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Nutrients, Volume 14, Issue 19 (October-1 2022) – 338 articles

Cover Story (view full-size image): Melatonin has become a popular dietary supplement, most known as a chronobiotic, and for establishing healthy sleep. Research over the last decade into cancer, Alzheimer’s disease, multiple sclerosis, fertility, PCOS, and many other conditions, combined with the COVID-19 pandemic, has led to greater awareness of melatonin because of its ability to act as a potent antioxidant, immune-active agent, and mitochondrial regulator. There are distinct similarities between melatonin and vitamin D in the depth and breadth of their impact on health. Both act as hormones, affect multiple systems through their immune-modulating, anti-inflammatory functions, are found in the skin, and are responsive to sunlight and darkness. View this paper
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16 pages, 1177 KiB  
Article
Effectiveness of a Multi-Strategy Behavioral Intervention to Increase Vegetable Sales in Primary School Canteens: A Randomized Controlled Trial
by Astrid A. M. Poelman, Shadia Djakovic, Jessica E. Heffernan, Maeva Cochet-Broch, Rebecca K. Golley, David N. Cox and Janne Beelen
Nutrients 2022, 14(19), 4218; https://doi.org/10.3390/nu14194218 - 10 Oct 2022
Cited by 1 | Viewed by 2728
Abstract
Children’s vegetable intake remains inadequate and school canteens may provide opportunities to address this public health concern. This study aimed to determine the effectiveness of an 8-week multi-strategy behavioral intervention that included vegetable provisioning and online menu architecture on vegetable sales in primary [...] Read more.
Children’s vegetable intake remains inadequate and school canteens may provide opportunities to address this public health concern. This study aimed to determine the effectiveness of an 8-week multi-strategy behavioral intervention that included vegetable provisioning and online menu architecture on vegetable sales in primary school canteens. A randomized controlled trial was undertaken in 16 Australian primary schools (n = 4302 students). The control arm kept their regular canteen menu. The primary outcome was vegetable sales measured by assessing vegetable content (in grams) from all menu items and using canteen sales (ordered online and over-the-counter) to calculate vegetable sales (in grams/week) at baseline (3 weeks) and during intervention implementation (8 weeks). Secondary outcomes were vegetable sales in subcategories, intervention acceptability among canteen managers and vegetable waste (four schools). Linear mixed model analysis showed that from baseline to follow-up, the intervention group had significantly higher weekly vegetable sales overall compared with the control group (2707 g/week, 95% CI 1276 to 4137 g/week; p < 0.001), with increased vegetable sales in the subcategories of burgers, hot foods and snacks, but not in sandwiches and pasta/rice dishes. The intervention did not lead to more vegetable waste, nor to a decrease in canteen revenue. The canteen managers found the intervention easy to implement and felt children responded favorably to three of the seven strategies. In conclusion, a multi-strategy behavioral canteen intervention increased vegetable sales amongst primary school students. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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14 pages, 2637 KiB  
Article
Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis
by Monika Olczak-Pruc, Damian Swieczkowski, Jerzy R. Ladny, Michal Pruc, Raul Juarez-Vela, Zubaid Rafique, Frank W. Peacock and Lukasz Szarpak
Nutrients 2022, 14(19), 4217; https://doi.org/10.3390/nu14194217 - 10 Oct 2022
Cited by 26 | Viewed by 6905
Abstract
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), millions of people have died, and the medical system has faced significant difficulties. Our purpose was to perform a meta-analysis to estimate the effect [...] Read more.
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), millions of people have died, and the medical system has faced significant difficulties. Our purpose was to perform a meta-analysis to estimate the effect of vitamin C on in-hospital mortality and the ICU or hospital length of stay for patients diagnosed with COVID-19. We conducted a systematic review with meta-analysis in the following databases: PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials. We included studies that evaluated the effect of vitamin C supplementation, compared with standard treatment in COVID-19 patients who are ≥18 y of age. Nineteen trials were included in the meta-analysis. In-hospital mortality with and without vitamin C supplementation was 24.1% vs. 33.9% (OR = 0.59; 95%CI: 0.37 to 0.95; p = 0.03), respectively. Sub-analysis showed that, in randomized clinical trials, in-hospital mortality varied and amounted to 23.9% vs. 35.8% (OR = 0.44; 95%CI: 0.25 to 0.76; p = 0.003), respectively. In the non-randomized trials, in-hospital mortality was 24.2% vs. 33.5% (OR = 0.72; 95%CI: 0.38 to 1.39; p = 0.33), respectively. The ICU length of stay was longer in patients treated with vitamin C vs. standard therapy, 11.1 (7.3) vs. 8.3 (4.7) days (MD = 1.91; 95%CI: 0.89 to 2.93; p < 0.001), respectively. Acute kidney injury in patients treated with and without vitamin C varied and amounted to 27.8% vs. 45.0% (OR = 0.56; 95%CI: 0.40 to 0.78; p < 0.001), respectively. There were no differences in the frequency of other adverse events among patients’ treatment with and without vitamin C (all p > 0.05). The use of vitamin C reduces hospital mortality. The length of stay in the ICU is longer among patients treated with vitamin C. In terms of patient safety, vitamin C has an acceptable profile. Low doses of vitamin C are effective and safe. Despite some evidence of the usefulness of vitamin C in modifying the course of COVID-19, it is too early to modify guidelines and recommendations. Further studies, in particular randomized clinical trials, are necessary. Full article
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15 pages, 1218 KiB  
Article
Intermittent Fasting—Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial
by Katharina Anic, Mona W. Schmidt, Larissa Furtado, Lina Weidenbach, Marco J. Battista, Marcus Schmidt, Roxana Schwab, Walburgis Brenner, Christian Ruckes, Johannes Lotz, Karl J. Lackner, Annbalou Hasenburg and Annette Hasenburg
Nutrients 2022, 14(19), 4216; https://doi.org/10.3390/nu14194216 - 10 Oct 2022
Cited by 13 | Viewed by 39010
Abstract
Background: Intermittent fasting (IF) is defined as an eating pattern without calorie restrictions, alternating between periods of fasting and eating. In the past decades IF has not only become a popular weight-reducing diet but is thought to improve Quality of Life (QoL) and [...] Read more.
Background: Intermittent fasting (IF) is defined as an eating pattern without calorie restrictions, alternating between periods of fasting and eating. In the past decades IF has not only become a popular weight-reducing diet but is thought to improve Quality of Life (QoL) and fatigue. However, very little evidence exists for the general population. Thus, we aimed to assess the impact of a 16-h fasting period per day over a three-month study period on QoL and especially fatigue in healthy people. Methods: We conducted a prospective cohort study including healthy subjects. All participants fasted 16 h for at least five days a week while maintaining their normal lifestyle. In the study, we analysed blood samples as well as QoL through standardized questionnaires (WHO-5 questionnaire, Short Form Health 36). Furthermore, we measured the degree of fatigue with the Fatigue Assessment Scale (FAS) and Fatigue Severity Scale (FSS) as well as compliance, activity records, and weight alterations. All endpoints were evaluated at baseline, after two weeks, four weeks, and three months of IF. Results: A total of 30 participants fasted for the entire study period. The results of the WHO-5 questionnaire (15.6 ± 4.6 vs. 18 ± 3.6, p < 0.0019) demonstrated a significant increase in QoL. For long-term QoL six out of eight domains measured by the Short Form Health 36 (SF-36) significantly improved (e.g., physical health: 92.3 ± 11.6 vs. 96.5 ± 6.3, p = 0.015; mental health: 75.5 ± 12.0 vs. 81.7 ± 9.0; p < 0.001 and body pain: 74.1 ± 31.8 vs. 89.5 ± 14.9; p = 0.008) after three months. Fatigue significantly decreased from 10.3 ± 3.2 to 8.4 ± 2.5; p = 0.002 for mental fatigue and from 12.6 ± 3.8 to 10.7 ± 3.3; p = 0.002 measured by the FAS. The mean FSS-Score at baseline was 3.5 ± 1.2 compared to 2.9 ± 1.1 (scale 1–7) after three months (p < 0.001). Notably, the proliferation marker IGF-1 was significantly reduced. No clinically significant changes in laboratory parameters were observed that would have endangered a participant’s safety. Conclusions: IF according to the 16:8 regime over a fasting period of three months significantly improved several aspects of the QoL and decreased fatigue in healthy people, while maintaining a good safety profile. The practicability of this diet was also demonstrated for shift workers and people with a high percentage of active labour. Apart from the improvement in QoL and fatigue, the significant reduction in IGF-1, which can act as an accelerator of tumour development and progression, might be an indicator of the potential benefits of IF for patients with cancer. Full article
(This article belongs to the Special Issue Mechanisms and Health Effects of Periodic and Intermittent Fasting)
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15 pages, 314 KiB  
Article
Association between Dietary Habits and Helicobacter pylori Infection among Bahraini Adults
by Fatema Habbash, Tariq Abdulkarim Alalwan, Simone Perna, Naila Ahmed, Omar Sharif, Adel Al Sayyad, Clara Gasparri, Cinzia Ferraris and Mariangela Rondanelli
Nutrients 2022, 14(19), 4215; https://doi.org/10.3390/nu14194215 - 10 Oct 2022
Cited by 7 | Viewed by 3869
Abstract
Helicobacter pylori (H. Pylori) infection is the main bacterial cause of several gastrointestinal disorders. This study aims to estimate the prevalence of H. pylori infection in a population of Bahraini adults seeking care in gastroenterology clinics in a tertiary care hospital [...] Read more.
Helicobacter pylori (H. Pylori) infection is the main bacterial cause of several gastrointestinal disorders. This study aims to estimate the prevalence of H. pylori infection in a population of Bahraini adults seeking care in gastroenterology clinics in a tertiary care hospital in the Kingdom of Bahrain and examine the association between dietary habits and other factors with H. pylori infection. The study is a hospital-based retrospective, cross-sectional analytical study that included 200 participants. H. pylori infection prevalence among the studied group was 55.5%, and it was significantly higher among participants with a high school education or less (44.1%). Among dietary habits, the mean of frequency of green tea, coffee and honey intake was significantly lower among the H. pylori infected participants compared to their non-infected counterparts. H. pylori infection was significantly higher among participants with vitamin D deficiency (63.6%) compared to participants with normal vitamin D (30%) (p = 0.001) and each unit decrease in serum vitamin D was associated with an increased risk of infection by 1.1 times (OR = 1.1; 95% CI: 1.05, 1.18; p < 0.001). The study revealed that high educational levels, consumption of honey, green tea, and coffee, as well as normal serum vitamin D level, were independent protectors against H. pylori infection. Additional studies are needed to estimate the prevalence and predisposing factors of H. pylori infection in the general population. Full article
(This article belongs to the Special Issue Nutrition in Chronic Conditions)
15 pages, 1173 KiB  
Article
Short-Term Effect of Additional Daily Dietary Fibre Intake on Appetite, Satiety, Gastrointestinal Comfort, Acceptability, and Feasibility
by Erika Borkoles, Digby Krastins, Jolieke C. van der Pols, Paul Sims and Remco Polman
Nutrients 2022, 14(19), 4214; https://doi.org/10.3390/nu14194214 - 10 Oct 2022
Cited by 5 | Viewed by 3203
Abstract
Background: There is evidence that high-fibre diets have significant health benefits, although the effect of increasing fibre on individuals’ appetite, satiety, and gastrointestinal comfort is not well established, nor is its acceptability and feasibility. Methods: This mixed-methods feasibility randomised control trial [...] Read more.
Background: There is evidence that high-fibre diets have significant health benefits, although the effect of increasing fibre on individuals’ appetite, satiety, and gastrointestinal comfort is not well established, nor is its acceptability and feasibility. Methods: This mixed-methods feasibility randomised control trial included 38 participants allocated to one of three conditions: FibreMAX (two daily servings of 25 g of BARLEYmax®), FibreGRAD (two daily servings with the amount of fibre gradually increased), and Control (two daily servings totalling 25 g of placebo product). Participants completed a food diary at baseline. The Hunger and Fullness Questionnaire and questions regarding gastrointestinal response were completed at baseline and at the end of each week. Participants completed the acceptability of intervention measure and engaged in a semi-structured interview, following trial completion. Results: The qualitative data suggested that increased fibre influenced appetite and fullness perceptions. Baseline fibre consumption and the method of increased fibre increase did not influence our findings. The qualitative results also indicated that the fibre intake was perceived as beneficial to well-being; it influenced feelings of hunger and caused some minor acute gastrointestinal symptoms that dissipated after a short adaption period. Conclusion: This study suggests that increasing fibre intake through BARLEYmax® is a safe intervention that is acceptable to participants. Full article
(This article belongs to the Section Nutrition and Public Health)
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14 pages, 1156 KiB  
Article
Impact of a Very Low-Calorie Ketogenic Diet (VLCKD) on Changes in Handgrip Strength in Women with Obesity
by Luigi Barrea, Giulia de Alteriis, Giovanna Muscogiuri, Claudia Vetrani, Ludovica Verde, Elisabetta Camajani, Sara Aprano, Annamaria Colao and Silvia Savastano
Nutrients 2022, 14(19), 4213; https://doi.org/10.3390/nu14194213 - 10 Oct 2022
Cited by 22 | Viewed by 4381
Abstract
The preservation of muscle mass, which is positively associated with muscle strength, has been included among the benefits of ketogenic diets due to the synergistic effects exerted by the reduction in visceral adipose tissue and obesity-related pro-inflammatory status. The handgrip strength (HGS) test [...] Read more.
The preservation of muscle mass, which is positively associated with muscle strength, has been included among the benefits of ketogenic diets due to the synergistic effects exerted by the reduction in visceral adipose tissue and obesity-related pro-inflammatory status. The handgrip strength (HGS) test is widely used as a single indicator to represent overall muscle strength. The possible association of changes in HGS in patients with obesity during the consumption of a very low-calorie ketogenic diet (VLCKD) has not yet been investigated. The aim of this prospective study was to assess the efficacy of VLCKD on promoting changes in HGS and high-sensitivity C-reactive protein (hs-CRP) levels, as a serological marker of obesity-related, low-grade inflammation, in a population of women with obesity after 45 days of active phase of the VLCKD. This pilot, uncontrolled, single-center, open-label clinical trial examined 247 Caucasian women, aged 18–51 years (body mass index, BMI: 30.0–50.9 kg/m2) who were consecutively enrolled following 45 days of active phase the VLCKD. Anthropometric measures and physical activity were evaluated. Muscle strength was measured by HGS using a grip strength dynamometer. Body composition was evaluated using a bioelectrical impedance analysis (BIA) phase-sensitive system. hs-CRP levels were determined by nephelometric assay. Adherence to the VLCKD, ketosis status, and physical activity were checked weekly by phone call. At day 45, BMI, fat mass (FM), and hs-CRP levels were significantly decreased (∆-7.5 ± 3.1%, ∆-15.6 ± 9.0%, and ∆-39.9 ± 44.6%; respectively; p < 0.001 for all three parameters), while HGS had increased (∆+17.4 ± 13.2%; p < 0.001). After adjusting for ∆BMI, ∆waist circumference, ∆hs-CRP levels, and physical activity, the correlation among changes in ∆HGS (kg), ∆FM (kg), and ∆ fat free mass (FFM) (kg) remained statistically significant (r = −0.331, and r = 0.362, respectively; p < 0.001). Interestingly, the correlation between ∆HGS with ∆FM (r = −0.288, p < 0.001) and ∆FFM (r = 0.395, p < 0.001) were also independent of the percentage of weight loss. We are the first to report that, along with a significant reduction in body weight and an overall improvement in body composition and inflammatory status, the muscle strength evaluated by the HGS test increased in a population of women with obesity after 45 days of the active phase of the VLCKD, also following adjustment for common confounding variables. Full article
(This article belongs to the Section Clinical Nutrition)
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13 pages, 770 KiB  
Article
The Association between Serum Vitamin D Concentration and New Inflammatory Biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response (SIRI)—In Patients with Ischemic Heart Disease
by Ewelina A. Dziedzic, Jakub S. Gąsior, Agnieszka Tuzimek, Marek Dąbrowski and Piotr Jankowski
Nutrients 2022, 14(19), 4212; https://doi.org/10.3390/nu14194212 - 10 Oct 2022
Cited by 16 | Viewed by 3156
Abstract
The incidence of ischemic heart disease (IHD) increases every year. This cardiovascular disease has an inflammatory factor in its etiology due to different immune cells that influence atherogenesis. New inflammatory biomarkers—the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response (SIRI)—attempt to describe [...] Read more.
The incidence of ischemic heart disease (IHD) increases every year. This cardiovascular disease has an inflammatory factor in its etiology due to different immune cells that influence atherogenesis. New inflammatory biomarkers—the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response (SIRI)—attempt to describe the pro- and anti-inflammatory balance and quantify the complex impact of the immune system on atherosclerosis, while vitamin D has a multidirectional impact on the human body, including the cardiovascular and immune systems. Hence, the objective of this research was to analyze the association between SII and SIRI and serum vitamin D concentrations in patients with IHD. A significant correlation was observed between SIRI and 25(OH)D in the whole group and between both biomarkers (SII and SIRI) and 25(OH)D in the group of patients with ACS but not in the group of patients with stable IHD. The role of vitamin D in IHD complications and its association with new inflammatory biomarkers requires further well-designed, large-scale research. Full article
(This article belongs to the Special Issue Nutrition and Diet in Immunomodulation)
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17 pages, 1866 KiB  
Article
External Validation with Accuracy Confounders of VCO2-Derived Predicted Energy Expenditure Compared to Resting Energy Expenditure Measured by Indirect Calorimetry in Mechanically Ventilated Children
by Panagiotis Briassoulis, Stavroula Ilia, Efrossini Briassouli and George Briassoulis
Nutrients 2022, 14(19), 4211; https://doi.org/10.3390/nu14194211 - 10 Oct 2022
Cited by 4 | Viewed by 1803
Abstract
Optimal energy provision, guided by measured resting energy expenditure (REE) and determined by indirect calorimetry (IC), is fundamental in Intensive Care Units (ICU). Because IC availability is limited, methods to predict REE based on carbon dioxide production (VCO2) measurements (REEVCO2 [...] Read more.
Optimal energy provision, guided by measured resting energy expenditure (REE) and determined by indirect calorimetry (IC), is fundamental in Intensive Care Units (ICU). Because IC availability is limited, methods to predict REE based on carbon dioxide production (VCO2) measurements (REEVCO2) alone have been proposed as a surrogate for REE measured by IC (REEIC). The study aimed at externally and internally validating the accuracy of the REEVCO2 as an alternative to REEIC in mechanically ventilated children. A ventilator’s integrated gas exchange module (E-COVX) was used to prospectively measure REEIC and predict REEVCO2 on 107 mechanically ventilated children during the first 24 h of admission. The accuracy of the REEVCO2 compared to REEIC was assessed through the calculation of bias and precision, paired median differences, linear regression, and ROC analysis. Accuracy within ±10% of the REEIC was deemed acceptable for the REEVCO2 equation. The calculated REEVCO2 based on respiratory quotient (RQ) 0.89 resulted in a mean bias of −72.7 kcal/day (95% limits of agreement −321.7 to 176.3 kcal/day) and a high coefficient of variation (174.7%), while 51.4% of the calculations fell outside the ±10% accuracy rate. REEVCO2 derived from RQ 0.80 or 0.85 did not improve accuracy. Only measured RQ (Beta 0.73, p < 0.001) and no-recorded neuromuscular blocking agents (Beta −0.13, p = 0.044) were independently associated with the REEVCO2−REEIC difference. Among the recorded anthropometric, metabolic, nutrition, or clinical variables, only measured RQ was a strong predictor of REEVCO2 inaccuracy (p < 0.001). Cutoffs of RQ = 0.80 predicted 89% of underestimated REEIC (sensitivity 0.99; specificity 0.89) and RQ = 0.82 predicted 56% of overestimated REEIC (sensitivity of 0.99; specificity 0.56). REEVCO2 cannot be recommended as an alternative to REEIC in mechanically ventilated children, regardless of the metabolic, anthropometric, or clinical status at the time of the evaluation. Full article
(This article belongs to the Special Issue Nutrition and Critical Illness)
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16 pages, 892 KiB  
Article
Effect of Whey Protein Supplementation in Postmenopausal Women: A Systematic Review and Meta-Analysis
by Yao-Yi Kuo, Hao-Yun Chang, Yu-Chen Huang and Che-Wei Liu
Nutrients 2022, 14(19), 4210; https://doi.org/10.3390/nu14194210 - 10 Oct 2022
Cited by 10 | Viewed by 5975
Abstract
(1) Background: Whey protein (WP) in combination with resistance training (RT) is beneficial in improving sarcopenic obesity and its damaging effects in older adults, while the difference between men and women should be considered while interpreting results. This review aims to investigate WP’s [...] Read more.
(1) Background: Whey protein (WP) in combination with resistance training (RT) is beneficial in improving sarcopenic obesity and its damaging effects in older adults, while the difference between men and women should be considered while interpreting results. This review aims to investigate WP’s efficacy on postmenopausal women with or without RT; (2) Material and Methods: We searched electronic databases including PubMed, EMBASE, and the Cochrane Library from inception to August 2021 for randomized controlled trials that included comparison groups to evaluate WP’s efficacy in women aged 55 years and above. The outcomes included body composition, muscular strength, functional capacity, and dietary intake. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to estimate the effect of WP. We also performed subgroup analysis with or without RT; (3) Results: We included 14 studies in the systematic review and 10 studies in the meta-analysis. Subgroup analyses showed RT was a major confounder for muscle strength, lean mass, and dietary protein intake (PI). In the RT subgroup, WP supplementation had a significant positive effect on biceps curl strength (BC) (SMD: 0.6805, 95% CI: 0.176, 1.185, I2: 0%), and lower limb lean-mass (LLLM) (SMD: 1.103, 95% CI: 0.632, 1.574, I2: 14%). In the subgroup without RT, a significant negative effect on PI (SMD: −0.4225, 95% CI: −0.774, −0.071, I2: 47%) was observed, while no significant effect on muscle strength or lean mass was revealed. WP supplementation did not show a significantly different effect on fat mass or body weight loss in both the subgroups; (4) Conclusions: In postmenopausal women, WP supplementation only in combination with RT enhances BC and LLLM compared to placebo controls. Without RT, WP has no significant benefit on muscle strength or lean mass. Full article
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11 pages, 1043 KiB  
Article
Effects of Substitution of Higher-Alcohol Products with Lower-Alcohol Products on Population-Level Alcohol Purchases: ARIMA Analyses of Spanish Household Data
by Peter Anderson and Daša Kokole
Nutrients 2022, 14(19), 4209; https://doi.org/10.3390/nu14194209 - 10 Oct 2022
Cited by 2 | Viewed by 1643
Abstract
In its action plan (2022–2030) to reduce the harmful use of alcohol, the WHO calls on economic operators to “substitute, whenever possible, higher-alcohol products with no-alcohol and lower-alcohol products in their overall product portfolios, with the goal of decreasing the overall levels of [...] Read more.
In its action plan (2022–2030) to reduce the harmful use of alcohol, the WHO calls on economic operators to “substitute, whenever possible, higher-alcohol products with no-alcohol and lower-alcohol products in their overall product portfolios, with the goal of decreasing the overall levels of alcohol consumption in populations and consumer groups”. This paper investigates substitution at the level of the consumer, based on Spanish household purchase data. ARIMA modelling of market research data of 1.29 million alcohol purchases from 18,954 Spanish households is used to study the potential impact of lower-strength alcohol products and the impact of beer prices in reducing household purchases of grams of alcohol between the 2nd quarter of 2017 and 1st quarter of 2022. Reducing the alcohol strength of existing higher-strength beers and wines had a much greater associated impact on reducing the purchases of all grams of alcohol than the relatively small increases in purchases of no-alcohol beers (ABV ≤ 1.0%) and zero-alcohol wines (ABV = 0.0%). For beers, the relative price per gram of alcohol decreased with the increasing ABV of the beer. Increasing the price per gram of alcohol in beers with an ABV > 3.5%, adjusted for the ABV of the beer, was associated with much greater increases in purchases of no-alcohol beers (ABV ≤ 1.0%) and much greater decreases in purchases of all grams of alcohol than decreases in the price of no-alcohol beers or increases in the price of beers with an ABV > 3.5% unadjusted for ABV. Thus, a key to reducing purchases of grams of alcohol, which also results in increased purchases of no-alcohol beers, is to increase the price of higher strength beers (ABV > 3.5%) with the price per gram of alcohol increasing as the ABV of the product increases. Full article
(This article belongs to the Special Issue Lower Strength Alcohol Products to Public Health)
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17 pages, 1955 KiB  
Article
Geraniol Treatment for Irritable Bowel Syndrome: A Double-Blind Randomized Clinical Trial
by Chiara Ricci, Fernando Rizzello, Maria Chiara Valerii, Enzo Spisni, Paolo Gionchetti, Silvia Turroni, Marco Candela, Federica D’Amico, Renato Spigarelli, Irene Bellocchio, Giovanni Marasco and Giovanni Barbara
Nutrients 2022, 14(19), 4208; https://doi.org/10.3390/nu14194208 - 10 Oct 2022
Cited by 12 | Viewed by 3507
Abstract
Geraniol is an acyclic monoterpene alcohol with well-known anti-inflammatory and antimicrobial properties which has shown eubiotic activity towards gut microbiota (GM) in patients with irritable bowel syndrome (IBS). Methods: Fifty-six IBS patients diagnosed according to Rome III criteria were enrolled in an interventional, [...] Read more.
Geraniol is an acyclic monoterpene alcohol with well-known anti-inflammatory and antimicrobial properties which has shown eubiotic activity towards gut microbiota (GM) in patients with irritable bowel syndrome (IBS). Methods: Fifty-six IBS patients diagnosed according to Rome III criteria were enrolled in an interventional, prospective, multicentric, randomized, double-blinded, placebo-controlled trial. In the treatment arm, patients received a low-absorbable geraniol food supplement (LAGS) once daily for four weeks. Results: Patients treated with LAGS showed a significant reduction in their IBS symptoms severity score (IBS-SSS) compared to the placebo (195 vs. 265, p = 0.001). The rate of responders according to IBS-SSS (reduction ≥ 50 points) was significantly higher in the geraniol vs placebo group (52.0% vs. 16.7%, p = 0.009) mainly due to the IBS mixed subtype. There were notable differences in the microbiota composition after geraniol administration, particularly a significant decrease in a genus of Ruminococcaceae, Oscillospira (p = 0.01), a decreasing trend for the Erysipelotrichaceae and Clostridiaceae families (p = 0.1), and an increasing trend for other Ruminococcaceae taxa, specifically Faecalibacterium (p = 0.09). The main circulating proinflammatory cytokines showed no differences between placebo and geraniol arms. Conclusion: LAGS was effective in treating overall IBS symptoms, together with an improvement in the gut microbiota profile, especially for the IBS mixed subtype. Full article
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16 pages, 3678 KiB  
Systematic Review
Effect of Casein Hydrolysate on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Shuaishuai Zhou, Teng Xu, Xu Zhang, Junjie Luo, Peng An and Yongting Luo
Nutrients 2022, 14(19), 4207; https://doi.org/10.3390/nu14194207 - 9 Oct 2022
Cited by 3 | Viewed by 2528
Abstract
Casein hydrolysate has various biological functional activities, especially prominent are angiotensin I-converting enzyme inhibitory activities. Increasing evidence has reported the prominent hypotensive effect of casein hydrolysate. However, the effects of casein hydrolysate on cardiovascular risk factors remain unclear and require more comprehensive and [...] Read more.
Casein hydrolysate has various biological functional activities, especially prominent are angiotensin I-converting enzyme inhibitory activities. Increasing evidence has reported the prominent hypotensive effect of casein hydrolysate. However, the effects of casein hydrolysate on cardiovascular risk factors remain unclear and require more comprehensive and detailed studies. Here, we conducted a systematic review and meta-analysis on eligible randomized controlled trials (RCTs) to summarize the effects of casein hydrolysate supplementation on blood pressure, blood lipids, and blood glucose. In the pooled analyses, casein hydrolysate significantly reduced systolic blood pressure by 3.20 mmHg (−4.53 to −1.87 mmHg) and diastolic blood pressure by 1.50 mmHg (−2.31 to −0.69 mmHg). Supplementation of casein hydrolysate displayed no effect on total cholesterol (−0.07 mmol/L; −0.17 to 0.03 mmol/L), low-density lipoprotein cholesterol (−0.04 mmol/L; −0.15 to 0.08 mmol/L), high-density lipoprotein cholesterol (−0.01 mmol/L; −0.06 to 0.03 mmol/L), triglycerides (−0.05 mmol/L, −0.14 to 0.05 mmol/L), or fasting blood glucose (−0.01 mmol/L; −0.10 to 0.09 mmol/L) compared with the placebo diets. Collectively, this study indicated that supplementation of casein hydrolysate displayed decreasing effect on blood pressure without affecting blood lipids or glycemic status. Full article
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19 pages, 9799 KiB  
Article
Weizmannia coagulans BC2000 Plus Ellagic Acid Inhibits High-Fat-Induced Insulin Resistance by Remodeling the Gut Microbiota and Activating the Hepatic Autophagy Pathway in Mice
by Long Jin, Hongyang Dang, Jinyong Wu, Lixia Yuan, Xiangsong Chen and Jianming Yao
Nutrients 2022, 14(19), 4206; https://doi.org/10.3390/nu14194206 - 9 Oct 2022
Cited by 6 | Viewed by 2155
Abstract
(1) Background: Ellagic acid (EA) acts as a product of gut microbiota transformation to prevent insulin resistance, which is limited by high-fat diet (HFD)-induced dysbiosis. The aim of this study was to investigate the synergistic effects and mechanisms of supplementation with the probiotic [...] Read more.
(1) Background: Ellagic acid (EA) acts as a product of gut microbiota transformation to prevent insulin resistance, which is limited by high-fat diet (HFD)-induced dysbiosis. The aim of this study was to investigate the synergistic effects and mechanisms of supplementation with the probiotic Weizmannia coagulans (W. coagulans) on the prevention of insulin resistance by EA; (2) Methods: C57BL/6J mice were divided into five groups (n = 10/group): low-fat-diet group, high-fat-diet group, EA intervention group, EA + W. coagulans BC77 group, and EA + W. coagulans BC2000 group; (3) Result: W. coagulans BC2000 showed a synergistic effect on EA’s lowering insulin resistance index and inhibiting high-fat diet-induced endotoxemia. The combined effect of BC2000 and EA activated the autophagy pathway in the mouse liver, a urolithin-like effect. This was associated with altered β-diversity of gut microbiota and increased Eggerthellaceae, a potential EA-converting family. Ellagic acid treatment alone and the combined use of ellagic acid and W. coagulans BC77 failed to activate the hepatic autophagy pathway; (4) Conclusions: W. coagulans BC2000 can assist EA in its role of preventing insulin resistance. This study provides a basis for the development of EA-rich functional food supplemented with W. coagulans BC2000. Full article
(This article belongs to the Special Issue Effect of a Nutritional Intervention on the Intestinal Microbiota)
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15 pages, 714 KiB  
Article
The Applicability of the ESPEN and EASO-Defined Diagnostic Criteria for Sarcopenic Obesity in Japanese Patients after Stroke: Prevalence and Association with Outcomes
by Yoshihiro Yoshimura, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido and Takahiro Bise
Nutrients 2022, 14(19), 4205; https://doi.org/10.3390/nu14194205 - 9 Oct 2022
Cited by 17 | Viewed by 2947
Abstract
Sarcopenic obesity is of growing research and clinical interest; however, validated diagnostic criteria are lacking. We therefore aimed to examine the prevalence of sarcopenic obesity as diagnosed by the criteria recently proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and [...] Read more.
Sarcopenic obesity is of growing research and clinical interest; however, validated diagnostic criteria are lacking. We therefore aimed to examine the prevalence of sarcopenic obesity as diagnosed by the criteria recently proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO), and its association with outcomes among patients after stroke. This study was based on a cohort of 760 Japanese patients after stroke admitted to a post-acute rehabilitation hospital. Sarcopenic obesity was diagnosed at admission according to the ESPEN and EASO criteria using reference values specific to Asians. Outcomes included the motor domain of the functional independence measure (FIM-motor) and the food intake level scale (FILS) at discharge. Multivariate linear regression models were used to assess the associations between sarcopenic obesity and outcomes. Among 760 patients (median age, 73 years; 352 women and 408 men), sarcopenic obesity was diagnosed in 34 patients (4.5%; 5.4% of women and 4.1% of men). In multivariate analyses, sarcopenic obesity was independently and negatively associated with FIM-motor (β = −0.048, p = 0.031) and FILS at discharge (β = −0.095, p = 0.046) in women. In contrast, in men, sarcopenic obesity showed an independent negative association with FIM-motor at discharge (β = −0.117, p < 0.001) but no statistically significant association with FILS at discharge (β = −0.004, p = 0.323). In conclusion, the prevalence of sarcopenic obesity diagnosed by the ESPEN and EASO-defined criteria was as low as 4.5% among Japanese patients after stroke. Furthermore, sarcopenic obesity was negatively associated with improvements in activities of daily living and dysphagia. Full article
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17 pages, 5759 KiB  
Article
Docosapentaenoic Acid (DPA, 22:5n-3) Alleviates Ulcerative Colitis via Modification of Gut Microbiota and Their Metabolism
by Ye Dong, Cheng Huang, Jiacheng Yang, Zhenxiao Zheng and Zhiyuan Dai
Nutrients 2022, 14(19), 4204; https://doi.org/10.3390/nu14194204 - 9 Oct 2022
Cited by 4 | Viewed by 2211
Abstract
N-3 polyunsaturated fatty acids (n-3PUFA) are regarded as viable alternatives to aid the treatment of ulcerative colitis (UC). Most research focuses on eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA); little information is available about the effect of docosapentaenoic acid (DPA) [...] Read more.
N-3 polyunsaturated fatty acids (n-3PUFA) are regarded as viable alternatives to aid the treatment of ulcerative colitis (UC). Most research focuses on eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA); little information is available about the effect of docosapentaenoic acid (DPA) on the gut microbiota and their metabolism in UC mice. In this study, the changes in gut microbiota and their metabolism in UC mice were studied through the 16S rRNA sequencing method and untargeted metabolomics. Moreover, the differential bacterial genus and differential metabolites in responding to DPA supplementation were screened through permutation test after orthogonal partial least squares discriminant analysis (OPLS-DA). The results indicated that DPA supplementation increased the diversity and altered the composition of the gut microbiota in UC mice; Akkermansia, Alistipes, Butyricicoccus, and Lactobacillus were selected as the differential bacterial genus. Supplementation of DPA also altered the fecal metabolite profile in the UC mice. Moreover, butyrate, N-carbamylglutamate (NCG), and histamine were screened as the differential metabolites. In conclusion, the regulation effect of DPA on the gut microbiota and their metabolism might be involved in the intervention mechanism of DPA in UC. More research needs to be carried out to elucidate the mechanism systematically. Full article
(This article belongs to the Special Issue Fish Intake and Human Health: Evaluating the Nutrients and Benefits)
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15 pages, 1444 KiB  
Article
Plant-Based Diets Improve Maternal–Fetal Outcomes in CKD Pregnancies
by Rossella Attini, Filomena Leone, Antoine Chatrenet, Elisa Longhitano, Viola Casula, Alice Tomasi Cont, Gaia Zaccaria, Eleonora Dalmasso, Ana Maria Manzione, Bianca Masturzo, Massimo Torreggiani, Alberto Revelli, Gianfranca Cabiddu and Giorgina Barbara Piccoli
Nutrients 2022, 14(19), 4203; https://doi.org/10.3390/nu14194203 - 9 Oct 2022
Cited by 5 | Viewed by 2962
Abstract
Reducing protein intake in patients with chronic kidney disease (CKD) limits glomerular stress induced by hyperfiltration and can prevent the progression of kidney disease; data in pregnancy are limited. The aim of this study is to analyze the results obtained in CKD patients [...] Read more.
Reducing protein intake in patients with chronic kidney disease (CKD) limits glomerular stress induced by hyperfiltration and can prevent the progression of kidney disease; data in pregnancy are limited. The aim of this study is to analyze the results obtained in CKD patients who followed a plant-based moderately protein-restricted diet during pregnancy in comparison with a propensity-score-matched cohort of CKD pregnancies on unrestricted diets. A total of 52 CKD pregnancies followed up with a protein-restricted plant-based diet (Torino, Italy) were matched with a propensity score based on kidney function and proteinuria with CKD pregnancies with unrestricted protein intake (Cagliari Italy). Outcomes included preterm (<37 weeks) and very preterm (<34 weeks) delivery and giving birth to a small-for-gestational-age baby. The median age in our cohort was 34 years, 63.46% of women were primiparous, and the median body mass index (BMI) was 23.15 kg/m2 with 13.46% of obese subjects. No statistical differences were found between women on a plant-based diet and women who were not in terms of age, parity, BMI, obesity, CKD stage, timing of referral, or cause of CKD. No differences were found between the two groups regarding the week of delivery. However, the combined negative outcome (birth before 37 completed gestational weeks or birth-weight centile <10) occurred less frequently in women following the diet than in women in the control group (61.54% versus 80.77%; p = 0.03). The lower risk was confirmed in a multivariable analysis adjusted for renal function and proteinuria (OR: 0.260 [Q1:0.093–Q3:0.724]; p = 0.010), in which the increase in proteinuria from the first to the last check-up before delivery was lower in patients on plant-based diets (median from 0.80 to 1.87 g/24 h; p: ns) than in controls (0.63 to 2.39 g/24 h p < 0.0001). Plant-based, moderately protein-restricted diets in pregnancy in patients with CKD are associated with a lower risk of preterm delivery and small-for-gestational-age babies; the effect may be mediated by better stabilization of proteinuria. Full article
(This article belongs to the Special Issue Plant-Based Diets: Working towards a Sustainable Future)
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13 pages, 604 KiB  
Article
FTO Common Obesity SNPs Interact with Actionable Environmental Factors: Physical Activity, Sugar-Sweetened Beverages and Wine Consumption
by Danyel Chermon and Ruth Birk
Nutrients 2022, 14(19), 4202; https://doi.org/10.3390/nu14194202 - 9 Oct 2022
Cited by 8 | Viewed by 2224
Abstract
Genetic background is estimated to play >50% in common obesity etiology. FTO single nucleotide polymorphisms (SNPs) are strongly associated with BMI, typically in European cohorts. We investigated the interaction of common FTO SNPs with actionable environmental factors, namely physical activity, sugar-sweetened beverages (SSB) [...] Read more.
Genetic background is estimated to play >50% in common obesity etiology. FTO single nucleotide polymorphisms (SNPs) are strongly associated with BMI, typically in European cohorts. We investigated the interaction of common FTO SNPs with actionable environmental factors, namely physical activity, sugar-sweetened beverages (SSB) and wine consumption, and verified FTO common SNPs predisposition to obesity in the Israeli population. Adults’ (>18 years old, n = 1720) FTO common SNPs data and lifestyle and nutrition habits questionnaires were analyzed using binary logistic regression models, adjusted for confounding variables (age, sex) assuming dominant, recessive and additive genetic models. Eighteen FTO SNPs were associated with significant increased obesity risk and interacted with physical activity (p < 0.001), wine consumption (p < 0.014) and SSB consumption (p < 0.01). Inactive rs9939609 risk-allele carriers had significantly higher obesity risk compared to their active counterparts (OR = 2.54, 95% CI 1.91–3.39 and OR = 3.77, 95% CI 2.47–5.75; p < 0.001 with 3.1 and 3.5 BMI increment for heterozygotes and homozygotes, respectively). SSB consumption (≥1 serving/day) significantly raised obesity risk and wine consumption (1–3 drinks/weekly) significantly lowered obesity risk for rs9939609 risk-allele carriers (OR = 1.54, 95% CI 1.05–2.27; p = 0.028 and OR = 0.61, 95% CI 0.47–0.79; p < 0.001, respectively). Our findings demonstrate that actionable lifestyle factors modify the common FTO obesity risk in predisposed carriers, and they have personal and public health implications. Full article
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17 pages, 725 KiB  
Review
Breastfeeding Practices, Infant Formula Use, Complementary Feeding and Childhood Malnutrition: An Updated Overview of the Eastern Mediterranean Landscape
by Carla Ibrahim, Khlood Bookari, Yonna Sacre, Lara Hanna-Wakim and Maha Hoteit
Nutrients 2022, 14(19), 4201; https://doi.org/10.3390/nu14194201 - 9 Oct 2022
Cited by 4 | Viewed by 4432
Abstract
Background: With increasing global rates of overweight, obesity and non-communicable diseases (NCDs) along with undernutrition and micronutrient deficiencies, the Eastern Mediterranean Region (EMR) is no exception. This review focuses on specific nutrition parameters among under five years children, namely ever breastfed, exclusive breastfeeding, [...] Read more.
Background: With increasing global rates of overweight, obesity and non-communicable diseases (NCDs) along with undernutrition and micronutrient deficiencies, the Eastern Mediterranean Region (EMR) is no exception. This review focuses on specific nutrition parameters among under five years children, namely ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods and malnutrition. Methodology: PubMed, Google Scholar, United Nations International Children’s Emergency Fund (UNICEF) databases, World Health Organization (WHO) databases, the World Bank databases and the Global Nutrition Report databases were explored between 10 January and 6 June 2022, to review the nutrition situation among under five years children in the EMR. Results: The regional average prevalence of ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods was estimated at 84.3%, 30.9%, 42.9%, 41.5%, 32.1% and 69.3%, respectively. Iran, Iraq, Libya and Palestine have seen a decline over time in the prevalence of exclusive breastfeeding. Lebanon, Egypt, Kuwait and Saudi Arabia reported early introduction of infant formula. Moreover, Lebanon, Pakistan, Saudi Arabia and United Arab Emirates were seen to introduce food early to the child, at between 4–6 months of age. The estimated weighted regional averages for stunting, wasting and underweight were 20.3%, 8.9% and 13.1%, respectively. Of concern is the increasing prevalence of stunting in Libya. As for overweight and obesity, the average prevalence was reported to be 8.9% and 3%, respectively. Lebanon, Libya, Kuwait and Palestine showed an increased trend throughout this time. Conclusions: In this review, the suboptimal infant and young child feeding patterns and the twofold incidence of malnutrition in the EMR are highlighted and we urge the prioritizing of measures to improve children’s nutrition. Full article
(This article belongs to the Special Issue Feeding Practice and Infant and Young Child Health)
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13 pages, 322 KiB  
Article
Relationship between Depression with Physical Activity and Obesity in Older Diabetes Patients: Inflammation as a Mediator
by Jui-Hua Huang, Ren-Hau Li and Leih-Ching Tsai
Nutrients 2022, 14(19), 4200; https://doi.org/10.3390/nu14194200 - 9 Oct 2022
Cited by 4 | Viewed by 2389
Abstract
Obesity and physical activity (PA) may affect inflammation and are also related to depression. This study aimed to explore the association between depression, obesity, and PA in older diabetes patients mediated by inflammation. We conducted a cross-sectional study with 197 elderly diabetes patients [...] Read more.
Obesity and physical activity (PA) may affect inflammation and are also related to depression. This study aimed to explore the association between depression, obesity, and PA in older diabetes patients mediated by inflammation. We conducted a cross-sectional study with 197 elderly diabetes patients (≥65 y/o). Participants were interviewed to gather demographic and lifestyle data. Assessment of depression was based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. High-sensitivity C-reactive protein was used as a marker of inflammation. Participants with a body mass index (kg/m2) ≥ 27 were considered to be obese. Our data indicated that among all participants with (n = 57) and without (n = 140) depression, older diabetes patients with depression had a lower intake of energy and protein and a lower prevalence of smoking and alcohol consumption than those without depression (p < 0.05). We also found that inflammation may be a partial mediator in the relationship between obesity and depression, and a significant mediator between PA and depression. Additionally, a regression model of obesity and PA showed that PA was a significant predictor of inflammation. However, the association between obesity and inflammation was not significant. When obesity, PA, and inflammation were included in a regression model together, inflammation significantly predicted depression (OR = 4.18, p = 0.004). The association between obesity and depression was also significant (OR = 2.45, p = 0.038). However, the association between PA and depression was not significant, and the mediating effect of inflammation was significant according to the Sobel test (z = −2.01, p = 0.045). In conclusion, the beneficial effects of PA may lower levels of inflammation produced by obesity, thus reducing inflammatory effects that may be related to depression. Overall, inflammation may mediate the relationship between depression and PA in older diabetes patients. Full article
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32 pages, 3719 KiB  
Article
Identification of a Hydroxygallic Acid Derivative, Zingibroside R1 and a Sterol Lipid as Potential Active Ingredients of Cuscuta chinensis Extract That Has Neuroprotective and Antioxidant Effects in Aged Caenorhabditis elegans
by Shimaa M. A. Sayed, Saleh Alseekh, Karsten Siems, Alisdair R. Fernie, Walter Luyten, Christian Schmitz-Linneweber and Nadine Saul
Nutrients 2022, 14(19), 4199; https://doi.org/10.3390/nu14194199 - 9 Oct 2022
Cited by 6 | Viewed by 2447
Abstract
We examined the effects of the extracts from two traditional Chinese medicine plants, Cuscuta chinensis and Eucommia ulmoides, on the healthspan of the model organism Caenorhabditis elegans. C. chinensis increased the short-term memory and the mechanosensory response of aged C. elegans. Furthermore, [...] Read more.
We examined the effects of the extracts from two traditional Chinese medicine plants, Cuscuta chinensis and Eucommia ulmoides, on the healthspan of the model organism Caenorhabditis elegans. C. chinensis increased the short-term memory and the mechanosensory response of aged C. elegans. Furthermore, both extracts improved the resistance towards oxidative stress, and decreased the intracellular level of reactive oxygen species. Chemical analyses of the extracts revealed the presence of several bioactive compounds such as chlorogenic acid, cinnamic acid, and quercetin. A fraction from the C. chinensis extract enriched in zingibroside R1 improved the lifespan, the survival after heat stress, and the locomotion in a manner similar to the full C. chinensis extract. Thus, zingibroside R1 could be (partly) responsible for the observed health benefits of C. chinensis. Furthermore, a hydroxygallic acid derivative and the sterol lipid 4-alpha-formyl-stigmasta-7,24(241)-dien-3-beta-ol are abundantly present in the C. chinensis extract and its most bioactive fraction, but hardly in E. ulmoides, making them good candidates to explain the overall healthspan benefits of C. chinensis compared to the specific positive effects on stress resistance by E. ulmoides. Our findings highlight the overall anti-aging effects of C. chinensis in C. elegans and provide first hints about the components responsible for these effects. Full article
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17 pages, 971 KiB  
Article
Higher Total Cholesterol Concentration May Be Associated with Better Cognitive Performance among Elderly Females
by Ke Pang, Chunxia Liu, Jianbin Tong, Wen Ouyang, Shuntong Hu and Yongzhong Tang
Nutrients 2022, 14(19), 4198; https://doi.org/10.3390/nu14194198 - 9 Oct 2022
Cited by 7 | Viewed by 3440
Abstract
Background: The brain contains the highest level of cholesterol in the body, and the total amount of serum cholesterol in the blood has a huge impact on brain aging and cognitive performance. However, the association of total serum cholesterol with cognitive function remains [...] Read more.
Background: The brain contains the highest level of cholesterol in the body, and the total amount of serum cholesterol in the blood has a huge impact on brain aging and cognitive performance. However, the association of total serum cholesterol with cognitive function remains uncertain. This study determines whether there is an association between the total amount of cholesterol in the blood and cognitive performance in elderly females without a history of stroke. Methods: This population-based cross-sectional study was conducted on elderly (over 60 years old) females and males without a history of stroke from 2011 to 2014 in the US National Health and Nutrition Examination Survey (NHANES). The primary exposure was total blood cholesterol, and the main outcome was cognitive performance; this association was assessed with logistic regression analysis and restricted cubic splines. Results: 1309 female and 1272 male participants were included. In females, higher total cholesterol was significantly associated with higher cognitive scores, particularly in the digit symbol substitution test (OR 0.51, 95% CI (0.36–0.72)) and the animal fluency test (OR 0.64, 95% CI (0.45–0.91)). This association remained significant in models adjusted for age, race, smoking status, education level, and chronic conditions (OR 0.40, 95% CI (0.25–0.63)). This association was not significant in males, however. Conclusions: A higher concentration of total cholesterol measured in later life may be a protective factor for cognitive performance among females over 60 years old without a history of stroke. Further, this association was more pronounced among women with higher levels of education than women with lower or no education. Full article
(This article belongs to the Special Issue Diet and Nutrition in Neurodegenerative Diseases)
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17 pages, 1887 KiB  
Article
Increasing Fruit and Vegetable Intake of Primary School Children in a Quasi-Randomized Trial: Evaluation of the Three-Year School-Based Multicomponent Intervention
by Ana Ilić, Ivana Rumbak, Ružica Brečić, Irena Colić Barić and Martina Bituh
Nutrients 2022, 14(19), 4197; https://doi.org/10.3390/nu14194197 - 8 Oct 2022
Cited by 3 | Viewed by 2533
Abstract
Insufficient consumption of fruit and vegetables was found in primary school children. To address this problem, a three-year school-based multicomponent intervention was conducted in 14 primary schools in the City of Zagreb. The aim of the study was therefore to evaluate one of [...] Read more.
Insufficient consumption of fruit and vegetables was found in primary school children. To address this problem, a three-year school-based multicomponent intervention was conducted in 14 primary schools in the City of Zagreb. The aim of the study was therefore to evaluate one of the primary goals of the intervention—the increase in fruit and vegetable intake among primary school children. A total of 681 children were allocated to the intervention (n = 300 in the control group and n = 381 in the intervention group). The intervention included 23 interactive classroom workshops, 10 cross-curricular activities, 13 homework challenges, visual exposure with educational posters in classrooms, parent education via the website, and the implementation of new dishes into the school food system. Fruit and vegetable intake was assessed using a semi-quantitative food frequency questionnaire at baseline and after the intervention. Data were analyzed by per-protocol analysis. The study involved 259 children (50.2% girls; age 7.7 ± 0.4 years; n = 116 in the control group and n = 143 in the intervention group) who completed a food intake frequency questionnaire at both time points. Children in the intervention group showed a significant increase (p < 0.001) in total daily fruit and vegetable intake (before: 332.1 ± 164.9 g; after: 430.1 ± 186.7 g) compared to the control group (before: 350.2 ± 187.5; after: 382.6 ± 196.8) after the intervention. The increase in fruit and vegetable intake was achieved in 89% of children, while 25% more children reached the daily recommendation of 400 g. The use of the multicomponent intervention showed potential to increase fruit and vegetable intake in primary school children. Full article
(This article belongs to the Section Nutrition and Public Health)
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21 pages, 1858 KiB  
Article
Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study
by Luis M. Béjar, María Dolores García-Perea and Pedro Mesa-Rodríguez
Nutrients 2022, 14(19), 4196; https://doi.org/10.3390/nu14194196 - 8 Oct 2022
Cited by 3 | Viewed by 1900
Abstract
Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence [...] Read more.
Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: ‘feedback’ e-12HR (IG) and ‘non-feedback’ e-12HR (CG). Only the ‘feedback’ e-12HR had two specific automatic functions: 1. Evaluation of the user’s AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students. Full article
(This article belongs to the Special Issue Dietary Assessment and Self-Monitoring Using Technology)
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13 pages, 277 KiB  
Article
Factors Associated with Significant Weight Loss in Hospitalised Patients with COVID-19: A Retrospective Cohort Study in a Large Teaching Hospital
by Dimitra Zannidi, Pinal S. Patel, Eleni Leventea, Jessica Paciepnik, Frances Dobson, Caroline Heyes, Robert J. B. Goudie, Linda M. Oude Griep, Jacobus Preller and Lynsey N. Spillman
Nutrients 2022, 14(19), 4195; https://doi.org/10.3390/nu14194195 - 8 Oct 2022
Cited by 5 | Viewed by 2274
Abstract
SARS-CoV-2 infection (COVID-19) is associated with malnutrition risk in hospitalised individuals. COVID-19 and malnutrition studies in large European cohorts are limited, and post-discharge dietary characteristics are understudied. This study aimed to assess the rates of and risk factors for ≥10% weight loss in [...] Read more.
SARS-CoV-2 infection (COVID-19) is associated with malnutrition risk in hospitalised individuals. COVID-19 and malnutrition studies in large European cohorts are limited, and post-discharge dietary characteristics are understudied. This study aimed to assess the rates of and risk factors for ≥10% weight loss in inpatients with COVID-19, and the need for post-discharge dietetic support and the General Practitioner (GP) prescription of oral nutritional supplements, during the first COVID-19 wave in a large teaching hospital in the UK. Hospitalised adult patients admitted between March and June 2020 with a confirmed COVID-19 diagnosis were included in this retrospective cohort study. Demographic, anthropometric, clinical, biochemical, and nutritional parameters associated with ≥10% weight loss and post-discharge characteristics were described. Logistic regression models were used to identify risk factors for ≥10% weight loss and post-discharge requirements for ongoing dietetic input and oral nutritional supplement prescription. From the total 288 patients analysed (40% females, 72 years median age), 19% lost ≥ 10% of their admission weight. The length of hospital stay was a significant risk factor for ≥10% weight loss in multivariable analysis (OR 1.22; 95% CI 1.08–1.38; p = 0.001). In addition, ≥10% weight loss was positively associated with higher admission weight and malnutrition screening scores, dysphagia, ICU admission, and artificial nutrition needs. The need for more than one dietetic input after discharge was associated with older age and ≥10% weight loss during admission. A large proportion of patients admitted to the hospital with COVID-19 experienced significant weight loss during admission. Longer hospital stay is a risk factor for ≥10% weight loss, independent of disease severity, reinforcing the importance of repeated malnutrition screening and timely referral to dietetics. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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13 pages, 2541 KiB  
Article
The Protective Effects of Corn Oligopeptides on Acute Alcoholic Liver Disease by Inhibiting the Activation of Kupffer Cells NF-κB/AMPK Signal Pathway
by Ying Wei, Mingliang Li, Zhiyuan Feng, Di Zhang, Meiling Sun, Yong Wang and Xiangning Chen
Nutrients 2022, 14(19), 4194; https://doi.org/10.3390/nu14194194 - 8 Oct 2022
Cited by 4 | Viewed by 2236
Abstract
Alcohol can cause injury and lead to an inflammatory response in the liver. The NF-κB/AMPK signaling pathway plays a vital role in regulating intracellular inflammatory cytokine levels. In this study, corn oligopeptides (CPs), as the research objects, were obtained from corn gluten meal, [...] Read more.
Alcohol can cause injury and lead to an inflammatory response in the liver. The NF-κB/AMPK signaling pathway plays a vital role in regulating intracellular inflammatory cytokine levels. In this study, corn oligopeptides (CPs), as the research objects, were obtained from corn gluten meal, and their regulation of the activation of the Kupffer cell NF-κB/AMPK signal pathway induced by LPS was investigated. Results showed that ALT, AST, and inflammatory cytokines in mice serum after the administration of CPs at 0.2, 0.4, and 0.8 g/kg of body weight displayed a distinct (p < 0.05) reduction. On the other hand, the CPs also inhibited the expression of recognized receptor CD14 and TLR4, down-regulated P-JNK, P-ERK, and P-p-38, and thus inhibited inflammatory cytokine levels in Kupffer cells (KCs). Furthermore, four kinds of dipeptides with a leucine residue at the C-terminus that might exhibit down-regulated inflammatory cytokines in the NF-κB/AMPK signaling pathway functions were detected using HPLC-MS/MS. These results indicated that CPs have a potential application value in acute alcoholic liver disease. Full article
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13 pages, 1828 KiB  
Article
Fat-to-Muscle Ratio Is Independently Associated with Hyperuricemia and a Reduced Estimated Glomerular Filtration Rate in Chinese Adults: The China National Health Survey
by Huijing He, Li Pan, Dingming Wang, Feng Liu, Jianwei Du, Lize Pa, Xianghua Wang, Ze Cui, Xiaolan Ren, Hailing Wang, Xia Peng, Jingbo Zhao and Guangliang Shan
Nutrients 2022, 14(19), 4193; https://doi.org/10.3390/nu14194193 - 8 Oct 2022
Cited by 6 | Viewed by 1940
Abstract
Background: The effects of the fat-to-muscle ratio (FMR) on hyperuricemia and a reduction in the estimated glomerular filtration rate (eGFR) are still unclear. Methods: Data from the China National Health Survey were used to explore the associations of the FMR with hyperuricemia and [...] Read more.
Background: The effects of the fat-to-muscle ratio (FMR) on hyperuricemia and a reduction in the estimated glomerular filtration rate (eGFR) are still unclear. Methods: Data from the China National Health Survey were used to explore the associations of the FMR with hyperuricemia and reduced eGFR. The fat mass and muscle mass were measured through bioelectrical impedance analysis. Mediation analysis was used to estimate the mediated effect of hyperuricemia on the association between the FMR and reduced eGFR. Results: A total of 31171 participants were included. For hyperuricemia, compared with the Q1 of the FMR, the ORs (95% CI) of Q2, Q3 and Q4 were 1.60 (1.32–1.95), 2.31 (1.91–2.80) and 2.71 (2.15–3.43) in men and 1.91 (1.56–2.34), 2.67 (2.12–3.36) and 4.47 (3.40–5.89) in women. For the reduced eGFR, the ORs (95% CI) of Q2, Q3 and Q4 of the FMR were 1.48 (1.18–1.87), 1.38 (1.05–1.82) and 1.45 (1.04–2.04) in men aged 40–59, but no positive association was found in younger men or in women. Hyperuricemia mediated the association between the FMR and reduced eGFR in men. The OR (95% CI) of the indirect effect was 1.08 (1.05–1.10), accounting for 35.11% of the total effect. Conclusions: The FMR was associated with hyperuricemia and reduced eGFR, and the associations varied based on sex and age. The effect of the FMR on the reduced eGFR was significantly mediated by hyperuricemia in men. Full article
(This article belongs to the Section Nutrition Methodology & Assessment)
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26 pages, 8818 KiB  
Article
Effect of Ketogenic Diets on Body Composition and Metabolic Parameters of Cancer Patients: A Systematic Review and Meta-Analysis
by Haobin Zhao, Han Jin, Junfang Xian, Zhifu Zhang, Junling Shi and Xiaosu Bai
Nutrients 2022, 14(19), 4192; https://doi.org/10.3390/nu14194192 - 8 Oct 2022
Cited by 12 | Viewed by 5939
Abstract
A ketogenic diet characterized by high fat and low carbohydrate can drive the body to produce a large number of ketone bodies, altering human metabolism. Unlike normal cells, tumor cells have difficulty in consuming ketone bodies. Therefore, the application of ketogenic diets in [...] Read more.
A ketogenic diet characterized by high fat and low carbohydrate can drive the body to produce a large number of ketone bodies, altering human metabolism. Unlike normal cells, tumor cells have difficulty in consuming ketone bodies. Therefore, the application of ketogenic diets in cancer therapy is gaining attention. However, the effect of ketogenic diets on body parameters of cancer patients is not well established. This meta-analysis aimed to summarize the effects of ketogenic diets on cancer patients in earlier controlled trials. PubMed, Embase, and Cochrane Library were searched for clinical trials that enrolled cancer patients who received ketogenic diets intervention. Ten controlled trials were included in this meta-analysis. Data were extracted and checked by three authors independently. Pooled effect sizes revealed a significant effect of ketogenic diets on body weight (SMD −1.83, 95% CI −2.30 to −1.35; p < 0.00001) and fat mass (SMD −1.52, 95% CI −1.92 to −1.07; p < 0.00001). No significant effect on blood glucose, insulin, or lipid profile except triglycerides was found in the analysis. It had no effect on liver and kidney function except that GGT were decreased a little. There were no significant changes in IGF-1 and TNF-α related to tumor growth. Mental health improvement of cancer patients was supported by several trials. Taken together, findings in this study confirmed that the ketogenic diet was a safe approach for cancer patients reducing body weight and fat mass. In addition, cancer treatment-related indicators changed insignificantly. Ketogenic diets may be beneficial to the quality of life of cancer patients. However, intervention duration in most studies is shorter than 6 months, and the effect of a long-term ketogenic diet is still required further validation. More trials with a larger sample size are necessary to give a more conclusive result; PROSPERO registration number: CRD42021277559. Full article
(This article belongs to the Special Issue The Role of Nutrition and Body Composition on Metabolism)
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19 pages, 1630 KiB  
Review
Molecular Mechanisms and Health Benefits of Ghrelin: A Narrative Review
by Zheng-Tong Jiao and Qi Luo
Nutrients 2022, 14(19), 4191; https://doi.org/10.3390/nu14194191 - 8 Oct 2022
Cited by 19 | Viewed by 6785
Abstract
Ghrelin, an endogenous brain–gut peptide, is secreted in large quantities, mainly from the stomach, in humans and rodents. It can perform the biological function of activating the growth hormone secretagogue receptor (GHSR). Since its discovery in 1999, ample research has focused on promoting [...] Read more.
Ghrelin, an endogenous brain–gut peptide, is secreted in large quantities, mainly from the stomach, in humans and rodents. It can perform the biological function of activating the growth hormone secretagogue receptor (GHSR). Since its discovery in 1999, ample research has focused on promoting its effects on the human appetite and pleasure–reward eating. Extensive, in-depth studies have shown that ghrelin is widely secreted and distributed in tissues. Its role in neurohumoral regulation, such as metabolic homeostasis, inflammation, cardiovascular regulation, anxiety and depression, and advanced cancer cachexia, has attracted increasing attention. However, the effects and regulatory mechanisms of ghrelin on obesity, gastrointestinal (GI) inflammation, cardiovascular disease, stress regulation, cachexia treatment, and the prognosis of advanced cancer have not been fully summarized. This review summarizes ghrelin’s numerous effects in participating in a variety of biochemical pathways and the clinical significance of ghrelin in the regulation of the homeostasis of organisms. In addition, potential mechanisms are also introduced. Full article
(This article belongs to the Section Nutrition and Public Health)
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15 pages, 3135 KiB  
Article
Energy Expenditure Estimation in Children, Adolescents and Adults by Using a Respiratory Magnetometer Plethysmography System and a Deep Learning Model
by Fenfen Zhou, Xiaojian Yin, Rui Hu, Aya Houssein, Steven Gastinger, Brice Martin, Shanshan Li and Jacques Prioux
Nutrients 2022, 14(19), 4190; https://doi.org/10.3390/nu14194190 - 8 Oct 2022
Cited by 1 | Viewed by 1709
Abstract
Purpose: Energy expenditure is a key parameter in quantifying physical activity. Traditional methods are limited because they are expensive and cumbersome. Additional portable and cheaper devices are developed to estimate energy expenditure to overcome this problem. It is essential to verify the accuracy [...] Read more.
Purpose: Energy expenditure is a key parameter in quantifying physical activity. Traditional methods are limited because they are expensive and cumbersome. Additional portable and cheaper devices are developed to estimate energy expenditure to overcome this problem. It is essential to verify the accuracy of these devices. This study aims to validate the accuracy of energy expenditure estimation by a respiratory magnetometer plethysmography system in children, adolescents and adults using a deep learning model. Methods: Twenty-three healthy subjects in three groups (nine adults (A), eight post-pubertal (PP) males and six pubertal (P) females) first sat or stood for six minutes and then performed a maximal graded test on a bicycle ergometer until exhaustion. We measured energy expenditure, oxygen uptake, ventilatory thresholds 1 and 2 and maximal oxygen uptake. The respiratory magnetometer plethysmography system measured four chest and abdomen distances using magnetometers sensors. We trained the models to predict energy expenditure based on the temporal convolutional networks model. Results: The respiratory magnetometer plethysmography system provided accurate energy expenditure estimation in groups A (R2 = 0.98), PP (R2 = 0.98) and P (R2 = 0.97). The temporal convolutional networks model efficiently estimates energy expenditure under sitting, standing and high levels of exercise intensities. Conclusion: Our results proved the respiratory magnetometer plethysmography system’s effectiveness in estimating energy expenditure for different age populations across various intensities of physical activity. Full article
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13 pages, 294 KiB  
Article
Understanding and Use of Nutrition Labels of Prepackaged Food by University Students: A Cross-Sectional Study in Chongqing, China
by Hao Wei, Ke Jiang, Boya Liu, Zhichuan Hu, Yong Zhao, Hong Xu, Manoj Sharma and Chuan Pu
Nutrients 2022, 14(19), 4189; https://doi.org/10.3390/nu14194189 - 8 Oct 2022
Cited by 5 | Viewed by 2577
Abstract
Object: The correct use of nutrition labels for prepackaged food helps university students develop healthy eating habits and prevent the occurrence of chronic non-communicable diseases. This study evaluates the understanding and use of nutrition labels of prepackaged food by university students in four [...] Read more.
Object: The correct use of nutrition labels for prepackaged food helps university students develop healthy eating habits and prevent the occurrence of chronic non-communicable diseases. This study evaluates the understanding and use of nutrition labels of prepackaged food by university students in four different fields of study in Chongqing, China. Methods: This cross-sectional study used an online survey platform conducted in July 2022 in colleges and universities in Chongqing, China. The convenience sampling method was used to select students in four different fields of study, including medicine, humanities, science and technology, and arts and sports. Ten questions were used to assess participants’ understanding of nutrition labels. A score of six or above (60%) indicates that the respondent has a basic understanding of the nutritional labels of prepackaged food. Descriptive statistics and generalized linear models (GLMs) were used to assess participants’ understanding and use of nutrition labels for prepackaged foods and their influencing factors. Results: A total of 1262 valid questionnaires was collected. The average age of the participants was 21.8 years (SD: 2.43), 50.1% were male, 80.8% were ethnic Han, and 50.9% were from rural areas. Only 21.3% of the university students in Chongqing had a good understanding of the nutrition labels of prepackaged food, where medical students were the highest (39.9%) and science and engineering students were the lowest (15.6%). Gender, ethnicity, grade, major, and whether received courses related to nutrition were influential factors in the understanding and use of nutrition labels of prepackaged food. Medical students also had more positive attitudes toward nutritional labels of prepackaged food. Conclusions: Understanding and use of nutrition labels for prepackaged food by university students in Chongqing are unsatisfactory. Student’s major was a significant influencing factor in nutrition label comprehension, with medical students having the greatest understanding. Based on these results, we suggest that nutrition and health courses should be popularized among non-medical students to narrow the differences between different fields of study. For university students in all fields of study, education and publicity of nutrition labels of prepackaged food are needed, not only in the classroom but also in daily life. Full article
(This article belongs to the Special Issue Impact of Front of Pack Nutrition Label on Nutritional Behavior)
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