Association of dietary selenium intake and all-cause mortality of Parkinson's disease and its interaction with blood cadmium level: a retrospective cohort study.

BACKGROUND: Parkinson's disease (PD) is a slowly progressive neurodegenerating disease that may eventually lead to disabling condition and pose a threat to the health of aging populations. This study aimed to explore the association of two potential risk factors, selenium and cadmium, with the prognosis of Parkinson's disease as well as their interaction effect. METHODS: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005-2006 to 2015-2016 and National Death Index (NDI). Participants were classified as Parkinson's patients by self-reported anti-Parkinson medications usage. Cox regression models and restricted cubic spline models were applied to evaluate the association between PD mortality and selenium intake level as well as blood cadmium level. Subgroup analysis was also conducted to explore the interaction between them. RESULTS: A total of 184 individuals were included. In full adjusted cox regression model (adjusted for age, gender, race, hypertension, pesticide exposure, smoking status and caffeine intake), compared with participants with low selenium intake, those with normal selenium intake level were significantly associated with less risk of death (95%CI: 0.18-0.76, P = 0.005) while no significant association was found between low selenium intake group and high selenium group (95%CI: 0.16-1.20, P = 0.112). Restricted cubic spline model indicated a nonlinear relationship between selenium intake and PD mortality (P for nonlinearity = 0.050). The association between PD mortality and blood cadmium level was not significant (95%CI: 0.19-5.57, P = 0.112). However, the interaction term of selenium intake and blood cadmium showed significance in the cox model (P for interaction = 0.048). Subgroup analysis showed that the significant protective effect of selenium intake existed in populations with high blood cadmium but not in populations with low blood cadmium. CONCLUSION: Moderate increase of selenium intake had a protective effect on PD mortality especially in high blood cadmium populations.

Sex differences in the association between sleep duration and frailty in older adults: evidence from the KNHANES study.

BACKGROUND: Frailty is a pervasive clinical syndrome among the older population. It is associated with an increased risk of diverse adverse health outcomes including death. The association between sleep duration and frailty remains unclear. Therefore, the aim of this study was to investigate the relationship between sleep duration and frailty in community-dwelling Korean older adults and to determine whether this relationship is sex-dependent. METHODS: Data on 3,953 older adults aged ≥ 65 years were obtained from the 7th (2016-2018) Korea National Health and Nutrition Examination Survey (KNHANES). Frailty was defined using the Fried phenotype with criteria customized for the KNHANES dataset. Self-reported sleep duration was classified as short sleep duration (≤ 6 h), middle sleep duration (6.1-8.9 h), and long sleep duration (≥ 9 h). Complex samples multivariate logistic regression analysis was conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The percentage of male participants with short, middle, and long sleep durations was 34.9%, 62.1%, and 16.8%, respectively, while that of female participants was 26.1%, 59.2%, and 14.7%. The prevalence of frailty in the middle sleep duration group was lower than that in the short and long sleep duration groups in both men (short, 14.7%; middle, 14.2%; long, 24.5%; p < 0.001) and women (short, 42.9%; middle, 27.6%; long, 48.6%; p < 0.001). Both short (OR = 2.61, 95% CI = 1.91 - 4.83) and long (OR = 2.57, 95% CI = 1.36 - 3.88) sleep duration groups had a significantly higher OR for frailty than the middle sleep duration group even after adjusting for confounding variables among women, but not among men. CONCLUSION: Short and long sleep durations were independently associated with frailty in community-dwelling Korean older adult women. Managing sleep problems among women should be prioritized, and effective interventions to prevent frailty should be developed accordingly.

Associations of CBC-Derived inflammatory indicators with sarcopenia and mortality in adults: evidence from Nhanes 1999 ∼ 2006.

BACKGROUND: It has been proposed that inflammation plays a role in the development of sarcopenia. This study aimed to investigate the links of complete blood cell count (CBC) parameters and CBC-derived inflammatory indicators with sarcopenia and mortality. METHODS: Data pertaining to sarcopenia were extracted from the 1999-2006 National Health and Nutrition Examination Survey (NHANES), and mortality events were ascertained through the National Death Index up to December 31, 2019. The CBC-derived inflammatory indicators assessed in this study included the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII). The prognostic significance of these CBC-derived inflammatory indicators was evaluated using the random survival forests (RSF) analysis. RESULTS: The study encompassed a cohort of 12,689 individuals, among whom 1,725 were diagnosed with sarcopenia. Among individuals with sarcopenia, 782 experienced all-cause mortality, and 195 succumbed to cardiovascular causes. Following adjustment for confounding variables, it was observed that elevated levels of NLR, dNLR, NMLR, SIRI, and SII were associated with an increased prevalence of sarcopenia. Among participants with sarcopenia, those in the highest quartile of NLR (HR = 1.336 [1.095-1.631]), dNLR (HR = 1.274 [1.046-1.550]), MLR (HR = 1.619 [1.290-2.032]), NMLR (HR = 1.390 [1.132-1.707]), and SIRI (HR = 1.501 [1.210-1.862]) exhibited an elevated risk of all-cause mortality compared to those in the lowest quartile of these inflammation-derived indicators. These associations were similarly observed in cardiovascular mortality (HR = 1.874 [1.169-3.003] for MLR, HR = 1.838 [1.175-2.878] for SIRI). The RSF analysis indicated that MLR exhibited the highest predictive power for both all-cause and cardiovascular mortality among individuals with sarcopenia. CONCLUSIONS: Our findings underscore the association between CBC-derived inflammatory indicators and mortality in adults with sarcopenia. Of note, MLR emerged as the most robust predictor of all-cause and cardiovascular mortality in this population.

Nonlinear relationship between oxidative balance score and hyperuricemia: analyses of NHANES 2007-2018.

BACKGROUND: Limited data regarding the correlation between oxidative balance score (OBS) and hyperuricemia highlights the necessity for thorough investigations. This study aims to examine the link between OBS, which incorporates dietary and lifestyle factors, and the occurrence of hyperuricemia. METHODS: We conducted a cross-sectional study involving 13,636 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). The oxidative balance score (OBS) was determined based on four lifestyle factors and sixteen dietary nutrients. We assessed the levels of serum uric acid (SUA) and the occurrence of hyperuricemia as outcomes. Weighted logistic regression and linear models were used for statistical analysis, using Restricted Cubic Splines (RCS) to examine potential nonlinear associations. Subgroup analysis and sensitivity assessments were performed to identify any variations and ensure the robustness of the findings. RESULTS: Higher OBS was consistently correlated with decreased SUA levels and a reduced prevalence of hyperuricemia. RCS highlighted a significant negative nonlinear association, particularly in females. Subgroup analysis revealed gender-based differences and interactive correlation, providing additional insights regarding OBS and hyperuricemia relationship. CONCLUSION: This study underscores a robust negative correlation between OBS and SUA levels as well as the incidence of hyperuricemia, emphasizing the importance of dietary and lifestyle factors. Incorporating RCS, subgroup analysis, and sensitivity assessments enhances the depth of our findings, providing valuable insights for further research.

Higher oxidative balance score was associated with decreased risk of erectile dysfunction: a population-based study.

BACKGROUND: Erectile dysfunction (ED) is a prevalent condition that is thought to be significantly impacted by oxidative stress. The oxidative balance score (OBS) has been built to characterize the state of antioxidant/pro-oxidant balance. There is less known regarding the relationship of OBS with ED. METHODS: This study conducted cross-sectional analyses on 1860 males who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004. OBS was constructed by the 16 dietary components and 4 lifestyle factors. Self-reported ED was defined as men who indicated that they "never" or "sometimes" could achieve or keeping an erection adequate for satisfactory intercourse. Multivariate logistic regression models were applied to examine the association between OBS and the risk of ED. RESULTS: Among 1860 participants, the median OBS was 20 (IQR 15-26), and OBS was lower in males with ED vs. those without ED (P = 0.001). The results of our analyses indicated a negative correlation between OBS and ED among male subjects. Specifically, each one-unit increase in the continuous OBS was relate to 3% reduction in the odds of ED after full adjustment. Moreover, when extreme OBS quartiles were compared, the adjusted odds ratio (95% confidence interval) for the 4th OBS category was 0.53 (0.32 to 0.88) after full adjustment (P for trend < 0.05). There was also statistical significance in the relationships between dietary/lifestyle OBS with ED, and the association between lifestyle OBS and ED may be even tighter. For each unit increase in lifestyle OBS, the odds of ED decreased by 11% after full adjustment. CONCLUSION: Higher OBS was associated with reduced risk of ED in U.S. males. These findings suggested that adopting an antioxidant-rich diet and engaging in antioxidant-promoting lifestyle behaviors may contribute to a lower incidence of ED. These results provided recommendations for a comprehensive dietary and lifestyle antioxidants for ED patients.

National trends in nine key minerals intake (quantity and source) among U.S. adults, 1999 to march 2020.

BACKGROUND: Changes in economy and dietary guidelines brought a great shock to diet quality and meal behaviors, but if these transformations have extended to minerals intake and their sources was still poorly understood. It is essential to evaluate time trends in minerals intake and their sources to inform policy makers. OBJECTIVE: To investigate trends in minerals intake and their sources among U.S. adults. METHODS: This analysis used dietary data collected by 24-h recalls from U.S. adults (≥ 20 years) in NHANES (1999-March 2020). Minerals intake, age-adjusted percentage of participants meeting recommendations, and minerals sources were calculated among all participants and by population subgroups in each NHANES survey cycle. Weighted linear or logistic regression models were used to examine the statistical significance of time trends. RESULTS: A total of 48223 U.S. adults were included in this analysis. From 1999 to March 2020, intake of calcium (from 0.94 to 1.02 g/day), magnesium (from 308.07 to 321.85 mg/day), phosphorus (from 1.24 to 1.30 g/day), and sodium (from 3.24 to 3.26 mg/day) from food and beverages (FB) and dietary supplements (DSs) significantly increased, and intake of iron (from 19.17 to 16.38 mg/day), zinc (from 16.45 to 14.19 mg/day), copper (from 1.79 to 1.38 mg/day), and potassium (from 2.65 to 2.50 g/day) from FB + DSs decreased (all FDR < 0.05). Additionally, age-adjusted percentage of participants meeting recommendations for calcium, phosphorus, sodium, and selenium significantly increased, that for iron, potassium, zinc, and copper decreased (all FDR < 0.05). Minerals intake and time trends in minerals intake were highly variable depending on age, gender, race/ethnicity, education, and income. For example, white, higher socioeconomic status participants had a higher minerals intake (e.g. iron, zinc, and copper), but had a greater decrease in minerals intake. Furthermore, the percentage of minerals from milks and DSs decreased, and that from beverages increased. CONCLUSION: From 1999 to March 2020, both minerals intake and their sources experienced a significant alteration among U.S. adults. Many differences in minerals intake and their food sources across sociodemographic characteristics appeared to narrow over time. Although some improvements were observed, important challenges, such as overconsumption of sodium and underconsumption of potassium, calcium, and magnesium, still remained among U.S. adults.

The impact of triglyceride glucose-body mass index on all-cause and cardiovascular mortality in elderly patients with diabetes mellitus: evidence from NHANES 2007-2016.

BACKGROUND: The relationship between triglyceride glucose-body mass index (TyG-BMI) index and mortality in elderly patients with diabetes mellitus (DM) are still unclear. This study aimed to investigate the association between TyG-BMI with all-cause and cardiovascular mortality among elderly DM patients in the United States (US). METHODS: Patients aged over 60 years with DM from the National Health and Nutrition Examination Survey (2007-2016) were included in this study. The study endpoints were all-cause and cardiovascular mortality and the morality data were extracted from the National Death Index (NDI) which records up to December 31, 2019. Multivariate Cox proportional hazards regression model was used to explore the association between TyG-BMI index with mortality. Restricted cubic spline was used to model nonlinear relationships. RESULTS: A total of 1363 elderly diabetic patients were included, and were categorized into four quartiles. The mean age was 70.0 ± 6.8 years, and 48.6% of them were female. Overall, there were 429 all-cause deaths and 123 cardiovascular deaths were recorded during a median follow-up of 77.3 months. Multivariate Cox regression analyses indicated that compared to the 1st quartile (used as the reference), the 3rd quartile demonstrated a significant association with all-cause mortality (model 2: HR = 0.64, 95% CI 0.46-0.89, P = 0.009; model 3: HR = 0.65, 95% CI 0.43-0.96, P = 0.030). Additionally, the 4th quartile was significantly associated with cardiovascular mortality (model 2: HR = 1.83, 95% CI 1.01-3.30, P = 0.047; model 3: HR = 2.45, 95% CI 1.07-5.57, P = 0.033). The restricted cubic spline revealed a U-shaped association between TyG-BMI index with all-cause mortality and a linear association with cardiovascular mortality, after adjustment for possible confounding factors. CONCLUSIONS: A U-shaped association was observed between the TyG-BMI index with all-cause mortality and a linear association was observed between the TyG-BMI index with cardiovascular mortality in elderly patients with DM in the US population.

Development of a sustainable diet index in US adults.

BACKGROUND: A transformation towards healthy diets through a sustainable food system is essential to enhance both human and planet health. Development of a valid, multidimensional, quantitative index of a sustainable diet would allow monitoring progress in the US population. We evaluated the content and construct validity of a sustainable diet index for US adults (SDI-US) based on data collected at the individual level. METHODS: The SDI-US, adapted from the SDI validated in the French population, was developed using data on US adults aged 20 years and older from the National Health and Nutrition Examination Survey, 2007-2018 (n = 25,543). The index consisted of 4 sub-indices, made up of 12 indicators, corresponding to 4 dimensions of sustainable diets (nutritional quality, environmental impacts, affordability (economic), and ready-made product use behaviors (sociocultural)). A higher SDI-US score indicates greater alignment with sustainable diets (range: 4-20). Validation analyses were performed, including the assessment of the relevance of each indicator, correlations between individual indicators, sub-indices, and total SDI-US, differences in scores between sociodemographic subgroups, and associations with selected food groups in dietary guidelines, the alternative Mediterranean diet (aMed) score, and the EAT-Lancet diet score. RESULTS: Total SDI-US mean was 13.1 (standard error 0.04). The correlation between SDI-US and sub-indices ranged from 0.39 for the environmental sub-index to 0.61 for the economic sub-index (Pearson Correlation coefficient). The correlation between a modified SDI-US after removing each sub-index and the SDI-US ranged from 0.83 to 0.93. aMed scores and EAT-Lancet diet scores were significantly higher among adults in the highest SDI-US quintile compared to the lowest quintile (aMed: 4.6 vs. 3.2; EAT-Lancet diet score: 9.9 vs. 8.7 p < .0001 for both). CONCLUSIONS: Overall, content and construct validity of the SDI-US were acceptable. The SDI-US reflected the key features of sustainable diets by integrating four sub-indices, comparable to the SDI-France. The SDI-US can be used to assess alignment with sustainable diets in the US. Continued monitoring of US adults' diets using the SDI-US could help improve dietary sustainability.

Comparisons of an automated oscillometric device with a hybrid manual auscultatory device for the Korea National Health and Nutrition Examination Survey.

This study evaluated an oscillometric device (OD), Microlife WatchBP Office AFIB, and a hybrid manual auscultatory device (AD), Greenlight 300TM, to determine a suitable blood pressure (BP) measurement device for the Korea National Health and Nutrition Examination Survey in a mercury-free context. Adhering to the 2018 Universal Standard's suggested consensus, the study involved 800 subjects (mean age 51.2 ± 17.5 years; 44.3% male), who underwent triplicate BP measurements following 5 min of rest in a randomized order (OD-first: 398 participants; AD-first: 402 participants). BP difference was calculated as OD value minus AD value, with results stratified by measurement sequence. The overall BP difference and tolerable error probability were -1.1 ± 6.5/-2.6 ± 4.9 mmHg and 89.2%/92.5% for systolic/diastolic BP (SBP/DBP), respectively. Lin's concordance correlation coefficient was 0.907/0.844 for SBP/DBP (OD-first/AD-first: 0.925/0.892 for SBP, 0.842/0.845 for DBP). The overall agreement for hypertension (BP ≥ 140 and/or 90 mmHg) was 0.71 (p < 0.0001), and the OD underestimated the overall hypertension prevalence by 5.1%. Analysis of the AD-first data revealed a lower level of agreement compared to the OD-first data; however, the observed blood pressure difference adhered to Criterion 1 of the 2018 Universal Standard. Microlife met the Criterion 1 of 2018 Universal Standard but underestimated the prevalence of hypertension. The BP discrepancy increased with higher BP levels, male sex, and smaller AC. With increasing age, the discrepancy decreased for SBP and increased for DBP.

Geographical distribution of nutritional status of adolescents in a Brazilian city in the early years of the pandemic / Distribuição espacial do estado nutricional de adolescentes de um município brasileiro nos anos iniciais da pandemia

ABSTRACT Objective This study aims to build geographic models related to the nutritional status of adolescents and describe territories regarding the prevalence of malnutrition, overweight, and obesity, in order to spatially represent how the nutritional status of adolescents is distributed in the city. Methods Using geocoding techniques, graphic models were built using data from the SISVAN platform, as well as the addresses and nutritional status of adolescents aged 10 to 19 years in the municipality of Divinópolis, in the state of Minas Gerais (Brazil), between 2020 and 2021. Results There was a prevalence of 34% of obesity and overweight in the 2020 and 2021 samples. The graphical models showed that there is no specific pattern of points for the spread of nutritional diagnoses, but it was possible to identify areas of heat and places with a higher concentration of overweight. Underweight had a homogeneous spread and did not stand out in the formation of profiles. Conclusion Geographic tools with the adolescents' nutritional profile were successfully modeled, which have the potential to contribute to better health indicator management in the assessed territory, even with the limitations of the study.

RESUMO Objetivo Este trabalho tem como objetivo construir modelos geográficos relativos ao perfil nutricional de adolescentes e descrever territórios quanto à prevalência de déficit de peso e excesso de peso, de modo a representar espacialmente como o diagnóstico nutricional de adolescentes está distribuído na área estudada. Métodos Através da técnica de geocodificação foram construídos modelos gráficos utilizando a plataforma SISVAN, os endereços e o estado nutricional de adolescentes de 10 a 19 anos do município de Divinópolis, Minas Gerais, nos anos de 2020 e 2021. Resultados Houve prevalência de 34% de excesso de peso na amostra de 2020 e 2021. Os modelos gráficos mostraram que não há um padrão específico de pontos de propagação dos diagnósticos nutricionais, porém foi possível identificar áreas de calor e locais de maior concentração de excesso de peso. O déficit de peso teve um espalhamento homogêneo e não se destacou na formação de perfis. Conclusão Foi possível modelar ferramentas geográficas com o perfil nutricional dos adolescentes, as quais têm potencial de contribuir para a melhor gestão de indicadores de saúde no território avaliado, mesmo com as limitações do estudo.

Association between the Oxidative Balance Score and Telomere Length from the National Health and Nutrition Examination Survey 1999-2002.

PURPOSE: Leukocyte telomere length (LTL) is an important biomarker of aging. The oxidative balance score (OBS) is used to assess the oxidative stress-related exposures of diet and lifestyle. This study is aimed at exploring if the OBS was associated with LTL. METHODS: 3220 adults were included in this study from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. LTL was assayed from leukocyte DNA. Twenty dietary and lifestyle factors were selected to score the OBS. Survey-based multivariable linear regression was conducted to assess the association between the OBS and log-transformed LTL. RESULTS: The association between the OBS and log-transformed LTL was positive in females but not males. For females, compared with the lowest OBS category as a reference, the multivariable-adjusted beta estimate (95% confidence interval, CI) for the highest OBS category was 0.0701 (0.0205-0.1197) (p for trend < 0.01), and the multivariable-adjusted beta estimate (95% CI) of the continuous OBS was 0.0039 (0.0014-0.0065). There was also the gender difference in the correlations of the dietary OBS and the lifestyle OBS with log-transformed LTL. CONCLUSION: There was a positive association between the OBS and LTL in females. This result suggested that diet and lifestyle might affect LTL by regulating oxidative balance.

Prevalence Trends and Influencing Factors of Post-Stroke Depression: A Study Based on the National Health and Nutrition Examination Survey.

BACKGROUND We aimed to investigate the prevalence trends and explore the influencing factors of post-stroke depression based on the National Health and Nutrition Examination Survey (NHANES) database, including data from 2005 to 2018. MATERIAL AND METHODS A total of 1298 patients with stroke were included in this study. Multivariate logistic regression analysis was performed to select influencing factors. Subgroup analysis was conducted based on different populations. The odds ratio (OR) and 95% confidence interval (CI) were calculated. RESULTS The prevalence of post-stroke depression was 16.35% in 2005 and 23.29% in 2018, and presented a linear upward trend by year (F=195.00, P<0.001) from 2005 to 2018. Age (≥60 years vs <60 years; OR=0.40; 95% CI, 0.30-0.54), sex (female vs male; OR=1.37; 95% CI, 1.02-1.84), education level (junior middle school or below vs college or above; OR=0.64; 95% CI, 0.46-0.90), annual household income (≥$20,000 vs <$20,000; OR=0.60; 95% CI, 0.45-0.80), and sleep disorders (sleep disorders vs no sleep disorders; OR=4.07; 95% CI, 3.01-5.49) were associated with the risk of post-stroke depression. The age-based subgroup analysis showed that sex and education level were not influencing factors of post-stroke depression in patients ≥60 years, and education level was not related to the risk of post-stroke depression among men in the sex-based analysis. CONCLUSIONS Stroke patients with sleep disorders, age <60 years, and female sex may have an increased risk of post-stroke depression.

Changing Food Consumption and Nutrition Intake in Kazakhstan.

Food resource is an important bond that connects human beings and nature. In this study, we investigated the changes in food consumption and nutrition intake in Kazakhstan from a spatial and temporal perspective, from 2001 to 2018. The data were obtained from the Bureau of Statistics, international organizations and our social interview work. After the start of the 21st century, it was found that per capita food consumption significantly increased; however, the consumption of crop, vegetables and milk decreased. Per capita meat consumption was similar in both urban and rural areas. However, some food consumption showed differences between urban and rural areas. Changes of food consumption quantity and structure also had some effects on nutrient intake and the proportion of nutrients. Per capita energy intake in the national, urban and rural areas all increased remarkably. The energy intake changes in eastern states increased much more than that in western states. Protein intake in rural and urban areas was similar; however, the gap between carbohydrates and fat intake in urban and rural areas increased. The intake of protein, carbohydrates and fat in different states showed the same trend. Food consumption and nutrition intake are affected by economic, social and ecological factors.

Dietary Intake and Status of Vitamin B12 in Slovenian Population.

Vitamin B12 deficiency poses a health concern, especially in vulnerable populations. Dietary vitamin B12 intake was obtained by two 24 h dietary recalls and food propensity questionnaires in a representative Slovenian cross-sectional food consumption survey, SI.Menu (n = 1248 subjects; 10-74 years). For a subgroup of 280 participants, data on serum vitamin B12 were available through the Nutrihealth study. The estimated usual population-weighted mean daily vitamin B12 intakes were 6.2 µg (adults), 5.4 µg (adolescents), and 5.0 µg (elderly). Lower intakes were observed in females. Inadequate daily vitamin B12 intake (<4 µg) was detected in 37.3% of adolescents, 31.7% of adults, and 58.3% elderlies. The significant predictors for inadequate daily vitamin B12 intake were physical activity score in all age groups, sex in adolescents and adults, financial status and smoking in elderly, and employment in adults. Meat (products), followed by milk (products), made the highest vitamin B12 contribution in all age groups. In adolescents, another important vitamin B12 contributor was cereals. The mean population-weighted serum vitamin B12 levels were 322.1 pmol/L (adults) and 287.3 pmol/L (elderly). Low serum vitamin B12 concentration (<148 nmol/L) and high serum homocysteine (>15 µmol/L) were used as criteria for vitamin B12 deficiency. The highest deficiency prevalence was found in elderlies (7.0%), particularly in males (7.9%). Factors associated with high serum homocysteine were also investigated. In conclusion, although vitamin B12 status was generally not critical, additional attention should be focused particularly to the elderly.

Relação do risco nutricional e perfil glicêmico no desfecho de pacientes críticos / Relationship of nutritional risk and glycemic profile in the outcome of critically ill patients

Em pacientes críticos o risco nutricional e a hiperglicemia associam-se ao aumento da incidência de desfechos desfavoráveis. Objetivo: Avaliar a relação do risco nutricional pelo Nutrition Risk in Critically III, versão modificada (mNUTRIC) e perfil glicêmico nos desfechos de alta, óbito e tempo de internação de pacientes críticos e verificar o impacto das ferramentas Acute Physiology and Chronic Health Disease Classification System II (APACHE II) e do Sepsis-Related Organ Failure Assessment (SOFA) nesses desfechos. Método: Estudo longitudinal prospectivo desenvolvido em Unidade de Terapia Intensiva (UTI). Foram incluídos adultos, com tempo ≥ 48 horas de internação e com registro mínimo de duas aferições glicêmicas. Excluíram-se pacientes em cuidados paliativos, readmitidos nas UTI e gestantes. O teste Exato de Fisher e Shapiro Wilk foram utilizados para avaliar as variáveis categóricas e contínuas, respectivamente. Posteriormente, utilizou-se o teste de Mann-Whitney ou t-Student não pareado. Realizou-se análise de regressão logística e linear. O nível de significância adotado foi de 5%. Resultados: Ao avaliar 35 pacientes, 45,7% apresentaram alto risco nutricional. Foi observado associação do risco nutricional com os desfechos de alta e óbito; o SOFA associou-se ao óbito e tempo de internação. O incremento de 1 ponto no escore do SOFA aumentou a chance de óbito em 83% e tempo maior de internação em 0,49 dias. O perfil glicêmico e APACHE II não se associou aos desfechos. Conclusão: o escore SOFA foi o instrumento que apresentou associações significativas com o desfecho do óbito e maior tempo de internação de pacientes críticos

In critically ill patients, nutritional risk and hyperglycemia are associated with an increased incidence of unfavorable outcomes. Objective: To evaluate the relationship of nutritional risk by the Nutrition Risk in Critically III, modified version (mNUTRIC) and glycemic profile in the outcomes of discharge, death and length of stay in critically ill patients and to verify the impact of the Acute Physiology and Chronic Health Disease Classification System II (APACHE II) and the Sepsis-Related Organ Failure Assessment (SOFA) tools on these outcomes. Method: Prospective longitudinal study developed in an Intensive Care Unit (ICU). Adults were included, with ≥ 48 hours of hospitalization and with a minimum record of two blood glucose measurements. Patients in palliative care, readmitted to ICU and pregnant women were excluded. Fisher's Exact test and Shapiro Wilk test were used to evaluate categorical and continuous variables, respectively. Subsequently, the Mann-Whitney or unpaired t-Student test was used. Logistic and linear regression analysis was performed. The significance level adopted was 5%. Results: When evaluating 35 patients, 45.7% were at high nutritional risk. An association was observed between nutritional risk and discharge and death outcomes; SOFA was associated with death and length of hospital stay. The increment of 1 point in the SOFA score increased the chance of death by 83% and a longer hospital stay by 0.49 days. Glycemic profile and APACHE II were not associated with outcomes. Conclusion: the SOFA score was the instrument that showed significant associations with the outcome of death and longer hospital stay in critically ill patients

Memorization of messages, satisfaction, and feasibility of a nutritional intervention using a mobile text messaging app among adolescents / Memorização de mensagens, satisfação e usabilidade de intervenção nutricional via aplicativo de envio de mensagens entre adolescentes

ABSTRACT Objective This study aimed to evaluate the memorization of messages that promote healthy eating, as well as satisfaction and feasibility of a nutritional intervention using a mobile text messaging app aimed at adolescents from public schools in the Federal District, Brazil. Methods The messages sent addressed aspects of healthy eating based on the Dietary Guidelines for the Brazilian Population. A self-reported questionnaire was applied with 94 students to assess the memorization of the messages received during the nutritional intervention, the level of satisfaction with the intervention, whether the messages were read and shared, the frequency of reading, and what was learned from the intervention. The association of memorization with satisfaction and with the frequency of reading the messages was also investigated. Results About 48% of participants reported remembering at least one message; 77.7% showed high ranges of satisfaction; 54.3% always read the messages; 66.0% did not share messages with other people. Most of the students reported positive learning or good impressions about the intervention. An association was found between memorization and satisfaction with the intervention (p=0.002), as well as between reading and memorization (p=0.005). Conclusion Although the memorization of the healthy eating messages sent in the nutritional intervention was less than expected, a great satisfaction and high frequency of reading the messages were reported by adolescents. Future studies should investigate the permanence of the results of long-term nutrition intervention, the main influencers of memorization, and how to improve it.

RESUMO Objetivo Este estudo teve como objetivo avaliar a memorização de mensagens de promoção de alimentação adequada e saudável, a satisfação e a usabilidade de uma intervenção nutricional via aplicativo direcionada para adolescentes de escolas públicas do Distrito Federal. Métodos As mensagens enviadas abordavam aspectos sobre alimentação adequada e saudável com base no Guia Alimentar para a População Brasileira. Foi aplicado um questionário de autopreenchimento a 94 estudantes para avaliar a memorização das mensagens recebidas durante a intervenção nutricional, o nível de satisfação com a intervenção, se as mensagens eram lidas e compartilhadas, a frequência de leitura e quais foram os aprendizados decorrentes da intervenção. Investigou-se ainda a associação entre a memorização, a satisfação e a frequência de leitura das mensagens. Resultados Cerca de 48% dos participantes referiram lembrar de pelo menos uma mensagem da intervenção; 77,7% se mostraram satisfeitos com o estudo; 54,3% sempre liam as mensagens que recebiam e 66% não compartilhava as mensagens com outras pessoas. A maioria relatou aprendizados ou impressões positivas sobre a intervenção. Foi encontrada uma associação entre a memorização das mensagens e a satisfação com o estudo (p=0,002), bem como entre a leitura e a memorização das mensagens (p=0,005). Conclusão Apesar de a memorização das mensagens enviadas na intervenção nutricional ter sido aquém do esperado, foi referida grande satisfação e alta frequência de leitura pelos adolescentes. Futuros estudos devem investigar a permanência dos resultados de intervenções nutricionais a longo prazo, os principais influenciadores da memorização e como melhorá-la.

Association of acrylamide hemoglobin biomarkers with chronic obstructive pulmonary disease in the general population in the US: NHANES 2013-2016.

Background: Acrylamide is a well-known potential carcinogenic compound formed as an intermediate in the Maillard reaction during heat treatment, mainly from high-temperature frying, and is found in baked goods and coffee, as well as resulting from water treatment, textiles and paper processing. The effects of acrylamide on lung disease in humans remains unclear. We aimed to investigate the association between blood acrylamide and glycidamide and chronic obstructive pulmonary disease (COPD) in the United States of America (U.S.) population using PROC logistic regression models. Results: 2744 participants aged 20 to 80 from the 2013-2016 National Health and Nutrition Examination Survey (NHANES) were enrolled. After adjusting for demographic data, health factors and serum cotinine, the ratio of HbGA to HbAA (HbGA/HbAA) significantly increased the risk of COPD (P for trend = 0.022). The odds ratio (OR) with a 95% confidence interval (95% CI) for HbGA/HbAA in the third tile was 2.45 (1.12-5.31), compared with the lowest tile. The restricted cubic spline (RCS) curve showed a positive linear correlation between the log (HbGA/HbAA) and the risk of COPD (P = 0.030). Conclusion: The ratio of glycidamide and acrylamide (HbGA/HbAA) was associated with COPD. This association was more prominent in males, obese individuals, people with a poverty income ratio (PIR) < 1.85 or people who never exercise. However, null associations were observed between HbAA, HbGA and HbAA + HbGA, and COPD.

The National Health and Nutrition Examination Survey (NHANES), 2021-2022: Adapting Data Collection in a COVID-19 Environment.

The National Health and Nutrition Examination Survey (NHANES) is a unique source of national data on the health and nutritional status of the US population, collecting data through interviews, standard exams, and biospecimen collection. Because of the COVID-19 pandemic, NHANES data collection was suspended, with more than a year gap in data collection. NHANES resumed operations in 2021 with the NHANES 2021-2022 survey, which will monitor the health and nutritional status of the nation while adding to the knowledge of COVID-19 in the US population. This article describes the reshaping of the NHANES program and, specifically, the planning of NHANES 2021-2022 for data collection during the COVID-19 pandemic. Details are provided on how NHANES transformed its participant recruitment and data collection plans at home and at the mobile examination center to safely collect data in a COVID-19 environment. The potential implications for data users are also discussed. (Am J Public Health. 2021;111(12):2149-2156. https://doi.org/10.2105/AJPH.2021.306517).

Evaluation of Disparities in Adults' Macronutrient Intake Status: Results from the China Health and Nutrition 2011 Survey.

Little is known about the macronutrient intake status of adult Chinese people. This cross-sectional study assessed the macronutrient intake status of adults (aged ≥20 years) by comparing their intake level of macronutrients against the Dietary Reference Intakes (DRI). It further explored the associations between macronutrient intake status and age groups, genders, education levels, smoking status, drinking frequency, social classes, knowledge of Chinese Dietary Guidelines 2016 (CDGs), healthy diet priorities, and areas (urban and rural) within two regions (northern and southern). The analysis includes the dietary intake data of 7860 Chinese adults, with complete data entries in the China Health and Nutrition 2011 survey. Dietary data were obtained through the 24 h recall method. More than half had carbohydrate intake below the recommended level of intake, and more than half had fat intake above the recommended level of intake. There were significant associations between three macronutrient intakes and education levels, social classes, healthy diet priorities, areas, and regions. Disparities in macronutrient consumptions revealed geographical and socioeconomic variations in dietary patterns, as well as risks for many different noncommunicable diseases. Public health and nutrition interventions should take notice of regional differences in dietary intake and place more emphasis on vulnerable populations including women, rural residents, and people with lower education level.

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

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