BMC NutritionPub Date : 2024-10-17DOI: 10.1186/s40795-024-00950-x
Zahra Rostampoor, Sima Afrashteh, Mohammad Mohammadianpanah, Haleh Ghaem, Maurice P Zeegers, Mohammad Fararouei
{"title":"Lifestyle, dietary pattern and colorectal cancer: a case-control study.","authors":"Zahra Rostampoor, Sima Afrashteh, Mohammad Mohammadianpanah, Haleh Ghaem, Maurice P Zeegers, Mohammad Fararouei","doi":"10.1186/s40795-024-00950-x","DOIUrl":"https://doi.org/10.1186/s40795-024-00950-x","url":null,"abstract":"<p><strong>Background: </strong>In Iran, not only the incidence of colorectal cancer (CRC) is increasing but also the age of patients at diagnosis is alarmingly dropping. We need urgent actions to better understand the epidemiology of CRC and the contributing factors for such pattern in Iranian population. The aim of our study was to determine the potential contribution of lifestyle, including dietary pattern, to CRC in a large Iranian province.</p><p><strong>Methods: </strong>A hospital based case-control study was performed on 572 participants (275 cases and 297 controls). Patients in the case group were newly diagnosed with CRC in a referral hospital and patients in the control group were selected from those patients with non-malignancy diseases who were admitted to the same hospital. Control group was frequency matched to the case group for gender and age.</p><p><strong>Results: </strong>Based on the results of multivariable logistic regression analysis, direct associations were observed between usual pattern of defecation (OR<sub>> 3rd /every day</sub> =4.74, 95% CI: 1.78-12.59), chicken consumption (OR<sub>sometimes or always/occasionally</sub> = 6.33, 95% CI:3.23-12.43), family history of CRC (OR<sub>yes/no</sub> =5.79, 95% CI: 2.72-12.31), and alcohol consumption (OR<sub>yes/no</sub> =6.03, 95% CI: 2.14-16.98) with the odds of CRC among the study population. On the other hand, taking multivitamins (OR<sub>yes/no</sub>=0.09, 95% CI:0.04-0.20), consumption of coffee (OR<sub>always/occasionally</sub> =0.29, 95% CI: 0.12-0.69), taking vitamins D supplement (OR<sub>yes/no</sub> =0.38,95% CI:0.22-0.66), and consumption of garlic (OR<sub>sometimes/occasionally</sub> =0.53,95% CI: 0.30-0.95) significantly reduced the odds of CRC.</p><p><strong>Conclusions: </strong>We revealed potentially significant effects of several lifestyle related factors with CRC risk in Iranian population. More studies are required to understand the mechanism of action of the associated factors in developing CRC.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"138"},"PeriodicalIF":1.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-10-16DOI: 10.1186/s40795-024-00952-9
Ghose Bishwajit, Sanni Yaya
{"title":"Uncovering the drivers of food insecurity in Cameroon: insights from a nationwide cross-sectional analysis.","authors":"Ghose Bishwajit, Sanni Yaya","doi":"10.1186/s40795-024-00952-9","DOIUrl":"https://doi.org/10.1186/s40795-024-00952-9","url":null,"abstract":"<p><strong>Background: </strong>Despite global efforts to achieve zero hunger, food insecurity remains a critical challenge in several African countries, including Cameroon. This study aims to identify sociodemographic predictors of food insecurity across Cameroon through a comprehensive, nationwide cross-sectional analysis.</p><p><strong>Methods: </strong>Data for this study were drawn from the 2018 Cameroon Demographic and Health Survey (CDHS). Food insecurity levels were evaluated using the Food Insecurity Experience Scale (FIES). To estimate the probabilities of moderate and severe food insecurity among different sociodemographic groups, logistic regression models were applied, with results expressed as average marginal effects (AME).</p><p><strong>Results: </strong>The findings reveal that approximately 24.86% of participants experienced moderate food insecurity, while 28.96% faced severe food insecurity. Among men, the proportion experiencing severe food insecurity was 38.8%, compared to 24.3% for women. Multivariable regression analysis showed that severe food insecurity was less likely among women [AME = 0.84, 95% CI = 0.83,0.86], Muslims [AME = 0.91, 95%CI = 0.90,0.93], individuals with higher education levels (secondary education: AME = 0.93, 95%CI = 0.90,0.95; higher education: AME = 0.87, 95%CI = 0.85,0.90), those owning land (either alone or jointly) [AME = 0.92, 95%CI = 0.89,0.96], wealthiest households (moderate food insecurity: AME = 0.91, 95%CI = 0.88,0.93; severe food insecurity: AME = 0.73, 95%CI = 0.70,0.75), female-headed households [AME = 0.97, 95%CI = 0.96,0.99], and rural residents [AME = 0.97, 95%CI = 0.95,0.98].</p><p><strong>Conclusions: </strong>These findings underscore that food insecurity affects a substantial portion of the Cameroonian population, with certain sociodemographic groups more vulnerable than others. This study proposes targeted policy recommendations to address food insecurity in Cameroon, including social assistance programs for at-risk groups, investments in socioeconomic empowerment, improvements in agricultural productivity, and ongoing research to guide evidence-based interventions.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"137"},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-10-14DOI: 10.1186/s40795-024-00947-6
Si-Hua Wen, Xin Tang, Tao Tang, Zheng-Rong Ye
{"title":"Association between serum iron and gallstones in US adults: a cross-sectional study.","authors":"Si-Hua Wen, Xin Tang, Tao Tang, Zheng-Rong Ye","doi":"10.1186/s40795-024-00947-6","DOIUrl":"https://doi.org/10.1186/s40795-024-00947-6","url":null,"abstract":"<p><strong>Background: </strong>Gallstones are a common digestive disorder that threatens human health. Iron deficiency may be related to the formation of gallstones, but there is limited current epidemiological research. The objective of this study was to investigate the relationship between iron status and gallstones.</p><p><strong>Methods: </strong>The datasets from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were used in a cross-sectional investigation. Gallstones were determined by using the 2007-2010 NHANES questionnaire. Multivariate linear regression models were used to examine the association between serum iron, serum ferritin and iron intake with the risk for gallstones. Subgroup analysis based on gender, age, race, and diabetes were performed. Fitted smoothing curves were used to describe the linear relationship.</p><p><strong>Results: </strong>The research involved 7847 participants aged 20 and above, among whom 845 were identified as having gallstones. Participants with higher serum iron levels tended to have a lower gallstones prevalence. A negative relationship between serum iron and gallstones prevalence was observed (OR = 0.979, 95% CI:0.965-0.992). The group with the highest serum iron tertile had a 23.7% lower risk of gallstones compared to the lowest tertile (OR = 0.763, 95% CI:0.628‒0.929). Gallstone prevalence was inversely correlated with iron intake in model 1. The negative association between serum iron and gallstones remained stable in stratifications, including gender, age, race, and diabetes.</p><p><strong>Conclusions: </strong>Elevated serum iron was associated with a decreased prevalence of gallstones. However, to confirm the impact of long-term iron metabolism on gallstone formation, additional prospective research is necessary.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"136"},"PeriodicalIF":1.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-10-10DOI: 10.1186/s40795-024-00933-y
Mina Darand, Vahid Arabi, Moloud Ghorbani, Zahra Salimi, Mahdieh Hosseinzadeh
{"title":"The association between Lifelines Diet Score (LLDS) and Polycystic Ovary Syndrome (PCOS) in Iranian women: a case-control study.","authors":"Mina Darand, Vahid Arabi, Moloud Ghorbani, Zahra Salimi, Mahdieh Hosseinzadeh","doi":"10.1186/s40795-024-00933-y","DOIUrl":"10.1186/s40795-024-00933-y","url":null,"abstract":"<p><strong>Background: </strong>Although adherence to a healthy dietary pattern is one of the primary recommendations for the prevention of polycystic ovary syndrome (PCOS), there is still no conclusive evidence of which specific dietary pattern is best. The Lifelines diet score (LLDS) is a new, evidence-based scoring system to determine diet quality, and its association with PCOS has not been investigated. The present study aimed to assess the association between LLDS and PCOS in Iranian women.</p><p><strong>Materials and methods: </strong>This frequency-matched case-control study was carried out on 108 women with PCOS and 108 women without PCOS as a control group in Yazd, Iran. Healthy controls were matched to PCOS women based on age and BMI. The validated 178-item food frequency questionnaire was used to assess the usual dietary intake. Logistic regression was used to estimate the association between LLDS and PCOS.</p><p><strong>Results: </strong>The findings of the present study showed women in the highest tertile of LLDS compared with the participants in the lowest tertile had 90% lower odds of PCOS (Odds Ratio (OR): 0.10; 95% Confidence Interval (CI): 0.04 to 0.21, p for trend: <0.001). This association remained significant after adjustment for energy intake, marital status, pregnancy history, WC, chronic disease history, physical activity, and BMI (Odds Ratio (OR): 0.11; 95% (CI):0.05 to 0.27, p for trend: <0.001).</p><p><strong>Conclusion: </strong>Although the present study found a significant protective association between adherence to LLDS and PCOS, more mechanism-based studies are needed to confirm these findings in the future.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"133"},"PeriodicalIF":1.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-10-10DOI: 10.1186/s40795-024-00945-8
Sanna Nybacka, Anton Kinnander, Hanna Augustin, Linnea Bärebring
{"title":"Perceived healthiness of foods, food avoidance and diet-related anxiety in individuals with self-reported irritable bowel syndrome: a cross-sectional study.","authors":"Sanna Nybacka, Anton Kinnander, Hanna Augustin, Linnea Bärebring","doi":"10.1186/s40795-024-00945-8","DOIUrl":"10.1186/s40795-024-00945-8","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in which the intake of food is known to exacerbate symptoms. Experiencing food related symptoms can lead to avoidance of food, and cause anxiety related to food intake. We aimed to explore perceptions of the healthiness of food, food avoidance, and food-related worry and anxiety among individuals with and without IBS.</p><p><strong>Methods: </strong>This study was based on a survey conducted in January-February 2017. In total, 2000 participants aged 20-65 were invited by postal letter randomly obtained through the Swedish state personal address register. The questionnaire included aspects of socioeconomic position, different disorders including IBS and food intolerances, food avoidance, and food-related worry or anxiety.</p><p><strong>Results: </strong>In total, 538 participants were included in this study, of whom 8.4% (n = 45) reported having IBS. There were few differences regarding the perceived healthiness of foods between individuals with and without IBS. Participants with IBS avoided gluten (OR 3.45, p = 0.002), lactose (OR 5.0, p < 0.001) and alcohol (OR 2.0, p = 0.042) more frequently than individuals without IBS, and avoidance was driven by abdominal pain. Participants with IBS also reported feeling more worried and having anxiety about diet than those without IBS (p = 0.032 and p = 0.002, respectively).</p><p><strong>Conclusion: </strong>This study indicates that individuals with IBS perceive most foods as equally healthy as individuals without IBS. Having IBS increases the odds of avoiding gluten, lactose, and alcohol. Worry and anxiety related to diet were more common among individuals with IBS, and these aspects need to be considered both in clinical practice and in future research.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"134"},"PeriodicalIF":1.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-10-10DOI: 10.1186/s40795-024-00944-9
Ranil Jayawardena, Kalani Weerasinghe, Gina Trakman, Terrence Madhujith, Andrew P Hills, Nishan Sudheera Kalupahana
{"title":"Validation of a sports nutrition knowledge questionnaire for Sri Lankan track and field athletes.","authors":"Ranil Jayawardena, Kalani Weerasinghe, Gina Trakman, Terrence Madhujith, Andrew P Hills, Nishan Sudheera Kalupahana","doi":"10.1186/s40795-024-00944-9","DOIUrl":"10.1186/s40795-024-00944-9","url":null,"abstract":"<p><strong>Background: </strong>While several validated sports nutrition knowledge questionnaires exist, none are specifically designed to assess the sports nutrition knowledge (SNK) of Sri Lankan track and field athletes. This study aims to validate the Sri Lankan Sports Nutrition Knowledge Questionnaire (SLn-SNKQ), tailored for this athlete group, to provide more accurate and meaningful insights for research and practice. This will enable health professionals and coaches to confidently assess athletes' nutrition knowledge, which directly influences their food choices.</p><p><strong>Methods: </strong>The validity of the questionnaire was established through a multi-step approach. Content validity was achieved via ratings from nutrition experts, all of whom had specialized training in human nutrition and experience of working with athletes. Face validity was evaluated through in-depth telephone interviews with elite or highly trained athletes, using a retrospective think-out-loud protocol to gather feedback on the clarity and relevance of the questions. Construct validity involved nutrition-trained doctors (NTG), non-nutrition-trained professionals (NNTG), and elite-level athletes' groups (AG). Internal consistency was assessed using Cronbach's alpha, and test-retest reliability was evaluated.</p><p><strong>Results: </strong>The final tool comprised 123 individual statements or prompts (items) that were organized into 32 broader questions, spanning 12 sub-sections. Content validity was confirmed by fully integrating 49 out of 70 comments and partially integrating four comments received from nutrition experts for each sub-section. Face validity was established by fully integrating 33 out of 40 comments received from 16 elite and highly trained athletes. Construct validity was confirmed, indicating significant differences in the total scores achieved as a percentage of the SLn-SNKQ among the NTG (462.5, 92.5%), NNTG (223.5, 44.7%), and AG (235, 47.0%; p < 0.001). Reproducibility was established by strong test-retest reliability between individuals' scores on two test attempts, three weeks apart (spearman's correlation; ρ = 0.99, p < 0.05). Internal reliability for each sub-section met psychometric reliability requirements (Cronbach's α > 0.7).</p><p><strong>Conclusions: </strong>The SLn-SNKQ has been validated and demonstrates robust psychometric properties, offering a reliable tool for assessing SNK among Sri Lankan track and field athletes.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"135"},"PeriodicalIF":1.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-10-08DOI: 10.1186/s40795-024-00942-x
Thomas Druetz, Sara Brenes-Garita, Frank Bicaba, Cheick Tiendrebeogo, Abel Bicaba
{"title":"COVID-19 and its effects on food producers: panel data evidence from Burkina Faso.","authors":"Thomas Druetz, Sara Brenes-Garita, Frank Bicaba, Cheick Tiendrebeogo, Abel Bicaba","doi":"10.1186/s40795-024-00942-x","DOIUrl":"10.1186/s40795-024-00942-x","url":null,"abstract":"<p><strong>Introduction: </strong>Burkina Faso implemented stringent measures in response to the COVID-19 pandemic that profoundly affected its economy and might have exacerbated food insecurity. While prior studies have assessed the impact of these measures on consumers, there is a dearth of evidence of its effects on food producers in Sub-Saharan Africa. This study aims (i) to evaluate the repercussions of COVID-19 on the possession of food production assets and on the number of livestock owned; and (ii) to determine the correlation between the food insecurity experience scale (FIES) score, ownership of these assets, and the number of livestock owned.</p><p><strong>Methods: </strong>This study employs a pre-post comparison design in two panels of randomly selected households in Burkina Faso. While Panel A was constituted of 384 households predominantly (76%) living in rural areas, Panel B comprised 504 households, only half of which (51%) lived in rural areas. All households were visited twice: in July 2019 and February 2021, for Panel A, and in February 2020 and February 2021, for Panel B. Panel B was added to the study before the pandemic thanks to additional funding; the timing of the survey was harmonized in both panels for the second round. Regression models were used with fixed effects at the household level, controlling for potential time-invariant confounding variables, and correlation coefficients between possession of production assets or number of livestock and FIES score were measured.</p><p><strong>Results: </strong>Our findings indicate that the possession of some assets in Panel A (cart, livestock, bicycle, watch) was significantly reduced during the pandemic, as was the herd sizes among livestock-owning households in both panels. Households with fewer production assets and number of livestock were more likely to experience food insecurity.</p><p><strong>Conclusion: </strong>This study underscores the vulnerability of rural households in Burkina Faso to the economic disruptions caused by the COVID-19 pandemic. Addressing the challenges faced by farming and livestock-owning households is crucial for mitigating food insecurity and improving resilience in the face of ongoing crises.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"132"},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Healthy beverage index is associated with metabolic syndrome: insights from the Ravansar non-communicable disease (RaNCD) cohort study.","authors":"Hawal Lateef Fateh, Neda Izadi, Shahab Rezaeian, Farid Najafi, Ebrahim Shakiba, Mitra Darbandi, Yahya Pasdar","doi":"10.1186/s40795-024-00940-z","DOIUrl":"10.1186/s40795-024-00940-z","url":null,"abstract":"<p><strong>Background: </strong>Dietary patterns play a crucial role in the development and management of metabolic syndrome (MetS). The Healthy Beverage Index (HBI) is a novel tool that assesses the quality of beverage choices in the diet and provides insights into their potential impact on metabolic health. The aim of this study was to investigate the association between the HBI and the MetS.</p><p><strong>Methods: </strong>This cross-sectional study was conducted using data collected at baseline from the Ravansar Noncommunicable Disease Cohort Study. A total of 9,025 participants aged 35 to 65 years were included in the analysis. HBI was calculated using food items from the Food Frequency Questionnaire (FFQ). MetS status was defined according to established criteria, and logistic regression analysis was performed to assess the association between HBI scores and MetS, adjusting for potential confounding variables.</p><p><strong>Results: </strong>In our study, 41.13% of the population was found to have MetS, with a significant association between MetS and tertiles of HBI. Furthermore, the logistic regression model showed a significant inverse association between HBI scores and the odds of developing a MetS (OR = 0.90; 95% CI: 0.86, 0.94), even after adjusting for confounding factors, emphasizing the potential protective effect of higher HBI scores.</p><p><strong>Conclusion: </strong>Increased HBI scores were associated with lower risk of MetS, emphasizing the importance of choosing health-promoting beverages in controlling MetS. These findings support the association between dietary habits and metabolic health and provide practical guidance for individuals and public health initiatives aimed at improving metabolic outcomes.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"131"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-09-30DOI: 10.1186/s40795-024-00937-8
Sabina F Mugusi, David M Sando, Ferdinand M Mugusi, Claudia A Hawkins, Said S Aboud, Wafaie W Fawzi, Christopher R Sudfeld
{"title":"Effect of high-dose multivitamin supplements on alanine aminotransferase elevations among adults living with HIV on antiretroviral therapy in Tanzania.","authors":"Sabina F Mugusi, David M Sando, Ferdinand M Mugusi, Claudia A Hawkins, Said S Aboud, Wafaie W Fawzi, Christopher R Sudfeld","doi":"10.1186/s40795-024-00937-8","DOIUrl":"10.1186/s40795-024-00937-8","url":null,"abstract":"<p><strong>Background: </strong>HIV infection can cause malabsorption and rapid utilization of nutrients. A randomized trial of multivitamin supplementation among people living with HIV/AIDS (PLWHA) initiating antiretroviral therapy (ART) in Tanzania was stopped early due to increased alanine aminotransferase (ALT) concentrations in the multiple recommended dietary allowances (RDA) multivitamin group. We conducted detailed analysis to assess the effect of multivitamins on ALT elevations and evaluate whether subgroups of PLWHA have greater hepatotoxicity risks associated with the use of high-dose multivitamins.</p><p><strong>Methods: </strong>We utilized data from a randomized, double-blind trial conducted in 2006-2009 that assessed the effect of high-dose multivitamins that contained vitamin B complex, vitamin C, and vitamin E at multiple RDA as compared to standard-dose multivitamins containing single RDAs among adults initiating ART in Tanzania. We evaluated the effect of high-dose multivitamins on incident mild/moderate ALT elevations > 40 IU/L, persistent ALT elevations > 40 IU/L (2 + clinic visits), and severe ALT elevations > 200IU/L using Cox proportional hazard models. We then evaluated effect modification by patient characteristics to determine if subgroups of PLWHA experienced different magnitudes of risk for ALT elevations associated with high-dose multivitamins.</p><p><strong>Results: </strong>High-dose multivitamins increased the risk of incident mild/moderate ALT elevations > 40 IU/mL as compared to standard-dose multivitamins (hazard ratio (HR): 1.41; 95%CI: 1.26,1.58) as well as incident sustained mild/moderate ALT elevations (HR: 1.19; 95%CI: 1.04,1.36), but there was no overall effect on severe ALT elevations (HR: 1.44; 95% CI: 0.91,2.28). There was no evidence that the effect of high-dose multivitamins on any or sustained mild/moderate ALT elevations was modified by any patient characteristic. However, CD4 T-cell count was found to modify the effect of high-dose multivitamins on severe ALT elevations (p-value for interaction:0.01). Among participants with a baseline CD4 T-cell count ≤ 100 cells/µL, individuals receiving high-dose multivitamins had 3.74 times (95%CI: 1.52-9.17) the risk of incident severe ALT elevations compared to standard-dose multivitamins, while participants with CD4 T-cell counts > 100 cells/µL, appeared to have no effect of high-dose multivitamins on severe ALT elevations (HR:0.92; 95% CI: 0.50,1.67).</p><p><strong>Conclusions: </strong>High-dose RDA multivitamin supplementation increased the incidence of any mild to moderate ALT elevations among adults starting ART in Tanzania and the magnitude of the risk does not appear to differ by patient characteristics. However, immunocompromised PLWHA with CD4 T-cell counts < 100 cells/µL may experience greater risk of severe ALT elevations associated with the use of high-dose multivitamins. Although the study findings offer significant insights, it is essential to","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"129"},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC NutritionPub Date : 2024-09-30DOI: 10.1186/s40795-024-00939-6
Damalie Nalwanga, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Hellen Mnjalla, Christabel Mogaka, Eva Nabawanuka, Elisa Giallongo, Charles Karamagi, André Briend, Kathryn Maitland
{"title":"Is fat mass a better predictor of 6-month survival than muscle mass among African children aged 6-59 months with severe pneumonia?","authors":"Damalie Nalwanga, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Hellen Mnjalla, Christabel Mogaka, Eva Nabawanuka, Elisa Giallongo, Charles Karamagi, André Briend, Kathryn Maitland","doi":"10.1186/s40795-024-00939-6","DOIUrl":"10.1186/s40795-024-00939-6","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia remains the leading cause of mortality among children under 5 years. Poor nutritional status increases pneumonia mortality. Nutritional status assessed by anthropometry alone does not provide information on which body composition element predicts survival. Body composition proxy measures including arm-fat-area (AFA), arm-muscle-area (AMA), and arm-muscle-circumference (AMC) could be useful predictors.</p><p><strong>Objective: </strong>To compare the ability of fat and muscle mass indices to predict 6-month survival among children with severe pneumonia.</p><p><strong>Methods: </strong>This prospective cohort study was nested in the COAST-Nutrition trial (ISRCTN10829073, 06/06/2018) conducted between June 2020 and October 2022 in Uganda and Kenya. We included children aged 6-59 months hospitalized for severe pneumonia with hypoxemia. Children with severe malnutrition, known chronic lung or cardiac diseases were excluded. Anthropometry and clinical status were assessed at enrolment and at follow-up to day 180. We examined Receiver Operator Characteristic (ROC) curves of fat and muscle mass indices with 6-month survival as the outcome, and compared the areas under the curve (AUCs) using chi-square tests. Cox survival analysis models assessed time-to-mortality.</p><p><strong>Results: </strong>We included 369 participants. The median age was 15-months (IQR 9, 26), and 59.4% (219/369) of participants were male. The baseline measurements were: median MUAC 15.0 cm (IQR 14.0,16.0); arm-fat-area 5.6cm<sup>2</sup> (IQR 4.7, 6.8); arm-muscle-area 11.4cm<sup>2</sup> (IQR 10.0, 12.7); and arm-muscle-circumference 12.2 cm (IQR 11.5, 12.9). Sixteen (4.3%) participants died and 4 (1.1%) were lost-to-follow-up. The AUC for Arm-Fat-Area was not significantly higher than that for Arm-Muscle-Area and Arm-Muscle-Circumference [AUC 0.77 (95%CI 0.64-0.90) vs. 0.61 (95%CI 0.48-0.74), p = 0.09 and 0.63 (95%CI 0.51-0.75), p = 0.16 respectively], but was not statistically different from MUAC (AUC 0.73 (95%CI 0.62-0.85), p = 0.47). Increase in Arm-Fat-Area and Arm-Muscle-Circumference significantly improved survival [aHR 0.40 (95%CI 0.24-0.64), p = < 0.01 and 0.59 (95%CI 0.36-1.06), p = 0.03 respectively]. Survival prediction using Arm-Fat-Area was not statistically different from that of MUAC (p = 0.54).</p><p><strong>Conclusions: </strong>Muscle mass did not predict 6-month survival better than fat mass in children with severe pneumonia. Fat mass appears to be a better predictor. Effects of fat and muscle could be considered for prognosis and targeted interventions.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"130"},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}