Frontiers in Nutrition

Background Post-Acute COVID-19 Syndrome (PACS) is an important sequalae of COVID-19. Then, our objective was to analyze the risk and protective factors for PACS in Brazilian adults participating in the Cohort of Universities of Minas Gerais (CUME Study), with emphasis on COVID-19 vaccination and food consumption. Methods In this sub-study, we included 2,065 participants of CUME Study who answered the baseline questionnaire in 2016 or 2018 or 2020 or 2022, and the follow-up COVID-19/PACS-specific questionnaire in 2023. PACS diagnosis was based on self-reporting of continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. To estimate the risk and protective factors for PACS, hierarchical multivariate statistical analysis was conducted using the Cox regression technique, producing two models: (1) focusing on consumption of macro and micronutrients; (2) focusing on consumption of food groups. Results After a median of 5.5 years of follow-up, 54.4% of the participants reported PACS. When we analyzed the consumption of macro and micronutrients, higher intake of proteins (HR: 1.36; 95% CI: 1.06–1.74-4th quartile) and lipids (HR: 1.23; 95% CI: 1.02–1.48-4th quartile) were risk factors for PACS. On the other hand, higher intake of vitamin C (HR: 0.78; 95% CI: 0.64–0.94-4th quartile), vitamin D (HR: 0.81; 95% CI: 0.67–0.99-4th quartile), and zinc (HR: 0.66; 95% CI: 0.52–0.83-4th quartile) were protective factors for the outcome (model 1). When we analyzed the consumption of food groups, higher intake of eggs (HR: 1.59; 95% CI: 1.34–1.89-4th quartile) increased the risk of PACS, whereas, respectively, higher and intermediate consumption of white meat (HR: 0.84; 95% CI: 0.71–1.00-4th quartile) and vegetables (HR: 0.81; 95% CI: 0.67–0.99-2nd quartile; HR: 0.81; 95% CI: 0.67–0.99-3rd quartile) decreased the risk of the outcome (model 2). In both models, pre-infection COVID-19 vaccination was a protective factor for PACS. Conclusion A healthy diet, with higher consumption of white meat, vegetables and specific micronutrients (vitamin C, vitamin D, zinc), in parallel with pre-infection COVID-19 vaccination, is essential to reduce the risk of PACS.

Background Sarcopenia, the accelerated loss of muscle mass and function, is commonly associated with aging, especially in older adults. While low serum calcium has been linked to muscle loss in individuals over 50, its relationship with sarcopenia in younger adults (20–60 years) is unclear. This study examines this association using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Methods This population-based, cross-sectional study analyzed participants aged 20–60 from NHANES 2011–2018. Individuals with missing data were excluded. Sarcopenia was assessed using appendicular skeletal muscle (ASM) measured by dual-energy X-ray absorptiometry, defined by ASM/BMI or ASM/Weight. Multiple logistic regression and stratified analyses were used to explore the correlation between serum calcium levels and sarcopenia prevalence. Results Among 7,309 adults, 578 (7.91%) had sarcopenia by ASM/BMI and 1,363 (18.65%) by ASM/Weight. Higher serum calcium levels were significantly associated with a lower risk of sarcopenia (ASM/BMI: OR 0.07, 95% CI 0.02–0.20; ASM/Weight: OR 0.09, 95% CI 0.04–0.19). The trend was consistent across age, gender, education, poverty income ratio, and race, with some exceptions. Conclusion This study highlights a negative association between serum calcium and sarcopenia risk in young and middle-aged adults, suggesting that calcium interventions could be beneficial in preventing sarcopenia in this population. However, the cross-sectional design precludes any inference of causality, and further longitudinal studies are warranted to confirm these findings.

Complex coacervation is a widely used method for bioactive compound microencapsulation. Red cabbage extract is a natural pigment that contains anthocyanins, which provide attractive and bright colors with no reported toxicity and associated healthy properties. These types of pigments have led to a deep interest in developing natural colorants to at least partially replace their synthetic counterparts in the food industry. The present study aimed to encapsulate red cabbage extract using a complex coacervation system comprising gum arabic:inulin (GA:In) and pea protein (PP) as wall materials. A total of four treatments were tested, maintaining a consistent pea protein concentration (1%), and the concentrations of GA:In (1 and 3%) and red cabbage extract (1 and 10%) were varied. The results showed high encapsulation efficiency values, with all treatments achieving encapsulation levels above 95%. The total monomeric anthocyanin concentration was 6.7 μg anthocyanin Eq. C3G/mg of flour, and to explore bioactivity of the extract, α -amylase inhibition was analyzed, with an inhibitory percentage of 22.48% at a concentration of 0.5 mg/mL. The solubility of the coacervates ranged from 70.12 to 75.84% in water, and their morphology revealed irregular and porous shapes. Fourier Transform Infrared Spectroscopy (FTIR) analysis confirmed the formation of the coacervate-encapsulation complex. Characteristic bands showed the presence of functional groups from the wall materials and the encapsulated anthocyanins. These findings showed that the use of GA, In and PP as wall materials in complex coacervation can develop natural colorants with improved stability and functionality.

Poor dietary practices among children aged 6–23 months pose a critical public health challenge, hindering their physical and cognitive development. The National Family Health Survey-5 (NFHS-5) reveals that only 11% of children in this age group consume diets meeting the minimum dietary diversity requirements. To address this, a targeted intervention was designed and implemented to improve dietary diversity in children. This study evaluates the intervention’s impact on enhancing dietary diversity and fostering changes in gender norms, such as increased male participation in nutrition-related decision-making, food procurement, shared childcare responsibilities, and discussions about children’s nutritional needs. This research employed a quasi-experimental design with baseline and endline rounds. The intervention and control blocks were selected from the same district based on matching criteria such as population size, literacy rate, etc. The sample size was determined using a two-sample proportion formula to detect an 9% difference between the intervention and control groups, with a 95% confidence level and 80% statistical power. Household listing identified 1,684 and 1,362 children aged 6–11 months in the intervention and control blocks, respectively. 400 fathers and 400 mothers were randomly sampled from both arms in each survey round. The intervention’s impact was assessed using a difference-in-differences (DID) approach. The results revealed significant improvements in the minimum dietary diversity of children aged 6–23 months (DID coefficient, 21%; p < 0.00). At baseline, the intervention and control groups had similar dietary diversity (14% and 13%, respectively), but by endline, the intervention group had significantly improved to 50% compared to 29% in the control group. Knowledge of dietary diversity increased substantially among mothers (DID: 31.3%; p < 0.00) and fathers (DID: 15.6%, p < 0.00). Collaborative meal planning improved (DID: 9.8%; p < 0.00) along with better planning for purchasing vitamin A-rich foods (DID: 28.1%; p < 0.00). These findings highlight the effectiveness of engaging men in nutrition programs to support women in child-feeding practices. The intervention improved dietary practices for young children and promoted a gender-inclusive approach. Scaling this program to other regions could enhance child nutrition outcomes and contribute to better child health and development.

Introduction Retinopathy is a multifactorial disease influenced by metabolism, immunity, inflammation, and other factors. The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel immunonutritional score that has shown promise in various health contexts. This study aims to investigate the association between the CALLY index and retinopathy risk, and to compare its predictive performance with other established inflammatory markers. Methods Data from 5,439 participants in the 2005–2008 National Health and Nutrition Examination Survey (NHANES) were utilized. Multivariable-weighted logistic regression was employed to assess the association between the CALLY index and retinopathy risk. Additionally, the predictive performance of the CALLY index was compared with other inflammatory markers. Mediation analysis was conducted to explore potential mediating factors in the association between the CALLY index and retinopathy. Results Multivariable-weighted logistic regression revealed a significant inverse association between the CALLY index and retinopathy risk (OR = 0.96, 95% CI = 0.94–0.98, P = 0.002). Participants in the highest CALLY index quartile exhibited a markedly lower risk of retinopathy ( P < 0.001). The CALLY index demonstrated superior predictive performance compared to other inflammatory markers, with an area under the curve (AUC) of 0.672 (95% CI = 0.643–0.701). Mediation analysis indicated that high-density lipoprotein (HDL) levels partially mediated the association between the CALLY index and retinopathy. Discussion These findings highlight the CALLY index as a reliable, independent biomarker for retinopathy risk assessment, outperforming traditional inflammatory markers and oering potential clinical value for early identification of retinopathy in individuals with chronic diseases.

Background Cardiorenal syndrome (CRS) represents a burgeoning global health concern characterized by its increasing prevalence. Life’s Crucial 9 (LC9), an innovative tool for cardiovascular health assessment, and the Dietary Inflammatory Index (DII), which quantifies diet’s impact on body inflammation, have not been previously studied in conjunction regarding their association with CRS. Objective This study aims to explore the relationship between LC9 and CRS, using data from the National Health and Nutrition Examination Survey (NHANES), and to examine whether DII serves as a mediator in this association. Methods This research included data from 25,792 NHANES participants spanning from 2005 to 2018. The study leverages the dataset’s comprehensive representativeness and robust statistical power to ensure generalizable and reliable findings. We employed weighted logistic regression to evaluate the association between LC9 scores and CRS presence, conducted subgroup analyses, and performed mediation analysis to investigate the role of DII. Results Our analysis demonstrated a significant inverse relationship between LC9 and CRS. Upon controlling for confounders, each 10-point rise in LC9 correlates with a 26% reduction in CRS prevalence ( p < 0.001). Additionally, stratifying LC9 into tertiles with T1 as the reference group revealed that T2 (OR = 0.59, 95% CI = 0.48–0.72, p < 0.001) and T3 (OR = 0.57, 95% CI = 0.38–0.88, p < 0.001) exhibited a strong negative correlation trend. The dose–response curve illustrates a linear relationship between LC9 and CRS; as LC9 increases, the occurrence of CRS decreases. DII shows a significant positive connection with CRS ( p < 0.001), but DII indicates a decreasing trend when LC9 rises ( β = −0.65, p < 0.001). Mediation analysis reveals that DII mediates the association between LC9 and CRS, with a mediation proportion of 12.5% ( p < 0.001). Conclusion The findings indicate a robust inverse correlation between LC9 scores and CRS incidence, with DII is associated with this relationship. This suggests potential preventive strategies against CRS through lifestyle modifications guided by LC9.

Background Previous studies have highlighted the effects of diet and gut microbiota on the incidence of kidney stones, and the dietary index for gut microbiota (DI-GM) is a new dietary index that accurately represents the variety of gut microbiota. The current study intends to examine the potential correlation between DI-GM and kidney stones. Methods Data from the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were employed in this cross-sectional study. The history of kidney stones was assessed using a kidney conditions questionnaire. In order to examine the correlation between DI-GM and kidney stones, multivariate logistic regression was implemented. Additionally, smoothed curve fitting, subgroup analyses, and sensitivity analyses were conducted. Results The investigation encompassed a total of 21,587 participants. After adjusting for all potential covariates, we found that DI-GM was negatively related to the incidence of kidney stones (OR = 0.96, 95% CI = 0.93–0.98, p = 0.0021). Compared to those in the lowest quartile, participants in the highest quartile had a lower prevalence of kidney stones (OR = 0.86, 95% CI = 0.75–0.98, p = 0.0252). Additionally, smoothed curve fitting revealed that DI-GM was linearly associated with the incidence of kidney stones. The results of the sensitivity analyses proved the robustness of the main analyses. Conclusion A negative correlation between the incidence of kidney stones and DI-GM is supported by the evidence presented in this study. This finding emphasizes the potential benefits of adjusting dietary structure according to DI-GM in reducing the incidence of kidney stones. Further research should validate this discovery by employing longitudinal studies.

Sugar reduction is a major public health priority. Due to the assumed correlation between dietary sweetness and sugars intake, some organizations suggest minimizing dietary sweetness regardless of source. Data describing the trends/patterns in the sweetness of the diet may inform dietary recommendations. This cross-sectional study utilized dietary data from 2008/09 to 2018/19, including 15,655 individuals ≥1.5 year from the United Kingdom's National Diet and Nutrition Survey Rolling Program. Products sweetened with low-calorie sweeteners (LCS) were matched to their sugar-sweetened pair (e.g., regular cola vs. diet cola), which was used to estimate the sugar equivalents from LCS-sweetened products and estimate dietary level sweetness, defined as grams of approximate sugar equivalent (ASE) per day. Foods and beverages that underwent reformulation during the study period through the use of LCS were also identified. From 2008/9 through 2018/19, the ASE of the overall UK diet declined by about 10%. LCS products contributed 13% of ASE. There was evidence of a non-linear trend, with ASE levels relatively stable until 2014/15 and then declining. Overall, the decline in ASE was larger for beverages than foods (ASE values declined 20.7% for beverages vs. 4.4% for foods), although both decreased significantly ( p -value < 0.01). Dietary sweetness has changed in the UK, due to a combination of consumer behavior, reformulations, policies, public health awareness programs, and media campaigns, emphasizing its multifactorial nature.

Background This study aimed to investigate the independent and combined effects of prolonged daily sitting time and sleep duration on the risk of constipation, using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010. Methods A total of 6,894 participants were included in the analysis. Daily sitting time and sleep duration were self-reported and categorized as short (<7 h/day) or long (≥7 h/day). Constipation was defined based on stool consistency and frequency using the Bristol Stool Form Scale. Multivariable logistic regression models were used to estimate the odds ratios (ORs) for constipation. A restricted cubic spline analysis was applied to assess the dose–response relationships. Results Participants with prolonged daily sitting time and short sleep duration showed a higher risk of constipation compared to those with long sleep duration and short sitting time. In multivariable-adjusted models, long sitting time was positively associated with an increased risk of constipation (OR = 1.424; 95% CI, 1.114–1.821), while long sleep duration was associated with a lower constipation risk (OR = 0.725; 95% CI, 0.553–0.952). The joint analysis revealed that the combination of short sleep duration and long sitting time was associated with the highest constipation prevalence (OR = 1.975; 95% CI, 1.378–2.833). Conclusion Both prolonged sitting time and insufficient sleep were associated with an increased risk of constipation, especially when combined. These findings underscore the importance of adopting healthier sleep habits and reducing sedentary behavior to lower constipation risk.

Background Recent studies demonstrated a strong association between dietary habits and liver health, particularly in the development of steatosis and fibrosis. This study aimed to examine the impact of ultra-processed foods (UPFs) on liver health, focusing specifically on their influence on the risks of liver steatosis and fibrosis. Methods A cross-sectional analysis was conducted on 4,992 participants aged 18 years and older from the 2017–2020 National Health and Nutrition Examination Survey (NHANES). Dietary intake was assessed using one or two 24-h dietary recalls, and foods were categorized by their processing level using the NOVA classification system. UPFs consumption was measured in grams and divided into quartiles. Liver health was assessed using controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) via elastography, to evaluate steatosis and fibrosis, respectively. Linear regression models were applied to assess the relationship between UPFs consumption and liver outcomes, adjusting for sociodemographic (age, sex, ethnicity), lifestyle (alcohol consumption, physical activity), and biomedical factors (liver enzyme levels). Results Higher UPF intake was significantly associated with increased CAP values, indicating a higher risk of liver steatosis. While liver fibrosis, measured by LSM, was also associated with UPF consumption, this relationship did not reach statistical significance. Multivariate analysis showed that increased UPF consumption did not significantly affect LSM ( p = 0.110) but was strongly associated with elevated CAP values ( p = 0.009). In participants with fatty liver (CAP > 248 dB/m), the association between UPF intake and CAP remained significant ( p = 0.020). Participants in the highest quartile of UPFs consumption (Q4) exhibited higher CAP values compared to those in the lowest quartile (Q1) (β = 1.22; 95% CI: 1.02, 1.47). Stratified analysis revealed that the association between UPF intake and CAP was more pronounced in obese individuals (HR = 1.08, 95% CI: 1.03–1.15, p = 0.022) and those with high waist circumference (HR = 1.06, 95% CI: 1.01–1.10, p = 0.032). Conclusion These results underscore the adverse impact of UPFs on liver health, particularly by increasing steatosis, while the connection with fibrosis remains less straightforward.

Introduction The significance of the C-reactive protein-albumin-lymphocyte index [CALLY index (CI)] as a prognostic factor in gastric cancer remains unexplored. Therefore, this study assessed the utility of the CI as a predictor of short-term postoperative outcomes and long-term prognosis after gastric cancer surgery. Methods This study consisted of two cohorts. Cohort 1 included 120 patients who underwent distal gastrectomy for clinical stages I–III primary gastric cancer between November 2022 and March 2024. Patients were categorized into high- and low-CI groups, and complications were classified accordingly. Propensity score matching was performed based on clinical stage, surgical approach, and lymph node dissection extent, yielding 40 matched cases. The relationship between preoperative CI and short-term postoperative outcomes was analyzed. Cohort 2 included 358 patients with pathological stages I–III gastric cancer who underwent distal gastrectomy between January 2014 and December 2017. Preoperative CI was assessed, and its association with long-term outcomes was evaluated. Prognostic factors were also analyzed. Results In Cohort 1, the preoperative CI was associated with short-term postoperative outcomes. Compared with the high-CI group, the low-CI group developed significantly more complications, including postoperative pneumonia. In Cohort 2, the 5-year overall survival (OS) and recurrence-free survival (RFS) differed significantly between the high and low CI groups. CI was an independent prognostic factor for OS and RFS. Conclusion The CI reflects patients' overall systemic conditions and may be a valuable predictor of short-term outcomes and long-term prognosis following gastric cancer surgery.

Background Children in the U.S. drink too little water and too much juice and sugar sweetened beverages. Inadequate access to drinking water in locations where children spend substantial time, like family childcare homes (FCCH) could play a role in low child water intake. The aim of this qualitative study was to explore barriers and facilitators to water availability and accessibility in FCCH, and determine potential strategies for facilitating water accessibility and children’s intake in FCCH. Methods We conducted virtual interviews, in Spanish and/or English, with family child care providers (FCCP) from Rhode Island, Connecticut, and Massachusetts. Interviews were conducted by University of Connecticut graduate students, including two who were fluent in Spanish and English. These were audio-recorded, transcribed verbatim, and translated to English. We conducted a deductive analysis using a priori themes. Additional codes were developed and applied to capture emerging themes from the qualitative data. Results Twenty FCCP (100% identified as female; 50% as Latina) participated in the interviews. FCCP barriers to water availability at FCCH included focus on other beverages, e.g., milk; confusion with the Child and Adult Care Food Program (CACFP) guidelines regarding water, and concerns about: water quality, mess, children eating enough food/milk, bathroom accidents, and cost for filters/bottled water. Barriers to children drinking water included: children not liking or preferring water, parental preferences/role modeling, and parental concerns about water quality. Suggested potential strategies to facilitate water access and intake included water filters to ensure safe water access, self-serving stations and water bottles to encourage autonomy among children, and incorporating water into daily routines. Participants also favored materials and activities to educate and encourage children to drink water and to keep track of their intake. Conclusion These findings suggest that interventions to increase water consumption at FCCH should provide resources to guarantee safe water access to children, encourage children to drink water, and help clarify misperceptions and confusion around CACFP beverage guidelines. Future research should evaluate the effectiveness of interventions to provide education and water access resources to FCCP and families on improving child water access, availability and intake.

Endometriosis is an estrogen-dependent chronic inflammatory disease which causes dysmenorrhea, chronic pelvic pain, and infertility in women of childbearing age, significantly impacting their quality of life and physical and mental health. The etiology of endometriosis remains unclear, with oxidative stress and inflammation currently thought to play pivotal roles in its pathophysiology. Epidemiological studies and clinical trials indicate that varying dietary patterns and specific nutrient supplementation can influence oxidative stress markers and levels of inflammatory factors and related pathways, potentially impacting the progression of endometriosis. In this review, we summarize the roles of oxidative stress and inflammation in endometriosis and thoroughly examine the current understanding of the effect of dietary patterns and nutrient supplementation in treating endometriosis. This study suggests that nutrients may prevent the occurrence of endometriosis by modulating levels of inflammatory factors, regulating angiogenesis, and influencing the metabolism of estrogen pathways. The findings might provide new insights into the treatment of endometriosis patients and the potential benefits of dietary patterns and nutrient supplementation in patients with endometriosis.

Objective Previous cross-sectional studies have demonstrated that the body roundness index (BRI) is associated with knee osteoarthritis (KOA). However, no longitudinal studies have confirmed this association. This study aims to explore the link between BRI and KOA risk in the Chinese population through longitudinal analysis and to evaluate its utility in early diagnosis and risk prediction. Methods This study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,318 participants who were followed from 2015 to 2020 were included. BRI was calculated using physical examinations and questionnaire data, and participants were categorized by quartiles. The relationship between BRI and KOA risk was assessed using multivariate weighted regression models and trend tests, while subgroup and sensitivity analyses were conducted to ensure the robustness of the findings. Results After 5 years of follow-up, 1,035 participants (14.14%) were diagnosed with KOA. Findings indicate a positive correlation between BRI and KOA risk ( HR = 1.08, 95% CI : 1.02–1.13, p = 0.0039), with an increasing trend in KOA risk across BRI quartiles ( p for trend = 0.0033). Subgroup analysis reveals that the association is particularly strong among individuals aged 50–59, males, those living in rural areas, and those without cardiovascular disease. Conclusion This study establishes that an increase in BRI significantly elevates KOA risk. These findings suggest that BRI could be an effective tool for KOA risk assessment and could contribute to the development of personalized prevention strategies. Additionally, BRI is valuable in elucidating the potential mechanisms linking body fat distribution and inflammatory responses in KOA progression.

Background The accumulation of heavy metals in soil and plants poses risks to food safety. Human exposure to heavy metals has been linked to stroke risk, though research on this connection is limited and findings are inconsistent. Methods We estimated the associations of 7 blood metals [cadmium (Cd), lead (Pb), mercury (Hg), manganese (Mn), copper (Cu), selenium (Se), and zinc (Zn)] with the risk of stroke among 11,803 U.S. adults. Logistic regression account for the intricate sampling design and restricted cubic spline (RCS) was used to explore the associations between single heavy metal and stroke risk. The weighted quantile sum (WQS) and quantile g-computation (qgcomp) were employed to explore the joint effects of seven metals on stroke. Potential confounders were adjusted. Results After adjusting for the potential confounders, the logistic regression analysis showed the log-transformed Cd and Zn level was associated with stroke (All p < 0.05). After adjusting for the potential confounders, the logistic regression analysis showed the log-transformed Cd and Zn level was associated with stroke (All p < 0.05). WQS and qgcomp analyses consistently demonstrated a positive correlation between metals-mixed exposure and stroke risk, identifying Cd and Cu as key contributors to the outcomes, while Zn may serve as a protective factor. Conclusion These findings indicated that heavy metal exposure is associated with stroke risk, and the protective effect of Zn on stroke risk deserves further research to verify.

Background Malnutrition commonly affects patients with oral squamous cell carcinoma (OSCC), which contributes to worsening prognosis. Moreover, specific strategies for diagnosing and managing malnutrition in OSCC are lacking. We aimed to investigate if the modality of nutritional treatment as standard oral (ON) or artificial enteral nutrition (AN), assigned by a dedicated nutritional team or not, influences survival in patients with OSCC. Moreover, given the difficulties in obtaining adequate nutritional evaluation in patients with OSCC we preliminary evaluated the magnetic resonance imaging volumetric reconstruction of posterior paraspinal muscles at the level of the third cervical vertebra (MRI-C3) as a tentative new approach to investigate sarcopenia. Methods This retrospective study included 52 consecutive patients with OSCC who underwent surgery at the University Hospital of Palermo (I) from Jan 2020 to May 2023. In-hospital nutritional support was provided by a dedicated team. The patients were retrospectively compared with a control group of 11 patients who were surgically treated for OSCC between January and December 2019 in the same unit of surgery, in the absence of a dedicated nutritional team. Upon discharge, the nutritional treatment consisted of ON or AN. In 2020–2023, industrially produced special medical food formulations were used rather than natural foods as it was in use in 2019; also, adequate protein supplements were assigned in order to reach the recommended protein intake of 1–0-1.2 g/kg ideal body weight. The MRI-C3 volumetric reconstruction was obtained in 16 patients. Findings As per-protocol, the patients were categorized according to pre-surgery TNM stage: groups A (TNM stages I-III) and B (IVa-IVc). The prevalence of group A patients was 59.6% in the case group and 85.7% in the control group ( p < 0.001), with higher survival rates at follow-up in the control group (80.5% vs. 27.3%), therefore, the two historical groups were not comparable. Given the limited number of cases, all patients were included in a unique group. Advanced stages of OSCC (log-rank test, p < 0.001) and AN ( p < 0.001) were independently associated with a lower survival rates. The 3–12 month post-surgery MRI_C3 volume increased in patients who received ON treatment and decreased in those who received AN treatment ( p < 0.001). Conclusion AN is associated with lower survival probability than ON in patients with OSCC. The MRI-C3 measurement of paravertebral muscles is a promising technique for detecting sarcopenia that needs to be confirmed by further studies including larger groups of patients.

Background: Hyperuricemia (HUA) is the presence of excessive uric acid (UA)in blood, which leads to an increased risk of chronic kidney disease and goutThere are about 120 million hyperuricemia patients in China, which has surpasseddiabetes as the second largest chronic diseaseObjective: The aim of the present study was to investigate the hypouricemiceffects of Dendrobium huoshanense C.2. Tang and S. j. Cheng (DH), and providea basis for its development into anti HUA products.Methods: This study established a mouse HUA model by gavage of potassiumoxonate (PlO) and hypoxanthine (HX), and treated with DH to investigate thetherapeutic effect of DH on hyperuricemia. Use a biochemical assay kit to detectchanges in the levels of UA, creatinine (Cr), and urea nitrogen (BUN) in mouseserum; Use ELlSA kit to detect the activity of xanthine oxidase (XOD) in serum,Untargeted Metabolomics analysis was performed on the serum of each groupof mice using liquid chromatography-mass spectrometry. This study recruited23 HUA volunteers, volunteers drank 0.5 g DH daily for four consecutive weekswith serum UA levels measured once a week.Results: Animal experiments have shown that DH has therapeutic effects onHUA, mainly manifested as: DH effectively reduces the levels of UA, Cr, and BUNin the serum of HUA mice, lowers XOD activity in the serum, and alleviates kidneytissue and glomerular damage. Metabolomics analysis showed that there were306 significant differences in metabolites between the Sham group, HUA modelgroup, and DH group. Pathway analysis of these differential metabolites revealedthat they were mainly involved in pyrimidine metabolism, histidine metabolismand riboflavin metabolism. Clinical research results show that after drinking DHUA levels in HUA volunteers significantly decreased, and most HUA volunteersUA levels decreased to normal levels.Conclusion: DH has the effect of preventing and treating hyperuricemia, andit belongs to the same class of traditional Chinese medicine as medicine andfood, with extremely low toxicity and high safety. Therefore, DH is suitable for preparation as a product for preventing and treating HUA in functional food andother products. KEYWORDS: Dendrobium huoshanense C.Z. Tang and s. J. Cheng, hyperuricemia, homology-of.medicine-and-food, untargeted metabolomics, functional food

Background Adolescent psychosocial symptoms continue to rise, negatively affecting academic performance and future achievement, and have become an important public health issue of common concern worldwide. However, few studies have been conducted on the association between body roundness index (BRI) and sugar-sweetened beverage (SSB) consumption and psychological symptoms in Chinese adolescents. The present study may provide implications for the intervention and prevention of psychological symptoms in Chinese adolescents. Methods In this study, 47,520 adolescents aged 12–18 years from six geographic regions of China were assessed cross-sectionally for BRI, SSB consumption, and psychological symptoms in 2023. Independent samples t-tests, chi-square tests, logistic regression analyses, and ordered logistic regression analyses were used to compare and analyze the associations that existed between BRI and SSB consumption and psychological symptoms among Chinese adolescents. Results The BRI of Chinese adolescents aged 12–18 years was (2.03 ± 0.94). The proportions of adolescents with SSB consumption ≤1 times/week, 2–3 times/week, and ≥ 4 times/week were 33.2, 52.0, and 14.7%, respectively, and the differences were statistically significant in comparison ( X ² value of 597.860, p < 0.001). The prevalence of psychological symptoms among Chinese adolescents was 19.2%. The prevalence rates of emotional problems, behavioral problems, and social adjustment difficulties were 26.1, 25.2, and 16.1%, respectively. After adjusting for relevant covariates, ordered logistic regression analysis showed that with BRI quartiles Q1 and SSB consumption ≤1 times/week as the reference group, the adolescents in the group with BRI quartiles of Q4 and SSB consumption ≥4 times/week (OR = 2.01, 95% CI: 1.77–2.30) had the highest risk of developing psychological symptoms ( p < 0.001). Conclusion There is an association between BRI and SSB consumption with psychological symptoms in Chinese adolescents. Chinese adolescents with higher BRI and SSB consumption were at higher risk of developing psychological symptoms. In the future, the increase in BRI and SSB consumption should be effectively controlled to prevent or reduce the occurrence of psychological symptoms.

Background The incidence of Chronic Inflammatory Airway Diseases (CIAD) has been steadily increasing, making it a significant contributor to the global disease burden. Additionally, the risk of airway diseases in elderly women continues to rise each year, with nutritional factors playing a crucial role in the progression of CIAD. The Geriatric Nutritional Risk Index (GNRI) is a novel tool for assessing individual nutritional status. This study aims to assess the relationship between GNRI and the risk of all-cause and cardiovascular mortality in elderly women with CIAD, providing guidance for nutritional interventions to reduce mortality risk. Methods Data from elderly female patients and relevant indicators were sourced from the National Health and Nutrition Examination Survey (NHANES) database. Nutritional status was assessed using the GNRI, and patients were divided into four groups based on their GNRI quartiles. Weighted Cox proportional hazards regression models were used to examine the relationship between GNRI and all-cause as well as cardiovascular mortality in elderly women with CIAD. Additionally, restricted cubic spline (RCS) analysis was applied to explore the association between GNRI and different mortality outcomes, and subgroup analysis was conducted to further validate the robustness of the findings. Results A total of 1,417 elderly female CIAD patients were included in this study. During a median follow-up of 91 months, 515 deaths from all causes and 157 deaths from cardiovascular causes occurred. Multivariable-adjusted Cox proportional hazards models indicated that compared to the lowest GNRI quartile, the other quartiles showed a general decreasing trend in both all-cause and cardiovascular mortality risk ( p < 0.05). In the fully adjusted model, the highest GNRI quartile had the lowest risks of all-cause mortality (HR = 0.40, 95% CI: 0.22–0.72, p < 0.05) and cardiovascular mortality (HR = 0.29, 95% CI: 0.11–0.78, p < 0.05).The RCS analysis demonstrated a nonlinear association between GNRI and both all-cause and cardiovascular mortality ( P for nonlinearity <0.001). Conclusion In elderly women with CIAD, lower GNRI levels are associated with an increased mortality risk. GNRI may serve as a potential predictive tool for both all-cause and cardiovascular mortality, providing valuable insights for nutritional interventions and clinical decision-making.

Background Mid-Upper Arm Circumference (MUAC) or Weight-for-Length Z-Score (WHZ) are used to screen for acute malnutrition in children. The relative merits of MUAC and WHZ, as well as whether they ought to be used separately, are still up for debate. Considering the significant impact of acute malnutrition on a large number of children in Africa, along with the constraints on resources, it is crucial to critically assess the validity of simple and widely used tools utilized in both African communities and clinical settings. Therefore, this study aimed to assess the diagnostic test accuracy of MUAC in screening acute malnutrition among children aged 6–59 months in Africa. Methods A systematic review and meta-analysis study was conducted to pool evidence on the diagnostic performance of MUAC compared to WHZ among children aged 6 to 59 months across various studies in Africa. The StataMP 17.0 software was utilized for analysis, employing a Bivariate Random-effects Meta-Analysis model. Sensitivity, specificity, the Diagnostic Odds Ratio, and the Area Under the Curve were calculated. Heterogeneity was assessed using Cochrane’s Q statistic and the I ² test. Additionally, meta-regression, subgroup analysis, sensitivity analysis, and assessments for publication bias were employed. The overall level of diagnostic test accuracy was estimated using a random-effects meta-analysis model. Results Seventeen studies were included in the meta-analysis. The pooled sensitivity and specificity were 38.1% (95% CI: 30.7, 46.1%) and 94.9% (95% CI: 93.2, 96.2%), respectively. The summary receiver operating characteristic curve plot showed that MUAC had good accuracy in detecting acute malnutrition (AUC = 0.85, 95% CI: 0.82, 0.88). The pooled level of diagnostic odds ratio was 13.22 (95% CI: 9.68, 16.77). The rate of misclassification in screening for acute malnutrition using MUAC was observed to be 11.7%. Conclusion The MUAC demonstrated low sensitivity but high specificity in diagnosing acute malnutrition in children aged 6 to 59 months across various regions of Africa. Furthermore, it was found that MUAC provides good diagnostic test accuracy when compared to WHZ. To enhance its accuracy, it is suggested to increase the MUAC cutoff thresholds.

This study used NHANES data from 2007 to 2018 to examine the relationship between frailty and the Body Roundness Index (BRI) in U.S. people 60 years of age and older. BRI = 364.2–365.5 × sqrt [1–(wc/2π) ² /(Height/2) ² ]. The degree of frailty was assessed by the frailty index (≥ 0.25). The relationship between frailty and BRI was examined using weighted multivariate logistic regression. To account for potential non-linear patterns, generalized additive modeling (GAM) was utilized, and the ability of BRI to predict frailty was assessed using receiver operating characteristic (ROC) analysis. Results showed that BRI was significantly and positively associated with prevalence of frailty, with a 34% increase in prevalence of frailty per unit increase in a fully adjusted model (OR: 1.34, 95% CI: 1.28, 1.40; p < 0.0001). The GAM model showed a significant nonlinear relationship and threshold effect. This study indicates that a higher BRI is closely linked to the onset of frailty in older adults, although additional confirmation through large-scale prospective studies is required.

Objective The evidence surrounding the connection between the Prognostic Nutritional Index (PNI) and the prognosis of patients with Acute Ischemic Stroke (AIS) remains insufficient. Therefore, this study is designed to examine how PNI relates to short-term outcomes in individuals affected by AIS. Methods This study is a single-center, prospective cohort investigation. The study sample comprised 1,697 patients with AIS who received treatment at Shenzhen Second People’s Hospital between January 2022 and June 2024. To evaluate the association between the PNI and the risk of at 90-day unfavorable outcomes, as well as 90-day mortality, a binary logistic regression model was employed. Furthermore, a logistic regression model incorporating cubic spline functions was utilized to explore the potential non-linear relationship between PNI and 90-day unfavorable outcomes. Additionally, a series of sensitivity analyses and subgroup analyses were performed to enhance the robustness of the findings. Results Following the adjustment for covariates, the binary logistic regression analysis demonstrated a notable inverse connection between PNI and the occurrence of unfavorable outcomes at 90 days among patients diagnosed with AIS (OR = 0.951, 95% CI: 0.925–0.979). A similarly significant negative relationship was found between PNI and 90-day mortality (OR = 0.868, 95% CI: 0.806–0.934). Additionally, the study revealed a non-linear association between PNI and 90-day, identifying an inflection point at PNI = 49.3. To the left of this inflection point, the OR for the risk of 90-day unfavorable outcomes in AIS patients was 0.910 (95% CI: 0.880–0.942). Conversely, to the right of the inflection point, the OR was 1.149 (95% CI: 0.998–1.249), although this finding was not statistically significant. The findings were further supported by sensitivity analyses, which reinforced the reliability of these results. Conclusion This study reveals a significant negative association between the PNI and 90-day unfavorable outcomes as well as 90-day mortality in patients with AIS. A non-linear relationship between PNI and 90-day unfavorable outcomes was observed. Specifically, a significant inverse association between them was evident when PNI values were below 49.3. These findings offer valuable insights for refining rehabilitation strategies and improving the clinical management of AIS patients.

Adhering to the ketogenic diet can reduce or stop seizures, even when other treatments fail, via mechanism(s) distinct from other available therapies. These results have led to interest in the diet for treating conditions such as Alzheimer’s disease, depression and schizophrenia. Evidence points to the neuromodulator adenosine as a key mechanism underlying therapeutic benefits of a ketogenic diet. Adenosine represents a unique and direct link among cell energy, neuronal activity, and gene expression, and adenosine receptors form functional heteromers with dopamine receptors. The importance of the dopaminergic system is established in addiction, as are the challenges of modulating the dopamine system directly. A mediator that could antagonize dopamine’s effects would be useful, and adenosine is such a mediator due to its function and location. Studies report that the ketogenic diet improves cognition, sociability, and perseverative behaviors, and might improve depression. Many of the translational opportunities based on the ketogenic diet/adenosine link have come to the fore, including addiction, autism spectrum disorder, painful conditions, and a range of hyperdopaminergic disorders.