• Clinical Nutrition Research
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• 제11권1호
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• pp.20-31
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• 2022

Through a survey on dietary intake of children and adolescents with brain lesions, the present study aimed to analyze the current status of nutrient intake and examine the effect of high-protein nutrient drink on their nutritional and muscle statuses. The study participants were 90 juvenile participants aged 8-19 years, with brain lesions. The participants were provided with a protein nutrient drink for 12 weeks and a questionnaire survey on dietary intake was performed to analyze the level of nutrient intake before and after ingestion. The physical measurements were taken to determine the improvements in nutrient and muscle statuses. The results showed that, before the intake of protein nutrient drink as a supplement, the participants exhibited lower height, weight, and body mass index than those of the standard levels of healthy individuals, and the level of nutrient intake through diet was lower than those of the required and recommended levels of nutrient intake for Koreans. Conversely, after the intake of protein nutrient drink for 12 weeks, the level of nutrient intake and physical statuses such as weight showed significant improvements. In addition, the muscle status had undergone approximately 10% of change during the intervention with no significant difference. Thus, to ensure an adequate level of nutrient supply to children and adolescents with brain lesions, there is an urgent need to develop a guideline of nutrient intake. The findings in this study are expected to serve as the basic data for such guidelines.

• Clinical Nutrition Research
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• 제11권4호
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• pp.277-288
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• 2022

This study aimed to investigate the relationship between dietary acidity load and clinical symptoms in the patients with rheumatoid arthritis (RA). This case-control study examined 55 patients with RA and 215 healthy individuals in a Ravansar non-communicable diseases (RaNCDs) cohort study, Iran. Participants' food intakes were assessed using a validated food frequency questionnaire. The dietary acidity was calculated using potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL) scores. The patients with RA were identified based on the self-reporting, medications history, and the approval of the cohort center physician following patients' examination. The odds ratio (OR) of joint stiffness in fully adjusted model was greater in the upper median of dietary acidity than in the lower median (PRAL: odds ratio [OR], 1.18; 95% confidence interval [CI], 0.59-2.36), but there was no statistically significant difference. The OR of joint pain in the upper median of dietary acidity was less than in the lower median in fully adjusted model (PRAL: OR, 0.70; 95% CI, 0.46-1.29), but the difference was not statistically significant. After adjusting potential confounders, people in the upper median of dietary acidity had a higher OR of developing RA than those in the lower median (PRAL: OR, 1.39; 95% CI, 0.70-2.76); however, it was not statistically significant. There was not any statistically significant relationship among dietary acidity and the odds of joint pain, joint stiffness, and developing RA.

• Clinical Nutrition Research
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• 제11권1호
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• pp.32-41
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• 2022

We evaluated the association between obesity status by body mass index (BMI) or waist circumference (WC) and osteoporotic fracture risk. We collected data of 143,673 women with a mean age of 58.5 years without history of osteoporotic fracture from the Korean National Health Insurance Service Cohort. Participants were divided into four groups according to obesity by BMI and WC, normal BMI/WC (BMI 18.5-24.9 kg/m² and WC < 85 cm, reference), obese BMI/normal WC (BMI ≥ 25 kg/m² and WC < 85 cm), normal BMI/obese WC (BMI < 25 kg/m² and WC ≥ 85 cm), and obese BMI/WC (BMI ≥ 25 kg/m² and WC < 85cm). Cox proportional hazards regression analyses were performed to obtain hazard ratios (HRs) with 95% confidence intervals (CIs) for the subsequent median 6.0 years, which were adjusted for age, socioeconomic status, lifestyle, morbidity index, and osteoporosis medication. Compared with the normal group, normal BMI/obese WC was associated with a higher osteoporotic fracture risk after multivariable adjustment (HRs [95% CI], 1.13 [1.05-1.21]), and obese BMI/normal WC was associated with a lower osteoporotic fracture risk (0.89 [0.84-0.94]). Obese BMI/normal WC was associated with a lower risk for hip fractures (0.75 [0.57-0.99]). Obese BMI/normal WC was associated with decreased risk of osteoporotic fracture, whereas normal BMI/obese WC was associated with increased risk of osteoporotic fracture compared with the normal group among East Asian women in their late 40s or more.

• Clinical Nutrition Research
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• 제11권4호
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• pp.289-301
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• 2022

This study was conducted to evaluate the associations between dietary diversity score (DDS) and cardiovascular risk factors in this population. In this cross-sectional study, 187 patients, aged 18-65 years with pemphigus vulgaris were included. DDS was assessed by a 24-hour dietary recall method. Anthropometric measures and biochemical parameters assessed according to standard protocols. Multivariate linear regression analyses used for detecting any associations between DDS and cardiovascular risk factors. The mean ± standard deviation age and body mass index of studied participants were (46.71 ± 11.49 years) and (27.83 ± 4.39 kg/m²) respectively. Our findings showed that a higher DDS intake was related with higher consumption of vegetables (p = 0.001), dairy products (p < 0.001), cereals (p = 0.002), red and processed meat (p < 0.001), sweets and desserts (p < 0.001). After controlling for confounding variables, the results showed positive associations between DDS and high-density lipoprotein cholesterol (HDL-C, β = 1.87, 95% confidence interval [CI], 0.30-3.45, p = 0.02) and total cholesterol (TC) levels (β = 6.41, 95% CI, 1.62-11.03, p = 0.02) (β = 1.75, 95% CI, 0.20-3.30, p = 0.02). However, there were no associations between DDS and prevalence of obesity and glucose homeostasis. The results of this cross-sectional study showed that DDS might be associated with increased HDL-C and TC. However, further prospective studies are needed to prove these findings.

• Clinical Nutrition Research
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• 제11권1호
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• pp.42-49
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• 2022

Data on the association between dietary red meat intake and non-alcoholic fatty liver disease (NAFLD) are limited. We designed this case-control study to determine the association between red and processed meat consumption and risk of NAFLD in Iranian adults. A total of 999 eligible subjects, including 196 NAFLD patients and 803 non-NAFLD controls were recruited from hepatology clinics in Tehran, Iran. A reliable and validated food frequency questionnaire was used to evaluate the red and processed meat intakes. The analyzes performed showed that in an age- and gender-adjusted model, patients with the highest quartile of red meat intake had an approximately three-fold higher risk of NAFLD than those with the lowest quartile of intake (odds ratio [OR], 3.42; 95% confidence interval [CI], 2.16-5.43; p value < 0.001). Moreover, patients in the highest quartile of processed meat intake had a 3.28 times higher risk of NAFLD, compared to the lowest quartile(OR, 3.28; 95% CI, 1.97-5.46; p value < 0.001).Both these associations remained significant by implementing additional adjustments for body mass index, energy intake, dietary factors, diabetes, smoking, and physical activity (OR, 3.65; 95% CI, 1.85-7.18; p value < 0.001 and OR, 3.25; 95% CI, 1.57-6.73; p value = 0.002, respectively).Our findings indicate that both red and processed meat intakes are related to the increased odds of NAFLD; however, prospective studies are needed to confirm these results.

• Clinical Nutrition Research
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• 제11권1호
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• pp.62-73
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• 2022

An insufficient intake of magnesium may be associated with the development of chronic obstructive pulmonary disease (COPD). We aimed to determine the relationship between health related quality of life (QoL), anthropometric indices and nutritional status with dietary magnesium intake in COPD patients. Sixty-one COPD patients participated in this cross-sectional study. QoL and nutritional status were assessed. Furthermore, body composition, calf circumference, and muscle strength were measured; equations were used to calculate fat-free mass index, body mass index, and muscle mass value. Dietary magnesium intake was assessed by three 24-hours recalls and magnesium intake was categorized as ≤ 188.08 mg/day (A group) and > 188.08 mg/day (B group). The χ², independent-sample t-test and Mann-Whitney test were used for statistical analysis. The p values less than 0.05 were considered significant. Of QoL assessments the total and impact mean scores of St. George's respiratory questionnaire in the B group were significantly lower than the means of the A group (p value = 0.007 and 0.005, respectively). The instrumental activity of daily living score was significantly improved in patients with higher consumption of dietary magnesium (p = 0.02). Participants had a significantly lower mean score of patient-generated subjective global assessment in the B group compared to the A group (p = 0.003). Higher intake of dietary magnesium can lead to improve QoL and nutrition status.

• Clinical Nutrition Research
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• 제11권3호
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• pp.183-193
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• 2022

We investigated the predictors of survival in patients with advanced BTC according to their baseline nutritional status estimated by the Nutritional Risk Screening (NRS)-2002. From September 2006 to July 2017, we reviewed the data of 601 inpatients with BTC. Data on demographic and clinical parameters was collected from electronic medical records, and overall survival (OS) and progression-free survival were analyzed using the Kaplan-Meier method and the stepwise Cox regression analysis. Patients with an NRS-2002 score of ≤ 2, 3, and ≥ 4 were respectively classified as "no risk," "moderate risk," "high risk." Following initial NRS-2002 score, 333 patients (55%) were classified as "no-risk," 109 patients (18%) as "moderate-risk," and 159 patients (27%) as "high-risk." Survival analysis demonstrated significant differences in the median OS: "no-risk": 12.6 months (95% confidence interval [CI], 11.5-13.7); "moderate-risk": 6.1 months (95% CI, 4.3-8.0); and "high-risk": 3.9 months (95% CI, 3.2-4.6) (p < 0.001). NRS-2002 score was an independent factor for OS (hazard ratio [HR], 1.616 for "moderate-risk", 95% CI, 1.288-2.027, p < 0.001; HR, 2.121 for "high-risk", 95% CI, 1.722-2.612, p < 0.001), along with liver metastasis, peritoneal seeding, white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, cholesterol, carcinoembryonic antigen, and carbohydrate antigen 19-9. In conclusion, baseline NRS-2002 is an appropriate method for discriminating those who are already malnourished and who have poor prognosis in advanced BTC patient. Significance of these results merit further validation to be integrated in the routine practice to improve quality of care in BTC patients.

• Clinical Nutrition Research
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• 제11권3호
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• pp.214-227
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• 2022

Despite controversies, no earlier study has systematically summarized findings from earlier studies on the effect of artichoke supplementation on blood pressure. Therefore, current systematic review and meta-analysis was done on the effect of artichoke supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults. Five databases were searched from inception to January 2022 using relevant keywords. All randomized clinical trials investigating the impact of oral artichoke supplementation on any of the blood pressure parameters including SBP or/and DBP were included. Out of 1,507 citations, 7 trials that enrolled 472 subjects were included. Artichoke supplementation resulted in significant reduction in SBP (weighted mean difference [WMD], -2.01 mmHg; 95% confidence interval [CI], -3.78, -0.24; p = 0.026) and DBP (WMD, -1.45 mmHg; 95% CI, -2.81, -0.08; p = 0.038). Greater effects on SBP were detected in trials using ≤ 500 mg artichoke, lasted > 8 weeks, participants aged < 50 years' old and sample size ≤ 70. There was also a similar impact of artichoke on DBP. However, significant non-linear associations were found between artichoke supplementation dosage and study duration with both SBP (for dosage: p_{non-linearity} = 0.002, for duration: p_{non-linearity} = 0.016) and DBP (for dosage: p_{non-linearity} = 0.005, for duration: p_{non-linearity} = 0.003). We found a significant reduction in both SBP and DBP following artichoke supplementation in adults. It could be proposed as a hypotensive supplement in hypertension management.

• Clinical Nutrition Research
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• 제11권3호
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• pp.228-239
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• 2022

Studies examining the effect of artichoke on liver enzymes have reported inconsistent results. This systematic review and meta-analysis aimed to assess the effects of artichoke administration on the liver enzymes. PubMed, Embase, the Cochrane Library, and Scopus databases were searched for articles published up to January 2022. Standardized mean difference (Hedges' g) were analyzed using a random-effects model. Heterogeneity, publication bias, and sensitivity analysis were assessed for the liver enzymes. Pooled analysis of seven randomized controlled trials (RCTs) suggested that the artichoke administration has an effect on both alanine aminotransferase (ALT) (Hedges' g, -1.08; 95% confidence interval [CI], -1.76 to -0.40; p = 0.002), and aspartate aminotransferase (AST) (Hedges' g, -1.02; 95% CI, -1.76 to -0.28; p = 0.007). Greater effects on ALT were detected in trials that lasted ≤8 weeks. Also, greater effects on AST were detected in trials using > 500 mg artichoke. Overall, this meta-analysis demonstrated artichoke supplementation decreased ALT and AST.

• Clinical Nutrition Research
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• 제11권4호
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• pp.241-254
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• 2022

Polycystic ovary syndrome (PCOS) is a heterogeneous clinical syndrome. Recent studies examine different strategies to modulate its related complications. Chlorogenic acid, as a bioactive component of green coffee (GC), is known to have great health benefits. The present study aimed to determine the effect of GC on lipid profile, glycemic indices, and inflammatory biomarkers. Forty-four PCOS patients were enrolled in this randomized clinical trial of whom 34 have completed the study protocol. The intervention group (n = 17) received 400 mg of GC supplements, while the placebo group (n = 17) received the same amount of starch for six weeks. Then, glycemic indices, lipid profiles, and inflammatory parameters were measured. After the intervention period, no significant difference was shown in fasting blood sugar, insulin level, Homeostasis model assessment of insulin resistance index, low-density lipoprotein, high-density lipoprotein, Interleukin 6 or 10 between supplementation and placebo groups. However, cholesterol and triglyceride serum levels decreased significantly in the intervention group (p < 0.05). This research confirmed that GC supplements might improve some lipid profiles in women with PCOS. However, more detailed studies with larger sample sizes are required to prove the effectiveness of this supplement.