Correlation of dietary mineral intake and malnutrition in cancer patients:A multicenter cross-sectional study

Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.

FOXO1 reshapes neutrophils to aggravate acute brain damage and promote late depression after traumatic brain injury

Background:Neutrophils are traditionally viewed as first responders but have a short onset of action in response to traumatic brain injury(TBI).However,the heterogeneity,multifunctionality,and time-dependent modulation of brain damage and outcome mediated by neutrophils after TBI remain poorly understood.Methods:Using the combined single-cell transcriptomics,metabolomics,and proteomics analysis from TBI patients and the TBI mouse model,we investigate a novel neutrophil phenotype and its associated effects on TBI outcome by neurological deficit scoring and behavioral tests.We also characterized the underlying mechanisms both invitro and invivo through molecular simulations,signaling detections,gene expression regulation assessments[including dual-luciferase reporter and chromatin immunoprecipitation(ChIP)assays],primary cultures or co-cultures of neutrophils and oligodendrocytes,intracellular iron,and lipid hydroperoxide concentration measurements,as well as forkhead box protein O1(FOXO1)conditional knockout mice.Results:We identified that high expression of the FOXO1 protein was induced in neutrophils after TBI both in TBI patients and the TBI mouse model.Infiltration of these FOXO1high neutrophils in the brain was detected not only in the acute phase but also in the chronic phase post-TBI,aggravating acute brain inflammatory damage and promoting late TBI-induced depression.In the acute stage,FOXO1 upregulated cytoplasmic Versican(VCAN)to interact with the apoptosis regulator B-cell lymphoma-2(BCL-2)-associated X protein(BAX),suppressing the mitochondrial translocation of BAX,which mediated the antiapoptotic effect companied with enhancing interleukin-6(IL-6)production of FOXO1high neutrophils.In the chronic stage,the“FOXO1-transferrin receptor(TFRC)”mechanism contributes to FOXO1high neutrophil ferroptosis,disturbing the iron homeostasis of oligodendrocytes and inducing a reduction in myelin basic protein,which contributes to the progression of late depression after TBI.Conclusions:FOXO1high neutrophils represent a novel neutrophil phenotype that emerges in response to acute and chronic TBI,which provides insight into the heterogeneity,reprogramming activity,and versatility of neutrophils in TBI.

Impact of Three-month Home Enteral Nutritional Supplementation on the Nutritional Status of Patients with Malignancy

Objective We analysed the impact of home nutritional interventions on the nutritional risk and the incidence and severity of malnutrition in patients with malignancy.Methods In this prospective interventional study,we recruited 60 patients with malignancy who were at nutritional risk(NRS 2002≥3 scores).These patients were given home enteral nutritional supplementation(HES)for 3 months.The HES included nutritional counselling,oral nutritional supplements(ONS)and tube feeding.The incidence and severity of nutritional risk and malnutrition,as well as the body composition and results of routine blood tests,were compared before and after the intervention.Results A total of 58 patients completed the study.After three months of home enteral nutritional intervention,the incidence and severity of nutritional risk and malnutrition were significantly reduced(the NRS 2002 score was reduced from 3 to 1,the PG-SGA score was reduced from 8.00 to 3.00,P<0.05).The patients’body mass index(BMI)and upper arm circumference increased(P<0.05),the muscle mass,appendicular skeletal muscle mass index(ASMI)and phase angle(PA)increased(P<0.05).The serum albumin,pre-albumin and haemoglobin levels increased significantly,while the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)decreased significantly(P<0.05).The incidence of hypoproteinaemia and anaemia also decreased significantly(P<0.05).Conclusion HES can effectively improve the nutritional status of patients and reduce the risk and severity of malnutrition.

Using the Delphi method to propose foods for special medical purposes health effect evaluation indicators

Objective:The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes(FSMPs).This lays the foundation for the formation of a big data model for human health testing,as well as a big data platform for the health and safety evaluation of special medical foods.Methods:The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.Results:Ten major items were identified after two rounds of expert consultation.Among these,there were 10 primary entries,32 secondary entries,50 tertiary entries,and 28 quaternary entries.Conclusion:The complete list of evaluation indicators contains 10 entries,which can comprehensively and systematically monitor adverse reactions to the use of FSMPs.The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.

Meta-Analysis of the Breast Cancer Risk Associated with Three Dietary Patterns

Objectives A meta-analysis was conducted to assess the association between breast cancer risk and three common dietary patterns.Methods The PubMed,Web of Science,CNKI,Wanfang,Embase,and Cochrane Library databases were systematically searched(until June 2022)for studies on the association between three common dietary patterns,including the Western dietary pattern,vegetarian dietary pattern and Mediterranean dietary pattern,and the risk of breast cancer.The Newcastle-Ottawa(NOS)scale was used to assess study quality.Results A total of 24 articles published from 2001 to 2021 that met the criteria were included for meta-analysis.The Western dietary pattern was positively associated with the breast cancer risk in women both before and after menopause,although the heterogeneity in the study was high(HR=1.05,95%CI:1.01-1.30,I^(2)=56.2%,P=0.019).There was an inverse association between the vegetarian dietary pattern and breast cancer risk among women(HR=0.87,95%CI:0.78-0.97,I^(2)=73.7%,P<0.001).No association was observed between the Mediterranean dietary pattern and women's risk of breast cancer(HR=0.96,95%CI:0.89-1.02,I^(2)=64.1%,P=0.010).Due to the presence of significant heterogeneity among the studies,we performed a subgroup analysis,meta-regression analysis and sensitivity analysis,and found that factors such as the type of study design were the main sources of heterogeneity in each group.These results remained largely unchanged after excluding studies of a specific type from the sensitivity analysis.Conclusion The Western dietary pattern can increase the risk of breast cancer,while the vegetarian dietary pattern can reduce the risk of breast cancer.No association between the Mediterranean dietary pattern and the risk of breast cancer was observed.