The association between dietary patterns before pregnancy and gestational diabetes mellitus: a matched case-control study in China.

BACKGROUND AND OBJECTIVES: We aimed to explore the relationship between dietary patterns and gestational diabetes mellitus (GDM) during pre-pregnancy six months using principal component analysis (PCA) and the geometric framework for nutrition (GFN). METHODS AND STUDY DESIGN: We conducted a case-control study that included 210 GDM pregnant women and 210 controls. The dietary intake of all participants was assessed by a validated semi-quantitative food frequency questionnaire (FFQ). Major dietary patterns were extracted by PCA. A conditional logistic regression model was used to determine whether specific dietary patterns are associated with the risk of GDM. Meanwhile, the relationship between dietary patterns and GDM was visualized using GFN. RESULTS: Four major dietary patterns were identified: "protein-rich pattern," "plant-based pattern," "oil-pickles-desserts pattern," and "cereals-nuts pattern." After adjustment for confounders, the "plant-based pattern" was associated with decreased risk of GDM (Q4 vs. Q1: OR = 0.01, 95% CI: 0.00-0.08), whereas no significant association was found in other dietary patterns. Moreover, there was no dietary intake of ice cream cones and deep-fried dough sticks for the population, which would produce fewer patients with GDM. Deep-fried dough sticks had statistically significant differences in the case and control groups (p < 0.001), while ice cream cones had the opposite result. CONCLUSIONS: The "plant-based pattern" may reduce the risk of GDM. Besides, although the "cereals-nuts pattern" had no association with GDM risk, avoiding the intake of deep-fried dough sticks could decrease GDM risk.

Malnutrition diagnosed by GLIM criteria better predicts long-term outcomes for patients with non-Hodgkin's lymphoma: A prospective multicenter cohort study.

Since Global Leadership Initiative on Malnutrition (GLIM) method was proposed, few studies have applied these new criteria to hematological tumors. In this study, we explored the prevalence of malnutrition according to the GLIM criteria and scored Patient-Generated Subjective Global Assessment (sPG-SGA) and their association with 1-year, 3-year and 5-year mortality among patients with non-Hodgkin's lymphoma (NHL). Malnutrition of all patients were assessed by GLIM criteria and sPG-SGA. Relationship between the malnutrition based on GLIM criteria or sPG-SGA and mortality was investigated by Cox regression analyses. The performance of GLIM criteria was evaluated by assessing the sensitivity, specificity, k-value, receiver operating characteristic (ROC) curve and time-dependent ROC. Of 963 patients with NHL, the prevalence of malnutrition was 38.8% with GLIM criteria, 65.3% with GLIM-omitted NRS-2002 and 53.2% with sPG-SGA. In comparison with sPG-SGA, the sensitivity of GLIM criteria was 61.7%, the specificity was 84.8%, and the agreement was moderate (k = 0.48, p < 0.001). Malnutrition based on GLIM criteria could also predict 3-year and 5-year mortality after adjusting for confounders, except for sPG-SGA (HR = 1.816, 95%CI = 1.274-2.589, p = 0.001 for 3-year mortality; HR = 1.707, 95%CI = 1.223-2.382, p = 0.002 for 5-year mortality). For patients with NHL, GLIM criteria could be applied as an effective replacement to sPG-SGA for nutrition assessment and mortality prediction, especially for predicting long-term prognostic outcomes.

Blueberry extracts antagonize Aß25-35 neurotoxicity and exert a neuroprotective effect through MEK-ERK-BDNF/UCH-L1 signaling pathway in rat and mouse hippocampus.

BACKGROUND: The neuroprotective potential of blueberry (BB) extracts against Alzheimer's disease (AD) has been previously hinted at, while its exact mechanism has remained largely enigmatic. OBJECTIVE: Our study endeavored to unravel the impacts and mechanisms by which BB extracts ameliorated the learning and memory prowess of AD-afflicted mice, with a specific focus on the MEK-ERK pathway. METHODS: We employed 3-month-old APP/PS1 transgenic mice and stratified them into three distinct groups: AD+BB, AD, and control (CT). The Morris Water Maze Test (MWMT) was then administered to gauge their learning and memory faculties. In vitro experiments were executed on Aß25-35-afflicted rat hippocampal neurons, which were subsequently treated with varying concentrations of BB extracts. We then assessed the expression levels of genes and proteins integral to the MEK-ERKBDNF/UCH-L1 pathway. RESULTS: The data showed that the AD mice demonstrated compromised learning and memory faculties in MWMT. However, the AD+BB cohort showcased marked improvements in performance. Furthermore, in the AD subset, significant elevations in the expressions of MEK2 and ERK1/2 were observed, both at the mRNA and protein levels. Conversely, UCH-L1 mRNA expressions exhibited a decline, while BDNF expressions surged significantly. However, post BB extract treatment, the expressions of MEK2 and ERK1/2 were subdued, with UCH-L1 and BDNF mRNA expressions reverting to control levels. CONCLUSIONS: Our findings propounded that BB extracts could offer therapeutic promise for AD by bolstering learning and memory capacities. The unwarranted activation of the MEK-ERK pathway, coupled with the aberrant expressions of BDNF and UCH-L1, might underpin AD's pathogenesis.

Iron supplementation and deworming during pregnancy reduces the risk of anemia and stunting in infants less than 2 years of age: a study from Sub-Saharan Africa.

BACKGROUND: In sub-Saharan Africa, infant anemia, stunting and low birth weight remains major public health problems. It is unclear whether prenatal iron supplementation and/or deworming can reduce the risk of infant stunting, anemia and low birth weight. The aim of this study was to investigate the relationship between iron supplementation and/or deworming and stunting, anemia, and low birth weight in infants under two years of age in sub-Saharan Africa. METHODS: Our studies examined pooled data from Demographic and Health Surveys (DHS) in twenty-three African countries collected between 2014 and 2020. childhood anemia and stunting in infants under the age of two were the primary outcomes. Iron supplementation and deworming during prenatal visits were the main exposure variables. A multivariate logistic regression model was used to investigate these relationships. RESULTS: The prevalence of stunting was 29.9%, severe stunting was 10.6%, childhood anemia was 74.3%, childhood severe anemia was 3.2%, and low birth weight was 16.4%, respectively. The use of prenatal iron supplementation alone was associated with a significant reduction of childhood anemia [aOR (95% CI) = 0.9 (0.8-1.0)]. Prenatal deworming alone was associated with a significantly reduced risk of stunting [aOR (95% CI) = 0.7 (0.8-1.0)], childhood anemia [aOR (95% CI) = 0.7 (0.8-0.9)], and low birth weight [aOR (95% CI) = 0.7 (0.8-1.0)]. Prenatal iron supplementation plus deworming or iron supplementation (with or without deworming) were not associated with childhood anemia, infant stunting and low birth weight. CONCLUSIONS: In Sub-Saharan Africa, prenatal deworming alone has the potential to improve infants' outcomes. Childhood anemia was improved with prenatal iron supplementation alone. Our recent findings indicate the necessity for prospective studies on the association between prenatal iron supplementation plus deworming and childhood anemia, stunting and low birth weight.

Association of diet quality with the risk of Sarcopenia based on the Chinese diet balance index 2016: a cross-sectional study among Chinese adults in Henan Province.

BACKGROUND: Sarcopenia can lead to a series of unfavourable health outcomes. Diet is an important factor influencing sarcopenia. In this study, we aimed to evaluate the association of sarcopenia with diet quality assessed by the Chinese Diet Balance Index 2016 (DBI-16). METHODS: A cross-sectional study was conducted to collect information on nutrition and health in Henan Province, China, and a total of 644 individuals were studied. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria updated in 2019. Diet quality was assessed by using the Chinese Diet Balance Index 2016 (DBI-16), which includes three indicators: the lower bound score (LBS), higher bound score (HBS) and diet quality distance (DQD). Binary logistic regression analysis was used to estimate the risk of sarcopenia associated with diet quality. RESULTS: A total of 49 of the 644 participants were diagnosed with sarcopenia. Excessive intake (score > 0) of cereals, meat, eggs and salt, inadequate intake (score < 0) of vegetables, fruits, dairy products, soybeans and low diet variety were commonly seen in both groups of participants. The participants with sarcopenia had a more serious inadequate intake of fruit than those without sarcopenia (p < 0.05). The overall LBS, HBS and DQD in both groups were in the interval of low-level problems. Compared with participants with a suitable LBS, those with an unsuitable LBS were more likely to have a low gait speed (OR: 2.58; 95%CI: 1.13-7.04) after multiple adjustments. However, the other two DBI-16 indicators, the HBS and DQD, were not associated with sarcopenia or its related diagnostic variables. CONCLUSION: Unfavourable diet quality, mainly referring to inadequate dietary intake in this study, may be a risk factor for low gait speed.

Nobiletin activates thermogenesis of brown and white adipose tissue in high-fat diet-fed C57BL/6 mice by shaping the gut microbiota.

Increasing energy expenditure by activating thermogenesis in brown and beige adipocytes is a critical approach to protect against obesity. Here, we investigated the action and mechanism of a natural polymethoxyflavone on adaptive thermogenesis in high-fat diet-induced obesity mouse model. Nobiletin treatment significantly ameliorated obesity, alleviated the whitening of brown adipose tissue, and promoted browning of white adipose tissue in mice fed a high-fat diet. Gut microbiota analysis and metabolomic profiling revealed that nobiletin treatment resulted in a composition shift in the gut microbiota thereby altering fermentation products acetate levels in the host feces and serum. Further, transplantation of the microbiota from nobiletin-treated mice to microbiota-depleted mice activated brown adipose tissue activity, promoted beige adipocytes formation, and improved high-fat diet-induced obesity. Our results indicate that nobiletin could be used as a dietary therapy to prevent HFD-induced obesity, and provide a potential target-specific gut microbial species-driven mechanism for activating thermogenesis in brown and beige adipocytes.

Antitumor Effects of Astaxanthin on Esophageal Squamous Cell Carcinoma by up-Regulation of PPARγ.

Esophageal squamous cell carcinoma is a malignant tumor that is difficult to find and has a poor prognosis. The aim of this study is to explore the chemoprevention effect of Astaxanthin (AST) and reveal the possible mechanism of AST on the development of esophageal cancer based on PPARγ. We found that a stable and strong binding between PPARγ molecules and AST molecules using Autodock 4.0 software. AST significantly inhibited the viability of EC109 cells in a dose and time dependent manners (all P < 0.05), and up-regulated the protein expression level of PPARγ from the concentration of 6.25 µM (P < 0.05). Animal experiment showed that AST significantly decreased the incidences of NMBzA-induced esophageal carcinogenesis at 50 mg/kg AST in F344 rats (P < 0.05). AST inhibited the oxidative stress by improving the levels of superoxide dismutase (SOD), total antioxidant capacity (TAOC) and suppressing malondialdehyde (MDA) in serum, and increasing the protein of PPARγ, Bax/Bcl-2, Caspase-3 in esophagus tissue, especially in the 50 mg/kg of AST intervention group (all P < 0.05). In conclusion, our data suggested that protective effect of AST on esophageal cancer by inhibiting oxidative stress, up-regulating PPARγ, and activating the apoptotic pathway, which could provide a basis for clinical application of AST.

Associations of dietary patterns and pre-eclampsia: a matched case-control study.

Little is known about the effects of dietary patterns on prevalent pre-eclampsia in Chinese population. This study aimed to investigate the associations between dietary patterns and the odds of pre-eclampsia among Chinese pregnant women. A 1:1 age- and gestational week-matched case-control study was conducted between March 2016 and February 2019. A total of 440 pairs of pre-eclampsia cases and healthy controls were included. Dietary intakes were assessed by a seventy-nine-item FFQ and subsequently grouped into twenty-eight distinct groups. Factor analysis using the principal component method was adopted to derive the dietary patterns. Conditional logistic regression was used to analyse the associations of dietary patterns with prevalent pre-eclampsia. We identified four distinct dietary patterns: high fruit-vegetable, high protein, high fat-grain and high salt-sugar. We found that high fruit-vegetable dietary pattern (quartile (Q)4 v. Q1, OR 0·71, 95 % CI 0·55, 0·92, Ptrend = 0·013) and high protein dietary pattern (Q4 v. Q1, OR 0·72, 95 % CI 0·54, 0·95, Ptrend = 0·011) were associated with a decreased odds of pre-eclampsia in Chinese pregnant women. Whereas high fat-grain dietary pattern showed a U-shaped association with pre-eclampsia, the lowest OR was observed in the third quartile (Q3 v. Q1, OR 0·75, 95 % CI 0·57, 0·98, Ptrend = 0·111). No significant association was observed for high salt-sugar dietary pattern. In conclusion, pregnancy dietary pattern characterised by high fruit-vegetable or high protein was found to be associated with a reduced odds of pre-eclampsia in Chinese pregnant women.

Dietary inflammatory index, inflammation biomarkers and preeclampsia risk: a hospital-based case-control study.

This study evaluated the association between inflammatory diets as measured by the Dietary Inflammatory index (DII), inflammation biomarkers and the development of preeclampsia among the Chinese population. We followed the reporting guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology statement for observational studies. A total of 466 preeclampsia cases aged over 18 years were recruited between March 2016 and June 2019, and 466 healthy controls were 1:1 ratio matched by age (±3 years), week of gestation (±1 week) and gestational diabetes mellitus. The energy-adjusted DII (E-DII) was computed based on dietary intake assessed using a seventy-nine item semiquantitative FFQ. Inflammatory biomarkers were analysed by ELISA kits. The mean E-DII scores were -0·65 ± 1·58 for cases and -1·19 ± 1·47 for controls (P value < 0·001). E-DII scores positively correlated with interferon-γ (r s = 0·194, P value = 0·001) and IL-4 (r s = 0·135, P value = 0·021). After multivariable adjustment, E-DII scores were positively related to preeclampsia risk (Ptrend < 0·001). The highest tertile of E-DII was 2·18 times the lowest tertiles (95 % CI = 1·52, 3·13). The odds of preeclampsia increased by 30 % (95 % CI = 18 %, 43 %, P value < 0·001) for each E-DII score increase. The preeclampsia risk was positively associated with IL-2 (OR = 1·07, 95 % CI = 1·03, 1·11), IL-4 (OR = 1·26, 95 % CI = 1·03, 1·54) and transforming growth factor beta (TGF-ß) (OR = 1·17, 95 % CI = 1·06, 1·29). Therefore, proinflammatory diets, corresponding to higher IL-2, IL-4 and TGF-ß levels, were associated with increased preeclampsia risk.

Dietary and serum vitamin D and preeclampsia risk in Chinese pregnant women: a matched case-control study.

The effect of vitamin D (VD) on the risk of preeclampsia (PE) is uncertain. Few of previous studies focused on the relationship between dietary VD intake and PE risk. Therefore, we conducted this 1:1 matched case-control study to explore the association of dietary VD intake and serum VD concentrations with PE risk in Chinese pregnant women. A total of 440 pairs of participants were recruited during March 2016 to June 2019. Dietary information was obtained using a seventy-eight-item semi-quantitative FFQ. Serum concentrations of 25(OH)D2 and 25(OH)D3 were measured by liquid chromatography-tandem MS. Multivariate conditional logistic regression was used to estimate OR and 95 % CI. Restricted cubic splines (RCS) were plotted to evaluate the dose-response relationship of dietary VD intake and serum VD concentrations with PE risk. Compared with the lowest quartile, the OR of the highest quartile were 0·45 (95 % CI 0·29, 0·71, Ptrend = 0·001) for VD dietary intake and 0·26 (95 % CI 0·11, 0·60, Ptrend = 0·003) for serum levels after adjusting for confounders. In addition, the RCS analysis suggested a reverse J-shaped relationship between dietary VD intake and PE risk (P-nonlinearity = 0·02). A similar association was also found between serum concentrations of total 25(OH)D and PE risk (P-nonlinearity = 0·02). In conclusion, this study provides evidence that higher dietary intake and serum levels of VD are associated with the lower risk of PE in Chinese pregnant women.

Dietary carotenoid intake and risk of developing preeclampsia: a hospital-based case-control study.

BACKGROUND: The effect of carotenoids on the risk of preeclampsia (PE) is uncertain. We aimed to examine the associations between the intake of dietary carotenoids and related compounds by pregnant women in China, and the risk of their developing PE. METHODS: Four hundred and forty PE cases and 440 age- (± 3 years), gestational age- (± 1 weeks) and gestational diabetes mellitus status- (yes/no) matched healthy controls were recruited from March 2016 to June 2019. Dietary intake of carotenoids was assessed using a 79-item validated food-frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. RESULTS: After adjusting for potential confounders, we found that the intake of total carotenoids, ß-carotene, ß-cryptoxanthin, lycopene, and lutein and zeaxanthin (lut-zea) were negatively associated with the odds of developing PE. Compared with the lowest quartile intake, the multivariate-adjusted OR (95% CI) of the highest quartile intake was 0.29 (0.16-0.54, Ptrend <  0.001) for total carotenoids, 0.31 (0.16-0.58, Ptrend <  0.001) for ß-carotene, 0.50 (0.27-0.90, Ptrend = 0.007) for ß-cryptoxanthin, 0.55 (0.30-0.99, Ptrend = 0.04) for lycopene and 0.32 (0.17-0.61, Ptrend = 0.001) for lut-zea. However, no significant associations were observed between the risk of developing PE and α-carotene intake (OR = 0.75, 95% CI: 0.41-1.36, Ptrend = 0.28). Moreover, similar negative associations were found for every one-standard-deviation increase in the intake of total carotenoids, ß-carotene, ß-cryptoxanthin, lycopene and lut-zea. CONCLUSION: These results indicate that a high intake of total carotenoids, ß-carotene, ß-cryptoxanthin, lycopene and lut-zea may be associated with a low risk of developing PE.

Validation of the nutrient-rich foods index estimated by 24-h dietary recall method among adults in Henan province of China.

OBJECTIVE: A family of nutrient-rich food (NRF) indices was validated against the mean adequacy ratio (MAR) and their associations with obesity were tested. DESIGN: Cross-sectional study. NRF indices include nutrients to encourage ranging from 6-11 (protein; fibre; vitamin A, vitamin C, vitamin E and vitamin B12; Ca; Fe; K; Mg; Zn) and two nutrients to limit (saturated fat and Na), described as NRFn.2 (where n 6-11), based on reference amount of 100 g or 100 kcal using the NRF index family of algorithms. The percentage of variation in MAR (R2) was the criteria of index performance. Logistic regression models were applied to predict the association between NRF index and obesity. SETTING: Three communities in Zhengzhou city, Henan province, China. PARTICIPANTS: A total of 656 adults were recruited from Henan as the subjects. RESULTS: The NRF9·2 index, based on nine beneficial nutrients and two nutrients to limit, using the algorithm based on sums and 100 kcal, had the higher R2 values (R2 = 0·232). The OR for overweight (defined by BMI) in the 4th quartile (Q4) v. the 1st quartile (Q1) of the NRF9·2 index was 0·61 (95 % CI = 0·37, 0·98) after multiple adjustments. CONCLUSION: NRF9·2 index using the algorithm based on sums and 100 kcal gave the best predicted model for diet quality. NRF9·2 index score was associated with overweight defined by BMI, but it was not associated with central obesity. The NRF9·2 index is a valid tool to assess the overall diet quality among adults in Henan province of China.

Alcohol consumption patterns and the risk of sarcopenia: a population-based cross-sectional study among chinese women and men from Henan province.

OBJECTIVES: Sarcopenia is a clinically relevant syndrome with health, social, and economic implications. Alcohol consumption is one of the risk factors for sarcopenia, but it has not been fully investigated in Chinese populations. The purpose of the present study was to assess the relationship between alcohol consumption patterns (including the volume and frequency of alcohol consumption) and sarcopenia or its elements among Chinese women and men from Henan Province. METHOD: A cross-sectional study was designed to collect information about nutrition and health in Henan Province, China, and a total of 680 individuals were studied. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria updated in 2019. Alcohol consumption was calculated in grams per day and divided into three groups. Drinking frequency was divided into four groups. We assessed the likelihood that sarcopenia was associated with drinking patterns using multiple logistic regression analysis by odds ratios (ORs) with 95% confidence interval (CIs) after multiple adjustments. RESULTS: We found that men who consumed > 25 g of ethanol per day were approximately three times more likely to have low muscle mass (OR, 3.99; 95% CI, 1.10-17.05) or low grip strength (OR, 3.39; 95% CI, 1.33-9.92) than nondrinkers after multiple adjustments. In addition, males who consumed alcohol more than 4 times per week were approximately threefold to fivefold more likely to have low muscle mass (OR, 4.99; 95% CI, 1.24-25.55) or low grip strength (OR, 3.37; 95% CI, 1.40-8.74) than nondrinkers. Unfortunately, we did not find a relationship between alcohol consumption patterns and sarcopenia or gait speed among males, and there was no association between alcohol consumption patterns and sarcopenia or any elements. CONCLUSION: Heavy alcohol consumption and frequent drinking are important risk factors for low muscle mass and muscle strength in Chinese men from Henan province.

The effect of oral nutritional supplements on the nutritional status of community elderly people with malnutrition or risk of malnutrition.

BACKGROUND AND OBJECTIVES: To evaluate the effect of oral nutritional supplements (ONS) on community elderly people with malnutrition or risk of malnutrition. METHODS AND STUDY DESIGN: A single arm intervention trial for 3 months was conducted. Whole nutrient powder was given to all the participants. Dietary intakes were measured by 3-day diet record. Nutritional status was evaluated using body weight, body mass index (BMI), calf circumference (CC), and Mini Nutritional Assessment Short-Form (MNA-SF) scores. Muscle mass was measured by bioimpedance analysis (BIA). All these parameters as well as muscle strength, physical function, and quality of life were measured at both the baseline and the end. RESULTS: Compared with the baseline, ONS increased protein intake (58.32±16.67 vs 41.90±18.49 g/d, p<0.001), body weight (57.03±8.31 vs 56.68±8.23 kg, p<0.05), BMI (22.16±2.13 vs 22.02±2.08 kg/m2, p<0.05), CC (34.21±2.53 vs 33.80±2.53 cm, p<0.001), MNA-SF scores (12.61±1.43 vs 10.48±0.99, p<0.05), hand grip strength (24.54±8.05 vs 23.27±7.74 kg, p<0.001), and 6-m gait speed (1.11±0.33 vs 0.96±0.28 m/s, p<0.001). Moreover, SF-36 scores of the overall subjects have been improved in all dimensions (p<0.05). CONCLUSIONS: The study demonstrated that ONS can effectively increase protein intake and improve nutritional status, muscle strength, physical function and quality of life of the elderly with malnutrition or malnutrition risk in communities.

Dietary patterns and sarcopenia in a Chinese population.

BACKGROUND AND OBJECTIVES: Malnutrition is implicated as a key modifiable risk factor for sarcopenia. As such, a dietary pattern analysis, rather than an analysis of single food items or nutrients, may provide insights into the comprehensive contribution of diet and nutrition to the risk of sarcopenia. Accordingly, the aim of this study was to evaluate the relationships between main dietary patterns and sarcopenia. METHODS AND STUDY DESIGN: A total of 591 participants aged over 40 years were included in this cross-sectional study. A validated food-frequency questionnaire was used to assess their dietary intake, and principal component analysis (PCA) was used to identify the main dietary patterns. A multivariate logistic regression model was used to explore the associations between their main dietary patterns and the risk of sarcopenia. RESULTS: This study identified 56 cases of sarcopenia, equating to an overall detection rate of 9.48%. The PCA revealed four major dietary patterns among the participants: "coarse cereals and vegetables"; "beverages and animal organs"; "poultry, fish and shrimp"; and "fruits and pasta". After adjusting for age, sex, physical activity and smoking, individuals with the "coarse cereals and vegetables" dietary pattern had a 63.0% reduction in the risk of sarcopenia. CONCLUSIONS: The "coarse cereals and vegetables" dietary pattern is negatively correlated with sarcopenia, and may reduce the risk of sarcopenia.

Associations of accelerometer-measured physical activity and sedentary time with renal function and chronic kidney disease: a national population-based study.

Introduction: There is limited information about the relationship between physical activity (PA) and sedentary behaviors in chronic kidney disease (CKD). Therefore, this study aims to explore the associations of accelerometer-measured PA and sedentary behaviors with CKD. Methods: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey in the 2003-2004 and 2005-2006 survey cycles. A uniaxial accelerometer measured physical activity (PA) and sedentary time (ST). The associations of PA and ST with estimated glomerular filtration rate (eGFR) and odds of CKD adopted the generalized linear regression, multivariable logistic regression, and isotemporal substitution models. Results: A total of 5,990 adults with 605 CKD patients were included in this study. Compared with the individuals in the first quartile group, participants in the fourth quartile of low-intensity physical activity (LIPA), moderate to vigorous physical activity (MVPA), and ST were associated with 52% (35%, 65%) and 42% (14%, 62%) lower odds of CKD and 64% (17%, 131%) higher odds of CKD, respectively. Substituting 30 min/day of ST with equivalent LIPA/MVPA contributed to risk reduction in CKD. Discussion: The findings suggest that increased LIPA and MVPA and reduced ST were associated with a lower risk of CKD and that replacing ST with LIPA may decrease the risk of CKD.

Bioactive Compounds in Citrus reticulata Peel Are Potential Candidates for Alleviating Physical Fatigue through a Triad Approach of Network Pharmacology, Molecular Docking, and Molecular Dynamics Modeling.

Physical fatigue (peripheral fatigue), which affects a considerable portion of the world population, is a decline in the ability of muscle fibers to contract effectively due to alterations in the regulatory processes of muscle action potentials. However, it lacks an efficacious therapeutic intervention. The present study explored bioactive compounds and the mechanism of action of Citrus reticulata peel (CR-P) in treating physical fatigue by utilizing network pharmacology (NP), molecular docking, and simulation-based molecular dynamics (MD). The bioactive ingredients of CR-P and prospective targets of CR-P and physical fatigue were obtained from various databases. A PPI network was generated by the STRING database, while the key overlapping targets were analyzed for enrichment by adopting KEGG and GO. The binding affinities of bioactive ingredients to the hub targets were determined by molecular docking. The results were further validated by MD simulation. Five bioactive compounds were screened, and 56 key overlapping targets were identified for CR-P and physical fatigue, whereas the hub targets with a greater degree in the PPI network were AKT1, TP53, STAT3, MTOR, KRAS, HRAS, JAK2, IL6, EGFR, and ESR1. The findings of the enrichment analysis indicated significant enrichment of the targets in three key signaling pathways, namely PI3K-AKT, MAPK, and JAK-STAT. The molecular docking and MD simulation results revealed that the bioactive compounds of CR-P exhibit a stronger affinity for interacting with the hub targets. The present work suggests that bioactive compounds of CR-P, specifically Hesperetin and Sitosterol, may ameliorate physical fatigue via the PI3K-AKT signaling pathway by targeting AKT1, KRAS, and MTOR proteins.

Exploring the optimal indicator of short-term peridiagnosis weight dynamics to predict cancer survival: A multicentre cohort study.

BACKGROUND: Body weight and its changes have been associated with cancer outcomes. However, the associations of short-term peridiagnosis weight dynamics in standardized, clinically operational time frames with cancer survival remain largely unknown. This study aimed to screen for and evaluate the optimal indicator of short-term peridiagnosis weight dynamics to predict overall survival (OS) in patients with cancer. METHODS: This multicentre cohort study prospectively collected data from 7460 patients pathologically diagnosed with cancer between 2013 and 2019. Body weight data were recorded 1 month before, at the time of and 1 month following diagnosis. By permuting different types (point value in kg, point height-adjusted value in kg/m2, absolute change in kg or relative change in percentage) and time frames (prediagnosis, postdiagnosis or peridiagnosis), we generated 12 different weight-related indicators and compared their prognostic performance using Harrell's C-index, integrated discrimination improvement, continuous net reclassification improvement and time-dependent C-index. We analysed associations of peridiagnosis relative weight change (RWC) with OS using restricted cubic spine (RCS), Kaplan-Meier analysis and multivariable-adjusted Cox regression models. RESULTS: The study enrolled 5012 males and 2448 females, with a median age of 59 years. During a median follow-up of 37 months, 1026 deaths occurred. Peridiagnosis (1 month before diagnosis to 1 month following diagnosis) RWC showed higher prognostic performance (Harrell's C-index = 0.601, 95% confidence interval [CI] = [0.583, 0.619]) than other types of indicators including body mass index (BMI), absolute weight change, absolute BMI change, prediagnosis RWC and postdiagnosis RWC in the study population (all P < 0.05). Time-dependent C-index analysis also indicated that peridiagnosis RWC was optimal for predicting OS. The multivariable-adjusted RCS analysis revealed an N-shaped non-linear association between peridiagnosis RWC and OS (PRWC < 0.001, Pnon-linear < 0.001). Univariate survival analysis showed that the peridiagnosis RWC groups could represent distinct mortality risk stratifications (P < 0.001). Multivariable survival analysis showed that, compared with the maintenance group (weight change < 5%), the significant (gain >10%, hazard ratio [HR] = 0.530, 95% CI = [0.413, 0.680]) and moderate (gain 5-10%, HR = 0.588, 95% CI = [0.422, 0.819]) weight gain groups were both associated with improved OS. In contrast, the moderate (loss 5-10%, HR = 1.219, 95% CI = [1.029, 1.443]) and significant (loss >10%, HR = 1.280, 95% CI = [1.095, 1.497]) weight loss groups were both associated with poorer OS. CONCLUSIONS: The prognostic performance of peridiagnosis RWC is superior to other weight-related indicators in patients with cancer. The findings underscore the importance of expanding the surveillance of body weight from at diagnosis to both past and future, and conducting it within clinically operational time frames, in order to identify and intervene with patients who are at risk of weight change-related premature deaths.

Socioeconomic inequality in overweight/obesity among US children: NHANES 2001 to 2018.

Background: Previous research has found that the prevalence of childhood overweight/obesity varies depending on household income, ethnicity, and sex. The goal of our research is to examine changes over time in socioeconomic inequality and the prevalence of overweight/obesity among American children under five by sex and ethnicity. Methods: This cross-sectional analysis used data from the National Health and Nutrition Examination Surveys (NHANES) collected from 2001-02 to 2017-18. Overweight/obesity in children under five [Body Mass Index (BMI)-for-age z-score >2 standard deviations] was defined according to the World Health Organization (WHO) growth reference standard. The slope inequality index (SII) and the concentration index (CIX) were used to measure the socioeconomic inequality in overweight/obesity. Results: Between 2001-02 and 2011-12, childhood overweight/obesity in the United States decreased from 7.3% to 6.3%, and had increased to 8.1% by 2017-18. However, this pattern varied widely by ethnicity and sex. For both the 2015-16 and 2017-18 surveys, overweight/obesity was more concentrated in the poorest household quintile for overall Caucasian children ((SII = -11.83, IC 95% = -23.17, -0.49 and CIX = -7.368, IC 95% = -13.92, -0.82) and (SII = -11.52, IC 95% = -22.13, -0.91 and CIX = -7.24, IC 95% = -13.27, -1.21), respectively) and for males of other ethnicities [(SII = -13.93, IC 95% = -26.95, -0.92) and CIX = -8.55, IC 95% = -0.86, -16.25] and (SII = -21.19, IC 95% = -40.65, -1.74) and CIX = -13.11, IC 95% = -1.42, -24.80), respectively). In the last three surveys, overweight/obesity was also more concentrated in the poorest household quintile for the overall children of other ethnicities. With the exception of African American females in the 2013-14 survey, for whom overweight/obesity was significantly concentrated in a quintile of the richest households (SII = 12.60, 95% CI = 0.24, 24.97 and CIX = 7.86, 95% CI = 15.59, 0.12); overweight/obesity was found to be concentrated in the richest household quintile for overall African American children, but not significantly so. Conclusions: Our findings give an update and reinforce the notion that overweight/obesity in children under the age of five has increased and that related wealth inequalities are a public health problem in the United States.

Intakes of folate, vitamin B6, and vitamin B12 and cardiovascular disease risk: a national population-based cross-sectional study.

Background: Only a few studies that investigated dietary intakes of folate, vitamin B6, and vitamin B12 in relation to cariovascular disease (CVD). This study aimed to assess the association of dietary folate, vitamin B6, and vitamin B12 with CVD in the United States population. Methods: A cross-sectional analysis of 65,322 adults aged ≥ 20 years who participated in the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 1999-2018. Before 2003, dietary intake data were assessed using a 24-hour dietary call, and two 24-hour dietary calls were used during 2003 and 2018. Odds ratios and 95% confidence intervals (CIs) for CVD associated with dietary folate, vitamin B6, and vitamin B12 were estimated using multivariate logistic regression models. Results: Dietary vitamin B6 intake were inversely associated with the odds of CVD. In males, the multivariable OR for the highest vs. lowest quartiles of vitamin B6 was 0.77 (95%CI: 0.61-0.97, Ptrend = 0.013) for the odds of CVD. In females, the adjusted OR for the highest quartile of vitamin B6 compared with the lowest quartile was 0.73 (95%CI: 0.56-0.95, Ptrend = 0.038) for the odds of CVD. No significant association was observed between dietary folate and vitamin B12 intakes and the odds of CVD. Conclusions: Our findings indicate that higher intake of dietary vitamin B6 may be associated with lower prevalence of CVD, suggesting that dietary vitamin B6 has major public health implications in the prevention of CVD in the United States population.