Targeted nutritional intervention attenuates experimental lung cancer cachexia.

BACKGROUND: Cachexia, a syndrome with high prevalence in non-small cell lung cancer patients, impairs quality of life and reduces tolerance and responsiveness to cancer therapy resulting in decreased survival. Optimal nutritional care is pivotal in the treatment of cachexia and a recommended cornerstone of multimodal therapy. Here, we investigated the therapeutic effect of an intervention diet consisting of a specific combination of high protein, leucine, fish oil, vitamin D, galacto-oligosaccharides, and fructo-oligosaccharides on the development and progression of cachexia in an orthotopic lung cancer mouse model. METHODS: Eleven-week-old male 129S2/Sv mice were orthotopically implanted with 344P lung epithelial tumour cells or vehicle (control). Seven days post-implantation tumour-bearing (TB) mice were allocated to either intervention- or isocaloric control diet. Cachexia was defined as 5 days of consecutive body weight loss, after which mice were euthanized for tissue analyses. RESULTS: TB mice developed cachexia accompanied by significant loss of skeletal muscle mass and epididymal fat mass compared with sham operated mice. The cachectic endpoint was significantly delayed (46.0 ± 15.2 vs. 34.7 ± 11.4 days), and the amount (-1.57 ± 0.62 vs. -2.13 ± 0.57 g) and progression (-0.26 ± 0.14 vs. -0.39 ± 0.11 g/day) of body weight loss were significantly reduced by the intervention compared with control diet. Moreover, systemic inflammation (pentraxin-2 plasma levels) and alterations in molecular markers for proteolysis and protein synthesis, indicative of muscle atrophy signalling in TB-mice, were suppressed in skeletal muscle by the intervention diet. CONCLUSIONS: Together, these data demonstrate the potential of this multinutrient intervention, targeting multiple components of cachexia, as integral part of lung cancer management.

Malnutrition management in children with chronic kidney disease.

Chronic kidney disease (CKD) encompasses diverse conditions such as congenital anomalies, glomerulonephritis, and hereditary nephropathies, necessitating individualized nutritional interventions. Early detection is pivotal due to the heightened risk of adverse outcomes, including compromised growth and increased healthcare costs. The nutritional assessment in pediatric CKD employs a comprehensive, multidisciplinary approach, considering disease-specific factors, growth metrics, and dietary habits. The prevalence of malnutrition, as identified through diverse tools and guidelines, underscores the necessity for regular and vigilant monitoring. Nutritional management strategies seek equilibrium in calorie intake, protein requirements, and electrolyte considerations. Maintaining a well-balanced nutritional intake is crucial for preventing systemic complications and preserving the remaining kidney function. The nuanced landscape of enteral nutrition, inclusive of gastrostomy placement, warrants consideration in scenarios requiring prolonged support, with an emphasis on minimizing risks for optimized outcomes. In conclusion, the ongoing challenge of managing nutrition in pediatric CKD necessitates continuous assessment and adaptation. This review underscores the significance of tailored dietary approaches, not only to foster growth and prevent complications but also to enhance the overall quality of life for children grappling with CKD.

Medical imaging in cancer cachexia.

Cancer cachexia, often referred to as "wasting syndrome," is characterized by fatigue, weakness, and involuntary weight loss. This syndrome is concomitant with progressive skeletal muscle atrophy with or without adipose tissue loss and is frequently accompanied by systemic inflammation. Understanding the complexities of cancer cachexia is crucial for early detection and intervention, and it is also paramount for enhancing patient outcomes. Medical imaging, comprising diverse imaging modalities, plays a pivotal role in this context, facilitating the diagnosis and surveillance assessment of both the disease extent and the body composition changes that offer valuable information and insights into disease progression. This article provides a comprehensive discourse of the pathophysiological mechanisms and clinical manifestations of cancer cachexia as well as the role of medical imaging in this setting. Particular emphasis is placed on contemporary multidisciplinary and translational research efforts for the development of diagnostic and treatment tools, aiming to mitigate the devastating consequences of cancer cachexia.

Involvement of the gut microbiota in cancer cachexia.

Cancer cachexia, or the unintentional loss of body weight in cancer patients, is a multi-organ and multi-factorial syndrome with a complex and largely unknown etiology; however, metabolic dysfunction and inflammation remain hallmarks of cancer-associated wasting. While cachexia manifests with muscle and adipose tissue loss, perturbations to the gastrointestinal tract may serve as the front line for both impaired nutrient absorption and immune activating gut dysbiosis. Investigations into the gut microbiota have exploded within the past 2 decades, demonstrating multiple gut-tissue axes; however, the link between adipose and skeletal muscle wasting and the gut microbiota with cancer is only beginning to be understood. Further, the most used anti-cancer drugs (e.g. chemotherapy, immune checkpoint inhibitors) negatively impact gut homeostasis, potentially exacerbating wasting and contributing to poor patient outcomes and survival. In this current review, we 1) highlight our current understanding of the microbial changes that occur with cachexia, 2) discuss how microbial changes may contribute to adipose and skeletal muscle wasting, and 3) outline study design considerations needed when examining the role of the microbiota in cancer-induced cachexia.

Decreased skeletal muscle intramyocellular lipid droplet-mitochondrial contact contributes to myosteatosis in cancer cachexia.

Cancer cachexia, the unintentional loss of lean mass, contributes to functional dependency, poor treatment outcomes, and decreased survival. While its pathogenicity is multifactorial, metabolic dysfunction remains a hallmark of cachexia. However, significant knowledge gaps exist in understanding the role of skeletal muscle lipid metabolism and dynamics in this condition. We examined skeletal muscle metabolic dysfunction, intramyocellular LD content, LD morphology and subcellular distribution, and LD-mitochondrial interactions using the Lewis Lung Carcinoma (LLC) murine model of cachexia. C57/BL6 male mice (n=20) were implanted with LLC cells [106] in the right flank or underwent PBS sham injections. Skeletal muscle was excised for transmission electron microscopy (TEM; soleus), oil red o/lipid staining (tibialis anterior), and protein (gastrocnemius). LLC mice had a greater number (232%; p=0.006) and size (130%; p=0.023) of intramyocellular LDs further supported by increased oil-red O positive (87%; p=0.0109) and 'very high' oil-red O positive (178%; p=0.0002) fibers compared to controls and this was inversely correlated with fiber size (R2=0.5294; p<0.0001). Morphological analyses of LDs show increased elongation and complexity (aspect ratio: IMF: 9%, p=0.046) with decreases in circularity (circularity: SS: 6%, p=0.042) or roundness (roundness: Whole: 10%, p=0.033; IMF: 8%, p=0.038) as well as decreased LD-mitochondria touch (-15%; p=0.006), contact length (-38%; p=0.036), and relative contact (86%; p=0.004). Further, dysregulation in lipid metabolism (adiponectin, CPT-1b) and LD-associated proteins, perilipin-2 and perilipin-5, in cachectic muscle (p<0.05) were observed. Collectively, we provide evidence that skeletal muscle myosteatosis, altered LD morphology, and decreased LD-mitochondrial interactions occur in a preclinical model of cancer cachexia.

The Socio-Environmental Determinants of Childhood Malnutrition: A Spatial and Hierarchical Analysis.

Despite a remarkable reduction in global poverty and famines, substantial childhood malnutrition continues to persist. In 2017, over 50 million and 150 million young children suffered from acute malnutrition (wasting) and chronic malnutrition (stunting), respectively. Yet, the measurable impact of determinants is obscure. We evaluate proposed socio-environmental related determinants of stunting and wasting across Kenya and Nigeria and quantify their effectiveness. We combine health and demographic data from Kenya and Nigeria Demographic Health Surveys (2003, 2008-2009, 2013, 2014) with spatially explicit precipitation, temperature, and vegetation data. Geospatial and disaggregated data help to understand better who is at risk and where to target mitigation efforts. We evaluate the responsiveness of malnutrition indicators using a four-level random intercept hierarchical generalized logit model. We find that spatial and hierarchical relationships explain 28% to 36% of malnutrition outcome variation. Temporal variation in precipitation, temperature, and vegetation corresponds with more than a 50% change in malnutrition rates. Wasting is most impacted by mother's education, family wealth, clinical delivery, and vaccinations. Stunting is most impacted by family wealth, mother's education, clinical delivery, vaccinations, and children asymptomatic of fever, cough, or diarrhea. Remotely monitored climatic variables are powerful determinants, however, their effects are inconsistent across different indicators and locations.

The role of interleukin-6 family cytokines in cancer cachexia.

Cachexia is a wasting syndrome that manifests in more than half of all cancer patients. Cancer-associated cachexia negatively influences the survival of patients and their quality of life. It is characterized by a rapid loss of adipose and skeletal muscle tissues, which is partly mediated by inflammatory cytokines. Here, we explored the crucial roles of interleukin-6 (IL-6) family cytokines, including IL-6, leukemia inhibitory factor, and oncostatin M, in the development of cancer cachexia. These cytokines have been shown to exacerbate cachexia by promoting the wasting of adipose and muscle tissues, activating mechanisms that enhance lipolysis and proteolysis. Overlapping effects of the IL-6 family cytokines depend on janus kinase/signal transducer and activator of transcription 3 signaling. We argue that the blockade of these cytokine pathways individually may fail due to redundancy and future therapeutic approaches should target common downstream elements to yield effective clinical outcomes.

Dietary inflammatory index could increase the risk of sarcopenia in patients with chronic kidney disease.

Using a system that incorporates a variety of food items rather than focusing on individual components can aid in assessing the inflammatory effects of a diet on disease outcomes such as chronic kidney disease (CKD). Therefore, we decided to investigate the association between dietary inflammatory index (DII) and the risk of protein-energy wasting (PEW) and sarcopenia in patients with CKD. In this cross-sectional study, 109 patients with CKD were selected from two clinics in Shiraz, Iran. The intake of individuals' diets was recorded using a validated 168-item food frequency questionnaire. Additionally, Asian Working Group for Sarcopenia (AWGS) guidelines were utilized to evaluate muscles' strength, mass, and function. Also, four International Society of Renal Nutrition and Metabolism (ISRNM) criteria (body mass index, intake of protein, albumin, and urine creatinine) were used  to diagnose PEW. Logistic regression was used to assess the association between DII and sarcopenia as well as PEW. The results showed that the intake of saturated fatty acids, trans fatty acids, niacin, beta-carotene, and vitamin C was significantly different between lower and higher DII groups. In the univariate model, higher odds of sarcopenia was observed by each unit increase in DII (odds ratio (OR) = 1.379, 95% confidence interval (CI): 1.042-1.824) and age (OR = 1.073, 95% CI: 1.017-1.132). Additionally, in the multivariate model, the association between DII and age with odds of sarcopenia remained significant (DII: OR = 1.379, 95% CI: 1.030-1.846 and age: OR = 1.063, 95% CI: 1.007-1.121). The current study suggests the possible role of pro-inflammatory foods in worsening muscle health, specifically sarcopenia, in CKD patients. Future longitudinal studies may reveal the causative nature of these correlations.

Scrapie versus Chronic Wasting Disease in White-Tailed Deer.

White-tailed deer are susceptible to scrapie (WTD scrapie) after oronasal inoculation with the classical scrapie agent from sheep. Deer affected by WTD scrapie are difficult to differentiate from deer infected with chronic wasting disease (CWD). To assess the transmissibility of the WTD scrapie agent and tissue phenotypes when further passaged in white-tailed deer, we oronasally inoculated wild-type white-tailed deer with WTD scrapie agent. We found that WTD scrapie and CWD agents were generally similar, although some differences were noted. The greatest differences were seen in bioassays of cervidized mice that exhibited significantly longer survival periods when inoculated with WTD scrapie agent than those inoculated with CWD agent. Our findings establish that white-tailed deer are susceptible to WTD scrapie and that the presence of WTD scrapie agent in the lymphoreticular system suggests the handling of suspected cases should be consistent with current CWD guidelines because environmental shedding may occur.

Mitigating skeletal muscle wasting in unloading and augmenting subsequent recovery.

Skeletal muscle wasting is the hallmark pathophysiological adaptation to unloading or disuse that demonstrates the dependency on frequent mechanical stimulation (e.g. muscle activation and subsequent loading) for homeostasis of normally load-bearing muscles. In the absence of mitigation strategies, no mammalian organism is resistant to muscle atrophy driven by unloading. Given the profound impact of unloading-induced muscle wasting on physical capacity, metabolic health and immune function; mitigation strategies during unloading and/or augmentation approaches during recovery have broad healthcare implications in settings of bed-bound hospitalization, cast immobilization and spaceflight. This topical review aims to: (1) provide a succinct, state-of-the-field summary of seminal and recent findings regarding the mechanisms of unloading-induced skeletal muscle wasting; (2) discuss unsuccessful vs. promising mitigation and recovery augmentation strategies; and (3) identify knowledge gaps ripe for future research. We focus on the rapid muscle atrophy driven by relatively short-term mechanical unloading/disuse, which is in many ways mechanistically distinct from both hypermetabolic muscle wasting and denervation-induced muscle atrophy. By restricting this discussion to mechanical unloading during which all components of the nervous system remain intact (e.g. without denervation models), mechanical loading requiring motor and sensory neural circuits in muscle remain viable targets for both mitigation and recovery augmentation. We emphasize findings in humans with comparative discussions of studies in rodents which enable elaboration of key mechanisms. We also discuss what is currently known about the effects of age and sex as biological factors, and both are highlighted as knowledge gaps and novel future directions due to limited research.

Nutritional status of school children in South-west Nigeria: Inferences from a national homegrown school feeding programme.

Background: The School Feeding Programme if properly executed has the capacity to improve the nutritional status of the school children. Objective: To assess the nutritional status of school children in Ondo State Nigeria given that the National Home-Grown School Feeding Programme (NHGSFP) has been operational in the state for over five years. Methods: This was a descriptive cross-sectional study. Results: A total of 234 subjects from public schools and 227 subjects from private schools were enrolled in the study. Their mean age was 8.23 ± 1.92 years. Wasting, overweight, obesity, underweight, and stunting were noted in 19.4%, 11.4%, 0.4%, 5.0%, and 20.7% of the children, respectively. The prevalence of stunting (30.3%) and wasting (23.9%) was more among subjects from the public schools. A significant association was found between Weight-for-Age Z-score, Height-for-Age Z-score, and BMI-for-Age Z-score and the children's school type (p < 0.005). Conclusion: Majority of the children showed normal growth, the rest were in both extremes of malnutrition, the subjects from private schools seem to present better nutritional status, although there is no baseline data to ratify this finding. A further study on this subject using the current finding as a baseline data is recommended.

Nexus Between Sarcopenia and Microbiome Research: A Bibliometric Exploration.

Despite over 30 years of microbiome and skeletal muscle research, no quantitative analysis of sarcopenia and the microbiome literature had been conducted. Our bibliometric study examined research status, hotspots, and future trends. We utilized bibliometric techniques to search the Science Citation Index Extended Database on February 27, 2023, using the Bibliometrix package in R to create a map displaying scientific production and subject categories. Collaborative network maps between countries/regions were visualized using Scimago Graphica, while VOSviewer explored collaboration modes among individuals and institutions. We analyzed the top 25 emerging keywords, top co-occurring keyword networks, and co-occurring keyword clusters using CiteSpace. A total of 997 articles were retrieved for sarcopenia and microbiome, of which 633 papers were analyzed. Both the number of publications and total citation frequency had been continuously increasing. The United States had the highest total citation frequency, while China had the highest number of publications. Research on the impact of the microbiome on sarcopenia was in its nascent stage and spans multiple disciplines, including nutrition, microbiology, geriatrics, immunology, endocrinology and metabolism, molecular biology, and sports medicine. The University of Copenhagen contributed the most to the number of publications (n=16), with Tibbett M (n=7) and Hulver MW (n=7) among the top authors. The most published journal was "Nutrients" (n=24). Analysis of keywords and clusters revealed new research hotspots in microbes and sarcopenia, such as malnutrition, dietary fiber, signaling pathways, frailty, and intestinal permeability. Research on the impact of the microbiome on sarcopenia is in its infancy and spans multiple disciplines. Malnutrition, dietary fiber, signaling pathways, frailty, and intestinal microbes are currently research hotspots. Furthermore, the visual atlas analysis of research on microbes and sarcopenia helps to track the knowledge structure in research fields related to sarcopenia and microbes, providing direction for future research.

Effect of quality and quantity of diet on nutritional status of under-five children residing in the rural area: A longitudinal study.

Introduction: Variety and adequacy of intake of food are required to meet the nutritional needs of the children. Due to poverty/illiteracy, poor families depend on a single food group that is, cereals. Due to the pandemic also, the nutrition of the growing children is affected. Objective: To know the effect of quantity and quality of diet on the nutritional status of under-five children. Methodology: This study had 270 children aged between 1 and 4 years registered at Anganwadi as study participants. Information on sociodemographic variables, quantity of calories and proteins consumed, quality of diet, and anthropometry of children was collected. Percentages and paired t-tests were used to find the difference between nutritional status and diet at different intervals, which was found to be statistically significant (P < 0.05). Results: In our study, we found that as the quantity and quality of diet improved nutritional status, especially weight for age, body mass index (BMI) for age Z score also improved. There was a significant difference between calories consumed at the baseline, 6 months and 1 year with P < 0.05. Protein intake was significant between baseline and six months with P < 0.005. Conclusion: Our study found a high percentage of undernutrition and wasting in the under-five population when diet was not sufficient in quality and quantity. As the quality and quantity of diet improved nutritional status also improved.

Unveiling the detrimental vicious cycle linking skeletal muscle and COVID-19: A systematic review and meta-analysis.

OBJECTIVE: Skeletal muscle catabolism supports multiple organs and systems during severe trauma and infection, but its role in COVID-19 remains unclear. This study investigates the interactions between skeletal muscle and COVID-19. METHODS: The PubMed, EMbase, and The Cochrane Library databases were systematically searched from January 2020 to August 2023 for cohort studies focusing on the impact of skeletal muscle on COVID-19 prevalence and outcomes, and longitudinal studies examining skeletal muscle changes caused by COVID-19. Skeletal muscle quantity (SMQN) and quality (SMQL) were assessed separately. The random-effect model was predominantly utilized for statistical analysis. RESULTS: Seventy studies with moderate to high quality were included. Low SMQN/SMQL was associated with an increased risk of COVID-19 infection (OR = 1.62, p < 0.001). Both the low SMQN and SMQL predicted COVID-19-related mortality (OR = 1.53, p = 0.016; OR = 2.18, p = 0.001, respectively). Mortality risk decreased with increasing SMQN (OR = 0.979, p = 0.009) and SMQL (OR = 0.972, p = 0.034). Low SMQN and SMQL were also linked to the need for intensive care unit/mechanical ventilation, increased COVID-19 severity, and longer hospital stays. Significant skeletal muscle wasting, characterized by reduced volume and strength, was observed during COVID-19 infection and the pandemic. CONCLUSIONS: This study reveals a detrimental vicious circle between skeletal muscle and COVID-19. Effective management of skeletal muscle could be beneficial for treating COVID-19 infections and addressing the broader pandemic. These findings have important implications for the management of future virus pandemics. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023395476.

The Never-Ending Story of Hyponatremia: A Current Problem to Overcome.

Hyponatremia is a common complication in patients undergoing neurosurgery. If undiagnosed, it has a negative prognostic impact. The two dominant causes of refractory hyponatremia include syndrome of inappropriate ADH secretion (SIADH) and cerebral salt wasting syndrome (CSWS). Discrimination between the two types of disease is not always obvious. We present a case of undiagnosed chronic hyponatremia caused by CSWS after neurosurgery, which not only resulted in a longer hospital stay but also slowed the patient's postoperative recovery. Meticulous clinical evaluation and the performance of appropriate laboratory tests are therefore essential not only for decisive treatment, but also for the establishment of comprehensive diagnostic algorithms that allow timely diagnosis and decisive therapy. LEARNING POINTS: The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt-wasting syndrome (CSWS) are in general associated to refractory hyponatremia especially in patients with neurologic disorders.Extracellular fluid (ECF) assessment is the key to distinguish between SIADH and CSWS.Nevertheless, measurement of the ECF volume is not sufficient to determine the correct etiology and more established diagnostic algorithms are required.

The therapeutic effect of NRF2 activator, ezetimibe, in cardiac cachexia.

INTRODUCTION: Heart failure (HF) is caused by functional and structural irregularity leading to impaired ejection or filling capacity of the heart. HF leads to chronic inflammatory conditions in the heart leads to weight loss, anorexia, and muscle atrophy known as cachexia. The present study was carried out to investigate the role of Ezetimibe, an NRF2 activator, in cardiac cachexia and to develop a treatment strategy for cardiac cachexia. METHOD: Balb/c mice of either sex at 6-8 weeks of age were given 2 mg/kg of doxorubicin in 0.9% sodium chloride solution intraperitoneally (i.p.) for the alternate days for the first week and then once a week for the next 4 weeks. After induction of cardiac atrophy, treatment with Ezetimibe (1.5 mg/kg, p.o) was given for the next 4 weeks. RESULT: In the cardiac cachectic animals, a significant decrease in body weight, food, and water intake was observed. Cardiac cachectic animals showed a significant increase in serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK-MB, LDH, and CRP levels. Cardiac atrophic index, heart weight to body weight ratios (HW/BW), right ventricular weight to heart weight ratios (RV/HW), and left ventricular weight to heart weight ratios (LV/HW), were significantly decreased in cardiac cachectic animals. The weights of the skeletal muscles such as EDL, gastrocnemius, soleus, tibialis anterior, and quadriceps muscles, and the weight of adipose tissue such as subcutaneous, visceral, perirenal, and brown adipose tissue were significantly decreased in the cardiac cachectic group relative to the normal group. Treatment with ezetimibe improves body weight, food intake, and water intake. Ezetimibe decreases serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK-MB, LDH and CRP levels. Cardiac atrophic markers such as HW/BW, RV/HW, and LV/HW were improved. The weight of skeletal muscles and adipose tissue was increased after treatment with ezetimibe. CONCLUSION: Our data showed that the NRF2 activator, Ezetimibe produces a beneficial effect on cardiac cachexia in the doxorubicin-induced cardiac cachexia model. Ezetimibe was successful to reduce the levels of inflammatory cytokines, ameliorate the effects on cardiac muscle wasting, lipid levels, fat tissues, and skeletal muscles.

Incorporating ultrasonography to the nutritional assessment process in intensive care settings to improve the prescription of enteral and parenteral nutrition: Benefits, practicality, and challenges.

The validity of the traditional nutritional assessment tools in intensive care settings might be compromised when the patient has conditions such as oedema and inflammation. Ultrasound (US) is considered a non-invasive, bedside tool that can be utilized to assess changes in muscle mass. Hence, US could guide healthcare practitioners in identifying the varying degrees of malnutrition and adjusting the nutritional prescription accordingly. This review discusses the currently available data regarding the feasibility and practicality of using US measurements in intensive care settings. Overall, the data suggest that using US as part of the standard anthropometric assessment for critically ill patients is a promising tool to track variations in muscle mass. This has the potential to enhance nutritional prescription and tailor the provision of protein and energy to critically ill patients based on their lean body mass measurements. Therefore, it is recommended to train dietitians on utilizing US for body composition measurements.

Prevalence and associated factors of malnutrition among under-five children living in slum areas of Bahir Dar Town, Ethiopia.

Introduction: child malnutrition is one of the most serious and least addressed health problems in the world and in Ethiopia. The prevalence of malnutrition, underweight, and wasting was 44%, 29%, and 10% respectively. The Amhara region has the highest rates of malnutrition at 52%, 33.4%, and 9.9% for children under five. The aim of this study was to assess the prevalence of malnutrition and its associated factors among children under five living in the slum areas of Bahir Dar City. Methods: a community-based cross-sectional study was conducted with 680 children aged 6-59 months in slum areas of Bahir Dar Town. Study participants were selected using a mass sampling technique and data were collected from April to June 2018 using a pre-tested structured questionnaire and anthropometric measurements. Finally, the collected data were coded, entered, cleaned, recorded, and stored, and the data were processed using EPI INFO and exported to the SPSS version 25.0 statistical package. Logistic regression analysis and interpretation were performed using bivariate and multivariate analysis. Results: a total of 680 children participated. The prevalence of stunting, underweight, and wasting was 46.2% (95% CI; 42.5-49.1), 24.3% (95% CI; 21.2-27.6), and 11.3% (95% CI; CI; 9.2-13.9). Income groups included children [AOR=3.476 (95% CI, 1.959-6.167)], male children [AOR=2.586 (95% CI; 1.532-4.365)] and mother's educational level [(AOR=2.600) (1.623) - 4.164)] were significantly associated with malnutrition. Conclusion: the results of this study showed that the prevalence of malnutrition due to stunting and wasting was high among children under five years of age. The gender of the child, the educational level of the mother, and the monthly income of the family were found to be significantly related to malnutrition. Promoting the use of family planning, preventing diarrheal diseases, and vaccinating children through nutrition education programs are important activities to improve the nutritional status of children.

Prevalence of wasting and associated factors among children aged 6-59 months in Habro district, Eastern Ethiopia: a cross-sectional study.

Background: Globally, five million children under the age of five died in 2021. Asia and African countries contributed to 69% and 27.2% of wasting, respectively. In Ethiopia, out of 901 (10.1%) under-five children, 632 (8.1%) were found to be moderately wasted, and 269 (3.0%) were severely wasted. The purpose of this study was to assess the prevalence of wasting and its associated factors among children between the ages of 6 and 59 months in Habro Woreda, Oromia, Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted in Habro Woreda from 25 August to 20 September 2020. In total, 306 participants were included in this study through a systematic sampling technique. Data were collected using a pretested structured questionnaire through a face-to-face interview, entered into EpiData version 3.1, and analyzed using SPSS version 25. Predictors were assessed using a multivariate logistic regression analysis model and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p < 0.05. Results: Overall, the prevalence of wasting among children aged 6-59 months in the Habro district was 28%, with a 95% confidence interval [26.5, 32.2%]. Factors such as mothers illiterate [AOR = 3.4; 95% CI: 1.14-10.47], households without latrines [AOR = 2.91; 95% CI: 1.33-6.37], food-insecure households [AOR = 4.11; 95% CI: 1.87-9], households that did not receive home visits [AOR = 4.2; 95% CI: 1.92-9.15], did not eat a variety of food [AOR = 7.44; 95% CI: 2.58-21.45], sick children after discharge from the program [AOR = 6.55; 95% CI: 2.85-15.02], readmitted children [AOR = 3.98; 95% CI: 1.43-15.07], and wasting 3.42 [AOR = 3.42; 95% CI: 1.24-9.45] were factors statistically associated with outcome variables. Conclusion: This study noted that the prevalence of wasting among children aged 6-59 months following discharge from the Outpatient Therapeutic Program remains high. Educational status of the mother, availability of a latrine, separate kitchen in the household, household food insecurity, household dietary diversity, home visit, and admission type were significantly associated with wasting of children after discharge from the outpatient therapeutic program. Therefore, efforts that target these factors should be maximized to reduce the occurrence of wasting among children aged 6-59 months after discharge from the outpatient therapeutic program.

C-C chemokine ligand 2 signaling promotes skeletal muscle wasting in non-tumor and breast tumor mouse models.

Despite advancements in treatment, approximately 25% of breast cancer patients experience long-term skeletal muscle wasting (SMW), which limits mobility, reduces drug tolerance and adversely impacts survival. By understanding the underlying molecular mechanisms of SMW, we may develop new strategies to alleviate this condition and improve the lives of breast cancer patients. Chemokines are small soluble factors that regulate homing of immune cells to tissues during inflammation. In breast cancers, overexpression of the C-C chemokine ligand 2 (CCL2) correlates with unfavorable prognosis. Elevated levels of CCL2 in peripheral blood indicate possible systemic effects of this chemokine in breast cancer patients. Here, we investigated the role of CCL2 signaling on SMW in a tumor and non-tumor context. In vitro, increasing concentrations of CCL2 inhibits myoblast and myotube function through C-C chemokine receptor 2 (CCR2) dependent mechanisms involving JNK, SMAD3 and AMPK signaling. In healthy mice, delivery of recombinant CCL2 protein promotes SMW in a dose dependent manner. In vivo knockdown of breast tumor derived CCL2 partially protects against SMW. Overall, chronic, upregulated CCL2/CCR2 signaling positively regulates SMW, with implications on therapeutic targeting.