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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]

Large-scale food fortification (LSFF) can increase dietary micronutrient intake and improve micronutrient status. Here we used food balance sheet data from the Food and Agriculture Organization of the United Nations to estimate current country-specific prevalences of inadequate zinc intake. We assessed the potential effects of improving existing LSFF programmes for cereal grains or implementing new programmes in 40 countries where zinc deficiency is a potential public health problem. Accounting for LSFF programmes as currently implemented, 15% of the global population (1.13 billion individuals) is estimated to have inadequate zinc intake. In countries where zinc deficiency is a potential public health problem, the implementation of high-quality mandatory LSFF programmes that include zinc as a fortificant would substantially increase the availability of zinc in the national food supply, reducing the estimated prevalence of inadequate zinc intake by up to 50% globally. Investments in strong LSFF programmes could have a substantial impact on population zinc status.

BACKGROUND: Nutritional impairment is associated with treatment toxicity and worse overall survival in patients with cancer. We aimed to (1) evaluate the association of nutritional impairment with psychological health and quality of life (QOL) and (2) examine which measures of nutrition had the strongest association with psychological health and QOL among older adults receiving cancer treatment with palliative intent. METHODS: This secondary analysis was performed on baseline data from a nationwide cluster randomized clinical trial (ClinicalTrials.gov identifier: NCT02107443; PI: Mohile). Adults age ≥70 with advanced cancer and ≥1 geriatric assessment (GA) impairment were enrolled from 2014 to 2017. In line with geriatric oncology standards, we defined nutritional impairment as Mini Nutritional Assessment Short Form (MNA-SF) ≤11, body mass index (BMI) 10% involuntary weight loss in the past 6 months. We conducted multivariable linear regressions to evaluate the association of nutritional impairment with each measure of psychological health and QOL: Geriatric Depression Scale (GDS-15, range 0-15), Generalized Anxiety Disorder-7 (GAD-7, range 0-21), NCCN Distress Thermometer (NCCN DT, range 0-10), and Functional Assessment of Cancer Therapy-General (FACT-G, range 0-108). Analyses were adjusted for patient demographics, clinical characteristics, and GA. RESULTS: Among 541 patients, the mean age was 77 (range 70-96) and 60% had nutritional impairment. Mean baseline scores: GDS-15 3.1 (SD 2.7), GAD-7 2.9 (SD 4.0), NCCN DT 2.9 (SD 2.7), and FACT-G 80 (SD 15). In the adjusted model, compared to those with no nutritional impairment, older adults with nutritional impairment had greater depression (β = 0.79, 95% CI 0.36-1.23) and anxiety severity (β = 0.86, 95% CI 0.19-1.53), and worse QOL (β = -6.31, 95% CI -8.62 to -4.00). Of the measures of nutrition, MNA-SF ≤11 demonstrated the strongest associations with depression, anxiety, distress, and QOL. CONCLUSION: Nutritional impairment is associated with impaired psychological health and worse QOL. Clinicians should use the MNA-SF to screen older adults for nutritional impairment and offer tailored supportive interventions.

INTRODUCTION: Micronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana. METHODS: This randomized, controlled doubly-masked trial will be conducted in the Kumbungu and Tolon districts in the Northern Region of Ghana, where prior data indicate multiple micronutrient deficiencies are common. Participants will be: 1) non-pregnant non-lactating WRA (15-49 y), 2) children 2-5 y, and 3) non-pregnant lactating women 4-18 months postpartum. Eligible participants will be randomly assigned to receive household rations of one of two types of bouillon cubes: 1) a multiple micronutrient-fortified bouillon cube containing vitamin A, folic acid, vitamin B12, iron, zinc, and iodine, or 2) a control cube containing iodine only. Each participants household will receive a ration of bouillon cubes every 2 weeks, and households will be advised to prepare meals as usual, using the study-provided cubes. The trial duration will be 9 months for non-pregnant non-lactating WRA and children, and 3 months for lactating women. The primary outcomes will be changes in biomarkers of micronutrient status and hemoglobin among WRA and children and milk micronutrient concentrations among lactating women. Secondary outcomes will include change in prevalence of micronutrient deficiency and anemia; dietary intake of bouillon and micronutrients; inflammation, malaria, and morbidity symptoms; and child growth and development. DISCUSSION: Evidence from this study will inform discussions about bouillon fortification in Ghana and West Africa. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov (NCT05178407) and the Pan-African Clinical Trial Registry (PACTR202206868437931). This manuscript reflects protocol version 4 (August 29, 2022).

This study aimed to determine the efficacy of the World Food Program to the pupils' performance of Binidayan Elementary School. This study utilized the descriptive qualitative, in which there were thirty (30) randomly selected Grades IV to VI pupils in Binidayan Elementary School, Binidayan District, Lanao del Sur II, ARMM. Findings revealed that the World Food Program has an effect on the increased of the academic performance, the behavior, the attendance, the nutritional status, and the enrollment of the respondent. There was no significant relationship between the status of World Food Program implementation to the academic performance, behavior, attendance, nutritional status (BMI) and enrollment of the respondent. One of the primary goals of World Food Programs was to provide meals or snacks to reduce short-term hunger in the classroom so that the students can concentrate and learned better, and to attract children to school and have them attend class regularly. An action plan is recommended to be followed to sustain the World Food Program. [ABSTRACT FROM AUTHOR]

Background: High body-mass index (BMI) is an established risk factor for late-life cognitive impairment and dementia, but most evidence comes from high-income contexts. Existing evidence from cross-sectional data in low- and middle-income settings is inconsistent, and many studies do not adequately address potential sources of bias. Methods: We used data from Wave 1 of the Longitudinal Aging Study in India (LASI) (analytic N = 56,753) to estimate the association between BMI categories and cognitive functioning among older adults aged 45 + years using survey-weighted linear regression models stratified by gender and controlling for potential confounders including demographic factors, socio-economic status (SES) characteristics, and health-related behaviors. To probe potential sources of bias, including residual confounding and reverse causation, we used weighting and trimming methods, sample restriction, and explored effect modification. Results: In fully adjusted models, relative to normal BMI underweight BMI was associated with lower cognitive scores (Men: -0.16 SD difference, 95% CI -0.18, -0.13; Women: -0.12 SD, -0.15, -0.10). Overweight and obesity were associated with higher cognitive scores in both men (overweight: 0.09; 0.07, 0.12, obese: 0.10; 0.05, 0.15) and women (overweight: 0.09; 0.07–0.12, obese: 0.12; 0.08–0.15). Estimates were similar after weighting and trimming but were attenuated after excluding those with low cognition (≥1 SD below the mean relative to those with similar demographic characteristics). Positive associations between overweight and obese BMI and cognition were attenuated or null in those living in urban settings and those with higher levels of educational attainment. Conclusions: Underweight BMI is a risk factor for poor cognitive outcomes in adults 45 years and older and may be indicative of poor nutritional status and life-course disadvantage in India. In tandem with existing literature, supplemental analyses and effect modification results indicate that unmeasured confounding and reverse causation may explain the observed positive associations between overweight and obese BMI and cognitive functioning from cross-sectional studies in low- and middle-income settings. Future data with longitudinal follow-up will be helpful to further disentangle biases. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Reducing meat and dairy consumption has been advocated for environmental benefits. This study aimed to better understand meat and dairy consumption in a population with high intakes.Dietary data were obtained from up to two online 24‐h dietary recalls of adults (≥16 years) in the 2021 Scottish Health Survey, a nationally representative, repeated cross‐sectional survey. The contribution of food groups to meat and dairy intake and the nutritional contributions of meat and milk products to intake of 28 nutrients were examined. Weighted mean (95% confidence interval [CI]) daily intakes were reported per capita, overall, and by demographic subgroups (age, gender and Scottish Index of Multiple Deprivation).Mean daily intakes of total meat and dairy were 80.4 g (95% CI 77.1–83.7) and 238.6 g (95% CI 228.9–248.3) per capita, respectively. Chicken dishes, beef dishes and sandwiches were the primary contributors to meat intake, together accounting for 56.1% of meat consumed. Liquid milk accounted for 63.4% of the dairy consumed. Meat products were an important source of selenium and zinc (accounting for 26% and 25% of intake, respectively), whereas milk products were an important source of calcium (34%), iodine (38%) and vitamin A (25%).Although meat and dairy consumption in Scotland is high, a number of food groups contributed to meat intake, providing several opportunities to target for a reduction in line with climate change ambitions. However, careful attention is required for replacements to ensure Scottish diets are nutritionally adequate. [ABSTRACT FROM AUTHOR]

Background: To assess the efficacy of preoperative halo-gravity traction (HGT) in treating severe spinal deformities, evaluating radiological outcomes, pulmonary function, and nutritional status. Methods: This study retrospectively included 33 patients with severe spinal deformity who were admitted to our department from April 2018 to January 2022. All the patients underwent HGT prior to the posterior spinal fusion corrective surgery, with no patients having undergone anterior or posterior release procedures. The correction of deformity, pulmonary function tests (PFTs), and nutritional status data were collected and analyzed before and after HGT. Results: A total of 33 patients (9 males, 24 females) were finally included in this study with an average age of 17.79 ± 7.96 (range 12–29) years. Among them, 20 patients were aged ≤ 16 years. The traction weight started from 1.5 kg and raised to 45.2 ± 13.2% of body weight on average progressively, with the average traction duration of 129 ± 63 days. After traction, the main curve was corrected from an average of 120.66 ± 3.89° to 94.88 ± 3.35°, and to 52.33 ± 22.36° (53%) after surgery(P < 0.05). PFTs also showed a significant increase in FVC%, FEV1%, and MEF% after traction [43.46 ± 14.76% vs. 47.33 ± 16.04%, 41.87 ± 13.68% vs. 45.19 ± 15.57%, and 40.44 ± 15.87% vs. 45.24 ± 17.91%, p < 0.05]. Total protein, albumin, and BMI were used as indicators of nutritional status. TP and albumin were significantly improved after traction, from 67.24 ± 5.43 g/L to 70.68 ± 6.98 g/L and 42.40 ± 3.44 g/L 45.72 ± 5.23 g/L, respectively(P < 0.05). No significant difference was found in deformity correction and lung function improvement between patients with traction for more or less than three months (p > 0.05). Two patients developed transient brachial plexus palsy during traction. Conclusions: Halo-gravity traction can partially correct spinal deformity, enhance pulmonary function. And HGT has been shown to facilitate an improved nutritional status in these patients. It could be used as a preoperative adjuvant treatment for severe spinal deformity. However, according to the study, a traction period longer than three months may not be necessary. [ABSTRACT FROM AUTHOR]

Xpert MTB/RIF is recommended for the diagnosis of tuberculosis (TB) in children. We determined the performance of Xpert MTB/RIF in the diagnosis of pulmonary TB in children. The characteristics of children influencing Xpert MTB/RIF positivity were explored. Children aged <15 years with symptoms suggestive of pulmonary TB were prospectively enrolled from 2013 to 2019. Two sputum/early morning gastric aspirate specimens were collected for examination by smear (fluorescence microscopy), Xpert MTB/RIF, and culture [Mycobacteria growth indicator tube (MGIT)/Lowenstein–Jensen (LJ) medium]. Diagnostic performance of Xpert MTB/RIF was evaluated using LJ and or MGIT culture positivity as the reference standard. Sensitivity, specificity with 95% confidence interval (CI) were calculated. Stratified analysis was done; P  < .05 was considered statistically significant. Of the total 1727 enrolled children, 1674 (97%) with complete results for at least one sputum/gastric aspirate sample were analyzed. The sensitivity of Xpert MTB/RIF was 68.5% in sputum and 53.6% in gastric aspirate while the specificity was 99% for both. The sensitivity compared to smear was 68.5% vs. 33.7% (P  < .001) and 53.6% vs. 14.5%; (P  < .001) in sputum and gastric aspirate, respectively. The sensitivity of Xpert MTB/RIF was 23.9% with decision to treat as reference standard. Xpert MTB/RIF positivity was significantly influenced by sex, age, nutritional status, chest X-ray abnormality, TB infection status, and symptoms suggestive of TB. Xpert MTB/RIF as an upfront test compared to smear improves diagnosis of pulmonary TB in children yet the sensitivity is suboptimal. Newer TB diagnostic tools with improved sensitivity is warranted in children. [ABSTRACT FROM AUTHOR]

Cervical cancer (CC) results from a subsequent process, starting from the infection of normal cervical epithelium with oncogenic human papillomavirus and gradually progressing to cervical intraepithelial neoplasia (CIN), before finally developing into invasive cervical cancer (ICC). Over recent decades, dietary micronutrients have gained much attention due to their pivotal role in cancer prevention. We reviewed several relevant literature studies to investigate the protective roles of dietary nutrient intake in CC. Dietary intake of vitamin C, green-yellow vegetables, and provitamin A carotenoids that are rich sources of antioxidants may widely inhibit the process of CC development, whereas vitamins A and D might be more helpful in preventing the early events in the disease development. Vitamin E, lycopene, and folate are more effective for the treatment of high-grade CIN. Fruits exert their protective effects in the late stages of the cancer process, thus playing a vital role in ICC prevention. Polyphenols, flavonoids, and polyunsaturated fatty acids are more often used in cases of CC in combination with chemotherapy and radiotherapy. Thus, as a primary prevention strategy, the health benefits of various nutrients in CC must be clarified by vitro and in vivo approaches rather than epidemiological studies. [ABSTRACT FROM AUTHOR]

Key messages: Formative research to understand the sociocultural and economic context into which interventions are introduced can help to maximize the uptake of interventions both in the context of effectiveness trials and ultimately for nutrition programs.Findings from the formative research study were used to inform different facets of the design of the effectiveness trial including providing evidence of the acceptability of the product, informing the decision to deliver the product to women's homes, and developing strategies to support adherence. [ABSTRACT FROM AUTHOR]

Background: The phase 3 NEURO-TTRansform trial showed eplontersen treatment for 65 weeks reduced transthyretin (TTR), halted progression of neuropathy impairment, and improved quality of life (QoL) in adult patients with hereditary TTR-mediated amyloidosis with polyneuropathy (ATTRv-PN), vs. historical placebo. Methods: NEURO-TTRansform enrolled patients with ATTRv-PN. A subset of patients were randomized to receive subcutaneous inotersen 300 mg weekly (Weeks 1–34) and subsequently switched to subcutaneous eplontersen 45 mg every 4 weeks (Weeks 37–81). Change in serum TTR and treatment-emergent adverse events (TEAEs) were evaluated through Week 85. Effects on neuropathy impairment, QoL, and nutritional status were also evaluated. Results: Of 24 patients randomized to inotersen, 20 (83%) switched to eplontersen at Week 37 and four discontinued due to AEs/investigator decision. Absolute change in serum TTR was greater after switching from inotersen (−74.3%; Week 35) to eplontersen (−80.6%; Week 85). From the end of inotersen treatment, neuropathy impairment and QoL were stable (i.e., did not progress) while on eplontersen, and there was no deterioration in nutritional status. TEAEs were fewer with eplontersen (Weeks 37–85; 19/20 [95%] patients) compared with inotersen (up to Week 35; 24/24 [100%] patients). Mean platelet counts decreased during inotersen treatment (mean nadir reduction ‒40.7%) and returned to baseline during eplontersen treatment (mean nadir reduction, ‒3.2%). Conclusions: Switching from inotersen to eplontersen further reduced serum TTR, halted disease progression, stabilized QoL, restored platelet count, and improved tolerability, without deterioration in nutritional status. This supports a positive benefit-risk profile for patients with ATTRv-PN who switch from inotersen to eplontersen. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine the nutritional status and its prognostic effect on the survival of patients with advanced gastrointestinal cancer. Methods: A prospective cohort study design was conducted in a tertiary hospital in Shanghai, China. The study consisted of 202 advanced gastrointestinal (GI) cancer patients from a palliative care unit. The following data were collected from the patients: biochemical indicators, i.e., anemia (hemoglobin levels), albumin, pre-albumin, C-reactive protein (CRP), and anthropometric parameters, i.e., body mass index (BMI), nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA), and performance status by Karnofsky Performance Status (KPS). Severe malnutrition was confirmed with the PG-SGA score of ≥ 9. Kaplan–Meier survival analysis and the log-rank test were used to calculate overall survival (OS). The effect of nutritional status on survival was performed by Cox regression analysis. Results: Severe malnutrition was found in 71.3% of patients according to the cutoff of the PG-SGA. PG-SGA score ≥ 9, albumin level < 35 g/L, and CRP level ≥ 10 mg/L predicted shortened life expectancy. Multivariate Cox regression analysis results showed that the PG-SGA score ≥ 9 and the albumin level < 35 g/L were predictive of OS. Conclusion: Our data support that severe malnutrition is a predictor for OS in patients with advanced GI cancer. Information on nutritional status should be considered to individualize palliative care plan for these patients, and hence improve their quality of life. [ABSTRACT FROM AUTHOR]

Aims: The reference nutrient intake for vitamin D in people aged ≥4 years is 10 μg/day (400 IU/day) in the UK, but the recommended daily allowance is 15 μg/day (600 IU/day) for people aged 1–70 years in the USA. Here, we aim to compare the 25‐hydroxyvitamin D (25(OH)D) serum concentration profiles between the 2 doses. Methods: With world‐wide trial data of adults aged ≥18 years, 45–93 kg, we constructed a minimal physiologically based pharmacokinetics model of serum concentrations of vitamin D and 25(OH)D using nonlinear mixed effects modelling. We used this model to forecast the mean, 2.5th and 97.5th percentiles for serum 25(OH)D concentrations in British adults aged ≥16 years. Results: Our final model used bodyweight to adjust volume of each compartment and maximum clearance of 25(OH)D. No other covariate was identified. The model accurately predicted independent data from trials of a broad range of dosing regimens. We simulated British adults and showed that circulating 25(OH)D concentrations in 95% of people taking 10 μg/day for a year is predicted to reach 50 nmol/L in 32 weeks, while 97.5% of those on 15 μg/day were predicted to attain this threshold within 28 weeks. Conclusion: Both doses are efficacious in >95% of the British population. The daily dose of 15 μg can help 97.5% of the British adults achieve 50 nmol/L serum 25(OH)D and reach the 25 nmol/L threshold in 4 weeks. [ABSTRACT FROM AUTHOR]

To identify modifier loci underlying variation in body mass index (BMI) in persons with cystic fibrosis (pwCF), we performed a genome-wide association study (GWAS). Utilizing longitudinal height and weight data, along with demographic information and covariates from 4,393 pwCF, we calculated AvgBMIz representing the average of per-quarter BMI Z scores. The GWAS incorporated 9.8M single nucleotide polymorphisms (SNPs) with a minor allele frequency (MAF) > 0.005 extracted from whole-genome sequencing (WGS) of each study subject. We observed genome-wide significant association with a variant in FTO (FaT mass and Obesity-associated gene; rs28567725; p value = 1.21e−08; MAF = 0.41, β = 0.106; n = 4,393 individuals) and a variant within ADAMTS5 (A Disintegrin And Metalloproteinase with ThromboSpondin motifs 5; rs162500; p value = 2.11e−10; MAF = 0.005, β = −0.768; n = 4,085 pancreatic-insufficient individuals). Notably, BMI-associated variants in ADAMTS5 occur on a haplotype that is much more common in African (AFR, MAF = 0.183) than European (EUR, MAF = 0.006) populations (1000 Genomes project). A polygenic risk score (PRS) calculated using 924 SNPs (excluding 17 in FTO) showed significant association with AvgBMIz (p value = 2.2e−16; r2 = 0.03). Association between variants in FTO and the PRS correlation reveals similarities in the genetic architecture of BMI in CF and the general population. Inclusion of Black individuals in whom the single-gene disorder CF is much less common but genomic diversity is greater facilitated detection of association with variants that are in LD with functional SNPs in ADAMTS5. Our results illustrate the importance of population diversity, particularly when attempting to identify variants that manifest only under certain physiologic conditions. [Display omitted] A GWAS reveals that BMI variation in persons with CF (pwCF) is determined by loci operating in the general population (e.g., FTO) and a unique locus containing ADAMTS5. Interaction with exocrine pancreatic status (sufficient or insufficient) in pwCF suggests that ADAMTS5 operates in the context of severe nutritional stress. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions There are limited hospital‐acquired malnutrition (HAM) studies among the plethora of malnutrition literature, and a few studies utilise electronic medical records to assist with malnutrition care. This study therefore aimed to determine the point prevalence of HAM in long‐stay adult patients across five facilities, whether any descriptors could assist in identifying these patients and whether a digital Dashboard accurately reflected ‘real‐time’ patient nutritional status.HAM was defined as malnutrition first diagnosed >14 days after hospital admission. Eligible patients were consenting adult (≥18 years) inpatients with a length of stay (LOS) >14 days. Palliative, mental health and intensive care patients were excluded. Descriptive, clinical and nutritional data were collected, including nutritional status, and whether a patient had hospital‐acquired malnutrition to determine point prevalence. Descriptive Fisher's exact and analysis of variance (ANOVA) tests were used.Eligible patients (n = 134) were aged 68 ± 16 years, 52% were female and 92% were acute admissions. HAM and malnutrition point prevalence were 4.5% (n = 6/134) and 19% (n = 26/134), respectively. Patients with HAM had 72 days greater LOS than those with malnutrition present on admission (p < 0.001). A high proportion of HAM patients were inpatients at a tertiary facility and longer‐stay wards. The Dashboard correctly reflected recent ward dietitian assessments in 94% of patients at one facility (n = 29/31).HAM point prevalence was 4.5% among adult long‐stay patients. Several descriptors may be suitable to screen for at‐risk patients in future studies. Digital Dashboards have the potential to explore factors related to HAM. [ABSTRACT FROM AUTHOR]

Background: Malnutrition often manifests as a body weight (BW) reduction and unhealthy alteration in body composition. The present study aimed to assess the efficacy of an oral nutritional supplement (ONS) in improving BW and body composition among older adults with malnutrition. Methods: An open‐label randomised controlled, parallel‐group study was conducted among older adults (age ≥ 60 years) with/at risk of malnutrition (mini nutrition assessment‐short form score ≤ 11). In total, 50 participants were randomly assigned to the intervention (IG) and control (CG) groups (1:1 ratio). The IG received the ONS (57 g/day; 247 kcal/serving, 12 g protein) before bedtime for 12 weeks. CG received 200 mL of water. Anthropometric measurements, body composition analysis, and dietary and physical activity assessments were performed at the beginning and end of the study. Results: Forty‐two participants (IG: 20, CG: 22) completed the study. The mean ± SD ages of the IG and CG were 75.4 ± 6.1 and 74.8 ± 5.2 years, respectively (p = 0.73). The IG had a significant increase in BW (+1.68 ± 1.16 vs. −0.46 ± 0.95 kg; p < 0.001), lean mass (+1.23 ± 0.93 vs. −0.45 ± 0.90 kg; p < 0.001) and fat mass (+0.54 ± 0.82 vs. −0.06 ± 0.82 kg; p = 0.02) compared to the CG. One‐quarter of the IG (n = 5) achieved a weight gain > 5% of BW, whereas none in the CG did (p = 0.01). No significant changes were observed in bone mineral content in either group. Conclusions: For malnourished older adults, supplementing with an ONS, along with regular food intake, significantly increased BW, lean mass and fat mass compared to control following the regular diet without supplementation. Highlights: Malnutrition in older adults has become a prevalent public health concern.Oral nutritional supplements (ONS) provide calories, high‐quality protein and micronutrients when a regular diet alone is insufficient.ONSs can be used as an effective intervention to prevent/treat malnutrition in older adults.Intervention with an ONS led to an increase in body weight and an improvement in body composition within the study group. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the relationship between Med-Diet adherence with sustainable nutrition and environmental footprints in academicians. Methods: The study involved 153 academicians aged 23-64 working in a university in Turkey. Data were collected through a questionnaire including socio-demographic characteristics, anthropometric measurements, Mediterranean Diet Adherence Scale (MEDAS) and Sustainable and Healthy Eating Behaviours Scale (SHEBS). Carbon and water footprints were calculated. Results: All sub-scales of SHEBS were higher in individuals who adhered to Med-Diet than those who did not (p<0.05). The carbon and water footprints of individuals with high adherence to the Med-Diet were lower than those of no adherence (p<0.05). Each 1-point increase in MEDAS score was associated with a 1-point increase in SHEBS score, a 0.15 CO2 eq/kg and a 0.001 m3/year decrease in the amount of carbon and water footprint of food. Conclusion: Higher adherence to the Med-Diet was associated with higher sustainable nutrition behaviours, and lower environmental footprints. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. The objective of this study was to evaluate the effect of energy and protein in the diet on the recovery of milk ethanol stability (MES) induced by feed restriction. Twelve Holstein and Holstein × Jersey crossbred cows with an average of 146 ± 50 DIM, 575.4 ± 70 kg of BW, and 18.93 ± 5.46 kg/d of milk yield were distributed in a 3 × 3 Latin square design with 3 treatments and 3 experimental periods. Each experimental period lasted 24 d, comprising 3 phases: a 13-d adaptation phase (100E+100P), a 4-d induction phase for milk ethanol instability (50E+50P), and a 7-d recovery phase for MES (3 treatments). The 3 treatments during the recovery phase consisted of 3 diets aiming to meet the requirements of energy and protein (100E+100P), only energy (100E+50P), or only protein (50E+100P). The diet during the adaptation and induction phases was common for all cows. The energy and protein levels to meet each cow's requirements were based on the group average. Restriction of energy and protein reduced DM, CP, and total digestive nutrient intake for cows fed 100E+50P and 50E+100P. The lowest BW was observed for cows fed 50E+100P, with no difference for BCS. During the induction phase, MES was reduced by 9 percentage units. Cows fed 100E+100P recovered MES in the first days of the recovery phase, whereas 100E+50P slightly improved MES, and 50E+100P had a constant decrease in MES. Cows fed 100E+50P and 50E+100P produced, respectively, 3.6 and 5.9 kg less milk than those fed 100E+100P. The 50E+100P treatment exhibited the highest milk fat content and SCS, along with the lowest milk lactose content. Protein content was higher in the 100E+100P treatment. Cows fed 50E+100P showed higher serum albumin levels compared with those on the 100E+100P treatment, not differing from the 100E+50P treatment. We concluded that the complete recovery of MES in cows with feed restrictions is possible only by supplying both the energy and protein requirements in the cows' diet. However, restricting energy intake poses a greater limitation on MES recovery compared with restricting protein. [ABSTRACT FROM AUTHOR]

In hospitalized children, height should be measured. When world health organization (WHO) height measurement gold standards is impossible, the ideal height estimation technique is still unclear. We conducted an international prospective study in eight different pediatric intensive care units to assess the accuracy, precision, practicability, safety, and inter-rater reliability of 12 different height estimation techniques, based on body segment measurement extrapolation, or other calculations using previous or projected heights. All extrapolation techniques were performed on each child, and later compared to their WHO gold standard heights. A total of 476 patients were enrolled. In the < 2-year subgroup, board length use and growth chart extrapolation performed best. In the ≥ 2-year subgroup, growth chart extrapolation and parents' report were the most accurate, followed by height measurement alongside the body with a tape measure. In both groups, body segment extrapolations were poorly predictive and showed mean bias and limits of agreement that varied a lot with age. Most body segment-based techniques presented with frequent measurement difficulties, but children's safety was rarely compromised. The inter-rater reliability of body segment measurement was low in the < 2-year subgroup. Conclusions: To accurately estimate height in hospitalized children, health care professionals should integrate the accuracy, precision, practicability, and reliability of each measurement technique to select the most appropriate one. Body segment-based techniques were the least accurate and should probably not be used. Simple techniques like growth chart extrapolation, or measurement alongside the body (and length board measurement in the youngest) should be implemented in daily practice. Trial Registration: The study protocol was registered (12th April 2019) on the clinical-trial.gov website (NCT03913247). What is Known: • Height should be measured in hospitalized children to assess nutritional status and calculate various clinical parameters. • Many hospitalized children cannot be measured using WHO conventional height measurement methods. The ideal height estimation method has not been identified yet. What is New: • Most estimation methods based on body segment measurement extrapolation fail to accurately predict height. • Board length use and growth chart extrapolation performed best in young children (≥2 years). Growth chart extrapolation and parents' report were the most accurate, followed by height measurement alongside the body with a tape measure in older children. [ABSTRACT FROM AUTHOR]

Gather perspectives on healthy retail policies and strategies from a national sample of Supplemental Nutrition Assistance Program (SNAP) participants. Anonymous web-based survey fielded in English and Spanish. The survey measured support for healthy retail policies and strategies. National Qualtrics panel fielded on September 30 and October 19, 2022. A total of 1,559 adult SNAP participants (in the last 12 months) participated in the Qualtrics SNAP survey panel. Overall support for retail policies and strategies was calculated using response frequencies and proportions. Cross-tabulations and chi-square tests of independence assessed differences in policy support by online shopping behavior and nutrition security status. Significance was determined at P < 0.05. Most SNAP participants were broadly supportive of policies and strategies to improve the healthy food retail environment. More restrictive policies were less popular than policies that expanded consumer choice. Support also varied by online shopping status and nutrition security status. Policies and strategies that improve the healthy food retail environment are popular among a national sample of SNAP participants. Policy discussions must understand SNAP participants' perspectives regarding changes to the retail environment that may impact their ability to access healthy foods. [ABSTRACT FROM AUTHOR]

As one of the three primary plant nutrients, plant growth and development depend on soil potassium (K) availability. However, plants often face K deficiency in the soil. Chickpea (Cicer arietinum L.) is an excellent source of vegetable protein. However, optimum chickpea growth is affected by K limitation. This study evaluated whether K application in an Oxisol influences chickpea growth, grain yield, and nutritional status. We conducted a greenhouse experiment in an Oxisol with four K application rates (0, 40, 80, and 150 kg ha−1) and four replicates. Our results showed that K application significantly increased chickpea grain yield (R2 = 0.968), shoot weight, root dry weight, and the number of pods. In addition, the K application rate in the soil increased with increasing K application rate. In addition, the concentrations of K and P in the grain are affected by K application. In addition, K improved the K concentration in the shoot (R2 = 0.756) and grain (R2 = 0.833). However, the application of high levels of K did not increase K accumulation in the seeds, indicating that the use of low doses of K (≤80 kg ha−1) is sufficient to support plant growth and nutrition and avoid K loss. Finally, the benefits of K in plants are more than an increase in the grain yield of crops. However, K plays a dominant role in the root system. For instance, this benefit enhances K acquisition from the soil for plants. [ABSTRACT FROM AUTHOR]

Children with chronic kidney disease (CKD) are at risk for vitamin deficiency or excess. Vitamin status can be affected by diet, supplements, kidney function, medications, and dialysis. Little is known about vitamin requirements in CKD, leading to practice variation. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric kidney dietitians and pediatric nephrologists, was established to develop evidence-based clinical practice points (CPPs) to address challenges and to serve as a resource for nutritional care. Questions were formulated using PICO (Patient, Intervention, Comparator, Outcomes), and literature searches undertaken to explore clinical practice from assessment to management of vitamin status in children with CKD stages 2–5, on dialysis and post-transplantation (CKD2-5D&T). The CPPs were developed and finalized using a Delphi consensus approach. We present six CPPs for vitamin management for children with CKD2-5D&T. We address assessment, intervention, and monitoring. We recommend avoiding supplementation of vitamin A and suggest water-soluble vitamin supplementation for those on dialysis. In the absence of evidence, a consistent structured approach to vitamin management that considers assessment and monitoring from dietary, physical, and biochemical viewpoints is needed. Careful consideration of the impact of accumulation, losses, comorbidities, and medications needs to be explored for the individual child and vitamin before supplementation can be considered. When supplementing, care needs to be taken not to over-prescribe. Research recommendations are suggested. [ABSTRACT FROM AUTHOR]

Due to its importance for oil production in Brazil and worldwide, the 'Picual' olive trees deserves special attention of to its good climatic adaptation and high yield and stability in the oil produced. However, there is a need to generate more technical information to improve the propagation and production system for nursery plants. The use of slow-release fertilizer (SRF) affects the quality standard of the plants formed in the nursery. The purpose of this study was to evaluate the effect of doses (0, 1.5, 3.0, 6.0, and 12 g L−1) of the SRF, Osmocote® (NPK 14-14-14), on morphological, biochemical and nutritional parameters of 'Picual' olive plants. It was found that the average value of maximum technical efficiency dose (MTED) for several morphological variables (plant height, stem diameter, total plant dry weight and root volume) was 7.18 g L−1. Furthermore, an Osmocote® dose of 8.35 g L−1 resulted in optimal leaf number and area. For the carbohydrate concentration (sucrose, starch and Total Soluble Sugar) in leaves, the best average values were obtained at 4.51, 5.48 and 6.12 g L−1 of Osmocote®, respectively. Additionally, the best growth responses of plants may also be due to increased internal macronutrient concentration such as nitrogen (N), phosphorus (P) and potassium (K) after treatment with 7.87 g L−1 of Osmocote®. The use of SRF (Osmocote®) is a viable alternative in the production of 'Picual' plants, as it promotes good morphological characteristics, synthesis of photosynthetic products as well as satisfactory nutritional status and plant growth. [ABSTRACT FROM AUTHOR]

Various risk factors for developing severe coronavirus disease 2019 (COVID-19) have been reported. However, studies on the nutritional-related risk factors are limited. In this study, we investigated the effects of serum zinc deficiency on the severity of COVID-19. The study included a total of 60 COVID-19 patients who were admitted to Tsuyama Chuo Hospital between March 2020 and April 2021. We divided the patients into two categories based on serum levels of zinc (normal and latent zinc deficiency vs. zinc deficiency [<60 μg/dL]) at the time of diagnosis. Severity of COVID-19 was defined as the most exaggerated disease status during admission. The associations between serum zinc deficiency and the severity of COVID-19 were examined using a logistic regression model adjusted for potential confounders. Patients who required oxygen therapy had a higher prevalence of comorbidities and poorer nutritional status, including zinc deficiency, than those who did not require oxygen therapy. Zinc deficiency was associated with an increased risk of COVID-19 severity, with an adjusted odds ratio of 7.29 (95% confidence interval: 1.70–31.18). This result remained significant in the sensitivity analyses conducted after adjusting for patient background factors. Zinc deficiency at the time of COVID-19 diagnosis is an independent risk factor for severe disease. Our findings need to be validated in external studies. [ABSTRACT FROM AUTHOR]

Background: The Mid-Day Meal Program plays a pivotal role in enhancing the nutritional status and educational outcomes of primary school children in India. This study investigates the program’s impact on the nutritional well-being of children across three districts in Bihar. Methods: A community-based cross-sectional study was conducted, involving 1,070 primary school children from Saran, Muzaffarpur, and Patna districts. The assessment of nutritional status was based on indicators such as BMI for age, weight for height, and weight for age. Data related to children’s participation in the Mid-Day Meal Program was collected through relevant questionnaire and analysed using descriptive statistics. Results: Patna has the highest percentage of children receiving mid-day meal (89.86%) with lowest prevalence of wasting and severe wasting. The prevalence of stunting or wasting were more common in children aged greater than 10 years. The analysis revealed substantial challenges in nutritional status, with a high prevalence of stunting, underweight, and wasting among primary school children in the surveyed districts. In contrast, promising trends were observed in terms of menu changes and vegetable inclusion within the Mid-Day Meal Program. Conclusion: The study highlights the pressing need for targeted interventions to address prevalent nutritional issues and improve the program’s impact. These findings provide valuable insights for policymakers and stakeholders to enhance the well-being of primary school children in the region through the Mid-Day Meal Program. [ABSTRACT FROM AUTHOR]

Background: Stunting is the common form of child undernutrition. The objective of the present study is to know the relationship of maternal characteristics and stunting in children below five years. Methods: A descriptive study was conducted among 233 children who were 6-59 months of age. Data was collected by structured interview schedule and length/height was measured and analysed length/ height for age to identify status of stunting and maternal characteristics was analysed to identify the relationship with stunting status Results: The study result shows that among 233 participants, 29(12.4%) were found to be stunted. Children being stunted or normal in height was associated with maternal height, frequency of meals per day in the family, inadequate iron supplementation during pregnancy, adequacy of antenatal check up during pregnancy. Maternal height below 145cm (OR: 0.009; p=<0.001), frequency of meal (OR: 0.005; p=0.001), inadequate iron supplementation (OR: <0.001;p=<0.001) increase the likelihood of a child being stunted Conclusion: There was correlation between maternal characteristics and stunting of children. There is needed to improve the nutritional status by improving adherence of iron supplementation during pregnancy and improving antenatal visit. [ABSTRACT FROM AUTHOR]

Introduction: The nutritional well being of a population is both an outcome and an indicator of national development. Reducing infant and child deaths and improving the level of nutritional status of the child is one of the important priority areas for Government of India. One of the important ways to achieve desired reduction of infant mortality is to ensure 100% exclusive breastfeeding for first 6 months followed by appropriate complementary feeding along continuation of breastfeeding. Objective: To study the prevalence of Breastfeeding practices of children less than 2years Methodology: The present study is a cross sectional study conducted in slums of AMC during June 2018 to August 2019. A total of 840 children between 0 to 2 years were selected using cluster sampling method. The Predesigned pretested proforma comprised of socio demographic details, components of antenatal care and breastfeeding practices of infants up to 24 months was used. The data so collected was entered into computer using appropriate software. The data was then analyzed for various parameters and cross tabulation was done using appropriate software. Results: Breastfeeding within one hour was received by 53.2% of children. 61.9% of the children were given pre lacteal feeding after birth as a part of ritual. Only (70.8%) of the children had received colostrum. One third (33.3%) of children less than 24 months of age, were receiving feedings other than breast-milk. Majority (60%) of children had received breastfeeding for 6 months. [ABSTRACT FROM AUTHOR]

The inflammatory nutritional status is widely associated with the long-term prognosis of non-fatal stroke. The objective of this study is to examine the correlation between the C-reactive protein to albumin ratio (CAR), a new marker indicating both inflammatory and nutritional status, and the overall mortality rate among stroke patients. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database and corresponding public-use mortality data from the linked National Death Index (NDI). The study utilized maximally selected rank statistics to determine the optimal cutoff points for the CAR. Subsequently, participants were stratified into higher- and lower-CAR groups based on these cutoff points. The Kaplan-Meier survival method was used to study overall survival probability. Multivariable Cox proportional regression models were employed to calculate the Hazard Ratio (HR) and corresponding confidence interval (CI). Restricted cubic spline (RCS) model was applied to detect potential non-linear relationship between CAR and mortality risk. Furthermore, stratified and sensitive analyses were performed to examine the robustness and reliability of the results. The study, encompassing 1043 participants with an average age of 64.61 years, identified a cutoff value of 0.32 for CAR, with notable variances observed across gender and age cohorts. Over an average follow-up period of 116 months, 679 instances of all-cause mortality were documented. Kaplan-Meier survival analysis unveiled noteworthy disparities in survival probabilities between groups categorized by high and low CAR levels (p = 0.00081). Continuous CAR analysis consistently demonstrated a positive correlation between elevated CAR values and heightened risk (HR = 1.78 (1.36, 2.33)) of all-cause mortality among stroke patients. Similarly, individuals in the high CAR group exhibited adjusted HR of 1.34 (0.96, 1.89) for all-cause mortality compared to their low CAR counterparts. Subgroup and sensitive analysis consistently reinforced these findings. Smoothing curve fitting further validated CAR's significance as a prognostic indicator of all-cause mortality, indicating a linear relationship. Elevated CAR is associated with increased long-term risk of mortality for individuals who have experienced a stroke, suggesting that CAR could serve as a survival indicator. • The inflammatory nutritional status is widely associated with the long-term prognosis of non-fatal stroke. • The relationship between C-reactive protein to albumin ratio (CAR) with the prognosis of patients of stroke is unknown. • Elevated CAR is associated with increased long-term risk of mortality for individuals who have experienced a stroke. • CAR should be thoroughly considered in the long-tern outcome management of patients with history of stroke. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy (ART) has improved the survival of people living with HIV (PLHIV) but this success has been accompanied by an increase in noncommunicable diseases. We conducted a prospective cohort study of 4000 adult PLHIV who were initiating ART in Dar es Salaam, Tanzania, to assess weight gain during the first year of treatment and associated sociodemographic and clinical factors. Anthropometric data were collected at ART initiation and monthly follow-up visits. The mean weight gain during the first year of treatment was 2.6 ± 0.3 kg, and the prevalence of overweight or obesity increased from 26.3% at baseline to 40.7%. Female sex, greater household wealth, lower CD4-T-cell counts, higher WHO HIV disease stage, and pulmonary tuberculosis were associated with a greater increase in body mass index (P <.05). Weight gain following ART initiation was common but was greater among females and PLHIV with advanced HIV or comorbidities. [ABSTRACT FROM AUTHOR]

Background Breakfast intake is considered as one of the most important factors in nutrition for adolescents, but the intake of breakfast has declined in past 25 years especially among adolescents. Breakfast not only fuels your body but also aids in carrying out whole day activities by providing the required energy. Objectives The objectives of the study were to identify the breakfast eating and skipping patterns, identify the nutritional status, and find association between breakfast skipping and nutritional status among nursing students. Methods To achieve this aim, a cross-sectional survey was performed among nursing students. The data related to patterns of breakfast skipping and eating was collected followed by assessment of nutritional status by checking weight and height of each student and was interpreted as per the World Health Organization criteria. Results Out of 437 samples, a majority of 305 (69.8%) students belonged to (17–21) years of age and most of the students 409 (93.6%) were females. It was found that approximately 214 (48.97%) students were skipping breakfast three times in a week. A significant association was found between nutritional status and breakfast skipping (χ 2 = 6.61, p = 0.03). Conclusion Breakfast being first meal of the day not only provides us energy but also maintains our nutrition on everyday basis. Thereby, the study concludes that breakfast skipping affects nutritional status if skipped for more than twice in a week on a longer run. Thus, the students should be motivated to have breakfast before beginning their everyday's activity. [ABSTRACT FROM AUTHOR]

One of the frequent causes of low back pain is intervertebral disc degeneration (IDD), which is followed by discogenic pain. Some significant risk factors that have been linked to the onset and progression of IDD include age, mechanical imbalance, changes in nutrition and inflammation. According to recent studies, five types of animal models are established for producing IDD: the spontaneous models, the puncture models, the biomechanical models, the chemical models and the hybrid models. These models are crucial in studying and understanding IDD's natural history and identifying potential treatment targets for IDD. In our study, we'll talk about the technical aspects of these models, the time between model establishment and the apparition of observable degradation, and their potential in various research. Each animal model should be compared to the human natural IDD pathogenesis to guide future research efforts in this area. By improving knowledge and appropriate application of various animal models, we seek to raise awareness of this illness and further translational research. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) and malnutrition exhibit overlapping risk factors, characterized by increased levels of natriuretic peptides and an inflammatory profile. The aim of this study was to compare the differences in plasma brain natriuretic peptide (BNP), N‐terminal‐pro B‐type natriuretic peptide (NT‐proBNP), and C‐reactive protein (CRP) in patients with HF and malnutrition versus normal nutrition. Methods: From inception until July 2023, the databases, PubMed, Scopus, Web of Science, and Cochrane Library were searched. To examine the association among malnutrition [controlling nutritional status (CONUT) score ≥2; Geriatric Nutritional Risk Index (GNRI) score <92] with BNP, NT‐proBNP and CRP in patients with HF, a meta‐analysis using a random‐effects model was conducted (CRD42023445076). Results: A significant association of GNRI with increased levels of BNP were demonstrated [mean difference (MD): 204.99, 95% confidence interval (CI) (101.02, 308.96, I2 = 88%, P < 0.01)], albeit no statistically significant findings were shown using CONUT [MD: 158.51, 95% CI (−1.78 to 318.79, I2 = 92%, P = 0.05)]. GNRI [MD: 1885.14, 95% CI (1428.76–2341.52, I2 = 0%, P < 0.01)] and CONUT [MD: 1160.05, 95% CI (701.04–1619.07, I2 = 0%, P < 0.01)] were associated with significantly higher levels of NT‐proBNP. Patients with normal GNRI scores had significantly lower levels of CRP [MD: 0.50, 95% CI (0.12–0.88, I2 = 87%, P = 0.01)] whereas significantly higher levels of CRP were observed in those with higher CONUT [MD: 0.40, 95% CI (0.08–0.72, I2 = 88%, P = 0.01)]. Employing meta‐regression, age was deemed a potential moderator between CRP and GNRI. Conclusions: Normal nutrition scores in patients with HF are linked to lower BNP, NT‐proBNP, and CRP levels compared with malnourished counterparts. Despite the significant link between CRP and malnutrition, their relationship may be influenced in older groups considering the sensitivity of GNRI due to ageing factors. [ABSTRACT FROM AUTHOR]

Background: Metabolic disorder, malnutrition and inflammation are involved and interplayed in the mechanisms of heart failure with preserved ejection fraction (HFpEF). We aimed to construct a Metabolism-malnutrition-inflammation score (MIS) to predict the risk of death in patients with HFpEF. Methods: We included patients diagnosed with HFpEF and without infective or systemic disease. 20 biomarkers were filtered by the Least absolute shrinkage and selection operator (Lasso)-Cox regression. 1000 times bootstrapping datasets were generated to select biomarkers that appeared above 95% frequency in repetitions to construct the MIS. Results: Among 1083 patients diagnosed with HFpEF, 342 patients (31.6%) died during a median follow-up period of 2.5 years. The MIS was finally constructed based on 6 biomarkers, they were albumin (ALB), red blood cell distribution width-standard deviation (RDW-SD), high-sensitivity C-reactive protein (hs-CRP), lymphocytes, triiodothyronine (T3) and uric acid (UA). Incorporating MIS into the basic predictive model significantly increased both discrimination (∆C-index = 0.034, 95% CI 0.013–0.050) and reclassification (IDI, 6.6%, 95% CI 4.0%-9.5%; NRI, 22.2% 95% CI 14.4%-30.2%) in predicting all-cause mortality. In the time-dependent receiver operating characteristic (ROC) analysis, the mean area under the curve (AUC) for the MIS was 0.778, 0.782 and 0.772 at 1, 3, and 5 years after discharge in the cross-validation sets. The MIS was independently associated with all-cause mortality (hazard ratio: 1.98, 95% CI [1.70–2.31], P < 0.001). Conclusions: A risk score derived from 6 commonly used inflammatory, nutritional, thyroid and uric acid metabolic biomarkers can effectively identify high-risk patients with HFpEF, providing potential individualized management strategies for patients with HFpEF. [ABSTRACT FROM AUTHOR]

1. An experiment was carried out examine if a heterogeneous diet consisting of pellets and coarse cereal particles would result in a similar feed intake to pelleted-only diets. It considered whether coarser particles entering the gizzard would encourage the development of the gizzard and thus improve digestive tract functionality. Maize and wheat were hammer milled through a 3 mm screen after coarse grinding using either one of the two screens with a novel pattern. Three pellet-only diets were produced based on three grinding sizes. Additionally, four diets were produced by separating coarse cereal particles from moderately coarse particles by sieving either once or twice, pelleting the remainder and finally mixing these into a complete heterogeneous diet.2. No difference in performance between birds fed the three pelleted-only diets was observed. However, heterogeneous diets resulted in a lower feed intake (FI) and weight gain (WG) than pelleted-only diets (p < 0.05). The dietary treatments neither affected the feed conversion ratio nor ileal digestibility of starch and protein (p > 0.05). As expected, feeding a heterogeneous diets increased (p < 0.05) the relative weight of the gizzard and its contents. Approximately 50% of the particles in the small intestine were between 0.15 mm and 0.36 mm in diameter, with more fine particles observed when the pelleted-only diets containing coarsely ground cereals were fed, confirming the capacity of the gizzard to finely grind feed.3. Sieving of the diet remaining in the feeder during 4 h of feeding two of the heterogeneous diets showed that the particles > 2.8 mm disappeared first (p < 0.05), showing the birds’ preference for larger particles when offered heterogeneous diets. Although the birds were able to handle the coarse microstructure of the diets without any negative effects, the reduced performance in the case of heterogeneous diets might have been related to feed intake issues and particle selection, resulting in an imbalance in nutrient intake. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the effects of enteral nutrition with different protein concentrations on muscle mass in severe pneumonia patients, providing insights for enteral nutrition practice in intensive care units (ICUs). Methods: A total of 120 severe pneumonia patients admitted to Dazhou Central Hospital's ICU between June 1, 2022, and February 1, 2023, meeting inclusion criteria, were randomly assigned to either a high-protein group (n = 60, 1.8 g/kg/d) or a standard-protein group (n = 60, 1.2 g/kg/d). Changes in relevant indicators were monitored on days 1, 5, and 10 of ICU admission, including quadriceps and diaphragm thickness, nutritional status (prealbumin and albumin), and adverse events such as diarrhea and constipation. Results: Autoregressive of order 1 model (AR(1)) analysis revealed a decrease in both quadriceps and diaphragm thickness over time in both groups. A significant group × time interaction was observed in quadriceps thickness. By day 10, compared to baseline, quadriceps thickness decreased in the high-protein (-0.315 cm [95% CI, -0.340 to -0.289]) and standard-protein (-0.429 cm [95% CI, -0.455 to -0.404]) groups. The high-protein group exhibited a lower quadriceps atrophy rate (13.97 ± 2.43%) compared to the standard-protein group (18.96 ± 2.61%), showing a significant difference (P < 0.001). No significant differences were found in diaphragmatic thickness between groups and over time. By day 10, both groups exhibited decreased diaphragmatic muscle thickness compared to baseline. The high-protein group (33.76 ± 5.09%) had a slightly lower phrenic atrophy rate compared to the standard-protein group (33.41 ± 4.53%). Both groups experienced enteral nutritional intolerance manifested as diarrhea, constipation, and other adverse events. Conclusion: High-protein enteral nutrition significantly improved quadriceps thickness and demonstrated good safety in severe pneumonia patients, suggesting its suitability for widespread clinical application. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic inflammatory skin disorder associated with various comorbidities. The role of nutrition and dietary antioxidants in psoriasis management has gained attention. The Composite Dietary Antioxidant Index (CDAI) quantifies overall dietary antioxidant intake, but its association with psoriasis remains unclear. This study aimed to investigate the association between the CDAI and psoriasis, as well as the relationship between individual components of CDAI and psoriasis risk. Methods: Data from the US National Health and Nutrition Examination Survey (NHANES) were analyzed. Baseline characteristics, CDAI scores, and psoriasis status were assessed. Multivariable logistic regression and restricted cubic splines were employed to analyze the association. Results: The study included 23,311 participants, with 621 diagnosed with psoriasis. Higher CDAI scores were associated with a lower odds ratio (OR) of psoriasis occurrence (OR = 0.72, 95% CI 0.56–0.92, P = 0.009 in Model 3). Vitamin E intake exhibited an inverse correlation with psoriasis risk (OR = 0.76, 95% CI 0.60–0.96, P = 0.039 in Model 3). Other CDAI components did not show significant associations with psoriasis. Conclusion: This study demonstrates a significant inverse association between CDAI and psoriasis, indicating that higher dietary antioxidant intake is associated with a reduced risk of psoriasis. Specifically, higher vitamin E intake was associated with a lower likelihood of psoriasis. These findings underscore the potential role of dietary antioxidants in psoriasis management. Further research is warranted to elucidate the underlying mechanisms and explore targeted dietary interventions. [ABSTRACT FROM AUTHOR]

Background: The Infant and young child feeding (IYCF) practices directly affect the health, development and nutritional status of children under two years of age. However, IYCF counseling is one of the Community Health and Nutrition Volunteers (CHNVs) activities provided, which may contribute to improving the IYCF knowledge and practice among mothers. Since establishment of the CHNVs program in Yemen, its outcome has never been evaluated. Therefore, the aim of this study was to evaluate the role of CHNVs in improving the IYCF knowledge and practice among mothers in Hajjah governorate. Methods: A comparative cross-sectional study design was conducted in Bani Qais and Al-Maghrabah districts, Hajjah governorate between January and April 2023. A three-stage cluster sampling method was used to select districts, volunteer villages and households. A total of 926 mothers were interviewed. A pre-tested structured questionnaire was used to collect data. SPSS 26 was used for data analysis. The multinomial logistic regression and Chi-Square test were used to compare the IYCF knowledge and practices among mothers between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p-value < 0.05 was considered statistically significant. Results: The mothers in volunteer villages had significantly better breastfeeding and complementary feeding (CF) knowledge than mothers in non-volunteer villages. The OR of having good and moderate knowledge of breastfeeding were 3.5 (95%CI: 2.4–5.2) and 1.6 (95% CI: 1.2–2.2), respectively. The OR for good and moderate knowledge of CF were 1.7 (95% CI: 1.1–2.7) and 2.2 (95% CI: 1.5-3.0), respectively. Moreover, there is a statistically significant association in prevalence of Exclusively breastfed for the first two days after birth (EBF2D), Mixed milk feeding under six months (MixMF) and Bottle feeding 0–23 months (BoF) between volunteer and non-volunteer villages [(OR = 1.4, 95% CI: 1.0-1.8), (OR = 0.4, 95% CI: 0.2–0.8) and (OR = 0.5, 95% CI: 0.4–0.7), respectively]. Conclusions: The study found that CHNVs play a significant effect in improving the breastfeeding and CF knowledge, and prevalence of EBF2D, MixMF and BoF practices among mothers in their villages compared to non-volunteer villages. Future follow-up study and expansion to other settings in different governorates is recommended. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the nutritional status of elderly Chinese patients with Parkinson's disease (PD) and analyze possible factors related to nutritional problems. Methods: Patients with PD aged 65 years or older were enrolled. Anthropometric assessment and Mini Nutritional Assessment were used to determine nutritional status. Various scales were completed to identify potentially related factors, such as Hoehn and Yahr stage (H&Y stage), 30 mL water swallow test, Clock Drawing Test (CDT), and Charlson Comorbidity Index (CCI). Results: 785 patients were enrolled. The prevalence of malnutrition and risk of malnutrition was 3.1% (24/785) and 25.7% (202/785), respectively. Regression analyses indicated that H&Y stage ≥ 3 (OR: 2.151; 95%CI: 1.174–3.941; p =.013), abnormal water swallow test (OR: 4.559; 95%CI: 2.130–9.759; p <.001), CDT score < 6 (OR: 2.810; 95%CI: 1.534–5.148; p =.001), and CCI (OR: 1.621; 95%CI: 1.238–2.124; p <.001) were considered to be potential factors associated with low BMI. Conclusion: 28.8% of elderly PD patients were in abnormal nutritional status. Disease severity, dysphagia, cognitive function, and comorbidities might be related factors. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionThis study aimed to evaluate the efficacy of a double-lumen biliary-enteric tube (DBET) for enteral nutrition (EN) in individuals with malignant obstructive jaundice (MOJ).A retrospective cohort study was conducted using data from a prospectively maintained single-center database, including patients with MOJ. In the intervention group, DBET placement was performed concurrently with percutaneous transhepatic cholangiodrainage and biliary stenting, followed by postoperative EN (DBET-EN). In the control group, deep vein catheterization was undertaken after endoscopic biliary stenting, and parenteral nutrition (PN) was provided. A multivariable generalized linear model was used to assess the association between DBET-EN and 6-month mortality.A total of 74 patients were included in this study, comprising 28 patients in the intervention group (DBET-EN group) and 46 patients in the control group (PN group). Within the 6-month follow-up, 5 patients (17.9%) in the DBET-EN group and 20 (43.5%) in the PN group died. The multivariable generalized linear model demonstrated a significantly reduced 6-month mortality in the DBET-EN group compared to the PN group (adjusted odds ratio [OR]: 0.25, 95% CI: 0.08–0.81, P = 0.020). Secondary outcomes indicated that patients in the DBET-EN group had lower 9-month mortality rates and longer tube retention durations compared to the PN group (all adjusted P < 0.05). Postoperative liver function improved similarly in both groups. At 3, 6, and 9 months postoperatively, patient-generated subjective global assessment (PG-SGA) scores and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) scores were significantly higher in the DBET-EN group than in the PN group (P < 0.05).The implementation of DBET for EN in patients in the advanced stage of MOJ proved to be a minimally invasive and safe intervention. It significantly improved patients’ nutritional status and quality of life while reducing mortality. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Design Methods Results Conclusions Patient and Public Involvement Reporting Approach Home parenteral nutrition (HPN) can improve the nutritional status of patients with gastrointestinal dysfunction. However, some patients face a series of challenges during its implementation, which significantly affect their quality of life.To explore the experience and needs of living with home parenteral nutrition in adult patients.A systematic review and meta‐synthesis.A search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database and Wipu Database, to explore the real‐life experiences and needs of adult patients receiving HPN. The search covered the period up to March 2024. Qualitative research quality was evaluated using the Joanna Briggs Institute's Australian Centre for Evidence‐Based Health Care Quality Assessment Criteria for Qualitative Research. Data synthesis was performed using Thomas and Harden's method of thematic and content analysis.Twelve studies, each offering qualitative data, were analysed, resulting in the identification of four themes: positive experiences of HPN; the interplay of dynamic changes across physical, mental and social levels; self‐adjustment to the new normal; and multidimensional needs of patients receiving HPN.Patients receiving HPN face multiple challenges physically, psychologically and socially. This paper also reveals the supportive needs of patients in adapting to a new lifestyle with HPN. This indicates that healthcare professionals should provide comprehensive, continuous and dynamic supportive medical services to facilitate patients' reintegration and return to normal social life.As this study constitutes a meta‐synthesis, patient or public contribution is not applicable.Adhering to the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) reporting guidelines, this meta‐synthesis was conducted. [ABSTRACT FROM AUTHOR]

Objective. The metabolic effects of metabolic syndrome (MetS) on musculoskeletal metabolism are controversial. This study explored the effect of MetS on bone mineral density (BMD) and muscle quality index (MQI). Methods. Data from the NHANES database from 2011 to 2014 were extracted, and nonpregnant participants aged 45–59 years were included. The included data were first weighted by complex sampling, and then, the effect of MetS on BMD and MQI was analyzed using multifactorial linear regression. We then performed a stratified analysis by gender and BMI classification. Moreover, a mediation analysis of MetS on BMD was conducted, with MQI as a mediating variable. A propensity score matching analysis method with a complex sampling design was additionally performed to verify the stability of the results. Results. A total of 1943 participants were eventually included. After adjusting for covariates, the results of linear regression show that MetS is associated with elevated pelvic BMD (beta = 0.03; 95% CI = 0.01, 0.06; P = 0.02) and reduced MQI, especially arm MQI (beta = −1.02; 95% CI = −1.27, −0.77; P < 0.0001). MetS is more associated with BMD in women, MQI in normal or heavyweight, and BMD in lightweight, according to stratified analysis. MQI explains the indirect effect of MetS on BMD (beta = 0.007; 95% CI = 0.003, 0.010). Conclusion. This study provides evidence that MetS elevates BMD and reduces MQI, and further, that there is a mediating effect of MQI on elevated BMD. [ABSTRACT FROM AUTHOR]

AbstractRadiotherapy is a common cancer treatment, and concurrent nutritional interventions can maintain nutritional status and improve clinical and supportive care outcomes. However, optimal nutritional interventions during radiotherapy are not firmly established. Herein, we assessed the feasibility, safety, and efficacy of dietary counseling interventions without oral nutrition supplements on health outcomes in adults receiving radiotherapy for cancer in a systematic review. Prospective clinical trials that implemented nutritional counseling interventions during radiotherapy were identified from four databases from inception through December 2023. Feasibility, safety, and efficacy were extracted from 32 articles that described 23 randomized and 4 non-randomized clinical trials. The interventions included individualized nutritional counseling (n = 14 articles), nutritional counseling plus exercise (n = 4), and nutritional counseling focused on increasing or reducing intake of specific nutrients (n = 9). Trials targeted head and neck (n = 12), pelvic cancers (n = 14), and/or breast (n = 5) cancers. Control groups had variable designs and included general nutrition education and intervention as needed. Studies recruited 120 ± 104 participants (range 26–468). Interventions tended to be feasible regarding retention and attendance at sessions, though feasibility metrics varied among different interventions. Most interventions were safe with no studies reporting adverse events attributable to dietary intervention. Individualized dietary counseling interventions tended to lead to between-group differences favoring the intervention group in regard to improved nutritional status, maintenance or attenuation of loss of body mass, improved quality of life, and reduced radiation-induced toxicities. Diets that encouraged/discouraged specific nutrients tended to recruit patients receiving radiation to the pelvic area and resulted in positive or neutral effects on gastrointestinal symptoms. In conclusion, nutritional interventions appear to be feasible, safe, and effective during radiotherapy for various symptom outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to reveal the effects of arbuscular mycorrhizae and K-humate on some of the morphological characteristics and growth of Russian olive (RO; Elaeagnus angustifolia L.) and black locust (BL; Robinia pseudoacacia L.). The indigenous mycorrhizal spores (Claroideoglomus claroideum, Claroideoglomus etunicatum, Claroideoglomus luteum, and Funneliformis mosseae) collected from rhizospheres of RO and BL trees in afforestation sites located in Central Anatolia. In addition, commercial mycorrhizal mixture and K-humate were used as treatments. Five treatments (1—indigenous mycorrhizal fungi, 2—K-humate, 3—indigenous mycorrhizal fungi + K-humate, 4—commercial mycorrhizal fungi, and 5—control) were assigned in a completely randomized design for both tree species. Four months after the treatments, inoculation rate, above-ground seedling height, fresh and dry weight, root collar diameter, length, fresh, and dry weight, leaf area index, shot-to-root dry weight ratio, seedling height to root collar diameter ratio, and Dickson quality index were determined. Plant and soil analyses were carried out to determine the effects of treatments on plant and soil nutrition. Indigenous arbuscular mycorrhizal fungi and K-humate combinations had positive effects on the morphological characteristics and nutritional status of the seedlings. The indigenous mycorrhizal and K-humate interaction showed the most pronounced effects on RO growth and nutrition. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion This scoping review aims to assess the utility of ultrasound as a prospective tool in measuring body composition and nutritional status in the paediatric population. We provide a comprehensive summary of the existing literature, identify gaps, and propose future research directions.We conducted a systematic scoping review following the PRISMA Extension for Scoping Reviews guidelines. This involved screening titles and abstracts of relevant studies, followed by a detailed full‐text review and extraction of pertinent data.We identified and synthesised 34 articles. The review revealed that while ultrasound has been used to assess body composition and bone properties in children, significant gaps remain in the literature. These include limited studies on ultrasound performance, insufficient attention to relevant sample characteristics, reliance on manual image measurements, and limited sample diversity.Point‐of‐care ultrasound shows significant promise for assessing paediatric body composition and nutritional status. To validate and enhance its effectiveness, further research is needed. Future studies should include larger and more diverse patient cohorts and conduct longitudinal investigations to evaluate nutritional interventions. Additionally, developing artificial intelligence (AI) for standardising and automating data interpretation will be crucial in improving the accuracy and efficiency of ultrasound assessments. [ABSTRACT FROM AUTHOR]

Immunonutrition (IN) is defined as using special nutritional substrates (immnonutrients) to regulate the nutritional status as well as immune and inflammatory functions. Patients with cancer often have chronic inflammation and impaired immune function due to the disease and its treatment, affecting the quality of life of patients and the outcome of cancer treatment. Malnutrition, metabolic abnormalities, immune imbalances and inflammatory responses permeate the entire process of tumor development and progression. Therefore, IN has its great potential in the treatment of cancer patients. Although there has been a large body of evidence, the application of IN in cancer patients meets the challenge, such as the optimal administration time, application population, ingredients of IN, and the dosage and ratio of application etc. Besides, new studies with better designed are emerging. The aim of this review is to summarize recent evidences in IN in patients with cancer, and to guide the clinical application. [ABSTRACT FROM AUTHOR]