European Journal of Clinical Nutrition

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ISSN / EISSN : 0954-3007 / 1476-5640
Published by: Springer Nature (10.1038)
Total articles ≅ 7,115
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Erika S. O. Patriota, Isis C. C. Lima, Eduardo A. F. Nilson, Sylvia C. C. Franceschini, ,
European Journal of Clinical Nutrition pp 1-13;

Iodine deficiency in pregnant women is related to impaired foetal growth and development. The objective of this study was to estimate the prevalence of insufficient iodine intake in pregnant women from different regions of the world. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and Google Scholar grey literature were searched until 10 April 2021. Two reviewers independently conducted article selection, data extraction, and assessment of the risk of bias. Meta-analyses with random effects, subgroup analyses, and meta-regressions were performed. In total, 4639 observational articles were found, with 61 eligible for inclusion. The population consisted of 163,021 pregnant women adults and adolescents, and the overall prevalence of insufficient iodine intake was 53% (95% confidence interval [CI]: 47–60; I2 = 99.8%). Pregnant women who live in insufficient iodine status country had a higher prevalence (86%; 95% CI: 78–93; I² =97.0%) of inadequate iodine nutritional status than to those living in country considered sufficient (51%; 95% IC: 45–57; I² = 99.8%). Despite the progress in iodine fortification policies and periodic monitoring of the iodine nutritional status of the population worldwide, salt iodination alone may not be sufficient to provide adequate iodine status to pregnant women. Thus, other actions may be necessary to improve the nutritional clinical care of pregnant group.
, , , Tetsuya Mizoue, Mitsuhiko Noda, Azumi Hida, Motoki Iwasaki,
European Journal of Clinical Nutrition pp 1-10;

We aimed to investigate the association between sugar or starch intake and the risk of type 2 diabetes (T2D) in middle-aged Japanese adults. Participants comprised 27,797 men and 36,880 women aged 45–75 years with no history of diabetes and critical illness before the second survey in the Japan Public Health Center-based Prospective Study. We calculated sugar (total sugar, total fructose, and sugar subtypes) and starch intakes (% energy/d) using a validated 147-item food frequency questionnaire, to estimate the average dietary intake over the previous year. T2D onset was defined by validated self-reports. ORs adjusted for potential confounders were estimated using multiple logistic regression with categorical and cubic spline models. During the 5-year follow-up, 690 men and 500 women were identified with T2D. In women, the quartiles of total sugar or total fructose intakes were not significantly associated with T2D risk; however, the spline curves showed an increased risk at extremely high intake levels (ORs [95% CI]: 1.88 [1.07–3.31] at 30% energy/d for total sugar and 1.87 [1.10–3.16] at 14% energy/d for total fructose). Starch intake was positively associated with T2D risk among women in the categorical and spline models (ORs [95% CI]: 1.55 [1.13–2.12] at 50% energy/d). In men, sugar and starch intakes were not associated with T2D risk. In this large-scale population-based cohort study, starch intake was associated with an increased T2D risk in Japanese women. An increased risk with extremely high intake of total sugar or total fructose among women cannot be disregarded.
Katrine Lindberg Hansen, Sanja Golubovic, Christian Ulrich Eriksen, Torben Jørgensen,
European Journal of Clinical Nutrition pp 1-10;

Unhealthy population diets contribute to the burden of non-communicable diseases. Policies targeting food environments (FE policies) may improve population diets. This review of systematic reviews aims to summarise recent evidence of the effectiveness of FE policies in improving diets. We searched PubMed for systematic reviews published from January 2010 onwards. Eligible FE policies included: nutrition and food labelling, provision of foods in public institutions or specific settings, price, marketing, nutrition quality and portion size, and availability of foods in retail and food service establishments. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) instrument was used to assess review quality. Reviews of critically low quality were excluded. Results were narratively reported in text and tables. The search identified 1102 records after removing duplicates. Following screening and quality assessment we included 12 systematic reviews. Two reviews focused on nutrition and food labelling, two on provision of foods in school settings, four on price, none on marketing policies, three on nutrition quality and portion size and one on the availability of foods in retail and food service establishments. Pricing policies (tax/subsidy) appear effective in altering intake and purchase of targeted foods and beverages. FE policies targeting the availability of foods in retail and food establishments, food provision in school settings, product reformulation and the size of portions/packages or items of tableware also appear effective. Overall, policies targeting food environments appear effective in improving population diets. However, there is a need for further high-quality evidence.
Ruixia Chang, Hong Mei, Yuanyuan Zhang, Ke Xu, Shaoping Yang, Jianduan Zhang
European Journal of Clinical Nutrition pp 1-6;

To evaluate the associations of maternal prepregnancy body mass index (pp-BMI) and gestational weight gain (GWG) with the childhood BMI z-score (BMI-z) trajectories from birth to 2 years old and the risk of overweight/obesity (OWO) at 2 years of age. Mother–child dyads (23,617) were involved in the analysis. They were followed up from early pregnancy to 2 years postpartum with their healthcare data recorded in the Wuhan Maternal and Child Health Management Information System (WMCHMIS). The OWO in children was defined as BMI-z > 1. Linear mixed models (LMM) and unconditional logistic regression were used to evaluate the independent and joint associations of pp-BMI and GWG with the BMI-z trajectory of children per their anthropometric measurements at 0, 1, 3, 6, 9, 12, 18, and 24 months old and the risk of OWO at 2 years of age. Maternal overweight/obesity and excessive GWG independently and jointly increased the risks of their offspring falling into high BMI-z trajectories of birth to 2 years (p < 0.001). In addition, the children whose mothers were overweight/obese before pregnancy and gained excessive weight during pregnancy independently and jointly increased the OWO risk in children at age 2, with adjusted odds ratios (adjOR) of 1.36 (95% CI, 1.22–1.53), 1.28 (95% CI, 1.18–1.39), and 1.76 (95% CI: 1.52–2.03), respectively. Maternal prepregnancy overweight/obesity and excessive GWG can independently and jointly increase the risks of their children falling into high BMI-z trajectories from birth to 2 years of age and becoming overweight/obese at age 2. Maternal overweight/obesity and excessive gestational weight should be the prime targets for early obese prevention efforts.
Lulin Wang, Lulu Song, Bingqing Liu, Lina Zhang, Mingyang Wu, Yunyun Liu, Jianing Bi, Senbei Yang, Zhongqiang Cao, Wei Xia, et al.
European Journal of Clinical Nutrition pp 1-6;

Newborn telomere length is considered as an effective predictor of lifespan and health outcomes in later life. Selenium is an essential trace element for human health, and its antioxidation is of great significance for the prevention of telomere erosion. We recruited 746 mother–newborn pairs in Wuhan Children’s Hospital between 2013 and 2015. Urine samples were repeatedly collected at three time points during pregnancy, and umbilical cord blood samples were collected right after parturition. Urinary selenium concentration was detected using inductively coupled plasma mass spectrometry, and newborn telomere length was measured using quantitative real-time polymerase chain reaction. We applied general estimating equations to examine the trimester-specific association between maternal urinary selenium during pregnancy and newborn telomere length. The median of creatinine-corrected selenium concentrations during pregnancy were 16.29, 18.08, and 18.35 μg/g·creatinine in the first, second, and third trimesters, respectively. Selenium concentrations in all the three trimesters were significantly associated with newborn telomere length. Per doubling of maternal urinary selenium concentrations was associated with 6.44% (95% CI: 0.92, 12.25), 6.54% (95% CI: 0.17, 13.31), and 6.02% (95% CI: 0.29, 12.09) longer newborn telomere length in the first, second, and third trimesters, respectively, after adjusting for potential confounders. This is the first study to provide evidence for the effect of maternal selenium levels on fetal telomere erosion. Findings from our study suggested that maternal urinary selenium was positively associated with newborn telomere length, indicating that intrauterine selenium exposure might have effect on initial setting of human telomere length.
P. Kochhar, P. Dwarkanath, , A. Thomas, J. Crasta, , ,
European Journal of Clinical Nutrition pp 1-8;

The current study aimed to identify suitable reference miRNA for placental miRNA expression analysis in a set of well-characterized and fetal-sex balanced small- (SGA) and appropriate- (AGA) for gestational age full-term singleton pregnancies. In this retrospective study, placental samples (n = 106) from 35 SGA (19 male and 16 female) and 71 AGA (30 male and 41 female) full-term singleton pregnancies were utilized. Placental transcript abundance of three widely used reference miRNAs [miR-16-5p and Small nucleolar RNAs (snoRNAs) RNU44 and RNU48] were assessed by real-time quantitative PCR. Raw cycle threshold (Ct) analysis and RefFinder tool analysis were conducted for evaluating stability of expression of these miRNAs. Raw Ct values of miR-16-5p were similar between SGA and AGA births (P = 0.140) and between male and female births within SGA (P = 0.159) and AGA (P = 0.060) births while that of RNU44 and RNU48 were higher in SGA births (P = 0.008 and 0.006 respectively) and in male births within the SGA group (P = 0.005) for RNU44 and in female births within the AGA group (P = 0.048) for RNU48. Across all 106 samples tested using the RefFinder tool, miR-16-5p and RNU44 were equally stable reference miRNAs. We recommend miR-16-5p and RNU44 as suitable reference miRNAs for placental samples from settings similar to our study.
Swapan Kumar Roy, Khurshid Jahan, A. K. M. Iqbal Kabir, Nila Akter Keya, Soofia Khatoon, Mohammad Abdul Mannan, Lalita Bhattacharjee
European Journal of Clinical Nutrition pp 1-9;

In Bangladesh, only 34% of children receive minimum acceptable diets as complementary foods (CF) for appropriate age while the rest of them remain at the risk of growth faltering, micronutrient deficiency, compromised cognitive development, and increased morbidity and mortality. The purpose of the study was to develop nutritious recipes for complementary feeding and provide necessary guidelines for improving complementary feeding practices for doctors, nutritionist and caregivers. This qualitative study including a baseline survey and Trials of Improved Practices of recipes (TIPs) was conducted on families having 6–23 months old children selected by Multi-stage random sampling methods from 2010 to 2012 throughout seven divisions of Bangladesh. Thirty-five food recipes were developed from local food items based on the ‘WHO indicators to assess the adequacy of CF practices’ for the TIP. Thirty (30) cooked recipes were analyzed for 10 nutrients in an accredited laboratory in Bangladesh. The baseline survey found that energy density of local recipes was low and did not have the required diversity, adequacy, and nutrient density according to IYCF indicators established by WHO. The TIPs found that 28 recipes out of the 35 recipes were most acceptable by both mothers and children. A manual of improved complementary food recipes and a complementary feeding guideline has been developed with calculation of dietary diversity scores, energy and nutrient density. This report will provide evidence-based practical knowledge for training and serve as nutrition education tool for nutrition practitioners, policy makers, and academicians.
Fardin Kalvandi, Mohammad Ali Azarbayjani, ,
European Journal of Clinical Nutrition pp 1-6;

Today, reducing oxidative stress and improving the antioxidant system with antioxidant supplements along with exercise training has received a lot of attention. Vitamin D plays a very important role in general health and reducing oxidative stress. The aim of this study was to examine the effect of vitamin D3 supplements during elastic-band resistance training (EBT) on oxidative stress and antioxidant indices in healthy men. Forty healthy men (Serum: 20 ≤ 25 (OH) D ≤ 25 ng/mL) voluntarily participated in the current study and randomly were assigned to EBT-vitamin D3 (ED, n = 10), EBT-placebo (EP, n = 10), vitamin D3 (VD, n = 10), and control (Con, n = 10). EBT was performed three times per week on non-consecutive days for eight weeks, in seven exercises. The subjects in the ED, VD, and EP consumed 50,000 IU vitamin D3 or placebo once every 2 weeks. Ten ccs blood samples were collected before and after exercise training and the total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidase (GPX), and creatine kinase (CK) activities were measured in the plasma. Malondialdehyde (MDA), as the lipid peroxidation index, and 25(OH) D were measured in the plasma. We found that there was a significant difference between ED with VD (p = 0.011) and Con (p = 0.022) for MDA. A significant difference was also seen for SOD in ED with VD (p = 0.024) and Con (p = 0.038) and TAC in ED with VD (p = 0.020) and Con (p = 0.030), and GPX in ED with VD (p = 0.040) and Con (p = 0.010). While there were no significant differences between ED and EP in all mentioned variables (p > 0.05). Finally, it can be said that elastic resistance training improved antioxidant defence. However, vitamin D3 supplementation during resistance elastic training has no synergistic effect on attenuating oxidative stress indices.
Shu Y. Lu, Tiffany M. N. Otero, D. Dante Yeh, Cecilia Canales, , Donna M. Belcher,
European Journal of Clinical Nutrition pp 1-6;

Nutrition is often thought to influence outcomes in critically ill patients. However, the relationship between macronutrient delivery and functional status is not well characterized. Our goal was to investigate whether caloric or protein deficit over the course of critical illness is associated with functional status at the time of intensive care unit (ICU) discharge. We performed a retrospective analysis of surgical ICU patients at a teaching hospital in Boston, MA. To investigate the association of caloric or protein deficit with Functional Status Score for the ICU (FSS-ICU), we constructed linear regression models, controlling for age, sex, race, body mass index, Nutritional Risk in the Critically Ill score, and ICU length of stay. We then dichotomized caloric as well as protein deficit, and performed logistic regressions to investigate their association with functional status, controlling for the same variables. Linear regression models (n = 976) demonstrated a caloric deficit of 238 kcal (237.88; 95%CI 75.13–400.63) or a protein deficit of 14 g (14.23; 95%CI 4.46–24.00) was associated with each unit decrement in FSS-ICU. Logistic regression models demonstrated a 6% likelihood (1.06; 95%CI 1.01–1.14) of caloric deficit ≥6000 vs. <6000 kcal and an 8% likelihood (1.08; 95%CI 1.01–1.15) of protein deficit ≥300 vs. <300 g with each unit decrement in FSS-ICU. In our cohort of patients, macronutrient deficit over the course of critical illness was associated with worse functional status at discharge. Future studies are needed to determine whether optimized macronutrient delivery can improve outcomes in ICU survivors.
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