Hip circumference has independent association with the risk of hyperuricemia in middle-aged but not in older male patients with type 2 diabetes mellitus.

BACKGROUND: Obesity and type 2 diabetes mellitus (T2DM) are risk factors for hyperuricemia. However, which anthropometric indices can better predict incident hyperuricemia in patients with T2DM remains inconsistent. This study aimed to examine the associations between hyperuricemia and different anthropometric indices in middle-aged and older male patients with T2DM. METHODS: In this retrospective study, a total of 1447 middle-aged (45-65 years, n = 791) and older (≥ 65 years, n = 656) male patients with T2DM were collected from December 2015 to January 2020 at Shanghai Xinhua Hospital. Hyperuricemia was defined as a serum uric acid level above 7.0 mg/dL. Weight, height, waist circumference (WC) and hip circumference (HC) were measured by trained nurses at visit. RESULTS: The median uric acid level of subjects was 5.6 (interquartile ranges: 4.7-6.7) mg/dl, and 279 (19.3%) were hyperuricemia, with 146 (18.5%) in the middle-aged group, and 133 (20.3%) in the older group. After adjusting for age, duration of T2DM, fasting plasma glucose and insulin, homeostasis model assessment-ß, aspartate aminotransferase, triglycerides, high-density lipoprotein cholesterol and estimated glomerular filtration rate, body mass index (BMI), WC, HC, and waist-to-height ratio (WHtR) were associated with a higher risk of hyperuricemia in both middle-aged and older group (P < 0.05). After further adjusting for BMI and WC, HC still showed a positive relationship with the risk of hyperuricemia (Odds Ratio = 1.51, 95% confidence intervals: 1.06-2.14) in the middle-aged group, but such relationship was not found in the older group. Moreover, according to receiver operating characteristic analysis, the optimal cutoff value was 101.3 cm of HC for hyperuricemia screening in the middle-aged male patients with T2DM. CONCLUSION: In middle-aged male patients with T2DM, more attention should be paid to HC with the cutoff value of 101.3 cm in clinical practice for early recognition of individuals with a high risk of hyperuricemia for targeted guidance on disease prevention, such as community screening.

Evaluation of a new digital pediatric malnutrition risk screening tool for hospitalized children with congenital heart disease.

BACKGROUND: In a cohort of hospitalized children with congenital heart disease (CHD), a new digital pediatric malnutrition screening tool as a mobile application was validated, and its effectiveness and clinical value were determined as a prospective study. METHODS AND RESULTS: Children with CHD (n = 1125) were screened for malnutrition risk. The incidence of risk and the differences among various age groups and types of CHD were characterized. The optimal threshold for the tool to determine if there is a risk of malnutrition is score 2, while the Youden index was 79.1%, and the sensitivity and specificity were 91.2% and 87.9%, respectively. Based on such criterion, 351 children were at risk of malnutrition accounting for 31.20% of the total. Compared with the non-malnutritional risk group, the median age for the group at risk for malnutrition was younger (8.641 months [4.8, 23.1] vs. 31.589 months [12.4, 54.3], P < 0.01), and the length of stay was longer (12.000 [8.0, 17.0] vs. (8.420 [5.0, 12.0], P < 0.01]. There were significant differences in malnutrition risk among different age groups (χ2 = 144.933, P < 0.01), and children under one year of age exhibited the highest risk for malnutrition and more extended hospital stay (H = 78.085, P < 0.01). The risk of malnutrition among children with cyanotic CHD was higher than in those with non-cyanotic CHD (χ2 = 104.384, P < 0.01). CONCLUSIONS: The new digital pediatric malnutrition screening tool showed high sensitivity and specificity in children with CHD. The tool indicated that the malnutrition risk for young children and children with cyanotic or Bethesda moderate and complex CHD was higher, and the hospitalization time was longer than in the non-risk group. The tool provides a rational approach to targeted nutrition intervention and support and may improve clinical outcomes.

Elevated serum triglyceride levels at first prenatal visit is associated with the development of gestational diabetes mellitus.

AIMS: While several studies have indicated that maternal serum lipid profiles are associated with the development of gestational diabetes mellitus (GDM), the results have been inconsistent. This study aimed to explore the relationship between maternal lipids profiles at first prenatal visit and GDM and determine the optimal cut-off values of possible trimester-specific variables in predicting GDM. MATERIALS AND METHODS: Clinical data of women with singleton pregnancies who delivered in Xinhua Hospital between January 2016 and January 2017 were collected from electronic databases. Multivariate logistic regression was used to determine the potential risk factors of GDM (specific to the trimester at first prenatal visit), including age, body mass index (BMI), and serum lipid profile and fasting plasma glucose (FPG) levels. The receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of significant variables. RESULTS: Among the 2191 pregnant women included, 315 (14.38%) were diagnosed with GDM. Of these, 880 (40.16%) had their first prenatal visit before 14 gestational weeks. Univariate and multivariate analyses showed that both FPG and triglyceride (TG) levels in the first and second trimesters were associated with a high risk of GDM (p < 0.05). The ROC curve showed that serum TG levels >1.235 mmol/L and >1.525 mmol/L in the first and second trimesters, respectively, were significantly associated with the development of GDM (p < 0.05). CONCLUSIONS: TG levels at first prenatal visit is associated with GDM risk. Different TG cut-off values should be applied in the different trimesters of pregnancy for GDM screening.

Comparing human milk macronutrients measured using analyzers based on mid-infrared spectroscopy and ultrasound and the application of machine learning in data fitting.

OBJECTIVE: Fat, carbohydrates (mainly lactose) and protein in breast milk all provide indispensable benefits for the growth of newborns. The only source of nutrition in early infancy is breast milk, so the energy of breast milk is also crucial to the growth of infants. Some macronutrients composition in human breast milk varies greatly, which could affect its nutritional fulfillment to preterm infant needs. Therefore, rapid analysis of macronutrients (including lactose, fat and protein) and milk energy in breast milk is of clinical importance. This study compared the macronutrients results of a mid-infrared (MIR) analyzer and an ultrasound-based breast milk analyzer and unified the results by machine learning. METHODS: This cross-sectional study included breastfeeding mothers aged 22-40 enrolled between November 2019 and February 2021. Breast milk samples (n = 546) were collected from 244 mothers (from Day 1 to Day 1086 postpartum). A MIR milk analyzer (BETTERREN Co., HMIR-05, SH, CHINA) and an ultrasonic milk analyzer (HonÉ¡yanÉ¡ Co,. HMA 3000, Hebei, CHINA) were used to determine the human milk macronutrient composition. A total of 465 samples completed the tests in both analyzers. The results of the ultrasonic method were mathematically converted using machine learning, while the Bland-Altman method was used to determine the limits of agreement (LOA) between the adjusted results of the ultrasonic method and MIR results. RESULTS: The MIR and ultrasonic milk analyzer results were significantly different. The protein, fat, and energy determined using the MIR method were higher than those determined by the ultrasonic method, while lactose determined by the MIR method were lower (all p < 0.05). The consistency between the measured MIR and the adjusted ultrasound values was evaluated using the Bland-Altman analysis and the scatter diagram was generated to calculate the 95% LOA. After adjustments, 93.96% protein points (436 out of 465), 94.41% fat points (439 out of 465), 95.91% lactose points (446 out of 465) and 94.62% energy points (440 out of 465) were within the LOA range. The 95% LOA of protein, fat, lactose and energy were - 0.6 to 0.6 g/dl, -0.92 to 0.92 g/dl, -0.88 to 0.88 g/dl and - 40.2 to 40.4 kj/dl, respectively and clinically acceptable. The adjusted ultrasonic results were consistent with the MIR results, and LOA results were high (close to 95%). CONCLUSIONS: While the results of the breast milk rapid analyzers using the two methods varied significantly, they could still be considered comparable after data adjustments using linear regression algorithm in machine learning. Machine learning methods can play a role in data fitting using different analyzers.

Efficacy and safety of parenteral nutrition with iron sucrose for anemia prevention in preterm infants: A randomized, double-blind controlled study.

BACKGROUND AND OBJECTIVES: Our objective is to study the efficacy and safety of parenteral nutrition (PN) with iron sucrose to prevent anemia in preterm infants. METHODS AND STUDY DESIGN: We performed a randomized, double-blind controlled trial in which preterm infants were divided into five groups randomly: a control group (PN without iron sucrose, namely group Iron-0), and intervention groups (PN with iron sucrose 100 µg/kg/d, 200 µg/kg/d, 300 µg/kg/d and 400 µg/kg/d, namely group Iron-1, 2, 3, and 4, respectively). The indicators were red blood cell (RBC) parameters, iron storage and oxidant stress. RESULTS: One hundred infants completed this study. Excepting the RBC count in Iron-2, the value of erythrocyte parameters in intervention groups decreased less than that in the control group. And the decrease of RBC count in Iron-1 (-0.6×1012/L vs -0.9×1012/L, p=0.033), hemoglobin in Iron-4 (-26.0 g/L vs -41.0 g/L, p=0.03) and hematocrit in Iron-1(-9.5% vs -14.0%, p=0.014) was significantly less than in the control group. The change of ferritin in Iron-4 was significantly higher than in the control group (280 ng/ml vs 118 ng/ml, p=0.04). There was no difference in serum iron in intervention groups when compared to the control group (p>0.05). Except for the change of malondialdehyde (MDA) in Iron-1, the increase in other intervention groups was higher than in the control group (p>0.05). CONCLUSIONS: PN with iron sucrose for prevention of anemia in preterm infants is safe and efficacious to some extent.

The effect of different adiposity factors on insulin resistance in obese children and adolescents.

CONTEXT: Insulin resistance (IR) has been common in obese children, but the effect of different adiposity factors on IR is still unclear. OBJECTIVE: To evaluate the associations between IR with body mass index (BMI), waist circumference (WC), body fat mass (BFM), and body fat percentage (BFP) in obese children and adolescents. METHODS: A total of 224 simple obese children were included in this study, including 150 boys and 74 girls, aged 3-18 who were seen in the clinical nutrition outpatient of Xinhua Hospital from September 2012 to December 2019. Basic information, body composition and laboratory tests were collected. RESULTS: Compared with girls, boys had higher height, weight, BMI, WC, and BFM (P < 0.05), but on the contrary, boys' FINS and HOMA- IR were lower than girls' (P > 0.05). With the age increasing, height, weight, BMI, BFM, WC, HC, WHtR, FINS and HOMA-IR increased accordingly (P < 0.05). The results from univariate analysis and multiple linear regression analysis showed that the impact of BMI on IR was slightly lower than BFM, WC and HC, but higher than BFP, with adjusting for the effects of age, sex and lipid metabolism (P < 0.01). CONCLUSION: Overall adipose tissue, especially abdominal adipose tissue, is a powerful marker in inducing IR in obese children and adolescents. In addition, more attention should be paid to WC and BFM than BMI in obese people with IR.

Resting Energy Expenditure Early after Cardiac Surgery and Validity of Predictive Equations: A Prospective Observational Study.

OBJECTIVE: Several predictive equations have been used to estimate patients' energy expenditure. The study aimed to describe the characteristics of resting energy expenditure (REE) in patients undergoing mechanical ventilation during early postoperative stage after cardiac surgery and evaluate the validity of 9 REE predictive equations. METHODS: This was a prospective observational study. Patients aged 18-80 years old, undergone open-heart surgery, were enrolled between January 2017 and 2018. The measured REE (mREE) was evaluated via indirect calorimetry (IC). The predictive resting energy expenditure (pREE) was suggested by 9 predictive equations, including Harris-Benedict (HB), HB coefficient method, Ireton-Jones, Owen, Mifflin, Liu, 25 × body weight (BW), 30 × BW, and 35 × BW. The association between mREE and pREE was assessed by Pearson's correlation, paired t test, Bland-Altman method, and the limits of agreement (LOA). RESULTS: mREE was related to gender, BMI, age, and body temperature. mREE was significantly correlated with pREE, as calculated by 9 equations (all p < 0.05). There was no significant difference between pREE and mREE, as calculated by 30 × BW kcal/kg/day (t = 0.782, p = 0.435), while significant differences were noted between mREE and pREE calculated by other equations (all p < 0.05). Taking the 30 × BW equation as a suitable candidate, most of the data points were within LOA, and the percentage was 95.6% (129/135). Considering the rationality of clinical use, accurate predictions (%) were calculated, and only 40.74% was acceptable. CONCLUSIONS: The 30 × BW equation is relatively acceptable for estimating REE in 9 predictive equations in the early stage after heart surgery. However, the IC method should be the first choice if it is feasible.

Primary intestinal lymphangiectasia in children: Twelve years of experience in the diagnosis and management.

BACKGROUND AND OBJECTIVES: Primary Intestinal Lymphangiectasia (PIL) is a rare congenital and digestive disease, which could present through a broad spectrum of clinical manifestations, diagnostic and treatment management. The aim of this study was to introduce the diagnosis and nutrition treatment of children with PIL through the twelve years of experience. METHODS AND STUDY DESIGN: The patients diagnosed with PIL admitted to the Department of Gastroenterology and Nutrition in Xinhua Hospital from June 2006 to September 2017 were included in the study. RESULTS: Ten patients were found to have PIL, and 5 of them were male. The mean age was 66 months at the time of diagnosis and 11 months at onset. The main clinical manifestations were diarrhea, edemas and abdominal distention. Marked dilatation of the intestinal lymphatic vessels was the characteristic of the endoscopic. All the patients presented with hypoproteinemia and hypoimmunoglobulinia. Six of them were treated with parenteral nutrition, and 9 of them were treated with a low-long-chain triglycerides (LCT), high-protein diet supplemented with medium-chain triglycerides (MCT). The clinical symptoms of the patients have improved after the MCT diet therapy. CONCLUSIONS: PIL should be considered first when there are clinical manifestations of chronic diarrhea, edema and abdominal distention, and biochemical results indicated the hypoproteinemia and hypoimmunoglobulinia, and the general treatment is invalid. Gastroscopy and E-colonoscopy with biopsies are the preferred method of diagnosis. Diet intervention (MCT diet) is the cornerstone and longtime medical treatment, which can improve the nutritional status and promote the survival quality of patients with PIL.

Relationship between energy intake, prognosis and related indicators in adults after cardiac, thoracic, and vascular surgery: A prospective observational study.

BACKGROUND AND OBJECTIVES: The study aimed to explore the association between energy intake (EI), the proportion of enteral nutrition intake (EN%), and prognostic-related indicators. METHODS AND STUDY DESIGN: This was a prospective observational study. Patients aged 18-80 years old, who had undergone cardiothoracic surgery, were enrolled between January 2017 and January 2018. The measured REE (mREE) was evaluated by indirect calorimetry (IC). The observational data on EI, EN% and EI/mREE% were collected following admission to ICU, ICU discharge, and prior to discharge. RESULTS: A total of 160 patients (60.6% male) were studied. The prealbumin and total protein were positively correlated with EN% at the time of ICU discharge; liver function index levels were negatively correlated with EI/mREE% at discharge (p<0.05). Multiple linear regression indicated that ALT levels as well as EI/mREE% were related to the duration of mechanical ventilation; ALT, AST, APACHE II were related to the ICU duration; EN% and EI/mREE% were related to the length of stay (LOS) following ICU discharge. EN% was related to the LOS in the hospital. CONCLUSIONS: The patients treated cardiothoracic surgery demonstrated associations of EN% with LOS in the hospital. Increased EN% and EI/mREE% were associated with higher serum protein levels and maintain normal liver function.

Dietary Choline Intake during Pregnancy and PEMT rs7946 Polymorphism on Risk of Preterm Birth: A Case-Control Study.

INTRODUCTION AND AIMS: Choline-metabolizing genetic variation may interact with choline intake on fetal programming and pregnancy outcome. This case-control study aims to explore the association of maternal choline consumption and phosphatidylethanolamine N-methyltransferase (PEMT) gene polymorphism rs7946 with preterm birth risk. METHODS: 145 Han Chinese women with preterm delivery and 157 Han Chinese women with term delivery were recruited in Shanghai. Dietary choline intake during pregnancy was assessed using a validated food frequency questionnaire. Additionally, DNA samples were genotyped for PEMT rs7946 (G5465A) with plasma homocysteine (Hcy) levels measured. RESULTS: Compared with the lowest quartile of choline intake, women within the highest consumption quartile had adjusted odds ratio (aOR) for preterm birth of 0.48 (95% confidence interval, CI [0.24, 0.95]). There was a significant interaction between maternal choline intake and PEMT rs7946 (p for interaction = 0.04), where the AA genotype carriers who consumed the energy-adjusted choline <255.01 mg/day had aOR for preterm birth of 3.75 (95% CI [1.24, 11.35]), compared to those with GG genotype and choline intake >255.01 mg/day during pregnancy. Additionally, the greatest elevated plasma Hcy was found in the cases with AA genotype and choline consumption <255.01 mg/day (p < 0.001). CONCLUSION: The AA genotype of PEMT rs7946 may be associated with increased preterm birth in these Han Chinese women with low choline intake during pregnancy.

Healthy adult vegetarians have better renal function than matched omnivores: a cross-sectional study in China.

BACKGROUND: An appropriate diet is an important determinant of kidney health. However, the association between vegetarian diets and renal function is unclear. We aimed to study the association between vegetarian diets and renal function in healthy adults. METHODS: A total of 269 vegetarians and 269 sex- and age-matched nonvegetarian omnivores were enrolled in this cross-sectional study. Basic characteristics and daily dietary intakes were assessed by face-to-face interviews. Blood samples were collected, and renal function was assessed by measuring blood urea nitrogen (BUN), serum creatinine (SCr), uric acid (UA) and the estimated glomerular filtration rate (eGFR). Blood pressure, fasting blood glucose and blood lipid profiles were also assessed. RESULTS: The average age of the vegetarians was 35.4 ± 8.6 years, 82.2% of whom were female. We evaluated the association between vegetarian diets and renal function using multivariate analysis. Compared with omnivores, vegetarians had lower BUN [ß = - 0.63, 95% confidence interval (CI): (- 0.88, - 0.38)], SCr [ß = - 2.04, 95% CI:(- 4.10, 0.02)], and UA levels [ß = - 15.15, 95% CI: (- 27.81, - 2.50)] and higher eGFRs [ß = 4.04, 95% CI: (0.30, 7.78)] after adjusting for sex, age, body mass index (BMI), physical activity, alcohol consumption, smoking status, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), systolic pressure and fasting blood glucose. Further analysis of food composition and renal function showed that dietary fiber intake was significantly negatively associated with BUN [ß = - 0.02, 95% CI: (- 0.03, 0.00)], SCr [ß = - 0.14, 95% CI: (- 0.25, 0.04)], and UA levels [ß = - 0.72, 95% CI: (- 1.36, 0.07)] and positively associated with the eGFR [ß = 0.20, 95% CI: (0.00, 0.40)]. CONCLUSIONS: Healthy adult vegetarians have better renal function than omnivores, and the higher dietary fiber intake associated with vegetarian diets may contribute to the protective effect on renal function.

Risk factors of parenteral nutrition-associated cholestasis in very-low-birthweight infants.

AIM: We aimed to explore risk factors associated with parenteral nutrition-associated cholestasis (PNAC) in very-low-birthweight (VLBW) infants. METHODS: VLBW infants receiving parenteral nutrition (PN) for at least 14 days were enrolled in a retrospective dual-centre study and divided into two groups chronologically: group A (2000-2007) and group B (2008-2015). The incidence of PNAC and related factors were investigated. We compared the differences between PNAC and non-PNAC groups. A multivariate binary logistic regression analysis was carried out to identify the potential risk factors of PNAC. RESULTS: A total of 387 VLBW infants (53 in group A and 334 in group B) were enrolled in the study. The total incidence of PNAC was 6.7%, 9.4% in group A and 6.3% in group B. The dosage of amino acid (P = 0.009), glucose (P = 0.006), PN calories (P = 0.021) and the ratio of glucose/fat (P = 0.014) were significantly higher in group B than in group A. Non-protein energy to nitrogen ratio (P = 0.017) was lower in group B. Birthweight was significantly lower in the PNAC group than in the non-PNAC group (P = 0.021). Subgroup analysis showed that gestational age and duration of PN were significantly different between the PNAC and non-PNAC groups (P < 0.05). Logistic regression showed that prolonged duration of PN (≥43 days) (odds ratio 3.155, 95% confidence interval 1.009-9.861, P = 0.048) was an independent risk factor of PNAC. CONCLUSIONS: For VLBW infants, prolonged duration of PN is a risk factor for the development of PNAC. PNAC may be prevented by weaning off PN as early as possible in VLBW infants.

Low vitamin D is associated with diabetes peripheral neuropathy in older but not in young and middle-aged patients.

BACKGROUND: The relationship between vitamin D and diabetes peripheral neuropathy (DPN) is not consistent among epidemiologic studies. Thus, we aimed to investigate this relationship in different age groups. METHODS: In this cross-sectional study, 1461 patients admitted to the Department of Endocrinology at Xinhua Hospital from June 2016 to September 2017 were divided into three age groups: a Youth group (24-44 years, n = 127), a Middle-age group (45-64 years, n = 779), and an Elderly group (≥65 years, n = 555). Basic information and laboratory results were collected from medical records. RESULTS: Among the patients, 32.72% had DPN, with 12.59% in the Youth group, 33.63% in the Middle-age group, and 36.04% in the Elderly group. For the total sample and the Elderly group, serum 25(OH)D concentrations in DPN patients were lower than in non-DPN patients (P < .05). The results of multivariate logistic regression indicated a low vitamin D concentration to be a risk factor for DPN in the Elderly group (P < .05), but such relationship was not found in the Youth or Middle-age groups. Moreover, according to ROC analysis, a serum 25(OH)D level < 34.87 nmol/L suggests the occurrence of DPN in elderly patients with type 2 diabetes (P < .001). CONCLUSIONS: This study is the first to report that a low vitamin D level is associated with DPN in diabetic patients over 65 years of age and might be used as a predictor of DPN in this population. The interaction between vitamin D and age in the development of DPN and its underlying mechanisms need to be further explored.

Association between trimester-specific gestational weight gain and childhood obesity at 5 years of age: results from Shanghai obesity cohort.

BACKGROUND: It is still unclear if and at which trimester gestational weight gain is related to childhood adiposity. Thus we aimed to evaluate the association between trimester-specific gestational weight gain and body-fat compositions in Chinese children. METHODS: Maternal gestational weight were measured by trained nurses every 2 to 4 weeks from the first prenatal care, and body-fat compositions of 407 children from the Shanghai Obesity Cohort at 5 years of age were measured by nutritionist through bioelectrical impedance analysis. Overweight/obesity of children was defined according to the criteria of International Obesity Task Force. Logistic and linear regression models adjusted for potential confounders were conducted to evaluate the associations of gestational weight gains with childhood obesity and body-fat compositions. Two-sided P-value < 0.05 was considered statistically significant. RESULTS: Greater gestational weight gain in the 1st-trimester was significantly associated with a higher risk of childhood overweight/obesity [OR: 1.40 (95% CI: 1.06, 1.86)], fat mass index [ß: 0.25 (95% CI: 0.12, 0.38)], body fat percentage [ß: 1.04 (95% CI: 0.43, 1.65)], and waist-to-height ratio [ß: 0.005 (95% CI: 0.002, 0.008)]. A positive but nonsignificant association was found between greater 3rd-trimester gestational weight gain and a higher risk of offspring overweight/obesity, and we speculated that the association between 2nd-trimester gestational weight gain and offspring overweight/obesity is the "U" type. CONCLUSIONS: Weight gain in the first trimester gestation is positively correlated with the risk of childhood overweight/obesity and with body adiposity distributions of children at 5 years of age. Weight gain should be well controlled and monitored from early pregnancy.

Young adult vegetarians in Shanghai have comparable bone health to omnivores despite lower serum 25(OH) vitamin D in vegans: a cross-sectional study.

BACKGROUND AND OBJECTIVES: The association between a vegetarian diet and bone mineral density (BMD) remains unclear, particularly in young adults. This study was designed to compare the bone health status of young vegetarians and omnivores in Shanghai, China. METHODS AND STUDY DESIGN: A total of 246 vegetarians (following a vegan or lacto-ovo-vegetarian diet for at least 1 year) and 246 age- and sex-matched omnivores were recruited among young adult residents of Shanghai, China. The ultrasound bone mineral density analyser CM-200 was employed to measure calcaneus mineral densities, and blood samples were collected to determine serum 25- hydroxyvitamin D status. Intakes of protein, calcium and vitamin D were assessed by the 24-hour dietary recall method. RESULTS: The average age of the vegetarians was 32.7±6.5 years, 83.3% of whom were female; 71.3% of the participants had been vegetarians for no more than 5 years. After adjusting for some potential cofounding factors, the serum 25-hydroxyvitamin D concentration of vegans (15.0±13.4 µg/L) was significantly lower than that of omnivores (17.6±8.8 µg/L, p<0.05). The protein, calcium and vitamin D intakes of vegetarians were all lower than those of omnivores (p<0.05). However, there was no significant difference in calcaneus mineral density between vegetarians and omnivores or between vegans and lacto-ovo vegetarians. CONCLUSIONS: Serum 25- hydroxyvitamin D concentrations in vegans, but not in lacto-ovo vegetarians, were slightly lower than those in omnivores. However, short-term vegetarian diets did not result in adverse effects on bone mineral density in young Chinese adults.

Circulating magnesium levels and incidence of coronary heart diseases, hypertension, and type 2 diabetes mellitus: a meta-analysis of prospective cohort studies.

BACKGROUND: Data on the associations between circulating magnesium (Mg) levels and incidence of coronary heart diseases (CHD), hypertension, and type 2 diabetes mellitus (T2DM) are inconsistent and inconclusive. The aim of this study was to examine circulating Mg levels in relation to incidence of CHD, hypertension, and T2DM. METHODS: Prospective cohort studies published before May 2017 were searched through PubMed, EmBase, SCOPUS, and Google Scholar. A total of 11 studies that reported multivariable-adjusted associations of interest were identified. Information on the characteristics of study and participants, exposure, main outcomes, risk estimates, and cofounders was extracted and analyzed. RESULTS: Of the 11 included studies, 5 reported results on CHD (38,808 individuals [4437 cases] with an average 10.5-year follow-up), 3 on hypertension (14,876 participants [3149 cases] with a 6.7-year follow-up), and 4 on T2DM (31,284 participants [2680 cases] with an 8.8-year follow-up). Comparing the highest to the lowest category of circulating Mg concentration, the pooled relative risks [RRs] (95% confidence intervals [CIs]) were 0.86 (0.74, 0.996), 0.91 (0.80, 1.02), and 0.64 (0.50, 0.81) for incidence of CHD, hypertension, and T2DM, respectively. Every 0.1 mmol/L increment in circulating Mg levels was associated with 4% (RR, 0.96; 95% CI: 0.94, 0.99) reduction in hypertension incidence. No significant linear association was found between circulating Mg levels and incidence of CHD (RR, 0.89; 95% CI: 0.77, 1.03) and T2DM (RR, 0.90; 95% CI: 0.81, 1.002). The observed associations of interest were sensitive to exclusion of individual studies. CONCLUSIONS: Findings in this meta-analysis suggest that circulating Mg levels are inversely associated with incidence of CHD, hypertension, and T2DM. Additional studies are needed to provide more solid evidence and identify the optimal range of circulating Mg concentration with respect to primary prevention of CHD, hypertension, and T2DM.

[Prevalence of vegetarians and vegetarian's health dietary behavior survey in Shanghai].

OBJECTIVE: To assess the prevalence of vegetarians in the whole Shanghai population, and to know the vegetarians' brief and behavior on diet, nutrition and health. METHODS: First, a multi-staged, stratified, clustered random sampling design was used. A total representative sample of 4 004 Shanghai resident subjects were asked if they were vegetarians and what type of vegetarian they were by a well-designed questionnaire. Second, from ten vegetarian restaurants located in Shanghai. 473 adult vegetarians completed a questionnaire about vegetarian status, among whom 274 vegetarians completed a detailed questionnaire about their brief and behaviors on diet, nutrition and health status. RESULTS: Of 4 004 subjects, 0.77% were vegetarians (0.45% were lacto-vegetarians and 0. 12% were vegans). The average age was 65. 0 years. 74. 2% of the vegetarians were female. Of 473 vegetarians, 70. 2% of the vegetarians had college or higher education. Compared to vegans, lacto-ovo-vegetarians were significantly younger and had higher educational level. The main reasons for choosing a vegetarian lifestyle were religion (49. 3%) and health (31. 3%). Furthermore, more vegan tend to be Buddhist. Vegetarians were more concerned about their health (209/274, 76. 5%) , the consumption of balance diets (183/274, 66. 8%). Comparing with lacto-ovo-vegetarians (58. 3%) more vegans (70. 4%) believed in that vegetarian diet is a kind of healthy dietary pattern and will not have any nutrients deficiency (P = 0. 037). Vegetarians consumed more healthy foods (e. g.,whole grains, vegetables, soy products, and nuts) than the general population (P < 0. 01). Only 5. 8% of the vegetarians took dietary supplements. CONCLUSION: 0. 77% of population in Shanghai was vegetarian. The two main reasons for adopting a vegetarian lifestyle were religion and health. The vegetarians tend to have more nutrition knowledge, better attitude and behavior on health. However, most of the vegetarians had not realized the nutrient deficiency risk of vegetarian diets.

Enteral supplementation of bovine lactoferrin improves gut barrier function in rats after massive bowel resection.

Previous studies have shown that bovine lactoferrin (bLF) exerts antibacterial, immune-modulating and anti-inflammatory effects. The present study aimed to investigate the effect of enteral bLF supplementation on intestinal adaptation and barrier function in a rat model of short bowel syndrome (SBS). Male Sprague-Dawley rats aged 4 weeks were randomised into three groups (n 10 per group): Sham group (rats submitted to bowel transection and reanastomosis); SBS group (rats submitted to 80 % small-bowel resection); SBS-bLF group (rats submitted to 80 % small-bowel resection plus treatment with bLF (0·5 g/kg per d) by oral administration from day 2 to day 20). Despite similar food intake, both the SBS and SBS-bLF groups exhibited significantly lower body weight gain, but increased villus height and crypt depth and a higher intestinal epithelial cell proliferation index (P< 0·05) when compared with the Sham group. Compared with that in the SBS group, in the SBS-bLF group, bacterial translocation to regional organs was low and intestinal permeability was significantly reduced. The SBS-bLF group also had increased secretory IgA (sIgA) concentrations in ileal contents (29·9 (23·8-33·0) ng/ml), when compared with the other two groups having similar sIgA concentrations (17·5 (12·6-29·1) and 19·3 (11·5-27·0) ng/ml, respectively). The relative expression levels of two tight junction (TJ) proteins, occludin and claudin-4, in the SBS-bLF group were significantly higher than those in the SBS group (P< 0·05), but did not exhibit any significant differences when compared with those in the Sham group. In conclusion, enteral bLF supplementation up-regulates small-bowel sIgA concentrations and TJ protein expression and reduces intestinal permeability and could thus support intestinal barrier integrity and protect against bacterial infections in SBS.

Relation between serum osteocalcin levels and body composition in obese children.

Overweight and obesity may contribute to bone fractures in children; however, the mechanism involved is not clear. In this study, we assessed the relation between serum osteocalcin levels and body composition in obese children. A total of 79 children (ages 7-12 years) were recruited. Serum osteocalcin levels were negatively correlated with fat percentage and visceral fat area (r = -0.24 and r = -0.46, respectively, P < 0.05); however, no statistically significant association was found between obesity degree and serum osteocalcin levels (r = -0.29, P = 0.052). Serum osteocalcin levels were positively correlated with lean body mass, fat-free mass, and fat-free mass index (r = 0.24, 0.23, and 0.31, respectively; P < 0.05). In addition, serum osteocalcin levels were significantly lower in severely obese (44.46 ±â€Š9.73 µg/mL) and moderately obese (48.72 ±â€Š10.82 µg/mL) children than in mildly obese (55.43 ±â€Š12.4 µg/mL) and overweight (54.36 ±â€Š11.96 µg/mL) children (P = 0.02). These findings indicate that body composition is related to serum osteocalcin levels in overweight and obese children.

The applicability of a commercial 3DO body scanner in measuring body composition in Chinese adults with overweight and obesity: a secondary analysis based on a weight-loss clinical trial.

BACKGROUND: A commercial three-dimensional optical (3DO) scanning system was reported to be used in body composition assessment. However, the applicability in Chinese adults has yet to be well-studied. METHODS: This secondary analysis was based on a 16-week weight-loss clinical trial with an optional extension to 24 weeks. Waist and hip circumference and body composition were measured by 3DO scanning at each follow-up visit during the study. Bioelectrical impedance analysis (BIA) was also performed to confirm the reliability of 3DO scanning at each visit. We used Lin's concordance correlation coefficients (CCC) to evaluate the correlation between the two methods above-mentioned. Bland-Altman analysis was also performed to evaluate the agreement and potential bias between different methods. RESULTS: A total number of 70 Chinese adults overweight and obese (23 men and 47 women, aged 31.8 ± 5.8 years) were included in the analysis, which resulted in 350 3DO scans and corresponding 350 BIA measurements. The percent body fat, fat mass, and fat-free mass were 33.9 ± 5.4%, 26.7 ± 4.6 kg, and 50.3 ± 8.7 kg before the trial by 3DO scanning. And they were 30.5 ± 5.8%, 22.5 ± 4.7 kg, and 49.4 ± 8.3 kg after 16 weeks of the trial. Compared with BIA, 3DO scanning performed best in the assessment of fat-free mass (CCC = 0.89, 95%CI: 0.86, 0.90), then followed by fat mass (CCC = 0.76, 95%CI: 0.71, 0.80) and percent body fat (CCC = 0.70, 95%CI: 0.64, 0.75). Subgroup analysis showed that 3DO scanning and BIA correlated better in women than that in men, and correlated better in measuring fat-free mass in participants with larger body weight (BMI ≥28.0 kg/m2) than those with smaller body weight (<28.0 kg/m2). CONCLUSIONS: 3DO scanning is an effective technology to monitor changes in body composition in Chinese adults overweight and obese. However its accuracy and reliability in different ethnicities needs further exploration.