Advances in Nutrition最新文献

{"title":"The Value of Integrating the Nutritional Ecology into the Nutrition Care Continuum—A Conceptual and Systems Approach","authors":"Daniel J Raiten ,&nbsp;Alison L Steiber ,&nbsp;Andrew A Bremer","doi":"10.1016/j.advnut.2025.100385","DOIUrl":"10.1016/j.advnut.2025.100385","url":null,"abstract":"<div><div>The domestic and global diet, nutrition, and health context is becoming increasingly complex. Our ability to effectively address the daunting challenges presented by malnutrition in all its forms—both clinically and from a public health perspective—is constrained by a number of issues that coalesce around our understanding of nutrition and the what, why, and how of its assessment. This complexity is further enhanced when screening, assessment, diagnosis, and care are often performed in different settings (hospital compared with school compared with home), across populations, and with a limited care team (e.g. certain care teams may only have a nurse or dietitian within a school district). In this perspective, we make the case that our ability to improve the precision of assessment, diagnosis, and intervention demands a view of nutrition as a biological variable: a complex system resulting from the interactions between our internal (biology, health status, developmental stage, genetics, etc.) and external (social determinants of health, home, community, physical) environments, i.e. a nutritional ecology. We offer both <em>1</em>) a conceptual framework for more effectively integrating nutrition in medical assessment and etiology-based care; and <em>2</em>) suggest solutions to overcome some of the systematic challenges in the clinical care continuum. Leveraging the concept of nutrition as a biological variable that emphasizes the integration of both internal and external variables into an assessment within the Nutrition Care Process model allows for both the identification of the nutrition problem and also the root cause (etiology) of the problem. Suggestions are offered for how to integrate this approach from both a clinical and public health perspective.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 3","pages":"Article 100385"},"PeriodicalIF":8.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Iodine Deficiency: Insights and Projections to 2050 Using XGBoost and SHAP","authors":"Dan Liang ,&nbsp;Li Wang ,&nbsp;Panpan Zhong ,&nbsp;Jiuxiu Lin ,&nbsp;Leyan Chen ,&nbsp;Qifang Chen ,&nbsp;Shuang Liu ,&nbsp;Zhen Luo ,&nbsp;Changwen Ke ,&nbsp;Yingsi Lai","doi":"10.1016/j.advnut.2025.100384","DOIUrl":"10.1016/j.advnut.2025.100384","url":null,"abstract":"<div><div>Iodine deficiency (ID) poses a significant global public health challenge. This study aimed to analyze trends from 1990 to 2021 and project future patterns ≤2050 using the extreme gradient boosting (XGBoost) model, with Shapley additive explanations (SHAP), to identify key factors and inform public health strategies. Data on ID from the Global Burden of Disease (GBD) 2021 study were used to model and predict its burden ≤2050 using XGBoost, with SHAP enhancing model interpretability. In 1990, global incident cases of ID were 7.51 million (age-standardized incidence rate [ASIR]: 126.11/100,000), rising to 8.08 million by 2021 (ASIR: 105.99/100,000, a 15.96% decrease), and projected to reach 8.48 million by 2050 (ASIR: 108.20/100,000). Prevalent cases increased from 146.42 million in 1990 (age-standardized prevalence rate [ASPR]: 2801.80/100,000) to 180.81 million in 2021 (ASPR: 2213.98/100,000, a 20.98% decrease), with 194.51 million expected by 2050 (ASPR: 1900.01/100,000). Disability-adjusted life years (DALYs) dropped from 2.46 million in 1990 (age-standardized disability-adjusted life year rate [ASDR]: 46.19/100,000) to 2.25 million in 2021 (ASDR: 27.67/100,000, a 40.10% decrease) but are projected to rise slightly to 2.51 million by 2050 (ASDR: 25.51/100,000). SHAP analysis identified iodized salt coverage as a key factor, with higher coverage levels associated with reduced ID burden in most countries. Women and people aged 10–30 y had higher incidence rates, although prevalence and DALYs peaked among those aged 20–45 y. Central and Eastern Sub-Saharan Africa and South Asia will continue to bear the highest burden through 2050. The XGBoost+SHAP model identified age, sex, and iodized salt coverage as key factors, with women and younger populations being high-risk groups. Strengthening iodization programs, improving health care access, targeted education, and consistent monitoring of vulnerable populations are essential to mitigate future risks and improve health outcomes.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 3","pages":"Article 100384"},"PeriodicalIF":8.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Traditional Body Composition Metrics: Load-Capacity Indices Emerge as Predictors of Cardiometabolic Outcomes—A Systematic Review and Meta-Analysis","authors":"Zhongyang Guan ,&nbsp;Marianna Minnetti ,&nbsp;Steven B Heymsfield ,&nbsp;Eleonora Poggiogalle ,&nbsp;Carla M Prado ,&nbsp;Marc Sim ,&nbsp;Blossom CM Stephan ,&nbsp;Jonathan CK Wells ,&nbsp;Lorenzo M Donini ,&nbsp;Mario Siervo","doi":"10.1016/j.advnut.2024.100364","DOIUrl":"10.1016/j.advnut.2024.100364","url":null,"abstract":"<div><div>The adaptive and independent interrelationships between different body composition components have been identified as crucial determinants of disease risk. On the basis of this concept, the load-capacity model of body composition, which utilizes measurements obtained through nonanthropometric techniques such as dual-energy X-ray absorptiometry, was proposed. This model is typically operationalized as the ratio of metabolic load (adipose mass) to metabolic capacity (lean mass). In recent years, a series of load-capacity indices (LCIs) have been utilized to identify abnormal body composition phenotypes such as sarcopenic obesity (SO) and to predict the risk of metabolic, cardiovascular, and cognitive disorders. In this review, we comprehensively review the characteristics of different LCIs used in previous studies, with a specific focus on their applications, especially in identifying SO and predicting cardiometabolic outcomes. A systematic literature search was performed using PubMed, MEDLINE, PsycINFO, Embase, and the Cochrane Library. Two meta-analyses were conducted to <em>1</em>) estimate the overall prevalence of SO mapped by LCIs, and <em>2</em>) assess the association of LCIs with cardiometabolic outcomes. A total of 48 studies (all observational) were included, comprising 22 different LCIs. Ten studies were included in the meta-analysis of SO prevalence, yielding a pooled prevalence of 14.5% [95% confidence interval (CI): 9.4%, 21.6%]. Seventeen studies were included in the meta-analysis of the association between LCIs and adverse cardiometabolic outcomes, which showed a significant association between higher LCI values and increased risk (odds ratio = 2.22; 95% CI: 1.81, 2.72) of cardiometabolic diseases (e.g. diabetes and metabolic syndrome). These findings suggest that the load-capacity model of body composition could be particularly useful in the identification of SO cases and prediction of cardiometabolic risk. Future longitudinal studies are needed to validate the association of LCIs with chronic cardiometabolic and neurodegenerative diseases.</div><div>This systematic review and meta-analysis has been registered with PROSPERO (CRD42024457750).</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100364"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Optimal Dosage and Duration of ω-3 PUFA Supplementation in Heart Failure Management: Evidence from a Network Meta-Analysis","authors":"Ping-Tao Tseng ,&nbsp;Bing-Yan Zeng ,&nbsp;Chih-Wei Hsu ,&nbsp;Chih-Sung Liang ,&nbsp;Brendon Stubbs ,&nbsp;Yen-Wen Chen ,&nbsp;Tien-Yu Chen ,&nbsp;Wei-Te Lei ,&nbsp;Jiann-Jy Chen ,&nbsp;Yow-Ling Shiue ,&nbsp;Kuan-Pin Su","doi":"10.1016/j.advnut.2025.100366","DOIUrl":"10.1016/j.advnut.2025.100366","url":null,"abstract":"<div><div>Heart failure is a progressive condition associated with a high mortality rate. Despite advancements in treatment, many patients continue to experience less-than-ideal outcomes. ω-3 (n–3) polyunsaturated fatty acids (PUFAs) have been studied as a potential supplementary therapy for heart failure, but the optimal dosage and duration of supplementation remain unclear. This network meta-analysis (NMA) aimed to assess the efficacy of various n–3 PUFA supplementation regimens in patients with heart failure, focusing on dose-dependent and time-dependent effects. We conducted a systematic search for randomized controlled trials (RCTs) on n–3 PUFA supplementation in heart failure till 13 September, 2024. The primary outcome was the change in heart function, specifically left ventricular ejection fraction. Secondary outcomes included changes in peak oxygen consumption (VO₂), blood B-type natriuretic peptide concentrations, and quality of life. The safety analysis focused on dropout rates (i.e., patients leaving the study for any reason before completion) and all-cause mortality. A frequentist-based NMA was performed. This NMA, which included 14 RCTs with 9075 participants (mean age, 66.0 y; 23.3% female), found that high-dose n–3 PUFA supplementation (2000–4000 mg/d) over a duration of ≥1 y significantly improved left ventricular ejection fraction and peak VO₂ compared with those of control groups. Lower doses and shorter treatment periods did not produce the same benefits. No significant differences were found in dropout rates or all-cause mortality between the n–3 PUFAs and control groups. Long-term, high-dose n–3 PUFA supplementation, particularly with a predominance of docosahexaenoic acid or eicosapentaenoic acid, enhances cardiac function in patients with heart failure without increasing risk of adverse events. Further well-designed RCTs with long treatment durations (i.e., &gt;1 y) and stringent heart failure inclusion criteria are necessary to confirm these findings and reduce potential biases.</div><div>This trial was registered at PROSPERO as CRD42024590476.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100366"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota: An Important Participant in Childhood Obesity","authors":"Yu Luo ,&nbsp;Maojun Li ,&nbsp;Dan Luo ,&nbsp;Binzhi Tang","doi":"10.1016/j.advnut.2024.100362","DOIUrl":"10.1016/j.advnut.2024.100362","url":null,"abstract":"<div><div>Increasing prevalence of childhood obesity has emerged as a critical global public health concern. Recent studies have challenged the previous belief that obesity was solely a result of excessive caloric intake. Alterations in early-life gut microbiota can contribute to childhood obesity through their influence on nutrient absorption and metabolism, initiation of inflammatory responses, and regulation of gut–brain communication. The gut microbiota is increasingly acknowledged to play a crucial role in human health, as certain beneficial bacteria have been scientifically proven to possess the capacity to reduce body fat content and enhance intestinal barrier function and their metabolic products to exhibit anti-inflammatory effect. Examples of such microbes include bifidobacteria, <em>Akkermansia muciniphila</em>, and <em>Lactobacillus reuteri</em>. In contrast, an increase in Enterobacteriaceae and propionate-producing bacteria (Prevotellaceae and Veillonellaceae) has been implicated in the induction of low-grade systemic inflammation and disturbances in lipid metabolism, which can predispose individuals to obesity. Studies have demonstrated that modulating the gut microbiota through diet, lifestyle changes, prebiotics, probiotics, or fecal microbiota transplantation may contribute to gut homeostasis and the management of obesity and its associated comorbidities. This review aimed to elucidate the impact of alterations in gut microbiota composition during early life on childhood obesity and explores the mechanisms by which gut microbiota contributes to the pathogenesis of obesity and specifically focused on recent advances in using short-chain fatty acids for regulating gut microbiota and ameliorating obesity. Additionally, it aimed to discuss the therapeutic strategies for childhood obesity from the perspective of gut microbiota, aiming to provide a theoretical foundation for interventions targeting pediatric obesity based on gut microbiota.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100362"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. Salvador Villalpando Hernández (1943–2024): A Tribute to his Scientific Legacy","authors":"Juan A Rivera,&nbsp;Teresa Shamah","doi":"10.1016/j.advnut.2024.100352","DOIUrl":"10.1016/j.advnut.2024.100352","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100352"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review: The Impact of COVID-19 Policy Flexibilities on SNAP and WIC Programmatic Outcomes","authors":"Mayra Crespo-Bellido ,&nbsp;Gabby Headrick ,&nbsp;Miguel Ángel López ,&nbsp;Jennifer Holcomb ,&nbsp;Ariana Khan ,&nbsp;Shanti Sapkota ,&nbsp;Kelseanna Hollis-Hansen","doi":"10.1016/j.advnut.2024.100361","DOIUrl":"10.1016/j.advnut.2024.100361","url":null,"abstract":"<div><div>In response to the coronavirus disease 2019 (COVID-19) public health emergency (PHE), the federal government deployed policy flexibilities in food and nutrition assistance programs including the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to meet the needs those experiencing economic hardship. Emergent literature evaluates the impact of these flexibilities on program outcomes. The objective of this study was to explore the impact of policy flexibilities deployed during the COVID-19 PHE on access, enrollment/retention, benefit utilization, and perceptions of SNAP and WIC. Keyword searches were performed in November 2023, February 2024, and August 2024. The search included peer-reviewed literature from 2020 to 2024, following Johanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, resulting in 37 eligible articles. Twelve studies evaluated policy flexibilities in SNAP only, 21 in WIC only, and 4 in both programs. Across these, 12 studies explored program access, 7 enrollment/retention, 13 benefit utilization, and 15 program perceptions. JBI critical appraisal tools were used to assess risk of bias. The reviewed articles show that although SNAP and WIC participants identified challenges to access, there were increases in enrollment/retention due to policy flexibilities enabling remote services and reducing administrative burden in both programs. Benefit increases led to greater purchase of preferred foods in SNAP and greater access to fruit and vegetables in WIC. Overall, participants were satisfied with the flexibilities and reported most were beneficial for their households. Some implementation challenges were identified by participants and staff. A few studies showed potential risks of bias, including selection bias and confounding bias. COVID-19-related policy flexibilities in SNAP and WIC demonstrated significant improvements in selected program outcomes; however, challenges communicating policy flexibilities to authorized vendors and participants created difficulties to benefiting from the flexibilities. Findings from the evaluations of these flexibilities can inform future program enhancements and long-term regulatory changes. This study was registered in PROSPERO (CRD42023493302).</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100361"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Vulnerability and Child Food Insecurity in Developed Countries: A Systematic Review","authors":"Liyuwork Mitiku Dana ,&nbsp;César Ramos-García ,&nbsp;Deborah A Kerr ,&nbsp;Jane M Fry ,&nbsp;Jeromey Temple ,&nbsp;Christina M Pollard","doi":"10.1016/j.advnut.2025.100365","DOIUrl":"10.1016/j.advnut.2025.100365","url":null,"abstract":"<div><div>Food insecurity (FI) is a serious public health concern in economically developed countries, mainly due to unequal resource distribution. Identifying social vulnerability factors [i.e., characteristics of a person or group regarding their capacity to anticipate, cope with, resist, and recover from the effects of child FI (CFI)] and their positive or negative relationship with CFI is important to support targeted action with a scale and intensity that is proportionate to the level of disadvantage. This review aimed to systematically and comprehensively identify key social vulnerability contributors to CFI in economically developed countries and discuss the factors in the context of the socio-ecological model. Five research databases were searched for observational studies published in 2000 assessing social vulnerability factors related to FI in children residing in developed countries. Data screening and extraction were independently conducted by 2 reviewers who recorded factors related to CFI. The QualSyst tool was used to assess risk of bias. From the studies identified (<em>N</em> = 5689), 49 articles, predominantly from the United States and Canada, met the inclusion criteria. The identified social vulnerability factors associated with CFI were grouped into 5 based on the socio-ecological model: <em>1</em>) individual child, <em>2</em>) parental, <em>3</em>) household, <em>4</em>) community, and <em>5</em>) societal factors. The most frequently reported contributors to CFI were income (household factor). Other social vulnerability factors were identified, including the child’s age, parental depression, household crowdedness, social connection, poverty, and residential instability. The lack of consistent measures to define both social vulnerability and CFI in diverse population subgroups impeded meaningful pooling and interpretation of factors interacting with CFI. Recommendations for future studies are to use comparable measures to estimate the extent and severity of CFI and to investigate the relation between social vulnerability, severity, and trajectories of CFI in developed countries.</div><div>This trial was registered at PROSPERO as CRD42022291638.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100365"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. Salvador Villalpando Hernández","authors":"Steven A Abrams","doi":"10.1016/j.advnut.2024.100349","DOIUrl":"10.1016/j.advnut.2024.100349","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100349"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials’ [Advances in Nutrition. 2024;15(10)]","authors":"Nanci S Guest ,&nbsp;Sudha Raj ,&nbsp;Matthew J Landry ,&nbsp;A Reed Mangels ,&nbsp;Roman Pawlak ,&nbsp;Katelyn E Senkus ,&nbsp;Deepa Handu ,&nbsp;Mary Rozga","doi":"10.1016/j.advnut.2025.100379","DOIUrl":"10.1016/j.advnut.2025.100379","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 2","pages":"Article 100379"},"PeriodicalIF":8.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}