The latest medical research on Nutrition

This study was registered with the National Institutes of Health (NIH) ClinicalTrials.gov system, with ID NCT03765047 . Registered 05 December 2018-Retrospectively registered.

In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8-9) and at follow-up in Grade 4 (ages 9-10). Standardized test scores were not measured in Grade 5 (ages 10-11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship.

Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (β = -0.159 p < 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (β = -0.128 (p < 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities.

Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics.

To determine the impact of computed tomography (CT)-based body composition and radiomics nomogram on the prediction of postoperative complications in gastric cancer.

The clinical data of 457 individuals with surgically confirmed gastric cancer, 320 patients in the training cohort (TC) and 137 patients in the validation cohort (VC), were retrospectively analyzed. Body composition data were measured using CT. Postoperative complications were graded using the Clavien-Dindo system. Dedicated radiomics prototype software was used to segment lesions and extract characteristics from preoperative portal venous-phase CT images. Clinical, radiomics, and combined models were developed using logistic regression analysis. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), and the prediction ability of the optimal model was evaluated using calibration curves and decision curve analysis (DCA).

Nutritional Risk Screening 2002 (NRS2002) score, sarcopenia, and blood loss were independent predictors of postoperative complications in gastric cancer. A radiomics signature was created using 19 conserved radiomics features. The nomogram based on both the clinical model and radiomics signature showed the greatest predictive performance, with AUCs of 0.763 (95% confidence interval [CI], 0.708-0.817) and 0.748 (95% CI, 0.667-0.818) in the TC and VC, respectively. The calibration curve and DCA revealed that the nomogram was beneficial in clinical practice for the preoperative prediction of postoperative complications.

The combined model consisting of NRS2002 score, sarcopenia, blood loss, and a radiomics signature holds potential application value for the individualized prediction of postoperative complications in gastric cancer patients.

High energy intake from non-nutrient dense sources correlates with poorer diet quality.

To, 1) estimate total energy intake, and energy from solid fats and added sugars, and combined (SOFAS), and identify their top food category sources for ages 2-18 years in 2015-2018, and 2) describe trends over time in 2009-2018.

Data were from the National Health and Nutrition Examination Survey. Pairwise differences were examined using univariate t statistics (2015-2018, n=5,038), and trends by age, and over time (2009-2018, n=14,038) examined using orthogonal polynomials.

In 2015-2018, SOFAS contributed (mean [SE], 30.0% [0.3%]) of total energy. Solid fats 16.1% [0.2%] and added sugars 13.8% [0.2%] each contributed >10%. The contribution of added sugars increased with age from 11.1% (2-3 years) to 14.4% (14-18 years), and was higher for all other race/Hispanic origins than Non-Hispanic Asians. Top five sources of energy were sweet bakery products, savory snacks, pizza, other mixed dishes, and unflavored milk, and for SOFAS also included soft drinks, other desserts, candy and snack bars. Total energy did not change between 2009-2018, but energy from SOFAS, and servings of solid fats, and added sugars declined. The contribution of unflavored milk to total energy declined for all ages and most race/Hispanic origins. Fruit drinks (all ages) and soft drinks (9-18 years) remained among top added sugars sources despite declines. The contribution of sweet bakery products to energy from SOFAS increased for most ages, and candy and snack bars to energy from added sugars.

In 2015-2018, SOFAS contributed over 30% of total energy for ages 2-18 years, which doubled the Dietary Guidelines for Americans' recommended limit of 15%. Top five sources of total energy were similar to those of solid fats, and those of SOFAs similar to those of added sugars. These results may inform public health efforts for improving diet quality.

Observational studies have linked Mediterranean Diets (MedDiet) and organic food consumption with positive health outcomes, which may be explained by higher mineral micronutrient and phenolic intake and lower dietary exposure to toxic compounds.

To determine the effects of diet and food type (organic versus conventional) on urinary excretion (UE) and/or plasma concentrations of mineral micronutrients, phenolics and toxic metals.

Healthy, adult participants were randomly allocated to a conventional (n=14) or an intervention (n=13) group. During a two-week period, the intervention group consumed a MedDiet made entirely from organic foods, while the conventional group consumed a MedDiet made from conventional foods. Before and after the intervention period, both groups consumed their habitual Western diets made from conventional foods. The primary outcome was UE and/or plasma concentrations of selected mineral micronutrients, toxic metals and phenolic markers. In addition, we monitored diets using food diaries. The participants were aware of study group assignment, but the study assessors were not.

Changing from a Western to a MedDiet for two weeks resulted in significant increases in UE of total phenolics and salicylic acid (by 46 and 45% respectively), the mineral micronutrients Co, I, and Mn (by 211, 70 and 102% respectively) and the toxic metal Ni (by 42%), and plasma Se concentrations (by 14%). However, no significant effects of food type (organic versus conventional) were detected. Redundancy analysis identified vegetables, coffee, wine and fruit as positive drivers for UE of phenolic markers and mineral micronutrients, and fish consumption as a positive driver for UE of Cd and Pb.

Although small effects of food type cannot be ruled out, our study suggests that only changing to a MedDiet with higher fruit and vegetable, and lower meat consumption results in a large increase in phenolic and mineral micronutrient intake.

Tracking dietary changes can inform strategies to improve nutrition, yet there is limited evidence on food consumption patterns and how disparities in food and nutrient intakes have changed in Bangladesh.

We assessed trends and adequacies in energy and macronutrient intakes and evaluated changes in inequities by age group, sex, and expenditure quintile.

We used panel data from the 2011 and 2018 Bangladesh Integrated Household Survey (n = 20,339 and 19,818 household members ≥ 2 years, respectively). Dietary intakes were collected using 24-hour recall and food-weighing methods. Changes in energy and macronutrient intakes were assessed using generalized linear models and adjusted Wald tests. Inequities in outcomes were examined by age group, sex, and expenditure quintile using the Slope Index of Inequality and Concentration Index.

Between 2011 and 2018, dietary diversity improved across sex and age groups (30-46% in children, 60-65% in adolescents, 37-87% in adults), but diets remain imbalanced with around 70% of energy coming from carbohydrates. There were declines in intakes of energy (3-8%), protein (3-9%), and carbohydrate (9-16%) for all age groups (except children 2-5 years), but an increase in fat intake (57-68% in children and 22-40% in adults). Insufficient intake remained high for protein (>50% among adults) and fat (>80%) while excessive carbohydrate intake was > 70%. Insufficient energy, protein, and fat intakes, and excessive carbohydrate intakes were more prevalent among poor households across survey years. Inequity gaps reduced for insufficient energy intake in most age groups, remained stable for insufficient protein intake, and increased for insufficient fat and excessive carbohydrate intakes.

Despite improvements in dietary diversity, diets remain imbalanced and inequities in insufficient energy, protein, and fat intakes persist. Our findings call for coherent sets of policies and investments toward a well-functioning food system and social protection to promote healthier, more equitable diets in rural Bangladesh.