搜索结果：Frontiers in nutrition

To summarize the available evidence on perioperative tube-fed enteral nutrition in esophageal cancer patients. This article was an evidence summary according to the evidence summary reporting standard of the Fudan University Center for Evidence-Based Nursing. A systematic literature search was conducted on the management of tube-fed enteral nutrition in patients with esophageal cancer. The types of literature included clinical decisions, guidelines, expert consensus, evidence summaries, and systematic evaluations. The following databases and resources were systematically searched: BMJ Best Practice, Up To Date, Guidelines International Network, National Guideline Clearing-house, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, Yi Mai Tong Guidelines Network, The Cochrane Library, PubMed, Web of Science, CINAHL, Embase, Wan Fang, CNKI, VIP, and SinoMed; and websites of relevant professional associations, including National Comprehensive Cancer Network, American Cancer Society, European Society for Clinical Nutrition and Metabolism website, American Society for Parenteral and Enteral Nutrition website, China Nutritional Sciences Resource Platform, and Chinese Nursing Association. The search period spanned from the database setup to November 2024. A total of 20 articles were included, including 2 clinical decisions, 9 guidelines, 7 expert consensus, 1 evidence summary, and 1 systematic review. A total of 40 pieces of evidence were summarized from 9 aspects: team management, nutritional risk screening and assessment, nutritional support indications, enteral nutritional support routes and timing, target nutrient requirements, enteral nutritional preparations, implementation of tube-fed enteral nutrition, maintenance of tubing, monitoring of nutritional support, and evaluation of outcomes. This article summarizes evidence on perioperative tube-fed enteral nutrition management in patients with esophageal cancer. Clinical practitioners should select and apply evidence, considering actual medical conditions and the patient's specific condition, to scientifically administer perioperative tube-fed enteral nutritional support in patients with esophageal cancer. identifier ES20246670.

Enteral feeding tolerance during vasopressor therapy remains uncertain, particularly within the moderate-dose gray zone. This preregistered analysis tested whether pre-feeding arterial lactate modifies the dose-response relationship between norepinephrine-equivalent dose and enteral feeding intolerance (vomiting). Using the same MIMIC-IV cohort (n&#x202f;=&#x202f;8,055), we examined whether baseline arterial lactate (most recent value within 24&#x202f;h before enteral nutrition initiation) modifies the norepinephrine-equivalent dose-vomiting association. Effect modification was assessed via multiplicative interaction in multivariable logistic regression and stratified restricted cubic spline analyses, with lactate dichotomized at 2&#x202f;mmol/L. A joint risk surface was constructed using generalized additive modeling. Among 5,542 patients with available lactate (68.8% of the parent cohort), 278 (5.0%) developed vomiting. The global test for multiplicative interaction was not significant (p&#x202f;=&#x202f;0.27). Exploratory stratified analysis showed a localized signal at doses of 0.3-0.5 &#x3bc;g/kg/min: vomiting was 9.8% among patients with lactate >2 mmol/L versus 4.9% among those with lactate &#x2264;2 mmol/L. Separately, in the dichotomized joint-exposure model, norepinephrine-equivalent dose &#x2265;0.3 &#x3bc;g/kg/min plus lactate >2 mmol/L was associated with an adjusted OR of 2.02 (95% CI 1.33-3.07; p = 0.001) versus dose <0.3 &#x3bc;g/kg/min plus lactate &#x2264;2 mmol/L. Dose-response curves showed steeper risk escalation in the elevated-lactate stratum, though confidence bands overlapped throughout; this divergence was directionally consistent across alternative lactate thresholds (1.5 and 4.0&#x202f;mmol/L) and exposure windows (6-h, 12-h). At moderate vasopressor doses, elevated arterial lactate may identify a subgroup with a higher observed vomiting rate-an exploratory signal not fully captured by vasopressor dose alone. If confirmed prospectively, this pattern could inform a lactate-stratified approach to enteral feeding advancement: at norepinephrine-equivalent 0.3-0.5&#x202f;&#x3bc;g/kg/min, lactate >2&#x202f;mmol/L might support slower advancement with closer monitoring rather than standard escalation. Given that feeding intolerance is a key driver of enteral nutrition interruption, these findings have potential downstream implications for nutritional adequacy and clinical outcomes. Because the global interaction was not statistically significant, these findings are hypothesis-generating and require prospective validation.

Severe traumatic brain injury (TBI) induces a hypermetabolic state that heightens the risk of mortality and poor neurological outcomes. Early enteral nutrition (EEN), typically defined as initiation within 48&#x202f;h of injury, is considered crucial, yet robust evidence of its specific benefits in TBI patients remains limited. Following PRISMA guidelines, we systematically searched the PubMed, Embase, Web of Science, and Cochrane Library databases through December 25, 2025, for studies comparing EEN with delayed enteral nutrition (DEN) in adults with TBI. Outcomes included clinical outcomes, nutrition status, and complications. Study quality was assessed using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. The primary outcome was short-term mortality, defined as from hospital admission to 90&#x202f;days post-discharge. Sensitivity analyses and subgroup analyses explored heterogeneity. Ten studies (6 randomized controlled trials [RCTs]; 4 observational; 13,046 patients) were included. When all studies (RCTs and observational) were pooled, there was no significant difference in short-term mortality risk between EEN and DEN (risk ratio [RR]&#x202f;=&#x202f;0.64; 95% CI, 0.32-1.31). However, a prespecified sensitivity analysis limited to RCTs showed a significant reduction in mortality with EEN (RR&#x202f;=&#x202f;0.58; 95% CI, 0.35-0.96). EEN significantly shortened mechanical ventilation duration and reduced both ICU and hospital length of stay. Nutritional status, including serum albumin levels, glucose control, caloric intake, and positive nitrogen balance, was markedly improved with EEN, without increasing hospitalization costs. EEN also significantly lowered rates of sepsis, central nervous system infection, stress ulcer, ventilator-associated pneumonia, and total adverse events (all p values range from <0.00001 to 0.04), though it was associated with a mildly elevated risk of diarrhea (p&#x202f;=&#x202f;0.02). In this meta-analysis, EEN initiated within 48&#x202f;h of TBI showed a trend toward reduced short-term mortality and improvements in clinical and nutritional outcomes compared to DEN. However, these findings should be interpreted cautiously given the high risk of bias and substantial statistical heterogeneity in the included studies. Future high-quality, large-scale RCTs are needed to confirm these effects and refine optimal feeding strategies in this population. https://inplasy.com/wp-content/uploads/2026/01/INPLASY-Protocol-8729.pdf.

Previous studies have identified the triglyceride-glucose (TyG) index as a practical surrogate marker of insulin resistance and have suggested its association with several metabolic disorders. However, the association between the TyG index and thyroid function parameters has not yet been fully clarified. The present study was conducted to examine this association in Chinese adults from the general population. This cross-sectional study included 5,189 adults who underwent health examinations. Multivariable linear regression was performed to investigate the associations between the TyG index and thyroid function parameters, including free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH). Potential non-linear dose-response associations were explored by using restricted cubic spline (RCS) analyses, while threshold effects were evaluated using piecewise linear regression. Subgroup analyses were conducted to examine whether the associations varied across subgroups, and sensitivity analyses were performed in strictly euthyroid participants. After full adjustment for potential confounders, the TyG index showed no clear linear association with FT3, whereas it was inversely associated with FT4. Non-linearity analyses indicated a significant inverted U-shaped association of the TyG index with FT3 (P for non-linearity < 0.001), the TyG index was positively associated with FT3 below the inflection point of 8.311 and negatively associated with FT3 above this point. In contrast, piecewise linear regression suggested a threshold effect for FT4 (P for likelihood ratio test&#x202f;=&#x202f;0.016), with the TyG index showing a positive association below 7.591 and a negative association above this point. Additionally, the TyG index was positively associated with lnTSH after full adjustment. Subgroup analyses suggested potential effect modification for FT3 by sex, FT4 by thyroid status, and TSH by age. The non-linear patterns for FT3 and FT4 remained generally similar in sensitivity analyses restricted to strictly euthyroid participants. This study observed complex linear and non-linear associations between the TyG index and thyroid function parameters. These findings suggest a potential metabolic-thyroid association that warrants further evaluation in longitudinal studies.

School meals are increasingly recognized as instruments for supporting child nutrition, educational participation, and social protection. However, limited attention has been given to how the absence of an institutionalized national program can be distinguished from implementation failure, low policy priority, or fragmented provision. This study examines the institutional organization of school food provision in T&#xfc;rkiye. A structured narrative review was combined with qualitative policy document analysis. Epidemiological studies, national institutional reports, legislative and regulatory documents, international guidelines, and comparative program evidence were reviewed. Policy documents were assessed across five dimensions: legal and institutional commitment, program coverage and entitlement, financing, implementation responsibility and continuity, and monitoring and accountability. The reviewed evidence indicates that nutritional vulnerability among children and adolescents in T&#xfc;rkiye includes excess body weight, irregular meal patterns, selected micronutrient-related concerns, and socioeconomic conditions that may constrain access to adequate food. The school food system combines household provision, regulated commercial food services, and publicly financed meals for particular eligible groups. Although these arrangements demonstrate that public intervention exists, the document analysis did not identify a comprehensive national program combining clearly defined entitlement, recurrent financing, designated implementation responsibility, continuity, nutritional standards, and integrated monitoring. The Turkish case is therefore characterized by policy absence at the level of institutionalized national program provision, coexisting with regulatory, targeted, and fragmented interventions. The study does not establish a causal relationship between this institutional configuration and specific nutritional or educational outcomes. It proposes a state-guaranteed, multi-level governance framework combining national financing and standards with decentralized implementation, professional nutritional oversight, participatory monitoring, and independent evaluation. The study contributes an operational framework for analyzing policy absence as an observable institutional condition rather than as the complete absence of public action.

Translating nutritional recommendations into practical day-to-day meal choices remains a challenging task, particularly when personalization, nutritional adequacy, dietary diversity, allergies, seasonal availability, and food-group constraints must be simultaneously satisfied. This study presents and evaluates the PLAN'EAT Nutrition Advisor, an Artificial Intelligence (AI)-driven, expert rule-based nutrition recommendation system, designed to generate personalized and nutritionally balanced weekly meal plans aligned with established dietary guidelines and food-group recommendations derived from Sustainable Healthy Diet (SHD) principles. The proposed approach is built upon the PLAN'EAT Expert-Curated Meal Database, a nutritionist-designed repository introduced in this work, comprising 401 expert-curated meals spanning Irish, Spanish, and Hungarian cuisines. Meal-plan generation follows a four-stage pipeline: (1) meal filtering based on country-specific cuisine, seasonality, dietary preferences, and allergies, (2) daily meal plan generation through large-scale sampling and scoring against expert-defined nutritional targets, (3) weekly meal plan assembly and optimization under nutritional and food-group constraints, and (4) diversity optimization to promote dietary variety while preserving nutritional validity. The proposed approach was validated through a large-scale in-silico validation involving 1,000 synthetic user profiles and the generation of 16,000 weekly meal plans corresponding to 112,000 daily meal plans. Adherence to daily and weekly nutritional targets, food-group constraints, and overall meal-plan validity at scale were assessed. In addition, we performed a preliminary descriptive evaluation against state-of-the-art Large Language Model (LLM)-based approaches under two complementary settings: Retrieval-Augmented Generation (RAG) and Supervised Fine-Tuning (SFT). Experimental results demonstrate that the proposed system can efficiently generate personalized, nutritionally compliant, and diverse weekly meal plans while maintaining transparent expert-rule-driven optimization. Furthermore, the descriptive evaluation against LLM approaches suggests that the proposed system achieves more consistent energy and macronutrient adherence under the evaluated conditions.

Chronotype reflects interindividual differences in the circadian timing system. Animal studies suggest reduced mitochondrial oxidative metabolism and tricarboxylic acid (TCA) cycle activity in individuals with an evening chronotype; however, human evidence linking chronotype to mitochondrial metabolic alterations remains limited. This cross-sectional study examined whether chronotype is associated with differences in circulating TCA-related metabolites, including pyruvate, lactate, and citrate. A total of 272 adults from the 2022 Gangwon Obesity and Metabolic Syndrome Cohort were classified as having morning (&#x2265;18), intermediate (12-17), or evening (&#x2264;11) chronotype using the reduced Morningness-Eveningness Questionnaire. Fasting serum concentrations of pyruvate, lactate, and citrate were measured. Associations were examined using general linear models adjusted for fasting status; demographic, socioeconomic, and lifestyle factors; as well as body mass index. Sensitivity analyses excluded participants taking metabolic disease-related medications. Major clinical and metabolic indicators did not differ across chronotypes. Serum pyruvate concentrations were higher in the evening chronotype group than in the morning chronotype group across all adjusted models (p&#x202f;<&#x202f;0.048), whereas lactate and citrate concentrations did not differ. These findings remained consistent in sensitivity analyses excluding participants with metabolic diseases (p&#x202f;=&#x202f;0.006-0.010). Across analyses that included and excluded participants using metabolic disease-related medications, evening chronotype was consistently associated with higher circulating pyruvate concentrations, a key metabolic branch point downstream of glycolysis. These findings suggest chronotype-related differences in pyruvate metabolism, with potential implications for metabolic regulation.

Maternal consumption of a Western diet (WD) during critical developmental periods has been shown to program long-term metabolic dysfunction in offspring. However, it remains unclear whether these early exposures leave a persistent transcriptomic imprint into adulthood and whether this signature can be reshaped by postnatal interventions, limiting insight into underlying mechanisms and opportunities for early intervention. Here, we aimed to identify long-term transcriptomic signatures associated with maternal WD exposure during gestation and lactation using peripheral blood mononuclear cells (PBMCs) from adult male and female offspring. We further evaluated the potential of two early-life interventions - maternal dietary normalization and pup leptin supplementation during lactation - to reverse these alterations. The offspring from dams fed a normal-fat diet during gestation and lactation was used as a control group. Considering all groups, the expression of 90 genes differed between the control and WD offspring. Both interventions normalized the expression of most genes altered by maternal WD exposure (83 and 76 out of 90, respectively), shifting the global transcriptomic profile toward control levels. Multivariate analyses identified the 20 highest-ranked contributors to the PLS-DA model distinguishing offspring of WD-fed dams from controls, with stronger discriminatory capacity in males than in females, suggesting coordinated dysregulation of immunometabolic pathways, primarily involving immune and inflammatory signaling, cell fate regulation, and metabolic homeostasis. In conclusion, interventions during lactation may effectively reverse most transcriptomic alterations associated with adverse maternal conditions, supporting this period as a critical window for postnatal reprogramming. These findings suggest that early nutritional interventions may help mitigate long-term health risks associated with adverse maternal diet and support the use of PBMC transcriptomic signatures as potential minimally invasive biomarkers of developmental programming.

Circulating amino acids (AAs) are important biomarkers of nutritional status, metabolic homeostasis, and disease related physiological changes. However, the influence of specimen type and age on AA measurements remains incompletely understood. This study aimed to establish a robust liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for quantifying 29 amino acids (AAs), compare serum and plasma matrices, and investigate age related variations in healthy populations. In a cross-sectional study, a total of 231 healthy adults (&#x2265;18&#x202f;years) and 140 children (<18&#x202f;years) were recruited from the Shanghai area with a subgroup of 26 adults providing paired serum and plasma samples. Twenty-nine AA quantification was performed using LC-MS/MS with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate (AQC) derivatization. Method validation followed Clinical and Laboratory Standards Institute (CLSI) guidelines for linearity, lower limit of quantitation (LLOQ), precision, accuracy, carryover, and stability. The assay demonstrated excellent linearity (R 2&#x202f;>&#x202f;0.99), precision (CV&#x202f;<&#x202f;15%), and accuracy (bias < 10%) with minimal carryover and acceptable LLOQs for all 29 AAs. Matrix differences and correlations were evaluated using the paired samples, while age related AA profiles were assessed in largely independent serum and plasma cohorts of pediatric and adult. Serum and plasma concentrations correlated well for most AA. However, significant matrix dependent differences were observed for several amino acids, including GABA, Ser, Tau, Sar, and Asp (R 2&#x202f;<&#x202f;0.5). Age related analysis revealed that most essential AAs (Leu, Ile, Trp, Phe, His, Tyr) exhibited higher median concentrations in children compared to adults in serum. Conversely, lysine and threonine were significantly higher in adult serum. In plasma, age related differences were less pronounced for essential AAs but consistent for specific non-essential AAs. Bubble plot showed Cit, Arg, and Gln were positively associated with age, while GABA was negatively associated with age. The validated LC-MS/MS platform provides a reliable platform for nutritional biomarker research. Matrix selection and age are critical factors in AA interpretation, offering valuable insights for clinical diagnostics and translational metabolomics research.

Maternal high-fat diet (mHFD) is a growing global nutritional concern during pregnancy. It induces maternal systemic low-grade inflammation and oxidative stress, reshaping the intrauterine milieu via the placenta and causing selective developmental impairments in offspring midbrain dopaminergic (DA) neurons-including aberrant precursor proliferation/differentiation, simplified synapses, and nigrostriatal circuit deficits-which may increase adulthood Parkinson's disease (PD) susceptibility. Mechanistically, mHFD acts through two synergistic pathways: persistent activation of the insulin resistant-NF-&#x3ba;B inflammatory axis and suppression of PINK1/Parkin-mediated mitophagy, mutually reinforcing and compromising DA neuron resilience. This article reviews the pathological process of mHFD-mediated remodeling of the intrauterine microenvironment to increase the susceptibility of offspring PD and its two core mechanism pathways: the continuous activation of the IR-NF-&#x3ba;B inflammatory pathway and the functional inhibition of the PINK1/Parkin-mediated mitophagy pathway. On this basis, multi-dimensional early warning markers based on inflammatory factors, mitophagy-related molecules, epigenetic markers and nutritional exposure indicators, as well as potential intervention strategies such as nutritional supplementation, anti-inflammatory and pro-mitophagy targeting the above pathways were summarized, in order to provide a theoretical reference for the primary prevention of PD.

This systematic review and meta-analysis aimed to estimate the prevalence of sarcopenic obesity (SO) among adults with diabetes and summarize associated factors. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven databases, including MEDLINE via PubMed, Cochrane Library, Embase, SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP, were searched from inception to 25 June 2026, for peer-reviewed observational studies published in English or Chinese. Two reviewers independently performed study selection, data extraction, and quality appraisal. For overlapping populations, the most recent and comprehensive report was retained. The pooled prevalence of SO was estimated using a random-effects model in Stata 18.0. Subgroup, sensitivity, and publication bias analyses were performed, and associated factors were summarized descriptively. Thirty-four observational studies published between 2013 and 2026 were included. The pooled prevalence of SO among adults with diabetes was 24% (95% confidence interval: 19-29%), with substantial heterogeneity. Higher prevalence estimates were observed among community-dwelling patients (29%), female patients (28%), individuals in North America (29%), studies using bioelectrical impedance analysis for muscle mass measurement (25%), studies applying criteria based on muscle mass, muscle strength, and physical function (27%), and studies defining obesity by body mass index (25%) or waist circumference (23%). Reported factors associated with SO or SO-related body composition phenotypes included body mass index, fat mass index, limb fat mass, and A Body Shape Index &#x2265; 0.083; low serum irisin levels (<9.49&#x202f;ng/mL) and poorer glycemic control or higher glycated hemoglobin levels; and older age, smaller calf circumference, lower handgrip strength, low physical activity, insulin use, and diabetes-related complications. Approximately one quarter of adults with diabetes are affected by SO, indicating a substantial clinical and public health burden. The prevalence of SO varied by patient source, sex, geographic region, assessment method, and diagnostic criteria, highlighting the need for standardized assessment. The reported associated factors suggest that SO is closely associated with adiposity, glycemic metabolism, physical function, and diabetes-related clinical characteristics. These findings support targeted screening, early identification, and integrated management to improve SO detection and reduce potential adverse outcomes. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251274126, identifier PROSPERO (CRD420251274126).

The gut microbiota has emerged as a key therapeutic target in clinical nutrition for special medical purposes for repairing intestinal barrier damage. However, current strategies primarily focus on modulating microbial composition while overlooking the functional microbial community structure-particularly biofilms, which play important roles in gut physical, chemical and immune barrier homeostasis. Relevant literature on nutrition intervention, gut microbiota and biofilm, and intestinal barrier published in PubMed and CNKI up to June 2026 was narratively reviewed. This review systematically analyzes nutrients-biofilm-barrier axis, highlights the function of microbial biofilm formation and interaction involved in barrier integrity, and evaluates innovative nutritional interventions capable of modulating biofilm formation, including with enteral nutrition (EN) and parenteral nutrition (PN). Clinically, we discuss how this biofilm-centric approach offers enhanced clinical outcomes in managing barrier dysfunction associated with diseases such as IBD, compared to conventional microbiota modulation alone. The function of nutrients to effectively modulate the gut microbial biofilm in barrier integrity has been increasingly recognized in recent years. Future research is needed to further explore biofilm-based nutritional interventions and their therapeutic role in disease management.

Optimal infant and young child feeding (IYCF) practices are important determinants of early childhood growth and development. Although breastfeeding and complementary feeding recommendations are well established, gaps often remain between maternal knowledge and actual feeding practices. Local evidence from the Northern Emirates of the United Arab Emirates (UAE) is limited, particularly regarding differences between local and expatriate mothers and the relationship between IYCF practices and child anthropometric outcomes. This study assessed maternal knowledge and practices related to IYCF and examined their association with weight-for-age (WAZ) and length-for-age z-scores (LAZ) among children under 2 years in Ras Al Khaimah and Fujairah, UAE. An analytical cross-sectional study was conducted among 381 mother-child pairs with children aged up to 24 months. Participants were recruited from community settings and pediatric outpatient areas. Data were collected using a structured English and Arabic questionnaire, and child anthropometric measurements were recorded. Descriptive statistics, chi-square tests, independent-samples t-tests, and regression analysis were used. The mean maternal age was 29.14 &#xb1; 6.53 years, and the mean child age was 15.04 &#xb1; 7.22 months. Knowledge was generally high for early initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding, but significant differences between local and expatriate mothers were observed for selected knowledge indicators. Correct early initiation of breastfeeding was reported by 284 mothers (74.5%), while exclusive breastfeeding for 6 months was reported by 189 of 345 eligible mothers (54.8%). Among eligible children aged 6-23 months, minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were achieved by 163 (47.2%), 185 (53.6%), and 134 (38.8%) children, respectively. In adjusted linear regression, early initiation of breastfeeding, exclusive breastfeeding, and higher maternal knowledge score were positively associated with WAZ, while number of children was negatively associated with WAZ. Exclusive breastfeeding was positively associated with LAZ, whereas male sex was negatively associated with LAZ. Maternal knowledge of recommended IYCF practices was generally favorable, but important gaps remained in actual feeding practices, particularly exclusive breastfeeding, avoidance of pre-lacteal feeding, continued breastfeeding, and minimum acceptable diet. As this was a cross-sectional study, the observed relationships between IYCF practices and anthropometric outcomes should be interpreted as associations rather than causal effects. Strengthening culturally appropriate breastfeeding and complementary feeding counseling may help improve recommended IYCF practices in the Northern Emirates of the UAE.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by dopaminergic neuronal degeneration, oxidative stress, neuroinflammation, and gut microbiota dysbiosis. Increasing evidence highlights the role of the gut-brain axis (GBA) and probiotic-derived short-chain fatty acids (SCFAs) in modulating neuroinflammation and disease progression. This study investigated the neuroprotective potential of SCFAs produced by Lactiplantibacillus plantarum C10 in a rotenone-induced PD zebrafish model. SCFA-producing lactic acid bacteria were isolated from traditionally fermented cabbage (sauerkraut), and the most promising isolate was identified as L. plantarum C10 using morphological, biochemical, phylogenetic, and 16S rRNA gene sequencing analyses. Fermentation conditions were optimized to maximize SCFA production, and the metabolites were characterized using Fourier-transform infrared spectroscopy (FTIR) and high-performance liquid chromatography (HPLC). Antioxidant activity was evaluated using DPPH and ABTS assays. Developmental toxicity was assessed in zebrafish embryos, followed by therapeutic evaluation in rotenone-induced adult zebrafish through behavioural, biochemical, molecular, and histopathological analyses. L. plantarum C10 exhibited strong probiotic characteristics, including antimicrobial activity, acid and bile tolerance, homofermentative metabolism, and extracellular polysaccharide production. Optimized fermentation significantly enhanced SCFA-associated metabolite production, while FTIR and HPLC confirmed the presence of fermentation-derived organic acid metabolites. The metabolites demonstrated potent antioxidant activity and showed minimal developmental toxicity up to 30 mg/mL in zebrafish embryos. In the rotenone-induced PD model, C10-derived SCFAs restored antioxidant enzyme activities, reduced oxidative stress, improved locomotor and cognitive performance, modulated genes associated with neuronal function, inflammation, the NRF2 signalling pathway, intestinal barrier integrity, and gut microbiota, and preserved normal brain and intestinal histoarchitecture. These findings demonstrate that L. plantarum C10-derived SCFA metabolites exert antioxidant, anti-inflammatory, and neuroprotective effects through modulation of the gut-brain axis. This study highlights the potential of probiotic-derived SCFAs as functional food-based therapeutic candidates for managing Parkinson's disease and associated gut dysbiosis.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide, highlighting an urgent need for non-invasive early biomarkers. The cholesterol, high-density lipoprotein, and glucose index (CHG) is a novel composite marker reflecting disturbances in glucose and lipid metabolism. However, the independent association between CHG and MASLD, and the potential statistical mediating effect of visceral adiposity, as represented by the body roundness index (BRI), remains unclear, especially in non-diabetic individuals. This cross-sectional study included 13,682 non-diabetic Japanese adults. Multivariable logistic regression, generalized additive models, and two-piecewise linear regression were used to explore the association, nonlinear relationship, and threshold effect between CHG and MASLD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate CHG's discriminatory performance. Exploratory mediation analysis was performed to statistically decompose the association between CHG and MASLD via BRI. The prevalence of MASLD was 15.25%. After full adjustment, each 1-unit increase in CHG was independently associated with a higher risk of MASLD (OR&#x202f;=&#x202f;4.46, 95% CI: 3.00-6.64). A significant dose-response trend was observed across CHG quartiles (Q4 vs. Q1: OR&#x202f;=&#x202f;4.09, 95% CI: 2.83-5.91). A nonlinear threshold effect was identified at CHG&#x202f;=&#x202f;5.52. CHG showed excellent discriminatory performance (AUC&#x202f;=&#x202f;0.84), with an optimal cutoff at 5.23 (sensitivity&#x202f;=&#x202f;0.81, specificity&#x202f;=&#x202f;0.73), and retained robust discriminatory capacity in non-obese and young individuals. BRI showed a significant statistical mediating effect in the CHG-MASLD association, accounting for 46.15% of the total observed association. Subgroup mediation analyses revealed that this mediating effect was more pronounced in non-obese and normotriglyceridemic individuals. In non-diabetic Japanese adults, CHG is independently and nonlinearly associated with MASLD risk, with BRI as a potential statistical mediator. This mediating effect exhibits heterogeneity and is more pronounced in non-obese individuals. The causal direction of this pathway remains to be verified in prospective studies. CHG shows potential as a low-cost indicator for early MASLD risk stratification, especially in non-obese and younger populations who are often missed by conventional screening.

Older patients with malnutrition who undergo hip arthroplasty for femoral neck fracture are at high risk of delayed postoperative recovery. This retrospective study aimed to examine the association of early oral nutritional supplementation (ONS) with postoperative nutrition-related laboratory indicators, recovery outcomes, and in-hospital complications in this population. We retrospectively analyzed consecutive patients aged 60&#x202f;years or older with malnutrition who underwent hemiarthroplasty or total hip arthroplasty for femoral neck fracture between January 2022 and December 2025. Patients were classified into an early ONS group if structured ONS was initiated within 24&#x202f;h after surgery and into a control group otherwise. Primary outcomes included postoperative changes in serum albumin, prealbumin, hemoglobin, total protein, lymphocyte count, length of hospital stay, time to first ambulation, and time to first flatus. Secondary outcomes were postoperative complications during the index hospitalization. Among 294 included patients, 118 received early ONS and 176 served as controls. At discharge, the early ONS group showed more favorable laboratory profiles, including higher serum albumin [&#x3b2;&#x202f;=&#x202f;1.42, 95% confidence interval (CI): 0.66 to 2.18; p&#x202f;<&#x202f;0.001], prealbumin (&#x3b2;&#x202f;=&#x202f;13.58, 95% CI: 5.92 to 21.24; p&#x202f;<&#x202f;0.001), total protein (&#x3b2;&#x202f;=&#x202f;1.76, 95% CI: 0.54 to 2.98; p&#x202f;=&#x202f;0.005), and lymphocyte count (&#x3b2;&#x202f;=&#x202f;0.11, 95% CI: 0.04 to 0.18; p&#x202f;=&#x202f;0.002). Early ONS was also associated with shorter time to first ambulation (&#x3b2;&#x202f;=&#x202f;-5.38&#x202f;h, 95% CI: -7.56 to -3.20; p&#x202f;<&#x202f;0.001), shorter time to first flatus (&#x3b2;&#x202f;=&#x202f;-6.84&#x202f;h, 95% CI: -9.53 to -4.15; p&#x202f;<&#x202f;0.001), and shorter hospital stay (&#x3b2;&#x202f;=&#x202f;-1.29&#x202f;days, 95% CI: -1.98 to -0.60; p&#x202f;<&#x202f;0.001). Lower odds of pulmonary infection were observed (odds ratio&#x202f;=&#x202f;0.46, 95% CI: 0.16 to 0.93; p&#x202f;=&#x202f;0.041), although this finding should be interpreted cautiously because of the limited number of events. Early ONS after hip arthroplasty in older patients with malnutrition and femoral neck fracture was associated with more favorable short-term nutrition-related laboratory profiles and faster postoperative recovery. The association with pulmonary infection warrants cautious interpretation and further validation in prospective studies.

Lipid accumulation product (LAP), derived from waist circumference and triglycerides, may reflect central lipid overaccumulation, but its relevance for a screening-defined cardiovascular disease (CVD) high-risk label is uncertain. We examined whether LAP could help flag community adults who may need more formal risk assessment rather than serve as a stand-alone prognostic tool. This cross-sectional analysis initially considered 6,860 adults aged 35-75 years from the ChinaHEART screening program in Luohe. After excluding participants with missing LAP or screening-defined CVD high-risk outcome data, 6,803 participants were included in the base analytic sample. LAP was analyzed continuously and dichotomized using a rounded cutoff of 42 derived from the Youden index in the LAP-only receiver operating characteristic (ROC) analysis. Logistic regression, restricted cubic splines, subgroup analyses, and ROC analyses were conducted under four stepwise models. Exploratory least absolute shrinkage and selection operator (LASSO), XGBoost, and TreeSHAP analyses were added as supplementary pattern-recognition analyses. ROC analysis identified an optimal LAP cutoff of 42.12 in the LAP-only model; the rounded value of 42 was used for categorical analyses. LAP alone showed modest discrimination for the concurrent screening-defined CVD high-risk label (AUC 0.583, 95% CI 0.566-0.600), which increased to 0.628 (95% CI 0.613-0.643) after adding age and sex and to 0.632 (95% CI 0.619-0.649) in Model 3. Using the rounded cutoff of 42, 42.3% of participants were classified as high LAP. The prevalence of screening-defined CVD high-risk status was higher in the high-LAP group than in the low-LAP group (28 vs. 17%, P < 0.001). Higher LAP was associated with a greater likelihood of meeting a contemporaneous screening-defined CVD high-risk criterion. These findings support LAP as a pragmatic screening trigger for further formal assessment in community settings, not as evidence of causal risk stratification or prediction of hard cardiovascular events.

Beverage consumption is a common dietary behavior that may be associated with adiposity and urinary biomarker profiles, yet population-based evidence in young adults remains limited. This study aimed to examine associations between beverage consumption patterns and adiposity indicators and urinary biomarkers among young adults in China. This multicenter cross-sectional study included 3,198 university students aged 18-25 years from seven geographic regions in China. Daily fluid intake (DFI) was assessed using a validated 7-day fluid intake diary with calibrated cups. Body mass index (BMI) and waist circumference (WC) and urinary biomarkers (creatinine, uric acid, uric acid-to-creatinine ratio, and urea) were obtained. Multivariable regression models adjusted for predefined covariates were used to evaluate associations. Plain water contributed the largest proportion of DFI (83.9%), followed by sugar-sweetened beverages (SSBs), with substantial regional variation in beverage consumption patterns. Higher plain water intake was positively associated with BMI (&#x3b2; = 0.06, 95% CI: 0.02, 0.10, p = 0.009) and WC (&#x3b2; = 0.14, 95% CI: 0.02, 0.27, p = 0.022), but inversely associated with urinary creatinine (&#x3b2; = -148.05, 95% CI: -197.52, -98.59, p < 0.001), urinary uric acid (&#x3b2; = -9.90, 95% CI: -17.58, -2.22, p = 0.012), and urinary urea (&#x3b2; = -3.69, 95% CI: -4.74, -2.63, p < 0.001). In contrast, SSB intake was positively associated with WC (&#x3b2; = 1.00, 95% CI: 0.62, 1.38, p < 0.001), urinary uric acid (&#x3b2; = 45.15, 95% CI: 21.40, 68.89, p < 0.001), and urinary uric acid-to-creatinine ratio (p < 0.001). Coffee/tea (&#x3b2; = -1.12, 95% CI: -2.18, -0.06, p = 0.038), 100% fruit juice (&#x3b2; = -0.86, 95% CI: -1.70, -0.02, p = 0.046), and other beverages (&#x3b2; = -1.13, 95% CI: -2.19, -0.07, p = 0.037) were inversely associated with waist circumference. Beverage consumption patterns were associated with adiposity indicators and urinary biomarker profiles among Chinese university students, and these associations differed according to beverage type.

This study aimed to investigate the effect of a 1-day outpatient intervention on insulin resistance in women with gestational diabetes mellitus (GDM), to explore its potential mechanisms, and to evaluate its impact on maternal and neonatal outcomes so as to optimize clinical intervention strategies and provide evidence for ensuring maternal and neonatal safety. A total of 252 patients with GDM were included in this study, and they were divided into the GDM intervention group (receiving 1-day outpatient comprehensive management mode of diabetes) and the GDM group (routine nutrition consultation). All participants were followed up to 6-week postpartum. Variance analysis, chi-square test, and bivariate Pearson's correlation were used to analyze changes in blood glucose, stress hormones, iron metabolism, and oxidative stress markers, as well as their correlations. After intervention, fasting insulin, HOMA-IR, and 2-h postprandial blood glucose were significantly decreased in the GDM intervention group (all p&#x202f;<&#x202f;0.05). Levels of epinephrine (E), cortisol, MDA, and serum ferritin (SF) were also lower than in the GDM group (all p&#x202f;<&#x202f;0.05). The rates of insulin use, postpartum glucose abnormality, preterm birth, and macrosomia were significantly reduced (all p&#x202f;<&#x202f;0.05). E, cortisol, MDA, and SF were positively correlated with HOMA-IR (r&#x202f;=&#x202f;0.457, 0.532, 0.324, 0.321, all p&#x202f;<&#x202f;0.05). One-day outpatient intervention can effectively alleviate insulin resistance, lower postprandial blood glucose, and improve maternal and infant outcomes in GDM patients. The mechanism may be associated with improved iron metabolism, reduced stress disorder, and oxidative stress injury in GDM patients.