Serum Albumin at Diagnosis is an Independent Predictor of Early Mortality in Veteran Patients with Esophageal Cancer

Aims: To identify independent factors that could predict mortality within 6 months in a cohort of patients with esophageal cancer.

Methods: Esophageal cancer patients were grouped into early (≤6 months, n?=?41) and late (>6 months, n?=?81) mortality groups. 52 variables were analyzed by univariable analysis (UA). A multivariable (MVA) regression model was created to identify predictors of early mortality.

Results: When comparing early and late mortality groups, there was no difference in age, BMI, race, histology, or anatomic location between the two groups. UA demonstrated that the early mortality group had a lower mean albumin level (3.3?±?0.1?g/dl vs. 3.8?±?0.1?g/dl; P?<?0.001), poorer ECOG performance status (1.9?±?0.2 vs. 1.1?±?0.1, P?=?0.02), higher WBC count (9.6?±?0.7 K/µL vs. 8.2?±?0.3 K/µL, P?=?0.04), and were less likely to receive surgery (2.4% vs. 22.2%; P?=?0.003), neoadjuvant treatment (4.9% vs. 28.4%; P?=?0.009) and definitive chemoradiation (7.3% vs. 27.2%; P?=?0.01). MVA revealed that only low albumin at diagnosis was an independent predictor of survival (P?=?0.016).

Conclusion: Albumin level at diagnosis is an independent predictor of early mortality and might be used with other variables to provide prognostic information for patients and to guide treatment.     

Associations of smoking with cardiometabolic profile and renal function in a Romanian population-based sample from the PREDATORR cross-sectional study

Background: The impact of smoking on morbidity is well known, but in Romania, limited data are available regarding the smoking prevalence and relationship with cardiometabolic profile and kidney function.

Objectives: To assess the association of smoking with cardiometabolic traits and kidney function, in a Romanian population-based sample from the PREDATORR study.

Methods: PREDATORR was an epidemiological cross-sectional study. Between 2012 and 2014, participants were randomly selected from the lists of general practitioners and enrolled if they were aged 20 to 79 years, born and living in the past 10 years in Romania. Sociodemographic and lifestyle characteristics were collected through interviewer-administered questionnaires.

Results: Overall, 2704 participants were included in the analysis, 18% of them being current smokers and 30.8% former smokers. Current smokers compared to non-smokers had higher total cholesterol (220.6?±?50.4 versus 213.9?±?86.8?mg/dl, P?=?0.017), LDL-cholesterol (137.8?±?45.2 versus 130.7?±?83.7?mg/dl, P?=?0.004) and glomerular filtration rate (96.9?±?16.8 versus 90.7?±?19.1?ml/min/1.73?m², P?<0.001) in women and higher triglycerides (170.7?±?129.8 versus 144.3?±?94.2?mg/dl, P?=?0.007), glomerular filtration rate (97.6?±?17 versus 90.3?±?18?ml/min/1.73?m², P?P?=?0.002) in men. Active smoking was associated with hypercholesterolaemia [OR: 1.40 (95% CI: 1.01–1.96), P?=?0.04] and low HDL-cholesterolaemia [OR: 1.39 (95% CI: 1.01–1.91), P?=?0.04] and negatively associated with overweight/obesity [OR: 0.67 (95% CI: 0.48–0.94), P?=?0.02]. Male former smokers had higher prevalence of abdominal obesity (82.4% versus 76.4%, P?=?0.02), hypertriglyceridaemia (43.6% versus 35.6%, P?=?0.01), hypertension (64% versus 56.4%, P?=?0.01) and ischaemic vascular disease (40.5% versus 30.9%, P?=?0.003) than male non-smokers.

Conclusion: The PREDATORR study showed a high prevalence of smoking in the adult Romanian population providing data on the association of smoking with cardiometabolic traits.     

The effects of probiotics on mental health and hypothalamic–pituitary–adrenal axis: A randomized,double-blind,placebo-controlled trial in petrochemical workers

Objective: The aim of this study was to determine effects of probiotic yogurt and multispecies probiotic capsule supplementation on mental health and hypothalamic–pituitary–adrenal axis in petrochemical workers.

Methods: The present randomized double-blind, placebo-controlled trial was conducted on 70 petrochemical workers. Subjects were randomly divided into three groups to receive 100?g/day probiotic yogurt?+?one placebo capsule (n?=?25) or one probiotic capsule daily?+?100?g/day conventional yogurt (n?=?25) or 100?g/day conventional yogurt?+?one placebo capsule (n?=?20) for 6 weeks. Mental health parameters including general health questionnaire (GHQ) and depression anxiety and stress scale (DASS) scores were measured. Fasting blood samples were obtained at the beginning and 6 weeks after the intervention to quantify hypothalamic–pituitary–adrenal axis.

Results: After 6 weeks of intervention, a significant improvement of GHQ was observed in the probiotic yogurt (18.0?±?1.5 vs. 13.5?±?1.9, P?=?0.007) and in the probiotic capsule group (16.9?±?1.8 vs. 9.8?±?1.9, P?=?0.001), as well as a significant improvement in DASS scores in the probiotic yogurt (23.3?±?3.7 vs. 13.0?±?3.7, P?=?0.02) and the probiotic capsule group (18.9?±?3.2 vs. 9.4?±?4.0, P?=?0.006). However, there was no significant improvement in the conventional yogurt group (P?=?0.05 for GHQ and P?=?0.08 for DASS).

Discussion: The consumption of probiotic yogurt or a multispecies probiotic capsule had beneficial effects on mental health parameters in petrochemical workers.     

The Impact of the Disease Trend on the Macro and Micro-Nutrients Intake in Patients with Gastric Cancer

Abstract

Background: Disease-related malnutrition, as a major cause of morbidity and mortality in cancer patients, is very common in patients with gastric cancer (GC). Malnutrition in cancer patients was reported to have important adverse effects, including a decreased response and tolerance to treatment, a decrease of performance, shorter survival, and lower quality of life. The treatment approaches involving chemotherapy is known to develop various acute and chronic symptoms that restrict eating and, thereby, exert a profound impact on nutritional status.

Method: In this study, 82 patients with GC with an average age of 48.33?±?10.74 were enrolled. Patients were followed up for 6 months without any nutritional intervention and/or education. A 168 item semi-quantities food frequency questioner was completed by a trained nutritionist at the beginning of the study and six months after the start of chemotherapy.

Results: Intake of vitamin A (T₀:585.52?±?203.34 vs. T₆:529.48?±?138.91, t?=?2.96), Thiamin (T₀:2.09?±?0.76 vs. T₆:1.80?±?0.72, t?=?2.81), vitamin B6 (T₀:2.03?±?0.53 vs. T₆:2.29?±?0.73, t?=?2.56), and vitamin B12 (T₀:5.79?±?3.96 vs. T₆:4.48?±?2.20, t?=?2.43) significantly decreased after 6 months of receiving chemotherapy. On the other intake of beef (T0:17.79?±?25.48 vs. T6:12.58?±?16.66, t?=?2.06), low-fat milk (T0:52.57?±?69.80 vs. T6:29.18?±?45.89, t?=?2.95), cream (T0:2.42?±?4.16 vs. T6:1.06?±?1.68, t?=?2.88), and raw vegetable (T0:6.54?±?9.55 vs. T6:3.85?±?5.23, t?=?2.54) significantly decreased.

Conclusion: Nutritional deterioration is an important part of the pathogenesis of cancer and its treatment that can occur at any point in the timeline of cancer diagnosis, treatment or support. Therefore nutritional counseling and supportive services are needed for cancer patients, especially when their disease is diagnosed.     

Coenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: A double blind randomized clinical trial

Objectives: Multiple sclerosis (MS) is the chronic inflammatory and demyelinating disorder of central nervous system which is accompanied with disability and negative life style changes such as fatigue and depression. The aim of this study is to investigate the effect of coenzyme Q10 (CoQ10) supplementation on fatigue and depression in patients with MS.

Methods: We performed a randomized, double-blinded, placebo-controlled trial to determine the effect of CoQ10 supplement (500?mg/day) vs. placebo for 12?weeks. Fatigue symptoms were quantified by means of fatigue severity scale (FSS) and the Beck depression inventory (BDI) was used to assess depressive symptoms.

Results: A significant decrease of FSS was observed in CoQ10 group during the intervention (P?=?0.001) and significant increase of FSS change was observed within placebo group (P?=?0.001). Repeated measure analysis of variance showed a significant time-by-treatment interaction for FSS (baseline 41.5?±?15.6 vs. endpoint 45?±?13.6; F_1,45?=?55.23, P?<?0.001, η²?=?0.56) and BDI (baseline 17.8?±?12.2 vs. endpoint 20.4?±?11.4; F_1,45?=?40.3, P?<?0.001, η²?=?0.48), indicating significant decrease of FSS and BDI in CoQ10 group compared to placebo group.

Conclusion: Our study suggests that CoQ10 supplementation (500?mg/day) can improve fatigue and depression in patients with multiple sclerosis.     

Effects of orthodox religious fasting versus combined energy and time restricted eating on body weight,lipid concentrations and glycaemic profile

Abstract

For seven weeks, 37 overweight adults followed a hypocaloric diet based on Orthodox Fasting (OF). A hypocaloric, time restricted eating (TRE) plan (eating between 08:00 to 16:00?h, water fasting from 16:00 to 08:00?h) was followed by 23 Body Mass Index (BMI)-matched participants. Anthropometric, glycaemic and inflammation markers and serum lipids were assessed before and after the diets. Both OF and TRE groups demonstrated reductions in BMI (28.54?±?5.45 vs 27.20?±?5.10?kg/m², p?<?0.001 and 26.40?±?4.11 vs 25.81?±?3.78?kg/m² p?=?0.001, respectively). Following the intervention, the OF group presented lower concentrations of total and low-density lipoprotein-cholesterol, compared with the pre-fasting values (178.40?±?34.14 vs 197.17?±?34.30?mg/dl, p?<?0.001 and 105.89?±?28.08 vs 122.37?±?29.70?mg/dl, p?<?0.001, respectively). Neither group manifested significant differences in glycaemic and inflammatory parameters. Our findings suggest that OF has superior lipid lowering effects than the TRE pattern.     

Using text messages to promote health in African-Americans: #HeartHealthyandCancerFree*

Objectives: African-Americans are vulnerable to both cancer and cardiovascular disease (CVD) due to intricately connected risk factors. Use of text messages is an innovative method to provide health information to reduce these risks. The aim of this study was to test the feasibility and acceptability of a text messaging intervention to reduce CVD and cancer risk factors in African-Americans.

Design: We developed an intervention using text messages culturally tailored for African-Americans over age 50 who were at risk (one or more modifiable risk factors) for CVD and/or cancer. Sociodemographic data, biologic measures, cancer screening practices, and general health status were assessed. Group interviews were conducted to assess feasibility and acceptability.

Results: Participants were primarily female (69%), aged 58?±?5 years, who were married (59%) and worked full time (56%). In terms of feasibility and acceptability, themes of encouragement through text messages received and a desire for a longer study period emerged from group interviews with participants. Participants experienced significant decreases in waist circumference (41?±?5 vs 40?±?5, p?=?.002), systolic blood pressure (147?±?25?mmHg vs 138?±?20?mmHg, p?=?.009), diastolic blood pressure (87?±?16?mmHg vs 82?±?10?mmHg, p?=?.02), total cholesterol (194?±?35?mg/dL vs 173?±?32?mg/dL, p?p?=?.015). Five participants had colorectal cancer screening, two had prostate cancer screening, and four had mammograms.

Conclusions: Use of text messages was widely accepted among participants. Significant CVD risk reductions and increased cancer screenings were noted. Future studies should incorporate innovative strategies such as text messaging in promoting health in vulnerable populations.     

Association of lifestyle,inflammatory factors,and dietary patterns with the risk of suffering a stroke: A case–control study

Background: Lifestyle, including dietary patterns, could involve specific factors participating in inflammation that confer a higher risk of suffering a stroke. However, little attention has been apparently given to habitual food consumption in patients suffering a cerebrovascular event.

Objective: To assess the influence of dietary habits as well as other lifestyle-related variables on the risk of suffering a stroke.

Design: A case–control study was designed. Fifty-one cases (age: 59.1?±?9.1y.o; BMI; 30.8?±?3.4?kg/m²) and 51 controls (age: 61.1?±?9.1y.o; BMI; 30.4?±?3.6?kg/m²) were enrolled in the study. Anthropometric and body composition variables were measured. Dietary information was obtained from a validated food frequency questionnaire. Physical activity and lifestyle-related factors were assessed. Blood samples were drawn.

Results: Patients suffering a stroke showed higher prevalence of diabetes (30 vs. 7.7%; P?=?0.020) and hypertension (74.5 vs. 40.3%; P?P?=?0.024) than controls. Patients registered worse glucose and lipid profiles, higher levels of hepatic biomarkers, and higher blood cell counts than controls. Stroked patients showed lower adherence to a statistically derived healthy dietary pattern than controls (23.5 vs. 42.3%; P?=?0.017). A logistic regression model was built up considering hypertension, diabetes, smoking, physical activity, adherence to a ‘healthy dietary pattern’ and C-reactive protein concentration. The final model strongly associated with the risk of suffering a stroke (R²: 44.6%; P_model?Conclusion: Lifestyle variables such as physical activity, smoking habit, and a dietary pattern including foods with low inflammatory potential play an important role in the reduction of the risk of suffering a stroke.     

Short-Term Mediterranean Diet Improves Endurance Exercise Performance: A Randomized-Sequence Crossover Trial

Abstract

Objective: Healthful dietary patterns have constituents that are known to improve exercise performance, such as antioxidants, nitrates, and alkalizing effects. However, ergogenic effects of such diets have not been evaluated. We hypothesized that a short-term Mediterranean diet results in better exercise performance, as compared to a typical Western diet.

Methods: Eleven recreationally active women (n?=?7) and men (n?=?4) (body mass index, 24.6?±?3.2?kg/m²; age 28?±?3?years) were studied in a randomized-sequence crossover study, in which they underwent exercise performance testing on one occasion after 4?days of a Mediterranean diet and on another occasion after 4?days of a Western diet. A 9- to 16-day washout period separated the two trials. Endurance exercise performance was evaluated with a 5-km treadmill time trial. Anaerobic exercise performance tests included a Wingate cycle test, a vertical jump test, and hand grip dynamometry.

Results: Five-kilometer run time was 6%?±?3% shorter (faster) in the Mediterranean diet trial than in the Western diet trial (27.09?±?3.55 vs 28.59?±?3.21?minutes; p?=?0.030) despite similar heart rates (160?±?5 vs 160?±?4 beats/min; p?=?0.941) and ratings of perceived exertion (14.6?±?0.5 vs 15.0?±?0.5; p?=?0.356). No differences between the diet conditions were observed for anaerobic exercise tests, including peak and mean power from the Wingate test (both p?≥?0.05), the vertical jump test (p?=?0.19), and the hand grip strength test (p?=?0.69).

Conclusions: Our findings extend existing evidence of the health benefits of the Mediterranean diet by showing that this diet is also effective for improving endurance exercise performance in as little as 4?days. Further studies are warranted to determine whether a longer-term Mediterranean diet provides greater benefits and whether it might also be beneficial for anaerobic exercise performance and muscle strength and power.     

Ethnic differences in the cardiac responses to aerobic exercise

Background: Cardiovascular disease disproportionately affects North American Indigenous populations. Ethnic differences in cardiac responses to exercise are known, though Indigenous populations response is unknown. To evaluate cardiac responses to aerobic exercise among Canadian Indigenous and European adults.

Methods: Indigenous (N?=?12, 4 females, 1 male incomplete) and European (N?=?12, all completed) Canadian age and sex-matched adults 19–40 years and free of cardiovascular disease or diabetes completed a cycle ergometer maximal aerobic power test and 30?min at 60% maximal aerobic capacity on two separate days. Echocardiographic assessments preceded and immediately followed exercise.

Results: Responses to maximal exercise were similar among ethnicities including decreases in stroke volume index, cardiac output index and ejection fraction, and increases in arterial-ventricular coupling. However, following submaximal exercise, only Indigenous adults demonstrated reductions in end systolic volume, end diastolic volume (154.8?±?40.6?mL to 136.5?±?33.0?mL, p?=?0.01, vs. 149.4?±?22.4?mL to 147.1?±?27.0?mL; p?=?0.81), stroke volume index (44.9?±?8.7?mL?m^?2 to 38.0?±?6.5?mL?m^?2, p?=?0.002, vs. 46.4?±?7.1?mL?m^?2 to 44.0?±?6.5?mL?m^?2; p?=?0.28) and arterial compliance.

Conclusion: Indigenous and European adults demonstrated similar cardiac responses to maximal exercise, though only Indigenous adults demonstrated cardiac responses to submaximal exercise.     

Effects of ginger (Zingiber officinale) on plasma glucose level,HbA1c and insulin sensitivity in type 2 diabetic patients

Abstract

The present study was aimed to evaluate the effects of Zingiber officinale on some biochemical parameters in type 2 diabetic (DM2) patients. In a randomized double-blind placebo controlled trial, 64 patients with DM2 were assigned to ginger or placebo groups (receiving 2?g/d of each). A 3?d diet record, anthropometric measurements and concentrations of fasting blood glucose (FPG), HbA1c, lipid profile (including total cholesterol, triglyceride, low density lipoprotein and high density lipoprotein) and also the homeostasis model assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) were determined before and after 2 months of intervention. Ginger supplementation significantly lowered the levels of insulin (11.0?±?2.3 versus 12.1?±?3.3; p?=?0.001), LDL-C (67.8?±?27.2 versus 89.2?±?24.9; p?=?0.04), TG (127.7?±?43.7 versus 128.2?±?37.7; p?=?0.03) and the HOMA index (3.9?±?1.09 versus 4.5?±?1.8; p?=?0.002) and increased the QUICKI index (0.313?±?0.012 versus 0.308?±?0.012; p?=?0.005) in comparison to the control group; while, there were no significant changes in FPG, TC, HDL-C and HbA1c (p?>?0.05). In summary, ginger supplementation improved insulin sensitivity and some fractions of lipid profile in DM2 patients. Therefore it may be considered as a useful remedy to reduce the secondary complications of DM2.     

Feasibility,Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study

Abstract

The present study was aimed to evaluate the safety, tolerability, and beneficial effects of a ketogenic diet (KD) on body composition and blood parameters and survival in patients with breast cancer. In this randomized, controlled trial, 60 patients with locally advanced or metastatic breast cancer and planned chemotherapy, were randomly assigned to a group receiving KDs (n?=?30) or to a control group with standard diet (n?=?30) for 3 months. Serum biochemical parameters and body composition were analyzed at baseline, every 3 weeks and end of each arm. Compliance and safety of KD were also checked weekly. Fasting blood sugar (FBS) was significantly decreased in intervention group compared to the baseline (84.5?±?11.3 vs. 100.4?±?11.8, P?=?0.001). A significant inter-group difference was also observed for FBS level at end of intervention. There was an increasing trend in serum levels of ketone bodies in intervention group (0.007–0.92, P?<?0.001). Compared to the control group, BMI, body weight, and fat% were significantly decreased in intervention group in last visit (P?<?0.001). No severe adverse side effect was found regarding lipid profile and kidney or liver marker. Overall survival was higher in KD group compared to the control group in neoadjuvant patients (P?=?0.04). Our results suggested that chemotherapy combined with KDs can improve the biochemical parameters, body composition, and overall survival with no substantial side effects in patients with breast cancer.     

A Pilot Study of Amino Acids in Unresectable Non-Small-Cell Lung Cancer Patients During Chemotherapy: A Randomized Serial N-of-1 Trials Design

The aim of this study was to evaluate the effect of amino acids (AAs) on immune function and inflammation level in patients with NSCLC receiving chemotherapy. We conducted a series of randomized, multiple-crossover, double-blind, placebo-controlled N-of-1 trials comparing AAs with isocaloric glucose in unresectable NSCLC patients and combined the individual results using Bayesian statistical modeling. 25 patients completed two cycles of chemotherapy. The baseline total blood albumin (ALB) level in all patients was 28?±?3.3?g/l, and the mean total ALB level in patients receiving AAs supplementation and isocaloric glucose was 29.2?±?2.2 and 28.1?±?3.7?g/l, respectively (P?=?0.028). Patients’ baseline C-reactive protein (CRP) level was 4?±?1.2?mg/l, the mean total CRP level in patients receiving AAs supplementation and isocaloric glucose was 11?±?2.8 and 13?±?3.2?mg/l, respectively (P?=?0.028). The baseline total blood CD4⁺ T cells level was 36?±?7.8%. The percentage of CD4⁺ T cells in patients receiving AAs supplementation and isocaloric glucose was 42?±?6.4 and 33.7?±?17.3, respectively (P?=?0.034). Our preliminary results indicated that AAs improve immune status and suppress inflammation in unresectable NSCLC patients receiving chemotherapy.     

Effects of high-intensity interval training on cardiometabolic risk in overweight and obese African-American women: a pilot study

Objective: Little is known about high-intensity interval training (HIIT) in African-American (AA) women. The purpose of this pilot study was to evaluate the effects of HIIT and steady-state (SS) exercise on cardiometabolic risk factors in young AA women.

Design: A 16-week exercise intervention was conducted 3x/week. Twenty-seven AA women were randomized to SS (n?=?11; 32 continuous minutes of treadmill walking at 60–70% of maximum heart rate (HR_max)), or HIIT (n?=?16; 32?min of treadmill HIIT alternating 3?min at 60–70% of HR_max with 1?min at 80–90% of HR_max). Two-way repeated measures ANOVA with intention-to-treat analysis was used to identify changes between groups. Significance was accepted at P?≤?0.05.

Results: Of the 27 women who entered the study (age: 30.5?±?6.8 years; BMI: 35.1?±?5.1 kg/m²; 5274?±?1646 baseline steps/day), 14 completed the intervention. HIIT significantly decreased waist circumference (107.0?±?11.3 to 105.1?±?11.9 cm) compared to SS, which showed no change. There was a significant time effect for steps where HIIT increased steps/day (5334?±?1586 to 7604?±?1817 steps/day), and SS had no change. There were no significant changes in either group for any other measurements.

Conclusion: HIIT was more effective at reducing waist circumference and increasing daily steps/day than SS treadmill exercise over 16 weeks. Further research in a larger sample is indicated to evaluate the effects of each protocol on cardiometabolic risk factors.     

Effects of 12-week supplementation of <Emphasis Type="Italic">Citrus bergamia</Emphasis> extracts-based formulation CitriCholess on cholesterol and body weight in older adults with dyslipidemia: a randomized,double-blind,placebo-controlled trial

Backgrounds

Recent experiments suggest that Citrus bergamia extracts could benefit people with dyslipidemia and obesity but this needs to be further validated.

Methods

A total of 98 people age-matched older adults (65 years) with elevated blood lipids were enrolled to receive 12-week supplementation of a Citrus bergamia extracts-based formulation (CitriCholess)(n?=?48) and placebo (n?=?50).

Results

No group differences were found in baseline bodyweight, body mass index (BMI), blood cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and glucose levels. CitriCholess supplementation resulted in lower levels than placebo in TG (1.83?±?0.92 vs. 1.95?±?1.34 mmol/L, P?=?0.612), TC (5.14?±?0.98 vs. 5.44?±?0.77 mmol/L, P?=?0.097), and LDL-C (3.13?±?0.74 vs. 3.43?±?0.62 mmol/L, P?=?0.032). Compared to placebo, CitriCholess also resulted in greater reductions in body weight (?0.604?±?0.939 vs. 0.06?±?0.74 kg, P?<?0.01), waist circumferences (?0.60?±?1.349 cm vs. -0.16?±?1.503 cm, P?<?0.01) and BMI (?0.207?±?0.357 vs. 0.025?±?0.274, P?<?0.01). Additionally, females had a significantly higher level of HDL-C than males. TC was significantly correlated with LDL-C, and to a less degree, with TG. TG was inversely correlated with HDL-C. Body weight and waist circumference were negatively correlated with HDL-C and positively correlated with glucose.

Conclusion

12-week supplementation of CitriCholess could benefit lipid metabolism and weight management in old adults with dyslipidemia.

     

The impact of functional constipation on quality of life of middle-aged Black Americans: a prospective case–control study

Purpose

To quantify the impact of constipation on health-related quality of life (HRQoL) in Black Americans.

Methods

Case?Ccontrol design. Black subjects referred for colon cancer screening with a Bristol Stool Score of 3?C5 for >75% of bowel movements served as controls. Frequency-matched functional constipation subjects had to fulfill Rome III criteria. Both groups completed demographic and health surveys. Short Form-36 assessed HRQoL.

Results

We recruited 102 constipated patients and 100 controls. The groups were well matched demographically. After adjustment for comorbidities, SF-36 scores for vitality, bodily pain, social functioning, and role-emotional were significantly lower in constipated patients. Unadjusted physical and mental component summary scores (PCS and MCS) were significantly higher in the control group (47.1?±?10.6 vs. 43.3?±?8.6; P?=?0.005 and 50.6?±?12.4 vs. 43.4?±?11.8; P?<?0.001, respectively). After adjustment for comorbidities, PCS differences were no longer significant (P?=?0.54); however, MCS differences were significant (P?=?0.004). Marginal mean scores for the MCS for controls and constipated subjects were 49.9?±?1.2 and 43.6?±?1.2, respectively. The presence of a comorbidity was independently associated with PCS (P?<?0.001) and MCS (P?=?0.026) results.

Conclusions

Functional constipation has a significant impact on HRQoL in middle-aged Black Americans, particularly in regard to mental well-being.     

Suppression of Implanted MDA-MB 231 Human Breast Cancer Growth in Nude Mice by Dietary Walnut

Walnuts contain components that may slow cancer growth including omega 3 fatty acids, phytosterols, polyphenols, carotenoids, and melatonin. A pilot study was performed to determine whether consumption of walnuts could affect growth of MDA-MB 231 human breast cancers implanted into nude mice. Tumor cells were injected into nude mice that were consuming an AIN-76A diet slightly modified to contain 10% corn oil. After the tumors reached 3 to 5 mm diameter, the diet of one group of mice was changed to include ground walnuts, equivalent to 56 g (2 oz) per day in humans. The tumor growth rate from Day 10, when tumor sizes began to diverge, until the end of the study of the group that consumed walnuts (2.9 ± 1.1 mm³/day; mean ± standard error of the mean) was significantly less (P > 0.05, t-test of the growth rates) than that of the group that did not consume walnuts (14.6 ± 1.3 mm ³ /day). The eicosapentaenoic and docosahexaenoic acid fractions of the livers of the group that consumed walnuts were significantly higher than that of the group that did not consume walnuts. Tumor cell proliferation was decreased, but apoptosis was not altered due to walnut consumption. Further work is merited to investigate applications to cancer in humans.     

Nutritional Status and Osteoporotic Fracture Rehabilitation Outcomes in Older Adults

Abstract

To determine the impact of nutritional status and risk factors for undernutrition based on the changes in functional outcomes and rehabilitation success, defined as the ability of older adults to return as close as possible to their original functional state. Retrospective cohort study among 107 rehabilitation patients, aged ≥65 y. Data included demographics, Functional Independence Measure (FIM), Short Nutritional Assessment Questionnaire (SNAQ), reported weight, Mini-Mental Status Examination (MMSE), and Cumulative Illness Rating-Scale for Geriatrics (CIRS-G). Rehabilitation success was determined by delta-FIM. Higher vs. lower functioning patients were younger, had shorter hospitalization, and lower CIRS-G score with higher mean MMSE. Delta-FIM was significantly higher in patients with low malnutrition risk (SNAQ): 14.2?±?10.5 vs. 6.9?±?13.9 in undernourished patients, those who did not lose weight 14.5?±?10.5 vs. 5.6?±?12.8 in patients who lost weight with normal dietary intake, normal albumin, and lower CIES-G. Patients who achieved functional independence, FIM_DC ≥90, ate normally and experienced less “appetite loss” [40.5% vs. 68.4%; P?=?0.048]. Weight loss was the strongest negative predictor of delta-FIM (B?=?–9.094; P?=?0.007). To conclude, nutritional status, mainly weight change, is an independent negative predictor for rehabilitation success.     

Bone Mineral Density and Growth in Children Having Undergone Liver Transplantation With Corticosteroid‐Free Immunosuppressive Protocol

Background: Children post–liver transplantation (post‐LTX) are at risk of growth delay and decreased bone mineral density (BMD) secondary to corticosteroid (CS) therapy and suboptimal intake of nutrients important for bone health. The pediatric LTX program at Stollery Children's Hospital introduced a CS‐free LTX regimen in 2003. This retrospective study investigated whether the implementation of a CS‐free protocol resulted in improvements in BMD (dual x‐ray absorptiometry) and growth following LTX. Methods: A retrospective chart review of all children undergoing LTX was conducted. The parameters included repeated measures of anthropometric (weight, weight z score, height, height z score), BMD/bone mineral content (BMC), laboratory variables, graft function (number/severity of rejection), and CS therapy (dose, duration). Results: A total of 39 patients met study inclusion (20 male; n = 28 on CS; n = 11 CS‐free). Mean duration of follow‐up was 5.5 ± 3.3 years. The mean weight and height z scores were ?0.31 ± 0.14 (CS) and 0.22 ± 0.23 (CS‐free; P = .09) and ?0.71 ± 0.13 (CS) and 0.23 ± 0.22 (CS‐free; P = .002), respectively. Lumbar and whole‐body BMD z score less than ?2 were present in 15% and 8% of the cohort, respectively. There were no significant differences between CS and CS‐free in lumbar BMC (22.2 ± 1.4 and 23.4 ± 2.02 g; P = .165) and lumbar BMD (0.57 ± 0.02 and 0.80 ± 0.22 g/cm²; P = .152), respectively. Lumbar BMC (r² = 0.89, P < .05) and whole‐body BMC (r² = 0.93, P < .05) were inversely related to CS dose >0.2 mg/kg/d and positively related to bone age (P < .01). Conclusion: CS therapy in children post‐LTX is associated with reduced BMC and delayed linear growth. Understanding the clinical and nutrition factors influencing bone health is important to optimizing growth and bone health in children post‐LTX.