The effects of dietary macronutrient composition on resting energy expenditure following active weight loss: A systematic review and meta-analysis.

A systematic review and meta-analysis was conducted to evaluate the relative effectiveness of different dietary macronutrient patterns on changes in resting energy expenditure (REE) in relation to weight loss, categorized as minimal (<5%) and moderate to high (>5%). Changes in REE were assessed using a DerSimonian and Laird random-effects meta-analysis. A diet lower in carbohydrates (CHO) or higher in fat and protein was associated with smaller reductions in REE, with these trends being more pronounced among participants who experienced moderate to high weight loss. Adjusted meta-regression analysis indicated that, within the participants who experienced moderate to high weight loss, each 1% increase in CHO intake was associated with a reduction of 2.30 kcal/day in REE (95% CI: -4.11 to -0.47, p = 0.013). In contrast, a 1% increase in protein and fat intake was correlated with an increase in REE by 3.00 (95% confidence interval [CI] [1.02, 5.07], p = 0.003) and 0.5 (95% CI [-2.43, 3.41], p = 0.740) kcal/day, respectively. No significant associations were found among participants who experienced minimal weight loss. These findings indicate that, under a caloric deficit, the impact of dietary macronutrient composition on REE may vary depending on the degree of weight loss and individual metabolic responses.

Mitigating errors in mobile-based dietary assessments: Effects of a data modification process on the validity of an image-assisted food and nutrition app.

OBJECTIVE: Mobile nutrition applications (apps) provide a simple way for individuals to record their diet, but the validity and inherent errors need to be carefully evaluated. The aim of this study was to assess the validity and clarify the sources of measurement errors of image-assisted mobile nutrition apps. METHODS: This was a cross-sectional study with 98 students recruited from School of Nutrition and Health Sciences, Taipei Medical University. A 3-d nutrient intake record by Formosa Food and Nutrient Recording App (FoodApp) was compared with a 24-h dietary recall (24-HDR). A two-stage data modification process, manual data cleaning, and reanalyzing of prepackaged foods were employed to address inherent errors. Nutrient intake levels obtained by the two methods were compared with the recommended daily intake (DRI), Taiwan. Paired t test, Spearman's correlation coefficients, and Bland-Altman plots were used to assess agreement between the FoodApp and 24-HDR. RESULTS: Manual data cleaning identified 166 food coding errors (12%; stage 1), and 426 food codes with missing micronutrients (32%) were reanalyzed (stage 2). Positive linear trends were observed for total energy and micronutrient intake (all Ptrend < 0.05) after the two stages of data modification, but not for dietary fat, carbohydrates, or vitamin D. There were no statistical differences in mean energy and macronutrient intake between the FoodApp and 24-HDR, and this agreement was confirmed by Bland-Altman plots. Spearman's correlation analyses showed strong to moderate correlations (r = 0.834 ∼ 0.386) between the two methods. Participants' nutrient intake tended to be lower than the DRI, but no differences in proportions of adequacy/inadequacy for DRI values were observed between the two methods. CONCLUSIONS: Mitigating errors significantly improved the accuracy of the Formosa FoodApp, indicating its validity and reliability as a self-reporting mobile-based dietary assessment tool. Dietitians and health professionals should be mindful of potential errors associated with self-reporting nutrition apps, and manual data cleaning is vital to obtain reliable nutrient intake data.

Postoperative Drip-Infusion of Remifentanil Reduces Postoperative Pain-A Retrospective Observative Study.

Development of remifentanil-induced hyperalgesia (RIH) postoperatively is an unpleasant experience that requires further treatment. This study assessed the effects of gradual withdrawal combined with drip infusion of remifentanil on postoperative pain and the requirement for rescue analgesics. A total of 559 patients receiving total intravenous anesthesia with propofol and remifentanil were enrolled. All patients either underwent gradual withdrawal of remifentanil (GWR) or gradual withdrawal combined with drip infusion (GWDR) with a dose of 1 mcg·kg-1 for 30 min after extubation. The numeric rating scale (NRS) and the requirement of rescue analgesics were assessed. The requirement for rescue analgesics was significantly lower in the GWDR group than in the GWR group (13.2% vs. 35.7%; p < 0.001). At the post-anesthetic care unit (PACU), patients in the GWDR group had a lower NRS pain score (p < 0.001). In addition, in the postoperative 2nd hour, patients in the GWDR group had a significantly lower NRS than the GWR group (beta, -0.31; p = 0.003). No remifentanil-related adverse effects were observed. We found that gradual withdrawal combined with drip infusion of remifentanil required less rescue analgesics and reduced pain scores. The new way of remifentanil administration may be effective to prevent RIH.

Clinical Use of Acid Suppressants and Risk of Dementia in the Elderly: A Pharmaco-Epidemiological Cohort Study.

BACKGROUND: Results of studies regarding the potential link between acid suppressant use and dementia risk are inconsistent. This study aimed to evaluate the association of cumulative exposure to histamine 2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) with dementia risk in an Asian older cohort aged ≥65 years. METHODS: Patients initiating H2RA (the H2RA user cohort, n = 21,449) or PPI (the PPI user cohort, n = 6584) and those without prescription for H2RA (the H2RA non-user cohort, n = 21,449) or PPI (the PPI non-user cohort, n = 6584) between 1 January 2000 and 31 December 2005 without a prior history of dementia were identified from Taiwan's National Health Insurance Research Database (NHIRD). The outcome of interest was all-cause dementia. Patients' exposure to H2RAs or PPIs was followed-up from dates of initial prescription to the earliest outcome of incident dementia, death, or the end of 2013. Potential associations between acid suppressant use and dementia risk were analyzed using time-dependent Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: After mutual adjustment for H2RA and PPI use and other potential confounders, patients with H2RA use had significantly higher risk of developing dementia as compared to those not treated with H2RAs (adjusted HR, 1.84; 95% CI, 1.49-2.20). Likewise, PPI users had significantly elevated risk of dementia compared to PPI non-users (adjusted HR, 1.42; 95% CI, 1.07-1.84). CONCLUSIONS: Our results indicate that exposures to H2RAs and PPIs are associated with increased dementia risk.

Lipid peroxidation in workers exposed to aluminium, gallium, indium, arsenic, and antimony in the optoelectronic industry.

OBJECTIVE: The objective of this study was to investigate whether exposure to aluminum, gallium, indium, arsenic, and antimony induces lipid peroxidation in humans. METHODS: Whole blood and urine levels of 103 exposed electronic industry workers and 67 referents were analyzed by use of inductively coupled plasma mass spectrometry. Malondialdehyde (MDA), the product of lipid peroxidation, was determined by high-performance liquid chromatography. RESULTS: The mean plasma MDA level in the 103 workers was significantly higher than that in 67 referents. The levels of MDA in the exposed workers were correlated significantly with the levels of urinary gallium and arsenic. CONCLUSIONS: Malondialdehyde as an index of lipid peroxidation can be induced by gallium and arsenic exposure. By reducing exposure to these metals, biologic effects such as lipid peroxidation may also be diminished.