| 1. |
- Alimoradi, Z., et al.
(författare)
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Prevalence of household food insecurity and its predictive role on the health of mothers with children aged under 60 months
- 2022
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 51, s. 246-252
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Tidskriftsartikel (refereegranskat)abstract
- Background: Food insecurity can have poor physical and mental health consequences for all family members. The present study investigated the prevalence of household food insecurity and its predictive role on the health of mothers of children aged under 60 months in Qazvin (Iran). Methods: A cross-sectional study was carried out between January 2019 and December 2020. Participants included all mothers with children aged under 60 months who referred themselves to comprehensive health centers in Qazvin (N = 1750; mean age 30.61 years). Convenience sampling was performed. Data were collected using a demographic information checklist, the General Health Questionnaire (GHQ) and the Household Food Insecurity Access Scale (HFIAS). Data analysis was performed using independent t-tests, one-way analyses of variance, uni-variable and multivariable linear regression with a significance level of p < 0.05. Results: Two-thirds of the participants had a secure food status (68.4%). Household food security status showed a significant, and inverse relationship with general health subscales. General health subscales of depression (standardized mean difference or SMD: −1.24 [95% CI: −1.36; −1.13]), somatic symptoms (SMD: −0.92 [95% CI: −1.03; −0.81]) and anxiety and insomnia (SMD: −0.72 [95% CI: −0.83; −0.61]) were significantly lower among food secure participants vs. food insecure participants. Social dysfunction was not significantly associated with household food security. The regression models demonstrated that household food security was a significant predictor for the health of mothers with children aged under 60 months: uni-variable (β = −0.38) and multivariable (β = −0.41). Conclusion: Household food security is associated with various aspects of mothers’ health. Since the growth and development of a healthy child depends on having a healthy mother, the food security situation of the family and the general health of mother can be assessed as part of providing health service regarding monitoring growth and development of children. This will help in targeting appropriate interventions if needed.
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| 2. |
- Baban, Bayar, 1973-, et al.
(författare)
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Altered insulin sensitivity and immune function in patients with colorectal cancer
- 2023
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 58, s. 193-200
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Insulin resistance and chronic inflammation have been reported in patients with cancer. However, many of the underlying mechanisms and associations are yet to be unveiled. We examined both the level of insulin sensitivity and markers of inflammation in patients with colorectal cancer for comparison to controls.Methods: Clinical exploratory study of patients with colorectal cancer (n = 20) and matched controls (n = 10). Insulin sensitivity was quantified using the hyperinsulinemic normoglycemic clamp and blood samples were taken for quantification of several key, both intra- and extracellular, inflammatory markers. We analysed the differences in these parameters between the two groups.Results: Patients exhibited both insulin resistance (M-value, patients median (Mdn) 4.57 interquartile range (IQR) 3.49-5.75; controls Mdn 5.79 (IQR 5.20-6.81), p = 0.049), as well as increased plasma levels of the pro-inflammatory cytokines IL-1b(patients Mdn 0.48 (IQR 0.33-0.58); controls Mdn 0.36 (IQR 0.29-0.42), p = 0.02) and IL-6 (patients Mdn 3.21 (IQR 2.31-4.93); controls Mdn 2.16 (IQR 1.50-2.65), p = 0.02). The latter is present despite an almost two to three fold decrease (p < 0.01) in caspase-1 activity, a facilitating enzyme of IL-1b production, within circulating immune cells.Conclusion: Patients with colorectal cancer displayed insulin resistance and higher levels of plasma IL-1b and IL-6, in comparison to matched healthy controls. The finding of a seemingly disconnect between inflammasome (caspase-1) activity and plasma levels of key pro-inflammatory cytokines in cancer patients may suggest that, in parallel to dysregulated immune cells, tumour-driven inflammatory pathways also are in effect.
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| 3. |
- Baban, Bayar, 1973-, et al.
(författare)
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Inflammasome activation, colonic cancer and glucose metabolism
- 2016
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the association between inflammasome activation (a potent initiator of inflammation acting via caspase-1 and maturation of interleukin-1β), colonic cancer and glucose metabolism.Methods: Five patients with colon cancer and ten matched controls without cancer were measured for insulin sensitivity using the hyperinsulinemic euglycemic clamp. For detection of inflammasome activation the caspase-1 activity, determined by detecting FLICA using flow cytometry, was measured in both monocytes and granulocytes at the start of, and at 120 minutes into the clamp. Descriptive and analytical statistics were performed using nonparametric methods by SPSS.Results: There was no difference in levels of insulin sensitivity between the two groups (p=0.09). The cancer patients had significantly lower levels of caspase-1 both in monocytes (p<0.05) and granulocytes (p<0.05) compared with the controls. However both patients and controls had significantly higher levels of both mono- and granulocyte caspase-1 activity at 120 minutes into the clamp as compared to at start (p<0.05). Patients showed an overall higher relative increase in caspase-1 during the clamp, however this finding did not reach statistical significance (monocytes; p=0.27, granulocytes; p=0.22).
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| 4. |
- Brook, M. S., et al.
(författare)
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Omega-3 supplementation during unilateral resistance exercise training in older women : A within subject and double-blind placebo-controlled trial
- 2021
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 46, s. 394-404
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: The skeletal muscle anabolic effects of n-3 polyunsaturated fatty acids (n-3 PUFA) appear favoured towards women; a property that could be exploited in older women who typically exhibit poor muscle growth responses to resistance exercise training (RET). Here we sought to generate novel insights into the efficacy and mechanisms of n-3 PUFA alongside short-term RET in older women.METHODS: We recruited 16 healthy older women (Placebo n = 8 (PLA): 67±1y, n-3 PUFA n = 8: 64±1y) to a randomised double-blind placebo-controlled trial (n-3 PUFA; 3680 mg/day versus PLA) of 6 weeks fully-supervised progressive unilateral RET (i.e. 6 × 8 reps, 75% 1-RM, 3/wk-1). Strength was assessed by knee extensor 1-RM and isokinetic dynamometry ∼ every 10 d. Thigh fat free mass (TFFM) was measured by DXA at 0/3/6 weeks. Bilateral vastus lateralis (VL) biopsies at 0/2/4/6 weeks with deuterium oxide (D2O) dosing were used to determine MPS responses for 0-2 and 4-6 weeks. Further, fibre cross sectional area (CSA), myonuclei number and satellite cell (SC) number were assessed, alongside muscle anabolic/catabolic signalling via immunoblotting.RESULTS: RET increased 1-RM equally in the trained leg of both groups (+23 ± 5% n-3 PUFA vs. +25 ± 5% PLA (both P < 0.01)) with no significant increase in maximum voluntary contraction (MVC) (+10 ± 6% n-3 PUFA vs. +13 ± 5% PLA). Only the n-3 PUFA group increased TFFM (3774 ± 158 g to 3961 ± 151 g n-3 PUFA (P < 0.05) vs. 3406 ± 201 g to 3561 ± 170 PLA) and type II fibre CSA (3097 ± 339 μm2 to 4329 ± 264 μm2 n-3 PUFA (P < 0.05) vs. 2520 ± 316 μm2 to 3467 ± 303 μm2 in PL) with RET. Myonuclei number increased equally in n-3 PUFA and PLA in both type I and type II fibres, with no change in SC number. N-3 PUFA had no added benefit on muscle protein synthesis (MPS), however, during weeks 4-6 of RET, absolute synthesis rates (ASR) displayed a trend to increase with n-3 PUFA only (5.6 ± 0.3 g d-1 to 7.1 ± 0.5 g d-1 n-3 PUFA (P = 0.09) vs. 5.5 ± 0.5 g d-1 to 6.5 ± 0.5 g d-1 PLA). Further, the n-3 PUFA group displayed greater 4EBP1 activation after acute RE at 6 weeks.CONCLUSION: n3-PUFA enhanced RET gains in muscle mass through type II fibre hypertrophy, with data suggesting a role for MPS rather than via SC recruitment. As such, the present study adds to a literature base illustrating the apparent enhancement of muscle hypertrophy with RET in older women fed adjuvant n3-PUFA.
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| 5. |
- Bärebring, Linnea, et al.
(författare)
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A validated screening tool correctly identifies the majority of pregnant women at high risk of vitamin D deficiency
- 2022
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Ingår i: Clinical Nutrition Espen. - : Elsevier BV. - 2405-4577. ; 49, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- Background & aim: The objective was to develop and validate a non-invasive screening tool to identify pregnant women at high risk of vitamin D deficiency. Methods: Data from the Swedish prospective cohort GraviD, 2125 pregnant women, were randomly split in halves; one for developing the screening tool, and one for validation. Risk factors of vitamin D deficiency (serum 25-hydroxyvitamin D < 30 nmol/L) were identified using logistic regression analyses and odds ratios were translated into scores. Cutt offs to indicate high risk of vitamin D deficiency were evaluated by receiver operator characteristics. Results: Five variables (season, clothing, eye color, fortified milk intake and vitamin D supplement use) were included in the screening tool. The possible total score was 0-42. Mean (95% CI) area under the curve for classification of vitamin D deficiency was 0.921 (0.893-0.948) (p < 0.001). A score of >15 points had 92% sensitivity and 76% specificity to identify women with 25OHD <30 nmol/L. This cut off had a positive predictive value of 31% and a negative predictive value of 99%. Conclusion: This short non-invasive screening tool is valid as it correctly identified the majority of the vitamin D deficient pregnant women, who may benefit from further investigation for definite diagnosis and subsequent treatment.0 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/).
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| 6. |
- Bärebring, Linnea, et al.
(författare)
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Use of bioelectrical impedance analysis to monitor changes in fat-free mass during recovery from colorectal cancer– a validation study
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 40, s. 201-207
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Although previous research show high correlation between fat-free mass (FFM) measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), the validity of BIA to track longitudinal changes in FFM is uncertain. Thus, the aim of this study was to validate the ability of BIA to assess changes in FFM during 6 months of recovery from non-metastatic colorectal cancer (CRC). Methods: A total of 136 women and men (50–80 years) with stage I-III CRC and a wide range of baseline FFM (35.7–73.5 kg) were included in the study. Body composition was measured at study baseline within 2–9 months of surgery and again 6 months later. Whole-body BIA FFM estimates (FFMBIA) were calculated using three different equations (manufacturer's, Schols' and Gray's) before comparison to FFM estimates obtained by DXA (FFMDXA). Results: Correlation between changes in FFMBIA and FFMDXA was intermediate regardless of equation (r ≈ 0.6). The difference in change of FFMBIA was significant compared to FFMDXA, using all three equations and BIA overestimated both loss and gain. However, BIA showed 100% sensitivity and about 90% specificity to identify individuals with ≥5% loss in FFM, using all three equations. Sensitivity of FFMBIA to detect a smaller loss of FFM (60–76%) or a gain in FFM of ≥5% (33–62%) was poor. Conclusion: In a well-nourished population of non-metastatic CRC patients, a single-frequency whole-body BIA device yielded imprecise data on changes in FFM, regardless of equation. BIA is thus not a valid option for quantifying changes in FFM in individuals. However, BIA could be used to identify patients with loss in FFM ≥5% in this population. The validity of BIA to monitor changes in FFM warrants further investigation before implementation in clinical praxis. © 2020 The Author(s)
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| 7. |
- Dimander, Josefin, et al.
(författare)
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Documented nutritional therapy in relation to nutritional guidelines post burn injury : a retrospective observational study
- 2023
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 56, s. 222-229
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Intensive nutritional therapy is an essential component of burn care. Regardingpost-minor burn injuries, the literature is lacking. The aim of this study was to evaluate documentednutritional therapy in relation to international guidelines after both minor and major burn injuries. The secondary aim of this study was to evaluate the adequacy of energy and protein intake compared toindividual nutritional goals post-burn injury.Methods: A retrospective observational single-centre study including patients admitted between 2017and 2019 at a burn centre in Sweden was performed. The patients included in the study were >18 years old and in need of hospital care for > 72 h post-burn injury. Information about patients' demographics,nutritional therapy, and clinical characteristics of burn injury was collected. The patients were dividedaccording to total body surface area burnt (TBSA %) into minor burn injuries (TBSA <20%) and major burninjuries (TBSA >20%). Descriptive statistics were used to analyse data. Adherence to guidelines wasestablished by comparing 24 nutritional therapy recommendations to documented treatment. If documented nutritional treatment were in accordance with guidelines, adherence was considered high(>80%), moderate (60-79.9%) or low (<59.9%).Results: One hundred thirty-four patients were included, 90 patients with minor burn injuries and 44patients with major burn injuries. Documented adherence to the nutritional guideline was overall low.After minor burn injury, 8% (2/24) of nutritional therapy recommendations had a high adherence (fatintake <35% of total energy intake and enteral nutrition as prioritized feeding route), 17% (4/24) amoderate adherence, and 75% (18/24) a low adherence. In patients treated after a major burn injury,there were two recommendations with documented high adherence (Vitamin C and Zinc); 25% (6/24)had moderate adherence, and 67% (16/24) had low adherence. In addition, quite a large amount ofmissing data was found.Adequacy of documented nutritional intake, compared to the individual documented goal, was 78%(±23%) for energy and 66% (±22%) for protein after minor burn injury. After major burn injury, the adequacy was 89% (±21%) for energy and 78% (±19%) for protein, respectively.Conclusions: This study revealed low adherence to nutritional guidelines in patients treated for minorand major burn injuries. Compared to major burn injuries, lower documented adequacy for both energyand proteins was found in minor burn injuries. Given the disparity between guidelines and documentednutritional therapy, and the lack of specific guidelines for minor burn injuries, there could be aconsiderable risk of inadequate nutritional therapy post-burn injury.
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| 8. |
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| 9. |
- Einarsson, Sandra, 1981-, et al.
(författare)
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Mapping impact factors leading to the GLIM diagnosis of malnutrition in patients with head and neck cancer
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 40, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: In head and neck cancer, the combination of weight loss and elevated C-reactive protein levels means that patients have malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). This study aimed to identify impact factors for malnutrition as defined by the GLIM criteria among patients with head and neck cancer at the start of treatment and up to 12 months posttreatment.Methods: In a prospective, observational study, patient, tumour, treatment, and nutritional data from 229 patients with head and neck cancer were collected at the start of treatment and at three follow-ups (7 weeks after the start of treatment and at 3 and 12 months after the termination of treatment). These clinical variables were statistically analysed in relation to malnutrition at each follow-up using univariate and multivariate analyses. Malnutrition was defined according to the two GLIM criteria of >5% body weight loss during the last 6 months and C-reactive protein >5 mg/L.Results: The following factors were predictive for malnutrition in the multivariate analysis performed 7 weeks after the start of treatment: moderate or severe mucositis, chemoradiotherapy +/- surgery, and the need for nutritional support (total or partial use of tube feeding/parenteral nutrition). Advanced tumour stage (III-IV) was significant for malnutrition at the start of treatment and at the 7 week and 3 month follow-ups, but not at 12 months.Conclusions: Severe mucositis, chemoradiotherapy +/- surgery, and advanced tumour stage were found to be impact factors for the diagnosis of malnutrition using GLIM at different follow-up times from the start of treatment up to 12 months after the end of treatment. Few patients with head and neck cancer are diagnosed with malnutrition according to the GLIM criteria in a long-term perspective after the termination of treatment. Research on the validity of the GLIM criteria is needed to build a comprehensive evidence base of impact factors for malnutrition in head and neck cancer.
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| 10. |
- Einarsson, Sandra, 1981-, et al.
(författare)
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Mapping the frequency of malnutrition in patients with head and neck cancer using the GLIM Criteria for the Diagnosis of Malnutrition
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 37, s. 100-106
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Patients with head and neck cancer are defined as high-risk patients for malnutrition, but the inconsistent practice of diagnosing malnutrition is a barrier in comparing studies and in assessing patients in clinical practice. The aim of the study was to describe the frequency of malnutrition over time in patients treated for head and neck cancer using the GLIM Criteria for the Diagnosis of Malnutrition.Methods: Data from a prospective observational study on patients with head and neck cancer were used (n = 210). Patients were assessed for malnutrition using the combination of one phenotypic and one etiologic criterion. The following phenotypic criteria for malnutrition were used: body weight loss (either >5% within the past six months or >10% beyond six months), body mass index (<20 kg/m2 if <70 years or <22 kg/m2 if ≥70 years), and fat free mass index measured by bioelectrical impedance analysis (<17 FFM/m2 for males and <15 FFM/m2 for females). The following etiologic criteria for malnutrition were used: reduced food intake (partial or no food intake with the need for artificial nutrition) and C-reactive protein (>5 mg/L).Results: For all eight possible combinations of GLIM, the frequency of malnutrition reached its highest point at seven weeks after the start of treatment. A total of 32% of the patients fulfilled the criteria for malnutrition using weight loss >5% within the past six months (phenotypic) in combination with C-reactive protein >5 mg/L (etiologic).Conclusions: GLIM Criteria for the Diagnosis of Malnutrition can be used to assess malnutrition in patients with head and neck cancer during treatment. Using the same criteria to define malnutrition in nutritional research will make it possible to produce multiple lines of evidence on malnutrition in head and neck cancer and its adverse effects on treatment, prognosis, and survival.
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