Nutrients

15 pages, 267 KiB

Open AccessArticle

Eating Behaviors and Dietary Patterns of Women during Pregnancy: Optimizing the Universal ‘Teachable Moment’

by Maryam Kebbe, Emily W. Flanagan, Joshua R. Sparks and Leanne M. Redman

Nutrients 2021, 13(9), 3298; https://doi.org/10.3390/nu13093298 - 21 Sep 2021

Cited by 18 | Viewed by 5111

Understanding women’s perceptions of eating behaviors and dietary patterns can inform the ‘teachable moment’ model of pregnancy. Our objectives were to describe eating behaviors and dietary patterns in pregnancy. This was a cross-sectional, national electronic survey. Women were ?18 years of age, living [...] Read more.

Understanding women’s perceptions of eating behaviors and dietary patterns can inform the ‘teachable moment’ model of pregnancy. Our objectives were to describe eating behaviors and dietary patterns in pregnancy. This was a cross-sectional, national electronic survey. Women were ?18 years of age, living in the United States, currently pregnant or less than two years postpartum, and had internet access. Age, education, race, and marriage were included as covariates in ordinal and binary logistic regressions (significance p < 0.05). Women (n = 587 eligible) made positive or negative changes to their diets, while others maintained pre-existing eating behaviors. The majority of women did not try (84.9 to 95.1% across diets) and were unwilling to try (66.6 to 81%) specific dietary patterns during pregnancy. Concerns included not eating a balanced diet (60.1 to 65.9%), difficulty in implementation without family (63.2 to 64.8%), and expense (58.7 to 60.1%). Helpful strategies included being provided all meals and snacks (88.1 to 90.6%) and periodic consultations with a dietitian or nutritionist (85 to 86.7%). Responses differed across subgroups of parity, body mass index, and trimester, notably in women with obesity who reported healthier changes to their diet (p < 0.05). Our study underscores the importance of tailoring care early to individual needs, characteristics, and circumstances. Full article

(This article belongs to the Section Nutrition in Women)

8 pages, 1521 KiB

Open AccessArticle

Gastroprotective Effect of Enteral Nutrition Formula in Mice Injected Subcutaneously with Indomethacin

by Yoshiaki Yamagishi, Rei Saiki, Takeshi Yoshimi, Toshiyuki Kudo and Kiyomi Ito

Nutrients 2021, 13(9), 3297; https://doi.org/10.3390/nu13093297 - 21 Sep 2021

Viewed by 2808

Abstract

We have previously shown that two enteral nutrition formulas suppressed gastric lesions induced by the oral administration of indomethacin (IND) in mice. However, the mechanism of their protective effect is unknown. In this study, the effect of the two enteral nutrition formulas on [...] Read more.

We have previously shown that two enteral nutrition formulas suppressed gastric lesions induced by the oral administration of indomethacin (IND) in mice. However, the mechanism of their protective effect is unknown. In this study, the effect of the two enteral nutrition formulas on gastric lesions induced by subcutaneous IND injection was investigated, with the objective of exploring the possibility that they may interact directly with IND in the gastrointestinal tract. Ten-week-old, male, ICR mice were fasted, then orally given either purified water, Mermed^® One, or 2-fold diluted Terumeal^® 2.0? as enteral nutrition formula (25 mL/kg). IND was injected subcutaneously at 20 mg/kg after 30 min, and the stomach was removed 6 h later and fixed in formalin. The number and area of lesions in the stomachs of mice given enteral nutrition formula was reduced to 56–89% and 34–61%, respectively, compared with the mice given purified water. The time courses of plasma IND concentrations were comparable among the three groups. These results suggested that the effect of these enteral nutrition formulas on gastric lesions did not originate from their direct interaction with IND in the gastrointestinal tract or their effect on the disposition of IND. Full article

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

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Experimental protocol. IND: indomethacin; EN_M: Mermed® One; EN_T: Terumeal®2.0α diluted by a factor of 2 with purified water to reduce the caloric content to that of EN_M; p.o.: per os; s.c.: subcutaneous. Full article ">Figure 2
Effects of EN_M and EN_T on IND-induced gastric lesions. Figures show representative photographs of stomachs taken after fixation for 21 h in 10% neutral-buffered formalin following removal 6 h after subcutaneous IND (20 mg/kg) administration. (A) Untreated group; (B) group treated with 25 mL/kg of purified water, EN_M, or EN_T orally 30 min before subcutaneous IND administration. Full article ">Figure 3
Effects of EN_M and EN_T on numbers and areas of gastric lesions induced by IND. Gross observations were performed to determine numbers (A) and areas (B) of lesions in stomachs taken after fixation for 21 h in 10% neutral-buffered formalin following removal 6 h after subcutaneous IND (20 mg/kg) administration. The gray column represents the untreated group; the red column, blue column, and green column represent the group treated with purified water, EN_M, and EN_T, respectively, 30 min before subcutaneous IND administration. Each column and vertical bar represents mean + S.D., n = 5. * p < 0.05 vs. untreated group and # p < 0.05 vs. water + IND group (Tukey’s test). Full article ">Figure 4
Effects of EN_M and EN_T on plasma IND concentrations. Blood was collected from the mice orally given 25 mL/kg of purified water, EN_M, or EN_T 30 min before subcutaneous IND (20 mg/kg) administration. LC-MS/MS was used to determine plasma IND concentrations. (A) Normal plot; (B) semilog plot. The closed red circles, blue triangles, and green triangles represent the profiles for the group treated with purified water, EN_M, and EN_T, respectively, orally 30 min before subcutaneous IND administration. Each symbol represents mean ± S.D., n = 5. Full article ">

12 pages, 630 KiB

Open AccessArticle

Prevalence of Excessive Weight and Underweight and Its Associated Knowledge and Lifestyle Behaviors among Urban Private School-Going Adolescents in New Delhi

by Tina Rawal, Maartje Willeboordse, Monika Arora, Nitika Sharma, Gaurang P. Nazar, Nikhil Tandon and Constant P. van Schayck

Nutrients 2021, 13(9), 3296; https://doi.org/10.3390/nu13093296 - 21 Sep 2021

Cited by 9 | Viewed by 4297

Abstract

With rapid urbanization and the Indian nutrition transition, Indian adolescents face a high risk of developing an energy imbalance. This study aims to assess the prevalence of excessive weight, underweight, and associated knowledge and lifestyle behaviors among private school-going adolescents in Delhi. A [...] Read more.

With rapid urbanization and the Indian nutrition transition, Indian adolescents face a high risk of developing an energy imbalance. This study aims to assess the prevalence of excessive weight, underweight, and associated knowledge and lifestyle behaviors among private school-going adolescents in Delhi. A cross-sectional study was conducted in students (6th–7th grades) of eight randomly selected private schools in Delhi, India in 2019. A self-administered survey was used to assess students’ dietary-and-physical-activity-related knowledge and behavior. Anthropometric measurements (height, weight, and waist circumference) were also conducted. Out of 1567 participants, 7.2% were underweight, 61.3% normal, and 31.5% excess in weight. Underweight was associated with significantly more eating whilst studying for exams (relative risk ratio (RRR) 1.7 (1.0–2.9)). Excessive weight was associated with less incorrect knowledge on behaviors causing overweight (RRR 0.7 (0.5–0.9)), more often reading nutritional labels of packed food items (RRR 0.6 (0.4–0.9)), and less frequent vegetable-intake (RRR 0.7 (0.4–0.9)). Underweight students showed more suboptimal knowledge and unhealthy behaviors, whilst students with excessive weight showed more correct knowledge and healthy behaviors. This study highlights the immediate need for effective health-promoting interventions focused on the importance of healthy lifestyle at least in underweight adolescents. Full article

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

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17 pages, 3065 KiB

Open AccessArticle

Associations between Maternal Diet, Body Composition and Gut Microbial Ecology in Pregnancy

by Meghan L. Ruebel, Stephanie P. Gilley, Clark R. Sims, Ying Zhong, Donald Turner, Sree V. Chintapalli, Brian D. Piccolo, Aline Andres and Kartik Shankar

Nutrients 2021, 13(9), 3295; https://doi.org/10.3390/nu13093295 - 21 Sep 2021

Cited by 28 | Viewed by 4839

Abstract

Maternal body composition, gestational weight gain (GWG) and diet quality influence offspring obesity risk. While the gut microbiome is thought to play a crucial role, it is understudied in pregnancy. Using a longitudinal pregnancy cohort, maternal anthropometrics, body composition, fecal microbiome and dietary [...] Read more.

Maternal body composition, gestational weight gain (GWG) and diet quality influence offspring obesity risk. While the gut microbiome is thought to play a crucial role, it is understudied in pregnancy. Using a longitudinal pregnancy cohort, maternal anthropometrics, body composition, fecal microbiome and dietary intake were assessed at 12, 24 and 36 weeks of gestation. Fecal samples (n = 101, 98 and 107, at each trimester, respectively) were utilized for microbiome analysis via 16S rRNA amplicon sequencing. Data analysis included alpha- and beta-diversity measures and assessment of compositional changes using MaAsLin2. Correlation analyses of serum metabolic and anthropometric markers were performed against bacterial abundance and predicted functional pathways. ?-diversity was unaltered by pregnancy stage or maternal obesity status. Actinobacteria, Lachnospiraceae, Akkermansia, Bifidobacterium, Streptococcus and Anaerotuncus abundances were associated with gestation stage. Maternal obesity status was associated with increased abundance of Lachnospiraceae, Bilophila, Dialister and Roseburia. Maternal BMI, fat mass, triglyceride and insulin levels were positively associated with Bilophila. Correlations of bacterial abundance with diet intake showed that Ruminococcus and Paraprevotella were associated with total fat and unsaturated fatty acid intake, while Collinsella and Anaerostipes were associated with protein intake. While causal relationships remain unclear, collectively, these findings indicate pregnancy- and maternal obesity-dependent interactions between dietary factors and the maternal gut microbiome. Full article

(This article belongs to the Section Nutrition and Obesity)

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17 pages, 681 KiB

Open AccessArticle

Development of Visceral and Subcutaneous-Abdominal Adipose Tissue in Breastfed Infants during First Year of Lactation

by Zoya Gridneva, Alethea Rea, Ching Tat Lai, Wan Jun Tie, Sambavi Kugananthan, Kevin Murray, Peter E. Hartmann and Donna T. Geddes

Nutrients 2021, 13(9), 3294; https://doi.org/10.3390/nu13093294 - 21 Sep 2021

Cited by 12 | Viewed by 3605

Abstract

This study aimed to investigate relationships between infant abdominal visceral and subcutaneous adiposity and human milk (HM) components and maternal body composition (BC) during first year of lactation. Subcutaneous-abdominal depth (SAD), subcutaneous-abdominal fat area (SFA), visceral depth (VD) and preperitoneal fat area of [...] Read more.

This study aimed to investigate relationships between infant abdominal visceral and subcutaneous adiposity and human milk (HM) components and maternal body composition (BC) during first year of lactation. Subcutaneous-abdominal depth (SAD), subcutaneous-abdominal fat area (SFA), visceral depth (VD) and preperitoneal fat area of 20 breastfed infants were assessed at 2, 5, 9 and 12 months using ultrasound. Maternal BC was determined with bioimpedance spectroscopy. HM macronutrients and bioactive components concentrations and infant 24-h milk intake were measured and calculated daily intakes (CDI) determined. Maternal adiposity associated with infant SFA (negatively at 2, 5, 12, positively at 9 months, all overall p < 0.05). 24-h milk intake positively associated with infant SAD (p = 0.007) and VD (p = 0.013). CDI of total protein (p = 0.013), total carbohydrates (p = 0.004) and lactose (p = 0.013) positively associated with SFA. Lactoferrin concentration associated with infant VD (negatively at 2, 12, positively at 5, 9 months, overall p = 0.003). CDI of HM components and maternal adiposity have differential effects on development of infant visceral and subcutaneous abdominal adiposity. Maintaining healthy maternal BC and continuing breastfeeding to 12 months and beyond may facilitate favourable BC development reducing risk of obesity. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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Significant associations between (A) infant visceral depth and lactoferrin concentration (p = 0.003); and infant subcutaneous fat area (SFA) and calculated daily intakes (CDI) of (B) total carbohydrates (p = 0.004), (C) lactose (p = 0.013) and (D) total protein (p = 0.013). Lines represent linear regression and grouped by the month of lactation. Full article ">Figure 2
Significant associations between infant subcutaneous fat area (SFA) and (A) maternal weight (p = 0.020), (B) maternal fat mass (p = 0.010) and (C) fat mass index (p = 0.023); 24h milk intake and (D) subcutaneous-abdominal (p = 0.007) and (E) visceral (p = 0.013) depths; and (F) breastfeeding frequency and peritoneal fat area to subcutaneous fat area ratio (PFA/SFA, p = 0.002). Lines represent linear regression and grouped by the month of lactation. Full article ">Figure 3
Suggested pathways of lactocrine programming of the infant abdominal adiposity during first 12 months postpartum. Associations between tested parameters and infant abdominal adiposity are indicated by the arrows (green—positive associations; red—negative associations); dotted arrows indicate time-dependent associations. BF—breastfeeding; CDI—calculated daily intake. Full article ">Figure A1
Flowchart of study participants. Full article ">

14 pages, 1369 KiB

Open AccessReview

Recovery Focused Nutritional Therapy across the Continuum of Care: Learning from COVID-19

by Emanuele Cereda, Pere Clavé, Peter F. Collins, Anne Holdoway and Paul E. Wischmeyer

Nutrients 2021, 13(9), 3293; https://doi.org/10.3390/nu13093293 - 21 Sep 2021

Cited by 15 | Viewed by 10594

Abstract

Targeted nutritional therapy should be started early in severe illness and sustained through to recovery if clinical and patient-centred outcomes are to be optimised. The coronavirus disease 2019 (COVID-19) pandemic has shone a light on this need. The literature on nutrition and COVID-19 [...] Read more.

Targeted nutritional therapy should be started early in severe illness and sustained through to recovery if clinical and patient-centred outcomes are to be optimised. The coronavirus disease 2019 (COVID-19) pandemic has shone a light on this need. The literature on nutrition and COVID-19 mainly focuses on the importance of nutrition to preserve life and prevent clinical deterioration during the acute phase of illness. However, there is a lack of information guiding practice across the whole patient journey (e.g., hospital to home) with a focus on targeting recovery (e.g., long COVID). This review paper is of relevance to doctors and other healthcare professionals in acute care and primary care worldwide, since it addresses early, multi-modal individualised nutrition interventions across the continuum of care to improve COVID-19 patient outcomes. It is of relevance to nutrition experts and non-nutrition experts and can be used to promote inter-professional and inter-organisational knowledge transfer on the topic. The primary goal is to prevent complications and support recovery to enable COVID-19 patients to achieve the best possible nutritional, physical, functional and mental health status and to apply the learning to date from the COVID-19 pandemic to other patient groups experiencing acute severe illness. Full article

(This article belongs to the Special Issue Exercise and Nutrition in COVID-19)

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16 pages, 317 KiB

Open AccessArticle

Identification and Characterization of Human Observational Studies in Nutritional Epidemiology on Gut Microbiomics for Joint Data Analysis

by Mariona Pinart, Katharina Nimptsch, Sofia K. Forslund, Kristina Schlicht, Miguel Gueimonde, Patrizia Brigidi, Silvia Turroni, Wolfgang Ahrens, Antje Hebestreit, Maike Wolters, Andreas Dötsch, Ute Nöthlings, Kolade Oluwagbemigun, Rafael R. C. Cuadrat, Matthias B. Schulze, Marie Standl, Michael Schloter, Maria De Angelis, Patricia Iozzo, Maria Angela Guzzardi, Geertrui Vlaemynck, John Penders, Daisy M. A. E. Jonkers, Maya Stemmer, Giulia Chiesa, Duccio Cavalieri, Carlotta De Filippo, Danilo Ercolini, Francesca De Filippis, David Ribet, Najate Achamrah, Marie-Pierre Tavolacci, Pierre Déchelotte, Jildau Bouwman, Matthias Laudes and Tobias Pischon Show full author list Hide full author list

Nutrients 2021, 13(9), 3292; https://doi.org/10.3390/nu13093292 - 21 Sep 2021

Cited by 5 | Viewed by 5091

Abstract

In any research field, data access and data integration are major challenges that even large, well-established consortia face. Although data sharing initiatives are increasing, joint data analyses on nutrition and microbiomics in health and disease are still scarce. We aimed to identify observational [...] Read more.

In any research field, data access and data integration are major challenges that even large, well-established consortia face. Although data sharing initiatives are increasing, joint data analyses on nutrition and microbiomics in health and disease are still scarce. We aimed to identify observational studies with data on nutrition and gut microbiome composition from the Intestinal Microbiomics (INTIMIC) Knowledge Platform following the findable, accessible, interoperable, and reusable (FAIR) principles. An adapted template from the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) consortium was used to collect microbiome-specific information and other related factors. In total, 23 studies (17 longitudinal and 6 cross-sectional) were identified from Italy (7), Germany (6), Netherlands (3), Spain (2), Belgium (1), and France (1) or multiple countries (3). Of these, 21 studies collected information on both dietary intake (24 h dietary recall, food frequency questionnaire (FFQ), or Food Records) and gut microbiome. All studies collected stool samples. The most often used sequencing platform was Illumina MiSeq, and the preferred hypervariable regions of the 16S rRNA gene were V3–V4 or V4. The combination of datasets will allow for sufficiently powered investigations to increase the knowledge and understanding of the relationship between food and gut microbiome in health and disease. Full article

(This article belongs to the Collection Connection between Microbiome, Lifestyle and Diet)

10 pages, 293 KiB

Open AccessArticle

Nutritional Quality of Plant-Based Cheese Available in Spanish Supermarkets: How Do They Compare to Dairy Cheese?

by Ujué Fresán and Holly Rippin

Nutrients 2021, 13(9), 3291; https://doi.org/10.3390/nu13093291 - 21 Sep 2021

Cited by 37 | Viewed by 10088

Abstract

Plant-based cheese is one of the most increasingly consumed dairy alternatives. Evidence is lacking on their nutritional quality. We aimed to evaluate the nutritional composition of the plant-based cheese options available in Spanish supermarkets, and how they compare with dairy cheese. An audit [...] Read more.

Plant-based cheese is one of the most increasingly consumed dairy alternatives. Evidence is lacking on their nutritional quality. We aimed to evaluate the nutritional composition of the plant-based cheese options available in Spanish supermarkets, and how they compare with dairy cheese. An audit of plant-based cheese alternatives has been conducted in seven of the most common supermarkets. For each product, the nutritional content per 100 g and ingredients were collected. Data on generic dairy cheese were retrieved from the BEDCA website. Descriptive statistics (median, minimum and maximum) were used to characterize the plant-based cheese products, for both all the products and grouped by main ingredients (i.e., coconut oil, cashew nuts and tofu). Mann–Whitney U tests were used for comparisons between dairy and different types of plant-based cheese. The coconut oil-based products (the large majority of plant-based cheese products, n = 34) could not be considered as healthy foods. Their major ingredients were refined coconut oil and starches and were high in saturated fats and salt. The other smaller groups, cashew nut- (n = 4) and tofu-based (n = 2), showed a healthier nutritional profile. Replacing dairy cheese with these groups could be nutritionally beneficial. Future investigations should address the health effects of substituting dairy cheese with these products. Full article

(This article belongs to the Special Issue Plant-Based Diets: Working towards a Sustainable Future)

16 pages, 5073 KiB

Open AccessArticle

Gut Microbiota Predicts Healthy Late-Life Aging in Male Mice

by Shanlin Ke, Sarah J. Mitchell, Michael R. MacArthur, Alice E. Kane, David A. Sinclair, Emily M. Venable, Katia S. Chadaideh, Rachel N. Carmody, Francine Grodstein, James R. Mitchell and Yang-Yu Liu

Nutrients 2021, 13(9), 3290; https://doi.org/10.3390/nu13093290 - 21 Sep 2021

Cited by 17 | Viewed by 7966

Abstract

Calorie restriction (CR) extends lifespan and retards age-related chronic diseases in most species. There is growing evidence that the gut microbiota has a pivotal role in host health and age-related pathological conditions. Yet, it is still unclear how CR and the gut microbiota [...] Read more.

Calorie restriction (CR) extends lifespan and retards age-related chronic diseases in most species. There is growing evidence that the gut microbiota has a pivotal role in host health and age-related pathological conditions. Yet, it is still unclear how CR and the gut microbiota are related to healthy aging. Here, we report findings from a small longitudinal study of male C57BL/6 mice maintained on either ad libitum or mild (15%) CR diets from 21 months of age and tracked until natural death. We demonstrate that CR results in a significantly reduced rate of increase in the frailty index (FI), a well-established indicator of aging. We observed significant alterations in diversity, as well as compositional patterns of the mouse gut microbiota during the aging process. Interrogating the FI-related microbial features using machine learning techniques, we show that gut microbial signatures from 21-month-old mice can predict the healthy aging of 30-month-old mice with reasonable accuracy. This study deepens our understanding of the links between CR, gut microbiota, and frailty in the aging process of mice. Full article

(This article belongs to the Special Issue Macronutrients in Frailty and Aging)

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Figure 1
Schematic diagram showing the experimental design. The study cohort was comprised of 22 adult male C57BL/6 mice, which were recruited into the study at 21 months of age after having been maintained since birth under standard husbandry conditions (see Methods). We collected blood and fecal samples and measured frailty using a compound index at 21 months (baseline) and 30 months of age. Following baseline measurements, we randomly divided these mice into two diet groups, fed either ad libitum (AL, n = 14) with standard chow or under mild (15%) calorie restriction (CR, n = 8). Mice were then followed longitudinally until death. We performed universal 16S quantitative PCR (qPCR) to quantify absolute bacterial abundance and 16S rRNA gene sequencing to determine taxonomic composition, using QIIME2 to characterize the ASV microbial features. Blood markers were measured using standard methods. We then used the median FI change (denoted as ΔFI) between 21 and 30 months of age to delineate healthy versus normal aging. Full article ">Figure 2
Frailty index associates with chronological age in mice. (a) Frailty index changes with age. Mice at 30 months of age were grouped into healthy and normal aging based on the median ΔFI. (b) The effect of caloric restriction on the ΔFI between 21 and 30 months of age. (c) Comparison of body mass (BM) for different groups. (d) The association between ΔFI and ΔBM in all mice. (e) Comparison of total bacterial load for different groups. (f) The association between ΔFI and ΔBL in all mice. Points obtained for the same subject from 21 and 30 months of age are joined by solid (AL diet) and dotted (CR diet) lines. p-value shown in (a–c,e) are the result of a Wilcoxon–Mann–Whitney test (unpaired) and a Wilcoxon signed rank test (paired). The correlation coefficient shown in (d,f) is the result of a Spearman correlation. The lines show lm fit for the data, and shaded areas show 95% confidence intervals for the fit. Full article ">Figure 3
Impact of aging on gut microbial communities. (a) Relative abundance of bacterial phyla. (b) The ratio of Firmicutes to Bacteroidetes. Alpha diversity using the Shannon (c) and Simpson (d) index. (e) Beta diversity using principal coordinate analysis (PCoA) of Bray–Curtis dissimilarity. The dotted ellipse borders with color represent the 95% confidence interval. (f) Boxplot of gut microbiota Bray–Curtis dissimilarity between subjects within each group. Points obtained for the same subject from 21 and 30 months of age in (b–e) are joined by solid (AL diet) and dotted (CR diet) lines. Points obtained for the same subject pairs from 21 and 30 months of age in (f) are joined by solid line. p-value shown in (b–d,f) are the result of a Wilcoxon–Mann–Whitney test (unpaired) or Wilcoxon signed rank test (paired). Full article ">Figure 4
Identification of associations between blood cell and gut microbial features. Dot plot showing the links between the blood markers and gut microbial taxa identified using MaAsLin2. The sizes of dots represent the q-values from MaAsLin2. The greater the size, the more significant the association. Symbols indicate the directions of associations in a given model: plus, significant positive associations; minus, significant negative associations. Threshold for the FDR-corrected q-value was set at 0.2. Linear mixed effects models were applied to the association with each mouse’s identifier treated as set as a random effect. Full article ">Figure 5
The significant associations between FI and gut microbial features. (a) ASV3100 (Clostridium sensu stricto). (b) ASV2882 (Clostridium XlVa). (c) ASV847 (Phocea massiliensis). (d) ASV338 (Lachnospiraceae). (e) ASV1726 (Parabacteroides goldsteinii). (f) ASV5389 (Lachnospiraceae). (g) ASV1123 (Enterorhabdus). (h) ASV1101(Clostridium XlVa). (i) ASV807 (Unclassified Bacteria). (j) ASV742 (Lachnospiraceae). (k) ASV157 (Subdoligranulum variabile). (l) ASV232 (Ruminococcaceae). (m) ASV2980 (Lachnospiraceae). (n) ASV466 (Lachnospiraceae). Data shown are the relative abundance versus FI for ASVs that were significantly associated with FI in MaAsLin2. Threshold for the FDR-corrected q-value was set at 0.2. Linear mixed-effects models (LMMs) were applied to the association with each mouse’s identifier treated as a random effect. The lines show lm fit for the data, and shaded areas show 95% confidence intervals for the fit. Full article ">Figure 6
A gut microbiota-based signature moderately predicts healthy aging. (a) Leave-one-out (LOOCV) accuracy evaluating ability to predict healthy aging using Elastic-net (ENET). Each bar represents the performance based on different combination of microbial feature: all ASVs, 14 FI-associated ASVs, and null model with 14 randomly selected features run 100 times. Error bars represent the standard errors of the means (SEM) in null model. (b) The mean relative abundance of 14 FI-related ASVs across different groups. The healthy aging status at 21 months of age was determined by the aging status at 30 months of age. Relative abundances are plotted on a log10 scale. Full article ">

23 pages, 5001 KiB

Open AccessArticle

Analyzing Type 2 Diabetes Associations with the Gut Microbiome in Individuals from Two Ethnic Backgrounds Living in the Same Geographic Area

by Manon Balvers, Mélanie Deschasaux, Bert-Jan van den Born, Koos Zwinderman, Max Nieuwdorp and Evgeni Levin

Nutrients 2021, 13(9), 3289; https://doi.org/10.3390/nu13093289 - 21 Sep 2021

Cited by 22 | Viewed by 4438

Abstract

It is currently unknown whether associations between gut microbiota composition and type 2 diabetes (T2D) differ according to the ethnic background of individuals. Thus, we studied these associations in participants from two ethnicities characterized by a high T2D prevalence and living in the [...] Read more.

It is currently unknown whether associations between gut microbiota composition and type 2 diabetes (T2D) differ according to the ethnic background of individuals. Thus, we studied these associations in participants from two ethnicities characterized by a high T2D prevalence and living in the same geographical area, using the Healthy Life In Urban Settings (HELIUS) study. We included 111 and 128 T2D participants on metformin (Met-T2D), 78 and 49 treatment-naïve T2D (TN-T2D) participants, as well as a 1:1 matched group of healthy controls from, respectively, African Surinamese and South-Asian Surinamese descent. Fecal microbiome profiles were obtained through 16S rRNA gene sequencing. Univariate and machine learning analyses were used to explore the associations between T2D and the composition and function of the gut microbiome in both ethnicities, comparing Met-T2D and TN-T2D participants to their respective healthy control. We found a lower ?-diversity for South-Asian Surinamese TN-T2D participants but no significant associations between TN-T2D status and the abundance of bacterial taxa or functional pathways. In African Surinamese participants, we did not find any association between TN-T2D status and the gut microbiome. With respect to Met-T2D participants, we identified several bacterial taxa and functional pathways with a significantly altered abundance in both ethnicities. More alterations were observed in South-Asian Surinamese. Some altered taxa and pathways observed in both ethnicities were previously related to metformin use. This included a strong negative association between the abundance of Romboutsia and Met-T2D status. Other bacterial taxa were consistent with previous observations in T2D, including reduced butyrate producers such as Anaerostipes hadrus. Hence, our results highlighted both shared and unique gut microbial biomarkers of Met-T2D in individuals from different ethnicities but living in the same geographical area. Future research using higher-resolution shotgun sequencing is needed to clarify the role of ethnicity in the association between T2D and gut microbiota composition. Full article

(This article belongs to the Section Nutrition and Diabetes)

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9 pages, 519 KiB

Open AccessArticle

Diet Quality and Bone Density in Youth with Healthy Weight, Obesity, and Type 2 Diabetes

by Joseph M. Kindler, Sina Gallo, Philip R. Khoury, Elaine M. Urbina and Babette S. Zemel

Nutrients 2021, 13(9), 3288; https://doi.org/10.3390/nu13093288 - 21 Sep 2021

Cited by 10 | Viewed by 3231

Abstract

Purpose: To assess relationships between diet quality and areal bone mineral density (aBMD) in youth with healthy weight, obesity, and type 2 diabetes (T2D). Methods: We performed a secondary analysis of cross-sectional data from youth (55% African American, 70% female) ages 10–23 years [...] Read more.

Purpose: To assess relationships between diet quality and areal bone mineral density (aBMD) in youth with healthy weight, obesity, and type 2 diabetes (T2D). Methods: We performed a secondary analysis of cross-sectional data from youth (55% African American, 70% female) ages 10–23 years with T2D (n = 90), obesity (BMI > 95th; n = 128), or healthy weight (BMI < 85th; n = 197). Whole body (less head) areal bone mineral density (aBMD) was assessed by dual-energy X-ray absorptiometry (DXA). aBMD was expressed as age-, sex-, and ancestry-specific standard deviation scores (Z-scores). Whole body aBMD Z-scores were adjusted for height-for-age Z-score. Diet was assessed via three-day diaries, and the Healthy Eating Index (HEI) was computed. Total HEI score and HEI subcomponent scores were compared across groups, and associations with aBMD Z-scores were assessed via linear regression adjusted for group, age, sex, and ancestry. Results: Mean HEI was similar between the healthy weight, obesity, and T2D groups. Several HEI sub-components differed between groups, including meats and beans, total vegetables, milk, saturated fat, sodium, oils, and empty calories. The obesity and T2D group had significantly greater aBMD Z-scores compared to the healthy weight group. Multiple linear regression analyses revealed a significant positive association between HEI and aBMD Z-score (p < 0.05). The HEI sub-components for whole grains (p = 0.052) and empty calories (p < 0.05) were positively associated with aBMD Z-score. Conclusions: Individuals that followed a dietary pattern more closely aligned with the Dietary Guidelines for Americans had greater bone density. Since few studies have investigated the role of diet on bone in youth with obesity-related conditions, additional research is required among these populations. Full article

(This article belongs to the Special Issue Nutrition and Bone Health)

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17 pages, 697 KiB

Open AccessReview

Vitamin D Supplementation and Cancer Mortality: Narrative Review of Observational Studies and Clinical Trials

by Patrizia Gnagnarella, Valeria Muzio, Saverio Caini, Sara Raimondi, Chiara Martinoli, Susanna Chiocca, Claudia Miccolo, Paolo Bossi, Diego Cortinovis, Ferdinando Chiaradonna, Roberta Palorini, Federica Facciotti, Federica Bellerba, Stefania Canova and Sara Gandini

Nutrients 2021, 13(9), 3285; https://doi.org/10.3390/nu13093285 - 21 Sep 2021

Cited by 30 | Viewed by 5000

Abstract

Several studies have investigated the beneficial effects of vitamin D on survival of cancer patients. Overall evidence has been accumulating with contrasting results. This paper aims at narratively reviewing the existing articles examining the link between vitamin D supplementation and cancer mortality. We [...] Read more.

Several studies have investigated the beneficial effects of vitamin D on survival of cancer patients. Overall evidence has been accumulating with contrasting results. This paper aims at narratively reviewing the existing articles examining the link between vitamin D supplementation and cancer mortality. We performed two distinct searches to identify observational (ObS) studies and randomized clinical trials (RCTs) of vitamin D supplementation (VDS) in cancer patients and cohorts of general population, which included cancer mortality as an outcome. Published reports were gathered until March 2021. We identified 25 papers published between 2003 and 2020, including n. 8 RCTs on cancer patients, n. 8 population RCTs and n. 9 ObS studies. There was some evidence that the use of VDS in cancer patients could improve cancer survival, but no significant effect was found in population RCTs. Some ObS studies reported evidence that VDS was associated with a longer survival among cancer patients, and only one study found an opposite effect. The findings do not allow conclusive answers. VDS may have the potential as treatment to improve survival in cancer patients, but further investigations are warranted. We strongly support investment in well-designed and sufficiently powered RCTs to fully evaluate this association. Full article

(This article belongs to the Special Issue Associations between Dietary Patterns, Nutrition and Risk of Cancer)

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7 pages, 248 KiB

Open AccessArticle

by Huidi Zhang, Yang Cao, Pengkun Song, Qingqing Man, Deqian Mao, Yichun Hu and Lichen Yang

Nutrients 2021, 13(9), 3287; https://doi.org/10.3390/nu13093287 - 20 Sep 2021

Cited by 7 | Viewed by 2754

Abstract

Background: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio [...] Read more.

Background: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio in plasma and whole blood for 18–44 years healthy childbearing women in China. Method: A total of 1921 women of childbearing age (18–44 years) were randomly selected from the 2015 China National Nutrition and Health Survey by taking into account the regional types and monitoring points. Among them, 182 healthy women were screened out with a series strict inclusion criteria to study the reference ranges of elements. Fundamental indicators (weight, height, waist, blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein, fast glucose, HbA1c, blood pressure, uric acid) and elements concentrations in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Mg, Ca, and Ca/Mg ratio. Results: The reference range of Mg, Ca, and Ca/Mg ratio in plasma were 0.75–1.13 mmol/L, 2.27–3.43 mmol/L, and 2.41–3.44, respectively. Additionally, the reference range of Mg, Ca, and Ca/Mg ratio in whole blood were 1.28–1.83 mmol/L, 1.39–2.26 mmol/L, and 0.90–1.66, respectively. According to the established reference range, the prevalence of magnesium deficiency was 4.79% in 1921 childbearing women, 21.05% in type 2 diabetes, and 5.63% in prediabetes. Conclusion: The reference values of Mg, Ca and Ca/Mg proportion in plasma and entire blood of healthy childbearing women can be utilized as a pointer to assess the status of component lack and over-burden. The lower limit of plasma Mg is in good agreement with the recommended criteria for the determination of hypomagnesemia. Full article

(This article belongs to the Collection Nutritional Epidemiology among Chinese Populations)

16 pages, 2997 KiB

Open AccessArticle

The Effect of Dietary Protein Imbalance during Pregnancy on the Growth, Metabolism and Circulatory Metabolome of Neonatal and Weaned Juvenile Porcine Offspring

by Quentin L. Sciascia, Cornelia Prehn, Jerzy Adamski, Gürbüz Daş, Iris S. Lang, Winfried Otten, Solvig Görs and Cornelia C. Metges

Nutrients 2021, 13(9), 3286; https://doi.org/10.3390/nu13093286 - 20 Sep 2021

Cited by 1 | Viewed by 3779

Abstract

Protein imbalance during pregnancy affects women in underdeveloped and developing countries and is associated with compromised offspring growth and an increased risk of metabolic diseases in later life. We studied in a porcine model the glucose and urea metabolism, and circulatory hormone and [...] Read more.

Protein imbalance during pregnancy affects women in underdeveloped and developing countries and is associated with compromised offspring growth and an increased risk of metabolic diseases in later life. We studied in a porcine model the glucose and urea metabolism, and circulatory hormone and metabolite profile of offspring exposed during gestation, to maternal isoenergetic low–high (LP-HC), high–low (HP-LC) or adequate (AP) protein–carbohydrate ratio diets. At birth, LP-HC were lighter and the plasma acetylcarnitine to free carnitine ratios at 1 day of life was lower compared to AP offspring. Plasma urea concentrations were lower in 1 day old LP-HC offspring than HP-LC. In the juvenile period, increased insulin concentrations were observed in LP-HC and HP-LC offspring compared to AP, as was body weight from HP-LC compared to LP-HC. Plasma triglyceride concentrations were lower in 80 than 1 day old HP-LC offspring, and glucagon concentrations lower in 80 than 1 day old AP and HP-LC offspring. Plasma urea and the ratio of glucagon to insulin were lower in all 80 than 1 day old offspring. Aminoacyl-tRNA, arginine and phenylalanine, tyrosine and tryptophan metabolism, histidine and beta-alanine metabolism differed between 1 and 80 day old AP and HP-LC offspring. Maternal protein imbalance throughout pregnancy did not result in significant consequences in offspring metabolism compared to AP, indicating enormous plasticity by the placenta and developing offspring. Full article

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

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Experimental design. Primiparous sows were fed low (LP-HC; 1:10.4, n = 18), high (HP-LC; 1:1.3, n = 16) or adequate (AP; 1:5, n = 17) protein to carbohydrate ratio diets from 1 day prior to insemination until birth. Full article ">Figure 2
Intravenous glucose tolerance test conducted at 68 days of life in juvenile porcine offspring exposed to low (LP-HC; 1:10.4, n = 25), high (HP-LC; 1:1.3, n = 27), or adequate (AP; 1:5, n = 25) protein to carbohydrate ratio diets during gestation. Plasma concentrations of (A) glucose and (B) insulin. Values are LSmeans ± SE; means without a common letter differ (p < 0.05), based on Tukey post hoc analysis. Full article ">Figure 3
Partial least square discriminate analysis (PLS-DA) and significantly different metabolites between age class 1 and 80 day porcine offspring exposed to low (LP-HC; 1:10.4), high (HP-LC; 1:1.3) or adequate (AP; 1:5) protein to carbohydrate ratio diets during gestation. PLS-DA plot for (A) AP (Measure, 3 comps; Accuracy, 1; R2 = 0.97; Q2 = 0.98), (B) LP-HC (Measure, 1 comp; Accuracy, 0.875; R2 = 0.59; Q2 = 0.41), (C) HP-LC (Measure, 5 comps; Accuracy, 1; R2 = 1; Q2 = 0.97) and (D) the number of differently abundant metabolites between the different offspring (black, higher; red, lower, in age class 80 compared to 1 day offspring). Red, green and blue symbols and areas denote the data of offspring exposed to AP, LP-HC and HP-LC offspring, respectively. Full article ">

8 pages, 255 KiB

Open AccessFeature PaperArticle

Prevalence and Factors Associated with Sarcopenia in Patients on Maintenance Dialysis in Australia—A Single Centre, Cross-Sectional Study

by Marille Umakanthan, John Wing Li, Kamal Sud, Gustavo Duque, Daniel Guilfoyle, Kenneth Cho, Chris Brown, Derek Boersma and Muralikrishna Gangadharan Komala

Nutrients 2021, 13(9), 3284; https://doi.org/10.3390/nu13093284 - 20 Sep 2021

Cited by 18 | Viewed by 4764

Abstract

Background: Sarcopenia is associated with significant morbidity and mortality in patients with chronic kidney disease. The prevalence of sarcopenia in the dialysis population varies from 4% to 63%. However, the prevalence and risk factors of sarcopenia in the Australian dialysis population remain uncertain. [...] Read more.

Background: Sarcopenia is associated with significant morbidity and mortality in patients with chronic kidney disease. The prevalence of sarcopenia in the dialysis population varies from 4% to 63%. However, the prevalence and risk factors of sarcopenia in the Australian dialysis population remain uncertain. Aim: To study the prevalence of sarcopenia in patients on maintenance dialysis by using the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria of sarcopenia and to identify associated risk factors. Methods: We evaluated adult patients on maintenance haemodialysis and peritoneal dialysis in this single-centre cross-sectional study in Australia. Patient’s clinical (age, gender, dialysis modality and diabetic status) and laboratory parameters (serum albumin, calcium, phosphate, 25-hydroxy-vitamin D and parathyroid hormone levels) were investigated. We employed bioimpedance spectroscopy, hand grip dynamometer and the timed up and go test (TUG) to evaluate muscle mass, strength and function, respectively. Results: We evaluated 39 dialysis patients with a median age of 69 years old. The prevalence of sarcopenia was 18%. Sarcopenia was associated with low serum albumin (p = 0.02) and low serum phosphate level (p = 0.04). Increasing age and female sex were potential risk factors for sarcopenia (p = 0.05 and 0.08, respectively). Low lean muscle mass, reduced hand grip strength and prolonged TUG were present in 23.1%, 41% and 40.5%, respectively, of the cohort. The hand grip test had good correlation with lean muscle evaluation and the TUG. Conclusions: Sarcopenia was prevalent in 18% of maintenance haemodialysis patients from an Australian single-centre cohort, with low serum albumin and phosphate as significant risk factors. Full article

(This article belongs to the Special Issue Nutritional Assessment and Chronic Disease)

40 pages, 2647 KiB

Open AccessReview

From Diospyros kaki L. (Persimmon) Phytochemical Profile and Health Impact to New Product Perspectives and Waste Valorization

by Rosa Direito, João Rocha, Bruno Sepodes and Maria Eduardo-Figueira

Nutrients 2021, 13(9), 3283; https://doi.org/10.3390/nu13093283 - 20 Sep 2021

Cited by 25 | Viewed by 10306

Abstract

Persimmon (Diospyros kaki L.) fruit’s phytochemical profile includes carotenoids, proanthocyanidins, and gallic acid among other phenolic compounds and vitamins. A huge antioxidant potential is present given this richness in antioxidant compounds. These bioactive compounds impact on health benefits. The intersection of nutrition [...] Read more.

Persimmon (Diospyros kaki L.) fruit’s phytochemical profile includes carotenoids, proanthocyanidins, and gallic acid among other phenolic compounds and vitamins. A huge antioxidant potential is present given this richness in antioxidant compounds. These bioactive compounds impact on health benefits. The intersection of nutrition and sustainability, the key idea behind the EAT-Lancet Commission, which could improve human health and decrease the global impact of food-related health conditions such as cancer, heart disease, diabetes, and obesity, bring the discussion regarding persimmon beyond the health effects from its consumption, but also on the valorization of a very perishable food that spoils quickly. A broad option of edible products with better storage stability or solutions that apply persimmon and its byproducts in the reinvention of old products or even creating new products, or with new and better packaging for the preservation of food products with postharvest technologies to preserve and extend the shelf-life of persimmon food products. Facing a global food crisis and the climate emergency, new and better day-to-day solutions are needed right now. Therefore, the use of persimmon waste has also been discussed as a good solution to produce biofuel, eco-friendly alternative reductants for fabric dyes, green plant growth regulator, biodegradable and edible films for vegetable packaging, antimicrobial activity against foodborne methicillin-resistant Staphylococcus aureus found in retail pork, anti-Helicobacter pylori agents from pedicel extracts, and persimmon pectin-based emulsifiers to prevent lipid peroxidation, among other solutions presented in the revised literature. It has become clear that the uses for persimmon go far beyond the kitchen table and the health impact consumption demonstrated over the years. The desired sustainable transition is already in progress, however, mechanistic studies and clinical trials are essential and scaling-up is fundamental to the future. Full article

(This article belongs to the Section Phytochemicals and Human Health)

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14 pages, 294 KiB

Open AccessArticle

Adherence to the Mediterranean Diet in Association with Self-Perception of Diet Sustainability, Anthropometric and Sociodemographic Factors: A Cross-Sectional Study in Italian Adults

by Beatrice Biasini, Alice Rosi, Davide Menozzi and Francesca Scazzina

Nutrients 2021, 13(9), 3282; https://doi.org/10.3390/nu13093282 - 20 Sep 2021

Cited by 29 | Viewed by 4835

Abstract

The adoption of sustainable dietary models, such as the Mediterranean Diet (MD), can be a valuable strategy to preserve ecosystems and human health. This study aims to investigate in an Italian adult representative sample the adherence to the MD and to what extent [...] Read more.

The adoption of sustainable dietary models, such as the Mediterranean Diet (MD), can be a valuable strategy to preserve ecosystems and human health. This study aims to investigate in an Italian adult representative sample the adherence to the MD and to what extent it is associated with the self-perceived adoption of a sustainable diet, the consideration of the MD as a sustainable dietary model, and anthropometric and sociodemographic factors. By applying an online survey (n = 838, 18–65 years, 52% female), an intermediate level of MD adherence (median: 4.0, IR: 3.0–4.0) in a 0–9 range was observed. Only 50% of the total sample confirmed the MD as a sustainable dietary model, and 84% declared no or low perception of adopting a sustainable diet. Being female, having a higher income and education level, considering the MD as a sustainable dietary model, as well as the perception of having a sustainable diet were the most relevant factors influencing the probability of having a high score (?6) of adherence to the MD. This study suggests a gradual shift away from the MD in Italy and supports the need to address efforts for developing intervention strategies tailored to adults for improving diet quality. Furthermore, a public campaign should stress the link between a diet and its environmental impact to foster nutritionally adequate and eco-friendly dietary behaviors. Full article

(This article belongs to the Special Issue Mediterranean Diet and Physical Activity as Healthy Lifestyles for Human Health)

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21 pages, 1557 KiB

Open AccessReview

Associations between Digital Health Intervention Engagement and Dietary Intake: A Systematic Review

by Tessa Delaney, Matthew Mclaughlin, Alix Hall, Sze Lin Yoong, Alison Brown, Kate O'Brien, Julia Dray, Courtney Barnes, Jenna Hollis, Rebecca Wyse, John Wiggers, Rachel Sutherland and Luke Wolfenden

Nutrients 2021, 13(9), 3281; https://doi.org/10.3390/nu13093281 - 20 Sep 2021

Cited by 10 | Viewed by 4428

Abstract

There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not [...] Read more.

There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. The aim of this review is to describe the association between DHI engagement and dietary intake. A systematic search of four electronic databases and grey literature for records published before December 2019 was conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ?18 years). From 10,653 citations, seven studies were included. Five studies included usage measures of engagement and two examined subjective experiences. Narrative synthesis, using vote counting, found mixed evidence of an association with usage measures (5 of 12 associations indicated a positive relationship, 7 were inconclusive) and no evidence regarding an association with subjective experience (both studies were inconclusive). The findings provide early evidence supporting an association between measures of usage and dietary intake; however, this was inconsistent. Further research examining the association between DHI engagement and dietary intake is warranted. Full article

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

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14 pages, 1006 KiB

Open AccessArticle

Exocrine Pancreatic Function in Girls with Anorexia Nervosa

by Żaneta Malczyk, Wojciech Roczniak, Bogdan Mazur, Jarosław Kwiecień, Katarzyna Ziora, Karolina Górska-Flak and Joanna Oświęcimska

Nutrients 2021, 13(9), 3280; https://doi.org/10.3390/nu13093280 - 20 Sep 2021

Cited by 3 | Viewed by 2771

Abstract

Objectives: To assess pancreatic exocrine function in patients with anorexia nervosa using a breath test with ¹³C-labeled mixed triglycerides (MTG-BT) and to determine the relationship between the test results and selected biochemical and hormonal parameters. Material and methods: Anthropometric measurements, biochemical and [...] Read more.

Objectives: To assess pancreatic exocrine function in patients with anorexia nervosa using a breath test with ¹³C-labeled mixed triglycerides (MTG-BT) and to determine the relationship between the test results and selected biochemical and hormonal parameters. Material and methods: Anthropometric measurements, biochemical and hormonal parameters (serum leptin, soluble leptin receptor (sLR), acylated and desacylated ghrelin, free leptin index (FLI)), and MTG-BT were performed in a group of 31 girls with the restrictive type of AN, as well as 38 healthy girls (C). Results: The average cumulative dose of ¹³C-triglycerides recovered with exhaled air (%CD) was similar in both study groups, while the average time from ¹³C-triglycerides administration to peak ¹³CO₂ excretion in expired air (time to peak (TTP)) was significantly longer in patients with AN compared to C. In both groups, %CD correlated negatively with FLI. TTP correlated negatively with sLR and FLI in the AN and with serum insulin and HOMA-IR values in the C. Conclusions: In girls with AN, the pancreatic efficiency of lipase secretion was found to be normal, while the kinetics of this enzyme secretion were disturbed. These changes may result from disorders in the functioning of the adipose–insular and islet–acinar axes. Full article

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

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14 pages, 3357 KiB

Open AccessArticle

Dietary Nucleotides Retard Oxidative Stress-Induced Senescence of Human Umbilical Vein Endothelial Cells

by Na Zhu, Xinran Liu, Meihong Xu and Yong Li

Nutrients 2021, 13(9), 3279; https://doi.org/10.3390/nu13093279 - 20 Sep 2021

Cited by 9 | Viewed by 3522

Abstract

Several lines of evidence suggest an inhibitory role of dietary nucleotides (NTs) against oxidative stress and inflammation, which promote senescence in age-associated cardiovascular diseases. We sought to test whether the dietary NTs could retard the hydrogen peroxide (H₂O₂)-induced senescence [...] Read more.

Several lines of evidence suggest an inhibitory role of dietary nucleotides (NTs) against oxidative stress and inflammation, which promote senescence in age-associated cardiovascular diseases. We sought to test whether the dietary NTs could retard the hydrogen peroxide (H₂O₂)-induced senescence of human umbilical vein endothelial cells (HUVECs) and to elucidate the efficiency of different NTs as well as the potential mechanism. Senescence was induced in HUVECs by 4 h exposure to 200 µM H₂O₂ and was confirmed using senescence-associated-?-galactosidase staining (SA-?-gal), cell viability, and Western blot analyses of p16^INK4A and p21^Waf1/Cip1 after 24 h administration of growth medium. We find that NTs retards oxidative stress-induced HUVECs senescence, as shown by a lower percentage of SA-?-gal-positive cells, lower expression of p16^INK4A, and p21^Waf1/Cip1 as well as higher cell viability. GMP100 was the most excellent in delaying HUVECs senescence, which was followed by the NTs mixture, NMN, CMP50, and UMP50/100, while AMP retards HUVECs senescence by specifically reducing p15^INK4b expression. NTs all have significant anti-inflammatory effects; AMP and CMP were more prominent in restoring mitochondrial function, GMP and CMP were more competent at eliminating ROS and MDA, while AMP and UMP were more efficient at enhancing antioxidant enzyme activity. The role of the NTs mixture in retarding HUVECs senescence is full-scaled. These results stated that the mechanisms of NTs retarding HUVECs senescence could be related to its antioxidant and anti-inflammation properties promoting cell proliferation and protecting mitochondrial function activities. Full article

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

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Effect of NTs on senescent HUVECs morphological changes, cell viability, and SA-β-gal activity. (A) Effect of NTs on senescent HUVECs morphological changes using transmission electron microscopy (3000×). (B) Cell viability evaluation of NTs using the CCK-8 assay (n = 5 per group). (C) Statistical quantification of SA-β-gal-positive cells (n = 3 per group). (D) Representative image of SA-β-gal staining. Values represented the mean ± S.D. # p < 0.05 versus control group, * p < 0.05 versus model group. Full article ">Figure 2
Effect of NTs on senescent HUVECs apoptotic rate, intracellular ROS production, and mitochondrial membrane potential. (A) Effect of NTs on senescent HUVECs apoptotic rate; (B) Effect of NTs on senescent HUVECs intracellular ROS production; (C) Effect of NTs on senescent HUVECs mitochondrial membrane potential. Values represented the mean ± S.D. (n = 3 per group). # p < 0.05 versus control group, * p < 0.05 versus model group. Full article ">Figure 2 Cont.
Effect of NTs on senescent HUVECs apoptotic rate, intracellular ROS production, and mitochondrial membrane potential. (A) Effect of NTs on senescent HUVECs apoptotic rate; (B) Effect of NTs on senescent HUVECs intracellular ROS production; (C) Effect of NTs on senescent HUVECs mitochondrial membrane potential. Values represented the mean ± S.D. (n = 3 per group). # p < 0.05 versus control group, * p < 0.05 versus model group. Full article ">Figure 3
Effect of NTs on senescent HUVECs SASP, antioxidant activity, NAD+ levels, NAD+/NADH ratio, and ATP production. (A) IL-1β concentration in senescent HUVECs supernatant; (B) IL-6 concentration in senescent HUVECs supernatant; (C) MMP-3 concentration in senescent HUVECs supernatant; (D) sICAM-1 concentration in senescent HUVECs supernatant; (E) VCAM-1 concentration in senescent HUVECs supernatant; (F) IL-17 concentration in senescent HUVECs supernatant; (G) GSH-Px activities in senescent HUVECs; (H) SOD activities in senescent HUVECs; (I) MDA levels in senescent HUVECs; (J) NAD+ levels in senescent HUVECs; (K) NAD+/NADH in senescent HUVECs; (L) ATP production in senescent HUVECs. Values represented the mean ± S.D. (n = 3 per group). # p < 0.05 versus control group, * p < 0.05 versus model group. Full article ">Figure 4
Effect of NTs on the protein expression of p16INK4A, p21Waf1/Cip1, p15INK4b, and ACE-2. (A) The Western blot strip in all groups; (B,E,H,K). The protein expression of p16INK4A, p21Waf1/Cip1, p15 INK4b, and ACE-2 in the NMN and AMP50/100/200 groups; (C,F,I,L). The protein expression of p16INK4A, p21Waf1/Cip1, p15 INK4b, and ACE-2 in the CMP50/100/200 and GMP50/100/200 groups; (D,G,J,M). The protein expression of p16INK4A, p21Waf1/Cip1, p15 INK4b, and ACE-2 in the UMP50/100/200 group. Values represented the mean ± S.D. (n = 3 per group). # p < 0.05 versus control group, * p < 0.05 versus model group. Full article ">

8 pages, 505 KiB

Open AccessReview

Maternal Fructose Diet-Induced Developmental Programming

by Michael D. Thompson and Brian J. DeBosch

Nutrients 2021, 13(9), 3278; https://doi.org/10.3390/nu13093278 - 20 Sep 2021

Cited by 12 | Viewed by 4459

Abstract

Developmental programming of chronic diseases by perinatal exposures/events is the basic tenet of the developmental origins hypothesis of adult disease (DOHaD). With consumption of fructose becoming more common in the diet, the effect of fructose exposure during pregnancy and lactation is of increasing [...] Read more.

Developmental programming of chronic diseases by perinatal exposures/events is the basic tenet of the developmental origins hypothesis of adult disease (DOHaD). With consumption of fructose becoming more common in the diet, the effect of fructose exposure during pregnancy and lactation is of increasing relevance. Human studies have identified a clear effect of fructose consumption on maternal health, but little is known of the direct or indirect effects on offspring. Animal models have been utilized to evaluate this concept and an association between maternal fructose and offspring chronic disease, including hypertension and metabolic syndrome. This review will address the mechanisms of developmental programming by maternal fructose and potential options for intervention. Full article

(This article belongs to the Special Issue Fructose Metabolism and Metabolic Health Effects)

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16 pages, 552 KiB

Open AccessReview

Chronic Kidney Disease: Role of Diet for a Reduction in the Severity of the Disease

by Tania Naber and Sharad Purohit

Nutrients 2021, 13(9), 3277; https://doi.org/10.3390/nu13093277 - 19 Sep 2021

Cited by 76 | Viewed by 25285

Abstract

Chronic kidney disease affects ~37 million adults in the US, and it is often undiagnosed due to a lack of apparent symptoms in early stages. Chronic kidney disease (CKD) interferes with the body’s physiological and biological mechanisms, such as fluid electrolyte and pH [...] Read more.

Chronic kidney disease affects ~37 million adults in the US, and it is often undiagnosed due to a lack of apparent symptoms in early stages. Chronic kidney disease (CKD) interferes with the body’s physiological and biological mechanisms, such as fluid electrolyte and pH balance, blood pressure regulation, excretion of toxins and waste, vitamin D metabolism, and hormonal regulation. Many CKD patients are at risk of hyperkalemia, hyperphosphatemia, chronic metabolic acidosis, bone deterioration, blood pressure abnormalities, and edema. These risks may be minimized, and the disease’s progression may be slowed through careful monitoring of protein, phosphorus, potassium, sodium, and calcium, relieving symptoms experienced by CKD patients. In this review, the current Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations are highlighted, reflecting the 2020 update, including explanations for the pathophysiology behind the recommendations. The Dietary Approaches to Stop Hypertension, the Mediterranean diet, and the whole foods plant-based diet are currently being examined for their potential role in delaying CKD progression. Biological explanations for why the whole foods plant-based diet may benefit CKD patients compared to diets that include animal products are examined. Strong evidence continues to support the importance of diet meeting the daily requirement in the prevention and progression of kidney disease, and medical nutrition therapy with a registered dietitian is a critical aspect in medical intervention for CKD. Full article

(This article belongs to the Special Issue Nutrition in Chronic Conditions)

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13 pages, 769 KiB

Open AccessReview

Energy Balance and Control of Body Weight: Possible Effects of Meal Timing and Circadian Rhythm Dysregulation

by Alessio Basolo, Susanna Bechi Genzano, Paolo Piaggi, Jonathan Krakoff and Ferruccio Santini

Nutrients 2021, 13(9), 3276; https://doi.org/10.3390/nu13093276 - 19 Sep 2021

Cited by 25 | Viewed by 12146

Abstract

Conservation of the energy equilibrium can be considered a dynamic process and variations of one component (energy intake or energy expenditure) cause biological and/or behavioral compensatory changes in the other part of the system. The interplay between energy demand and caloric intake appears [...] Read more.

Conservation of the energy equilibrium can be considered a dynamic process and variations of one component (energy intake or energy expenditure) cause biological and/or behavioral compensatory changes in the other part of the system. The interplay between energy demand and caloric intake appears designed to guarantee an adequate food supply in variable life contexts. The circadian rhythm plays a major role in systemic homeostasis by acting as “timekeeper” of the human body, under the control of central and peripheral clocks that regulate many physiological functions such as sleep, hunger and body temperature. Clock-associated biological processes anticipate the daily demands imposed by the environment, being synchronized under ideal physiologic conditions. Factors that interfere with the expected demand, including daily distribution of macronutrients, physical activity and light exposure, may disrupt the physiologic harmony between predicted and actual behavior. Such a desynchronization may favor the development of a wide range of disease-related processes, including obesity and its comorbidities. Evidence has been provided that the main components of 24-h EE may be affected by disruption of the circadian rhythm. The sleep pattern, meal timing and meal composition could mediate these effects. An increased understanding of the crosstalk between disruption of the circadian rhythm and energy balance may shed light on the pathophysiologic mechanisms underlying weight gain, which may eventually lead to design effective strategies to fight the obesity pandemic. Full article

(This article belongs to the Special Issue Chrononutrition and Chronic Diseases)

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11 pages, 278 KiB

Open AccessArticle

Self-Reported Restrictive Eating, Eating Disorders, Menstrual Dysfunction, and Injuries in Athletes Competing at Different Levels and Sports

by Suvi Ravi, Johanna K. Ihalainen, Ritva S. Taipale-Mikkonen, Urho M. Kujala, Benjamin Waller, Laura Mierlahti, Johanna Lehto and Maarit Valtonen

Nutrients 2021, 13(9), 3275; https://doi.org/10.3390/nu13093275 - 19 Sep 2021

Cited by 32 | Viewed by 9405

Abstract

The purpose of this study was to investigate the prevalence of self-reported restrictive eating, current or past eating disorder, and menstrual dysfunction and their relationships with injuries. Furthermore, we aimed to compare these prevalences and associations between younger (aged 15–24) and older (aged [...] Read more.

The purpose of this study was to investigate the prevalence of self-reported restrictive eating, current or past eating disorder, and menstrual dysfunction and their relationships with injuries. Furthermore, we aimed to compare these prevalences and associations between younger (aged 15–24) and older (aged 25–45) athletes, between elite and non-elite athletes, and between athletes competing in lean and non-lean sports. Data were collected using a web-based questionnaire. Participants were 846 female athletes representing 67 different sports. Results showed that 25%, 18%, and 32% of the athletes reported restrictive eating, eating disorders, and menstrual dysfunction, respectively. Higher rates of lean sport athletes compared with non-lean sport athletes reported these symptoms, while no differences were found between elite and non-elite athletes. Younger athletes reported higher rates of menstrual dysfunction and lower lifetime prevalence of eating disorders. Both restrictive eating (OR 1.41, 95% CI 1.02–1.94) and eating disorders (OR 1.89, 95% CI 1.31–2.73) were associated with injuries, while menstrual dysfunction was associated with more missed participation days compared with a regular menstrual cycle (OR 1.79, 95% CI 1.05–3.07). Our findings indicate that eating disorder symptoms and menstrual dysfunction are common problems in athletes that should be managed properly as they are linked to injuries and missed training/competition days. Full article

(This article belongs to the Section Sports Nutrition)

10 pages, 486 KiB

Open AccessFeature PaperArticle

Stored Energy Increases Body Weight and Skeletal Muscle Mass in Older, Underweight Patients after Stroke

by Yoshihiro Yoshimura, Hidetaka Wakabayashi, Ryo Momosaki, Fumihiko Nagano, Takahiro Bise, Sayuri Shimazu and Ai Shiraishi

Nutrients 2021, 13(9), 3274; https://doi.org/10.3390/nu13093274 - 19 Sep 2021

Cited by 22 | Viewed by 5973

Abstract

We conducted a retrospective observational study in 170 older, underweight patients after stroke to elucidate whether stored energy was associated with gains in body weight (BW) and skeletal muscle mass (SMM). Energy intake was recorded on admission. The energy requirement was estimated as [...] Read more.

We conducted a retrospective observational study in 170 older, underweight patients after stroke to elucidate whether stored energy was associated with gains in body weight (BW) and skeletal muscle mass (SMM). Energy intake was recorded on admission. The energy requirement was estimated as actual BW (kg) × 30 (kcal/day), and the stored energy was defined as the energy intake minus the energy requirement. Body composition was measured by bioelectrical impedance analysis. The study participants gained an average of 1.0 ± 2.6 kg of BW over a mean hospital stay of 100 ± 42 days with a mean stored energy of 96.2 ± 91.4 kcal per day. They also gained an average of 0.2 ± 1.6 kg of SMM and 0.5 ± 2.3 kg of fat mass (FM). This means about 9600 kcal were needed to gain 1 kg of BW. In addition, a 1 kg increase in body weight resulted in a 23.7% increase in SMM and a 45.8% increase in FM. Multivariate regression analyses showed that the stored energy was significantly associated with gains in BW and SMM. Aggressive nutrition therapy is important for improving nutritional status and function in patients with malnutrition and sarcopenia. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Nutrition in Stroke Rehabilitation)

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14 pages, 4279 KiB

Open AccessArticle

DW2009 Elevates the Efficacy of Donepezil against Cognitive Impairment in Mice

by Dong-Yun Lee, Jeon-Kyung Kim, Soo-Won Yun, Myung Joo Han and Dong-Hyun Kim

Nutrients 2021, 13(9), 3273; https://doi.org/10.3390/nu13093273 - 19 Sep 2021

Cited by 8 | Viewed by 3696

Abstract

Lactobacillus plantarum C29 and DW2009 (C29-fermented soybean) alleviate cognitive impairment through the modulation of the microbiota-gut-brain axis. Therefore, we examined whether combining donepezil, a well-known acetylcholinesterase inhibitor, with C29 or DW2009 could synergistically alleviate cognitive impairment in mice. Oral administration of donepezil combined [...] Read more.

Lactobacillus plantarum C29 and DW2009 (C29-fermented soybean) alleviate cognitive impairment through the modulation of the microbiota-gut-brain axis. Therefore, we examined whether combining donepezil, a well-known acetylcholinesterase inhibitor, with C29 or DW2009 could synergistically alleviate cognitive impairment in mice. Oral administration of donepezil combined with or without C29 (DC) or DW2009 (DD) alleviated lipopolysaccharide (LPS)-induced cognitive impairment-like behaviors more strongly than treatment with each one alone. Their treatments significantly suppressed the NF-?B⁺/Iba1⁺ (activated microglia) population, NF-?B activation, and tumor necrosis factor-? and interleukin-1? expression in the hippocampus, while the brain-derived neurotropic factor (BDNF)⁺/NeuN⁺ cell population and BDNF expression increased. Their treatments strongly suppressed LPS-induced colitis. Moreover, they increased the Firmicutes population and decreased the Cyanobacteria population in gut microbiota. Of these, DD most strongly alleviated cognitive impairment, followed by DC. In conclusion, DW2009 may synergistically or additively increase the effect of donepezil against cognitive impairment and colitis by regulating NF-?B-mediated BDNF expression. Full article

(This article belongs to the Section Phytochemicals and Human Health)

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13 pages, 415 KiB

Open AccessFeature PaperArticle

Effects of Individual Dietary Intervention on Nutrient Intake in Postpartum Japanese Women: A Randomized Controlled Trial

by Mie Shiraishi, Masayo Matsuzaki, Rina Tsunematsu, Sachi Watanabe, Risa Kobayashi and Megumi Haruna

Nutrients 2021, 13(9), 3272; https://doi.org/10.3390/nu13093272 - 19 Sep 2021

Cited by 3 | Viewed by 4062

Abstract

No dietary intervention that focuses on the diet quality of postpartum women has been developed in Japan, although most postpartum women experience an insufficient intake of vitamins and minerals. We aimed to examine whether dietary intervention, based on the health belief model, at [...] Read more.

No dietary intervention that focuses on the diet quality of postpartum women has been developed in Japan, although most postpartum women experience an insufficient intake of vitamins and minerals. We aimed to examine whether dietary intervention, based on the health belief model, at both 1 and 3 months postpartum affects nutrient intake and food group consumption at 6 months postpartum. A randomized controlled trial was conducted at a university hospital in Tokyo between 2015 and 2016. Healthy women at 1 month postpartum were randomly allocated to either an intervention group (n = 100) or a control group (n = 94). Dietary intervention included dietary assessment, individual feedback, and dietary guidance. The dietary intakes between the two groups were compared using the Mann-Whitney U test. At 6 months postpartum, the energy-adjusted intakes of protein, total dietary fiber, potassium, magnesium, phosphorus, zinc, vitamin B₆, and ?-carotene were significantly higher in the intervention group than in the control group. The changes in energy-adjusted intakes of total dietary fiber and iron from 1 month postpartum to 6 months postpartum were significantly different between the two groups. Dietary intervention based on the health belief model improved nutrition at 6 months postpartum, although the impact was limited. Full article

(This article belongs to the Special Issue Nutrition Education in the Perinatal Period)

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14 pages, 3925 KiB

Open AccessArticle

Ghee Butter from Bovine Colostrum Reduces Inflammation in the Mouse Model of Acute Pancreatitis with Potential Involvement of Free Fatty Acid Receptors

by Aleksandra Tarasiuk, Marcin Talar, Kamila Bulak and Jakub Fichna

Nutrients 2021, 13(9), 3271; https://doi.org/10.3390/nu13093271 - 19 Sep 2021

Cited by 3 | Viewed by 6054

Abstract

Acute pancreatitis (AP) is an inflammatory disease that causes severe tissue damage. Ghee butter from bovine colostrum (GBBC) is a clarified butter produced by heating milk fat to 40 °C and separating the precipitating protein. As colostrum mainly contains fatty acids (FAs), immunoglobulins, [...] Read more.

Acute pancreatitis (AP) is an inflammatory disease that causes severe tissue damage. Ghee butter from bovine colostrum (GBBC) is a clarified butter produced by heating milk fat to 40 °C and separating the precipitating protein. As colostrum mainly contains fatty acids (FAs), immunoglobulins, maternal immune cells, and cytokines, we hypothesized that it may exert anti-inflammatory effects. We investigated the effects of GBBC on experimental AP in mice. Two intraperitoneal (ip) injections of L-arginine (8%) were given 1 h apart to generate the AP murine model. After 12 h from the first L-arginine injection, mice were divided into the following experimental groups: AP mice treated with GBBC (oral gavage (po) every 12 h) and non-treated AP mice (po vehicle every 12 h). Control animals received vehicle only. At 72 h, mice were euthanized. Histopathological examination along with myeloperoxidase (MPO) and amylase/lipase activity assays were performed. In a separate set of experiments, FFAR1 and FFAR4 antagonists were used to verify the involvement of respective receptors. Administration of GBBC decreased MPO activity in the pancreas and lungs along with the microscopical severity of AP in mice. Moreover, treatment with GBBC normalized pancreatic enzyme activity. FFAR1 and FFAR4 antagonists tended to reverse the anti-inflammatory effect of GBBC in mouse AP. Our results suggest that GBBC displays anti-inflammatory effects in the mouse model of AP, with the putative involvement of FFARs. This is the first study to show the anti-inflammatory potential of a nutritional supplement derived from GBBC. Full article

(This article belongs to the Section Lipids)

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11 pages, 617 KiB

Open AccessFeature PaperArticle

Human Leukocyte Antigen (HLA) Typing Study Identifies Maternal DQ2 Susceptibility Alleles among Infertile Women: Potential Associations with Autoimmunity and Micronutrients

by Paola Triggianese, Carlo Perricone, Erica De Martino, Arianna D’Antonio, Maria Sole Chimenti, Paola Conigliaro, Sara Ferrigno, Ilio Giambini, Elisabetta Greco and Caterina De Carolis

Nutrients 2021, 13(9), 3270; https://doi.org/10.3390/nu13093270 - 19 Sep 2021

Cited by 6 | Viewed by 3798

Abstract

Background. The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status. Methods. Consecutive women ( [...] Read more.

Background. The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status. Methods. Consecutive women (n = 187) with infertility and RSA, and controls (n = 350) were included. All women were genotyped for HLA-DQ2 (DQA1*0201, A1*05, and B1*02) and -DQ8 (DQA1*03 and DQB1*0302) alleles. Serum 25(OH)D, VB12, folate, and ferritin were evaluated. Results. DQA1*05/B1*02 and the occurrence of at least one DQ2 allele were more prevalent among RSA and infertile women than controls. Infertile women showed lower 25(OH)D and higher prevalence of AIDs than RSA women. In the multivariate analysis, DQA1*05/B1*02 was associated with a significantly higher risk of AIDs in infertile women, and DQA1*05 was independently associated with both 25(OH)D deficiency and AIDs. In RSA women, the presence of AIDs was associated with a significantly higher risk of 25(OH)D deficiency. Conclusion. Our findings showed, for the first time, a higher proportion of DQ2 alleles in infertile and RSA women as compared to controls. Predisposing DQ2 alleles are independent risk factors for AIDs and 25(OH)D deficiency in infertile women and could represent biomarkers for performing early detection of women requiring individually tailored management. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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28 pages, 2967 KiB

Open AccessReview

Nuts: Natural Pleiotropic Nutraceuticals

by Emilio Ros, Annapoorna Singh and James H. O’Keefe

Nutrients 2021, 13(9), 3269; https://doi.org/10.3390/nu13093269 - 19 Sep 2021

Cited by 75 | Viewed by 15337

Abstract

Common nuts (tree nuts and peanuts) are energy-dense foods that nature has gifted with a complex matrix of beneficial nutrients and bioactives, including monounsaturated and polyunsaturated fatty acids, high-quality protein, fiber, non-sodium minerals, tocopherols, phytosterols, and antioxidant phenolics. These nut components synergize to [...] Read more.

Common nuts (tree nuts and peanuts) are energy-dense foods that nature has gifted with a complex matrix of beneficial nutrients and bioactives, including monounsaturated and polyunsaturated fatty acids, high-quality protein, fiber, non-sodium minerals, tocopherols, phytosterols, and antioxidant phenolics. These nut components synergize to favorably influence metabolic and vascular physiology pathways, ameliorate cardiovascular risk factors and improve cardiovascular prognosis. There is increasing evidence that nuts positively impact myriad other health outcomes as well. Nut consumption is correlated with lower cancer incidence and cancer mortality, and decreased all-cause mortality. Favorable effects on cognitive function and depression have also been reported. Randomized controlled trials consistently show nuts have a cholesterol-lowering effect. Nut consumption also confers modest improvements on glycemic control, blood pressure (BP), endothelial function, and inflammation. Although nuts are energy-dense foods, they do not predispose to obesity, and in fact may even help in weight loss. Tree nuts and peanuts, but not peanut butter, generally produce similar positive effects on outcomes. First level evidence from the PREDIMED trial shows that, in the context of a Mediterranean diet, consumption of 30 g/d of nuts (walnuts, almonds, and hazelnuts) significantly lowered the risk of a composite endpoint of major adverse cardiovascular events (myocardial infarction, stroke, and death from cardiovascular disease) by ?30% after intervention for 5 y. Impressively, the nut-supplemented diet reduced stroke risk by 45%. As they are rich in salutary bioactive compounds and beneficially impact various health outcomes, nuts can be considered natural pleiotropic nutraceuticals. Full article

(This article belongs to the Special Issue Nutraceutical Approaches to Cardiovascular and Metabolic Diseases: Evidence and Opportunities)

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Percent fatty acid profile of common nuts. Full article ">Figure 2
Schematic representation of the effects of nuts on risk of cardiometabolic diseases mediated by their main bioactive nutrients and phytochemicals (yellow boxes), which synergize to positively influence metabolic and vascular physiology pathways (thin arrows and orange boxes). The net effects on intermediate markers of CV risk are lowering of blood cholesterol, improved glycemic control, decreased blood pressure, improved vascular reactivity, and anti-inflammatory actions. Crucially, clinical trials of nuts have demonstrated all such effects. The overall result is reduced cardiometabolic risk (thick arrow connections), as observed in many prospective cohort studies and proven in the PREDIMED trial. Abbreviations: Ca, calcium; K, potassium; LDL-C, LDL-cholesterol; Mg, magnesium; NO, nitric oxide; TG, triglycerides. ↑: increase, ↓: decrease. Full article ">Figure 3
Percentage change for adiposity outcomes in the healthy/normal weight groups vs. the overweight/obesity group with regard to the length of time following the nut interventions in 105 RCTs. Reproduced from reference [<a href="#B64-nutrients-13-03269" class="html-bibr">64</a>], with permission. BW: body weight; BMI: body mass index; WC: waist circumference; % BF: body fat percentage. Full article ">Figure 4
LDL-cholesterol responses to nut diets by baseline LDL-cholesterol and BMI. Data obtained in a pooled study of 25 nut RCTs (adapted from ref. [<a href="#B67-nutrients-13-03269" class="html-bibr">67</a>] with permission). Full article ">Figure 5
Cumulative incidence of stroke by intervention group in the PREDIMED trial [<a href="#B23-nutrients-13-03269" class="html-bibr">23</a>]. Copyright © (2018) Massachusetts Medical Society. Reprinted with permission. Med diet, Mediterranean diet; EVOO, extra-virgin olive oil. Full article ">

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