{"title":"Safety, Compliance, and Efficacy of Prehabilitation in Obese Patients with Gastric Cancer Undergoing Minimally Invasive Gastrectomy: A Pilot Prospective Study.","authors":"Kazuyuki Okada, Tatsuto Nishigori, Koya Hida, Shigeo Hisamori, Shigeru Tsunoda, Shintaro Okumura, Yoshiro Itatani, Nobuaki Hoshino, Keiko Kasahara, Ryosuke Okamura, Kazutaka Obama","doi":"10.1159/000546976","DOIUrl":"10.1159/000546976","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive visceral fat area is a risk factor for postoperative complications in gastric cancer patients undergoing minimally invasive gastrectomy. This prospective pilot study aimed to evaluate the safety, compliance, and efficacy of prehabilitation in obese patients with gastric cancer who were scheduled to undergo curative gastrectomy.</p><p><strong>Methods: </strong>Patients with a preoperative visceral fat area ≥100 cm2 who were scheduled to undergo curative minimally invasive gastrectomy for stage I-III gastric cancer were included. The patients were instructed to walk 10,000 steps per day and consume a low-carbohydrate, high-protein diet without energy restrictions for 1 month before surgery. The primary outcome was the visceral fat area reduction rate, and clinical significance was set at a 10% reduction.</p><p><strong>Results: </strong>Eighteen patients were enrolled in the study, and no adverse events were observed. The mean number of steps per day was 10,572. The mean exercise time greater than or equal to moderate intensity was 42.3 min per day, and 88% of the patients completed the 1-month intervention. Although the skeletal muscle mass was preserved, the visceral fat area reduced by 17% (95% confidence interval: 11%-24%, p = 0.039).</p><p><strong>Conclusion: </strong>Prehabilitation can safely reduce visceral fat area before performing minimally invasive gastrectomy in patients with gastric cancer who are obese.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julian Gomahr, Julia Lischka, Caroline Braet, Marie-Laure Frelut, Teodora Handjieva-Darlenska, Edyta Łuszczki, Dénes Molnár, David Thivel, Gabriel Torbahn, Susanne Ring-Dimitriou, Andrea Vania, Elpis Vlachopapadopoulou, Daniel Weghuber
{"title":"The Economic Dimension of Childhood Obesity: Costs and Potential of New Anti-Obesity Medications.","authors":"Julian Gomahr, Julia Lischka, Caroline Braet, Marie-Laure Frelut, Teodora Handjieva-Darlenska, Edyta Łuszczki, Dénes Molnár, David Thivel, Gabriel Torbahn, Susanne Ring-Dimitriou, Andrea Vania, Elpis Vlachopapadopoulou, Daniel Weghuber","doi":"10.1159/000546140","DOIUrl":"10.1159/000546140","url":null,"abstract":"","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-3"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutrition for Preconception Health and Fertility.","authors":"Linden Stocker, Alexandra Kermack, Keith Godfrey","doi":"10.1159/000543616","DOIUrl":"https://doi.org/10.1159/000543616","url":null,"abstract":"<p><strong>Background: </strong>The importance of preconception care is now widely recognised. Optimisation of the lifestyle, nutrition, and the health of a couple not only affects the chances of conception and a successful pregnancy but also the health of the resulting offspring. Currently, limited data reinforce the importance of further research examining the role of individual nutrients. The complex interactions that these nutrients have with each other and the resultant effect on fertility should also be a focus for future investigation. Modifiable risk factors such as alcohol, caffeine, and body mass index should be optimised prior to attempting to conceive. New research is examining the role of personalised preconception advice.</p><p><strong>Summary: </strong>This review examines the roles of macronutrients, micronutrients, and lifestyle in fertility and reproductive health. Raising awareness of the importance of the effect of preconception nutrition and lifestyle on hormone balance, gamete development, implantation, and pregnancy should be paramount. This applies to all healthcare professionals who come into contact with people of child-bearing age, as well as the general public.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preface.","authors":"Flavia Indrio, Hania Szajewska","doi":"10.1159/000540495","DOIUrl":"https://doi.org/10.1159/000540495","url":null,"abstract":"","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-2"},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Calcium and Iron Nutrition through the Reproductive Life Course.","authors":"Kate A Ward, Ann Prentice","doi":"10.1159/000543618","DOIUrl":"https://doi.org/10.1159/000543618","url":null,"abstract":"<p><strong>Background: </strong>Two essential micronutrients over the life course are calcium and iron, and both are especially important during the reproductive cycle. The role of calcium in maternal and offspring bone health and in the prevention of pre-eclampsia in pregnancy are well described, although results from randomised controlled trials for both outcomes vary. Iron is essential for synthesis of red blood cells, being a core component of haemoglobin, which carries oxygen around the body, and hence is key in the prevention of anaemia and sequelae.</p><p><strong>Summary: </strong>This article reviews the evidence across the reproductive life course for dietary calcium and iron intakes and health outcomes. For calcium, focusing on bone health and prevention of pre-eclampsia, for iron considering its crucial role in foetal and neonatal development and how requirements may be impacted through inflammation and infection, particularly in environments where iron availability may be low.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maternal Nutrition and the Lifelong Health of Their Offspring.","authors":"Andrew Prentice","doi":"10.1159/000542383","DOIUrl":"https://doi.org/10.1159/000542383","url":null,"abstract":"","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-4"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Economic Burden of Obesity in Children and Adolescents in Austria.","authors":"Stephanie Reitzinger, Thomas Czypionka","doi":"10.1159/000545082","DOIUrl":"10.1159/000545082","url":null,"abstract":"<p><strong>Introduction: </strong>In Europe, one in three school-aged children live with overweight or obesity and are at high risk of continuing to be affected by it throughout their lives. The objective of our study was to quantify the economic burden of obesity among Austrian children and adolescents born between 2000 and 2019.</p><p><strong>Methods: </strong>We used obesity projections and the share of young adults assumed to have remained with obesity since childhood or adolescence to project the lifetime costs of birth cohorts from 2000 to 2019. We estimated lifetime costs per individual using population-attributable fractions, considering a discount rate of 3%, obesity-associated mortality, an obesity-associated \"income penalty,\" and future cost increases in the healthcare system.</p><p><strong>Results: </strong>For Austria, we estimated that around 95,000 of all children and adolescents in 2019 remain with obesity as adults, which leads to a present value of EUR 9.2 billion or an annuity of approximately EUR 285 million (0.07% of GDP in 2019). Approximately 15% of costs arise from direct costs and 85% from indirect costs.</p><p><strong>Conclusion: </strong>We highlighted the long-term economic burden of early-onset obesity in Austria and concluded that public health programs addressing children and adolescents with obesity could relieve high costs not only for individuals but also for society.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-7"},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutrition for Optimal Lactation.","authors":"Otilia Perichart-Perera","doi":"10.1159/000541757","DOIUrl":"https://doi.org/10.1159/000541757","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is the ideal method of feeding for all newborns and is associated with multiple positive health outcomes. Human milk provides all essential nutrients and bioactive molecules needed for optimal infant health and development. Maternal nutrition during lactation plays an important role in supporting breastfeeding and in preventing nutrition and metabolic imbalances. The aim of this narrative review was to describe the most prevalent nutrition issues in lactating women and provide a summary of current diet recommendations as well as controversies on supplementation, in order to facilitate the information for clinicians and health professionals.</p><p><strong>Summary: </strong>Breastfeeding is a nutritionally demanding stage and adequate nutrition is key to avoid alterations in maternal nutritional status, to produce an adequate quantity of milk with good quality, and to avoid nutrition programming of diseases. Anemia and vitamin D, A, iodine, and iron deficiencies are common, while obesity and metabolic diseases keep rising. Inadequate maternal intake of many nutrients is also frequent in this stage.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-12"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutrition during Pregnancy and Birth Outcomes.","authors":"Nandita Perumal, Alison D Gernand","doi":"10.1159/000541205","DOIUrl":"https://doi.org/10.1159/000541205","url":null,"abstract":"<p><strong>Background: </strong>The \"first 1,000 days\" - the duration of pregnancy and the first 2 years of life - is widely recognized as a sensitive period of early life, with implications for health and developmental outcomes throughout the life course. Optimal nutrition during pregnancy is therefore essential to reduce the risk of adverse pregnancy outcomes and support healthy life trajectories.</p><p><strong>Summary: </strong>This narrative review summarizes the physiological changes during pregnancy and how these changes affect the energy and nutrient requirements in pregnancy to support maternal, placental, and fetal development and tissue accretion. Recommendations for weight gain and macro- and micronutrient requirements during pregnancy are summarized along with the current evidence.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-14"},"PeriodicalIF":3.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prehabilitation: Do We Need Metabolic Flexibility?","authors":"Nicholas Tetlow, John Whittle","doi":"10.1159/000545266","DOIUrl":"10.1159/000545266","url":null,"abstract":"<p><strong>Background: </strong>Metabolic flexibility, the capacity to switch between energy sources in response to changing physiological demands, emerges as a critical determinant of perioperative resilience. In the context of surgery, where metabolic demands are high and energy homeostasis is disrupted, patients with metabolic inflexibility may experience worse outcomes due to impaired immune responses and heightened insulin resistance, resulting in prolonged recovery times.</p><p><strong>Summary: </strong>This article explores the implications of metabolic flexibility in the perioperative period and examines the potential for prehabilitation strategies, such as targeted exercise and nutritional interventions, to improve patient readiness for surgery. Cardiopulmonary exercise testing is discussed as a valuable assessment tool for metabolic flexibility, capable of providing insights into a patient's fuel adaptability and overall metabolic health preoperatively. Evidence suggests that targeted exercise and nutritional strategies can enhance mitochondrial function, improve nutrient-sensing pathways, and increase substrate oxidation, which may reduce perioperative complications and support immune resilience.</p><p><strong>Key messages: </strong>Future research should prioritise refining methods to identify metabolically inflexible patients and tailoring prehabilitation interventions to optimise metabolic flexibility. Enhancing perioperative metabolic readiness is important for populations vulnerable to metabolic dysfunction, such as those with obesity, diabetes, and cancer. Aligning metabolic optimisation with surgical recovery demands may help establish new standards in perioperative care and improve patient outcomes.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"223-233"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}