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Summary: To evaluate the nutritional modes of orchids associated with 'rhizoctonia' fungi, analyses of hydrogen (δ2H), carbon (δ13C), and nitrogen (δ15N) stable isotope ratios are usually adopted. However, previous studies have not fully accounted for exchangeable hydrogens, which could affect these evaluations.Here, we performed standard δ13C, δ15N, and δ2H analyses on bulk samples. Additionally, we conducted δ2H analysis on α‐cellulose and cellulose nitrate samples to investigate whether the heterogeneity of exchangeable hydrogens among plant species influences the assessment of nutritional modes.The δ2H of orchids were consistently higher than those of surrounding autotrophic plants, irrespective of the three pretreatments. Although the rhizoctonia‐associated orchid exhibited lower δ13C, its δ2H was higher than those of the autotrophs. Notably, among all response variables, δ15N and δ2H exhibited high abilities for discriminating the nutritional modes of rhizoctonia‐associated orchids.These results indicate that a time‐efficient bulk sample analysis is an effective method for evaluating plant nutritional modes, as the heterogeneity of exchangeable hydrogens does not significantly impact the estimation. Using δ15N and δ2H benefits the assessment of partial mycoheterotrophy among rhizoctonia‐associated orchids. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown significant associations between individual fat-soluble vitamins (FSVs) and metabolic syndromes (MetS). However, evidence on the multiple FSVs co-exposure and MetS odds is limited. Given that individuals are typically exposed to different levels of FSVs simultaneously, and FSVs can interact with each other. It's necessary to explore the association between multiple FSVs co-exposure and MetS odds. This study aims to address this gap in general U.S. adults aged ≥ 20 years. Methods: We conducted a cross-sectional study utilizing data from the National Health and Nutrition Examination Surveys (NHANESs) 2003–2006 and 2017–2018. Three FSV, including vitamin A (VA), vitamin E (VE), and vitamin D (VD), and MetS diagnosed according to the ATP III guidelines were selected as exposure and outcome, respectively. Multivariable-adjusted logistic model was used to explore the associations of individual FSV exposure with MetS odds and MetS components. Restricted cubic splines were performed to explore the dose–response relationships among them. The quantile g-computation method was adopted to explore the associations of multiple FSVs co-exposure with MetS odds and MetS components. Results: The presented study included a total of 13,975 individuals, with 2400 (17.17%) were diagnosed with MetS. After adjusting for various confounders, a positive linear pattern was observed for serum VA and VE and MetS associations. Serum VD was found to be negatively associated with MetS in a linear dose–response way. For each component of MetS, higher serum VA and VE were associated with higher triglyceride and high-density lipoprotein; higher serum VD was negatively associated with triglyceride, blood pressure, and fasting plasma glucose. MetS odds increased by 15% and 13%, respectively, in response to one quartile increase in FSVs co-exposure index (qgcomp) in the conditional model (OR = 1.15, 95%CI: 1.06, 1.24) and the marginal structural model (OR = 1.13, 95%CI: 1.06, 1.20). Besides, co-exposure to VA, VE, and VD was positively associated with triglyceride, high-density lipoprotein, and blood pressure levels. Conclusion: Findings in the present study revealed that high serum VA and VE levels were associated with elevated MetS odds, while serum VD was inversely associated with MetS odds. FSVs co-exposure was positively associated with MetS odds. [ABSTRACT FROM AUTHOR]

Background: Little is known on the prospective associations between an empirically derived dietary pattern (DP) and life satisfaction among adolescents. This PUTRA-Adol follow-up study aimed to assess the prospective associations between the empirically derived DP and life satisfaction during adolescence. Methods: A total of 585 and 262 adolescents participated in the baseline PUTRA-Adol study in 2016 and PUTRA-Adol follow-up study in 2019–2020, respectively. These adolescents were recruited from three southern states in peninsular Malaysia, namely Negeri Sembilan, Melaka and Johor. Dietary assessments were estimated using a validated food frequency questionnaire (FFQ) while a Multidimensional Students' Life Satisfaction Scale (MSLSS) was used to measure life satisfaction at baseline in 2016 as well as at follow-up in 2019–2020. A DP characterised by foods high in free sugar and energy dense was identified using reduced rank regression (RRR), cross-sectionally at baseline and was reported elsewhere. Similar RRR analysis was used to find a DP that best explained the variation in response variables linked to poorer life satisfaction, including dietary energy density (DED), fiber density, and percentage of energy from total fat and sugar at the PUTRA-Adol follow-up study. Prospective relationship between adherence to the identified DPs and overall life satisfaction scores as well as its domains between 2016 and 2019–2020 were evaluated using generalized estimating equation models (GEE). Results: A DP characterized by high intakes of percentage energy from sugar, fibre and low in DED and percentage energy from total fat was identified at the 2019–2020 follow-up. The identified DP explained 11% of total variations in the response variables and was characterized by high intakes of sweets, sugar sweetened beverages (SSB) and fruits. Female adolescents [67.6(8.9)] had a mean (SD) of life satisfaction that was higher than male adolescents [67.5(10.8)] p < 0.05 in 2019–2020. Prospective analysis found a significant positive association between the identified DP and school domain, in male adolescents (β = 0.117; 95% CI 0.001, 0.234) and an inverse relationship between the DP z-score and self-domain in all adolescents (β = − 0.060; 95% CI − 0.115, − 0.005) from 2016 to 2019–2020. Conclusions: An increasing score for the predominant 'High sugar and High fibre' DP was prospectively associated with increasing life satisfaction score for the school domain in male adolescents and decreasing score for self-domain in both male and females during adolescence. A lifestyle intervention targeting reduced dietary intakes, particularly sugar, may improve life satisfaction in adolescents and promote healthier future without compromising dietary intakes for chronic disease prevention later in life. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to examine the association between dietary patterns and type 2 diabetes mellitus (T2DM) while considering the potential effect modification by metabolic phenotypes (metabotypes). Additionally, we aimed to explore the association between dietary scores and prediabetes. Methods: A total of 1460 participants (11.8% with T2DM) from the cross-sectional population-based KORA FF4 study were included. Participants, classified into three metabotype subgroups, had both their FSAm-NPS dietary index (underpinning the Nutri-Score) and ultra-processed foods (UPF) intake (using NOVA classification) calculated. Glucose tolerance status was assessed via oral glucose tolerance tests (OGTT) in non-diabetic participants and was classified according to the American Diabetes Association criteria. Logistic regression models were used for both the overall and metabotype-stratified analyses of dietary scores' association with T2DM, and multinomial probit models for their association with prediabetes. Results: Participants who had a diet with a higher FSAm-NPS dietary index (i.e., a lower diet quality) or a greater percentage of UPF consumption showed a positive association with T2DM. Stratified analyses demonstrated a strengthened association between UPF consumption and T2DM specifically in the metabolically most unfavorable metabotype (Odds Ratio, OR 1.92; 95% Confidence Interval, CI 1.35, 2.73). A diet with a higher FSAm-NPS dietary index was also positively associated with prediabetes (OR 1.19; 95% CI 1.04, 1.35). Conclusion: Our study suggests different associations between poorer diet quality and T2DM across individuals exhibiting diverse metabotypes, pointing to the option for stratified dietary interventions in diabetes prevention. [ABSTRACT FROM AUTHOR]

Background: Cognitive and mood status influence both personal and social daily activities, with great impact on life quality, particularly among the elderly population. Aim: This cross-sectional study aimed to investigate the psycho-affective status concerning eating habits within an elderly population of the Chania area in Crete, Greece. Methods: Cognitive status was assessed in 101 elderly subjects through the Mini-Mental State Examination (MMSE), and mood was evaluated using the Hospital Anxiety and Depression Scale (HADS). Nutritional status was assessed using a validated food frequency questionnaire. Results: Multivariable statistical analysis, after adjustment for age, marital status, education, and comorbidity, highlighted among males a positive association of the MMSE score with vegetable consumption (RR 1.18; 95%CI 1.03‒1.34) and a negative association with potato consumption (RR 0.83; 95%CI 0.72‒0.95). Conversely, among females, no statistically significant association was observed for any food. Further, among males, a protective effect on affective status was identified for chicken meat (RR 0.45; 95%CI 0.27‒0.77), fish (RR 0.41; 95%CI 0.21‒0.82), fruit (RR 0.70; 95%CI 0.52‒0.94), cereals (RR 0.67; 95%CI 0.53‒0.87), and cheese (RR 0.78; 95%CI 0.63‒0.97) consumption. Among females, the adjusted model showed a significant detrimental effect of vegetable consumption (RR 1.33; 95%CI 1.02‒1.73). Conclusion: A predominantly vegetable-based diet—with the notable exception of fruits and legumes—was associated with better cognitive status in males, albeit not in females. A higher intake of fruit, as well as fish, chicken meat, and cheese among males was associated with a better affective status, indicating that adequate protein supply may play a role in maintaining emotional balance. [ABSTRACT FROM AUTHOR]

Background: Quality of life (QOL) among older adults is a crucial aspect of geriatric care, particularly in the context of global demographic shifts toward ageing societies. Understanding the determinants of QOL in older adults is essential for developing effective interventions to promote well‐being in this population. Methods: This cross‐sectional study conducted in Greece aimed to investigate the complex relationship between depression, frailty, nutritional status, and QOL on 90 older adults (aged ≤65). Assessment instruments including the World Health Organization Quality of Life (WHOQoL)‐BREF questionnaire, Geriatric Depression Scale (GDS), Clinical Frailty Scale (CFS), and Mini Nutritional Assessment (MNA) were utilised to evaluate various dimensions of QOL, depressive symptoms, frailty, and nutritional status. Results: The study revealed significant negative correlations between depression and frailty with all domains of QOL (P < 0.05), indicating that higher levels of depressive symptoms and frailty were associated with lower QOL across physical, psychological, social, and environmental dimensions. Conversely, positive correlations were found between nutritional status and all QOL domains (P < 0.05), suggesting that better nutritional status was linked to higher QOL. Multivariate logistic regression analysis further demonstrated associations between nutritional status and participant characteristics, with females being more likely to be malnourished (odds ratio (OR) = 6.56, P = 0.013), while better health status (OR = 0.34, P = 0.486) and marital status (OR = 0.02, P = 0.019) were protective against malnutrition. Conclusion: These findings underscore the interconnectedness of depression, frailty, and nutritional status in shaping QOL among individuals. Holistic interventions targeting mental health, physical vulnerability, and nutritional well‐being are essential for promoting overall well‐being and functional outcomes in this population. [ABSTRACT FROM AUTHOR]

The aim of this literature review was to identify and provide a summary update on the validity and applicability of the most promising dietary biomarkers reflecting the intake of important foods in the Western diet for application in epidemiological studies. Many dietary biomarker candidates, reflecting intake of common foods and their specific constituents, have been discovered from intervention and observational studies in humans, but few have been validated. The literature search was targeted for biomarker candidates previously reported to reflect intakes of specific food groups or components that are of major importance in health and disease. Their validity was evaluated according to 8 predefined validation criteria and adapted to epidemiological studies; we summarized the findings and listed the most promising food intake biomarkers based on the evaluation. Biomarker candidates for alcohol, cereals, coffee, dairy, fats and oils, fruits, legumes, meat, seafood, sugar, tea, and vegetables were identified. Top candidates for all categories are specific to certain foods, have defined parent compounds, and their concentrations are unaffected by nonfood determinants. The correlations of candidate dietary biomarkers with habitual food intake were moderate to strong and their reproducibility over time ranged from low to high. For many biomarker candidates, critical information regarding dose response, correlation with habitual food intake, and reproducibility over time is yet unknown. The nutritional epidemiology field will benefit from the development of novel methods to combine single biomarkers to generate biomarker panels in combination with self-reported data. The most promising dietary biomarker candidates that reflect commonly consumed foods and food components for application in epidemiological studies were identified, and research required for their full validation was summarized. [ABSTRACT FROM AUTHOR]

In Burkina Faso, one in every four children under 5 years is stunted. Climate change will exacerbate childhood stunting. Strengthening the health system, particularly the quality of nutrition care at primary health facilities, can minimise the adverse climate effect on stunting. Thus, we examined the quality of nutritional status assessment (QoNA) during curative childcare services in primary health facilities in rural Burkina Faso and its relationship with rainfall-induced childhood stunting. We conducted a cross-sectional analysis using anthropometric, rainfall, and clinical observation data. Our dependent variable was the height-for-age z-score (HAZ) of children under 2 years. Our focal climatic measure was mean rainfall deviation (MRD), calculated as the mean of the difference between 30-year monthly household-level rainfall means and the corresponding months for each child from conception to data collection. QoNA was based on the weight, height, general paleness and oedema assessment. We used a mixed-effect multilevel model and analysed heterogeneity by sex and socio-economic status. Among 5027 young (3–23 months) children (mean age 12 ± 6 months), 21% were stunted (HAZ ≤ −2). The mean MRD was 11 ± 4 mm, and the mean QoNA was 2.86 ± 0.99. The proportion of children in low, medium, and high QoNA areas was 10%, 54%, and 36%, respectively. HAZ showed a negative correlation with MRD. Higher QoNA lowered the negative effect of MRD on HAZ (β = 0.017, P = 0.003, confidence interval = [0.006, 0.029]). Males and children from poor households benefited less from the moderating effect of QoNA. Improving the quality of nutrition assessments can supplement existing efforts to reduce the adverse effects of climate change on children's nutritional well-being. [ABSTRACT FROM AUTHOR]

Malnutrition is a prevalent, yet often underdiagnosed and undertreated, condition in older adults. It is characterized by weight loss and/or reduced muscle mass due to diminished caloric intake, inflammation, and/or disease burden. In return, malnutrition can lead to diminished skeletal muscle functionality and disability, among others. Malnutrition plays a crucial role in the pathogenesis of two prevalent geriatric syndromes, namely sarcopenia and frailty. The complex interplay between malnutrition, sarcopenia, and frailty significantly impacts the older population, leading to increased morbidity, mortality, hospitalization rates, quality-of-life, and healthcare costs. Given the prognostic significance of malnutrition in geriatric care, recent guidelines emphasized the role of nutritional support in vulnerable populations. A group of vulnerable populations to malnutrition, sarcopenia, and frailty are older patients with hip fractures, cancer patients, and those with sarcopenic dysphagia. This article highlights the importance of individualized nutritional assessment and treatment in the management of vulnerable populations such as older patients with hip fractures, cancer, and those suffering from sarcopenic dysphagia. It presents practical protocols and guidelines that can be instrumental in enhancing the nutritional care of these groups, thereby improving their overall health outcomes. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the relationship between mortality and the prognostic nutritional index (PNI) in the pediatric patient group with ventriculoperitoneal shunt (VPS) infection. A total of 63 pediatric patients with a VPS infection and positive cerebrospinal fluid (CSF) culture were retrospectively registered. The CSF specimens were analyzed to conduct culture and microscopic evaluation. A total of 44.4% of the cases were men and 55.6% of the cases were women. Patients were divided into 2 groups (survivor and non-survivor patients). When survivor and non-survivor patients were compared, it was found that CSF leukocytes, CSF glucose, CSF protein, CSF/blood glucose ratio, lymphocyte, albumin, and PNI levels were lower in the non-survivor patients' group. Nevertheless, blood glucose and CRP (C-reactive protein) were significantly higher in the non-survivor patients' group than in the survivor patients' group. In our investigation, we suggested that low PNI was related to high mortality in cases of VPS infection. [ABSTRACT FROM AUTHOR]

Purpose: To develop, validate and apply a context-specific nutrition knowledge, attitude and practice questionnaire (KAP-Q) among adolescent Indian athletes. Method: This study used the mixed-method sequential exploratory design using qualitative and quantitative approaches on adolescent athletes (n = 170). The formative phase consisted of in-depth interviews (IDIs) with coaches (n = 10). The validation phase included testing of the internal consistency (n = 80) and test–retest reliability (n = 25), followed by the administration (n = 65) of the KAP-Q on adolescent athletes. Internal consistency was determined using Cronbach's α, reliability using Bland–Altman plots and intra-class correlation (ICC) coefficient and the KAP-Q responses using the Chi-square test. Results: The themes and items (> 90%) for KAP-Q were developed from the qualitative phase and literature review. KAP-Q exhibited a Cronbach's α of 0.700 after removing 29 items. The Bland–Altman plots showed good agreement, with an ICC greater than 0.75. Greater than 71% of items exhibited good scores in the discrimination index, with greater than 50% showing moderate difficulty. The test–retest reliability (I-CVI) was > 0.80. On administering the KAP-Q, the knowledge scores relating to macronutrients, meal timing and supplement usage for training were lower among athletes. However, they exhibited knowledge relating to micronutrients and hygiene practices, with poor attitude/practice scores. Psychological stressors also influenced their food intake. Conclusion: The newly developed context-specific KAP-Q is suitable for the impact evaluation of nutrition education interventions. The methodology adopted in the study supports translation in other contexts. [ABSTRACT FROM AUTHOR]

Introduction: The scored Patient‐Generated Subjective Global Assessment (PG‐SGA©) is a validated tool for the screening, assessment and monitoring of malnutrition, and triaging of interventions. It contains a patient‐generated component and a healthcare professional (HCP)‐generated component. Aim: To translate the PG‐SGA into Swedish, assess the linguistic and content validity of the Swedish version, and ensure conceptional, semantic and operational equivalence to the original English PG‐SGA. Methods: In line with the methodology used in previously translated and culturally adapted versions, the standardised 10‐step process suggested by the International Society for Health Economics and Outcomes Research (ISPOR) was followed. In step 7, a cross‐sectional study targeting patients n = 51 and HCPs n = 52 was performed at a university hospital in Sweden. Using separate questionnaires, patients assessed the patient component and HCPs, the professional component regarding perceived comprehensibility and difficulty (linguistic validity). The HCPs also assessed perceived relevance (content validity) of all items on the PG‐SGA. Item indices for comprehensibility (I‐CI), difficulty (I‐DI) and content validity (I‐CVI) were calculated and averaged into scale indices (S‐CI, S‐DI and S‐CVI). Cut‐off standards for item and scale indices were used as reference. Results: The Swedish version of the PG‐SGA rated excellent for comprehensibility (S‐CI 0.96) and difficulty (S‐DI 0.93) for the patient component. The professional component rated acceptable for comprehensibility (S‐CI 0.89) and below acceptable for difficulty (S‐DI 0.70), with the physical examination rated most difficult (I‐DI 0.39 to 0.69). Content validity for the full Swedish PG‐SGA was rated excellent (S‐CVI 0.94). Conclusion: The patient component was considered clear and easy to complete. The full Swedish PG‐SGA was considered relevant by HCPs for screening and assessment of malnutrition. Due to perceived difficulty with the physical examination, training of Swedish HCPs in using the PG‐SGA is essential before implementing the professional component into clinical practice or research. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests neuro‐immune mechanisms may link dietary patterns to chronic painful conditions (CPC). In the research field of oro‐facial pain (OFP), studies focuses primarily on dietary mechanical limitations due to pain and dysfunction. Objective: This narrative review aimed to overview the role of nutrition on CPC, with emphasis on temporomandibular disorder (TMD), enlightening OFP researcher on dietary assessment possibilities and providing directions for studies in the field of OFP and nutrition. Methods: A PubMed database search was performed using the MeSH and non‐MeSH descriptors: "temporomandibular joint disorder"; "orofacial pain"; "musculoskeletal pain"; "chronic pain disorders"; "nutrition"; "diet"; "dietary therapy"; "dietary intake" and "inflammation". No time restrictions were applied. Literature reviews, systematic reviews, meta‐analyses and clinical and pre‐clinical trials were included. Results: Exogenous oxidants from unhealthy dietary patterns may contribute to peripheral and central pro‐inflammatory immune signalling leading to peripheral and central sensitization. Furthermore, diets rich in bioactive compounds are suggested to contribute to pain management of CPC. High dietary intake of ultra‐processed foods impacts the quality of the diet and shows adverse health outcomes. In this context, the role of nutrition on TMD remains overlooked. Conclusion: Considering diet may influence CPC, allied with the scarcity of studies evaluating the role of nutrition on TMD, well‐designed clinical trials based on dietary assessments and measurements capable of evaluating food quality, UPF consumption and nutrient adequacy—added to serum nutrient levels evaluation—are suggested. [ABSTRACT FROM AUTHOR]

Background: In postmenopausal women (PMW), vasomotor symptoms, emotional oscillations and sleep disturbances can affect physiological and psychological functioning. However, the effect of menopause on oral health‐related parameters is not been thoroughly studied. Objective: To evaluate oral health, taste perception, eating habits, nutritional status and emotional well‐being in PMW compared with a group of young and healthy pre‐menopausal women (PrMW). Materials and Methods: Two groups (Group I: PMW and Group II: PrMW) with 30 participants each, participated in the cross‐sectional study. The study proforma contained measures of oral health, taste perception, nutritional status and anxiety levels of the women in both groups using validated and previously used tools were designed and implemented. The data were analysed with student t, Mann–Whitney U, and chi‐squared tests to evaluate the differences between the two groups. Results: The cross‐sectional study indicates no major differences in oral health, taste perception, nutritional and emotional status between PMW and PrMW. Nonetheless, there was a significant difference in perception of 'front teeth lengthening in size' and change in hot and cold sensations between the groups. Furthermore, the study group with PMW tends to have fewer natural teeth than the reference group. Conclusion: Overall, menopause does not appear to affect oral health, taste perception, nutrition or emotional health. It is suggested that oral health and taste perception, as well as nutritional and emotional status, are associated with gradual aging processes that may or may not be affected by menopause. [ABSTRACT FROM AUTHOR]

The improved efficacy and generally favorable safety profile of recently approved and emerging antiobesity medications (AOMs), which result in an average weight reduction of ≥15%, represent significant advancement in the treatment of obesity. This narrative review aims to provide practical evidence‐based recommendations for nutritional assessment, management, and monitoring of patients treated with AOMs. Prior to treatment, clinicians can identify preexisting nutritional risk factors and counsel their patients on recommended intakes of protein, dietary fiber, micronutrients, and fluids. During treatment with AOMs, ongoing monitoring can facilitate early recognition and management of gastrointestinal symptoms or inadequate nutrient or fluid intake. Attention should also be paid to other factors that can impact response to treatment and quality of life, such as physical activity and social and emotional health. In the context of treatment with AOMs, clinicians can play an active role in supporting their patients with obesity to improve their health and well‐being and promote optimal nutritional and medical outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. Background: Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. Materials and Methods: The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). Results: The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow‐up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. Conclusion: In community‐dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) patients are reported to be at greater risk of malnourishment, and at risk of increased morbidity and mortality. However, most studies report from economically advanced countries. We therefore assessed the nutritional status and diet among HD patients attending a public university hospital in a sub-Saharan African country. Subjects: We performed nutritional assessments in HD patients attending the largest dialysis centre, in the country, collecting demographic and clinical data, dietary intake, along with anthropometric and bioimpedance body composition measurements in May 2022. Malnutrition was classified according to subjective global assessment score (SGA). Additional assessments of protein energy wasting (PEW), clinical frailty, and sarcopenia were made. Results: All 97 HD patients were recruited, mean age 44.7 ± 12.2 years, with 55 (56.7%) males. Malnutrition was present in 43.8%, PEW 20.6%, frailty 17.6% and sarcopenia 4.1%. On multivariable logistic regression higher serum albumin (adjusted odds ratio (AOR) 0.89, 95% confidence intervals (CI) 0.85-0.95, p < 0.001), creatinine (AOR 0.99, 95%CI 0.98–0.99, p < 0.001), greater mid upper arm circumference (AOR 0.89, 95%CI 0.83–0.95, p = 0.001), body cell mass (BCM) (AOR 0.79, 95%CI 0.67–0.95, p = 0.013) and employment (AOR 0.45, 95%CI 0.23–0.87, p = 0.017), were are all protective against malnourishment. Almost 75% had reduced dietary protein intake. Conclusions: Despite a younger, less co-morbid patient population, malnutrition is common in this resource poor setting. The staple diet is based on maize, a low protein foodstuff. Employment improved finances and potentially allows better nutrition. Further studies are required to determine whether additional dietary protein can reduce the prevalence of malnutrition in this population. [ABSTRACT FROM AUTHOR]

Background: Accurate and feasible assessment of dietary intake remains challenging for research and healthcare. Experience Sampling Methodology (ESM) is a real-time real-life data capturing method with low burden and good feasibility not yet fully explored as alternative dietary assessment method. Methods: This scoping review is the first to explore the implementation of ESM as an alternative to traditional dietary assessment methods by mapping the methodological considerations to apply ESM and formulating recommendations to develop an Experience Sampling-based Dietary Assessment Method (ESDAM). The scoping review methodology framework was followed by searching PubMed (including OVID) and Web of Science from 2012 until 2024. Results: Screening of 646 articles resulted in 39 included articles describing 24 studies. ESM was mostly applied for qualitative dietary assessment (i.e. type of consumed foods) (n = 12), next to semi-quantitative dietary assessment (i.e. frequency of consumption, no portion size) (n = 7), and quantitative dietary assessment (i.e. type and portion size of consumed foods) (n = 5). Most studies used ESM to assess the intake of selected foods. Two studies applied ESM as an alternative to traditional dietary assessment methods assessing total dietary intake quantitatively (i.e. all food groups). ESM duration ranged from 4 to 30 days and most studies applied ESM for 7 days (n = 15). Sampling schedules were mostly semi-random (n = 12) or fixed (n = 9) with prompts starting at 8–10 AM and ending at 8–12 PM. ESM questionnaires were adapted from existing questionnaires, based on food consumption data or focus group discussions, and respond options were mostly presented as multiple-choice. Recall period to report dietary intake in ESM prompts varied from 15 min to 3.5 h. Conclusions: Most studies used ESM for 7 days with fixed or semi-random sampling during waking hours and 2-h recall periods. An ESDAM can be developed starting from a food record approach (actual intake) or a validated food frequency questionnaire (long-term or habitual intake). Actual dietary intake can be measured by ESM through short intensive fixed sampling schedules while habitual dietary intake measurement by ESM allows for longer less frequent semi-random sampling schedules. ESM sampling protocols should be developed carefully to optimize feasibility and accuracy of dietary data. [ABSTRACT FROM AUTHOR]

Background: Established evidences have demonstrated that hypertension was associated with the cognitive impairment. But the associations between the duration of hypertension exposure and cognitive performance are still inconclusive. Objectives: The objective of this study was to assess the association between the duration of hypertension diagnosis and cognitive performance in older adults by the National Health and Nutrition Examination Survey (2011–2014). Methods: To evaluate the relationship between the hypertension duration and cognitive performance, we conducted the logistic regression analysis. Furthermore, we also performed the Restricted cubic spline (RCS) analysis to assess the nonlinear relationship between the duration of exposure to hypertension and cognitive performance. Results: Initially, total 19,931 participants were included in this study, and 2928 individuals were enrolled. With the increase of hypertension duration, more risk of cognitive impairment was observed in the Digit Symbol Substitution test (DSST) (OR = 1.012, 1.006–1.019), and a similar trend was observed in Animal Fluency test (AFT) (OR = 1.009,1.003–1.016). The RCS results showed that the hypertension duration pattern was linear associated with the risk of cognitive impairment in DDST (P for non–linearity = 0.758). Meanwhile, subgroups analysis of midlife hypertension, we revealed that linear association with the risk of cognitive impairment in DSST (P for non–linearity = 0.391) and CERAD (P for non–linearity = 0.849) among hypertension diagnose < 55 years populations. Conclusion: Collectively, our finding indicates that longer duration of exposure to hypertension worsens the cognition performance, especially for middle-aged hypertension. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is a well-known risk factor for mortality among older adults. Arthritis and rheumatism are characterized by chronic inflammation and are also related to malnutrition as diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. This study was thus developed to examine the associations linking malnutrition and all-cause death among older adults in China, employing the GLIM criteria to assess malnutrition. Methods: Two waves of the China Health and Retirement Longitudinal Study from 2013 and 2018 were used to conduct this study. Moderate malnutrition was defined as low BMI (< 18.5 and < 20 for individuals < 70 and 70 + years of age, respectively), an unintended 10–20% decrease in weight, or low muscle mass based on the sex-specific lowest 20% of the height-adjusted muscle mass as < 5.039 kg/m2 in women and < 6.866 kg/m2 in men. Severe malnutrition was defined as a > 20% unintended decrease in weight only or the combination of both low muscle mass and an unintended reduction of over 10% in weight. Associations between malnutrition and the risk of all-cause death were assessed through Cox regression analyses. Results: Overall, this study enrolled 1766 subjects 60 + years of age, of whom 57.36% (1033/1766) were female. Malnutrition was estimated to affect 418 (23.67%) of these individuals at baseline, with 21.06% and 2.60% affected by moderate and severe malnutrition, respectively. Over the 5-year follow-up, 189 of these individuals died. Covariate-adjusted Cox regression analyses confirmed a significant association between severe malnutrition and the risk of death in this cohort (HR = 2.196, 95%CI 1.125–4.286, P = 0.021). Conclusions: Severe malnutrition, identified through screening based on the GLIM criteria, was associated with an increased risk of all-cause death among older Chinese adults with arthritis or rheumatism. [ABSTRACT FROM AUTHOR]

This article discusses the relationship between aging, age-related diseases, oxidative stress, and plant polyphenols. It explains that aging is a complex process that involves a decline in biological functions and increased susceptibility to diseases. The "free radical theory" suggests that oxidative damage caused by reactive oxygen species (ROS) contributes to aging. The article explores the effects of antioxidants, such as vitamins and polyphenols found in plant-based foods, on aging and age-related diseases. However, the results of these studies are contradictory, and factors such as the type of antioxidants, methods of extraction, and individual characteristics can influence the outcomes. The article concludes that further research is needed to develop effective strategies for healthy aging. Additionally, the document compiles various scientific studies related to aging, age-related diseases, oxidative stress, and plant polyphenols. These studies investigate the effects of different dietary interventions and supplements on cognitive function, Alzheimer's disease, oxidative stress, and overall health in older adults. The findings suggest that certain dietary interventions and supplements may have positive effects on cognitive function, oxidative stress, and age-related diseases in older adults. However, more research is needed to fully understand the mechanisms and potential benefits of these interventions. [Extracted from the article]

AbstractCancer cachexia, characterized by the progressive loss of skeletal muscle mass, leads to functional impairment and poor prognosis. Anamorelin is approved for treating cancer cachexia in Japan; however, the factors influencing its discontinuation and the impact of combining anamorelin with rehabilitation remain unclear. Therefore, we retrospectively analyzed 82 patients with cancer cachexia to identify factors associated with anamorelin discontinuation and assess changes in nutritional status and motor function using non-dominant handgrip strength after 12 wk. Patients received outpatient rehabilitation, combining resistance and aerobic training every two weeks, alongside anamorelin therapy. Our findings indicate that patients with an ECOG performance status of 1 or 2 were less likely to continue anamorelin therapy for 12 wk compared to those with a performance status of 0 (odds ratio 2.71; 95% CI 1.05 − 7.00; p = 0.040). Significant improvements were observed in body weight (48.8 to 53.7 kg, p < 0.001), skeletal muscle mass (6.4 to 6.9 kg/m2, p < 0.001), FAACT score (11.5 to 18.0, p < 0.001), and non-dominant handgrip strength (20.5 to 21.7 kg, p = 0.018) after 12 wk. Early initiation of anamorelin with regular rehabilitation is recommended to enhance nutritional status and motor function in patients with cancer cachexia. [ABSTRACT FROM AUTHOR]

Background: Previous studies have hinted at the benefits of following an anti-inflammatory diet for potentially reducing breast cancer prevalence. However, the combined influence of diet and inflammation on breast cancer remains unclear. Methods: The advanced lung cancer inflammation index (ALI) was used to assess inflammation and nutritional status. Statistical methods, such as multivariable logistic regression, eXtreme Gradient Boosting (XGBoost) model, and subgroup analysis, were employed to analyze the impact of ALI on prevalence of BC. Additionally, a two-piece-wise logistic regression model with smoothing was used to determine the ALI threshold for BC prevalence. The study aimed to understand the mechanistic association between ALI levels and BC development. Results: The mean (SD) age of the study population was 50.0 (17.7) years, with 40.0% of individuals classified as obese. Comparing ALI tertiles to the lowest tertile, the odds ratios (95% CI) for breast cancer (BC) were 0.78 (0.62, 0.98) and 0.68 (0.52, 0.87) for T2-T3. The XGBoost machine learning model was employed to assess the importance of selected factors, revealing ALI as one of the top five variables influencing BC. Subgroup analysis identified a correlation between ALI, alcohol consumption, and menopausal status. Additionally, ALI levels were associated with decreased estradiol (E2) levels, increased total testosterone (TT)/E2 ratio, and TT/sex hormone-binding globulin (SHBG) ratio. Conclusion: This study indicates a potential protective effect of ALI levels against breast cancer, possibly related to sex hormone disruption. The findings support the use of optimal therapeutic strategies for preventing breast cancer. [ABSTRACT FROM AUTHOR]

Issue Addressed Methods Results Conclusion So What? School food policies in Australia have the potential to positively impact healthy eating in schools. While the policies are reviewed regularly, it is unknown if revised school food policies have incorporated the recommendations from a 2020 review of nutrition policies in publicly funded institutions. This review aims to examine the current state of Australian school food policy environment, including national‐level guidelines, food safety, allergy, and anaphylaxis management policies.School food policy documents were identified by searching the federal government, and Departments of Health and Education websites of Australian jurisdictions. The L'Abbé framework for monitoring and evaluation of nutrition policies guided the data analysis.Eleven policies/guidelines from Australian national and state/territory governments were reviewed in 2023. Four state/territory policies had major updates since 2020. The consistency of nutrition standards improved across five jurisdictions, although a common nutrient classification system would have allowed better comparison. Implementation guides/tools and supporting resources were provided in all policies although their comprehensiveness varied. Policy monitoring and evaluation guide/tools, and local food procurement were incorporated in two additional policies. School principals were responsible for policy implementation and schools for independent compliance monitoring.Continued improvement in monitoring and evaluation plans, policy review timelines, and support systems for schools is needed to enhance implementation and impact of school food policies. External stakeholder support may help school leadership in more effective policy implementation.Limited progress in incorporating recommendations into current school food policies calls for additional support and strategies to enhance policy implementation and monitoring. [ABSTRACT FROM AUTHOR]

Introduction: Geriatric fracture is a pressing global health issue, marked by elevated mortality and morbidity rates and escalating health care costs. The evolving health care system from fee-for-service to quality-based reimbursement has led to externally driven reward and reimbursement systems that may not account for the complexity of caring for older adults with fracture. Significance: The aim of this review is to highlight the need for a shift towards meaningful metrics that impact geriatric fracture care and to issue a call to action for all medical societies to advocate for national reimbursement and ranking systems that focus on metrics that truly matter. Results: Traditional metrics, while easier to capture, may not necessarily represent high quality care and may even have unintentional adverse consequences. For example, the focus on reducing length of stay may lead to older patients being discharged too early, without adequately addressing pain, constipation, or delirium. In addition, a focus on mortality may miss the opportunity to deliver compassionate end-of-life care. Existing geriatric fracture care metrics have expanded beyond traditional metrics to include assessment by geriatricians, fracture prevention, and delirium assessments. However, there is a need to further consider and develop patient-focused metrics. The Age-Friendly Health Initiative (4 Ms), which includes Mobility, Medication, Mentation, and what Matters is an evidence-based framework for assessing and acting on critical issues in the care of older adults. Additional metrics that should be considered include an assessment of nutrition and secondary fracture prevention. Conclusion: In the realm of geriatric fracture care, the metrics currently employed often revolve around adherence to established guidelines and are heavily influenced by financial considerations. It is crucial to shift the paradigm towards metrics that truly matter for geriatric fracture patients, recognizing the multifaceted nature of their care and the profound impact these fractures have on their lives. [ABSTRACT FROM AUTHOR]

Multifactorial lifestyle approaches could be more effective than a single factor for maintaining cognitive function. This study investigated the association of combining cognitively stimulating leisure activities (CSLAs), including puzzles, quizzes, and cognitive training games, with intake of long-chain polyunsaturated fatty acids (LCPUFAs), including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA), on cognitive function in the older Japanese individuals without dementia. Participants were community-dwelling Japanese individuals without a self-reported history of dementia (n = 906, aged 60-88 years) from datasets of a 2-year longitudinal study (baseline: 2006-2008 and follow-up: 2008-2010). CSLA engagement and LCPUFA intake were divided into high and low groups according to frequency (≥once/week and

Simple Summary: Inflammation-based prognostic markers have been recognized as useful in a range of oncologic conditions. Given the high mortality rate associated with pancreatic ductal adenocarcinoma (PDAC), the demand for accurate prognostic tools is significant. Nonetheless, the literature still shows conflicting results regarding the effectiveness of the various available scoring systems. Our data confirm that NLR and PNI are useful biomarkers regarding overall survival in PDAC. Especially in advanced disease stages, they seem to be of considerable benefit as easily accessible tools for prognosis prediction. Purpose: Prognostic inflammation-based parameters have been reported as useful tools in various oncologic diseases. Pancreatic ductal adenocarcinoma (PDAC) is characterized by a high mortality rate, making reliable prognostic markers highly desirable. However, there is still inconsistency in the literature regarding the efficacy of the different available scores. Methods: A total of 207 patients, who underwent primary resection of PDAC from January 2000 to December 2018 at the University Hospital of Erlangen, were included in this retrospective single-center study. Different biomarkers, including the preoperative neutrophil–lymphocyte ratio (NLR), the platelet–lymphocyte ratio (PLR), the c-reactive protein (CRP)–albumin ratio (CAR), the lymphocyte–CRP ratio (LCR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGPS) were analyzed for their ability to predict overall survival (OS). Results: In our cohort, the median overall survival was 20.7 months. Among the investigated biomarkers, NLR and PNI were identified as independent prognostic markers (Hazard Ratio (HR) 1.6 (1.0–2.5), p = 0.048 and HR 0.6 (0.4–0.9), p = 0.018), whereas PLR, CAR, LCR and mGPS did not reach significance in the multivariate analysis. Subgroup analysis revealed that the prognostic value of NLR and PNI is particularly evident in locally advanced tumor stages (pT3/4 and pN+). Conclusions: The NLR and PNI could serve as valuable tools for estimating prognosis in patients with PDAC undergoing pancreatic resection in curative intention, especially in locally advanced tumor stages. However, conflicting results in the current literature highlight the need for further prospective studies to validate these findings. [ABSTRACT FROM AUTHOR]

The aims of this research were to evaluate the current nutritional status, dietary intake, and level of physical activity and assess the need for intervention. This was a cross-sectional study with 2724 participating children aged 6–9 years old. Nutritional status was assessed using nutrimetry, dietary intake with a 3-day food-recall questionnaire and physical activity with an ad hoc questionnaire. The nutricode with the highest prevalence was healthy weight/normal stature, with 51.3% of the sample. For the BMI for age Z-score, those in the overweight/obesity category represented 37.5% of the sample, while the thinness category included 7.6%. Intake of calories, proteins, sugar, lipids, SFA, MUFA, and cholesterol were significantly higher than recommended. The thinness groups consumed a significantly higher amount of excess calories while the overweight/obesity groups had the lowest mean excess calorie intake. Children in the thinness category presented the highest rates at both ends of the spectrum for sedentary activities. This study showed the high prevalence of malnutrition in schoolchildren. The results for the risk of thinness and overweight/obesity according to individual nutrient intake should be carefully interpreted. Lifestyle is a fundamental aspect to consider when combating malnutrition, especially at the level of dietary and physical activity habits, to combine various methods of intervention to improve nutritional status. [ABSTRACT FROM AUTHOR]

Background: Obesity is a global health concern associated with increased risk of diseases like cardiovascular conditions including ischemic heart disease, a leading cause of mortality. The ketogenic diet (KD) has potential therapeutic applications in managing obesity and related disorders. However, the intricate effects of KD on diverse physiological conditions remain incompletely understood. The PI3K-Akt signaling pathway is critical for heart health, and its dysregulation implicates numerous cardiac diseases. Methods: We developed comprehensive mathematical models of the PI3K-Akt signaling pathway under high-fat diet (HFD) and KD conditions to elucidate their differential impacts and quantify apoptosis. Simulations and sensitivity analysis were performed. Results: Simulations demonstrate that KD can reduce the activation of key molecules like Erk and Trp53 to mitigate apoptosis compared to HFD. Findings align with experimental data, highlighting the potential cardiac benefits of KD. Sensitivity analysis identifies regulators like Trp53 and Bcl2l1 that critically influence apoptosis under HFD. Conclusions: Mathematical modeling provides quantitative insights into the contrasting effects of HFD and KD on cardiac PI3K-Akt signaling and apoptosis. Findings have implications for precision nutrition and developing novel therapeutic strategies to address obesity-related cardiovascular diseases. [ABSTRACT FROM AUTHOR]

AbstractPineapple plants needs to be nutritionally balanced to reach maximum productivity potential. Therefore, the most current parameters must be used, centered on plant nutritional status diagnosis methodologies developed through leaf chemical analysis, which consider the relationships between nutrients and take advantage of data from productivity monitoring and foliar diagnosis of crops. This study aimed to establish nutrient norms and sufficiency ranges for pineapple in the Triângulo Mineiro, MG, Brazil, using the Diagnosis and Recommendation Integrated System (DRIS). To achieve the proposed objectives, productivity data and chemical analysis of leaf tissue from 88 commercial farming plots of 'Pérola’ pineapple, sampled between the 2018 and 2019 harvests, in the Triângulo Mineiro were used. The DRIS method was used to establish the norms and sufficiency ranges of N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, and Zn. The average nutritional balance index (NBIm) did not correlate with productivity. However, the content of P, Ca, Mg, S, B, Cu, Fe, Mn, and Zn highly correlated with their respective nutritional indices. The sufficiency ranges and the adequacy levels of nutrients differed from the values established for pineapple in the literature. [ABSTRACT FROM AUTHOR]

Introduction and purpose of the study: Small bowel obstruction (SBO) accounts for a substantial proportion of emergency surgical admissions. Malignancy is a common cause of obstruction, either due to a primary tumour or intra-abdominal metastases. However, little is known regarding the current treatment or outcomes of patients with malignant SBO. This study aimed to characterise the treatment of malignant SBO and identify areas for potential improvement and compare overall survival of patients with malignant SBO to patients with non-malignant SBO. Materials and methods: This was a subgroup analysis of a multicentre observational study of patients admitted with SBO. Details regarding these patients' diagnoses, treatments, and outcomes up to 1-year after admission were recorded. The primary outcome was overall survival in patients with malignant SBO. Results: A total of 316 patients with small bowel obstruction were included, of whom 33 (10.4%) had malignant SBO. Out of the 33 patients with malignant SBO, 20 patients (60.6%) were treated with palliative intent although only 7 patients were seen by a palliative team during admission. Nutritional assessments were performed on 12 patients, and 11 of these patients received parenteral nutrition. 23 patients underwent surgery, with the most common surgical interventions being loop ileostomies (9 patients) and gastrointestinal bypasses (9 patients). 4 patients underwent right hemicolectomies, with a primary anastomosis formed and 1 patient had a right hemicolectomy with a terminal ileostomy. Median survival was 114 days, and no difference was seen in survival between patients treated with or without palliative intent. Conclusion: Malignant SBO is associated with significant risks of short-term complications and a poor prognosis. Consideration should be given to the early involvement of senior decision-makers upon patient admission is essential for optimal management and setting expectation for a realistic outcome. [ABSTRACT FROM AUTHOR]

Plant-based meat alternatives (PBMAs) have been included in Filipino’s diet since their availability in the Philippines, making it important to evaluate their nutritional profile to assist consumers in purchase and consumption decisions. This study identified various PBMAs in Metro Manila, Bulacan, and Pampanga. Information based on the labels of PBMAs and animal-based meats (ABM) was collected and evaluated. PBMAs (n = 37) included chicken products (n = 4), ground meat (n = 5), patties and sausages (n = 19), jerkies (n = 4), and others [i.e. tocino (Philippine sweet bacon), luncheon meat, and belly rolls]. PBMAs generally have lower energy, total and saturated fat, and higher price/g protein, dietary fiber, sodium, and calcium content compared to ABM. Proteins, carbohydrates, and other micronutrients (i.e. iron, potassium, and vitamin B complex) vary depending on the meat category and ingredient used. Current findings highlight the need to redesign existing PBMAs considering nutritional and economic factors to be at par with ABMs. [ABSTRACT FROM AUTHOR]

Malnutrition, which is often underestimated in patients with hepatocellular carcinoma (HCC), has a proven adverse effect on survival rates. The purpose of this study was to verify the effectiveness of the cholesterol-modified prognostic nutritional index (CPNI) in determining the nutritional status and predicting overall survival (OS) and recurrence-free survival (RFS) in patients with HCC by comparing it with several other nutritional indicators. This retrospective single-center study enrolled 1450 consecutive HCC patients who underwent curative liver resection from January 2015 to November 2019. We evaluated the prognostic significance of several nutritional indicators, including CPNI, the controlling nutritional status (CONUT), the nutritional risk index (NRI), and the prognostic nutritional index (PNI), by applying time-dependent receiver operating characteristic (ROC) curves, Kaplan-Meier survival analysis, and Cox proportional hazards regression analysis. Among several objective nutrition evaluations (including CPNI, CONUT, NRI, and PNI), CPNI demonstrated the greatest prognostic predictive power for predicting OS. Meanwhile, CPNI demonstrated marginally higher accuracy in predicting RFS compared to PNI, and significantly outperformed CONUT and NRI. Univariate and multivariate analyses suggested that CPNI was an independent risk factor for the OS and RFS of patients with HCC undergoing curative liver resection. In most subgroups, malnutrition as identified by CPNI demonstrates strong stratification ability in predicting both OS and RFS. CPNI serves as an accurate and stable instrument for evaluating nutritional status and forecasting survival outcomes in HCC patients following liver resection, which has the potential to markedly influence clinical decision-making processes and the management of patient care. [ABSTRACT FROM AUTHOR]

Introduction: Atezolizumab plus bevacizumab (Atez/Bev) is the preferred treatment for advanced hepatocellular carcinoma (HCC). However, biomarkers of therapeutic efficacy have remained unclear. We took a retrospective approach to explore the role of prognostic nutritional index (PNI) for predicting the outcomes of Atez/Bev treatment. Methods: One hundred 25 HCC patients were enlisted; these patients received Atez/Bev treatment and underwent dynamic computerized tomography/magnetic resonance imaging to determine the treatment response on at least one occasion between October 2020 and January 2023, and their PNI before treatment and at the beginning of the second cycle (PNI-2c) was evaluated. Results: During the initial evaluation, 2 (2%), 28 (22%), 70 (56%), and 25 (20%) patients exhibited a complete response, partial response, stable disease, and progressive disease (PD), respectively. Patients with non-PD tended to have higher PNI at baseline and PNI-2c than those with PD (p = 0.245 and 0.122, respectively), with optimal baseline PNI and PNI-2c cut-off values of 42.6 and 40.4, respectively. PNI at baseline could not be used to predict overall survival (OS) or progression-free survival (PFS). However, PNI-2c predicted OS and PFS (PNI-2c ≥ 40.4 vs. < 40.4: 25.3 vs. 16.2 months, p = 0.008 for OS; 12.7 vs. 8.4 months, p = 0.036 for PFS). A multivariate analysis showed a significant association between PNI-2c and OS. Conclusions: PNI-2c is a predictor of prognosis in HCC patients treated with Atez/Bev therapy. Plain Language Summary: Atezolizumab plus bevacizumab (Atez/Bev) is the preferred treatment for advanced hepatocellular carcinoma (HCC). However, biomarkers of therapeutic efficacy have remained unclear. We took a retrospective approach to explore the role of prognostic nutritional index (PNI) for predicting the outcomes of Atez/Bev treatment. 125 HCC patients were enlisted; these patients received Atez/Bev treatment and underwent dynamic computerized tomography/magnetic resonance imaging to determine the treatment response on at least one occasion between October 2020 and January 2023, and their PNI before treatment and at the beginning of the second cycle (PNI-2c) was evaluated. During the initial evaluation, 2 (2%), 28 (22%), 70 (56%), and 25 (20%) patients exhibited a complete response, partial response, stable disease, and progressive disease (PD), respectively. Patients with non-PD tended to have higher PNI at baseline and PNI-2c than those with PD (p = 0.245 and 0.122, respectively), with optimal baseline PNI and PNI-2c cut-off values of 42.6 and 40.4, respectively. PNI at baseline could not be used to predict overall survival (OS) or progression-free survival (PFS). However, PNI-2c predicted OS and PFS (PNI-2c ≥ 40.4 vs. < 40.4: 25.3 vs. 16.2 months, p = 0.008 for OS; 12.7 vs. 8.4 months, p = 0.036 for PFS). A multivariate analysis showed a significant association between PNI-2c and OS. Therefore, PNI-2c is a predictor of prognosis in HCC patients treated with Atez/Bev therapy. [ABSTRACT FROM AUTHOR]

Purpose: Although numerous studies have investigated the impact of dietary factors on the prevention of decreased muscle mass and function, limited research has examined the relationship between dietary patterns and sarcopenia. This study aimed to assess the associations between dietary patterns, and sarcopenia, muscle strength, and mass in adults following a Mediterranean diet residing in southern Italian cities. Methods: This cross-sectional study utilized data from an existing database, comprising 528 individuals aged 50 years or older who underwent health-screening tests at the Clinical Nutrition Unit of the "R.Dulbecco" University Hospital. Strength was assessed through handgrip strength, and appendicular skeletal muscle mass was estimated using bioelectrical impedance analysis. Dietary intake information was collected through a food frequency questionnaire linked to the MetaDieta 3.0.1 nutrient composition database. Principal Component Analysis, a statistical technique identifying underlying relationships among different nutrients, was employed to determine dietary patterns. Multinomial logistic regression analysis was conducted to estimate the odds ratio for sarcopenia or low handgrip strength in relation to the lowest tertile of dietary pattern adherence compared to the highest adherence. Results: The participants had a mean age of 61 ± 8 years. Four dietary patterns were identified, with only the Western and Mediterranean patterns showing correlations with handgrip strength and appendicular skeletal muscle mass. However, only the Mediterranean pattern exhibited a correlation with sarcopenia (r = − 0.17, p = 0.02). The highest tertile of adherence to the Mediterranean dietary pattern demonstrated significantly higher handgrip strength compared to the lowest tertile (III Tertile: 28.3 ± 0.5 kg vs I Tertile: 26.3 ± 0.5 kg; p = 0.01). Furthermore, even after adjustment, the highest tertile of adherence to the Mediterranean pattern showed a significantly lower prevalence of sarcopenia than the lowest adherence tertile (4% vs 16%, p = 0.04). The lowest adherence to the Mediterranean dietary pattern was associated with increased odds of having low muscle strength (OR = 2.38; p = 0.03; 95%CI = 1.05–5.37) and sarcopenia (OR = 9.69; p = 0.0295; %CI = 1.41–66.29). Conclusion: A high adherence to the Mediterranean dietary pattern, characterized by increased consumption of legumes, cereals, fruits, vegetables, and limited amounts of meat, fish, and eggs, is positively associated with handgrip strength and appendicular skeletal muscle mass. The highest adherence to this dietary model is associated with the lowest odds of low muscle strength and sarcopenia. Despite the changes brought about by urbanization in southern Italy compared to the past, our findings continue to affirm the superior benefits of the Mediterranean diet in postponing the onset of frailty among older adults when compared to other dietary patterns that are rich in animal foods. [ABSTRACT FROM AUTHOR]

Aims: Evidence regarding impact of protein intake distribution on skeletal muscle mass in older adults is limited and inconsistent. This study aims to investigate the relationship of evenness of dietary protein distribution and number of meals exceeding a threshold with appendicular skeletal muscle mass (ASM) in healthy and free-living Chinese older adults. Methods: Repeated measured data of 5689 adult participants aged ≥ 60 years from the China Health and Nutrition Survey (CHNS) 2015 and 2018 waves were analyzed. Mixed-effects linear regression model was performed to examine the relationship between coefficient of variance (CV) of protein intake across meals, number of meals ≥ 0.4 g protein/kg BW and ASM, respectively. Analyses were conducted separately for male and female. Results: The average CV of protein intake in each wave was in the range of 0.34–0.35. More than 40% male and female participants in each wave had no meal reaching 0.4 g protein/kg BW. Female participants in the highest quartile of protein intake CV had significantly lower ASM (β = -0.18, 95%CI = -0.32, -0.04) compared with those in the lowest quartile, after adjustment for multiple confounders. Significant negative trends were observed across dietary protein CV quartiles with ASM both in male (P trend = 0.043) and female (P trend = 0.007). Significant positive association between number of meals exceeding 0.4 g protein /kg BW and relative ASM were observed in females (2 meals vs. 0 meal: β = 0.003, 95%CI = 0.0007,0.006;≥3 meals vs. 0 meal: β = 0.008, 95%CI = 0.003,0.013), after adjusting for multiple covariates. Conclusions: A more even-distributed protein intake pattern and more meals reaching protein intake threshold were respectively associated with higher appendicular skeletal muscle mass in healthy and free-living older Chinese adults. Prospective studies and intervention trials are needed to confirm these cross-sectional findings. [ABSTRACT FROM AUTHOR]

The incidence and mortality of ST-elevated myocardial infarction are increasing year by year, causing a huge economic burden to patients' families due to its severe clinical symptoms, high mortality, and poor prognosis. Percutaneous coronary intervention is the best treatment strategy for reducing myocardial infarction area, prolonging survival, and improving prognosis. To further improve the clinical effect of percutaneous coronary intervention in the treatment of ST-elevated myocardial infarction, this study explored the application value of nicorandil in the procedure. Oral nicorandil tablets were found to improve the cardiac function and myocardial microcirculation of patients with ST-elevated myocardial infarction, enhance their nutritional status, and reduce the risk of malnutrition. In the 6-month prognostic follow-up, nicorandil tablets provided more effective prognostic myocardial protection for patients. Therefore, we recommend the use of nicorandil tablets for adjuvant therapy during primary percutaneous coronary intervention in the future. [ABSTRACT FROM AUTHOR]

This study was conducted at Beijing Luhe Hospital, from January 2022 to October 2023. The aim of this study was to investigate the influence of malnutrition on the vulnerability to neonatal pneumonia. The study aimed to investigate the concept that malnourished children, who are admitted to the Neonatal Intensive Care Unit and pediatric hospital within the first 28 days of life, may have reduced immune responses, which could potentially increase their susceptibility to respiratory infections. The sample consisted of 150 newborns and a comprehensive dataset was gathered encompassing demographic information, birth weight, gestational age, breastfeeding status, clinical manifestations of pneumonia, and nutritional status. The nutritional assessment was performed utilizing the growth guidelines established by the World Health Organization. The results highlighted a notable correlation between malnutrition and heightened susceptibility to newborn pneumonia. Infants who were malnourished had a greater prevalence of pneumonia, extended durations of hospitalization, increased reliance on mechanical ventilation, and raised rates of mortality in comparison to their well-nourished counterparts. The practice of exclusive breastfeeding was identified as a protective factor that decreased the incidence of pneumonia. Additionally, early nutritional interventions have been found to dramatically enhance the prognosis. These findings emphasized the crucial importance of nutritional status in the management of newborn pneumonia and support the incorporation of nutritional evaluations and interventions into neonatal care. [ABSTRACT FROM AUTHOR]

The purpose of this article is to describe the impact of the research program entitled "Adherence to healthy eating recommendations: identification of measures, determinants and interventions". Beyond the main results described in this article, this program had a major impact on the training of graduate students. It was also a unique opportunity to develop and validate measurement tools relevant to nutrition research, and to make them available to the scientific community. Lastly, this program was a catalyst for establishing new collaborations and setting up larger-scale studies. [ABSTRACT FROM AUTHOR]

• Infant diet assessment validity varies by dietary component and feeding stage. • Carotenoid intake estimates differ by milk carotenoid adjustment and approach. • Carotenoid intake estimates from 3 days of food diaries correlate with 7 days. Validated carotenoid assessment methods are needed to study infant carotenoid nutrition. This is a secondary analysis of repeated diet assessments of healthy participants collected at 4- (n = 21), 6- (n = 12), and 8- (n = 9) months of age in Houston, TX between April 2019 and June 2020. Intake was assessed with 3 assessment tools, analyzed with 3 nutrient databases, and underwent 3 adjustments to account for milk composition variability. We hypothesized that manual adjustment of milk carotenoid intake based on laboratory measurements would improve the validity of all assessment approaches and that using a database with greater coverage of infant food carotenoid compositions would improve accuracy. Generalized linear mixed models assessed associations between tool, nutrient database, age, and milk carotenoid adjustment variables with carotenoid, energy, fruit, and vegetable intakes. The effect of the number of food diary days on intake estimate precision was evaluated by testing the correlation between intake estimates derived from 1, 3, or 5, vs. 7 days. Visit age influenced energy intake estimates (p =.029), along with assessment tool (p =.020). Estimates of vegetable intake were influenced by tool (p =.009). Combined fruit and vegetable intake differed by nutrient database (p =.007). Carotenoid intake differed by age (p =<.0001), tool (p =.002), and nutrient database (p =.004). A minimum of 3 food diary days strongly correlated (rho = 0.79-1) with reference estimates across ages. Milk carotenoid adjustment was most influential in estimating 4-month olds' carotenoid intake, while nutrient database and tool were important for 6- and 8-month-olds', highlighting the dynamic nature of infant diet assessment validity across feeding stages. There are multiple methods available to assess infant carotenoid intake. This study finds that estimated infant carotenoid intake is influenced by child age, milk carotenoid adjustment method, nutrient database, and assessment tool. [Display omitted] [ABSTRACT FROM AUTHOR]

Context Conflicting predictions of malnutrition for the long-term prognosis of coronary artery disease (CAD) exist. Objective This study aimed to investigate the relationship between malnutrition and long-term prognosis of patients with CAD. Data Sources Four databases were searched for articles from February 11, 1936, to September 10, 2022. Data Extraction Cohort studies adjusting for multiple cardiovascular risk factors with data on CAD and malnutrition were included. Malnutrition was measured and defined by different nutritional evaluation tools. The hazard ratios (HRs) and confidence intervals (CIs) for all-cause mortality and major adverse cardiovascular events (MACEs) were synthesized. Subgroup analyses were performed based on study design, assessment tools, ethnicity/race, follow-up, sample size, and types of CAD. Meta-regression was used to compare whether the effect sizes of the 2 subgroups were statistically significant. Data Analysis A total of 30 cohort studies were included, totaling 81 361 participants with CAD. Nutritional evaluation tools, including the Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status (CONUT), Nutritional Risk Screening 2002, Mini-Nutritional Assessment, and Prognostic Nutritional Index, were used. Malnutrition increased all-cause mortality (HR = 1.72; 95% CI: 1.53, 1.93) and MACEs (HR = 1.47; 95% CI: 1.35, 1.60) in patients with CAD. Subgroup analysis revealed the results were consistent across study design, ethnicity/race, follow-up, sample size, and types of CAD. Subgroup analyses and meta-regression revealed that malnutrition was associated with a higher risk of all-cause mortality (HR = 2.26; 95% CI: 1.91, 2.68) and MACEs (HR = 2.28; 95% CI: 1.69, 3.08) in patients with stable CAD than those with other types of CAD. Meta-regression revealed that the GNRI (HR = 2.20; 95% CI: 1.65, 2.93) was more effective than CONUT (HR = 1.47; 95% CI: 1.21, 1.78) in predicting all-cause mortality. Conclusion Malnutrition independently increased all-cause mortality by 72% and MACEs by 47% in patients with CAD, especially with stable CAD. The GNRI is a more effective nutritional evaluation tool than CONUT in predicting all-cause mortality. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Malnutrition is a prevalent health issue among hemodialysis patients. Oral frailty, a condition characterized by impairments in multiple oral health aspects and functions, has been associated with nutritional status in the general population. We aimed to determine whether oral frailty was associated with nutritional status in hemodialysis patients aged ≥50 years. Our secondary aim was to determine the prevalence of oral frailty in this population.This cross‐sectional study included hemodialysis patients who were admitted to a single medical center. According to the Oral Frailty 5‐item Checklist, oral frailty is characterized by the presence of two or more of the following criteria: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Patients' nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Multivariable ordinal logistic regression analysis was performed to assess the association between oral frailty and nutritional status (classified into three categories according to the GNRI: >98, 92–98, and <92).In total, 152 hemodialysis patients (55 women and 97 men) with a mean age of 70.4 years were included. The prevalence of oral frailty was 61.2%. After adjusting for health characteristics and sociodemographic background, oral frailty was associated with poor nutritional status according to the GNRI (odds ratio = 2.04, 95% confidence interval = 1.02–4.09).In this study, approximately 60% of hemodialysis patients aged ≥50 years exhibited oral frailty, and hemodialysis patients with oral frailty had poor nutritional status according to the GNRI. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Simple Summary: Nutritional status is closely related to the outcomes of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). However, the prognostic value of the Controlling Nutritional Status (CONUT) score in CRS-HIPEC has not yet been investigated. This study evaluated the predictive power of the CONUT score for mortality and postoperative complications after CRS-HIPEC. We found that patients with high CONUT score exhibited significantly higher 1-year mortality and postoperative complication rates than those with low CONUT score. Notably, a high CONUT score was identified as an independent risk factor for 1-year mortality and postoperative complications. These results suggest the potential of the CONUT score as a robust risk stratification tool for identifying high-risk patients within the CRS-HIPEC surgical demographic. The Controlling Nutritional Status (CONUT) score is a novel nutritional index that integrates the serum albumin level, peripheral blood lymphocyte count, and total cholesterol level. This retrospective study explores its prognostic significance in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). We included 436 patients who underwent CRS-HIPEC, categorized into low (0–3) and high (4–12) CONUT score groups, and performed logistic regression analysis to predict one-year mortality and postoperative morbidity. Our findings revealed that high CONUT scores correlate with increased one-year mortality (47.1% vs. 20.3%, p < 0.001) and morbidity (39.2% vs. 18.2%, p < 0.001) compared to low CONUT scores. Multivariable regression analysis confirmed high CONUT scores as independent predictors of one-year mortality (odds ratio: 2.253, 95% CI: 1.014–5.005, p = 0.046) and postoperative morbidity (odds ratio: 2.201, 95% CI: 1.066–4.547, p = 0.033). These results underscore the CONUT score's effectiveness as an independent marker for evaluating risks associated with CRS-HIPEC, emphasizing its potential to improve risk stratification. [ABSTRACT FROM AUTHOR]

Background: This research aimed at understanding how changes in one behavior affect other behaviors, known as "transfer effect," could extend knowledge of shared constructs among compound health risk behaviors, and improve methods for promoting simultaneous behavior changes. The current study explored whether participants who completed a randomized controlled trial for physical activity (PA) improved their diet with no intervention in diet or nutrition. Methods: US adults (N = 283) were randomly assigned to 12 weeks of either exercise videogames, standard exercise, or an attention control. Secondary analyses were conducted to examine a possible transfer effect of the intervention on diet at end of intervention (EOT) and 6-month follow-up. Assessments of potential PA constructs (i.e., exercise enjoyment, self-efficacy) and demographics (e.g., age, gender) were conducted. PA, specifically moderate-to-vigorous levels of physical activity (MVPA), was measured using a self-report measure. Diet was measured using the Rate Your Plate dietary assessment. Results: Findings support that a randomization effect was associated with a higher likelihood of increasing MVPA (β = 30.00, 95% CI = 4.46, 64.46) and dietary improvement at EOT (β = 1.48, SE =.83, P =.01) and follow-up (β = 1.74, SE =.52, P =.02). At EOT, changes in diet were associated with higher PA enjoyment (β = 0.41, SE = 0.15, P =.01). This intervention effect on diet was moderated by gender, with women showing more dietary improvement than men (β = −.78, SE = 13, P =.03). At 6 months, dietary improvement was associated with greater self-efficacy (β =.04, SE =.01, P =.01). Conclusion: This study shows evidence of a transfer effect among two synergistic behaviors and expands understanding of factors that predict the occurrence of this type of behavior change. [ABSTRACT FROM AUTHOR]

Background: It is well established that the elderly have a greater risk of malnutrition. social, physical, & mental aspects all come together to form the multidisciplinary concept of malnutrition in the elderly. In this research, we set out to assess the nutritional condition & to identify the frequency and risk factors for malnutrition between elderly individuals living in nursing homes in addition to those living in the community in Zagazig City, Sharkia governorate. Methods: A comparative cross-sectional research was performed on 222 cases, 111 cases in each group. Elderly residents of nursing homes and elderly persons attending geriatric clubs in Zagazig city to represent the nursing home living group and the community living group, respectively from the first of October 2022 to the end of April 2023.Anthropometric measures & information gathered from the Mini Nutritional Assessment (MNA) scale were utilized to assess the condition of nutrition. Results: The mean score of MNA was statistically higher among the elderly in the community than elderly in nursing homes (24.76± 3.27 and 17.2±5.25), respectively. The frequency of malnutrition was significantly more prevalent among nursing home living elderly (43.2%) versus zero percent among community living elderly, and the risk of malnourishment was significantly associated with advancement in age among both groups. There was a significant positive correlation amongst the MNA score & the Body Mass Index (BMI) among both groups. Conclusion: Malnutrition is a greater risk for the elderly. The study's findings highlight the critical value of nutritional screening among elderly people. Counseling families and staff in nursing homes about the appropriate nutritional care of the elderly is advised. [ABSTRACT FROM AUTHOR]

It is critical to screen and assess malnutrition in cancer patients early. However, there is no uniform standard for nutritional risk screening and malnutrition assessment. We aimed to analyze the effects of the Nutrition Risk Screening 2002 (NRS2002) in screening for nutritional risk among adult cancer patients, using the Patient-Generated Subjective Global Assessment (PG-SGA) as the reference standard. A systematic search was performed using PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Science and Technology Journal Database (VIP). Studies comparing NRS2002 with PG-SGA in adult cancer patients were included. To assess the quality of the included studies, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used. The combined sensitivity, specificity, diagnostic odds ratio (DOR), and the area under the receiver-operating characteristic curve (AUC) were calculated. In addition, sensitivity, subgroup, and publication bias analyses were performed. Thirteen articles involving 3,373 participants were included. The combined sensitivity, specificity, DOR, and AUC were 0.62 (95% CI, 0.60–0.64), 0.86 (95% CI, 0.84–0.88), 11.23 (95% CI, 8.26–15.27), and 0.85 (95% CI, 0.82–0.88), respectively. For adult cancer patients, NRS2002 has moderate sensitivity, high specificity, and high AUC in screening for nutritional risk. [ABSTRACT FROM AUTHOR]

Vitamin B12 plays a role in DNA methylation, influencing the 1-carbon cycle; However, its effect on colorectal cancer (CRC) mortality remains uncertain. This study assessed the relationship between vitamin B12 intake and all-cause and cancer-specific mortality among CRC patients. We analyzed data from the NHANES from 1999 to 2018, using multivariable Cox regression, competing risk model, Kaplan-Meier survival curves, and stratified analysis with interaction effects. The studied involved 4,554 cancer patients (mean age 65.8 years, 47.6% males). Results from multivariate Cox regression indicated that each additional 1 mcg/day of dietary vitamin B12 independently increased the risk of all-cause (HR, 1.07; 95% CI: 1.04–1.09, p < 0.001) and cancer-specific mortality (HR, 1.04; 95% CI, 1.02-1.06; p < 0.001). Kaplan-Meier curves indicated a higher risk of all-cause mortality with increased vitamin B12 intake (Log rank p = 0.01). Subgroup analysis suggested that higher vitamin B12 intake correlated with increased all-cause mortality risk, especially in individuals with higher protein (HR, 1.04; 95% CI, 1.02-1.06; p = 0.019) or carbohydrate intake (HR, 1.03; 95% CI, 1.01-1.05; p = 0.04). Thus, higher vitamin B12 intake correlates with increased all-cause and cancer-specific mortality in CRC patients, particularly those with higher protein or carbohydrate intake. [ABSTRACT FROM AUTHOR]

Nutritional status is an essential factor in the occurrence of complications in patients with esophageal cancer. We sought to assess the relationship between malnutrition and complications using various nutritional assessment indicators. We conducted a comprehensive literature search of medical databases for articles published up to July 2023. The primary outcome indicator is the occurrence of complications, for which we combined 95% confidence intervals (CIs) and odds ratios (ORs) for postoperative complications and analyzed them using a random effects model. The analysis was carried out using STATA15.0 software. A total of 33 study groups from 22 publications with 5,675 subjects were included. Pooled results show that nutritional indicators are strongly correlated with the occurrence of postoperative complications (OR = 1.45, 95% CI: 1.30–1.62). In the subgroup analyses, comprehensive indicators and the skeletal muscle index were significantly associated with complications, whereas laboratory indicators were not associated with complications (comprehensive indicators OR = 2.68, 95% CI: 1.80–4.00; skeletal muscle index OR = 2.93, 95% CI: 1.44–5.99; laboratory indicators OR = 1.05, 95% CI: 0.96–1.16). Patients with normal body mass index and hospitalized patients were more likely to develop complications. Malnutrition is strongly associated with the development of complications. Nutritional indicators and patient characteristics influenced this relationship. [ABSTRACT FROM AUTHOR]

Nutritional status and its index (Prognostic Nutritional Index, PNI) is an important prognostic factor for ST-segment elevation myocardial infarction (STEMI). The present study investigated whether PNI it is associated with no-reflow in patients with STEMI. In this retrospective study, 404 patients with STEMI and underwent primary percutaneous coronary intervention (pPCI) were consecutively included, between January 2016 and December 2018. No-reflow phenomenon (NRP) was detected in 103 (25.4%) patients. In multivariate logistic regression analysis C-reactive protein (CRP) (odds ratio (OR): 1.693, 95% confidence interval (CI): 1.126–2.547, P =.011), left ventricle ejection fraction (LVEF) (OR: 0.777, 95% CI: 0.678–0.891, P <.001), SYNTAX score (OR: 1.114, 95% CI: 1.050–1.183, P =.001), low density lipoprotein cholesterol (LDL-C) (OR: 1.033, 95% CI: 1.013–1.055, P =.002), hemoglobin level (OR: 0.572, 95% CI: 0.395–0.827, P =.003), PNI (OR: 0.554, 95% CI: 0.448–0.686, P <.001) were associated with NRP. The area under curve of PNI was significantly higher than albumin (z = 4.747, P <.001) and lymphocyte values (z = 3.481 P <.001). PNI was associated with no-reflow occurrence and mortality. So, PNI may be useful to predict NRP risk in patients with STEMI before pPCI. [ABSTRACT FROM AUTHOR]

Aim: This study describes the study design, study participants, participation rate and underreporting in the Danish National Surveys of Diet and Physical Activity (DANSDA) from 1995 to 2011–2013. Methods: DANSDA are government-funded surveys of food and nutrient intake, physical activity and lifestyle, undertaken to support nutritional policy, risk assessment and public health research. The surveys are cross-sectional based on primarily simple random samples (ages 1–80 years in 1995, 4–75 years in 2000–2013) drawn from the Danish Civil Registration System. Approximately 4800 individuals in 1995, 8200 in 2000–2002, 8400 in 2003–2008 and 7300 in 2011–2013 were invited to participate. Participants completed a seven-day food diary, a physical activity questionnaire (2000–2008), a step diary (2011–2013) and a face-to-face interview. Self-reported anthropometrics (1995–2013) were supplemented with device-based measures (2011–2013). Pedometers were included in 2011–2013. Results: The number of participants included per survey round was 3100-4400. Participant rates decreased from 66% (1995) to 54% (2011–2013). Non-participation was primarily refusal. Ages 18–30 years, 61–75 years (2000–2013), 61–80 years (1995) and low educated and individuals living alone were underrepresented. Underreporting of energy intake among adults ranged from 14% (1995) to 26% (2008). Conclusions: The methods in DANSDA have been developed to include device-based measures on physical activity and anthropometrics. This has improved the applicability of the results of the survey. The participation rate has fallen, which has affected sample representativity, and underreporting has increased. Future DANSDA surveys should explore and consider new initiatives to counteract non-response and underreporting, with the aim of enhancing data representativeness and applicability. [ABSTRACT FROM AUTHOR]