Nutrients

12 pages, 1747 KiB

Open AccessArticle

The Role of Physical Fitness in the Relationship between Nut Consumption and Body Composition in Young Adults

by Miriam Garrido-Miguel, Vicente Martínez-Vizcaíno, Rubén Fernández-Rodríguez, Isabel Antonia Martínez-Ortega, Luis Enrique Hernández-Castillejo, Bruno Bizzozero-Peroni, Marta Carolina Ruiz-Grao and Arthur Eumann Mesas

Nutrients 2021, 13(6), 2126; https://doi.org/10.3390/nu13062126 - 21 Jun 2021

Cited by 4 | Viewed by 3728

Abstract

The main objective of this study was to estimate the association between nut consumption and body composition-related measures and to examine whether this relationship is mediated by cardiorespiratory fitness (CRF) and the muscle strength index (MSI) in young adults. A cross-sectional study involving [...] Read more.

The main objective of this study was to estimate the association between nut consumption and body composition-related measures and to examine whether this relationship is mediated by cardiorespiratory fitness (CRF) and the muscle strength index (MSI) in young adults. A cross-sectional study involving college students (n = 354) aged 18–30 years from a Spanish public university was conducted. Body composition and fitness components were assessed using standard methods. Nut consumption was evaluated using a Food-Frequency Questionnaire. ANCOVA models were used to assess the mean differences in physical fitness and body composition by nut consumption categories. Hayes’s PROCESS macro was applied for mediation and interaction analyses adjusted for the main confounders. Young adults with high nut consumption (≥5 portions of 30 g/week) showed significantly higher values of physical fitness components and fat-free mass and lower values of adiposity-related measures than their peers in the lowest categories of nut consumption (˂1 portion/week) (p < 0.05). No significant interaction between CRF and nut consumption on body composition was found. In the mediation analysis, CRF and MSI acted as full mediators of the relationship of nut consumption with fat-free mass and waist circumference/height index. Otherwise, CRF and MSI partially mediated the relationship between nut consumption and body mass index and percent of fat mass. Finally, nut consumption, per se, does not appear to have a significant impact on body composition indicators because these associations have been shown to be partially (for BMI and %BF) or entirely (for ratio WC/height and fat-free mass) explained by CRF and MSI. Full article

(This article belongs to the Special Issue The Effects of Nutrition on Physical Activity and Human Health)

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12 pages, 474 KiB

Open AccessArticle

Contribution of Dietary Composition on Water Turnover Rates in Active and Sedentary Men

by Alice E. Disher, Kelly L. Stewart, Aaron J. E. Bach and Ian B. Stewart

Nutrients 2021, 13(6), 2124; https://doi.org/10.3390/nu13062124 - 21 Jun 2021

Viewed by 3071

Abstract

Body water turnover is a marker of hydration status for measuring total fluid gains and losses over a 24-h period. It can be particularly useful in predicting (and hence, managing) fluid loss in individuals to prevent potential physical, physiological and cognitive declines associated [...] Read more.

Body water turnover is a marker of hydration status for measuring total fluid gains and losses over a 24-h period. It can be particularly useful in predicting (and hence, managing) fluid loss in individuals to prevent potential physical, physiological and cognitive declines associated with hypohydration. There is currently limited research investigating the interrelationship of fluid balance, dietary intake and activity level when considering body water turnover. Therefore, this study investigates whether dietary composition and energy expenditure influences body water turnover. In our methodology, thirty-eight males (19 sedentary and 19 physically active) had their total body water and water turnover measured via the isotopic tracer deuterium oxide. Simultaneous tracking of dietary intake (food and fluid) is carried out via dietary recall, and energy expenditure is estimated via accelerometery. Our results show that active participants display a higher energy expenditure, water intake, carbohydrate intake and fibre intake; however, there is no difference in sodium or alcohol intake between the two groups. Relative water turnover in the active group is significantly greater than the sedentary group (Mean Difference (MD) [95% CI] = 17.55 g·kg⁻¹·day⁻¹ [10.90, 24.19]; p = < 0.001; g[95% CI] = 1.70 [0.98, 2.48]). A penalised linear regression provides evidence that the fibre intake (p = 0.033), water intake (p = 0.008), and activity level (p = 0.063) predict participants’ relative body water turnover (R²= 0.585). In conclusion, water turnover is faster in individuals undertaking regular exercise than in their sedentary counterparts, and is, in part, explained by the intake of water from fluid and high-moisture content foods. The nutrient analysis of the participant diets indicates that increased dietary fibre intake is also positively associated with water turnover rates. The water loss between groups also contributes to the differences observed in water turnover; this is partly related to differences in sweat output during increased energy expenditure from physical activity. Full article

(This article belongs to the Special Issue Hydration and Fluid Needs during Physical Activity)

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13 pages, 658 KiB

Open AccessReview

The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

by Daniela Pollakova, Aikaterini Andreadi, Francesca Pacifici, David Della-Morte, Davide Lauro and Claudio Tubili

Nutrients 2021, 13(6), 2123; https://doi.org/10.3390/nu13062123 - 21 Jun 2021

Cited by 34 | Viewed by 20166

Abstract

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes [...] Read more.

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women. Full article

(This article belongs to the Section Nutritional Epidemiology)

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10 pages, 264 KiB

Open AccessArticle

Could Vitamin D3 Deficiency Influence Malocclusion Development?

by Anna Leszczyszyn, Sylwia Hnitecka and Marzena Dominiak

Nutrients 2021, 13(6), 2122; https://doi.org/10.3390/nu13062122 - 21 Jun 2021

Cited by 7 | Viewed by 4310

Abstract

The abnormal growth of the craniofacial bone leads to skeletal and dental defects, which result in the presence of malocclusions. Not all causes of malocclusion have been explained. In the development of skeletal abnormalities, attention is paid to general deficiencies, including of vitamin [...] Read more.

The abnormal growth of the craniofacial bone leads to skeletal and dental defects, which result in the presence of malocclusions. Not all causes of malocclusion have been explained. In the development of skeletal abnormalities, attention is paid to general deficiencies, including of vitamin D3 (VD3), which causes rickets. Its chronic deficiency may contribute to skeletal malocclusion. The aim of the study was to assess the impact of VD3 deficiency on the development of malocclusions. The examination consisted of a medical interview, oral examination, an alginate impression and radiological imaging, orthodontic assessment, and taking a venous blood sample for VD3 level testing. In about 42.1% of patients, the presence of a skeletal defect was found, and in 46.5% of patients, dentoalveolar malocclusion. The most common defect was transverse constriction of the maxilla with a narrow upper arch (30.7%). The concentration of vitamin 25 (OH) D in the study group was on average 23.6 ± 10.5 (ng/mL). VD3 deficiency was found in 86 subjects (75.4%). Our research showed that VD3 deficiency could be one of an important factor influencing maxillary development. Patients had a greater risk of a narrowed upper arch (OR = 4.94), crowding (OR = 4.94) and crossbite (OR = 6.16). Thus, there was a link between the deficiency of this hormone and the underdevelopment of the maxilla. Full article

(This article belongs to the Special Issue Vitamin D, Diet and Musculoskeletal Health)

14 pages, 3961 KiB

Open AccessReview

Effects of Anthocyanin Supplementation on Reduction of Obesity Criteria: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Seongmin Park, Munji Choi and Myoungsook Lee

Nutrients 2021, 13(6), 2121; https://doi.org/10.3390/nu13062121 - 21 Jun 2021

Cited by 25 | Viewed by 4122

Abstract

Anthocyanins, water-soluble flavonoids that produce red-to-blue pigment in plants, have antioxidant properties and have been developed as a functional food to fight obesity. In randomized controlled trials (RCTs), a systematic review with meta-analysis (SR-MA) was used to investigate these anti-obesity effects. Using search [...] Read more.

Anthocyanins, water-soluble flavonoids that produce red-to-blue pigment in plants, have antioxidant properties and have been developed as a functional food to fight obesity. In randomized controlled trials (RCTs), a systematic review with meta-analysis (SR-MA) was used to investigate these anti-obesity effects. Using search engines (PubMed, EMBASE, Cochrane-library, and CINAHL) and keywords (anthocyanins, BMI, WC, WHR, and inflammatory biomarkers), 11 out of 642 RCTs (28.3–500 mg/day of anthocyanins for 4 to 24 weeks) were included. The results showed a significant reduction in body mass index (BMI) (MD = −0.36, 95% CI = −0.58 to −0.13), but body weight (BW) and waist circumference (WC) did not change. Anthocyanins decreased BMI in the non-obese (non-OB) group in five RCTs (BMI ≤ 25; MD = −0.40 kg/m²; 95% CI = −0.64 to −0.16;) but did not affect BMI in the obese (OB) group. A subgroup analysis of six RCTs showed that fewer than 300 mg/day reduced BMI (MD = −0.37; 95% CI = −0.06 to −0.14), but ≥300 mg/day did not. A treatment duration of four weeks for four RCTs was sufficient to decrease the BMI (MD = −0.41; 95% CI = −0.66 to −0.16) as opposed to a longer treatment (6–8 or ≥12 weeks). An analysis of the effect of anthocyanins on the BMI showed a significant fall among those from the Middle East compared to those from Asia, Europe, South America, or Oceania. In conclusion, the anthocyanin supplementation of 300 mg/day or less for four weeks was sufficient to reduce the BMI and BW compared to the higher-dose and longer-treatment RCTs. However, further studies might be conducted regarding the dose- or period-dependent responses on various obese biomarkers. Full article

(This article belongs to the Special Issue Health Benefits of Dietary Bioactives)

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Flow chart of the study selection process for SR-MA. Full article ">Figure 2
Risk of bias (ROB) results of quality assessment of the 11 RCTs. Risk of bias levels; low (green or “+”), Unclear (yellow or “?”), High (red or “-“) Full article ">Figure 3
Forest plot of BMI changes (A) and subgroup analysis by obesity degree (B), intervention levels (C), and intervention periods (D). Abbreviations: SD: standard deviation, CI: confidence interval, df:degrees of freedom, Statistical heterogeneity was assessed by I2 test, Chochran's Q-test; I2: Higgin's I2 test, Chi2: Cochran’s Q-test, IV: inverse variance, Z: Z-score, P: P-value. Full article ">Figure 3 Cont.
Forest plot of BMI changes (A) and subgroup analysis by obesity degree (B), intervention levels (C), and intervention periods (D). Abbreviations: SD: standard deviation, CI: confidence interval, df:degrees of freedom, Statistical heterogeneity was assessed by I2 test, Chochran's Q-test; I2: Higgin's I2 test, Chi2: Cochran’s Q-test, IV: inverse variance, Z: Z-score, P: P-value. Full article ">Figure 4
Forest plot of BW changes (A) and the subgroup analysis of obesity degree (B), treated levels (C), and intervention periods (D). Abbreviations: SD: standard deviation, CI: confidence interval, df:degrees of freedom, Statistical heterogeneity was assessed by I2 test, Chochran's Q-test; I2: Higgin's I2 test, Chi2: Cochran’s Q-test, IV: inverse variance, Z: Z-score, P: P-value. Full article ">Figure 4 Cont.
Forest plot of BW changes (A) and the subgroup analysis of obesity degree (B), treated levels (C), and intervention periods (D). Abbreviations: SD: standard deviation, CI: confidence interval, df:degrees of freedom, Statistical heterogeneity was assessed by I2 test, Chochran's Q-test; I2: Higgin's I2 test, Chi2: Cochran’s Q-test, IV: inverse variance, Z: Z-score, P: P-value. Full article ">Figure 5
Forest plot of the changes of BMI (A) and BW (B) by country. Abbreviations: SD: standard deviation, CI: confidence interval, df:degrees of freedom, Statistical heterogeneity was assessed by I2 test, Chochran’s Q-test; I2: Higgin's I2 test, Chi2: Cochran's Q-test, IV: inverse variance, Z: Z-score, P: P-value. Full article ">

14 pages, 317 KiB

Open AccessArticle

Untargeted Plasma Metabolomics Unravels a Metabolic Signature for Tissue Sensitivity to Glucocorticoids in Healthy Subjects: Its Implications in Dietary Planning for a Healthy Lifestyle

by Nicolas C. Nicolaides, Maria-Konstantina Ioannidi, Eleni Koniari, Ifigeneia Papageorgiou, Anastasia Bartzeliotou, Amalia Sertedaki, Maria I. Klapa and Evangelia Charmandari

Nutrients 2021, 13(6), 2120; https://doi.org/10.3390/nu13062120 - 21 Jun 2021

Cited by 5 | Viewed by 3691

Abstract

In clinical practice, differences in glucocorticoid sensitivity among healthy subjects may influence the outcome and any adverse effects of glucocorticoid therapy. Thus, a fast and accurate methodology that could enable the classification of individuals based on their tissue glucocorticoid sensitivity would be of [...] Read more.

In clinical practice, differences in glucocorticoid sensitivity among healthy subjects may influence the outcome and any adverse effects of glucocorticoid therapy. Thus, a fast and accurate methodology that could enable the classification of individuals based on their tissue glucocorticoid sensitivity would be of value. We investigated the usefulness of untargeted plasma metabolomics in identifying a panel of metabolites to distinguish glucocorticoid-resistant from glucocorticoid-sensitive healthy subjects who do not carry mutations in the human glucocorticoid receptor (NR3C1) gene. Applying a published methodology designed for the study of glucocorticoid sensitivity in healthy adults, 101 healthy subjects were ranked according to their tissue glucocorticoid sensitivity based on 8:00 a.m. serum cortisol concentrations following a very low-dose dexamethasone suppression test. Ten percent of the cohort, i.e., 11 participants, on each side of the ranking, with no NR3C1 mutations or polymorphisms, were selected, respectively, as the most glucocorticoid-sensitive and most glucocorticoid-resistant of the cohort to be analyzed and compared with untargeted blood plasma metabolomics using gas chromatography–mass spectrometry (GC–MS). The acquired metabolic profiles were evaluated using multivariate statistical analysis methods. Nineteen metabolites were identified with significantly lower abundance in the most sensitive compared to the most resistant group of the cohort, including fatty acids, sugar alcohols, and serine/threonine metabolism intermediates. These results, combined with a higher glucose, sorbitol, and lactate abundance, suggest a higher Cori cycle, polyol pathway, and inter-tissue one-carbon metabolism rate and a lower fat mobilization rate at the fasting state in the most sensitive compared to the most resistant group. In fact, this was the first study correlating tissue glucocorticoid sensitivity with serine/threonine metabolism. Overall, the observed metabolic signature in this cohort implies a worse cardiometabolic profile in the most glucocorticoid-sensitive compared to the most glucocorticoid-resistant healthy subjects. These findings offer a metabolic signature that distinguishes most glucocorticoid-sensitive from most glucocorticoid-resistant healthy subjects to be further validated in larger cohorts. Moreover, they support the correlation of tissue glucocorticoid sensitivity with insulin resistance and metabolic syndrome-associated pathways, further emphasizing the need for nutritionists and doctors to consider the tissue glucocorticoid sensitivity in dietary and exercise planning, particularly when these subjects are to be treated with glucocorticoids. Full article

(This article belongs to the Special Issue Nutrition and Endocrine Disorders)

1 pages, 179 KiB

Open AccessComment

Is High Cholesterol Deleterious? An Alternative Point of View. Comment on Burén et al. A Ketogenic Low-Carbohydrate High-Fat Diet Increases LDL Cholesterol in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial. Nutrients 2021, 13, 814

by Uffe Ravnskov

Nutrients 2021, 13(6), 2119; https://doi.org/10.3390/nu13062119 - 21 Jun 2021

Cited by 2 | Viewed by 4400

Abstract

In their study of the effect of an LCHF-diet on blood lipids, Burén et al. [...] Full article

13 pages, 315 KiB

Open AccessReview

The Role of High Triglycerides Level in Predicting Cognitive Impairment: A Review of Current Evidence

by Alina Mihaela Dimache, Delia Lidia Șalaru, Radu Sascău and Cristian Stătescu

Nutrients 2021, 13(6), 2118; https://doi.org/10.3390/nu13062118 - 20 Jun 2021

Cited by 39 | Viewed by 4947

Abstract

The burden of cognitive disorders is huge and still growing, however the etiology and the degree of cognitive impairment vary considerably. Neurodegenerative and vascular mechanisms were most frequently assessed in patients with dementia. Recent studies have shown the possible involvement of triglycerides levels [...] Read more.

The burden of cognitive disorders is huge and still growing, however the etiology and the degree of cognitive impairment vary considerably. Neurodegenerative and vascular mechanisms were most frequently assessed in patients with dementia. Recent studies have shown the possible involvement of triglycerides levels in cognitive function through putative mechanisms such as brain blood barrier dysfunction or amyloid metabolism imbalance, but not all research in the field found this association. Several clinical studies evaluated the relationship between different forms of cognitive decline and levels of serum triglycerides, independent of other cardiovascular risk factors. This review focuses on the role of triglycerides in cognitive decline, cerebral amyloidosis and vascular impairment. Considering that the management of hypertriglyceridemia benefits from lifestyle modification, diet, and specific drug therapy, future studies are requested to appraise the triglycerides–cognitive impairment relationship. Full article

(This article belongs to the Special Issue The Role of Triglycerides and Triglyceride Metabolism in Human Health)

11 pages, 508 KiB

Open AccessArticle

Prevalence of Hypovitaminosis C and its Relationship with Frailty in Older Hospitalised Patients: A Cross-Sectional Study

by Yogesh Sharma, Alexandra Popescu, Chris Horwood, Paul Hakendorf and Campbell Thompson

Nutrients 2021, 13(6), 2117; https://doi.org/10.3390/nu13062117 - 20 Jun 2021

Cited by 7 | Viewed by 3715

Abstract

Frailty is common in older hospitalised patients and may be associated with micronutrient malnutrition. Only limited studies have explored the relationship between frailty and vitamin C deficiency. This study investigated the prevalence of vitamin C deficiency and its association with frailty severity in [...] Read more.

Frailty is common in older hospitalised patients and may be associated with micronutrient malnutrition. Only limited studies have explored the relationship between frailty and vitamin C deficiency. This study investigated the prevalence of vitamin C deficiency and its association with frailty severity in patients ≥75 years admitted under a geriatric unit. Patients (n = 160) with a mean age of 84.4 ± 6.4 years were recruited and underwent frailty assessment by use of the Edmonton Frail Scale (EFS). Patients with an EFS score <10 were classified as non-frail/vulnerable/mildly frail and those with ≥10 as moderate–severely frail. Patients with vitamin C levels between 11–28 μmol/L were classified as vitamin C depleted while those with levels <11 μmol/L were classified as vitamin C deficient. A multivariate logistic regression model determined the relationship between vitamin C deficiency and frailty severity after adjustment for various co-variates. Fifty-seven (35.6%) patients were vitamin C depleted, while 42 (26.3%) had vitamin C deficiency. Vitamin C levels were significantly lower among patients who were moderate–severely frail when compared to those who were non-frail/vulnerable/mildly frail (p < 0.05). After adjusted analysis, vitamin C deficiency was 4.3-fold more likely to be associated with moderate–severe frailty (aOR 4.30, 95% CI 1.33-13.86, p = 0.015). Vitamin C deficiency is common and is associated with a greater severity of frailty in older hospitalised patients. Full article

(This article belongs to the Special Issue Vitamins C and D: Global and Population Health Perspectives)

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22 pages, 824 KiB

Open AccessArticle

The Role of Plant-Based Protein Functional Food in Preventing Acute Respiratory Disease: A Case Study

by Andrei V. Tarasov, Rofail S. Rakhmanov, Elena S. Bogomolova, Ludmila A. Perminova and Zhanna L. Malakhova

Nutrients 2021, 13(6), 2116; https://doi.org/10.3390/nu13062116 - 20 Jun 2021

Cited by 2 | Viewed by 5606

Abstract

The Kaliningrad region is known for its specific climate, which can negatively affect the adaptive potential of the body. This manifests in an increased incidence of respiratory diseases and skin conditions. To prevent high morbidity, a plant protein product was included in the [...] Read more.

The Kaliningrad region is known for its specific climate, which can negatively affect the adaptive potential of the body. This manifests in an increased incidence of respiratory diseases and skin conditions. To prevent high morbidity, a plant protein product was included in the diet of first-year university students. This study aimed to assess the effectiveness of this food intervention in preventing the most common diseases among Kaliningrad students. Two groups of university students took part in the food trial. In the control group, catabolic processes prevailed in nutrient metabolism. Disadaptation manifested itself in the metabolism of proteins, vitamins, minerals, hematopoiesis and humoral immunity. Inflammation was indicated by α1- and α2-globulins, a weak immune response, and IgM and IgG. High oxidative stress and low antioxidative ability of blood serum were observed. The plant-based protein product (FP) helped preserve testosterone level and prevent an increase in catabolic reactions. Moreover, it had a positive effect on both red blood cell hematopoiesis (a smaller increase in the average volume of erythrocytes, the same average concentration and content of hemoglobin, an increased relative red cell distribution width (RDW) and white blood cell hematopoiesis (a beneficial effect for the immune system: lymphocytes, the relative content of neutrophils, monocytes, basophils and eosinophils). The stimulation of humoral immunity was evidenced by beta- and gamma-globulins, an active immune response, the level of IgM and IgG, antioxidant protection, reduction of peroxides and an increase in antioxidant activity of blood serum. The 34-week observation showed a 1.7-fold decrease in the incidence of respiratory illnesses and a 5.7-fold decrease in skin and subcutaneous tissue diseases. Acute respiratory infections were reduced 1.8-fold. There were no cases of community-acquired pneumonia in the treatment group, compared with 55.1‰ in the control group. The incidence of respiratory diseases was 3.3–10.6 times lower in the treatment group than in the control group in weeks 6–19. The findings testify to the prophylactic effect of functional food during social adaptation and acclimatization of students. Full article

(This article belongs to the Special Issue Precision Nutrition: Better Strategies for Research and Practice Aimed at Prevention and Management of Complex, Common, Chronic Diseases)

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16 pages, 554 KiB

Open AccessArticle

Application of Clinical Decision Support System to Assist Breast Cancer Patients with Lifestyle Modifications during the COVID-19 Pandemic: A Randomised Controlled Trial

by Panos Papandreou, Aristea Gioxari, Frantzeska Nimee and Maria Skouroliakou

Nutrients 2021, 13(6), 2115; https://doi.org/10.3390/nu13062115 - 20 Jun 2021

Cited by 18 | Viewed by 4840

Abstract

Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients [...] Read more.

Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients by means of CDSS during the COVID-19 pandemic. In total, 55 BC women at stages I-IIIA were enrolled. They were randomly assigned either to Control group, receiving general lifestyle advice (n = 28) or the CDSS group (n = 27), to whom the CDSS provided personalised dietary plans based on the Mediterranean diet (MD) together with physical activity guidelines. Food data, anthropometry, blood markers and quality of life were evaluated. At 3 months, higher adherence to MD was recorded in the CDSS group, accompanied by lower body weight (kg) and body fat mass percentage compared to control (p < 0.001). In the CDSS arm, global health/quality of life was significantly improved at the trial endpoint (p < 0.05). Fasting blood glucose and lipid levels (i.e., cholesterol, LDL, triacylglycerols) of the CDSS arm remained unchanged (p > 0.05) but were elevated in the control arm at 3 months (p < 0.05). In conclusion, CDSS could be a promising tool to assist BC patients with lifestyle modifications during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Dietary Intervention and Lifestyle Modification in the Management of Obesity: Progresses and Challenges)

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12 pages, 10887 KiB

Open AccessArticle

Dietary Behaviors and Incident COVID-19 in the UK Biobank

by Thanh-Huyen T. Vu, Kelsey J. Rydland, Chad J. Achenbach, Linda Van Horn and Marilyn C. Cornelis

Nutrients 2021, 13(6), 2114; https://doi.org/10.3390/nu13062114 - 20 Jun 2021

Cited by 22 | Viewed by 55324

Abstract

Background: Nutritional status influences immunity but its specific association with susceptibility to COVID-19 remains unclear. We examined the association of specific dietary data and incident COVID-19 in the UK Biobank (UKB). Methods: We considered UKB participants in England with self-reported baseline (2006–2010) data [...] Read more.

Background: Nutritional status influences immunity but its specific association with susceptibility to COVID-19 remains unclear. We examined the association of specific dietary data and incident COVID-19 in the UK Biobank (UKB). Methods: We considered UKB participants in England with self-reported baseline (2006–2010) data and linked them to Public Health England COVID-19 test results—performed on samples from combined nose/throat swabs, using real time polymerase chain reaction (RT-PCR)—between March and November 2020. Baseline diet factors included breastfed as baby and specific consumption of coffee, tea, oily fish, processed meat, red meat, fruit, and vegetables. Individual COVID-19 exposure was estimated using the UK’s average monthly positive case rate per specific geo-populations. Logistic regression estimated the odds of COVID-19 positivity by diet status adjusting for baseline socio-demographic factors, medical history, and other lifestyle factors. Another model was further adjusted for COVID-19 exposure. Results: Eligible UKB participants (n = 37,988) were 40 to 70 years of age at baseline; 17% tested positive for COVID-19 by SAR-CoV-2 PCR. After multivariable adjustment, the odds (95% CI) of COVID-19 positivity was 0.90 (0.83, 0.96) when consuming 2–3 cups of coffee/day (vs. <1 cup/day), 0.88 (0.80, 0.98) when consuming vegetables in the third quartile of servings/day (vs. lowest quartile), 1.14 (1.01, 1.29) when consuming fourth quartile servings of processed meats (vs. lowest quartile), and 0.91 (0.85, 0.98) when having been breastfed (vs. not breastfed). Associations were attenuated when further adjusted for COVID-19 exposure, but patterns of associations remained. Conclusions: In the UK Biobank, consumption of coffee, vegetables, and being breastfed as a baby were favorably associated with incident COVID-19; intake of processed meat was adversely associated. Although these findings warrant independent confirmation, adherence to certain dietary behaviors may be an additional tool to existing COVID-19 protection guidelines to limit the spread of this virus. Full article

(This article belongs to the Special Issue The Role of Nutrition in the Prevention and Recovery from Infectious Diseases)

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13 pages, 1163 KiB

Open AccessArticle

Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS

by Quirin Notz, Johannes Herrmann, Tobias Schlesinger, Philipp Helmer, Stephan Sudowe, Qian Sun, Julian Hackler, Daniel Roeder, Christopher Lotz, Patrick Meybohm, Peter Kranke, Lutz Schomburg and Christian Stoppe

Nutrients 2021, 13(6), 2113; https://doi.org/10.3390/nu13062113 - 20 Jun 2021

Cited by 35 | Viewed by 7650

Abstract

The interplay between inflammation and oxidative stress is a vicious circle, potentially resulting in organ damage. Essential micronutrients such as selenium (Se) and zinc (Zn) support anti-oxidative defense systems and are commonly depleted in severe disease. This single-center retrospective study investigated micronutrient levels [...] Read more.

The interplay between inflammation and oxidative stress is a vicious circle, potentially resulting in organ damage. Essential micronutrients such as selenium (Se) and zinc (Zn) support anti-oxidative defense systems and are commonly depleted in severe disease. This single-center retrospective study investigated micronutrient levels under Se and Zn supplementation in critically ill patients with COVID-19 induced acute respiratory distress syndrome (ARDS) and explored potential relationships with immunological and clinical parameters. According to intensive care unit (ICU) standard operating procedures, patients received 1.0 mg of intravenous Se daily on top of artificial nutrition, which contained various amounts of Se and Zn. Micronutrients, inflammatory cytokines, lymphocyte subsets and clinical data were extracted from the patient data management system on admission and after 10 to 14 days of treatment. Forty-six patients were screened for eligibility and 22 patients were included in the study. Twenty-one patients (95%) suffered from severe ARDS and 14 patients (64%) survived to ICU discharge. On admission, the majority of patients had low Se status biomarkers and Zn levels, along with elevated inflammatory parameters. Se supplementation significantly elevated Se (p = 0.027) and selenoprotein P levels (SELENOP; p = 0.016) to normal range. Accordingly, glutathione peroxidase 3 (GPx3) activity increased over time (p = 0.021). Se biomarkers, most notably SELENOP, were inversely correlated with CRP (r_s = −0.495), PCT (r_s = −0.413), IL-6 (r_s = −0.429), IL-1β (r_s = −0.440) and IL-10 (r_s = −0.461). Positive associations were found for CD8⁺ T cells (r_s = 0.636), NK cells (r_s = 0.772), total IgG (r_s = 0.493) and PaO₂/FiO₂ ratios (r_s = 0.504). In addition, survivors tended to have higher Se levels after 10 to 14 days compared to non-survivors (p = 0.075). Sufficient Se and Zn levels may potentially be of clinical significance for an adequate immune response in critically ill patients with severe COVID-19 ARDS. Full article

(This article belongs to the Section Clinical Nutrition)

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Flow diagram of retrospective study inclusion. All 22 patients received high-dose selenium (Se) as selenite and artificial diet, which additionally included various amounts of zinc (Zn). ARDS, acute respiratory distress syndrome; ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit. Full article ">Figure 2
Supplementation increased the (A) selenium (Se) status biomarkers and (B) zinc (Zn) levels over the course of intensive care. Each black dot represents an individual patient. The lower end of each reference range is indicated by a red dashed line. Ranges were adopted from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. However, glutathione peroxidase 3 (GPx3) levels have not been determined in a large patient collective so far. Therefore, a validated and comparable reference range is not available. SELENOP, selenoprotein P. p < 0.05 (*), p < 0.01 (**). Full article ">Figure 3
(A) Correlation analyses of selenium (Se), selenoprotein P (SELENOP) and glutathione peroxidase 3 (GPx3). (B) Correlation of Se status biomarkers and zinc (Zn). Spearman’s correlation coefficients (rs) and respective p-values are indicated. Linear regression was applied and the 95% confidence interval is shown. Full article ">Figure 4
Correlation matrix of nutritional status and inflammation. Red colors indicate a positive and blue colors a negative correlation coefficient (rs). p < 0.05 (*), p < 0.01 (**), p < 0.001 (***). CPB, circulating plasmablasts; CRP, C-reactive protein; Ig, immunoglobulin; IL, interleukin; GPx3, glutathione peroxidase 3; NK, natural killer; PCT, procalcitonin; Se, selenium; SELENOP, selenoprotein P; SOFA, sequential organ failure assessment score; TNF, tumor necrosis factor; Zn, zinc. Full article ">Figure 5
Effects of trace element supplementation on (A) selenium (Se) and (B) zinc (Zn) concentrations in survivors and non-survivors. Wilcoxon’s paired test was used to compare micronutrient levels between admission and day 10 to 14. p < 0.05 (*), p < 0.01 (**). GPx3, glutathione peroxidase 3; SELENOP, selenoprotein P. Full article ">

27 pages, 1648 KiB

Open AccessEditor’s ChoiceReview

Probiotics, Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome

by Elemer Simon, Lavinia Florina Călinoiu, Laura Mitrea and Dan Cristian Vodnar

Nutrients 2021, 13(6), 2112; https://doi.org/10.3390/nu13062112 - 20 Jun 2021

Cited by 87 | Viewed by 15224

Abstract

Irritable bowel syndrome (IBS) is still a common functional gastrointestinal disease that presents chronic abdominal symptoms but with a pathophysiology that is not yet fully elucidated. Moreover, the use of the synergistic combination of prebiotics and probiotics, known as synbiotics, for IBS therapy [...] Read more.

Irritable bowel syndrome (IBS) is still a common functional gastrointestinal disease that presents chronic abdominal symptoms but with a pathophysiology that is not yet fully elucidated. Moreover, the use of the synergistic combination of prebiotics and probiotics, known as synbiotics, for IBS therapy is still in the early stages. Advancements in technology led to determining the important role played by probiotics in IBS, whereas the present paper focuses on the detailed review of the various pathophysiologic mechanisms of action of probiotics, prebiotics, and synbiotics via multidisciplinary domains involving the gastroenterology (microbiota modulation, alteration of gut barrier function, visceral hypersensitivity, and gastrointestinal dysmotility) immunology (intestinal immunological modulation), and neurology (microbiota–gut–brain axis communication and co-morbidities) in mitigating the symptoms of IBS. In addition, this review synthesizes literature about the mechanisms involved in the beneficial effects of prebiotics and synbiotics for patients with IBS, discussing clinical studies testing the efficiency and outcomes of synbiotics used as therapy for IBS. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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Effects of probiotics at the gut level. In the first half of this image (a) is an illustration of the gut microbiota modulation mechanisms of probiotics and their impact on the IECs and the enteric nervous system. Probiotics can alter the gut microbiota via competitive adhesion and/or exclusion of pathogens, production of antibacterial substances such as SCFAs, bacteriocins, AhR, Nrf2 ligands, poly-P, and by stimulating the production of mucins. Additionally, probiotics stimulate the proliferation of IECs, inhibit their apoptosis, alter their cytokines profile through MAPK and NF-κB signaling, and promote the maintenance of tight junctions. Interaction of probiotics with the enteric nervous system leads to a reduction of visceral sensitivity and pain, and modulation of the gut motility. In the second half (b) are illustrated the mechanisms of probiotics for immune and inflammatory modulation. The main probiotic-mediated immunologic alteration is realized by their interaction with the DCs, leading to T cells differentiation and stimulation of cytokines production by the immune cells, also of sIgA by the plasma cells. Change of the pro- and anti-inflammatory cytokines profile and of the Th1 to Th2 ratio, due to probiotic interaction, allows them to manipulate the inflammatory response. Abbreviations. SCFA: Short-chained fatty acid; AhR: Aryl hydrocarbon receptor; Nrf2: Nuclear factor erythroid 2-related factor 2; poly-P: Polyphosphate; IEC: Intestinal epithelial cells; MAPK: Mitogen-activated protein kinase; NF-κB: Nuclear transcription factor κB; DC: Dendritic cell; sIgA: Secretory immunoglobulin A; Treg: Regulatory T cell; Th: Helper T cell; TJ: Tight junction; PP: Peyer’s patch; TLR: Toll-like receptor; LPS: Lipopolysaccharide; IL: Interleukin; IFN-γ: Interferon-γ; TGF-β: Transforming growth factor β; TNFα: Tumor necrosis factor-α; BAFF: B-cell activating factor; APRIL: A proliferation-inducing ligand; RA: Retinoic acid. Figure created with BioRender.com. Full article ">Figure 2
Microbiota–gut–brain axis communication pathways. In this figure, the main bidirectional communication routes between the brain and the gut microbiota are illustrated. The most studied interaction paths between the brain and the gut microbiota are represented by the endocrine pathway, consisting mainly of the HPA axis and enteric endocrine cells (EECs), the neural pathway, that includes the vagal nerve and the enteric nervous system, and the immune pathway, which is mediated via cytokines. Abbreviations. HPA-axis: Hypothalamic–pituitary–adrenal axis; IEC: Intestinal epithelial cell; EEC: Enteric endocrine cell; PC: Paneth cell; SCFA: Short-chained fatty acid; IL: Interleukin; GABA: γ-aminobutyric acid; 5-HT: Serotonin; AMP: Antimicrobial peptide; miRNA: MicroRNA. Figure created with BioRender.com. Full article ">

16 pages, 511 KiB

Open AccessArticle

Evaluation of Body Composition, Physical Activity, and Food Intake in Patients with Inborn Errors of Intermediary Metabolism

by María-José de Castro, Paula Sánchez-Pintos, Nisreem Abdelaziz-Salem, Rosaura Leis and María L. Couce

Nutrients 2021, 13(6), 2111; https://doi.org/10.3390/nu13062111 - 20 Jun 2021

Cited by 7 | Viewed by 3085

Abstract

Children with inborn errors of intermediary metabolism (IEiM) must follow special diets that restrict their intake of essential nutrients and may compromise normal growth and development. We evaluated body composition, bone mineral density, physical activity, and food intake in IEiM patients undergoing dietary [...] Read more.

Children with inborn errors of intermediary metabolism (IEiM) must follow special diets that restrict their intake of essential nutrients and may compromise normal growth and development. We evaluated body composition, bone mineral density, physical activity, and food intake in IEiM patients undergoing dietary treatment. IEiM patients (n = 99) aged 5–19 years and healthy age- and sex-matched controls (n = 98) were recruited and underwent dual-energy X-ray absorptiometry to evaluate anthropometric characteristics and body composition. Data on food intake and physical activity were also collected using validated questionnaires. The height z-score was significantly lower in IEiM patients than controls (−0.28 vs. 0.15; p = 0.008), particularly in those with carbohydrate and amino acid metabolism disorders. Significant differences in adiposity were observed between patients and controls for the waist circumference z-score (−0.08 vs. −0.58; p = 0.005), but not the body mass index z-score (0.56 vs. 0.42; p = 0.279). IEiM patients had a significantly lower total bone mineral density (BMD) than controls (0.89 vs. 1.6; p = 0.001) and a higher risk of osteopenia (z-score < −2, 33.3% vs. 20.4%) and osteoporosis (z-score < −2.5, 7.1% vs. 0%), but none presented fractures. There was a significant positive correlation between natural protein intake and BMD. Our results indicate that patients with IEiM undergoing dietary treatment, especially those with amino acid and carbohydrate metabolism disorders, present alterations in body composition, including a reduced height, a tendency towards overweight and obesity, and a reduced BMD. Full article

(This article belongs to the Special Issue Bone Mineralization and Calcium Phosphorus Metabolism)

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15 pages, 581 KiB

Open AccessArticle

Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial

by Eyal Ben-Arie, Tzu-Hsuan Wei, Hung-Chi Chen, Tsung-Chun Huang, Wen-Chao Ho, Chiu-Ming Chang, Pei-Yu Kao and Yu-Chen Lee

Nutrients 2021, 13(6), 2110; https://doi.org/10.3390/nu13062110 - 19 Jun 2021

Cited by 6 | Viewed by 3977

Abstract

Malnourishment is prevalent in patients suffering from head and neck cancer. The postoperative period is crucial in terms of nutritional support, especially after composite resection and reconstruction surgery. These patients present with a number of risk factors that aggravate feeding intolerance, including postoperative [...] Read more.

Malnourishment is prevalent in patients suffering from head and neck cancer. The postoperative period is crucial in terms of nutritional support, especially after composite resection and reconstruction surgery. These patients present with a number of risk factors that aggravate feeding intolerance, including postoperative status, prolonged immobility, decreased head elevation, mechanical ventilation, and applied sedative agents. Routine management protocols for feeding intolerance include prokinetic drug use and post-pyloric tube insertion, which could be both limited and accompanied by detrimental adverse events. This single-blind clinical trial aimed to investigate the effects of acupuncture in postoperative feeding intolerance in critically ill oral and hypopharyngeal cancer patients. Twenty-eight patients were randomized into two groups: Intervention group and Control group. Interventions were administered daily over three consecutive postoperative days. The primary outcome revealed that the intervention group reached 70% and 80% of target energy expenditure (EE) significantly earlier than the control group (4.00 ± 1.22 versus 6.69 ± 3.50 days, p = 0.012), accompanied by higher total calorie intake within the first postoperative week (10263.62 ± 1086.11 kcals versus 8384.69 ± 2120.05 kcals, p = 0.004). Furthermore, the intervention group also needed less of the prokinetic drug (Metoclopramide, 20.77 ± 48.73 mg versus 68.46 ± 66.56 mg, p = 0.010). In conclusion, digestion-specific acupuncture facilitated reduced postoperative feeding intolerance in oral and hypopharyngeal cancer patients. Full article

(This article belongs to the Section Clinical Nutrition)

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23 pages, 1210 KiB

Open AccessReview

Nutritional Aspects of Pediatric Gastrointestinal Diseases

by Teresa Di Chio, Christiane Sokollik, Diego G. Peroni, Lara Hart, Giacomo Simonetti, Franziska Righini-Grunder and Osvaldo Borrelli

Nutrients 2021, 13(6), 2109; https://doi.org/10.3390/nu13062109 - 19 Jun 2021

Cited by 4 | Viewed by 5588

Abstract

In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively “harmless” [...] Read more.

In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively “harmless” nature. Apart from a diet’s therapeutic role, nutritional support is crucial in maintaining growth and improving clinical outcomes in pediatric patients. Despite the absence of classical “side effects”, however, it should be emphasized that any dietary modification might have negative consequences on children’s growth and development. Hence, expert supervision is always advised, in order to support adequate nutritional requirements. Unfortunately, the media provide an inaccurate perception of the role of diet for gastrointestinal diseases, leading to misconceptions by patients or their caregivers that tends to overestimate the beneficial role of diets and underestimate the potential adverse effects. Moreover, not only patients, but also healthcare professionals, have a number of misconceptions about the nutritional benefits of diet modification on gastrointestinal diseases. The aim of this review is to highlight the role of diet in pediatric gastrointestinal diseases, to detect misconceptions and to give a practical guide for physicians on the basis of current scientific evidence. Full article

(This article belongs to the Special Issue Nutritional Pearls and Pitfalls of Gastrointestinal Diseases)

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14 pages, 449 KiB

Open AccessArticle

The Role of Resilience and Basic Hope in the Adherence to Dietary Recommendations in the Polish Population during the COVID-19 Pandemic

by Beata Sińska, Mariusz Jaworski, Mariusz Panczyk, Iwona Traczyk and Alicja Kucharska

Nutrients 2021, 13(6), 2108; https://doi.org/10.3390/nu13062108 - 19 Jun 2021

Cited by 14 | Viewed by 3053

Abstract

(1) Background: The COVID-19 pandemic exerts a negative influence on dietary behaviors, which may lead to health deterioration. Dietary behaviors may be determined by psychological characteristics, such as basic hope and resilience, which facilitate the effective adjustment to new difficult conditions. The professional [...] Read more.

(1) Background: The COVID-19 pandemic exerts a negative influence on dietary behaviors, which may lead to health deterioration. Dietary behaviors may be determined by psychological characteristics, such as basic hope and resilience, which facilitate the effective adjustment to new difficult conditions. The professional literature includes no research on the role of basic hope and resilience in the context of undertaken dietary behaviors in the situations of mental load associated with pandemics. The study aimed at the description of the dietary behaviors of individuals with various intensities of the discussed psychological characteristics (basic hope and resilience); (2) The observational cross-sectional online questionnaire study was conducted with the participation of 1082 adult Polish inhabitants. Three psychological scales were used: PSS-10, the Brief Resilient Coping Scale (BRCS) and BHI-12 questionnaire. The assessment of the adherence to dietary recommendations was performed with the present authors’ Dietary Guidelines Adherence Index (DGA Index); (3) Results: The value of DGA Index was variable depending on the psychological profile of study participants. The highest adherence to the principles of appropriate nutrition was observed in individuals characterized by the ability to cope with difficult situations and those who quickly adapted to new changing circumstances. The DGA Index values became poorer with the deterioration of the coping ability as regards stress and mental load; (4) Conclusions: Nutritional education during pandemics should encompass the psychological profile of the patients. It requires the implementation of a different psychodietetic approach which will facilitate a more effective introduction of a well-balanced diet. Full article

(This article belongs to the Section Nutritional Epidemiology)

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14 pages, 2340 KiB

Open AccessArticle

Habitual Dietary Intake Affects the Altered Pattern of Gut Microbiome by Acarbose in Patients with Type 2 Diabetes

by Fumie Takewaki, Hanako Nakajima, Daiki Takewaki, Yoshitaka Hashimoto, Saori Majima, Hiroshi Okada, Takafumi Senmaru, Emi Ushigome, Masahide Hamaguchi, Masahiro Yamazaki, Yoshiki Tanaka, Shunji Nakajima, Hiroshi Ohno and Michiaki Fukui

Nutrients 2021, 13(6), 2107; https://doi.org/10.3390/nu13062107 - 19 Jun 2021

Cited by 19 | Viewed by 4128

Abstract

The aim of this research was to reveal the characteristics of gut microbiome altered by acarbose intervention in Japanese patients with type 2 diabetes (T2D) and its possible association with habitual dietary intake. Eighteen patients with T2D were administered acarbose for four weeks. [...] Read more.

The aim of this research was to reveal the characteristics of gut microbiome altered by acarbose intervention in Japanese patients with type 2 diabetes (T2D) and its possible association with habitual dietary intake. Eighteen patients with T2D were administered acarbose for four weeks. The abundances of two major phyla, namely Actinobacteria and Bacteroidetes, were reciprocally changed accompanied by the acarbose intervention. There were also significant changes in the abundances of ten genera, including the greater abundance of Bifidobacterium, Eubacterium, and Lactobacillus and the lower abundance of Bacteroides in the group after the intervention than that before the intervention. Hierarchical clustering of habitual dietary intake was performed based on the pattern of changes in the gut microbiota and were classified into distinct three clusters. Cluster I consisted of sucrose, cluster II mainly included fat intake, and cluster III mainly included carbohydrate intake. Moreover, the amount of change in Faecalibacterium was positively correlated with the intake of rice, but negatively correlated with the intake of bread. The intake of potato was negatively correlated with the amount of change in Akkermansia and Subdoligranulum. Acarbose altered the composition of gut microbiome in Japanese patients with T2D, which might be linked to the habitual dietary intake. Full article

(This article belongs to the Special Issue Dietary Carbohydrate and Human Health)

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Alterations in the microbiome at the phylum-level associated with the intervention of acarbose. (A), Firmicute; (B), Bacteroidetes; (C), Actinobacteria; (D), Proteobacteria. Comparison of the microbial abundance at the phylum-level between the two groups (before and after the intervention of acarbose) based on 16S data. Top four abundant phyla are represented. Each box plot represents median, interquartile range, minimum, and maximum values; * p < 0.05 and ** p < 0.01, based on the paired t-test. (A), represents phylum Firmicutes; (B), represents phylum Bacteroides; (C), represents phylum Actinobacteria; and (D), represents phylum Proteobacteria. Full article ">Figure 2
Alterations in the microbiome at the genus-level associated with the intervention of acarbose. Comparison of the abundance at the genus-level before and after the intervention of acarbose based on 16S data. (A), Bifidobacterium; (B), Bacteroides; (C), Blautia; (D), Prevotella; (E), Eubacterium; (F), Faecalibacterium; (G), Megamonas; (H), Streptococcus; (I), Megasphera; (J), Fusicatenibacte.Top ten abundant genera are represented. Each box plot shows median, interquartile range, minimum, and maximum values; * p < 0.05 based on the paired t-test. (A), represents genus Bifidobacterium; (B), represents genus Bacteroides; (C), represents genus Blautia; (D), represents genus Prevotella; (E), represents genus Eubacterium; (F), represents genus Faecallbacterium; (G), represents genus Megamonas; (H), represents genus Streptococcus; (I), represents genus Megasphera; and (J), represents genus Fusicatenibacte. Full article ">Figure 3
Association between habitual dietary intake and changes in microbial data. Spearman’s correlation of habitual dietary nutrient intake with the observed OTU number delta, Shannon index delta, and average relative abundance delta of the top four phyla and top five genera using a heatmap. The 12 dietary nutrient items were used for hierarchical clustering. The z-score based on the Spearman’s r between changes in the composition of the gut microbiome and habitual dietary nutrient intake is depicted from the lowest (blue) to the highest (red) according to the scale shown at the top. X delta = X after intervention − X before intervention. Full article ">Figure 4
Correlation between the intake of various staple foods and changes in microbial data. Spearman’s correlation between the relative abundance delta of microbial data and the intake of various staple foods with statistical significance. X delta = X after intervention − X before intervention. (A), represents correlation between rice intake and Faecallbacterium delta; (B), represents correlation between bread intake and Faecallbacterium delta; (C), represents correlation between bread intake and Lactobacillus delta; (D), represents correlation between bread intake and Dorea delta; (E), represents correlation between potato intake and Bacteroides delta; (F), represents correlation between potato intake and Akkemanisa delta; and (G), represents correlation between potato intake and Subdoligranuium delta. Full article ">

15 pages, 1094 KiB

Open AccessArticle

Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children

by Khitam Muhsen, Wasef Na’amnih, Rebecca Goldsmith, Maayan Maya, Nuha Zeidan, Eias Kassem and Asher Ornoy

Nutrients 2021, 13(6), 2106; https://doi.org/10.3390/nu13062106 - 19 Jun 2021

Cited by 1 | Viewed by 2723

Abstract

Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age [...] Read more.

Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity. Full article

(This article belongs to the Special Issue Children's Health: Studies of the Effect of Lifestyle and Dietary Habits)

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15 pages, 1626 KiB

Open AccessArticle

Applying the Stages of Change Model in a Nutrition Education Programme for the Promotion of Fruit and Vegetable Consumption among People with Severe Mental Disorders (DIETMENT)

by Mireia Vilamala-Orra, Cristina Vaqué-Crusellas, Quintí Foguet-Boreu, Marta Guimerà Gallent and Ruben del Río Sáez

Nutrients 2021, 13(6), 2105; https://doi.org/10.3390/nu13062105 - 19 Jun 2021

Cited by 9 | Viewed by 5222

Abstract

Despite growing evidence of the benefits of adequate intake of fruit and vegetables (F&V) and the recommendation to consume five servings daily, the adoption of these habits is poor among people with severe mental disorder (SMD). The main aim of the present study [...] Read more.

Despite growing evidence of the benefits of adequate intake of fruit and vegetables (F&V) and the recommendation to consume five servings daily, the adoption of these habits is poor among people with severe mental disorder (SMD). The main aim of the present study is to determine changes in the intake of F&V and motivation to do so among people with SMDs after participating in a food education programme. A community-based randomized controlled trial was conducted in Spain, with the intervention group (IG) participating in a food education programme based on the stages of change model to promote consumption of F&V and the control group (CG) receiving three informative sessions on basic healthy eating. The main outcomes were related to the intake of F&V and stages of change. Data collection was performed at baseline, post intervention, and 12-month follow-up. Seventy-four participants enrolled in the study and sixty completed the 12-month follow-up. An increase in motivation towards the intake of F&V was observed in the IG but not in the CG (McNemar’s test p = 0.016, p = 0.625). No significant difference was observed for the intake of fruit, vegetables, or F&V. Basing food education strategies on the stages of change model shows positive results, increasing the awareness and disposition of people with SMD towards the intake of F&V. More research is needed to identify the most appropriate eating intervention to increase the intake of F&V. Full article

(This article belongs to the Special Issue Implications of Nutrition Education for Health, Behavior and Lifestyle)

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21 pages, 1156 KiB

Open AccessArticle

Mapping Geographical Differences and Examining the Determinants of Childhood Stunting in Ethiopia: A Bayesian Geostatistical Analysis

by Kedir Y. Ahmed, Kingsley E. Agho, Andrew Page, Amit Arora, Felix Akpojene Ogbo and on behalf of the Global Maternal and Child Health Research Collaboration (GloMACH)

Nutrients 2021, 13(6), 2104; https://doi.org/10.3390/nu13062104 - 19 Jun 2021

Cited by 13 | Viewed by 4855

Abstract

Understanding the specific geographical distribution of stunting is essential for planning and implementing targeted public health interventions in high-burdened countries. This study investigated geographical variations in the prevalence of stunting sub-nationally, and the determinants of stunting among children under 5 years of age [...] Read more.

Understanding the specific geographical distribution of stunting is essential for planning and implementing targeted public health interventions in high-burdened countries. This study investigated geographical variations in the prevalence of stunting sub-nationally, and the determinants of stunting among children under 5 years of age in Ethiopia. We used the 2016 Ethiopia Demographic and Health Survey (EDHS) dataset for children aged 0–59 months with valid anthropometric measurements and geographic coordinates (n = 9089). We modelled the prevalence of stunting and its determinants using Bayesian geospatially explicit regression models. The prevalence of stunting among children under five years was 36.3% (95% credible interval (CrI); 22.6%, 51.4%) in Ethiopia, with wide variations sub-nationally and by age group. The prevalence of childhood stunting ranged from 56.6% (37.4–74.6%) in the Mekelle Special zone of the Tigray region to 25.5% (10.5–48.9%) in the Sheka zone of the Southern Nations, Nationalities and Peoples region. Factors associated with a reduced likelihood of stunting in Ethiopia included non-receipt of breastmilk, mother’s BMI (overweight/obese), employment status (employed), and higher household wealth, while the enablers were residence in the “arid” geographic areas, small birth size of the child, and mother’s BMI (underweight). The prevalence and determinants of stunting varied across Ethiopia. Efforts to reduce the burden of childhood stunting should consider geographical heterogeneity and modifiable risk factors. Full article

(This article belongs to the Special Issue Nutritional Status among Vulnerable Populations)

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10 pages, 599 KiB

Open AccessArticle

The Effects of Gold Kiwifruit Intake Timing with or without Pericarp on Postprandial Blood Glucose Level

by Yutaka Inoue, Yukari Kitani, Satoshi Osakabe, Yukitoshi Yamamoto, Isamu Murata and Ikuo Kanamoto

Nutrients 2021, 13(6), 2103; https://doi.org/10.3390/nu13062103 - 19 Jun 2021

Cited by 3 | Viewed by 2831

Abstract

The purpose of this study was to examine how gold kiwifruit pericarp (pericarp is defined as the skin of the fruit) consumption and the timing thereof affect the postprandial blood glucose profile. The study was conducted on twelve healthy volunteers (six men and [...] Read more.

The purpose of this study was to examine how gold kiwifruit pericarp (pericarp is defined as the skin of the fruit) consumption and the timing thereof affect the postprandial blood glucose profile. The study was conducted on twelve healthy volunteers (six men and six women). According to our results, the simultaneous intake of gold kiwifruit with bread and the prior intake of gold kiwifruit evidently suppressed the postprandial blood glucose elevation compared with exclusive bread intake. There was no significant difference in postprandial blood glucose changes between the ingestion of gold kiwifruit pericarp and pulp and that of gold kiwifruit pulp only. The highest postprandial blood glucose elevation was suppressed by 27.6% and the area under the blood glucose elevation curve by 29.3%, even with the exclusive ingestion of gold kiwifruit pulp. We predicted that the ingestion of both the pericarp and pulp of gold kiwifruit would reduce the postprandial blood glucose elevation to a greater extent than that of gold kiwifruit pulp only; however, there was no significant difference between the two. These results indicate that gold kiwifruit consumption significantly suppresses the postprandial blood glucose elevation regardless of pericarp presence or absence and the timing of ingestion. Full article

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15 pages, 1284 KiB

Open AccessArticle

Individual Diet Modification Reduces the Metabolic Syndrome in Patients Before Pharmacological Treatment

by Małgorzata Elżbieta Zujko, Marta Rożniata and Kinga Zujko

Nutrients 2021, 13(6), 2102; https://doi.org/10.3390/nu13062102 - 19 Jun 2021

Cited by 9 | Viewed by 3750

Abstract

Modification of lifestyle, including healthy nutrition, is the primary approach for metabolic syndrome (MetS) therapy. The aim of this study was to estimate how individual nutrition intervention affects the reduction of MetS components. Subjects diagnosed with MetS were recruited in the Lomza Medical [...] Read more.

Modification of lifestyle, including healthy nutrition, is the primary approach for metabolic syndrome (MetS) therapy. The aim of this study was to estimate how individual nutrition intervention affects the reduction of MetS components. Subjects diagnosed with MetS were recruited in the Lomza Medical Centre. The study group consisted of 90 participants and was divided into one intervention group (individual nutrition education group (INEG)) and one control group (CG). The research was conducted over 3 months. The following measurements were obtained during the first visit and after completion of the 3 months intervention: body mass, waist circumference, body composition, blood pressure, fasting glucose, and blood lipids. Dietary assessments were performed before and post-intervention using 3-day 24-h dietary recalls. Dietary knowledge was evaluated with the KomPAN questionnaire. The total polyphenol content of the diet was calculated. Sociodemographic and lifestyle characteristics were collected from a self-reported questionnaire. The physical activity was assessed by the short version of the International Physical Activity Questionnaire (IPAQ). It was found that the individual nutrition education was an effective method to improve the knowledge, dietary habits, and physical activity of the study participants. The modification of the diet in terms of higher intake of polyphenols (flavonoids and anthocyanins), fiber, polyunsaturated fatty acids (PUFA), PUFA n-3, and lower intake of saturated fatty acids (SFA) had a significant impact on the improvement of some MetS risk factors (waist circumference, fasting glucose, and HDL-cholesterol). Full article

(This article belongs to the Special Issue Dietary Modifications from Benefits to Pathology)

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25 pages, 1263 KiB

Open AccessReview

Visceral Adiposity and Cancer: Role in Pathogenesis and Prognosis

by Lucilla Crudele, Elena Piccinin and Antonio Moschetta

Nutrients 2021, 13(6), 2101; https://doi.org/10.3390/nu13062101 - 19 Jun 2021

Cited by 40 | Viewed by 6425

Abstract

The prevalence of being overweight and obese has been expanded dramatically in recent years worldwide. Obesity usually occurs when the energetic introit overtakes energy expenditure from metabolic and physical activity, leading to fat accumulation mainly in the visceral depots. Excessive fat accumulation represents [...] Read more.

The prevalence of being overweight and obese has been expanded dramatically in recent years worldwide. Obesity usually occurs when the energetic introit overtakes energy expenditure from metabolic and physical activity, leading to fat accumulation mainly in the visceral depots. Excessive fat accumulation represents a risk factor for many chronic diseases, including cancer. Adiposity, chronic low-grade inflammation, and hyperinsulinemia are essential factors of obesity that also play a crucial role in tumor onset. In recent years, several strategies have been pointed toward boundary fat accumulation, thus limiting the burden of cancer attributable to obesity. While remodeling fat via adipocytes browning seems a tempting prospect, lifestyle interventions still represent the main pathway to prevent cancer and enhance the efficacy of treatments. Specifically, the Mediterranean Diet stands out as one of the best dietary approaches to curtail visceral adiposity and, therefore, cancer risk. In this Review, the close relationship between obesity and cancer has been investigated, highlighting the biological mechanisms at the basis of this link. Finally, strategies to remodel fat, including browning and lifestyle interventions, have been taken into consideration as a major perspective to limit excess body weight and tumor onset. Full article

(This article belongs to the Special Issue Human Nutrition and Cancer Prevention)

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22 pages, 4850 KiB

Open AccessArticle

The Antioxidant Effects of Whey Protein Peptide on Learning and Memory Improvement in Aging Mice Models

by Xiao-Chen Yu, Zhen Li, Xin-Ran Liu, Jia-Ni Hu, Rui Liu, Na Zhu and Yong Li

Nutrients 2021, 13(6), 2100; https://doi.org/10.3390/nu13062100 - 19 Jun 2021

Cited by 24 | Viewed by 4129

Abstract

This study investigated the antioxidant effects of whey protein peptide on learning and memory in aging C57BL/6N mice. A total of 72 SPF male C57BL/6N mice were used. Twelve mice were randomly selected as the control group, and the other mice were intraperitoneally [...] Read more.

This study investigated the antioxidant effects of whey protein peptide on learning and memory in aging C57BL/6N mice. A total of 72 SPF male C57BL/6N mice were used. Twelve mice were randomly selected as the control group, and the other mice were intraperitoneally injected with D-galactose (100 mg/kg body weight for 6 weeks), during which, the mice in the control group were intraperitoneally injected with the same amount of normal saline. After 6 weeks, the blood was taken from the epicanthus and the serum MDA level was measured, according to which, the mice were randomly divided into the model control group, the whey protein group (1.5 g/kg body weight), and three Whey protein peptide (WHP) intervention groups (0.3 g/kg body weight, 1.5 g/kg body weight, 3.0 g/kg body weight). The water solution of the test sample was administered by oral gavage every day. The intervention period was 30 days, during which, the model control group, the whey protein group, and the whey protein peptide group continued receiving intraperitoneal injections of D-galactose, while the control group continued receiving intraperitoneal injections of normal saline. After the intervention, behavioral experiments were conducted in the following order: open field test, water maze test, and new object recognition test. After the behavioral experiment, the morphology of hippocampal formation was observed by HE staining and TUNEL labeling. Oxidative stress-related indexes in the serum, liver, and brain were detected. Expression levels of the cholinergic system-related enzymes and proinflammatory cytokines in brain tissue were detected. Western blot was used to detect the expression of synaptic plasticity-related proteins in the mouse brain. The results showed that WHP could significantly improve the accumulation of MDA and PC, increase the activities of SOD and GSH-Px, resist oxidative stress injury, and enhance the potential of endogenous antioxidant defense mechanisms. WHP can significantly improve the decline of aging-related spatial exploration, body movement, and spatial and non-spatial learning/memory ability. Its specific mechanism may be related to reducing the degeneration of hippocampal nerve cells, reducing the apoptosis of nerve cells, improving the activity of AChE, reducing the expression of inflammatory factors (TNF-α and IL-1β) in brain tissue, reducing oxidative stress injury, and improving the expression of p-CaMKⅡ and BDNF synaptic plasticity protein. These results indicate that WHP can improve aging-related oxidative stress, as well as learning and memory impairment. Full article

(This article belongs to the Section Nutrition and Metabolism)

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21 pages, 735 KiB

Open AccessEditor’s ChoiceReview

Regulation of Neurotransmitters by the Gut Microbiota and Effects on Cognition in Neurological Disorders

by Yijing Chen, Jinying Xu and Yu Chen

Nutrients 2021, 13(6), 2099; https://doi.org/10.3390/nu13062099 - 19 Jun 2021

Cited by 277 | Viewed by 36063

Abstract

Emerging evidence indicates that gut microbiota is important in the regulation of brain activity and cognitive functions. Microbes mediate communication among the metabolic, peripheral immune, and central nervous systems via the microbiota–gut–brain axis. However, it is not well understood how the gut microbiome [...] Read more.

Emerging evidence indicates that gut microbiota is important in the regulation of brain activity and cognitive functions. Microbes mediate communication among the metabolic, peripheral immune, and central nervous systems via the microbiota–gut–brain axis. However, it is not well understood how the gut microbiome and neurons in the brain mutually interact or how these interactions affect normal brain functioning and cognition. We summarize the mechanisms whereby the gut microbiota regulate the production, transportation, and functioning of neurotransmitters. We also discuss how microbiome dysbiosis affects cognitive function, especially in neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. Full article

(This article belongs to the Special Issue Gut Microbiota in Cognition, Behaviour and Alzheimer's Disease)

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9 pages, 270 KiB

Open AccessArticle

Household Food Insecurity, Lung Function, and COPD in US Adults

by Francisca de Castro Mendes, Kirstie Ducharme-Smith, Gustavo Mora-Garcia, Saleh A. Alqahtani, Maria Stephany Ruiz-Diaz, Andre Moreira, Rodrigo Villegas and Vanessa Garcia-Larsen

Nutrients 2021, 13(6), 2098; https://doi.org/10.3390/nu13062098 - 19 Jun 2021

Cited by 8 | Viewed by 3209

Abstract

Increasing epidemiological evidence suggests that optimal diet quality helps to improve preservation of lung function and to reduce chronic obstructive pulmonary disease (COPD) risk, but no study has investigated the association of food insecurity (FI) and lung health in the general population. Using [...] Read more.

Increasing epidemiological evidence suggests that optimal diet quality helps to improve preservation of lung function and to reduce chronic obstructive pulmonary disease (COPD) risk, but no study has investigated the association of food insecurity (FI) and lung health in the general population. Using data from a representative sample of US adults who participated in the National Health and Nutrition Examination Survey (NHANES) 2007–2012 cycles, we investigated the association between FI with lung function and spirometrically defined COPD in 12,469 individuals aged ≥ 18 years of age. FI (high vs. low) was defined using the US Department of Agriculture’s Food Security Scale). Population-weighted adjusted regression models were used to investigate associations between FI, and forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), their ratio, and spirometrically defined restriction (FVC below the lower limit of normal) and airflow obstruction (COPD). The prevalence of household FI was 13.2%. High household FI was associated with lower FVC (adjusted β-coefficient −70.9 mL, 95% CI −116.6, −25.3), and with higher odds (OR) of spirometric restriction (1.02, 95% CI 1.00, 1.03). Stratified analyses showed similar effect sizes within specific ethnic groups. High FI was associated with worse lung health in a nationally representative sample of adults in the US. Full article

(This article belongs to the Section Nutritional Epidemiology)

18 pages, 2306 KiB

Open AccessArticle

Predictors of COVID-19-Related Perceived Improvements in Dietary Health: Results from a US Cross-Sectional Study

by Kelly Cosgrove and Christopher Wharton

Nutrients 2021, 13(6), 2097; https://doi.org/10.3390/nu13062097 - 19 Jun 2021

Cited by 16 | Viewed by 3523

Abstract

The COVID-19 pandemic resulted in substantial lifestyle changes. No US study has identified predictors of perceived dietary healthfulness changes during the pandemic period. This study included analyses of lifestyle and dietary healthfulness changes using 958 survey responses from US primary household food purchasers. [...] Read more.

The COVID-19 pandemic resulted in substantial lifestyle changes. No US study has identified predictors of perceived dietary healthfulness changes during the pandemic period. This study included analyses of lifestyle and dietary healthfulness changes using 958 survey responses from US primary household food purchasers. Information was collected related to demographics, COVID-19-related household changes, and health-related habits before and during the pandemic. Binary logistic regression identified predictors of perceived increase in dietary healthfulness during the pandemic period. Overall, 59.8%, 16.4%, and 23.4% of participants reported that their eating habits likely changed, may have changed, and likely did not change, respectively. Of the participants whose dietary habits likely or may have changed, 64.1%, 16.8%, and 19% reported healthier, neither healthier nor less healthy, and less healthy eating habits, respectively. COVID-19-related income loss, more meals consumed with household members in front of the television, an increase in food advertisement exposure, increased perceived stress, and better perceived current health were significant predictors of a perceived increase in dietary healthfulness. Overall, dietary habits were perceived to become healthier during the pandemic. The predictors of perceived improvement in dietary healthfulness were surprising and indicate the need for further study of these factors in crisis and noncrisis situations. Full article

(This article belongs to the Section Nutrition and Public Health)

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12 pages, 516 KiB

Open AccessArticle

Breastfeeding Prevalence in Austria according to the WHO IYCF Indicators—The SUKIE-Study

by Bernadette Bürger, Karin Schindler, Tanja Tripolt, Hans Peter Stüger, Karl-Heinz Wagner, Adelheid Weber and Alexandra Wolf-Spitzer

Nutrients 2021, 13(6), 2096; https://doi.org/10.3390/nu13062096 - 19 Jun 2021

Cited by 4 | Viewed by 3868

Abstract

Breastfeeding and infant nutrition have an important impact on child health. The last representative data on breastfeeding in Austria was collected in 2006. The SUKIE-Study (Säuglings- und Kinderernährung) is a representative, longitudinal survey (online questionnaire) for participating mothers at four time points (14 [...] Read more.

Breastfeeding and infant nutrition have an important impact on child health. The last representative data on breastfeeding in Austria was collected in 2006. The SUKIE-Study (Säuglings- und Kinderernährung) is a representative, longitudinal survey (online questionnaire) for participating mothers at four time points (14 days, four, six and 12 months post-partum). Questions on when other foods were first introduced were asked retrospectively. To ensure international comparisons, the World Health Organization’s definitions for breastfeeding, including “Infant and Young Child Feeding” indicators, were used. After eligibility screening, 1214 of 1666 invited mothers were included in the analysis. The initial breastfeeding rate was 97.5% and was reduced to 40.8% after 12 months. The rate of exclusive breastfeeding at one week of age was 55.5% and decreased to 1.9% after six months. Half of the infants received infant formula for the first time within the first three days of life (median). Out of the mothers that did wean breastfeeding in the first 12 months, the median duration was 27 weeks (right-censored data). Compared with 2006, an increase (93.2% to 97.5%) in the initial breastfeeding rate was found. However, other findings show that breastfeeding duration, including exclusive breastfeeding rates, need further improvement. Full article

(This article belongs to the Special Issue Nutrition Intake and Status of Breastfed Infants and Their Mothers)

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