American Journal of Clinical Nutrition最新文献

{"title":"Mortality burden of protein-energy malnutrition associated with ambient temperature in China: a nationwide case-crossover study.","authors":"Yulin Zhuo, Jiangmei Liu, Jianxiong Hu, Jinlei Qi, Guanhao He, Peng Yin, Tao Liu, Yingyin Liu, Yi Lin, Mengen Guo, Fengrui Jing, Ziqiang Lin, Jinling You, Wenjun Ma, Maigeng Zhou","doi":"10.1016/j.ajcnut.2025.06.002","DOIUrl":"10.1016/j.ajcnut.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>In the context of global warming, the health effects of non-optimum temperatures have attracted increasing attention. Studies have shown that high temperatures increase risk of hospitalization for protein-energy malnutrition (PEM), yet the impact of non-optimum temperatures on PEM mortality is unknown.</p><p><strong>Objectives: </strong>This study aims to quantitatively assess risk and burden of PEM-related mortality associated with short-term temperature exposure across 31 provinces in China.</p><p><strong>Methods: </strong>We collected mortality and meteorological data from 1 January, 2013, to 31 December, 2022, in 31 provinces of mainland China. Based on time-stratified case-crossover design, we integrated logistic model with distributed lag nonlinear model to assess the association between non-optimum temperatures and PEM-related mortality. Subgroup analyses were performed by age, sex, type of PEM, and province to identify vulnerable populations.</p><p><strong>Results: </strong>A total of 197,406 PEM-related deaths were recorded during 2013-2022. The exposure-response curves were inversely J-shaped with higher effect for low temperature than high temperature. Nationally, we estimated that 17.03% [95% empirical confidence intervals (eCI): 14.59%, 19.17%] of PEM mortality was attributable to non-optimum temperatures. Subgroup analyses suggested that the attributable fraction of PEM mortality resulting from non-optimum temperatures was more prominent in males (17.69%; 95% eCI: 13.57%, 21.48%), the older adults ≥65 y (17.44%; 95% eCI: 14.84%, 19.80%), and non-severe PEM (17.45%; 95% eCI: 14.30%, 20.56%). In terms of spatial disparities, the top provinces with higher AFs were Anhui (27.63%; 95% eCI: 20.31%, 33.80%), Xinjiang (22.73%; 95% eCI: -0.14%, 39.55%), and Hubei (22.05%; 95% eCI: 12.36%, 29.87%).</p><p><strong>Conclusions: </strong>Findings from this nationwide study suggest that both heat and cold are associated with increased risks and burden of PEM-related deaths. These findings underscore the necessity of targeted interventions to reduce the PEM-related mortality burden associated with ambient temperature.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paving the way for improved action: how nuclear techniques can advance the assessment of malnutrition.","authors":"Shruti P Shertukde, Ramya Padmanabha, Stephanie T Chung, Claire Gaudichon, Kerry S Jones, Paul Kelly, Nancy F Krebs, Anura Kurpad, Yvonne Lamers, Veronica Lopez-Teros, Alida Melse-Boonstra, Fatima C Pereira, Carla M Prado, Susan B Roberts, John Shepherd, Pattanee Winichagoon, Jonathan C K Wells, Cornelia U Loechl, Daniel J Hoffman","doi":"10.1016/j.ajcnut.2025.06.003","DOIUrl":"10.1016/j.ajcnut.2025.06.003","url":null,"abstract":"<p><p>Malnutrition in all its forms-including undernutrition, micronutrient deficiencies, and overnutrition-continues to rise globally, driven by complex structural and biological factors that contribute to an increased risk of noncommunicable diseases (NCDs). Addressing this multifaceted challenge requires precise assessment tools. To advance this effort, the International Atomic Energy Agency held a technical meeting of global experts to explore how nuclear techniques, specifically stable isotope tracers and imaging methods, and emerging technologies can enhance nutrition assessments to better address malnutrition. On the basis of the meeting's discussions, this report highlights the application of nuclear techniques to improve the measurement of body composition across life stages and disease states, assess nutrient bioavailability more holistically, elucidate nutrient flux under conditions of malnutrition, trace metabolic processes linked to NCDs, and refine nutrient requirements to better reflect diverse populations. The integration of nuclear techniques with emerging tools such as artificial intelligence and model-based compartmental analysis was emphasized as a key strategy to enhance their utility. This report also highlights the important role of nuclear techniques in addressing malnutrition and calls for interdisciplinary collaboration and reduced research silos to fully leverage these techniques to combat this condition more effectively.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of environmental enteric dysfunction and neurodevelopmental outcomes among children in rural Bangladesh and Kenya: a prospective cohort study.","authors":"Gene G Ho, Beryl S Achando, Shahjahan Ali, Caitlin Hemlock, Helen O Pitchik, Christine P Stewart, Fahmida Tofail, Md Ziaur Rahman, Mohammad Alauddin, Gouthami Rao, Holly N Dentz, John P Buleti, Cecilia Nekesa, Charles D Arnold, Syeda L Famida, Md Saheen Hossen, Palash Mutsuddi, Salma Akther, Jessica A Grembi, Sophia T Tan, Sarah T Alauddin, Theodora Meerkerk, Marlene K Wolfe, Priscah Cheruiyot, Sammy M Njenga, Abul K Shoab, Mahbubur Rahman, Leanne Unicomb, Benjamin F Arnold, Patricia Kariger, Alan E Hubbard, John M Colford, Amy J Pickering, Clair Null, Stephen P Luby, Lia Ch Fernald, Andrew N Mertens, Audrie Lin","doi":"10.1016/j.ajcnut.2025.05.034","DOIUrl":"10.1016/j.ajcnut.2025.05.034","url":null,"abstract":"<p><strong>Background: </strong>Environmental enteric dysfunction (EED) may worsen undernutrition, with potential adverse effects on the developmental trajectories of millions of children in low-resource settings.</p><p><strong>Objectives: </strong>This study aimed to assess associations between EED biomarkers and subsequent child development.</p><p><strong>Methods: </strong>In a prospective cohort of 2646 children nested within 2 randomized trials in rural Bangladesh (n = 1374) and Kenya (n = 1272), EED was measured by markers of intestinal permeability (fecal alpha-1 antitrypsin; urinary lactulose and mannitol assessed through the dual sugar absorption test), inflammation (fecal myeloperoxidase and neopterin), and repair (fecal regenerating gene 1β). In Bangladesh, EED biomarkers were measured at ages 3 and 14 mo, whereas in Kenya, they were measured at 6 and 17 mo. Child development was measured by Communicative Development Inventories and World Health Organization (WHO) motor milestones at 1 y of age and by the Extended Ages and Stages Questionnaire at 2 y of age. We used generalized additive models to estimate associations between EED biomarkers and child development, adjusting for potential confounders and controlling for the false discovery rate (FDR).</p><p><strong>Results: </strong>In Bangladesh, higher concentrations of lactulose, mannitol, and alpha-1 antitrypsin were associated with worse subsequent child motor development outcomes. Elevated mannitol at 3 mo was associated with a lower WHO motor milestones sum score {-0.22 adjusted mean difference between the 25th and 75th percentile of mannitol distribution [(95% confidence interval (CI): -0.36, -0.08); FDR-corrected P value = 0.03]} and lower attainment of hands-and-knees crawling at year 1 [hazard ratio 0.74 (95% CI: 0.64, 0.86); FDR-corrected P value < 0.001]. In Kenya, we observed weak positive associations that were neither consistent nor significant after FDR correction.</p><p><strong>Conclusions: </strong>Higher concentrations of biomarkers of intestinal permeability were associated with poor child motor development in Bangladesh. These relationships were not replicated in the Kenyan cohort. The associations between EED and child neurodevelopment vary across geographic contexts, highlighting the need for further research to determine the generalizability of these findings.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term high fat diet-induced metabolic endotoxemia in older individuals with obesity: a randomized crossover study.","authors":"Anna R Ogilvie, Janet C Onishi, Yvette Schlussel, Anil Kumar, Max M Häggblom, Lee J Kerkhof, Sue A Shapses","doi":"10.1016/j.ajcnut.2025.06.001","DOIUrl":"10.1016/j.ajcnut.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>Lipopolysaccharide, also known as endotoxin, in Gram-negative bacteria is associated with obesity and a high fat (HF) diet.</p><p><strong>Objectives: </strong>The objective of this study was to determine whether short-term HF diet compared with low fat (LF) intake affects serum endotoxin and gut microbiota in a controlled trial of older individuals with obesity or normal weight.</p><p><strong>Methods: </strong>In this randomized crossover study, adults (50-79 y old) with obesity or normal weight were assigned to 5 d of HF (40%) diet or LF (20%) diet followed by a washout period and then the other diet. A 5-h mixed meal tolerance test (46% fat) was performed after the LF diet. Serum was analyzed for endotoxin, zonulin, and inflammatory biomarkers. Fecal bacterial community was analyzed by rRNA operon profiling.</p><p><strong>Results: </strong>Participants were 64 y old (95% confidence interval [95% CI]: 62, 66), and 66% were female. Body mass index (BMI; kg/m²) was 24.3 kg/m² (95% CI: 23.5, 25.0) and 36.6 kg/m² (95% CI: 33.4, 39.8) in the group with normal body weight (n = 16) and obesity (n = 16), respectively. The rise in postprandial endotoxin was 1.8-fold higher in individuals with obesity compared with normal weight (P = 0.010). After the study diets, fasting serum endotoxin was higher after the HF diet than the LF diet in the group with obesity (mean difference: 0.13 endotoxin unit [EU]/mL [95% CI: 0.02, 0.24], P = 0.022) but not in the normal weight group (mean difference: 0.03 EU/mL [95% CI: -0.07, 0.14], P = 0.613). Serum zonulin concentrations were higher after the HF diet than the LF diet (P < 0.001) and in the group with obesity compared with normal weight (P < 0.001). Fecal community analysis indicated minimal changes in Gram-negative bacteria due to diet or BMI groups.</p><p><strong>Conclusions: </strong>Serum endotoxin concentrations in individuals with obesity increase following a HF diet or a meal, and these data suggest that it is explained by intestinal permeability rather than a shift in the gut microbiome. This trial was registered at https://clinicaltrials.gov/study/NCT05327868.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A key step toward gaining a deeper understanding of individual responses to protein supplementation.","authors":"Philipp Schuetz","doi":"10.1016/j.ajcnut.2025.05.030","DOIUrl":"10.1016/j.ajcnut.2025.05.030","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study.","authors":"Alyssa Feinberg, Casey M Rebholz, Rozenn N Lemaitre, Amanda M Fretts, Kerri Wiggins, Nona Sotoodehnia, Bruce M Psaty, Hyunju Kim","doi":"10.1016/j.ajcnut.2025.05.033","DOIUrl":"10.1016/j.ajcnut.2025.05.033","url":null,"abstract":"<p><strong>Background: </strong>Ultra-processed food (UPF) consumption is associated with adverse health outcomes. Plant- and animal-sourced UPFs have a unique nutritional composition to improve palatability, which may impact health, but evidence is limited.</p><p><strong>Objectives: </strong>The objective of this study was to investigate the association between UPF intake, plant- and animal-sourced UPF, and mortality outcomes in older adults.</p><p><strong>Methods: </strong>We conducted prospective analyses of 2582 participants (median age: 77 y) in the Cardiovascular Health Study who completed a food frequency questionnaire (FFQ) in 1995-1996. We used responses from the FFQ to identify UPF and classify UPF based on their source (plant or animal). Cox proportional hazard regression models were used to study the association between UPF, plant- and animal-sourced UPF, and mortality outcomes (all-cause, cardiovascular disease [CVD] related, non-CVD related, and cancer).</p><p><strong>Results: </strong>Over a median follow-up of 10 y, there were 2242 deaths. After adjusting for sociodemographic characteristics and health behaviors, per standard deviation (SD) higher intake of UPF was associated with 8%-10% higher risk of all-cause mortality (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.02, 1.14), non-CVD related mortality (HR: 1.10; 95% CI: 1.03, 1.18), and cancer mortality (HR: 1.13; 95% CI: 1.08, 1.46). Similarly, per SD, higher intake of plant- and animal-sourced UPFs was associated with a 4%-17% higher risk of all-cause mortality, non-CVD related mortality, and cancer mortality. However, in a model additionally adjusting for clinical factors, the associations between plant-sourced UPF and mortality attenuated, except for cancer mortality. No significant associations were observed for CVD related mortality.</p><p><strong>Conclusion: </strong>Higher consumption of UPF and plant- and animal-sourced UPFs was associated with higher risk of all-cause, non-CVD related, and cancer mortality. Our findings emphasize the need to consider the impact of food processing, even in plant-sourced foods, to prevent a shorter lifespan in older adults. Findings on plant-sourced UPF and mortality require replication.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"You are what you don’t eat","authors":"Deirdre K Tobias","doi":"10.1016/j.ajcnut.2025.04.005","DOIUrl":"10.1016/j.ajcnut.2025.04.005","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 6","pages":"Pages 1214-1216"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content of selected nutrients and heavy metals in prenatal multivitamins and minerals: an observational study","authors":"Laura M Borgelt ,&nbsp;Michael Armstrong ,&nbsp;Stephen Brindley ,&nbsp;Jared M Brown ,&nbsp;Nichole Reisdorph ,&nbsp;Carol A Stamm","doi":"10.1016/j.ajcnut.2025.04.013","DOIUrl":"10.1016/j.ajcnut.2025.04.013","url":null,"abstract":"<div><h3>Background</h3><div>Increasing consumer reliance on prenatal multivitamins and minerals (PMVMs) underscores the importance of ensuring their quality and safety. Adequate choline and iodine intakes during pregnancy are crucial for fetal development, yet discrepancies between labeled and actual content in PMVM products pose significant health risks. Additionally, the potential presence of toxic heavy metals, such as arsenic, lead, and cadmium, raises concerns about potential adverse health effects.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate nonprescription and prescription PMVMs regarding choline and iodine content as well as arsenic, lead, and cadmium.</div></div><div><h3>Methods</h3><div>This observational study evaluated a convenience sample of nonprescription and prescription PMVM products from online retailers and local retail pharmacies. Products were analyzed using liquid chromatograph mass spectrometry for choline and inductively coupled plasma mass spectrometry for iodine, arsenic, lead, and cadmium. Choline and iodine actual amounts were compared with reported label amounts and heavy metal amounts were compared with United States Pharmacopeia standards.</div></div><div><h3>Results</h3><div>In total, 32 nonprescription and 15 prescription PMVM products were analyzed. Choline amounts were reported on 12 of the 47 (25.6%) products including 5 (41.7%) within 20% of the claimed amount, 2 (16.7%) over the claimed amount by &gt;20%, and 5 (41.7%) under the claimed amount by &gt;20%. Iodine amounts were reported on 25 of the 47 (53.2%) products including 4 (16.0%) within 20% of the claimed amount, 20 (80.0%) under the claimed amount by &gt;20%, and 1 (4.0%) over the claimed amount by &gt;20%. Measurable amounts of arsenic, lead, and cadmium were found in 7 (14.9%), 32 (68.1%) and 29 (61.7%) PMVMs, respectively; however, no PMVMs exceeded United States Pharmacopeia standard limits.</div></div><div><h3>Conclusions</h3><div>Current PMVM products are misleading through omission or inaccurate content of essential nutrients. Federal regulation of dietary supplements in the United States is needed to ensure accurate content of essential nutrients in PMVM formulations.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 6","pages":"Pages 1395-1402"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multisite community-based, case-control study to examine the nutrient intake adequacy of young children with and without developmental delays and other disorders: findings from the Study to Explore Early Development (SEED)","authors":"Susan L Johnson ,&nbsp;Eric J Moody ,&nbsp;Tanja VE Kral ,&nbsp;Brady Holst ,&nbsp;Ethan Dahl ,&nbsp;Nicole A Withrow ,&nbsp;Susan E Levy ,&nbsp;Ann M Reynolds ,&nbsp;Cordelia Robinson Rosenberg","doi":"10.1016/j.ajcnut.2025.02.017","DOIUrl":"10.1016/j.ajcnut.2025.02.017","url":null,"abstract":"<div><h3>Background</h3><div>Frequent concerns are expressed about the diets of children with developmental disabilities. However, previous reports have been based on small samples.</div></div><div><h3>Objectives</h3><div>The study aimed to assess nutrient intakes of young children with autism spectrum disorder (ASD), children with other developmental delays and disorders (DD), and general population controls (POP) and to examine nutrient intakes for adequacy.</div></div><div><h3>Methods</h3><div>The Study to Explore Early Development is a multisite community-based, case-control study designed to understand ASD better. Parents of children (aged 2–5 y) completed 3-d diet diaries to capture all foods and beverages (excluding dietary supplements) consumed by their children. Foods from diaries were analyzed for macronutrient and micronutrient content. Analysis of variances examined group differences in nutrient intakes (criterion of <em>P</em> &lt; 0.001). Chi-square tests of independence examined differences in the proportion of children in each group: <em>1</em>) not meeting the estimated average requirements (EAR) and <em>2</em>) exceeding the tolerable upper intake level (UL) for each nutrient, with the examination of standardized residuals (= ±1.96) to ascertain differences among groups.</div></div><div><h3>Results</h3><div>Diet records (<em>n</em> = 1227) were obtained for children in the 3 groups: ASD (<em>n</em> = 338), DD (<em>n</em> = 412), and POP (<em>n</em> = 477). Few clinically important group differences were noted in children’s nutrient intakes and most met EARs although few had intakes above the ULs. Notable exceptions included: <em>1</em>) &gt;10% of children below the EAR for vitamins A and E, pantothenate, calcium, and fiber; <em>2</em>) &gt;10% above the ULs for niacin, folate, manganese, and added sugars; <em>3</em>) &gt;80% were above the UL for added sugars and &gt;95% did not meet EAR for fiber.</div></div><div><h3>Conclusions</h3><div>Reassurance can be taken from this study that young children’s nutrient intakes from food, including those with developmental disabilities, meet most recommendations for nutrient adequacy. Further study of food intake patterns and diet quality is warranted, with concurrent clinical indicators of nutrient status.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 6","pages":"Pages 1286-1295"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin B6 status is related to disease severity and modulated by endurance exercise in individuals with multiple sclerosis: a secondary analysis of a randomized controlled trial","authors":"Sergen Belen ,&nbsp;Nadine Patt ,&nbsp;Marie Kupjetz ,&nbsp;Per M Ueland ,&nbsp;Adrian McCann ,&nbsp;Roman Gonzenbach ,&nbsp;Jens Bansi ,&nbsp;Philipp Zimmer","doi":"10.1016/j.ajcnut.2025.04.014","DOIUrl":"10.1016/j.ajcnut.2025.04.014","url":null,"abstract":"<div><h3>Background</h3><div>Low circulating concentrations of B vitamins are linked to various chronic and neurodegenerative diseases. Notably, pyridoxal 5'-phosphate (vitamin B₆) deficiency is linked to altered inflammatory responses and cellular immune function, both critical in multiple sclerosis (MS). Nevertheless, most MS research has focused on folate (vitamin B₉) and vitamin B₁₂, leaving other B vitamins understudied.</div></div><div><h3>Objectives</h3><div>This secondary analysis investigated B-vitamin serum concentrations and related metabolites across MS phenotypes (primary progressive MS, relapsing-remitting MS, and secondary progressive MS) and disease severity levels. Additionally, the impact of endurance exercise on B-vitamin concentrations was investigated.</div></div><div><h3>Methods</h3><div>In total, 106 individuals with MS participated in a randomized controlled trial, including different endurance exercise conditions. Serum B-vitamin concentrations were analyzed in 99 participants before and after 3 wk of intervention. Before analysis, participants were dichotomized to 1 of the 2 disability groups based on their expanded disability status scale (EDSS) score: EDSS_≥4.5 (<em>n</em> = 47, EDSS: 5.86 ± 0.56) and EDSS_&lt;4 (<em>n</em> = 52, EDSS: 3.59 ± 0.83).</div></div><div><h3>Results</h3><div>Higher EDSS scores were associated with lower pyridoxal 5'-phosphate (vitamin B-6) concentrations (<em>r</em>_s: −0.32; 95% CI: −0.49, −0.12; <em>P</em> = 0.011), with the EDSS_≥4.5 group also showing lower baseline pyridoxal 5'-phosphate (vitamin B₆) concentrations (β: −0.18; 95% CI: −0.30, −0.07; <em>P</em> = 0.007) than the EDSS_&lt;4 group. Significant time × EDSS group interactions were evident for pyridoxal 5'-phosphate (vitamin B₆; β: 0.05; 95% CI: 0.02, 0.08; <em>P</em> = 0.011), pyridoxal (vitamin B₆; β: 0.05; 95% CI: 0.02, 0.09; <em>P</em> = 0.005), and riboflavin (vitamin B₂; β: 0.06; 95% CI: 0.02, 0.09; <em>P</em> = 0.008), showing increases in these vitamers in the EDSS_≥4.5 group postexercise. N1-Methylnicotinamide (vitamin B₃; β: −0.11; 95% CI: −0.15, −0.06; <em>P</em> &lt; 0.001) decreased in both groups over time.</div></div><div><h3>Conclusions</h3><div>Disease severity is associated with distinct B-vitamin profiles in individuals with MS, although endurance exercise appears to modify specific B-vitamin concentrations.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT04356248.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 6","pages":"Pages 1403-1414"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}