Perinatal dietary patterns and symptomatic depression: A prospective cohort study.

To promote maternal and infant health, there is a need to optimise the dietary pattern of pregnant women to reduce perinatal depression. This prospective cohort study was conducted from June 2020 to February 2022, 300 women from a medical center were interviewed during late pregnancy and at 4-6 weeks postpartum. Dietary patterns were derived by factor analysis using a semiquantitative food frequency questionnaire. Symptomatic depression was defined using the Edinburgh Postpartum Depression Scale (EPDS, ranged 0-30). Their dairy, vegetable and fruit intakes were below the Taiwanese recommendations for pregnant women. Symptomatic depression (EPDS ≥10) affected 31.3% in the third trimester and 35.7% postpartum. Pre- and post-EPDS scores were positively correlated (r = 0.386, p < 0.001). Approximately 55% of those depressed before delivery were also depressed postpartum. For late pregnancy, four dietary patterns were identified ('Good oil', 'Vegetables and fruits', 'Omnivorous' and 'Refined-grain and organ meats'). Dietary patterns were classified according to quartiles (Q). Higher omnivorous pattern scores reduced the risk of depression. For prenatal depression, with Q1 as a reference, the risk was reduced by 38% for Q2, 43% for Q3 and 59% for Q4 (p for trend = 0.068). These findings became evident postpartum (reduced risk by 68% for Q2, 69% for Q3 and 70% for Q4 (p = 0.031; p for trend = 0.0032). The association between dietary patterns and depression encourages the routine nutritional management of pregnant women.

Effect of time-restricted feeding on body composition and cardio-metabolic risk in middle-aged women in Taiwan.

OBJECTIVES: We sought to investigate the effects of time-restricted feeding (TRF) and a traditional weight-loss method on body composition and cardio-metabolic risk factors in middle-aged women. METHODS: In a single-center, randomized, open-label, parallel-group design, women ages 40 to 65 y with body mass index ≥ 24 kg/m2 or waist circumference > 80 cm were recruited. They were guided to a daily low-calorie diet of 1400 kcal and randomly assigned into a TRF group (limit 8 h of eating time and fasting for 16 h) or a non-TRF group (traditional weight-loss method, unrestricted eating time) for 8 wk. Body composition, blood pressure, blood biochemical variables, and insulin resistance status were measured before and after intervention. RESULTS: Body weight, body mass index, waist circumference, and body fat mass decreased significantly in both groups after 8 wk of intervention (P < 0.05). Body weight decreased more in the TRF group than the non-TRF group (-4.1% ± 2.8% versus -2.4% ± 2.5%; P = 0.012), as did diastolic blood pressure (75.3 ± 11.2 mm Hg versus 70.5 ± 9.4 mm Hg; P = 0.012). There were no statistical differences between the two groups in total cholesterol, triacylglycerols, high- or low-density lipoprotein cholesterol, and fasting insulin level. However, fasting glucose and insulin resistance status increased significantly for the TRF group after the intervention (respectively, 88.3 ± 7.6 mg/dL versus 92.6 ± 9.6 mg/dL, P = 0.003; 1.7 ± 0.7 versus 2.1 ± 1.0, P = 0.048). CONCLUSION: The weight loss and reduction in diastolic blood pressure using the TRF method were better than with the traditional weight-loss method. However, this method may increase fasting glucose levels and adverse insulin resistance status.

Nutrition counseling is associated with less sarcopenia in diabetes: A cross-sectional and retrospective cohort study.

OBJECTIVES: Muscle is crucial for blood glucose regulation. There is a need to prevent and treat sarcopenia in diabetes mellitus (DM). This study aimed to estimate the prevalence of sarcopenia and evaluate the association of nutritional counseling with the development of sarcopenia for people with DM. METHODS: In a cross-sectional and retrospective cohort study, people with type 2 DM were recruited from the Diabetes Shared Care Program of a teaching hospital. Muscle mass, muscle strength, and physical functional performance were evaluated using the Asian Working Group for Sarcopenia criteria. The skeletal muscle mass index was determined by dividing muscle mass by the square of the height. Clinical information, including the nutrition counseling record, was retrospectively obtained from medical records for a 2-y period. RESULTS: The prevalence of low skeletal muscle mass index (presarcopenia) and sarcopenia were, respectively, 20.4% and 9.6% (including 3.1% severe) among 1292 participants. Specifically, 15.3% of participants age ≥ 65 y were categorized as having sarcopenia. With more frequent nutritional counseling, there was a lesser risk of sarcopenia; the adjusted odds ratio (95% confidence interval) was 0.51 (0.27-0.94) for ≥ 3 times/2 y compared to no counseling. DM duration and age, glycemic status and medication, and body mass index and counseling frequency had no joint effects; however, these variables (except HbA1 c) were independent risk factors for low skeletal muscle mass index and sarcopenia. CONCLUSIONS: People with type 2 DM have a high risk of sarcopenia. Increased nutrition counseling in outpatients was associated with less sarcopenia. Education about sarcopenia-associated risk factors should be encouraged early in the onset of DM.

More Frequent Nutrition Counseling Limits Weight Loss and Improves Energy Intake During Oncology Management: A Longitudinal Inpatient Study in Taiwan.

INTRODUCTION: Malnutrition increases the risk of cancer treatment-related complications. Nutritional intervention is beneficial for the outcomes of outpatients with cancer. This study investigated the impacts of nutrition consultation and care on energy intake and weight change in inpatients receiving cancer treatment. METHODS: We conducted a longitudinal study, enrolling 3221 inpatients with head and neck, lung, hepatobiliary, upper gastrointestinal, colorectal, breast, or gynecological cancer who received at least two nutrition consultations between April 2010 and July 2015. In every consultation, a dietitian calculated the total energy requirement and the actual energy intake was assessed using a 24-h dietary recall. RESULTS: Patients with head and neck cancer lost the most weight (1.16 kg/mo). For every consultation, a 0.03-kg weight gain per month was observed (P = 0.001). The average energy consumption percentage (% estimated energy requirement) at the third consultation was 87.0%. After controlling for potential covariates, the energy consumption percentages at the third, fourth, fifth-seventh, eighth, and subsequent consultations were significantly higher than those at the first consultation (P < 0.05). CONCLUSION: For oncology inpatients, routine screening and at least three active nutrition consultations with dietitians effectively improved energy intake and preserved body weight.

Energy requirements for ICU burn patients in whom the total body surface area affected exceeds 50 percent: a practical equation.

BACKGROUND AND OBJECTIVES: Energy requirement estimations are crucial for major burn patients' nutrition management. To find a practical equation for patients with burns over >50% of their total body surface area (TBSA)in an intensive care unit (ICU). METHODS AND STUDY DESIGN: We conducted a six-week follow-up study of 21 ICU burn patients aged 17-28 years (second- and third-degree burns, TBSA: 50-90%) who were prescribed enteral nutritional support. The energy consumption ratio (ECR) was calculated by dividing the actual energy intake by the estimated energy requirement. Linear regression was used to evaluate the stability of each equation and the wound healing rate over time. RESULTS: All included patients survived. On the fifth day, among the seven equations used, the ECRs of those dependent on the basal metabolic rate and body weight, namely, 35 kcal/kg BW, BMR × 1.5, and the Toronto formula, reached 74%, 71% and 69%, respectively. The ECRs for the abovementioned formulae achieved nutritional support goal sufficiency (0.9-1.1) from the third week. Additionally, with every 1% increase in the Energy Consumption Increase Rate per week, the wound healing rate increased from 0.35% to 0.80% per week. Both the 28 and 35 kcal/kg BW formulas had the smallest regression coefficients (0.46) over 6 weeks. CONCLUSION: The 35 kcal/kg BW equation was suitable for young patients with burns over >50%TBSA in the ICU because it could be applied without equivocation, in time, and with acceptable wound healing rates. Additionally, it was well tolerated and contributed to stable management with feeding simplicity.