutritional status of PC survivors is thus of paramount importance from a public health nutrition perspective. We used 24-h dietary recall data from the National Health and Nutrition Examination Surveys (NHANES) to systematically estimate nutrient intakes in n = 360 PC survivors (which may be extrapolated to represent n = 1,841,030 PC survivors) aged 70.69 years on average, and contrasted the results to the daily nutritional goals (DNG) in the 2020–2025 Dietary Guidelines for Americans (DGA). Diet quality in PC survivors was found to be generally poor, and the DNG as specified in the DGA were not met for many micronutrients, including calcium, magnesium and potassium. PC survivors had an insufficient intake of many vitamins (including vitamins A, C, D and E), and did not meet the intake recommendations for dietary fiber. Racial disparities in PC were reflected in the lower overall DQ in Non-Hispanic Black participants. Our results reiterate the need for nutritional assessment and counseling to improve DQ in PC patients. [ABSTRACT FROM AUTHOR]

The use of dietary supplements by cancer patients is common but contentious, particularly during chemotherapy. Few studies have investigated this for ovarian cancer. In a prospective study of women with ovarian cancer, dietary supplement use was collected through questionnaires. Data on the use of supplements were available for 421 women before diagnosis, during chemotherapy, and after chemotherapy completion. Predictors of changes in supplement use were investigated using logistic regression. The use of ≥1 supplement pre-diagnosis, during, and after chemotherapy completion was reported by 72%, 57%, and 68% of women, respectively. Multivitamins, vitamin D, and fish oils were the most commonly used supplements at all time points. The supplements most commonly discontinued during treatment were fish oils (69% of pre-diagnosis users) and multivitamins (53% of users); while 9%–10% of pre-diagnosis non-users initiated vitamin D and multivitamins. Predictors of supplement initiation during chemotherapy included pre-diagnosis use of medications, such as statins (Odds Ratio, OR = 4.12, 95% confidence interval, CI = 1.28–13.3), antidepressants (5.39, 1.18–24.7), acetaminophen (3.13, 1.05–9.33), and NSAIDs (2.15, 0.81–5.72). Other factors included younger age, university education, neoadjuvant chemotherapy, and/or experiencing fatigue during treatment, although not statistically significant. In conclusion, a high proportion of women with ovarian cancer reported using supplements at all time points. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the presence of nutritional impact symptoms (NIS) throughout radiotherapy treatment in the head and neck, thorax, abdomen, and pelvis areas. Methods: A prospective cohort study was conducted with individuals undergoing radiotherapy for cancer. Three assessments were carried out: at the start of radiotherapy, midway through, and in the last week of treatment. Clinical, anthropometric data, and the Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess symptoms. Results: A total of 254 participants were evaluated at the start, 165 at the midpoint, and 120 at the end of the treatment. More than half of the participants at all stages were elderly. At the start, 51.6% were women, while at the end, 57.5% were men. Pelvic tumors were the most common, followed by tumors in the head and neck and thorax. The prevalence of NIS increased from 58.2% at the beginning to 76.9% at the midpoint (RR 1.32; 95% CI 1.17–1.48; p = < 0.001) and 78.3% at the end of treatment (RR 1.34; 95% CI 1.18–1.52; p = < 0.001). Odynophagia was the most reported symptom among patients with head and neck tumors, increasing from 24.5 to 66.6%, and from 3.0 to 22.2% by the end of treatment in patients with thoracic tumors. Diarrhea was common at the end of treatment among those with abdominal (69.2%) and pelvic (35.8%) tumors. Conclusion: NIS increased during radiotherapy. The location of tumors influences symptom prevalence, highlighting the need for continuous nutritional support. [ABSTRACT FROM AUTHOR]

Objectives: The potential association between oral health and nutritional status of the very old, has been poorly investigated. Thus, we carried out the cross-sectional study to evaluate the association of oral health with the nutritional status of the older adults. Methods: 210 participants aged over 75 years were included in the study. Nutritional status was assessed by the Short-form Mini-Nutritional Assessment (MNA-SF) and body composition measurement. Data were available for self-reported oral health (10-item Eating Assessment Tool (EAT-10) and Chewing Function Questionnaire (CFQ)) and specific experimental tests including salivary flow, tongue and lip pressure, occlusal force, water swallow test and taste test for the detection of oral functions. Spearman rank correlation was used to analyze the correlation between body composition and oral health. Logistic regression and restricted cubic spline models were applied to examine the association of oral health with malnutrition. Results: The study reveals that poor oral health is related to the malnutrition. The tongue pressure and molar occlusal force were significantly associated with malnutrition in an L-shaped dose-response relationship after adjustment for potential confounding factors. The higher the tongue pressure and molar occlusal force, the lower the risk of malnutrition. Besides, the CFQ score, salty, sour, and bitter taste, are risk factors for malnutrition. Conclusions: The presence of malnutrition is significantly associated with poor oral health in older adults. Our study supposes that the design of food suitable for oral conditions of the older adults may be another feasible solution to the nutritional problems among them. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to examine the factors affecting eating behavior of adolescents aged 17–19 years, residing in a college hostel and to assess the effectiveness of nutrition education in improving their knowledge, attitude and practices (KAP). Design/methodology/approach: A convenient sampling technique was used to recruit 200 adolescent female participants of age 17–19 years. The obesity and underweight status of the participants were assessed using body mass index (BMI). Diet history was obtained using a 24-h dietary recall and food frequency questionnaire. A standard pretested questionnaire was used to analyze the factors affecting the eating behavior of adolescents. A nutrition education program was conducted to improve the KAP of the adolescents. A structured questionnaire was used to assess the improvement in KAP after the education program. Descriptive statistics was used to examine the factors affecting eating behavior. Paired t-test was used to check the effectiveness of the nutrition education program. Findings: The findings of the study indicated that 50.5% of the adolescents were underweight (20%), overweight (12%) and obese (18.5%). The mean nutritional adequacy of the adolescents was 68.1%. Social factor had the highest impact on the eating behavior of adolescents (70.8%), followed by the environmental factor (69.7%). Imparting nutrition education was significant in improving the KAP of adolescents with a p-value < 0.05. Thus, it is necessary to analyze the factors affecting the eating behavior of adolescents and establish corrective measures such as community education intervention programs and awareness programs on healthy eating habits to modify the eating behavior of adolescents. Research limitations/implications: The dietary intake and the factors influencing eating behavior of the adolescents were assessed considering the transition in the intrapersonal, social and community food environment. The inadquate food intake affected the nutritional status of 50% of the adolescents.The taste, temptation, sight of the food, peer pressure, parental influence and unmindful eating practices majorly influenced the eating behavior of adolescents. Unhealthful eating behavior can increase the risk of chronic diseases during the adolescence and may extend in to adulthood. Hence it is necessary to bring a positive change in the eating behavior of the adolescents through a well planned comprehensive nutrition education program. The findings of the study proved that the knowledge, attitude and behavior of the adolescents could be significantly improved through a well planned nutrition eduation program. Further the study also provide insights to plan and implement community food policies targeted to improve the eating behavior and health status of the adolescents. One of the limitations of the study was, in addition to anthropometric measurements and diet history including biochemical parameters would be a better indicator of nutritional status. The cultural and religious influence on eating behavior would also be studied. In future a study on gender differences on the dietary intake and eating behavior of the adolescents can be conducted. Practical implications: The study reflects the eating behavior of late adolescents and major factors affecting eating behavior of adolescents residing in college hostel. The findings will add on to the existing knowledge on the factors affecting eating behavior of adolescents. As eating behavior is correlated to the health status of the adolescents understanding the factors affecting eating behavior would help in modifying the eating behavior of late adolescents by implementing appropriate measures and help develop programs and policies that aid in improving the nutritional status. Since nutrition education is effective in improving the KAP of adolescents' nutrition literacy is imperative in schools and colleges to improve the eating behavior and health status of the adolescents. Social implications: The research provides a scientific basis for understanding the factors affecting eating behavior of adolescents and the interaction between personal, social and environmental factors. It also acts as basis to be aware of one's own eating behavior, modify and model healthy eating behavior. Inappropriate eating behavior in late adolescents can continue into adulthood affecting nutritional status and leading to an increase in the prevalence of diseases and disorders in adulthood. This can affect human potential and capital and thereby economic development. Hence, it is imperative to improve the nutritional status of the adolescents by creating awareness and implementing corrective measures to modify unhealthy eating behavior. The research also supports devising policy and programs regarding the nutritional behavior of adolescents. Originality/value: Eating behavior is a complex interplay of various factors at multiple levels. The adolescents' eating behavior correlates directly with their nutritional status. In total, 50.5% of adolescents were malnourished. The nutrient intake of the majority of the adolescents was less than the recommended intake. The mean nutrient adequacy was 68.1%. The quality of the diet was largely affected as they did not include 5–7 food groups in a day. The social factors such as peer group influence and parental influence had the predominant impact on eating behavior followed by environmental factors. The nutrition education program helped improve the nutrition KAP. Hence, it is necessary to create awareness and make policies and programs that can improve the eating behavior of adolescents. [ABSTRACT FROM AUTHOR]

Purpose: Dietary diversity (DD) is a proxy indicator of nutrient adequacy and has been propagated as a health beneficial component of dietary behavior. This study aims to understand DD and its association with lipid indices among Indian Kho-Kho players. Design/methodology/approach: In all, 50 Indian Kho-Kho players aged between 16 years and 31 years belonging to different regions of India were recruited. Dietary diversity score (DDS; food groups/day) and food variety score (FVS; number of food items/day) were considered to assess the DD. The United Nations Food and Agricultural Organization food frequency questionnaire was used as a tool. Serum total cholesterol (TC), triglycerides (TG), LDL, VLDL and HDL were measured. Findings: The DDS and FVS showed that athletes were consuming approximately 7 of 9 food groups (Mean ± SD: 6.5 ± 1.3) and 27 varieties of foods (Mean ± SD:27.0 ± 8.6) from 9 food groups per day. This study could not find significant differences for DDS and FVS among athletes belonging to different regions. FVSs of organ meat, eggs and spices and condiments were significantly positively associated with TG (p < 0.036, p < 0.020 and p < 0.001) and VLDL (p < 0.054, p < 0.021 and p < 0.001). LDL was inversely significantly associated with FVS of cereals, white root and tubers (p < 0.032). Research limitations/implications: DDS and FVS were not associated with lipid indices among Kho-Kho players. However, individual FVS of organ meat, eggs and spices and condiments may increase TG and VLDL. Optimum consumption of cereals and root tubers may help to maintain LDL levels among Kho-Kho players. Originality/value: It was found that daily consumption of organ meat and eggs may increase TG and VLDL, and optimum consumption of cereals and white roots and tubers may help to maintain LDL. High energy and fat foods may act as mediators along with spices and condiments in increasing TG and VLDL. [ABSTRACT FROM AUTHOR]

Background: Malnutrition presents a significant challenge in managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), yet its impact on AF recurrence after catheter ablation in this population remains unclear. Methods: We conducted a retrospective analysis of 204 patients with paroxysmal non-valvular AF and HFpEF who underwent radiofrequency or cryoballoon ablation. Risk of malnutrition as assessed using three screening tools: the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI)]. We examined the relationship between risk of malnutrition and AF recurrence post-ablation. Results: After a mean follow-up period of 11.2 ± 1.8 months, 43 patients (21.1%) experienced AF recurrence. Despite being classified as overweight or obese based on body mass index, many patients were at risk of malnutrition according to the CONUT score, NRI, and PNI. Adjusted analyses showed that higher CONUT scores (HR: 10.132; 95% CI: 2.545–40.336; P = 0.001), lower NRI (HR: 22.734; 95% CI: 6.399–80.776; P < 0.001), or lower PNI (HR: 9.469; 95% CI: 3.232–27.739; P < 0.001) were significantly associated with increased risk of AF recurrence. Restricted cubic spline regression revealed an inverted U-shaped relationship between the CONUT score and AF recurrence, and L-shaped relationships for both NRI and PNI with AF recurrence. Conclusions: Systematic nutritional assessment is crucial in patients with paroxysmal non-valvular AF and HFpEF. High CONUT scores, low NRI, or low PNI serve as independent predictors for AF recurrence. Further large-scale randomized controlled trials are required to validate these findings. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is characterised by chronic inflammation in joints. Obesity, stress, being women and dietary pattern are important in pathogenesis. The joint damage in RA is accelerated by oxidative stress. The aim of this study was to examine the serum total antioxidant level, nutritional status and Mediterranean diet adherence of adult women with RA. Thirty-five adult women RA patients and thirty-five healthy control participated in this study (45·4 ± 11·61 and 42·5 ± 8·50 years, respectively). Nutritional status, physical activity levels and adherence to the Mediterranean diet were questioned. Physicians assessed the disease activity score of patients with RA. Serum total antioxidant and oxidant status were analysed. The serum total antioxidant status of the control group was higher, whereas the oxidative stress index and total oxidant status were lower than that of the RA group. Dietary protein, fibre, EPA, retinol, Fe, Zn and total antioxidant intake in the RA group were lower than in the control group (P < 0·05). Individuals with higher fibre intake showed a significantly lower risk for RA after adjusting for potential confounding factors (OR = 0·845, 95 % CI = 0·773–0·923, P < 0·001). The mean physical activity level of the control group was higher than that of the RA group (1·59 ± 0·10 and 1·53 ± 0·13, respectively) (P = 0·01). In conclusion, serum antioxidant parameters and dietary antioxidant intake are decreased in patients with RA. Therefore, medical treatment for these patients should be supplemented with medical nutrition therapy to achieve optimal nutritional status. [ABSTRACT FROM AUTHOR]

Background: The significance of the controlling nutritional status (CONUT) score in predicting the prognostic outcomes of diffuse large B-cell lymphoma (DLBCL) has been widely explored, with conflicting results. Therefore, the present meta-analysis aimed to identify the prognostic significance of the CONUT in DLBCL by aggregating current evidence. Methods: The Web of Science, PubMed, Embase, CNKI and Cochrane Library databases were searched for articles from inception to October 15, 2024. The prognostic value of CONUT for DLBCL was analyzed by determining the pooled hazard ratios (HRs) with 95% confidence intervals (CIs). The Newcastle–Ottawa Scale (NOS) was used to analyze study quality. Results: Eight studies including 2687 cases were included in this work. The NOS scores of these studies were 7–9 (median, 8), demonstrating high quality. Our analyses revealed that an elevated CONUT score significantly predicted poor overall survival (OS) (HR = 1.63, 95%CI = 1.29–2.05, p < 0.001) and inferior progression-free survival (PFS) (HR=1.22, 95%CI = 1.12–1.33, p < 0.001) in patients with DLBCL. Further, the elevated CONUT score showed a significant correlation with the following clinicopathological factors in DLBCL: Ann Arbor stage III-IV, Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 2–4, presence of extranodal disease, ≥high intermediate National Comprehensive Cancer Network International Prognostic Index (NCCN IPI), presence of B symptoms, elevated lactose dehydrogenase (LDH) levels, and presence of bone marrow infiltration. Conclusions: An increased CONUT score was dramatically associated with poor OS and PFS in patients with DLBCL, as well as with clinicopathological characteristics representing DLBCL tumor development. [ABSTRACT FROM AUTHOR]

Background: This study employs a LSTM-FC neural networks to address the critical public health issue of child undernutrition in Ethiopia. By employing this method, the study aims classify children's nutritional status and predict transitions between different undernutrition states over time. This analysis is based on longitudinal data extracted from the Young Lives cohort study, which tracked 1,997 Ethiopian children across five survey rounds conducted from 2002 to 2016. This paper applies rigorous data preprocessing, including handling missing values, normalization, and balancing, to ensure optimal model performance. Feature selection was performed using SHapley Additive exPlanations to identify key factors influencing nutritional status predictions. Hyperparameter tuning was thoroughly applied during model training to optimize performance. Furthermore, this paper compares the performance of LSTM-FC with existing baseline models to demonstrate its superiority. We used Python's TensorFlow and Keras libraries on a GPU-equipped system for model training. Results: LSTM-FC demonstrated superior predictive accuracy and long-term forecasting compared to baseline models for assessing child nutritional status. The classification and prediction performance of the model showed high accuracy rates above 93%, with perfect predictions for Normal (N) and Stunted & Wasted (SW) categories, minimal errors in most other nutritional statuses, and slight over- or underestimations in a few instances. The LSTM-FC model demonstrates strong generalization performance across multiple folds, with high recall and consistent F1-scores, indicating its robustness in predicting nutritional status. We analyzed the prevalence of children's nutritional status during their transition from late adolescence to early adulthood. The results show a notable decline in normal nutritional status among males, decreasing from 58.3% at age 5 to 33.5% by age 25. At the same time, the risk of severe undernutrition, including conditions of being underweight, stunted, and wasted (USW), increased from 1.3% to 9.4%. Conclusions: The LSTM-FC model outperforms baseline methods in classifying and predicting Ethiopian children's nutritional statuses. The findings reveal a critical rise in undernutrition, emphasizing the need for urgent public health interventions. [ABSTRACT FROM AUTHOR]

Objective: Colorectal cancer (CRC) is a common cancer, with chemotherapy as its major therapy. Nutritional status (NS) and adipokines implicated in CRC. We explored the impacts of NS indicators (hemoglobin, albumin, and prealbumin) and serum adipokine (visfatin, adiponectin, and resistin) level on chemotherapy efficacy in late-stage CRC patients. Methods: Late-stage CRC patients were divided into the effective and ineffective groups based on chemotherapy efficacy, with clinical data, NS indicator, and serum adipokine levels documented. They were divided into hemoglobin, albumin, prealbumin, visfatin, adiponectin, and resistin high and low expression groups, with their relationships with clinical parameters and chemotherapy efficacy analyzed. Independent risk factors (IRFs) affecting chemotherapy efficacy in late-stage CRC patients were analyzed by logistic multivariate regression. Results: Hemoglobin, albumin, prealbumin, and adiponectin levels were reduced, while NRS 2002 ≥ 3 proportion, visfatin, and resistin levels were increased in the ineffective group versus the effective group. Areas under receiver operating characteristic curve of hemoglobin, albumin, prealbumin, visfatin, adiponectin, and resistin in diagnosing ineffective chemotherapy were 0.80, 0.88, 0.86, 0.88, 0.83, and 0.83, respectively. NS indicator and serum adipokine levels were markedly associated with chemotherapy efficacy in late-stage CRC patients. Highly expressed albumin and prealbumin were protective factors for effective chemotherapy, and highly expressed visfatin and resistin were risk factors for effective chemotherapy. Conclusion: NS indicators and serum adipokine level are correlated with the chemotherapy efficacy in late-stage CRC patients, and both have diagnostic value for chemotherapy efficacy. Albumin, prealbumin, visfatin, and resistin are independent influencing factors affecting chemotherapy efficacy in late-stage CRC patients. [ABSTRACT FROM AUTHOR]

Background: Primary school teachers play a critical role as educators in imparting healthy eating behaviour and the importance of physical activity to prevent health issues. However, the teachers' health behaviors have not been studied much, particularly in Saudi Arabia. Understanding these factors is essential to developing interventions that enhance teachers' well-being and their ability to influence students positively. This study aims to assess nutritional knowledge and physical activity; to determine correlations between health behaviour factors and Body Mass Index (BMI), and evaluate BMI status concerning demographic factors among primary school teachers in the Asir Region, KSA. Methods: A cross-sectional design was employed, involving 370 primary school teachers. Data were collected using a self-administered questionnaire that covered sociodemographic details, anthropometric measurements, physical activity levels, and nutritional knowledge. Statistical analyses included Pearson's correlation and Chi-square tests, with significance at p < 0.05. Results: Among the participants, 38.6% were overweight, and 33.5% were obese, with 76% of married teachers classified as overweight or obese. Only 9.0% exhibited excellent nutritional knowledge, while 25.0% demonstrated poor knowledge. The majority (84.0%) engaged in low or minimal physical activity. A weak but significant correlation was observed between nutritional knowledge and BMI (p < 0.05), whereas no significant associations were found between physical activity levels and either BMI or nutritional knowledge. Conclusion: The study highlights critical gaps in nutritional knowledge and physical activity among teachers, emphasizing the need for targeted school-based health education programs. Improving teacher health behaviors could enhance their well-being and enable them to act as positive role models for their students. [ABSTRACT FROM AUTHOR]

Introduction: Dietary diversity is the utilization of food and food groups consumed by individuals over 24 h, which is an indicator of a diet's micronutrient adequacy. Dietary management in people with HIV patients is the key to sustaining their day-to-day activities and contributing to their lively hood. The level of dietary diversity among HIV-positive patients in Ethiopia shows considerable variation, ranging from 29 to 71.3%. This study aimed to assess the pooled prevalence of low dietary diversity and associated factors among HIV-positive patients attending ART clinics in Ethiopia. Method: Multiple international database searching methods (articles found in PubMed/MEDLINE, Google scholar Africa, Hinari journal online, Embase, Scopus) and Ethiopian university repository online have been covered in this systemic review and meta-analysis. Data were extracted using Microsoft excel and analyzed by using the Stata version 14 software program. The heterogeneity between studies and publication bias was detected by using the I2 test and a funnel plot test respectively. Results: The pooled prevalence of low dietary diversity among People with HIV patients on antiretroviral therapy in Ethiopia was 55.9% 95% CI (45.73, 66.09) based on the random effect analysis. This systemic review and meta-analysis showed that only HIV positive patients with an antiretroviral therapy duration of less than one year (AOR = 2.3, 95% CI 1.3, 4.1), and having low wealth quintile (AOR = 2.5, 95% CI 1.5, 4.4) were factors significantly associated with low dietary diversity among People with HIV patients on ant-retroviral therapy clinics of Ethiopia. Conclusion and recommendation: The overall pooled prevalence of low dietary diversity among People with HIV patients attending antiretroviral therapy clinics in Ethiopia was high. We strongly recommend holistic nutritional interventions to address nutritional problems and promote the overall health status of HIV-positive patients in Ethiopia. [ABSTRACT FROM AUTHOR]

Malnutrition is a prevalent complication in hemodialysis patients and is associated with increased mortality and morbidity. This study aimed to identify the risk factors associated with malnutrition among hemodialysis patients including patient's general characteristics, functional status, and dietary intake. This study involved hemodialysis patients in An-Najah National University Hospital at Nablus/Palestine. An interview-based questionnaire was used to collect data related to sociodemographic, lifestyle, hemodialysis, medical history, anthropometrics, biochemical indices, dietary data using 3-days diet recall, and functional status. Malnutrition-inflammation score tool (MIS) was used for malnutrition screening of the studied patients. The study involved 188 patients, with a mean age of 57.8±14 years. A total of 28.2% participants are reported malnourished. Malnutrition was significantly associated with being female (p = 0.001), unemployed (p = 0.009), nonsmoker or ex-smoker (p = 0.018). Patients with CVDs (p = 0.006), higher months on dialysis (p = 0.002), lower BMI (p = 0.018), and using catheter for dialysis access are more likely to develop malnutrition (p = 0.018). Furthermore, patients with poor functional status (poor handgrip strength (p<0.001), inability to walk (p<0.001), needing help in daily activity or in transfer (p<0.001)) were significantly associated with malnutrition. Additionally, malnutrition was significantly higher among patients who does not meet their recommended calorie intake (p = 0.008), whose sodium intake within recommendation (p = 0.049), patients with low levels of hemoglobin (p = 0.022), albumin (p<0.001), TIBC (p = 0.002), phosphate (p<0.001), and patients with higher levels of ferritin (p<0.001). Higher months on dialysis (Exp(B) = 1.02), unmet calorie intake (Exp(B) = 4.3), needing help in daily activities (Exp(B) = 0.238), and low albumin level (Exp(B) = 0.048) were the independent predictors of malnutrition. This study highlights the significant association between malnutrition and various demographic, clinical, functional, and dietary factors in hemodialysis patients, revealing the burden of malnutrition during HD. It also necessitates targeted intervention to address these risk factors and improve nutritional status and the overall health outcomes of HD patients. [ABSTRACT FROM AUTHOR]

Background: FAO/WHO introduced food-based dietary guidelines (FBDG) to promote healthy dietary habits. To translate the FBDG, optimized food-based recommendations (FBR) can be developed using linear programming (LP) to address problem nutrients. Despite the importance of local-specific FBR for anemia prevention, no study has reported the effect of nutrition education which promoted FBR in adolescent girls. Therefore, this study aimed to investigate the effect of optimized FBR in adolescent girls in improving dietary and nutrient intakes, hemoglobin levels, and memory performance. Methods: The intervention study was carried out in Malang District, Indonesia amongst 14–18 year adolescent girls. The study's Indonesian slogan was Remaja which meant Active, Healthy, Smart, and Creative adolescents. The optimized FBR was developed using LP and translated into six key messages. Twenty-week nutrition education was integrated into the weekly school's system. Results: After 20 weeks, a significant increase in dietary practices (animal protein, liver, plant protein, vegetables), nutrient intakes (protein, fat, iron), and memory performance (digit span forward and backward) were found in the intervention group. In contrast, there was decreases in the control group's intakes of animal and plant protein. Conclusions: This finding shows that nutrition education with optimized FBR increased intakes of nutrient-dense food, protein, fat, iron, and memory performance (concentration). Nutrition education with optimized FBR should be integrated into the school system together with weekly iron supplementation for anemia prevention among these adolescent girls. Trial registration: The study was registered on ClinicalTrials.gov (ID No: NCT03946475). [ABSTRACT FROM AUTHOR]

Background: Malnutrition frequently affects older adults, increasing their risk for numerous diseases, as well as healthcare costs. Therefore, nutritional assessment and appropriate nutritional support addressed to meet individual nutritional needs and prevent malnutrition and its consequences should be a fundamental part of healthcare for older adults. This study aimed to compare the knowledge of nutrition guidelines for older adults between healthcare and non-healthcare professionals working with older adults. Methods: The study was conducted during May and June 2021 using a validated "Knowledge of nutrition guidelines for older adults" questionnaire designed by Andrija Stampar Teaching Institute of Public Health, Croatia. The study participants were recruited from various institutions providing care for older adults in Split-Dalmatia and Dubrovnik-Neretva County. The final convenience sample consisted of 214 participants (163 healthcare professionals and 51 non-healthcare professionals). The obtained results were analyzed using descriptive and inferential statistics. The associations between participants' characteristics and knowledge about the importance of nutrition in disease prevention and treatment, the assessment of nutritional status in older adults, and clinical nutrition were analyzed using multiple linear regression models. Results: Participants' overall knowledge of nutrition guidelines for older adults was moderate in both groups, with healthcare professionals scoring a median of 7.0 (IQR = 1.0) and non-healthcare professionals scoring a median of 6.0 (IQR = 2.0). Compared to non-healthcare professionals, healthcare professionals had lower knowledge about the importance of nutrition in disease prevention and treatment (β = − 0.16; p = 0.024). No statistically significant differences were found between healthcare and non-healthcare professionals in the level of knowledge about the assessment of nutritional status in older adults (β = − 0.02; p = 0.769) and clinical nutrition (β = 0.08; p = 0.267). Conclusions: This study highlights gaps in knowledge regarding dietary guidelines for older adults among healthcare and non-healthcare professionals working with this specific population group. These findings suggest that targeted educational programs might be needed to improve understanding of geriatric nutrition. [ABSTRACT FROM AUTHOR]

Background: High-intensity exercise is recommended for the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease (COPD); however, it can cause an energy imbalance due to increased energy expenditure. Here, we aimed to explore the effect of reducing exercise intensity on energy balance in patients with COPD experiencing high-intensity training-induced weight loss. Methods: All participants underwent high-intensity endurance and resistance training for a 2-week preliminary period. Those who lost more than 1% of their weight were then randomized to either continue high-intensity exercise (AA group) or switch to low-intensity exercise (AB group) for another 2 weeks (experimental period). Results: The analysis included 30 participants (AA, n = 15; AB, n = 15). The AA group showed significant increases in body composition, dietary intake, nutritional status, muscle strength, and exercise capacity at week 4 than at week 2, with no significant changes in the AB group. After the experimental period, a greater proportion of the AA group had energy intake exceeding expenditure than did the AB group (80% vs. 40%). Conclusions: In patients with COPD who lost body weight during pulmonary rehabilitation with high-intensity exercise, continuing this exercise had a more positive effect on body composition, nutritional status, physical function, and energy balance than did reducing exercise intensity. These results suggest the importance of continuing high-intensity exercise, while taking into consideration energy intake and nutritional therapy, even when body weight loss occurs during pulmonary rehabilitation in patients with COPD. Trial registration: This study was retrospectively registered on the UMIN-CTR as UMIN000050976 on May 5, 2023. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is a significant challenge in stroke patients, affecting both rehabilitation and independence. This study aims to evaluate whether early L-carnitine supplementation can effectively improve anthropometric parameters and malnutrition status in acute-phase ischemic stroke patients to mitigate the catabolic state. Methods: Eighty-two first-ever ischemic stroke patients were randomly assigned to either the L-carnitine group (1000 mg three times/day for seven consecutive days) or the matching placebo group. The study outcomes based on intention-to-treat analyses included changes in weight, body mass index, triceps skinfold thickness, mid-arm circumference, mid-arm muscle circumference, arm muscle area, calf circumference, serum ALB and malnutrition status over the seven-day treatment protocol. Malnutrition was assessed based on the serum ALB concentration, mid-arm muscle circumference, and triceps skinfold thickness. Analysis of covariance (ANCOVA) was applied for assessing the between-group changes along with adjusting the baseline mean value effect. Results: Patients receiving L-carnitine had significantly lower changes in terms of weight, body mass index, triceps skinfold thickness, mid-arm circumference, mid-arm muscle circumference, and calf circumference than did those in the placebo group. After the intervention, the placebo group experienced a significantly greater reduction in the mid-arm muscle circumference indicator (P < 0.001). The between-group change in the serum ALB concentration significantly increased in the L-carnitine group (P = 0.001). Moreover, the L-carnitine group was less malnourished than the placebo group [17 (41.5%) vs. 30 (73.2%), respectively; P = 0.01], after the intrvention. The "recovery" frequency was significantly greater in the L-carnitine group (18 (43.9%) vs. 3 (7.3%), P < 0.001) than the placebo group. Conclusions: Early L-carnitine supplementation effectively improves anthropometric indices and malnutrition, muscle wasting, and rapid weight loss in acute ischemic stroke patients, highlighting its potential as a supportive nutritional therapy during stroke rehabilitation. Trial registration: The current clinical trial study was registered in the Iranian Registry of Clinical Trials (registration code: IRCT20221206056734N1) at 2023-02-11. [ABSTRACT FROM AUTHOR]

Purpose: Optimal management of retroperitoneal soft tissue sarcoma (RPS) often requires extensive tumor resections, frequently involving gastrointestinal organs. The impact of these procedures on the nutritional status and hemoglobin (Hb) levels of RPS patients remain unexplored. In this study, we aimed to evaluate preoperative nutritional status as well as the prevalence of anemia in RPS patients, and to investigate longitudinal changes throughout the disease course in order to identify potential strategies for prehabilitation. Materials and methods: Patients undergoing resection of primary and recurrent RPS at Heidelberg University Hospital were retrospectively analyzed. Changes in nutritional parameters and Hb levels throughout the disease course were analyzed using hierarchical linear regression models. Multivariable Cox regression analyses were performed to identify independent predictors of overall survival. Subgroup analyses were conducted for primary tumors, first, second and third recurrences. Results: Amongst 370 patients analyzed, comprising 219 with primary disease, we observed neither a significant prevalence of preoperative malnutrition nor notable changes in BMI or serum albumin levels throughout the disease course. Preoperative anemia affected up to 40% of RPS patients, and Hb levels significantly decreased over the course of the disease (p = 0.022), particularly in correlation with the number of tumor resections performed (p = 0.010). Low preoperative Hb levels were associated with increased 30-day mortality and they were identified as an independent prognostic factor for shorter overall survival in primary RPS as well as in second and third recurrences. Conclusion: Anemia screening should be performed preoperatively and during regular follow-ups to enable early-on therapy, thus potentially improving patient outcomes in RPS. [ABSTRACT FROM AUTHOR]

Purpose: Optimal management of retroperitoneal soft tissue sarcoma (RPS) often requires extensive tumor resections, frequently involving gastrointestinal organs. The impact of these procedures on the nutritional status and hemoglobin (Hb) levels of RPS patients remain unexplored. In this study, we aimed to evaluate preoperative nutritional status as well as the prevalence of anemia in RPS patients, and to investigate longitudinal changes throughout the disease course in order to identify potential strategies for prehabilitation. Materials and methods: Patients undergoing resection of primary and recurrent RPS at Heidelberg University Hospital were retrospectively analyzed. Changes in nutritional parameters and Hb levels throughout the disease course were analyzed using hierarchical linear regression models. Multivariable Cox regression analyses were performed to identify independent predictors of overall survival. Subgroup analyses were conducted for primary tumors, first, second and third recurrences. Results: Amongst 370 patients analyzed, comprising 219 with primary disease, we observed neither a significant prevalence of preoperative malnutrition nor notable changes in BMI or serum albumin levels throughout the disease course. Preoperative anemia affected up to 40% of RPS patients, and Hb levels significantly decreased over the course of the disease (p = 0.022), particularly in correlation with the number of tumor resections performed (p = 0.010). Low preoperative Hb levels were associated with increased 30-day mortality and they were identified as an independent prognostic factor for shorter overall survival in primary RPS as well as in second and third recurrences. Conclusion: Anemia screening should be performed preoperatively and during regular follow-ups to enable early-on therapy, thus potentially improving patient outcomes in RPS. [ABSTRACT FROM AUTHOR]

Background: Low dietary quality significantly contributes to public health risks in low-income countries. This situation is particularly concerning for vulnerable groups, such as women and children, who are at increased risk of malnutrition due to inadequate access to proper nutrition. This study aimed to assess the influence of nutrition-related knowledge, attitudes, and practices, and kitchen characteristics on women's dietary quality in Ethiopia. Method: A population-based cross-sectional survey was conducted from August to September 2022 in five regions and two city administrations in Ethiopia. A multistage stratified cluster sampling method was employed. From ninety-nine enumeration areas, twenty eligible households were selected. A total of 1,980 women aged 15–49 years were included in this survey. The data were collected using a structured questionnaire about socio-demographic characteristics, food frequency, 24-hour dietary recall, and nutrition-related knowledge, attitudes, and practices. The determinants of dietary quality were identified using Poisson, logistic, and ordinary least square regression analyses. Variables with a p-value less than 0.05 were considered to indicate statistical significance. Results: The results showed that the average dietary diversity score for women was 3.4 ± 0.85. Only 21.5% of the participants achieved the minimum dietary diversity for women (MDD-W), and the mean adequacy ratio for nutrients was 61.6%. The participants' average nutrition-related knowledge, attitudes, and practices scores were 63%, 39%, and 23%, respectively. The regression analysis showed knowledge and attitude positively associated with dietary diversity and the mean nutrient adequacy ratio (P < 0.01). Cooking time and propensity to prepare new food were also positively associated with dietary diversity and with minimum dietary diversity (P < 0.01). Conclusion: Our study showed that good nutrition-related knowledge and a positive attitude toward nutrition positively and significantly influence dietary quality, along with cooking time and the propensity to prepare new foods. [ABSTRACT FROM AUTHOR]

Background: Both dietary magnesium and serum magnesium are associated with the prognosis of diabetic patients. However, the impact of the magnesium depletion score (MDS), which assesses systemic magnesium deficiency, on the prognosis of diabetic patients remains unclear. This cohort study aims to explore the potential association between the MDS and all-cause and cardiovascular mortality in diabetic patients. Methods: In this study, we analyzed data from 5,219 diabetic individuals from National Health and Nutrition Examination Survey (NHANES) 2003–2018. Participant mortality information was sourced from the National Death Index records. MDS was divided into lower MDS (0–1 points), middle MDS (2 points), and higher MDS (3–5 points) groups. Weighted multivariable Cox regression was utilized to explore the potential association between MDS and mortality in diabetic patients. Stratified analyses and sensitivity analyses were employed to validate the robustness of our findings. Results: Among the 5,219 participants included in this study, 1,212 experienced all-cause mortality, and 348 experienced cardiovascular mortality. Weighted multivariable Cox regression indicated that higher MDS was strongly linked to a heightened risk of mortality in all models, including the fully adjusted model (all-cause mortality: HR = 1.58, 95% CI: 1.20–2.08; cardiovascular mortality: HR = 1.92, 95% CI: 1.28–2.88). In the stratified analysis, we found that the association between MDS and all-cause mortality was stronger among individuals aged <60 years. No significant differences were found in the relationship between MDS and mortality within other subgroups. In the sensitivity analyses, our results remained robust. Conclusions: An increase in MDS is significantly correlated with a higher risk of all-cause and cardiovascular mortality in diabetic patients. The risk of all-cause mortality was higher in diabetic patients aged <60. Early monitoring and management of MDS, as well as optimizing magnesium nutritional status, may benefit diabetic patients. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between the Dietary Inflammatory Index (DII) and osteosarcopenia using nationally representative data. Methods: We utilized data from 1,418 men and women aged ≥ 50 years old participating in Iranian Multicenter Osteoporosis Study (IMOS), a nation-wide, cross-sectional study conducted in 2021. Osteosarcopenia was defined based on standard criteria, considering the presence of both osteopenia/osteoporosis and sarcopenia. We assessed dietary patterns using a semi-quantitative 168-item Food Frequency Questionnaire (FFQ) and calculated energy-adjusted DII (E-DII) scores based on 31 specific food items. Multivariable logistic regression models were used to examine the association between osteosarcopenia and E-DII, adjusting for potential confounders. Nutrient intake calculations were performed using Nutritionist IV software. Results: The mean age of participants was 60.1 (SD = 7.9) years, with 770 (54.3%) being women. The prevalence of osteosarcopenia was 8.8% (95% CI: 7.3-10.6%). Osteosarcopenia was more prevalent among women, older participants, and rural inhabitants. However, the difference was not statistically significant for sex and area of residence. After adjusting for confounders, the odds ratios for osteosarcopenia in the second and third tertiles of E-DII score were 2.23 (95% CI: 1.23–4.05) and 2.47 (95% CI: 1.40–4.37), respectively. Conclusions: Our findings suggest an association between osteosarcopenia and the DII. A healthy low-inflammatory diet may play a crucial role in maintaining musculoskeletal health among the elderly. [ABSTRACT FROM AUTHOR]

Background: It has been reported that the cognitive responses to physical activity (PA) in postmenopausal women vary by parity status, and women with higher parity show a significant association between PA and cognitive function. However, the potential pathways mediating the relationship between PA and cognitive function in women with higher parity remain unclear. The objective of this study was to examine this association in Chinese cohort and further investigate the mediating pathways. Methods: A total of 2296 postmenopausal women were enrolled from the Baoshan District, from April to December 2020. All participant information was collected through interviewer-administered questionnaires or measurements, including personal information, medical history, lifestyle, body mass index (BMI), cognitive function, nutritional status, and depression status. In this cross-sectional study, generalized linear regression models and the chain-mediation analysis were used to examine the relationship between PA and cognitive function and the mediating pathways. Results: There was a significant relationship between PA and cognitive function in the high-parity group (≥ three births). In the fully adjusted generalized linear regression model, PA was significantly associated with cognitive function [β: 0.795, 95% confidence interval (CI): 0.251–1.340, P < 0.05]. The chain-mediation analysis showed that depression and nutritional status were two significant mediators, contributing 37.96% of the indirect effect of the overall effect. Conclusions: Our findings suggest that PA is beneficial for women (≥ three births) to maintain cognitive function, and these benefits are mediated by depression and nutritional status. [ABSTRACT FROM AUTHOR]