Mandatory thresholds for accuracy of reported energy on food and beverage product labels do not exist for many countries. Accurate nutrition information is essential for ensuring nutritional adequacy among hospital patients. The aim of this study was to compare direct measures of energy of nutritional fluids provided in hospital to values determined via manufacturers’ specifications. Nutritional fluids were identified as any liquid provided to hospital patients orally, enterally, or parenterally, to deliver nutrition. These were categorised into six groups aligned to food/medical standards, including: 1) local recipes, 2) pre-packaged general fluids, 3) supplementary fluids, 4) prescribed nutrition fluids – thickened, 5) prescribed nutrition fluids – oral/enteral, and 6) prescribed medical nutrition – IV and parenteral. An equivalence testing statistical approach (±10% thresholds) was used to compare energy values derived directly via bomb calorimetry against those obtained from manufacturer specifications. A total of 69 fluids were measured. One fifth (n=14) exhibited non-equivalent energy values, with majority of these (n=11; 79%) likely to contain fewer calories than that calculated from reported values. Almost all (34/35; 97%) prescribed nutrition fluids (oral/enteral (20/20; 100%), IV and parenteral (7/7; 100%) and thickened fluid (7/8; 88%) products were equivalent. In contrast, only 21/34 (62%) non-prescribed fluids (local recipes (2/11; 18%), supplementary fluids (4/5; 80%) and pre-packaged general fluid (15/18; 83%) products) demonstrated equivalence. Energy content of nutritional fluids prescribed to hospital patients typically align with manufacturers’ values. Consumption of non-prescribed fluids may result in lower energy intakes than expected.

Gastroesophageal reflux disease (GERD) is a prevalent condition observed across various medical specialties, including gastroenterology, otorhinolaryngology, surgery, and primary care. Despite the routine prescription of proton pump inhibitors (PPIs), some patients fail to experience adequate symptom relief. This review delves into the multifactorial mechanisms of reflux, which extend beyond hydrochloric acid to include pepsin, bile acids and trypsin. These factors significantly contribute to mucosal injury in GERD and are influenced by dietary composition. Moreover, dietary patterns with anti-inflammatory properties, such as the Mediterranean and DASH (dietary approaches to stop hypertension) diets, have shown potential in GERD managing, particularly in the context of obesity–an important risk factor.

This study was designed to explore the mediating role of serum 25-hydroxyvitamin D (25(OH) D) in triglyceride glucose (TyG) index and hypertension (HTN). Study participants were selected from the 2001-2018 National Health and Nutrition Examination Survey. Firstly, we estimated the association between TyG index, and serum 25(OH)D with HTN using weighted multivariable logistic regression model and restricted cubic spline. Secondly, we used generalized additive model to investigate the correlation between TyG index and serum 25(OH)D. Lastly, serum 25(OH)D was investigated as a mediator in the association between TyG index and HTN. There were 14,099 subjects in total. TyG index was positively and linearly associated with HTN risk, while serum 25(OH)D had a U-shaped relationship with prevalence of HTN. When the serum 25(OH)D levels were lower than 57.464 mmol/L, prevalence of HTN decreased with the increase of serum 25(OH)D levels. When serum 25(OH)D levels rise above 57.464 mmol/L, risk of HTN increased rapidly. Based on the U-shaped curve, serum 25(OH)D concentrations were divided into two groups: (<57.464 and ≥57.464 mmol/L). According to the mediation analysis, when serum 25(OH)D levels <57.464 mmol/L, the positive association between TyG index and incident HTN was increased by 25(OH)D. When serum 25(OH)D levels ≥57.464 mmol/L, the negative association between TyG index and incident HTN was increased by 25(OH)D. There was a mediation effect between TyG index and HTN, which was mediated by 25(OH)D. Therefore, we found that the association between serum 25(OH)D levels and TyG index may influence prevalence of HTN.

N-3 polyunsaturated fatty acids (n-3 PUFAs) delivered by fish oil supplements alter the number and functions of circulating extracellular vesicles (EVs), but consumption of oily fish does not reproduce this effect. In order to assess the effects of fish oil supplements and oily fish, at a level achievable in the diet, on EV numbers, composition and procoagulant activity in healthy human volunteers, forty-two healthy subjects were assigned to one of three treatment groups: (i) fish oil supplements plus white fish meals, (ii) control supplements plus oily fish meals or (iii) control supplements plus white fish meals for 12 weeks in a randomized, double-blind, placebo-controlled, parallel trial; circulating EVs were enumerated and their procoagulant activity assessed using thrombin generation and fibrinolysis assays. Our results showed that fish oil supplements decreased circulating EV numbers and reduced EV-stimulated thrombin generation, but the consumption of oily fish at half the dose of EPA had no effect on either EV number or thrombogenic capacity. Consumption of both oily fish and fish oil supplements increased the EPA and DHA contents of EVs and the proportion of EPA in circulating EVs was strongly associated with EV-stimulated thrombin generation. This study revealed that the additional 1 g/d EPA delivered in the fish oil supplements is required to decrease the numbers and thrombogenic capacity of EVs, since oily fish at a level achievable in the diet had no effect. Increasing EPA intake beyond current guidelines for oily fish consumption may therefore be required for cardiovascular benefits relating to EVs.

This study aimed to assess the concordance between different anthropometric indexes in the Global Leaders Initiated Malnutrition Standards (GLIM) and the Geriatric Risk Index (GNRI) for evaluating muscle mass, while also exploring performance-based criteria for GLIM muscle content suitable for elderly patients with intermediate and advanced tumors. A total of 312 patients admitted to Shanghai Tenth People’s Hospital between September 2022 and June 2023 were retrospectively included. Nutritional assessments were conducted using the GLIM framework, employing grip strength, upper arm circumference, and calf circumference as criteria for muscle content evaluation. The diagnostic value of these tools was compared against the GNRI as a reference standard. Among the participants, 127 (40.71%) were diagnosed as malnourished by GNRI, while the GLIM assessments yielded 138 (44.23%), 128 (41.03%), and 162 (51.92%) malnutrition diagnoses based on grip strength, calf circumference, and upper arm circumference, respectively. Both GNRI and GLIM-grip strength were significantly associated with complications and length of hospital stays. Notably, using GNRI as a reference, GLIM-grip strength demonstrated good consistency in diagnosing malnutrition (K value = 0.692, P < 0.001), with calf circumference having the highest diagnostic value. In conclusion, grip strength is a practical and effective performance-based criterion within the GLIM standards and has the potential to enhance malnutrition diagnosis in elderly patients with advanced malignancies, highlighting its relevance in nutritional science.

Substantial changes resulting from the interaction of environmental and dietary factors contribute to an increased risk of obesity, while their specific associations with obesity remain unclear. Identify inflammation-related dietary patterns (DPs) and explore their associations with obesity among urbanized Tibetan adults under significant environmental and dietary changes.Totally, 1826 subjects from the suburbs of Golmud City were enrolled in an open cohort study, of which 514 were followed up. Height, weight, and waist circumference were used to define overweight and obesity. DPs were derived using reduced rank regression with 41 food groups as predictors and hs-CRP and prognostic nutritional index as inflammatory response variables. Altitude was classified as high or ultra-high. Two DPs were extracted. DP-1 was characterized by having high consumptions of sugar-sweetened beverages, savory snacks, and poultry, and a low intake of tsamba. DP-2 had high intakes of poultry, pork, animal offal, and fruits, and a low intake of butter tea. Participants in the highest tertiles (T3) of DPs had increased risks of overweight and obesity (DP-1: OR=1.37, 95% CI: 1.07, 1.77; DP-2: OR=1.48, 95% CI: 1.18, 1.85) than those in the lowest tertiles (T1). Participants in T3 of DP-2 had an increased risk of central obesity (OR=2.25, 95% CI: 1.49, 3.39) than those in T1. The positive association of DP-1 with overweight and obesity was only significant at high altitudes, while no similar effect was observed for DP-2. Inflammation-related DPs were associated with increased risks of overweight and/or obesity.

The therapeutic effects of probiotics in patients with traumatic brain injury (TBI) remain unclear. This study aimed to investigate the effects of probiotic supplementation on cell adhesion molecules, oxidative stress, and antioxidant parameters in TBI patients. This randomized, double-blind, placebo-controlled trial included 46 TBI patients who were randomly assigned to receive either a probiotic supplement (n = 23) or a placebo (n = 23) for 14 days. The probiotic capsule contained four strains of Lactobacillus (L. casei, L. bulgaricus, L. rhamnosus, L. acidophilus), two strains of Bifidobacterium (B. longum, B. breve), and Streptococcus thermophilus. Serum levels of intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, pro-oxidant antioxidant balance (PAB), malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (TAC), and arylesterase (ARE) activity were measured at the beginning and end of the trial. Dietary intakes of patients were also recorded at the beginning and end of the trial. At the end of the study, there were no significant changes in ICAM-1, VCAM-1, PAB, MDA, NO, TAC, and ARE levels. However, patients who received probiotic supplements had significantly increased dietary intakes of energy, macronutrients, vitamin E, zinc, copper, and selenium compared with the placebo group. This study provides evidence that probiotic supplementation for 14 days in TBI patients has beneficial effects on dietary intake. However, it did not affect serum levels of cell adhesion molecules, oxidative stress, or antioxidant parameters. These findings should be considered preliminary, and further research is needed to evaluate long-term and clinical outcomes.

Anaemia continues to be a major public health challenge in developing countries, particularly in Sub-Saharan Africa. This study estimated the proportion of anaemia cases that could be potentially prevented among children aged 6-59 months in Togo. Data from the 2017 national Malaria Indicator survey in Togo, the last one conducted to date, was used for this study. Maternal, child and household data were collected using a standard questionnaire administered face-to-face by trained interviewers. Haemoglobin tests were conducted for children and their mothers. A total of 2796 children were included in the analyses. The prevalence of anaemia was 75.0% (95% confidence interval, CI: 72.5-88.0). Factors associated with childhood anaemia were: age [(adjusted prevalence ratio, aPR=1.46 (CI: 1.37-1.56) for 6-23 months and aPR=1.23 (1.14-1.32) for 24-42 months, ref: 43-59 months], a later birth order (≥4th position) [aPR=1.11 (1.03-1.19), ref: 1st-2nd position], malaria in children [aPR=1.30 (1.22-1.38)], maternal age ≤25 [aPR=1.17 (1.08-1.27), ref: ≥35 years], maternal anaemia [aPR=1.13 (1.07-1.19)], lack of maternal education [aPR=1.10 (1.02-1.18), ref: ≥secondary], number of children under 5 in household [aPR=1.07 (1.00-1.14) for ≥3, ref: 0-1], unimproved sanitation facilities [aPR=1.12 (1.02-1.22)] and low/middle household incomes [aPR=1.16 (1.04-1.30) and aPR=1.13 (1.01-1.26), respectively, ref: high]. The population-attributable fraction was estimated at 8.2% (6.3-10.1%) for child-related modifiable factors, 11.1% (5.7-16.3%) for maternal-related factors, 15.8% (8.6-22.5%) for household-related factors, and 30.9% (24.0-37.2%) for the combination of all modifiable factors. This study highlighted a high prevalence of childhood anaemia in Togo and showed that a high proportion of this could be prevented.

Emerging evidence has shown a strong correlation between serum triacylglycerol (TAG) levels, the inflammatory response, and Parkinson’s disease (PD) onset. However, the causal relationship between TAG levels and PD has not been well-established. We aimed to investigate the relationship between serum TAG levels and risk of PD and explore the potential mediating role of circulating immune cells and inflammatory proteins. We utilised genotype data from the GeneRISK cohort, and summary data from genome wide association studies investigating PD, circulating immune cells, inflammatory proteins, and plasma lipidomes. Using Mendelian randomization (MR) and multivariate MR (MVMR) analysis, we further adjusted for phosphatidylcholine (17:0_18:1) and triacylglycerol (58:7). Our results suggested a robust causal link between higher serum TAG (51:4) levels and a decreased risk of PD, with one standard deviation genetically instrumented higher serum TAG (51:4) level leading to a 21 percent [95% CI, 0.66 – 0.96] reduction in the risk of PD (p = 0.015). Additionally, the results of the mediation analysis suggested a possible role for mediation through circulating immune cells (including IgD-CD38-B cells and resting CD4 regulatory T cells), but not circulating inflammatory proteins, in the causal relationship between the plasma lipidomes and PD. Our study confirms a causal relationship between higher serum TAG (51:4) levels and a lower risk of PD and clarifies a possible role for mediation through circulating immune cells, but not inflammatory proteins. These findings indicate that serum triacylglycerol (51:4) regulates immunity to effectively lower the risk of PD.