BACKGROUND Cold exposure has traditionally been considered a pathological factor that can easily impair gastrointestinal(GI)digestion.Shihosogan-tang(ST),Yijung-tang(YT),and Pyeongwi-san(PS)are well-known herbal formu...BACKGROUND Cold exposure has traditionally been considered a pathological factor that can easily impair gastrointestinal(GI)digestion.Shihosogan-tang(ST),Yijung-tang(YT),and Pyeongwi-san(PS)are well-known herbal formulas frequently used to treat GI disorders in East Asia.AIM To compare the effects of these herbal formulas on GI motility and investigate their mechanisms of action using a cold stress(CS)-induced dyspepsia mouse model.METHODS C57BL/6J mice were exposed to CS by immersion in cold water(10±1℃)while being restrained in conical tubes for 1 hour.This procedure was repeated six times over 2 weeks.Herbal formulas or mosapride(positive control)were administered orally five times per week over a 2-week period.RESULTS The pre-test results revealed that CS,rather than restraint stress,significantly delayed gut motility in mice.However,PS and ST notably improved gastric emptying and intestinal transit,surpassing YT.Additionally,PS and ST significantly reduced gastric potential of hydrogen and increased pepsin and lipase gene expression compared to CS.The observed mechanisms likely involved increased gastric acidity and enhanced levels of digestive enzymes,such as pepsin and lipase.Furthermore,PS administration elevated GI hormone levels and metabolites related to the gut microbiota(5-hydroxytryptamine and short-chain fatty acid)more effectively than ST and YT treatments.CONCLUSION PS more effectively alleviated CS-induced GI dysfunction than both YT and ST.These comparative findings offer valuable insights for clinical applications in the treatment of cold-related digestive disorders.展开更多
Inflammatory bowel disease(IBD),comprising Crohn’s disease and ulcerative colitis,represents the two predominant clinical entities within this spectrum of gastrointestinal disorders.Current evidence indicates that th...Inflammatory bowel disease(IBD),comprising Crohn’s disease and ulcerative colitis,represents the two predominant clinical entities within this spectrum of gastrointestinal disorders.Current evidence indicates that the etiology of IBD is multifactorial,involving a complex interplay between host genetic susceptibility and environmental determinants.In recent years,non-pharmacological strategies such as physical exercise and vagus nerve stimulation have gained increasing attention as adjunctive therapeutic approaches.Vagus nerve stimulation has emerged as a promising therapeutic modality,particularly in conditions characterized by autonomic dysfunction and diminished vagal tone.Conversely,vagotomy,by disrupting vagal control,abolishes parasympathetic reflexes and may potentiate inflammatory responses and exacerbate IBD symptomatology under stress conditions.Physical exercise has likewise been investigated as a non-pharmacological intervention in Crohn’s disease and ulcerative colitis.Although the precise mechanisms remain to be fully elucidated,accumulating evidence suggests that skeletal muscle contractions promote the secretion of myokines,with recognized anti-inflammatory properties.These myokines act on the intestinal microenvironment,conferring protection against malignant transformation and modulating the composition and function of the gut microbiota.In this review,we critically examine the interplay between physical exercise,vagus nerve stimulation,and vagotomy in the pathophysiology and management of IBD,with particular emphasis on their immunomodulatory and therapeutic potential.展开更多
A symbiotic relationship has set up between the gut microbiota and its host in the course of evolution,forming an interkingdom consortium.The gut offers a favorable ecological niche for microbial communities,with the ...A symbiotic relationship has set up between the gut microbiota and its host in the course of evolution,forming an interkingdom consortium.The gut offers a favorable ecological niche for microbial communities,with the whole body and external factors(e.g.,diet or medications)contributing to modulating this microenvironment.Reciprocally,the gut microbiota is important for maintaining health by acting not only on the gut mucosa but also on other organs.However,failure in one or another of these two partners can lead to the breakdown in their symbiotic equilibrium and contribute to disease onset and/or progression.Several microbial and host processes are devoted to facing up the stress that could alter the symbiosis,ensuring the resilience of the ecosystem.Among these processes,autophagy is a host catabolic process integrating a wide range of stress in order to maintain cell survival and homeostasis.This cytoprotective mechanism,which is ubiquitous and operates at basal level in all tissues,can be rapidly down-or upregulated at the transcriptional,post-transcriptional,or post-translational levels,to respond to various stress conditions.Because of its sensitivity to all,metabolic-,immune-,and microbial-derived stimuli,autophagy is at the crossroad of the dialogue between changes occurring in the gut microbiota and the host responses.In this review,we first delineate the modulation of host autophagy by the gut microbiota locally in the gut and in peripheral organs.Then,we describe the autophagy-related mechanisms affecting the gut microbiota.We conclude this review with the current challenges and an outlook toward the future interventions aiming at modulating host autophagy by targeting the gut microbiota.展开更多
Background:Regular physical activity(PA)has been postulated to improve,or at least maintain,immunity across the life span.However,the link between physical(in)activity and coronavirus disease 2019(COVID-19)remains to ...Background:Regular physical activity(PA)has been postulated to improve,or at least maintain,immunity across the life span.However,the link between physical(in)activity and coronavirus disease 2019(COVID-19)remains to be established.This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.Methods:Hospitalized patients with COVID-19(mean age:54.9 years)were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo(a quaternary referral teaching hospital)and from Ibirapuera Field Hospital,both located in Sao Paulo,Brazil.PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity.The primary outcome was hospital length of stay.The secondary outcomes were mortality,admission to the intensive care unit(ICU),and mechanical ventilation requirement.Results:The median hospital length of stay was 7.0§4.0 days,median§IQR;3.3%of patients died,13.8%were admitted to the ICU,and 8.6%required mechanical ventilation.Adjusted linear regression models showed that PA indices were not associated with hospital length of stay(work index:b=-0.57(95%confidence interval(95%CI):-1.80 to 0.65),p=0.355;sport index:b=0.43(95%CI:-0.94 to 1.80),p=0.536;leisure-time index:b=1.18(95%CI:-0.22 to 2.59),p=0.099;and total activity index:b=0.20(95%CI:-0.48 to 0.87),p=0.563).None of the PA indices were associated with mortality,admission to the ICU,or mechanical ventilation requirement(all p>0.050).Conclusion:Among hospitalized patients with COVID-19,PA did not independently associate with hospital length of stay or any other clinically relevant outcomes.These findings should be interpreted as meaning that,among already hospitalized patients with more severe forms of COVID-19,being active is a potential protective factor likely outweighed by a cluster of comorbidities(e.g.,type 2 diabetes,hypertension,weight excess)and older age,suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.展开更多
Background: Aloe vera has been used by many civilizations throughout history due to the numerous properties attributed. Gastro oesophageal reflux disease is a common disorder with consequences for the patient’s healt...Background: Aloe vera has been used by many civilizations throughout history due to the numerous properties attributed. Gastro oesophageal reflux disease is a common disorder with consequences for the patient’s health related quality of life. Aims: The purpose of this study was to assess the benefits of the Aloe vera in 80 patients with gastro oesophageal reflux. Methods: This is probably the first randomised and double-blind trail ever performed on this subject. The study included eight weeks of treatment with milk enriched with Aloe vera or placebo. Data of diet (frequency questionnaire), symptoms (gastrointestinal symptom rating scale) and quality of life (quality of life in reflux and disease) were obtained. Results: So far, there has been hardly any proof that Aloe vera decreases symptoms of reflux disease;on the contrary, a lower percentage of remission of pain is observed among the Aloe vera group. As long as its effectiveness has not been proven properly, the use of Aloe vera in reflux disease cannot be recommend. Conclusion: Aloe vera does not have a beneficial effect on reflux disease under the study conditions.展开更多
Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental a...Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental and physical quality of life. Study Design: This analysis included 8335 participants from the 'Seguimiento Universidad de Navarra' (SUN) Project (a multipurpose, dynamic cohort). Methods: The consumption of commercial bakery, fast food and soft drinks was assessed through a validated food-frequency questionnaire at baseline. Quality of life was measured after 4 years of follow-up with the Short-Form 36 (SF-36) Health Survey. Generalized Linear Models were fit to assess the regression coefficients (b) and their 95% confidence intervals (95% CI) for the association between commercial bakery, fast food and soft drinks consumption and each domain and the two standardized measures of the SF-36. Results: As compared to the participants in the lowest quintile of consumption, those participants in the highest quintile of consumption of commercial bakery, fast food and soft drinks showed a score significantly lower (>2 points) for vitality (b = -2.14, 95% CI = -3.31 to -0.96), role emotional (b = -2.23, 95% CI = -4.33 to -0.13), and role physical (b = -2.31, 95% IC = -4.26 to -0.36) domains with statistically significant dose-response relationships (p for trend < 0.05). When the food groups were analysed separately, significant inverse associations were found only for commercial bakery and fast-food consumption. Conclusions: The results suggest that high consumption of commercial bakery, fast-food and soft drinks at baseline was associated with worse scores on self-perceived quality of life. This association was stronger for the mental domains of the SF-36.展开更多
Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was p...Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was performed for randomized controlled trials in PubMed,Scopus,Web of Science,and SciELO.Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity,metabolic risk,and inflammation with a control group(CG) were included.Independent reviewers selected the studies,extracted the data,and performed the risk of bias and certainty of the evidence(Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)) evaluations.Total body and abdominal adiposity,blood lipids,glucose,and C-reactive protein were included for meta-analysis.A random-effects model,standardized mean difference(Hedges’ g),and 95% confidence interval(95%CI) were used for meta-analysis.Results:Twenty randomized controlled trials(overall risk of bias:some concerns;GRADE:low to very low) with overweight/obese postmenopausal and older females were included.RT groups were divided into low-volume RT(LVRT,~44 sets/week) and high-volume RT(HVRT,~77 sets/week).Both RT groups presented improved body adiposity,metabolic risk,and inflammation when compared to CG.However,HVRT demonstrated higher effect sizes than LVRT for glucose(HVRT=-1.19;95%CI:-1.63 to-0.74;LVRT=-0.78;95%CI:-1.15 to-0.41) and C-reactive protein(HVRT=-1.00;95%CI:-1.32 to-0.67;LVRT=-0.34;95%CI,-0.63 to-0.04)) when compared to CG.Conclusion:Compared to CG,HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.展开更多
Hospitalized patients affected by coronavirus disease 19(COVID-19)have a sustained pro-inflammatory state and recurrent gastrointestinal symptoms that correlate with a decline in the nutritional status,which is direct...Hospitalized patients affected by coronavirus disease 19(COVID-19)have a sustained pro-inflammatory state and recurrent gastrointestinal symptoms that correlate with a decline in the nutritional status,which is directly related to poor immune response and clinical evolution.Nutritional therapy has proven crucial in COVID-19 treatment through the provision of adequate amounts of nutrients.Since the beginning of the pandemic,medical societies have mobilized to provide practical nutritional guidelines to support decision-making;despite this,there are only a few studies dedicated to compiling the most relevant recommendations.In this narrative review,we aimed to summarize and stratify the current scientific literature on nutritional support for hospitalized COVID-19 patients.We carried out a literature review from three databases between January 2020 and July 2021,using nutrition therapy(or medical nutrition or enteral nutrition or parental nutrition or nutritional support)and COVID-19(SARS-CoV-2 infection)as the search terms.Only those studies that evaluated adult hospitalized patients with admissions to wards,specific clinics,or intensive care units were included.The nutritional intervention considered was that of specific nutritional support via oral,enteral,or parenteral modes.A total of 37 articles were included.In general,the nutritional care provided to COVID-19 patients follows the same premises as for other patients,i.e.,it opts for the most physiological route and meets nutritional demands based on the clinical condition.However,some protocols that minimize the risk of contamination exposure for the health team have to be considered.Energy requirements varied from 15 kcal/kg/day to 30 kcal/kg/day and protein goals from 1.2 g/kg/day to 2 g/kg/day.In both cases,the ramp protocol for increased supply should be considered.In cases of enteral therapy,ready-to-use diet and continuous mode are recommended.Attention to refeeding syndrome is essential when parenteral nutrition is used.展开更多
Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate ...Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with obesity.Methods The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)status.They were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(ISM1)serum levels.This population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in children.Furthermore,the study population had blood whole-genome DNA methylation examined,allowing deepening into the obesity–ISM1 molecular relationship.Results Higher serum ISM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)boys.ISM1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in boys.Although we did not find associations between ISM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DNA methylation levels in two-enhancer-related CpG sites of ISM1(cg03304641 and cg14269097)were associated with serum levels of ISM1 in children.Conclusions ISM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in children.Further studies including a longitudinal design during puberty are needed.展开更多
Objective Diabetes remission has emerged as an achievable treatment goal,shifting the focus of care from increasing medication use to restoring metabolic health.While clinical trials show that remission is possible in...Objective Diabetes remission has emerged as an achievable treatment goal,shifting the focus of care from increasing medication use to restoring metabolic health.While clinical trials show that remission is possible in controlled settings,evidence remains limited regarding its implementation in routine care within middle-income,rice-based dietary contexts.This study aims to explore healthcare provider experiences with implementing diabetes remission services in Thailand,focusing on dietary strategies,deprescription practices and patient management in routine care settings.Design Qualitative study using semi-structured,in-depth interviews,supplemented by structured questionnaires and programme documents.Setting Thirteen healthcare facilities across six Thai regions and two national-level professional or policy organisations.Participants 17 key informants purposively sampled for regional,institutional and professional diversity,including physicians,nurses,dietitians and national programme leaders.Data were collected and analysed iteratively until no new insights emerged.Thematic content analysis was conducted in QDA Miner Lite v3.0 with investigator triangulation.Result Five major themes emerged:key strengths,success factors,nutritional approaches and lifestyle modification,implementation challenges,and development strategies.Multidisciplinary teamwork,personalised care plans and regular monitoring facilitated service delivery.Culturally adapted dietary strategies,such as low-carbohydrate Thai-style meals and intermittent fasting,were widely used.Challenges included unclear clinical guidelines,limited staffing and technological disparities.Medication deprescription varied across sites due to the absence of standardised protocols.Healthcare providers emphasised the need for community engagement and policy support to enable scale-up.Real-world implementation of diabetes remission services is feasible but challenged by systemic constraints and contextual variability.Flexible,culturally tailored approaches,empowered care teams and supportive policy frameworks are essential for sustainability.展开更多
Background Preschoolers and young children are vulnerable to psychosocial and behavioral disorders linked to lifestyle factors such as screen time and sleep disturbances.Our study examines the relationship between scr...Background Preschoolers and young children are vulnerable to psychosocial and behavioral disorders linked to lifestyle factors such as screen time and sleep disturbances.Our study examines the relationship between screen time and adherence to recommendations with children's behavioral and emotional difficulties,with a focus on the role of sleep duration.Methods Cross-sectional analyses were conducted within the multicenter prospective Childhood Obesity Risk Assessment Longitudinal Study(CORALS),which included 1420 children aged 3-6 years.Screen time(hours/day)and adherence to recommendations(≤2 hours/day)were assessed.Behavioral and emotional difficulties were measured via the strengths and difficulties questionnaire.Multivariable linear and logistic regression models were used to estimate associations between screen time(continuous and dichotomous)and strengths and difficulties questionnaire scores,adjusting for potential confounders.We also tested the moderating effect of sleep and conducted isotemporal substitution analyses replacing screen time with sleep duration.Results Higher screen time was associated with higher total strengths and difficulties questionnaire scores[β95%confidence interval(CI),0.35(0.10,0.61)],emotional symptoms[0.10(0.01,0.19)],conduct problems[0.10(0.01,0.18)],and greater odds of exceeding the 16-point strengths and difficulties questionnaire cutofffor behavioral and emotional difficulties[odds ratio(OR)(95%CI),1.21(1.04,1.41)].Children who adhered to screen time recommendations had lower strengths and difficulties questionnaire total scores[β(95%CI),-0.64(-1.19,-0.10)]and odds of experiencing behavioral and emotional difficulties[OR(95%CI),0.67(0.47,0.95)].Sleep duration moderated the screen time–strengths and difficulties questionnaire association(P=0.020).The isotemporal substitution of screen time for sleep duration was associated with lower strengths and difficulties questionnaire scores across all subscales,except for prosocial behavior.Conclusions Higher screen time was associated with greater emotional and behavioral difficulties,whereas adherence to screen time recommendations and adequate sleep duration were inversely associated.Managing screen time and promoting sleep are crucial for children's well-being.展开更多
基金Supported by the National Research Foundation of Korea,No.2022M3A9E4017033。
文摘BACKGROUND Cold exposure has traditionally been considered a pathological factor that can easily impair gastrointestinal(GI)digestion.Shihosogan-tang(ST),Yijung-tang(YT),and Pyeongwi-san(PS)are well-known herbal formulas frequently used to treat GI disorders in East Asia.AIM To compare the effects of these herbal formulas on GI motility and investigate their mechanisms of action using a cold stress(CS)-induced dyspepsia mouse model.METHODS C57BL/6J mice were exposed to CS by immersion in cold water(10±1℃)while being restrained in conical tubes for 1 hour.This procedure was repeated six times over 2 weeks.Herbal formulas or mosapride(positive control)were administered orally five times per week over a 2-week period.RESULTS The pre-test results revealed that CS,rather than restraint stress,significantly delayed gut motility in mice.However,PS and ST notably improved gastric emptying and intestinal transit,surpassing YT.Additionally,PS and ST significantly reduced gastric potential of hydrogen and increased pepsin and lipase gene expression compared to CS.The observed mechanisms likely involved increased gastric acidity and enhanced levels of digestive enzymes,such as pepsin and lipase.Furthermore,PS administration elevated GI hormone levels and metabolites related to the gut microbiota(5-hydroxytryptamine and short-chain fatty acid)more effectively than ST and YT treatments.CONCLUSION PS more effectively alleviated CS-induced GI dysfunction than both YT and ST.These comparative findings offer valuable insights for clinical applications in the treatment of cold-related digestive disorders.
文摘Inflammatory bowel disease(IBD),comprising Crohn’s disease and ulcerative colitis,represents the two predominant clinical entities within this spectrum of gastrointestinal disorders.Current evidence indicates that the etiology of IBD is multifactorial,involving a complex interplay between host genetic susceptibility and environmental determinants.In recent years,non-pharmacological strategies such as physical exercise and vagus nerve stimulation have gained increasing attention as adjunctive therapeutic approaches.Vagus nerve stimulation has emerged as a promising therapeutic modality,particularly in conditions characterized by autonomic dysfunction and diminished vagal tone.Conversely,vagotomy,by disrupting vagal control,abolishes parasympathetic reflexes and may potentiate inflammatory responses and exacerbate IBD symptomatology under stress conditions.Physical exercise has likewise been investigated as a non-pharmacological intervention in Crohn’s disease and ulcerative colitis.Although the precise mechanisms remain to be fully elucidated,accumulating evidence suggests that skeletal muscle contractions promote the secretion of myokines,with recognized anti-inflammatory properties.These myokines act on the intestinal microenvironment,conferring protection against malignant transformation and modulating the composition and function of the gut microbiota.In this review,we critically examine the interplay between physical exercise,vagus nerve stimulation,and vagotomy in the pathophysiology and management of IBD,with particular emphasis on their immunomodulatory and therapeutic potential.
基金Agence Nationale de la Recherche,No.ANR-11-LABX-0021-01French“Investissements d’Avenir”program,project ISITE-BFC,No.ANR-15-IDEX-0003+2 种基金Conseil Régional de Bourgogne,Franche-Comté,No.RECH-E1INV-000131-0-EarlEATInstitut Carnot Qualiment,INPROBIAUS grantFEDER(European Funding for Regional Economic Development),EARLEAT,PO FEDER-FSE Bourgogne 2014-2020 BG 0027905 BG 0027810.
文摘A symbiotic relationship has set up between the gut microbiota and its host in the course of evolution,forming an interkingdom consortium.The gut offers a favorable ecological niche for microbial communities,with the whole body and external factors(e.g.,diet or medications)contributing to modulating this microenvironment.Reciprocally,the gut microbiota is important for maintaining health by acting not only on the gut mucosa but also on other organs.However,failure in one or another of these two partners can lead to the breakdown in their symbiotic equilibrium and contribute to disease onset and/or progression.Several microbial and host processes are devoted to facing up the stress that could alter the symbiosis,ensuring the resilience of the ecosystem.Among these processes,autophagy is a host catabolic process integrating a wide range of stress in order to maintain cell survival and homeostasis.This cytoprotective mechanism,which is ubiquitous and operates at basal level in all tissues,can be rapidly down-or upregulated at the transcriptional,post-transcriptional,or post-translational levels,to respond to various stress conditions.Because of its sensitivity to all,metabolic-,immune-,and microbial-derived stimuli,autophagy is at the crossroad of the dialogue between changes occurring in the gut microbiota and the host responses.In this review,we first delineate the modulation of host autophagy by the gut microbiota locally in the gut and in peripheral organs.Then,we describe the autophagy-related mechanisms affecting the gut microbiota.We conclude this review with the current challenges and an outlook toward the future interventions aiming at modulating host autophagy by targeting the gut microbiota.
基金supported by Sao Paulo Research Foundation-FAPESP(grants No.2015/26937-4,No.2019/18039-7,No.2019/24782-4,No.2020/11102-2,No.2016/00006-7 and No.2020/05752-4,and No.2017/13552-2)RMRP,HR,and BG were supported by Conselho Nacional de Desenvolvimento Cient-ıfico e Tecnologico(grants No.305556/2017-7,No.301571/2017-1,and No.301914/2017-6)。
文摘Background:Regular physical activity(PA)has been postulated to improve,or at least maintain,immunity across the life span.However,the link between physical(in)activity and coronavirus disease 2019(COVID-19)remains to be established.This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.Methods:Hospitalized patients with COVID-19(mean age:54.9 years)were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo(a quaternary referral teaching hospital)and from Ibirapuera Field Hospital,both located in Sao Paulo,Brazil.PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity.The primary outcome was hospital length of stay.The secondary outcomes were mortality,admission to the intensive care unit(ICU),and mechanical ventilation requirement.Results:The median hospital length of stay was 7.0§4.0 days,median§IQR;3.3%of patients died,13.8%were admitted to the ICU,and 8.6%required mechanical ventilation.Adjusted linear regression models showed that PA indices were not associated with hospital length of stay(work index:b=-0.57(95%confidence interval(95%CI):-1.80 to 0.65),p=0.355;sport index:b=0.43(95%CI:-0.94 to 1.80),p=0.536;leisure-time index:b=1.18(95%CI:-0.22 to 2.59),p=0.099;and total activity index:b=0.20(95%CI:-0.48 to 0.87),p=0.563).None of the PA indices were associated with mortality,admission to the ICU,or mechanical ventilation requirement(all p>0.050).Conclusion:Among hospitalized patients with COVID-19,PA did not independently associate with hospital length of stay or any other clinically relevant outcomes.These findings should be interpreted as meaning that,among already hospitalized patients with more severe forms of COVID-19,being active is a potential protective factor likely outweighed by a cluster of comorbidities(e.g.,type 2 diabetes,hypertension,weight excess)and older age,suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.
文摘Background: Aloe vera has been used by many civilizations throughout history due to the numerous properties attributed. Gastro oesophageal reflux disease is a common disorder with consequences for the patient’s health related quality of life. Aims: The purpose of this study was to assess the benefits of the Aloe vera in 80 patients with gastro oesophageal reflux. Methods: This is probably the first randomised and double-blind trail ever performed on this subject. The study included eight weeks of treatment with milk enriched with Aloe vera or placebo. Data of diet (frequency questionnaire), symptoms (gastrointestinal symptom rating scale) and quality of life (quality of life in reflux and disease) were obtained. Results: So far, there has been hardly any proof that Aloe vera decreases symptoms of reflux disease;on the contrary, a lower percentage of remission of pain is observed among the Aloe vera group. As long as its effectiveness has not been proven properly, the use of Aloe vera in reflux disease cannot be recommend. Conclusion: Aloe vera does not have a beneficial effect on reflux disease under the study conditions.
文摘Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental and physical quality of life. Study Design: This analysis included 8335 participants from the 'Seguimiento Universidad de Navarra' (SUN) Project (a multipurpose, dynamic cohort). Methods: The consumption of commercial bakery, fast food and soft drinks was assessed through a validated food-frequency questionnaire at baseline. Quality of life was measured after 4 years of follow-up with the Short-Form 36 (SF-36) Health Survey. Generalized Linear Models were fit to assess the regression coefficients (b) and their 95% confidence intervals (95% CI) for the association between commercial bakery, fast food and soft drinks consumption and each domain and the two standardized measures of the SF-36. Results: As compared to the participants in the lowest quintile of consumption, those participants in the highest quintile of consumption of commercial bakery, fast food and soft drinks showed a score significantly lower (>2 points) for vitality (b = -2.14, 95% CI = -3.31 to -0.96), role emotional (b = -2.23, 95% CI = -4.33 to -0.13), and role physical (b = -2.31, 95% IC = -4.26 to -0.36) domains with statistically significant dose-response relationships (p for trend < 0.05). When the food groups were analysed separately, significant inverse associations were found only for commercial bakery and fast-food consumption. Conclusions: The results suggest that high consumption of commercial bakery, fast-food and soft drinks at baseline was associated with worse scores on self-perceived quality of life. This association was stronger for the mental domains of the SF-36.
基金supported by the Minas Gerais State University (UEMG/Brazil)a Research Productivity Scholarship Program (UEMG-PQ08/2021)+1 种基金a doctorate scholarship from the National Council of Technological and Scientific Development (CNPq/Brazil-Process140473/2020-3)a doctorate scholarship fromthe Coordination of Improvement of Higher Education Personnel (CAPES/Brazil-Code 001)。
文摘Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was performed for randomized controlled trials in PubMed,Scopus,Web of Science,and SciELO.Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity,metabolic risk,and inflammation with a control group(CG) were included.Independent reviewers selected the studies,extracted the data,and performed the risk of bias and certainty of the evidence(Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)) evaluations.Total body and abdominal adiposity,blood lipids,glucose,and C-reactive protein were included for meta-analysis.A random-effects model,standardized mean difference(Hedges’ g),and 95% confidence interval(95%CI) were used for meta-analysis.Results:Twenty randomized controlled trials(overall risk of bias:some concerns;GRADE:low to very low) with overweight/obese postmenopausal and older females were included.RT groups were divided into low-volume RT(LVRT,~44 sets/week) and high-volume RT(HVRT,~77 sets/week).Both RT groups presented improved body adiposity,metabolic risk,and inflammation when compared to CG.However,HVRT demonstrated higher effect sizes than LVRT for glucose(HVRT=-1.19;95%CI:-1.63 to-0.74;LVRT=-0.78;95%CI:-1.15 to-0.41) and C-reactive protein(HVRT=-1.00;95%CI:-1.32 to-0.67;LVRT=-0.34;95%CI,-0.63 to-0.04)) when compared to CG.Conclusion:Compared to CG,HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.
文摘Hospitalized patients affected by coronavirus disease 19(COVID-19)have a sustained pro-inflammatory state and recurrent gastrointestinal symptoms that correlate with a decline in the nutritional status,which is directly related to poor immune response and clinical evolution.Nutritional therapy has proven crucial in COVID-19 treatment through the provision of adequate amounts of nutrients.Since the beginning of the pandemic,medical societies have mobilized to provide practical nutritional guidelines to support decision-making;despite this,there are only a few studies dedicated to compiling the most relevant recommendations.In this narrative review,we aimed to summarize and stratify the current scientific literature on nutritional support for hospitalized COVID-19 patients.We carried out a literature review from three databases between January 2020 and July 2021,using nutrition therapy(or medical nutrition or enteral nutrition or parental nutrition or nutritional support)and COVID-19(SARS-CoV-2 infection)as the search terms.Only those studies that evaluated adult hospitalized patients with admissions to wards,specific clinics,or intensive care units were included.The nutritional intervention considered was that of specific nutritional support via oral,enteral,or parenteral modes.A total of 37 articles were included.In general,the nutritional care provided to COVID-19 patients follows the same premises as for other patients,i.e.,it opts for the most physiological route and meets nutritional demands based on the clinical condition.However,some protocols that minimize the risk of contamination exposure for the health team have to be considered.Energy requirements varied from 15 kcal/kg/day to 30 kcal/kg/day and protein goals from 1.2 g/kg/day to 2 g/kg/day.In both cases,the ramp protocol for increased supply should be considered.In cases of enteral therapy,ready-to-use diet and continuous mode are recommended.Attention to refeeding syndrome is essential when parenteral nutrition is used.
基金supported by the Plan Nacional de Investigación Científca,Desarrollo e Innovación Tecnológica(I+D+I)Instituto de Salud Carlos III-Health Research Funding(FONDOS FEDER)(PI051968,PI1102042 and PI1600871)Maria C.Rico is funded by Redes temáticas de Investigación cooperativa RETIC(Red SAMID RD12/0026/0015)and the Mapfre Foundation.
文摘Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with obesity.Methods The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)status.They were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(ISM1)serum levels.This population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in children.Furthermore,the study population had blood whole-genome DNA methylation examined,allowing deepening into the obesity–ISM1 molecular relationship.Results Higher serum ISM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)boys.ISM1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in boys.Although we did not find associations between ISM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DNA methylation levels in two-enhancer-related CpG sites of ISM1(cg03304641 and cg14269097)were associated with serum levels of ISM1 in children.Conclusions ISM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in children.Further studies including a longitudinal design during puberty are needed.
文摘Objective Diabetes remission has emerged as an achievable treatment goal,shifting the focus of care from increasing medication use to restoring metabolic health.While clinical trials show that remission is possible in controlled settings,evidence remains limited regarding its implementation in routine care within middle-income,rice-based dietary contexts.This study aims to explore healthcare provider experiences with implementing diabetes remission services in Thailand,focusing on dietary strategies,deprescription practices and patient management in routine care settings.Design Qualitative study using semi-structured,in-depth interviews,supplemented by structured questionnaires and programme documents.Setting Thirteen healthcare facilities across six Thai regions and two national-level professional or policy organisations.Participants 17 key informants purposively sampled for regional,institutional and professional diversity,including physicians,nurses,dietitians and national programme leaders.Data were collected and analysed iteratively until no new insights emerged.Thematic content analysis was conducted in QDA Miner Lite v3.0 with investigator triangulation.Result Five major themes emerged:key strengths,success factors,nutritional approaches and lifestyle modification,implementation challenges,and development strategies.Multidisciplinary teamwork,personalised care plans and regular monitoring facilitated service delivery.Culturally adapted dietary strategies,such as low-carbohydrate Thai-style meals and intermittent fasting,were widely used.Challenges included unclear clinical guidelines,limited staffing and technological disparities.Medication deprescription varied across sites due to the absence of standardised protocols.Healthcare providers emphasised the need for community engagement and policy support to enable scale-up.Real-world implementation of diabetes remission services is feasible but challenged by systemic constraints and contextual variability.Flexible,culturally tailored approaches,empowered care teams and supportive policy frameworks are essential for sustainability.
基金Instituto Danone,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición,Generalitat Valenciana,PROMETEO 21/2021Dolores Corella,Instituto de Salud Carlos III,PI24/00711,Nancy Babio。
文摘Background Preschoolers and young children are vulnerable to psychosocial and behavioral disorders linked to lifestyle factors such as screen time and sleep disturbances.Our study examines the relationship between screen time and adherence to recommendations with children's behavioral and emotional difficulties,with a focus on the role of sleep duration.Methods Cross-sectional analyses were conducted within the multicenter prospective Childhood Obesity Risk Assessment Longitudinal Study(CORALS),which included 1420 children aged 3-6 years.Screen time(hours/day)and adherence to recommendations(≤2 hours/day)were assessed.Behavioral and emotional difficulties were measured via the strengths and difficulties questionnaire.Multivariable linear and logistic regression models were used to estimate associations between screen time(continuous and dichotomous)and strengths and difficulties questionnaire scores,adjusting for potential confounders.We also tested the moderating effect of sleep and conducted isotemporal substitution analyses replacing screen time with sleep duration.Results Higher screen time was associated with higher total strengths and difficulties questionnaire scores[β95%confidence interval(CI),0.35(0.10,0.61)],emotional symptoms[0.10(0.01,0.19)],conduct problems[0.10(0.01,0.18)],and greater odds of exceeding the 16-point strengths and difficulties questionnaire cutofffor behavioral and emotional difficulties[odds ratio(OR)(95%CI),1.21(1.04,1.41)].Children who adhered to screen time recommendations had lower strengths and difficulties questionnaire total scores[β(95%CI),-0.64(-1.19,-0.10)]and odds of experiencing behavioral and emotional difficulties[OR(95%CI),0.67(0.47,0.95)].Sleep duration moderated the screen time–strengths and difficulties questionnaire association(P=0.020).The isotemporal substitution of screen time for sleep duration was associated with lower strengths and difficulties questionnaire scores across all subscales,except for prosocial behavior.Conclusions Higher screen time was associated with greater emotional and behavioral difficulties,whereas adherence to screen time recommendations and adequate sleep duration were inversely associated.Managing screen time and promoting sleep are crucial for children's well-being.
