Dietary intake and quality among adults with cystic fibrosis: A systematic review.

AIMS: This systematic review aims to describe the dietary quality, dietary intake and related behaviours of adults diagnosed with cystic fibrosis. METHODS: A comprehensive literature search was conducted in four databases (Medline, CINAHL, EMBASE, CENTRAL); studies were included if they addressed dietary intake, diet quality or eating behaviours among adults (≥15 years) living with cystic fibrosis and were published from January 2000 to November 2022. The Mixed Methods Appraisal Tool was used to assess the risk of bias and quality of included studies. Findings were synthesised narratively. RESULTS: Nineteen observational studies (n = 2236) were included and considered high to moderate quality. Most (13/19) studies reported that individuals with cystic fibrosis were consuming high-energy diets; where studies reported energy intake as a proportion of requirements met, energy intake was high, even when using individualised or cystic fibrosis-specific referents. In addition, fat intakes as a proportion of energy appeared high (29%-39% of total energy), particularly as current guidelines recommend macronutrient profile similar to the general population (<30% of total energy). There was considerable variation in the reporting of fatty acid profiles and other nutrients. Five studies reported on concerns regarding diet and eating in this population. CONCLUSION: Findings from the current review suggest dietary intakes of adults with cystic fibrosis appear to be less than optimal and concerns about diet, weight and food may be emerging in this population. Future research utilising consistent measures of dietary assessment and reporting, reporting of medical therapies, and exploring potential concerns about diet and eating is warranted.

Rearing and Experimental Uses of Daphnia: Controlling Animal Nutrition and Assessing Lifespan and Life-History Traits.

Caloric restriction has been found to extend the lifespan of many organisms including mammals and other vertebrates. With lifespans exceeding months to years, age-related experiments involving fish and mammals can be overtly costly, both in terms of time and funding. The freshwater crustacean, Daphnia, has a relatively short lifespan (∼50 to 100 days), which makes it a cost-effective alternative animal model for longevity and aging studies. Besides age-specific mortality, there are a suite of physiological responses connected to "healthspan" that can be tracked as these animals age including growth, reproduction, and metabolic rates. These responses can be complemented by assessment of molecular and cellular processes connected to aging and health. Lifespan and metabolism of this model organism is responsive to long studied modulators of aging, such as rearing temperature and nutritional manipulation, but also pharmacological agents that target aging, e.g., rapamycin, which adds to its usefulness as a model organism. Here we describe how to culture Daphnia for aging experiments including maintaining laboratory populations of Daphnia mothers, growing algal food, and manipulating nutrition of these animals. In addition, we provide methods for tracking common physiological and longevity responses of Daphnia. This protocol provides researchers planning to use this model organism with methods to establish and maintain Daphnia populations and to standardize their experimental approaches. © 2024 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Culturing algae for Daphnia food Basic Protocol 2: General methods for culturing Daphnia Basic Protocol 3: Standardizing and controlling nutrition for experimental Daphnia Basic Protocol 4: Monitoring Daphnia lifespan Basic Protocol 5: Evaluating Daphnia health: Heart rate and respiration, body mass and growth rates, and reproduction.

Reducing extrauterine growth restriction in very preterm neonates: A before-after intervention study.

BACKGROUND: Focus on preterm nutrition strategies is imperative. Extrauterine growth restriction (EUGR) is a clinically relevant, but seemingly elusive consequence, often used to benchmark and compare outcomes. METHODS: This before-after observational study was designed to study the effect of a multipronged updated "nutrition care bundle" in very preterm infants on rate of EUGR compared with a cohort from a previous period. Eligible participants were neonates born at <32 weeks' gestation who completed care in the unit; a retrospective group from a previous period and a prospective cohort after implementation of the bundle were included. The bundle constituted of three key areas: (1) aggressive parenteral nutrition with high-dose amino acids and lipids from day 1, (2) "rapid-escalation" enteral feed regimens including earlier introduction of human milk fortifier (at 40-ml/kg/day feeds), and (3) colostrum mouth paint and structured oromotor stimulation to promote oral feeding. EUGR was defined as a z score difference of >-1 in weight for postmenstrual age (PMA) at discharge and at birth. RESULTS: Data of 116 infants were retrieved for the retrospective group; 103 infants were included in the prospective group. EUGR was reduced from 71% to 58% (P = 0.039) after implementation of the bundle. Infants in the prospective group achieved full oral feeds at earlier PMA (P < 0.001) and were discharged at earlier PMA (P = 0.002). CONCLUSIONS: The proportion of neonates with EUGR was reduced significantly after implementation of the revised nutrition care bundle. Achievement of full oral feeds and discharge readiness were earlier in the prospective group.

Food (in)security in relation to nutrition (in)security in a national cross-sectional sample of Supplemental Nutrition Assistance Program participants: considerations of an emerging construct.

BACKGROUND: Food insecurity, lack of access to sufficient food for an active, healthy life, is a persistent problem in the United States. Recently, nutrition security has emerged as a new concept. However, limited research exists examining how nutrition security relates to the established concept of food security. OBJECTIVES: This study assessed a recent metric of nutrition security and explored how well it describes the underlying construct among a sample of Supplemental Nutrition Assistance Program (SNAP) participants. We examined the correlation between food and nutrition security and demographic predictors of joint food and nutrition security status. METHODS: We conducted a national, web-based survey (Qualtrics; 30 September-19 October, 2022) in English and Spanish of adults aged ≥18 y (n = 1454) who reported receiving SNAP benefits in the past 12 mo. We measured food security using the US Department of Agriculture 6-item Food Security Survey and assessed nutrition security using the Gretchen Swanson Center for Nutrition Household Nutrition Security measure. We used multinominal logistic regression to examine demographic predictors of food and nutrition security. RESULTS: The majority (80.4%) of SNAP participants experienced food insecurity, and 59.1% reported experiencing nutrition insecurity. Food and nutrition security were moderately correlated (0.41); 55.6% of SNAP participants were both food and nutrition insecure, 3.5% were food secure but nutrition insecure, 24.8% were food insecure but nutrition secure, and 16.1% were both food and nutrition secure. Of SNAP participants, 24.8% reported experiencing food insecurity but not nutrition insecurity. Hispanic ethnicity and Southern residence were associated with joint food and nutrition insecurity. CONCLUSIONS: These findings raise questions about how nutrition security is conceptualized and measured and its added value beyond existing food security measurement scales. Further research is needed to understand differences in food and nutrition security experiences and risk factors and determine a validated definition and measure of nutrition security for future policy solutions.

[Vegetable-first eating habits are associated with a reduced risk of mild cognitive impairment in elderly diabetic patients].

OBJECTIVE: To examine the relationship between vegetable-first eating habits and the cognitive function in elderly patients with diabetes. METHODS: The subjects were outpatients with diabetes ≥60 years old at Ise Red Cross Hospital. A self-administered dementia checklist was used to assess mild cognitive impairment and dementia. The participants were asked to fill out a questionnaire on their vegetable-first eating habits and were classified into 4 groups: 0, 1, 2, and 3 times a day. The dependent variables were mild cognitive impairment and dementia, and the explanatory variable was vegetable-first eating habits (0 as a reference). RESULTS: In total, 358 patients were included in the analysis. The number of vegetable-first meals was 0 in 153 (42.7%), 1 in 48 (13.4%), 2 in 46 (12.8%), and 3 in 111 (31.1%) patients. The adjusted odds ratios for 1, 2, and 3 times of mild cognitive impairment were 0.83 (95% confidence interval [CI], 0.35-1.94; P=0.680), 0.81 (95% CI, 0.32-2.00; P=0.653), and 0.37 (95% CI, 0.17-0.81; P=0.014), respectively. However, there was no significant association between vegetable-first eating habits and dementia. CONCLUSION: In elderly patients with diabetes, a vegetable-first eating habit at each meal was associated with a decreased risk of mild cognitive impairment.

[Change of dietary pattern among young people aged 18-35 in China from 1989 to 2018].

OBJECTIVE: To analyze the dietary patterns changes of young people aged 18-35 in 15 provinces(autonomous regions, municipalities) from 1989 to 2018. METHODS: Using the data of China Health and Nutrition Survey, a total of 25 400 young people aged 18-35 with complete dietary and sociodemographic information from 1989 to 2018 in 15 provinces(autonomous regions, municipalities) were selected as the research objects. Nutrition survey was carried out by using 3 consecutive days of 24-hour review method combined with weighing accounting method. Energy and nutrient intake was calculated based on food composition list. The principal component cluster analysis was used to select food groups and K-mean cluster was uesd to extract dietary patterns. Dwass-Steel-Critchlow-Fligner was used to test the difference of food intake in different dietary patterns. Cochran-Armitage trend test was to analyze the change of dietary patterns with the years. Chi-square test was to analyze the difference of people with different dietary patterns in 2018. RESULTS: The dietary patterns of young people aged 18-35 in 15 provinces(autonomous regions, municipalities) were mainly divided into three categories: "traditional rice", "traditional pasta" and "high-quality protein". In 2018, the proportion of "traditional rice" dietary patterns was higher for men than for women, and the proportion of "high-quality protein" dietary patterns was lower than for women. The proportion of "traditional pasta" dietary pattern in people aged 25-35 was higher than that aged 18-24, and the proportion of "high-quality protein" dietary pattern was lower than that aged 18-24. The proportion of people in urban with "traditional rice" dietary pattern was lower than that in rural areas, and the proportion of "high-quality protein" dietary pattern was higher than that in rural areas. The northern region was dominated by "traditional pasta" dietary pattern, while the southern region was dominated by "traditional rice" dietary pattern, and the proportion of people with "high-quality protein" dietary pattern was higher in the northern region than in the southern region. With the increase of education level and income level, the proportion of people with "high-quality protein" dietary pattern showed an increasing trend. From 1989 to 2018, the "traditional rice" dietary pattern had always maintained a high proportion among young people aged 18-35 in 15 provinces(autonomous regions, municipalities) in China, and the "traditional pasta" dietary pattern had been decreasing since 2009, and the "high-quality protein" dietary pattern had significantly increased since 2011. CONCLUSION: From 1989 to 2018, the proportion of young people aged 18-35 with reasonable dietary pattern has increased in 15 provinces(autonomous regions, municipalities), but the traditional dietary pattern still needs to be improved.

Effect of nonpharmacological interventions on nutrition status, complications and quality of life in head and neck cancer patients undergoing radiotherapy: A systematic review and meta-analysis.

PURPOSE: To evaluate the effect of nonpharmacological therapies on nutrition status, complications and quality of life in head and neck cancer patients and to provide a basis for clinical practice. METHODS: This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Ten databases were systematically searched for all available articles from construction to November 2023. Two researchers independently conducted literature screening, data extraction and quality evaluation. Cochrane Review Manager 5.3 was used for meta-analysis. RESULTS: Finally, 27 RCT studies including 2814 patients with head and neck cancer were included. Five categories of interventions were used: nutritional support, exercise, swallowing function training, psychological intervention and low-level laser therapy. Nonpharmacological interventions can improve body weight loss in patients with HNC at the end of treatment (MD: 1.66 kg; 95% CI: 0.80 to 2.51), and subgroup analysis showed that nutritional support, psychological intervention and low-level laser therapy were effective. Nonpharmacological interventions can also ameliorate decreases in BMI (MD: 0.71; 95% CI: 0.16 to 1.26) and reduce the incidence of malnutrition (RR: 0.76; 95% CI: 0.67 to 0.86), oral mucositis (RR: 0.54; 95% CI: 0.37 to 0.80) and gastrointestinal complications (RR: 0.61; 95% CI: 0.38 to 0.96) during radiotherapy; however, no significant differences were found in other complications and quality of life. CONCLUSION: Nonpharmacological interventions can improve the nutrition status of patients with head and neck cancer and reduce the incidence of severe oral mucositis and gastrointestinal complications during radiotherapy but have no significant impact on quality of life.

An environmental scan of food and drink advertising on public transport around Adelaide schools.

ISSUE ADDRESSED: Children and adolescents are particularly receptive to cues from food and drink advertising. Several policies recommend restricting unhealthy or discretionary ('junk') food advertising on government infrastructure such as public transport. Prior research in New South Wales (NSW) and Western Australia (WA) reveals a high proportion of discretionary food advertising outdoors and on public transport. The aim of this study was to identify the landscape of food and drink advertising on public transport assets around Adelaide schools. METHODS: An environmental scan of food and drink advertising on public transport assets within 500 m of 65 Adelaide schools was conducted. The Council of Australian Governments Health Council's interim guide was used to categorise advertisements as 'suitable' or 'unsuitable' for promotion. RESULTS: Almost four in every five food and drink advertisements on public-transport assets observed around Adelaide schools included discretionary food or drink, and therefore were categorised as unsuitable for promotion. Advertisements on bus exteriors were more likely to promote discretionary foods, compared with bus shelters. CONCLUSIONS: This proportion of 'unhealthy' food advertising was comparable to previous research conducted in WA and NSW. SO WHAT?: In light of historic state/territory actions such as the ACT preventing discretionary food advertising on public transport, these findings should prompt a review and discussion of the suitability of food and drink promotion on government-owned South Australian transport and their associated assets.

Beyond the lunchbox: Menu development guidelines for the Tasmanian School Lunch Project.

ISSUE: Universal school lunches hold the potential to improve student nutritional intake and access to food, but to do so menus must be nutritionally adequate. There is growing interest in school lunch programs (SLPs) in Australia, and one is currently being trialled in Tasmania. No nutrition guidelines currently exist for menu development in Australian schools. METHODS: A desktop review of international SLPs was completed, and findings analysed in the context of Australian Nutrient Reference Values and Australian Dietary Guidelines to inform the development of Tasmanian SLP guidelines. DISCUSSION: Globally, SLPs are guided by portion sizes and/or nutrient criteria. SLPs (many of which address food insecurity) must provide children the opportunity to meet energy and nutrient needs, while minimising food waste. We propose energy-based nutrient criteria and qualitative recommendations for menu development. SO WHAT?: We have developed guidelines to inform the development of Tasmanian SLP menus. These guidelines may be applicable to other states and territories piloting similar programs.

Xylitol is prothrombotic and associated with cardiovascular risk.

BACKGROUND AND AIMS: The pathways and metabolites that contribute to residual cardiovascular disease risks are unclear. Low-calorie sweeteners are widely used sugar substitutes in processed foods with presumed health benefits. Many low-calorie sweeteners are sugar alcohols that also are produced endogenously, albeit at levels over 1000-fold lower than observed following consumption as a sugar substitute. METHODS: Untargeted metabolomics studies were performed on overnight fasting plasma samples in a discovery cohort (n = 1157) of sequential stable subjects undergoing elective diagnostic cardiac evaluations; subsequent stable isotope dilution liquid chromatography tandem mass spectrometry (LC-MS/MS) analyses were performed on an independent, non-overlapping validation cohort (n = 2149). Complementary isolated human platelet, platelet-rich plasma, whole blood, and animal model studies examined the effect of xylitol on platelet responsiveness and thrombus formation in vivo. Finally, an intervention study was performed to assess the effects of xylitol consumption on platelet function in healthy volunteers (n = 10). RESULTS: In initial untargeted metabolomics studies (discovery cohort), circulating levels of a polyol tentatively assigned as xylitol were associated with incident (3-year) major adverse cardiovascular event (MACE) risk. Subsequent stable isotope dilution LC-MS/MS analyses (validation cohort) specific for xylitol (and not its structural isomers) confirmed its association with incident MACE risk [third vs. first tertile adjusted hazard ratio (95% confidence interval), 1.57 (1.12-2.21), P < .01]. Complementary mechanistic studies showed xylitol-enhanced multiple indices of platelet reactivity and in vivo thrombosis formation at levels observed in fasting plasma. In interventional studies, consumption of a xylitol-sweetened drink markedly raised plasma levels and enhanced multiple functional measures of platelet responsiveness in all subjects. CONCLUSIONS: Xylitol is associated with incident MACE risk. Moreover, xylitol both enhanced platelet reactivity and thrombosis potential in vivo. Further studies examining the cardiovascular safety of xylitol are warranted.

Lower plasma melatonin levels in non-hypoxic premature newborns associated with neonatal pain.

We analyzed plasma melatonin levels in different groups of preterm newborns without hypoxia and their relationship with several perinatal variables like gestational age or neonatal pain. Prospective cohort study of preterm newborns (PTNB) without perinatal hypoxia, Apgar > 6 at 5 min, and oxygen needs on the third day of life. We compared melatonin levels at day 3 of life in different groups of non-hypoxic preterm infants (Student's t-tests, Mann-Whitney U, and chi2) and analyzed the relationship of melatonin with GA, birth weight, neonatal pain (Premature Infant Pain Profile (PIPP) scale), caffeine treatment, parenteral nutrition, or the development of free radical diseases (correlation study, linear regression) and factors associated with moderate/intense pain and free radical diseases (logistic regression analysis). Sixty-one preterm infants with gestational age (GA) of 30.7 ± 2.0 weeks with no oxygen requirements at day 3 of life were studied with plasma melatonin levels of 33.8 ± 12.01 pg/ml. Preterm infants weighing < 1250 g at birth had lower plasma melatonin levels (p = 0.05). Preterm infants with moderate or severe pain (PPIPP > 5) have lower melatonin levels (p = 0.01), and being preterm with PIPP > 5 is associated with lower plasma melatonin levels (p = 0.03). Being very preterm (GA < 32 GS), having low weight for gestational age (LWGA), receiving caffeine treatment, or requiring parenteral nutrition did not modify melatonin levels in non-hypoxic preterm infants (p = NS). Melatonin on day 3 of life in non-hypoxic preterm infants is not associated with later development of free radical diseases (BPD, sepsis, ROP, HIV, NEC). CONCLUSION: We observed that preterm infants with moderate to severe pain have lower melatonin levels. These findings are relevant because they reinforce the findings of other authors that melatonin supplementation decreases pain and oxidative stress in painful procedures in premature infants. Further studies are needed to evaluate whether melatonin could be used as an analgesic in painful procedures in preterm infants. TRIAL REGISTRATION: Trial registration was not required since this was an observational study. WHAT IS KNOWN: • Melatonin is a potent antioxidant and free radical scavenger in newborns under stress conditions: hypoxia, acidosis, hypotension, painful procedures, or parenteral nutrition. • Pain stimulates the production of melatonin. • Various studies conclude that melatonin administration decreases pain during the neonatal period. WHAT IS NEW: • Non-hypoxic preterm infants with moderate to severe pain (PIPP>5) have lower levels of melatonin. • Administration of caffeine and treatment with parenteral nutrition do not modify melatonin levels in non-hypoxic preterm infants.

Enhancing Brain Health and Well-Being in Older Adults: Innovations in Lifestyle Interventions.

PURPOSE OF REVIEW: This article will provide clinicians with guidance on helping older adult patients make lifestyle changes to enhance brain health and well-being. RECENT FINDINGS: Evidence suggests that physical activity might be helpful in improving cognitive functioning. The data on the benefits of cognitive activity is inconsistent and not as robust. The MediDiet, DASH, and MIND diets have been associated with better cognitive health. Sleep hygiene and cognitive behavioral therapies are considered first line evidence-based treatments for insomnia and the maintenance of healthy sleep patterns. Mindfulness based interventions have been shown to reduce anxiety, depression, and stress, and can help some older adults manage pain more constructively. Evidence-based information regarding the four topics of exercise, nutrition, sleep, and mindfulness is reviewed, so that clinicians may be better able to optimize care for their older adult patients.

Dietary Flavonoid and Subclass Intakes are not Associated with Markers of Bone Health in U.S. Adults Age 50+ Years.

BACKGROUND: Dietary flavonoid intakes have been associated with improved markers of bone health in Chinese and Scottish cohorts, but little data exist in middle aged to older adults in the United States. OBJECTIVES: The objective of our research was to assess if dietary flavonoid intakes are associated with bone mineral density (BMD), bone mineral content (BMC), and bone area of the lumbar spine and femoral neck in a nationally representative population of middle aged to older U.S. adults. We further sought to investigate if relationships of the main flavonoid subgroups (i.e., anthocyanins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones) exist, as a secondary objective. METHODS: Cross-sectional data from individuals aged 50+ years enrolled in the 2017-2018 National Health and Nutrition Examination Survey (NHANES) were used in our analyses (N = 2590). Weighted multivariate logistic regression models were used to investigate the relationship between quartiles of flavonoid intake and BMD, BMC, and bone area of the lumbar spine and femoral neck of participants. RESULTS: Mean age of participants was 63.4 ± 0.52 years and 64.1 ± 0.52 years for men and women, respectively. Average total flavonoid intake was 217 ± 19.4 mg/day and 306 ± 26.9 mg/day for men and women, respectively. Total flavonoid intakes were not significantly associated with BMD, BMC, or bone area of the femoral neck or lumbar spine in male or female participants. Flavonoid subclass intakes were also not consistently associated with improved markers of bone health. CONCLUSION: Although several limitations exist, this cross-sectional analysis of U.S. adults aged 50+ years provides contradictory evidence to the hypothesis that higher flavonoid and flavonoid subclass intakes beneficially impacts markers of bone health. Large prospective cohort investigations that better capture long-term dietary flavonoid intake and ascertain fractures the primary outcome, as well as randomized controlled trials, are needed to fully elucidate the effects flavonoids on bone health.

Associations between body weight dissatisfaction and diet quality in women with a body mass index in the healthy weight category: Results from the 2014-2015 Swiss National Nutrition Survey.

BACKGROUND: Few studies have examined whether diet quality is lower in women with body weight dissatisfaction compared to women without body weight dissatisfaction. OBJECTIVES: 1) To examine the association between body weight dissatisfaction and diet quality among women (18-65 years old) in the healthy weight body mass index (BMI) category and 2) to explore dietary and behavioral patterns among women with body weight dissatisfaction. DESIGN: Data were extracted from the cross-sectional 2014-2015 Swiss National Nutrition Survey. PARTICIPANTS/SETTING: Population-based sample of 507 women with BMI ≥ 18.5 and < 25 kg/m2. OUTCOME MEASURES: Dietary intakes assessed by dietitians using two non-consecutive computer-assisted multi-pass 24-hour dietary recalls. Diet quality was measured with a slightly modified version of the Healthy Eating Index (HEI) -2020. STATISTICAL ANALYSES PERFORMED: Multiple linear regressions to test the association between body weight dissatisfaction and total HEI-2020 score. Hierarchical cluster analysis to identify subgroups of women with body weight dissatisfaction. RESULTS: Body weight dissatisfaction was not found to be associated with diet quality (ß = - 1.73 [-4.18 ; 0.71], P =0.16). However, women who were dissatisfied with their body weight had lower scores for the HEI-2020 total fruits (P = 0.050) and whole grains (P = 0.014) components than women who were satisfied with their body weight. Four profiles with different dietary patterns were identified among women with body weight dissatisfaction: "Unhealthy diet with dairy", "Protein and fat", "Vegetables without protein", and "Healthier diet without dairy". CONCLUSIONS: Among women with a BMI in the healthy weight category, overall diet quality was not observed to differ between those with or without body weight dissatisfaction. More research is needed to explore the different profiles of dietary intake in women with body weight dissatisfaction.

Effects of food bar chewing duration on the physiologic, metabolic, and perceptual responses to moderate-intensity running.

PURPOSE: Chewing duration can affect food particle size, gastric processing, and postprandial glycemia, but these effects have not been investigated with exercise. This study examined how the chewing duration of a food bar impacts glycemic and metabolic responses, gastrointestinal (GI) symptoms, psychological affect, and performance during endurance running. METHODS: This randomized, unblinded, crossover study had 15 males (35.2 ± 7.4 years, VO2peak: 56.1 ± 5.2 ml/kg/min) attend three laboratory visits. Visit 1 required a VO2peak test, 10 min familiarization run at 60% VO2peak, and familiarization time-to-exhaustion (TTE) test (10 min at 90% VO2peak, followed by TTE at 100% VO2peak). Visits 2 and 3 consisted of a 60 min run at 60% VO2peak, followed by TTE testing. Participants were fed 45 g of a bar (180 kcal, 4 g fat, 33 g carbohydrate, 3 g protein, 1 g fiber) in 9 g servings 30 min before running, and 27 g of bar in 9 g servings at three timepoints during the 60 min run. Participants consumed the servings in 20 (20CHEW) or 40 (40CHEW) masticatory cycles, at 1 chew/second. Outcomes included blood glucose, substrate use, GI symptoms, perceived exertion (RPE), overall feeling, and TTE. RESULTS: Post-prandial blood glucose, GI symptoms, and RPE increased over time, but there were no significant between-condition or condition-by-time effects. TTE showed no significant between-condition effect (20CHEW: 288 ± 133 s; 40CHEW: 335 ± 299 s; p = 0.240). Overall feeling demonstrated a time-by-condition effect (p = 0.006), suggesting possible better maintenance over time with 40CHEW. CONCLUSION: Cumulatively, the results suggest that extended chewing minimally impacts physiology, perceptions, and performance during 60 min moderate-intensity running.

Impact of total parenteral nutrition versus exclusive enteral nutrition on postoperative adverse outcomes in patients with penetrating Crohn's disease undergoing surgical resection: A retrospective cohort study.

Achieving optimal nutritional status in patients with penetrating Crohn's disease (CD) is crucial in preparing for surgical resection. However, there is a dearth of literature comparing the efficacy of total parenteral nutrition (TPN) versus exclusive enteral nutrition (EEN) in optimizing postoperative outcomes. Hence, we conducted a case-matched study to assess the impact of preoperative EEN versus TPN on the incidence of postoperative adverse outcomes, encompassing overall postoperative morbidity and stoma formation, among penetrating CD patients undergoing bowel surgery. From December 1, 2012 to December 1, 2021, a retrospective study was conducted at a tertiary center to enroll consecutive patients with penetrating CD who underwent surgical resection. Propensity score matching (PSM) was utilized to compare the incidence of postoperative adverse outcomes. Furthermore, univariate and multivariate logistic regression analyses were conducted to identify the risk factors associated with adverse outcomes. The study included 510 patients meeting the criteria. Among them, 101 patients in the TPN group showed significant improvements in laboratory indicators at the time of surgery compared to pre-optimization levels. After matching, TPN was increased occurrence of postoperative adverse outcomes (92.2% vs. 64.1%, p = 0.001) when compared to EEN group. In the multivariate analysis, TPN showed a significantly higher odds ratio for adverse outcomes than EEN (OR = 4.241; 95% CI 1.567-11.478; p = 0.004). The study revealed that penetrating CD patients who were able to fulfill their nutritional requirements through EEN exhibited superior nutritional and surgical outcomes in comparison to those who received TPN.

Influence of COVID-19 on mental health of postpartum women, breastfeeding time and infant development.

BACKGROUND: The COVID-19 pandemic may have affected the mental health of pregnant and postpartum women, influencing the duration of exclusive breastfeeding and the child's neuropsychomotor development. RESEARCH AIM: To evaluate the influence of COVID-19 on the mental health of postpartum women, on the protein and antioxidant profile of breast milk, on the duration of exclusive breastfeeding and on the neuropsychomotor development of their infants. METHODS: Observational study, prospective cohort, with 180 postpartum women. Psychosocial status was assessed by changes in mood and lifestyle; trait and state anxiety, and postpartum depression. Breastfeeding time and neuropsychomotor development were determined at the three-month well-child consultation based on the child's health record and the WHO Anthro software. 5 ml of mature breast milk were collected from the full breast of the lactating women. RESULTS: There was no difference between the prevalence of anxious traits and states and postpartum depression among seropositive and negative postpartum women for COVID-19. There was no difference in the prevalence of time and type of breastfeeding, and of normal and delayed neuropsychomotor development between seropositive and negative postpartum women for COVID-19. The fact that the baby smiles and raises and keeps his head elevated were associated with lower chances of an anxious state among postpartum women (OR: 0.23; OR: 0.28 and OR: 0.20, respectively). CONCLUSIONS: The need for more studies to investigate the influence of the COVID-19 pandemic on the mental health of postpartum women, breastfeeding and the neuropsychomotor development of babies is highlighted, given the importance of breast milk for the growth and development of babies.

Association between serum vitamin E and bacterial vaginitis in women: a cross-sectional study.

INTRODUCTION: Bacterial vaginitis (BV) is a common vaginal disease. Vitamin E has been shown to reduce BV by enhancing immune function, but no studies have analyzed the relationship between vitamin E and BV at different BMIs and ages. METHOD: This study used 2242 participants from four cycles of NHANES 1999-2006 in American. Participants' vitamin E levels were divided into four groups, and analyses such as study population description, stratified analysis, multiple logistic regression analysis, and curve fitting were performed. To perform data processing, the researchers used the statistical package R (The R Foundation; http://www.r-project.org ; version 3.6.3) and Empower Stats software ( www.empowerstats.net , X&Y solutions, Inc. Boston, Massachusetts). RESULT: The concentrations of serum vitamin E were negatively correlated with the risk of BV, especially when vitamin E were at 1198-5459ug/dL with (OR = -0.443, 95%CI = 0.447-0.923, P = 0.032) or without (OR = -0.521, 95%CI = 0.421-0.837, P = 0.006) adjustment for variables. At the same time, at lower levels, there was no significant association. Vitamin E supplementation may significantly reduce the risk of BV (p < 0.001). In addition, the risk of having BV decreased and then increased with increasing vitamin E concentrations at high BMI levels (p < 0.01). CONCLUSION: Vitamin E at moderate to high concentrations may significantly reduce BV risk, says the study, providing clinical evidence for the prevention and the treatment of BV.