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Type 2 diabetes mellitus (T2DM) has become a global epidemic. To effectively control T2DM, individuals must adhere to a high-quality diet that encompasses not only healthy dietary patterns but also promotes positive eating behaviors. We conducted a cross-sectional study on 314 patients with T2DM, and we evaluated the diet quality and also examined the associations between eating behavior, diet quality, and anthropometric and clinical factors in T2DM patients. We used the Diet Quality Index-International and Dutch Eating Behavior Questionnaire to assess dietary characteristics. We found that women had a significantly higher diet quality than men (61.40 vs. 58.68, p = 0.002) but were also more prone to emotional eating (2.00 vs. 1.53, p < 0.001) and restrained eating (2.39 vs. 2.05, p = 0.002). Restrained eating correlated with duration of diabetes (r = −0.169, p = 0.003), body mass index (r = 0.182, p = 0.001), and external eating with glycated hemoglobin (r = 0.114, p = 0.044). Patients with emotional eating had a higher vitamin C adequacy score (β = 0.117, p = 0.045). External eating was positively associated with grain adequacy (β = 0.208, p < 0.001) and negatively associated with empty-calorie food moderation score (β = −0.125, p = 0.032). For restrained eating, we found associations with vitamin C adequacy (β = −0.138, p = 0.017) and fruit adequacy (β = 0.125, p = 0.033). In conclusion, the results of this study provide valuable insight into dietary behavior and emphasize the importance of promoting healthy eating habits for T2DM patients. [ABSTRACT FROM AUTHOR]

Healthy dietary patterns during pregnancy are crucial for ensuring maternal and foetal health outcomes. Numerous methodologies exist for assessing the diet of pregnant women, including dietary patterns and various appraisal tools of diet quality. This study aimed to assess the dietary patterns and diet quality of pregnant women and to investigate the relationship between dietary patterns, diet quality estimators, and the adequacy of nutrient intake. EPIC FFQ was applied to a sample of 251 pregnant women, and questionnaires were interpreted with the FETA program. Dietary patterns were then determined by means of principal component analysis. Our results showed a substantial association between dietary patterns and total diet quality, as measured by the Diet Quality Index for Pregnancy (DQI-Pc), PURE Healthy Diet Score, and FIGO Diet Quality Score. We also found correlations between certain dietary patterns and particular nutrient intakes recommended by the European Food Safety Authority during pregnancy. The most deficient intake was registered for iron (86.1%), zinc (87.3%) and magnesium (79.3%), posing a threat to normal bone development, anaemia prophylaxis, and immune status. These results highlight the importance of assessing and understanding eating habits during pregnancy in order to achieve optimal outcomes for both the mother and the foetus. [ABSTRACT FROM AUTHOR]

Diet and eating behavior both play a crucial role in the prevention and management of type 2 diabetes mellitus (T2DM). The main objective of this study was to investigate the relationship between dietary intake and eating behavior in a population of patients with T2DM. A cross-sectional study was performed using 416 patients with T2DM and their dietary intake and eating behavior were assessed with validated questionnaires. Women scored significantly higher than men for emotional and restrained eating (p < 0.001). Correlation analyses showed that emotional eaters consumed significantly more calories (r = 0.120, p = 0.014) and fat (r = 0.101, p = 0.039), as well as non-alcoholic beverages for women (r = 0.193, p = 0.003) and alcohol for men (r = 0.154, p = 0.038). Also, individuals who ate based on external cues consumed significantly more calories (r = 0.188, p < 0.001) and fat (r = 0.139, p = 0.005). These results demonstrate that eating behavior influences dietary intake. Understanding this relationship could optimize diabetes management and allow for more individualized nutritional guidance. [ABSTRACT FROM AUTHOR]

The significance of dietary patterns during pregnancy is highlighted by accumulating evidence, emphasizing their pivotal role in promoting a healthy pregnancy for both the mother and the child. This study aimed to assess the current dietary patterns of pregnant women, compare the energy and nutrient intake of two distinct groups with a 10-year interval, and identify changes in dietary patterns. EPIC FFQ was applied, and its data were interpreted with the FETA program version 6 (CAMB/PQ/6/1205). By means of principal component analysis, three different food patterns were identified in each study group: vegetarian, balanced, and traditional (2013); and prudent, vegetarian, and modern (2023). Analyzing the relationship between food groups and gestational weight, we found that gestational weight gain in 2013 was positively correlated with eggs and egg dishes and milk and milk products, whereas in 2023, gestational weight gain was positively correlated with fats and oils, non-alcoholic beverages, and the modern pattern. Additionally, in 2023, pre-gestational BMI correlated positively with eggs and egg dishes. The balanced pattern emerged as a predictor for a lower likelihood of inadequate gestational weight gain in both groups. Furthermore, normal and overweight pregnant women showed a reduced likelihood of excessive gestational weight gain. [ABSTRACT FROM AUTHOR]

Obesity affects more than one billion people worldwide and often leads to cardiometabolic chronic comorbidities. It induces senescence-related alterations in adipose tissue, and senescence is closely linked to obesity. Fully elucidating the pathways through which vitamin D exerts anti-inflammatory effects may improve our understanding of local adipose tissue inflammation and the pathogenesis of metabolic disorders. In this narrative review, we compiled and analyzed the literature from diverse academic sources, focusing on recent developments to provide a comprehensive overview of the effect of vitamin D on inflammation associated with obesity and senescence. The article reveals that the activation of the NF-κB (nuclear factor kappa B subunit 1) and NLRP3 inflammasome (nucleotide-binding domain, leucine-rich-containing, pyrin domain-containing-3) pathways through the toll-like receptors, which increases oxidative stress and cytokine release, is a common mechanism underlying inflammation associated with obesity and senescence, and it discusses the potential beneficial effect of vitamin D in alleviating the development of subclinical inflammation. Investigating the main target cells and pathways of vitamin D action in adipose tissue could help uncover complex mechanisms of obesity and cellular senescence. This review summarizes significant findings related to opportunities for improving metabolic health. [ABSTRACT FROM AUTHOR]

Our paper proposes the first machine learning model to predict long-term mortality in patients with diabetic foot ulcers (DFUs). The study includes 635 patients with DFUs admitted from January 2007 to December 2017, with a follow-up period extending until December 2020. Two multilayer perceptron (MLP) classifiers were developed. The first MLP model was developed to predict whether the patient will die in the next 5 years after the current hospitalization. The second MLP classifier was built to estimate whether the patient will die in the following 10 years. The 5-year and 10-year mortality models were based on the following predictors: age; the University of Texas Staging System for Diabetic Foot Ulcers score; the Wagner–Meggitt classification; the Saint Elian Wound Score System; glomerular filtration rate; topographic aspects and the depth of the lesion; and the presence of foot ischemia, cardiovascular disease, diabetic nephropathy, and hypertension. The accuracy for the 5-year and 10-year models was 0.7717 and 0.7598, respectively (for the training set) and 0.7244 and 0.7087, respectively (for the test set). Our findings indicate that it is possible to predict with good accuracy the risk of death in patients with DFUs using non-invasive and low-cost predictors. [ABSTRACT FROM AUTHOR]

Malnutriția este o constatare frecventă și importantă în secțiile chirurgicale. Deşi consecințele sale includ complicații postoperatorii și costuri mai mari, evaluarea nutrițională nu face parte din protocoalele preoperatorii de rutină. Evaluarea nutriţională include parametri clinici și biologici și este vitală pentru a începe tratamentul și a îmbunătăți rezultatele. Prealbumina este în prezent recunoscută ca un marker fidel al malnutriției şi este inclusă în ghidurile de practică. Unul dintre cele mai importante aspecte legate de prealbumină este faptul că variațiile sale în timp sunt mai valoroase decât valorile absolute. Scopul acestui studiu a fost de a evalua și compara evoluția nutrițională perioperatorie a pacienţilor care necesită intervenţii de chirurgie toracică, cu şi fără cancer, folosind prealbumina - preoperator și postoperator - ca marker principal. Treizeci şi şase de pacienţi de la Clinica de Chirurgie Toracică au fost evaluaţi înainte de intervenţia chirurgicală, prin indicele de masă corporală, scorul de risc nutriţional Subjective Global Assessment (SGA) și parametri biochimici de rutină. Prealbumina a fost evaluată înainte de intervenţia chirurgicală şi la 3 zile după operaţie.Vârstă, durata spitalizării postoperatorii și prezența complicaţiilor au fost notate. Pacienții cu cancer (n = 19) au fost semnificativ mai în vârstă decât pacienții fără cancer (p = 0,007) și au fost mai frecvent, dar nu în mod semnificativ, evaluaţi prin SGA ca fiind malnutriţi (42,1% față de 11,6%). Prealbumina preoperator și alți parametri nu diferă semnificativ între grupuri. Cu toate acestea, a existat o scădere semnificativă a prealbuminei postoperator doar la pacienții cu cancer. Prin urmare, prealbumina s-a dovedit a fi valoroasă în evaluarea malnutriţiei acute la pacienţii cu cancer, în special prin monitorizarea variaţiilor în timp, ceea ce ar putea fi util în planificarea tratamentului nutriţional.

(1) Background: This study examines the survival of patients after their first presentation with diabetic foot ulcers (DFUs) to the regional Diabetes, Nutrition, and Metabolic Diseases Clinic within the Emergency Clinical Hospital "Sf. Spiridon", Iaşi, and analyzes the factors associated with this outcome. (2) Methods: In this retrospective study, patients with DFUs consecutively referred between 1 January 2007 and 31 December 2017 were followed up until 31 December 2020 (for 13 years). The study group included 659 subjects. (3) Results: During the study period, there were 278 deaths (42.2%) and the average survival time was 9 years. The length of hospitalization, diabetic nephropathy, chronic kidney disease, glomerular filtration rate, cardiovascular disease, hypertension, anemia, and DFU severity were the most significant contributors to the increase in mortality. Patients with severe ulcers, meaning DFUs involving the tendon, joint, or bone, had a higher mortality risk than those with superficial or pre-ulcerative lesions on initial presentation (Texas classification HR = 1.963, 95% CI: 1.063–3.617; Wagner–Meggitt classification HR = 1.889, 95% CI: 1.024–3.417, SINBAD Classification System and Score HR = 2.333, 95% CI: 1.258–4.326) after adjusting for confounding factors. (4) Conclusions: The findings of this study suggested that patients presenting with severe ulcers involving the tendon, joint, or bone exhibited a significantly higher risk of mortality, even when potential confounders were taken into consideration. [ABSTRACT FROM AUTHOR]

Modern lifestyles have led to sedentary behavior, lower participation in active movement and physical activities during leisure time, unhealthy diets, and increased exposure to stress. It is important to examine the interaction of several lifestyle risk factors instead of focusing on one alone. The purpose of this study was to identify lifestyle patterns in a group of patients with type 2 diabetes and the associations of its components with certain metabolic parameters. Using principal component analysis, we identified three dietary patterns: the prudent pattern (fat, oil, cereals, potatoes, vegetables, fish, nuts, seeds and fruits), the Western pattern (meat and meat products, eggs and soft drinks) and the traditional pattern (milk and its derivatives, soups and sauces, with a low intake of sugar/snacks). In addition, using the same method of analysis, we identified two lifestyle patterns: the inadequate lifestyle pattern (Western dietary pattern, increased hours of sleep and lower levels of stress) and the traditional lifestyle pattern (traditional dietary pattern, increased physical activity (PA) and non-smoking status). The inadequate lifestyle pattern was associated with younger age, hypertension and diabetic neuropathy. The traditional lifestyle pattern was related to lower postprandial blood glucose levels. Sedentary individuals were more likely to be over 65 years old and to have higher glycated hemoglobin (HbA1c). Smokers were also more likely to have inadequate glycemic and lipid profile control. [ABSTRACT FROM AUTHOR]

Intermittent fasting (IF) has been promoted as an alternative to dietary caloric restriction for the treatment of obesity. IF restricts the amount of food consumed and improves the metabolic balance by synchronizing it with the circadian rhythm. Dietary changes have a rapid effect on the gut microbiota, modulating the interaction between meal timing and host circadian rhythms. Our paper aims to review the relationships between IF and human gut microbiota. In this study, the primary area of focus was the effect of IF on the diversity and composition of gut microbiota and its relationship with weight loss and metabolomic alterations, which are particularly significant for metabolic syndrome characteristics. We discussed each of these findings according to the type of IF involved, i.e., time-restricted feeding, Ramadan fasting, alternate-day fasting, and the 5:2 diet. Favorable metabolic effects regarding the reciprocity between IF and gut microbiota changes have also been highlighted. In conclusion, IF may enhance metabolic health by modifying the gut microbiota. However additional research is required to draw definitive conclusions about this outcome because of the limited number and diverse designs of existing studies. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether serum uric acid levels are significantly associated with the parameters that contribute to the metabolic syndrome in a rural community from Iasi County, Romania. We observed that the components associated most with the serum levels of uric acid were body mass index, triglycerides, waist circumference and hip circumference. Significant correlations were found for the levels of uric acid and total cholesterol, fasting glycemia, systolic blood pressure and diastolic blood pressure. The observed correlations point to uric acid as a potential marker of the metabolic syndrome.

The aim of this study was to determine the frequency of impaired glucose tolerance (IGT) in a cross-section of the adult rural population of the village Deleni in northeast Romania. We observed a IGT in 25.9% and diabetes in 14.55% of the general population, and only 60% of randomly selected subjects with a normal glucose tolerance. With regards to gender, we observed slightly higher values in female patients (28.3% with IGT, 17.3% with diabetes), as compared to 10.47% with diabetes and 20.95% with IGT in males. Our report reveals a high prevalence of diabetes and IGT among the rural population of Deleni, Romania. Therefore, there is an urgent need for an increased awareness of diabetes and for an energetic intervention against diabetes and similar lifestyle-related diseases in the rural areas of Romania.

Hepatic diseases pose a significant public health concern. Regardless of the severity of hepatic fibrosis, treatment is recommended for all chronic hepatitis C virus (HCV) subjects. However, fibrosis and steatosis assessment remains crucial for evaluating the prognosis, progression, and hepatic disease monitoring, particularly following the treatment with direct-acting antivirals (DAAs). The aim of our study was to evaluate the impact of metabolic factors and the extent of hepatic fibrosis and fat accumulation in chronic HCV infection subjects. Additionally, another objective was to investigate modifications regarding fibrosis and steatosis three months after a successful sustained viral response (SVR). A total of 100 patients with compensated cirrhosis and chronic hepatitis C (CHC) were included in our study. These patients received treatment with DAA and underwent Fibromax assessment before and three months post SVR. After DAA treatment, a significant decrease was observed in the degree of hepatic fibrosis and hepatic steatosis. This regression was evident three months following the achievement of SVR. Chronic viral hepatitis C may trigger risk factors for metabolic syndromes, such as obesity and type 2 diabetes mellitus. Conclusions: It is crucial to monitor metabolic factors and take timely measures to prevent or treat metabolic syndrome in patients with chronic viral hepatitis C. [ABSTRACT FROM AUTHOR]

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Non-alcoholic fatty liver disease is a worldwide significant public health problem, particularly in patients with type 2 diabetes mellitus. Identifying possible risk factors for the disease is mandatory for a better understanding and management of this condition. Patatin-like phospholipase domain-containing protein 3 (PNPLA3) has been linked to the development and evolution of fatty liver but not to insulin resistance. The aim of this study is to evaluate the relationships between PNPLA3 and fatty liver, metabolic syndrome and subclinical atherosclerosis. Materials and Methods: The study group consisted of patients with type 2 diabetes mellitus without insulin treatment. The degree of liver fat loading was assessed by ultrasonography, and subclinical atherosclerosis was assessed using carotid intima-media thickness (CIMT). PNPLA3 rs738409 genotype determination was performed by high-resolution melting analysis that allowed three standard genotypes: CC, CG, and GG. Results: Among the 92 patients, more than 90% showed various degrees of hepatic steatosis, almost 62% presented values over the normal limit for the CIMT. The majority of the included subjects met the criteria for metabolic syndrome. Genotyping of PNPLA3 in 68 patients showed that the difference between subjects without steatosis and subjects with hepatic steatosis was due to the higher frequency of genotype GG. The CC genotype was the most common in the group we studied and was significantly more frequent in the group of subjects with severe steatosis; the GG genotype was significantly more frequent in subjects with moderate steatosis; the frequency of the CG genotype was not significantly different among the groups. When we divided the group of subjects into two groups: those with no or mild steatosis and those with moderate or severe steatosis it was shown that the frequency of the GG genotype was significantly higher in the group of subjects with moderate or severe steatosis. PNPLA3 genotypes were not associated with metabolic syndrome, subclinical atherosclerosis, or insulin resistance. Conclusions: Our results suggest that PNPLA3 does not independently influence cardiovascular risk in patients with type 2 diabetes mellitus. The hypothesis that PNPLA3 may have a cardioprotective effect requires future confirmation. [ABSTRACT FROM AUTHOR]

Irisin is a novel hormone that provides a possible solution for the treatment of metabolic disorders. Discovered in 2012 by Boström et al., irisin very quickly became an interesting subject in medical research. Irisin has been found in cerebrospinal fluid, the cerebellum, thyroid, pineal gland, liver, pancreas, testis, spleen, adult stomach, and human fetuses. Regarding the actions of irisin, both in animals and humans, the results are contradictory but interesting. Its capability to influence adipose tissue and glycemic homeostasis may be utilized in order to treat hypothyroidism, polycystic ovary syndrome, Prader–Willi syndrome, and other endocrine and metabolic disorders. Considering its osteogenic potential, irisin might be a therapeutic choice in diseases caused by a sedentary lifestyle. New data indicate that irisin treatment may serve in the treatment of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection. Furthermore, several therapeutic agents, such as insulin, metformin, fenofibrate, exenatide, and melatonin, influence the concentrations of irisin in animal models or in humans. Nutritional factors including polyunsaturated fatty acids may also have an effect on irisin concentrations. While it may be "too good to be true," irisin offers many opportunities for future research that would aim to find its optimal therapeutical role in endocrine and metabolic diseases. [ABSTRACT FROM AUTHOR]

Diabetes mellitus has a major impact on metabolism, inducing many complications and contributing to increased mortality. Such complications often represent complex disorders, such as the diabetic foot, one of the major causes of non-traumatic lower limb amputation. Bone turnover and skeletal integrity can be affected in diabetes, with diabetic bone disease as a long-standing complication of it. Alveolar bone loss is one of the main features of periodontal disease, and diabetes is one of the risk factors for this condition. The present review provides complex, up-to-date information on possible common pathogenic ways related to bone turnover in these two chronic conditions, and also on the direct link between persistent hyperglycaemia, inflammation and alveolar bone loss. [ABSTRACT FROM AUTHOR]

We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socio-economic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'. [ABSTRACT FROM AUTHOR]

White adipose tissue (WAT) is an endocrine organ highly integrated in homeostasis and capable of establishing ways of communicating and influencing multiple metabolic processes. Brown adipose tissue promotes energy expenditure by incorporating the uncoupling protein 1 (UCP1), also known as thermogenin, which decouples cellular respiration and heat production, in the mitochondrial membranes. Recent data suggest the presence of a thermogenic cell formation from white adipocytes (beige or brite cells) with a potential role in preventing obesity and metabolic syndrome. The formation of these cells is influenced by physical exertion that induces expression of PPARγ coactivator-1 (PGC1) and downstream membrane protein, fibronectin type III domain-containing protein 5 (FNDC5) in skeletal muscle. Irisin, a thermogenic adipomyokine produced by FNDC5 cleavage is involved in the browning of adipose tissue. While animal studies are congruent with regard to the relationship between physical exertion and irisin release, the results from human studies are less than clear. Therefore, this review focuses on recent advances in our understanding of muscle and adipose tissue thermogenesis. Further, it describes the molecular mechanisms by which irisin impacts exercise, glucose homeostasis and obesity. Finally, the review discusses current gaps and controversies related to irisin release, its mode of action and its future potential as a therapeutic tool in managing obesity and metabolic syndrome. [ABSTRACT FROM AUTHOR]

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Obesity is a complex, multifactorial condition which is characterized by the increase in body weight due to adipose tissue. The sedentary lives of many children and adolescents, the growing number of hours spent in front of the computer, the game console or the TV represent risk factors for obesity. The authors conducted a prospective study between the 1st of April and the 30th of June 2017, which included 38 adolescents with obesity, aged 12 to 18 years (mean age 13.7 ± 2.6 years). To evaluate the physical activity program for obese adolescents, a questionnaire was applied which focused on the impact of computer and TV use on their behaviour. The questionnaire contained 15 items referring to the computer and television exposure. The results showed that most obese adolescents do not follow the recommended daily physical activity: 94.7% prefer to spend their free time in front of the TV compared to 68.4% who prefer computer use, with negative consequences (fatigue, addiction, isolation, boredom). The factors with a significant negative influence on healthy lifestyle were urban area, age, male gender and low self-esteem, allowing the identification of risk subjects. [ABSTRACT FROM AUTHOR]

Ghrelin is a neuroendocrine hormone mainly produced in the stomach, much lower levels being detected in the gut, pancreas, kidneys, lung, placenta, testis, hypothalamus and pituitary gland. Ghrelin exerts its specific actions through the specific receptor GSH-R1a, expressed in both central and peripheral organs/tissues. It is recognized that ghrelin transmits hunger signals from the periphery to the central nervous system. Thus, it enhances appetite, increases food intake and reduces energy consumption. There is a lot of evidence indicating that ghrelin is involved in the regulation of insulin secretion, and also in the modulation of cardiovascular function. The discovery of ghrelin-specific receptors in the brain areas involved with mood and emotions led to the idea that ghrelin plays a role in stress, mood and anxiety regulation. Moreover, ghrelin improves learning and memory in a dosedependent manner. Recent researches have demonstrated the involvement of ghrelin in the reproductive function in both sexes, in bone metabolism, and also in the modulation of immune functions. Demonstration of both central and peripheral actions of ghrelin has already triggered numerous debates about the possibility of using ghrelin as a therapeutic agent, further studies being needed to confirm its usefulness and safety in humans. [ABSTRACT FROM AUTHOR]

Background and aims. The aim of the study is to evaluate fluid intake during adolescence and correlate it with weight status. Material and methods. We assessed fluid intake using a validated questionnaire in a group of 106 adolescent students (22 boys - 20.8%), aged 15-19 years. Weight status was evaluated with the BMI-for-age values,using growth normograms. Results. There were no statistically significant differences in the frequency of water intake between sexes (p>0.05). Water intake at least 3 times a day was declared by 72.16% of normal weight students and in 66% of overweight and obese, the difference being statistically significant (p=0.003). Boys consumed larger amounts of water (p=0.042) than girls. Intake of 100% natural fruit juice was significantly higher in boys compared to girls (p=0.002). A significantly higher percentage of normal weight adolescents consumed≤500 mL/day non-carbonated (p=0.004) and carbonated (p<0.001) sugar-sweetened beverages compared to the overweight or obese, who consumed ≥500 mL/day. Conclusions. The quantitative and qualitative assessment of fluid intake among adolescents is a mandatory step in the assessment of calorie and nutritional intake. Promoting low-calorie fluid intake in this age group, along with the principles of healthy eating, could contribute to achieving an optimal weight status. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess nutritional status in a group of institutionalized elderly and to establish correlations between nutritional screening score and anthropometric parameters. We analyzed a sample of 156 seniors, 62 (39.7%) men, 94 (60.3%) women, to whom we performed nutritional screening using Mini Nutritional Assessment - MNA and we evaluated anthropometric parameters (body mass index - BMI, waist circumference - WC, calf circumference - CC and mid-upper arm circumference - MUAC). In the group of elderly institutionalized to whom the MNA has been applied, 69.2% had optimal nutritional status, 24.4% had a score of screening indicating risk of malnutrition and 6.4% had a screening score corresponding to malnutrition. A significantly higher percentage of women had a screening score indicating malnutrition (9.6% vs. 1.6%) and a screening score showing risk of malnutrition (26.6% vs. 21%) (p=0.029). Analysis by gender showed strong correlation between BMI and WC value (r = 0.869) in men, and between MUAC and CC value (r = 0.838) in women (p<0.001). Nutritional screening score was positively correlated with all anthropometric parameters (r>0.400, p<0.001), the strongest correlation being recorded with CC (r = 0.528). MNA short form (MNA-SF) represents a useful tool for rapid nutritional screening of elderly, enabling the identification of individuals at risk for malnutrition and those with a score indicating malnutrition. Calf circumference is a parameter which is positively correlated with nutritional screening score in institutionalized elderly population, and can be proposed as a starting point in nutritional assessment algorithm. [ABSTRACT FROM AUTHOR]

Background Pregnancy is a critical period for both woman and baby from a nutritional perspective. Nutritional education is considered an important tool for promoting a healthy lifestyle, but has not been studied as a determinant for maternal use of supplements during pregnancy, especially in Romania, where evidence about pregnancy and nutrition is scarce. This study aimed to evaluate the relationship between nutritional knowledge and the use of folic acid, iron and multivitamin supplements during pregnancy and to assess the influence of socio-demographic factors and prenatal care. Methods We conducted a cross-sectional study on a sample of 400 pregnant women admitted to the Cuza-Vodă Obstetrics and Gynaecology Clinical Hospital in Iaşi, Romania, during August-September 2010. We collected self-reported data regarding socio-demographic characteristics, number of prenatal check-ups and the use of folic acid, iron and multivitamin supplements during pregnancy. We assessed nutritional knowledge using a standardized questionnaire divided into three sections: general nutritional recommendations for pregnant women; the roles of nutrients; and sources of nutrients. We used logistic regression to analyse the associations between these factors. Results The prevalence of the use of supplements during pregnancy was 48% for folic acid, 45.3% for iron and 68% for multivitamins. Above-average nutritional knowledge was independently associated with the use of folic acid (aOR, 4.7; 95% CI, 1.6-13.8), iron (aOR, 2.6; 95% CI, 1.2-5.7) and multivitamins (aOR, 2.8; 95% CI, 1.2-6.8). The use of folic acid was independently associated with a higher level of formal education (aOR, 5.2; 95% CI, 2.1-12.8) and an early start in prenatal care (aOR, 3.4; 95% CI, 1.0-11.1). Women with a higher education (aOR, 2.3; 95% CI, 1.1-4.9), more than 10 prenatal visits (aOR, 7.2; 95% CI, 3.4- 15.0) and those who received advice on breastfeeding (aOR, 2.0; 95% CI, 1.1-3.5) were more likely to use iron during pregnancy. Similar results were found when analysing the contributing factors for the use of multivitamins: more than 12 years of schooling (aOR, 3.4; 95% CI, 1.4-7.9) and appropriate prenatal care (aOR, 9.4; 95% CI, 4.5-19.5). Conclusions Level of nutritional knowledge has a strong independent association with the use of supplements during pregnancy. [ABSTRACT FROM AUTHOR]

(1) Background: Obesity, part of the triple global burden of disease, is increasingly attracting research on its preventive and curative management. Knowledge of eating behavior can be useful both at the individual level (to individualize treatment for obesity) and the population level (to implement more suitable food policies). The Dutch Eating Behavior Questionnaire (DEBQ) is a widely used international tool to assess eating behavior, i.e., emotional, external and restricted eating styles. The aim of this study was to validate the Romanian version of DEBQ, as obesity is a major concern in Romania. (2) Methods: Our study tested the psychometric properties of the Romanian version of DEBQ on an adult population and explored the associations of eating behavior with weight status (3) Results: The study showed a factor load similar to the original version of the questionnaire and a very good internal validity (Cronbach's alpha fidelity coefficient greater than 0.8 for all scales of the questionnaire) for the Romanian version of DEBQ and showed that all of the scales positively correlated with body mass index in both men and women. (4) Conclusions: This study will enable the use of the DEBQ Romanian version on the adult population of Romania where the findings could be incorporated into developing better strategies to reduce the burden of nutrition-related diseases. [ABSTRACT FROM AUTHOR]

Background This study aimed to establish the reliability and validity of the Anti-Fat Attitudes (AFA) questionnaire and the Beliefs About Obese Persons (BAOP) scale. Methodology A convenience sample of 257 students from three distinct sections of the University of Medicine and Pharmacy "Grigore T. Popa" Iasi (Medical Faculty, Nutrition and Dietetics, and Nursing) participated in an observational study. Construction validity was tested with exploratory factor analysis. The students completed a form containing sociodemographic data, the AFA questionnaire, and the BAOP scale. Weight and height were self-reported and used to determine the body mass index. Results The value of the Cronbach alpha coefficient for the AFA questionnaire indicated adequate internal consistency (0.862). The exploratory factor analysis identified the following three factors corresponding to the original questionnaire: Dislike, Fear of Fat, and Willpower. We validated a single-factor structure of the BAOP scale, which had adequate internal consistency (0.781). There were statistically significant differences (AFA: p = 0.02; BAOP: p = 0.03) between the scores of the students from Nutrition and Dietetics, Nursing, and General Medicine. Conclusions This study demonstrated that the AFA questionnaire and the BAOP scale could be used to evaluate weight stigma in healthcare students, providing a useful tool to assess the effects of weight stigma awareness interventions in this population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. University of Medicine and Pharmacy “Grigore T. Popa” Ethics Committee issued approval 391/30.01.2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mihalache et al.)

Obesity affects more than one billion people worldwide and often leads to cardiometabolic chronic comorbidities. It induces senescence-related alterations in adipose tissue, and senescence is closely linked to obesity. Fully elucidating the pathways through which vitamin D exerts anti-inflammatory effects may improve our understanding of local adipose tissue inflammation and the pathogenesis of metabolic disorders. In this narrative review, we compiled and analyzed the literature from diverse academic sources, focusing on recent developments to provide a comprehensive overview of the effect of vitamin D on inflammation associated with obesity and senescence. The article reveals that the activation of the NF-κB (nuclear factor kappa B subunit 1) and NLRP3 inflammasome (nucleotide-binding domain, leucine-rich-containing, pyrin domain-containing-3) pathways through the toll-like receptors, which increases oxidative stress and cytokine release, is a common mechanism underlying inflammation associated with obesity and senescence, and it discusses the potential beneficial effect of vitamin D in alleviating the development of subclinical inflammation. Investigating the main target cells and pathways of vitamin D action in adipose tissue could help uncover complex mechanisms of obesity and cellular senescence. This review summarizes significant findings related to opportunities for improving metabolic health.

Nonalcoholic fatty liver disease is the most common cause of liver disease in the Western world. Liver biopsy is considered the gold standard in the diagnosis and progression of the disease and its usefulness cannot be neglected in terms of research. But in current clinical practice, liver biopsy tends to be replaced by less expensive and noninvasive methods allowing the identification of cardiovascular and metabolic risks. Given the fact that a small percentage of individuals with nonalcoholic fatty liver disease will progress to cirrhosis, attention will be focused more on cardiovascular risk as nonalcoholic fatty liver is now regarded as a distinct component of the metabolic syndrome. The aim of the clinician is to identify the early stages of fatty liver, using in this purpose simple and easily accessible methods. Many techniques have been proposed for the diagnosis of nonalcoholic fatty liver, from simple clinical factors (anthropometric indices measuring,blood pressure) laboratory biomarkers, imaging methods and scores, which should allow early treatment. This review describes different methods for identifying nonalcoholic fatty liver and various stages of this disease.

Aim: To estimate specific nutrient intake in patients with type 2 diabetes., Materials and Methods: The study was conducted on a group of subjects with type 2 diabetes. The collected data included: anthropometry, lifestyle, blood measurements, and the mean daily nutrient intake assessed by the EPIC food frequency questionnaire., Results: The study group included 101 subjects with type 2 diabetes mellitus (DM) with a mean age of 60.6±10 years, of which 45 men (59±10.6 years) and 56 women (62±9.6 years). The average energy intake was 1714.4±713.9 Kcal/day, with a statistically significant gender difference (1877.7±850.9 kcal/day for men, 1583.1±554.9 kcal/day for women, p = 0.039, and the average daily micronutrient intake was 2.44±1.44 μg/day for vitamin D, 724.5μ263.2 mg/day for Calcium (Ca), 266.7±98 mg/day for magnesium (Mg), which was low compared to dietary recommendations. Calcium intake was correlated with intake of carbohydrates, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), fiber and energy. Vitamin D intake was correlated only with protein intake (R=0.695), while magnesium intake correlated with intake of fibers, energy, carbohydrates and SFA., Conclusions: Our study in patients with type 2 diabetes showed a reduced average intake of calcium, magnesium and vitamin D compared to standard recommendations, requiring an individualized approach.

Aim: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain., Material and Methods: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Vodă Obstetrics and Gynecology Clinical Hospital, Iaşi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy., Results: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet., Conclusions: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.

Ghrelin is an important neuroendocrine peptide having as main purpose the stimulation of growth hormone (GH) secretion. It is also an important regulator of the long-term energy balance and short-term nutritional intake. Ghrelin has several other biological actions, among which the capacity to regulate gastrointestinal motility, to modulate the reproductive and stress axes as well as the glucose metabolism, and other well-defined actions within the cardiovascular and renal physiology. Due to its numerous effects, ghrelin is considered on one hand a potential target in the treatment of obesity and on the other, a therapeutic option in other dysfunctions and illnesses.

Unlabelled: The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI) and waist circumference (WC), two anthropometric parameters used in daily practice, for detecting cardio-metabolic diseases, in a rural community in north-east Romania., Material and Methods: We evaluated 3248 persons, aged 19 or over, for whom we collected the following data: medical history, anthropometric parameters, blood pressure value and biochemical parameters., Results and Conclusions: Both WC and BMI help correctly determine the presence of arterial hypertension, diabetes and dislipidemia. However, the cut-off value of each of these parameters differs for each pathology. The predictive value of WC for different cardio-metabolic diseases is maintained even at normal or borderline overweight values of BMI.

Aim: To evaluate the prevalence of steatosis and to assess its correlations with the classical cardiovascular (CV) risk factors, components of metabolic syndrome (MS) in a rural population., Material and Methods: A sample of 254 subjects was enrolled in the study. Collected data included: age, gender, complete medical history, anthropometric and blood pressure (BP) measurements. The biological evaluation included metabolic and hepatic parameters. Ultrasound evaluation of steatosis relied on the criteria of the National Health and Nutrition Examination Survey (NHANES) III., Results: Two thirds of the study population were obese or overweight (64.96%); 32.66% had systolic BP and 27.16% diastolic BP levels higher than normal. 38% of the subjects had abnormal fasting blood glucose levels, 14.56% having glycated hemoglobin (HbA1c) values corresponding to pre-diabetes, and 9.84% to overt diabetes; 8% had low HDL-cholesterol and 14.96% high triglycerides (Tg) levels. MS was present in 50.8% of individuals. Only 10.8% of all subjects did not have an ultrasound appearance of steatosis; 28.8% had moderate and 32% severe steatosis. There were statistically significant differences in subjects with steatosis vs. subjects without steatosis with regard to body mass index (BMI), WC, presence of MS, and BP and Tg levels, but not to ALAT, ASAT and GGT values., Conclusions: The important prevalence of obesity, fasting hyperglycamia, steatosis and MS shows a particularly metabolic fragile population; early diagnosis and interventional strategies are mandatory.

Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to non-alcoholic steatohepatitis (NASH) and cirrhosis. Most NAFLD patients are hyperinsulinaemic and more insulin resistant compared with nonsteatotic healthy subjects, and there is a near universal association between NAFLD and insulinresistance (IR) irrespective of obesity. The metabolic syndrome (MS) is highly prevalent in the general adult population (approximatively 22%) and it carries an increased cardiovascular morbidity and mortality. Pathophysiologic considerations, clinical associations, and laboratory investigations support that IR and hyperinsulinaemia have a central role in pathogenesis of both MS and NAFLD. The fatty liver is resistant to the action of insulin to suppress hepatic glucose production, which results in hyperglycaemia and, further, in hyperinsulinemia. The MS is associated with maldistribution of body fat, increased free fatty acids (FFAs) and IR, leading to type 2 diabetes, hypertension, dyslipidemia. Visceral fat is an important clinical marker of metabolic cardiovascular risk and a marker of IR in multiple tissues, independent of body mass index (BMI). NAFLD and atherosclerosis share common molecular mediators and NAFLD itself might play an early role in the development and progression of atherosclerosis. These data suggest that NAFLD should be considered part of a multi-organ system derangement in insulin sensitivity, and help explain why NAFLD is so closely linked with diabetes, MS and is an important risk factor for coronary heart disease. NAFLD may be the hepatic manifestation of the MS and raises the possibility that it may play an early role in the etiology of MS.