Short Nutritional Assessment Questionnaire as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy: A retrospective study.

PURPOSE: The purpose of this retrospective study was to verify whether the revised Short Nutritional Assessment Questionnaire© (SNAQ), a simplified nutritional assessment, could be comparable with serum albumin (ALB) levels as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. METHODS: Of 111 patients, 79 patients with baseline ALB levels ≥3.5 g/dL were included in the analysis. Patients completed the revised SNAQ, which evaluated items including appetite loss, weight loss, nutritional supplement usage, age, and body mass index, using a maximum of 12 points (a score of ≥3 was marked as severe undernutrition). ALB levels were then monitored for 1 year using patient medical records. RESULTS: There was a significant difference in event-free survival (EFS) when the SNAQ scores were classified into two groups [i.e., scores of ≤3 (SNAQ3) or scores of ≥4 (SNAQ4)]. The 150-day EFS rate was 86.8% and 57.6% for SNAQ3 and SNAQ4, respectively (hazard ratio: 2.92; 95% confidence interval: 1.31-6.51; p = 0.009). Based on the Cox proportional-hazards analysis, a higher risk of undernutrition was associated with SNAQ4 (compared with SNAQ3), C-reactive protein levels, and serum transthyretin levels. CONCLUSION: The revised SNAQ is a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. In particular, it is important that patients with a SNAQ score of ≥4 receive dietary guidance at an early stage as they are likely to become undernourished within a year.

Polysorbate 80-induced leaky gut impairs skeletal muscle metabolism in mice.

Impaired intestinal permeability can induce systemic inflammation and metabolic disturbance. However, the effect of impaired intestinal permeability on metabolic function in the skeletal muscle is unknown. Dietary polysorbate 80 (PS80), a common emulsifier, has been shown to impair intestinal permeability in mice. Here, we investigated the effect of PS80-induced intestinal permeability on glucose tolerance with metabolic signaling in the skeletal muscle. Male ICR mice were divided into control and PS80 groups. In the PS80 group, PS80 was contained in the drinking water at 1% (w/v). After 4 weeks, plasma fluorescein isothiocyanate (FITC) intensity was measured after orally administering FITC-dextran. Half of the mice in each group underwent running exercises. Metabolic and inflammatory parameters were examined in the blood and skeletal muscle. Plasma FITC and lipopolysaccharide levels were higher in the PS80 group than the control group (p < .01, p = .085). The expression of tumor necrosis factor-α in the skeletal muscle was increased upon PS80 administration (p < .05). Although the homeostasis model assessment ratio was higher in the PS80-fed mice (p < .05), insulin-signaling activity in the muscle did not differ between groups. Muscular pH, mitochondrial cytochrome oxidase activity, and glycogen content after exercise were lower in the PS80 group (p < .05) than the control group. There was a negative correlation between plasma FITC and muscle glycogen levels in the exercised groups (r = -.60, p < .05). These results suggest that daily PS80 intake induces intestinal permeability, leading to glucose intolerance and mitochondrial dysfunction in the skeletal muscle.

Effect of dietary antioxidant-rich foods combined with aerobic training on energy metabolism in healthy young men.

Although supplementation with several antioxidants has been suggested to improve aerobic metabolism during exercise, whether dietary foods containing such antioxidants can exert the metabolic modulation is unclear. This study aimed to investigate the effect of intake of the specific antioxidant-rich foods coupled with exercise training on energy metabolism. Twenty young healthy, untrained men were assigned to antioxidant and control groups: participants in the antioxidant group were encouraged to consume foods containing catechin, astaxanthin, quercetin, glutathione, and anthocyanin. All participants performed cycle training at 60% maximum oxygen consumption for 30 min, 3 days per week for 4 weeks. Maximum work load was significantly increased by training in both groups, while oxygen consumption during exercise was significantly increased in the antioxidant group only. There were positive correlations between maximum work load and fat/carbohydrate oxidations in the antioxidant group. Carbohydrate oxidation during rest was significantly higher in the post-training than that in the pre-training only in the antioxidant group. More decreased levels of serum insulin and HOMA-IR after training were observed in the antioxidant group than in the control group. This study suggests that specific antioxidant-rich foods could modulate training-induced aerobic metabolism of carbohydrate and fat during rest and exercise.

Validity of the Short Nutritional Assessment Questionnaire for Japanese Patients with Cancer Undergoing Outpatient Chemotherapy.

PURPOSE: To investigate the utility of the Short Nutritional Assessment Questionnaire (SNAQ) in the nutritional evaluation of patients with cancer undergoing outpatient chemotherapy. METHODS: We included 229 patients with cancer who were undergoing outpatient chemotherapy between October 2015 and April 2016. The SNAQ and the revised SNAQ (addition of age and body mass index) were implemented, and their relationships with Controlling Nutritional Status (CONUT), an indicator of bionutritional assessment, were examined. RESULTS: The cutoff value of the SNAQ score corresponding to moderate-to-severe undernourishment in CONUT values was 0.5, with a sensitivity of 87.5% and a specificity of 65.9%, and the corresponding values for the revised SNAQ score were 2.5, 91.7%, and 62.9%, respectively. This cutoff value and the corresponding positive prediction value for the revised SNAQ were superior to those of SNAQ. Binary logistic regression analysis with the revised SNAQ and sex as independent variables and the CONUT value as the dependent variable revealed that the higher the SNAQ score, the more likely it was that CONUT moderate-to-severe undernourishment would be identified (odds ratio, 1.48;, 1.34-1.96). CONCLUSION: Nutritional evaluation with the revised SNAQ can predict moderate-to-severe undernourishment according to CONUT in patients with cancer undergoing outpatient chemotherapy. J. Med. Invest. 64: 117-121, February, 2017.

Maternal Body Mass Index Correlates with the Neonatal Physique of Male Infants.

Recently, in Japan, the percentage of leanness has risen in young women, and the average birth weight has decreased. An increase in the risk of low birth weight has been reported in lean expectant mothers. In this study, we aimed to clarify the relationship between mother's physique at the beginning of pregnancy and the infant's physique, by focusing on sex differences. The participants were 3,722 mothers who attended health checkups for 18-month-old infants in an urban Japanese city. The participants were limited to those with full-term births, thereby excluding the influence of gestational length. A total of 1,287 mothers, with 621 boys and 666 girls, were analyzed. Public health professionals interviewed the mothers, and transferred the required information from their maternity passbooks. We examined the physical characteristics of the mothers and their infants. Partial correlation analysis, adjusted by gestational length and the mother's age at delivery, was applied to study the association between the mother's BMI and the infant's physique at birth. In the primipara group, only the boys showed significant positive correlation between the mother's BMI and the birth weight (P = 0.025) and the Kaup index (P = 0.035). In the pluripara group, only the boys showed significant positive correlation between the mother's BMI and the head circumference (P = 0.035). Thus, mother's physique may have a stronger influence on the physique of male infants, compared to female infants. The growth-promoting effect of the mother's physique is more apparent in the infants born to the pluripara.

Fermented milk improves glucose metabolism in exercise-induced muscle damage in young healthy men.

BACKGROUND: This study investigated the effect of fermented milk supplementation on glucose metabolism associated with muscle damage after acute exercise in humans. METHODS: Eighteen healthy young men participated in each of the three trials of the study: rest, exercise with placebo, and exercise with fermented milk. In the exercise trials, subjects carried out resistance exercise consisting of five sets of leg and bench presses at 70-100% 12 repetition maximum. Examination beverage (fermented milk or placebo) was taken before and after exercise in double-blind method. On the following day, we conducted an analysis of respiratory metabolic performance, blood collection, and evaluation of muscle soreness. RESULTS: Muscle soreness was significantly suppressed by the consumption of fermented milk compared with placebo (placebo, 14.2 ± 1.2 score vs. fermented milk, 12.6 ± 1.1 score, p < 0.05). Serum creatine phosphokinase was significantly increased by exercise, but this increase showed a tendency of suppression after the consumption of fermented milk. Exercise significantly decreased the respiratory quotient (rest, 0.88 ± 0.01 vs. placebo, 0.84 ± 0.02, p < 0.05), although this decrease was negated by the consumption of fermented milk (0.88 ± 0.01, p < 0.05). Furthermore, exercise significantly reduced the absorption capacity of serum oxygen radical (rest, 6.9 ± 0.4 µmol TE/g vs. placebo, 6.0 ± 0.3 µmol TE/g, p < 0.05), although this reduction was not observed with the consumption of fermented milk (6.2 ± 0.3 µmol TE/g). CONCLUSION: These results suggest that fermented milk supplementation improves glucose metabolism and alleviates the effects of muscle soreness after high-intensity exercise, possibly associated with the regulation of antioxidant capacity.

A novel myokine, secreted protein acidic and rich in cysteine (SPARC), suppresses colon tumorigenesis via regular exercise.

OBJECTIVE: Several epidemiological studies have shown that regular exercise can prevent the onset of colon cancer, although the underlying mechanism is unclear. Myokines are secreted skeletal muscle proteins responsible for some exercise-induced health benefits including metabolic improvement and anti-inflammatory effects in organs. The purpose of this study was to identify new myokines that contribute to the prevention of colon tumorigenesis. METHODS: To identify novel secreted muscle-derived proteins, DNA microarrays were used to compare the transcriptome of muscle tissue in sedentary and exercised young and old mice. The level of circulating secreted protein acidic and rich in cysteine (SPARC) was measured in mice and humans that performed a single bout of exercise. The effect of SPARC on colon tumorigenesis was examined using SPARC-null mice. The secretion and function of SPARC was examined in culture experiments. RESULTS: A single bout of exercise increased the expression and secretion of SPARC in skeletal muscle in both mice and humans. In addition, in an azoxymethane-induced colon cancer mouse model, regular low-intensity exercise significantly reduced the formation of aberrant crypt foci in wild-type mice but not in SPARC-null mice. Furthermore, regular exercise enhanced apoptosis in colon mucosal cells and increased the cleaved forms of caspase-3 and caspase-8 in wild-type mice but not in SPARC-null mice. Culture experiments showed that SPARC secretion from myocytes was induced by cyclic stretch and inhibited proliferation with apoptotic effect of colon cancer cells. CONCLUSIONS: These findings suggest that exercise stimulates SPARC secretion from muscle tissues and that SPARC inhibits colon tumorigenesis by increasing apoptosis.

Association between low birth weight and high adult waist-to-height ratio in non-obese women: a cross-sectional study in a Japanese population.

Low birth weight has been associated with cardiovascular diseases. The waist-to-height ratio is a good indicator of risks for these diseases. The objective of this study was to examine the associations between birth weight and adult waist-to-height ratio in a Japanese population. A cross-sectional study, comprised of 851 subjects (401 men and 450 women) aged 35-62 years who were born at full term, was conducted at a medical checkup. The subjects responded to a questionnaire about weight at birth, and data on physical characteristics were collected from the results of the medical checkup. The subjects were stratified with sex and a Body Mass Index of 25 kg/m(2) to elucidate the effects of birth weight on adult waist-to-height ratio. Analysis of covariance was used to compare the physical condition among the 4 birth weight categories. After adjusting for age, alcohol consumption, smoking status and exercise, the height was significantly lower in the birth weight < 2,500 g category among men (P < 0.001) and women (P < 0.001), while the waist-to-height ratio was significantly higher in the birth weight < 2,500 g category, compared with the > 3,500 g category in the non-obese women (P = 0.004), but not in the obese women. In conclusion, low birth weight was independently associated with a low adult height among men and women and with a high adult waist-to-height ratio among non-obese women. Our results suggest that intrauterine environmental insults might lead to accumulation of visceral fat among non-obese women.

Lifestyle and psychological factors related to irritable bowel syndrome in nursing and medical school students.

BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder comprising abdominal pain, abdominal discomfort, and disordered defecation. The prevalence of IBS is 10-15% in the general population. This study investigated the prevalence of IBS and the relationship between IBS and stress, lifestyle, and dietary habits among nursing and medical school students. METHODS: A blank self-administrated questionnaire was used to survey 2,639 students studying nursing or medicine. This questionnaire asked about IBS symptoms, lifestyle, dietary intake, life events, anxiety, and depression. The questionnaires were collected from 2,365 students (89.6%) and the responses of 1,768 students (74.8%) were analyzed. RESULTS: The prevalence of IBS was 35.5% as a whole, 25.2% in males and 41.5% in females. Significantly higher stress scores (anxiety and depression) and life events were found in the IBS group than in the non-IBS group. Sleep disorders and the time spent sitting were also higher in males with IBS. In the IBS group, females ate less fish, fruit, milk, and green-yellow vegetables, and more processed food products than the non-IBS group (p = 0.001, p = 0.002, p = 0.032, p = 0.037, p < 0.001). The rates of missed meals and irregular mealtimes were significantly higher in females in the IBS group (p = 0.001, p = 0.013). CONCLUSIONS: The prevalence of IBS was higher among nursing and medical students, and further interventional studies are needed to improve IBS symptoms.

Identification of food-derived collagen peptides in human blood after oral ingestion of gelatin hydrolysates.

In the present study, we identified several food-derived collagen peptides in human blood after oral ingestion of some gelatin hydrolysates. Healthy human volunteers ingested the gelatin hydrolysates (9.4-23 g) from porcine skin, chicken feet, and cartilage after 12 h of fasting. Negligible amounts of the peptide form of hydroxyproline (Hyp) were observed in human blood before the ingestion. After the oral ingestion, the peptide form of Hyp significantly increased and reached a maximum level (20-60 nmol/mL of plasma) after 1-2 h and then decreased to half of the maximum level at 4 h after the ingestion. Major constituents of food-derived collagen peptides in human serum and plasma were identified as Pro-Hyp. In addition, small but significant amounts of Ala-Hyp, Ala-Hyp-Gly, Pro-Hyp-Gly, Leu-Hyp, Ile-Hyp, and Phe-Hyp were contained.

[Relationship between life satisfaction and lifestyle in residents of Kyoto].

OBJECTIVE: The purpose of this study was to assess relationships between life satisfaction and lifestyle in residents of the city of Kyoto, Japan, by addressing their subjective evaluation of their own health status. METHODS: The subjects comprised 4746 men and women (15-97 years old) who had completed a questionnaire on life style in the 1998 Kyoto Citizen's Health and Nutrition Study. Stratified by their responses to subjective health, the relationship between life-satisfaction and lifestyle was evaluated by odds ratios and chi-square tests of the subjects classified by age and gender. RESULTS: The proportion of respondents who felt their subjective health was good decreased with age, while the proportion of respondents who considered their life satisfaction good increased with age. Whether the residents had good or poor subjective health, the proportion of respondents who had a healthy lifestyle, as exemplified by having breakfast everyday, having dinner with their family regularly and having a good intake of greeny-ellow vegetables increased with age in both men and women. This healthy lifestyle was also positively associated with good life satisfaction. CONCLUSION: Whether the residents had good or poor subjective health, these results suggest that thos with a healthy lifestyle feel good life satisfaction.

The Role of the Human Dry Dock in Smoking Cessation in Japan.

The human dry dock, a Japanese system of detailed health check-ups for middle-aged and elderly people was originally set up for the purpose of secondary prevention, but it is now expected to increasingly play a role in primary prevention. A series of our studies of smoking cessation in the human dry dock setting showed that the abstinence rate increased from 5-6% for non-advised smokers to 9-10% for those who were advised. Thoracic CT screening participants were found to be more likely to quit smoking. It can be estimated that an additional seventy thousand male smokers would quit smoking every year if advice on smoking cessation was routinely given in every dock in Japan.