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13 pages, 291 KiB

Open AccessReview

A Comprehensive Review of Hepatitis B Vaccine Nonresponse and Associated Risk Factors

by Albashir Tahir, Sa’adatu Haruna Shinkafi, Ahmed Subeh Alshrari, Abdulmajeed Yunusa, Muhammad Tukur Umar, Shuaibu Abdullahi Hudu and Abdulgafar Olayiwola Jimoh

Vaccines 2024, 12(7), 710; https://doi.org/10.3390/vaccines12070710 (registering DOI) - 25 Jun 2024

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Abstract

Hepatitis B virus (HBV) infection remains a significant global health concern worldwide, contributing to high rates of mortality and morbidity, including chronic hepatitis B, cirrhosis, and hepatocellular carcinoma (HCC). Universal vaccination programs have significantly reduced the rate of HBV transmission; however, a subset of individuals fail to develop a protective immune response following vaccination and are termed nonresponders. A comprehensive search strategy using the PubMed, Google Scholar, and Web of Science databases was employed to search for relevant studies using keywords including “hepatitis B vaccine”, “vaccine nonresponse”, “immunogenicity”, “immune response to the hepatitis B vaccine”, and “associated risk factors”. Factors influencing the vaccine’s response include demographic factors, such as age and sex, with increased nonresponse rates being observed in older adults and males. Obesity, smoking, and alcohol consumption are lifestyle factors that decrease the vaccine response. Medical conditions, including diabetes, chronic kidney and liver diseases, HIV, celiac disease, and inflammatory bowel disease, affect the vaccine response. Major histocompatibility complex (MHC) haplotypes and genetic polymorphisms linked to immune regulation are genetic factors that further influence the vaccine’s effectiveness. To reduce the global burden of hepatitis B infection, it is essential to understand these factors to improve vaccine effectiveness and develop individualized vaccination strategies. Full article

13 pages, 908 KiB

Open AccessArticle

Experience in Post-Bariatric Abdominoplasty for Patients with Significant Weight Loss: A Prospective Study

by Roberto Cuomo, Claudia Cuccaro, Ishith Seth, Warren M. Rozen, Maria Giovanna Vastarella, Giuseppe A. G. Lombardo, Francesco Ciancio, Domenico Pagliara, Gorizio Pieretti and Feliciano Ciccarelli

J. Pers. Med. 2024, 14(7), 681; https://doi.org/10.3390/jpm14070681 (registering DOI) - 25 Jun 2024

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Abstract

Background: Abdominoplasty is a critical aesthetic and functional procedure for individuals who have undergone massive weight loss. Numerous techniques have been proposed to optimize aesthetic results while minimizing complications. Methods: This prospective study examined 500 patients who underwent abdominoplasty during body-contouring procedures between 1 January 2018 and 31 December 2021 at a tertiary center. The Skin–Adipose Tissue–Muscle (SAM) protocol was employed to analyze the operative strategies and complication rates and compare them with the existing literature. Furthermore, patient satisfaction and aesthetic outcomes were measured one year post-operation using a comprehensive four-point questionnaire evaluated by the patients themselves and two independent surgeons. Results: Participants had an average age of 34.8 years and a mean BMI of 31.1 kg/m². The surgeries included 328 full abdominoplasties and 172 T-inverted abdominoplasties. Notable complications included wound infection (4%), wound dehiscence (8.6%), tissue necrosis (0.6%), seroma (8.4%), and hematoma (2.6%). A higher BMI was correlated with an increased risk of complications and lower patient satisfaction. Data analysis was performed using Stata version 18 software. Conclusions: The increasing prevalence of obesity highlights an urgent need for more bariatric surgeries and subsequent abdominoplasties to mitigate the effects of massive weight loss. A crucial link between elevated BMI and a heightened risk of postoperative complications, emphasizing the necessity for standardized surgical protocols tailored to individuals with higher BMI, was noted. Innovatively, future studies must further investigate the intricate dynamics between BMI and surgical risks. Exploring and establishing uniform, adaptive surgical guidelines promise to revolutionize patient care by significantly reducing complications and enhancing recovery and satisfaction following abdominoplasty. Full article

(This article belongs to the Special Issue Precision Medicine in Plastic and Reconstructive Surgery)

16 pages, 1488 KiB

Open AccessArticle

Human Health Benefits and Microbial Consortium of Stevia Fermented with Barley Nuruk

by Hyun-Ju Han, Min Nyeong Ko, Chan Seong Shin and Chang-Gu Hyun

Fermentation 2024, 10(7), 330; https://doi.org/10.3390/fermentation10070330 - 25 Jun 2024

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Abstract

In this study, the microbial community present during the barley yeast fermentation of stevia leaves and its correlation with antioxidant, anti-obesity, and anti-inflammatory properties, as well as metabolites, were investigated using UPLC-Q-TOF-MS. Stevia was fermented using commercial TSB media (TSB 1, TSB 3, and TSB 5) and sucrose (Sucrose 1, Sucrose 3, and Sucrose 5) for 1, 3, and 5 days, respectively. Stevia ferments showed higher DPPH and ABTS radical scavenging capacity compared to samples incubated with sucrose for 5 days, and all six ferments inhibited nitric oxide production in a concentration-dependent manner in LPS-induced mouse macrophages. Furthermore, UPLC-QTOF-MS analysis identified 23 related substances, including 10 terpenoids (including rubusoside, steviolbioside, and rebadioside derivatives), dulcoside A, and phlomisoside II, which are indicators of stevia, as well as five flavonoids, four phenolic acids, and four fatty acids. We also identified the microbial community during fermentation via the next-generation sequencing of the 16S rRNA gene for bacteria and the internal transcribed spacer (ITS) gene for fungi. The results showed that TSB 1 and Sucrose 1 ferments were dominated by the pathogens Enterococcus hirae (58.93%) and Cronobacter sakazakii (80.92%), while samples fermented for more than 3 days were pathogen-free and dominated by lactic acid bacteria such as Pediococcus stilesii (73.37%). Microbial community analysis using the ITS region showed that Saccharomycopsis fibuligera, classified as a yeast rather than a mold, dominated the stevia fermentation regardless of the fermentation duration. In particular, the microbial community of the fermentation with a sucrose solution was dominated by S. fibuligera by more than 99% throughout the fermentation periods of 1, 3, and 5 days. Finally, to apply the stevia ferments topically to human skin, skin irritation tests were performed on 30 volunteers. The results showed that the highly concentrated extracts (1 mg/mL) of all six stevia ferments were hypoallergenic. Taken together, these findings suggest that barley nuruk fermented from stevia leaves with a sucrose solution offers promise as a natural ingredient for use in functional foods and cosmetics. Full article

(This article belongs to the Special Issue Functional Properties of Microorganisms in Fermented Foods)

19 pages, 1440 KiB

Open AccessArticle

Splicing Machinery Is Impaired in Oral Squamous Cell Carcinomas and Linked to Key Pathophysiological Features

by Alba Sanjuan-Sanjuan, Emilia Alors-Perez, Marina Sanchez-Frías, José A. Monserrat-Barbudo, Mabel Falguera Uceda, Susana Heredero-Jung and Raúl M. Luque

Int. J. Mol. Sci. 2024, 25(13), 6929; https://doi.org/10.3390/ijms25136929 (registering DOI) - 25 Jun 2024

Viewed by 106

Abstract

Alternative splicing dysregulation is an emerging cancer hallmark, potentially serving as a source of novel diagnostic, prognostic, or therapeutic tools. Inhibitors of the activity of the splicing machinery can exert antitumoral effects in cancer cells. We aimed to characterize the splicing machinery (SM) components in oral squamous cell carcinoma (OSCC) and to evaluate the direct impact of the inhibition of SM-activity on OSCC-cells. The expression of 59 SM-components was assessed using a prospective case-control study of tumor and healthy samples from 37 OSCC patients, and the relationship with clinical and histopathological features was assessed. The direct effect of pladienolide-B (SM-inhibitor) on the proliferation rate of primary OSCC cell cultures was evaluated. A significant dysregulation in several SM components was found in OSCC vs. adjacent-healthy tissues [i.e., 12 out of 59 (20%)], and their expression was associated with clinical and histopathological features of less aggressiveness and overall survival. Pladienolide-B treatment significantly decreased OSCC-cell proliferation. Our data reveal a significantly altered expression of several SM-components and link it to pathophysiological features, reinforcing a potential clinical and pathophysiological relevance of the SM dysregulation in OSCC. The inhibition of SM-activity might be a therapeutic avenue in OSCC, offering a clinically relevant opportunity to be explored. Full article

(This article belongs to the Special Issue Oral Cancer and Disease in Humans and Animals)

15 pages, 954 KiB

Open AccessArticle

Body Mass Index: An Unreliable Adiposity Indicator for Predicting Outcomes of Liver Transplantation Due to Hepatocellular Carcinoma

by Kinga Czarnecka, Paulina Czarnecka, Olga Tronina, Teresa Bączkowska and Magdalena Durlik

Gastrointest. Disord. 2024, 6(3), 607-621; https://doi.org/10.3390/gidisord6030040 (registering DOI) - 25 Jun 2024

Viewed by 178

Abstract

Obesity is a well-documented risk factor for the development of hepatocellular carcinoma (HCC) in the general population. The applicability of these findings to liver recipients is uncertain, and the results of available data have not been unanimous. The objective of the current study was to investigate the impact of the pre-operative body mass index (BMI) on oncological outcomes of liver transplantation due to HCC. Methods: This observational retrospective study enrolled all patients with histologically confirmed HCC who underwent liver transplantation from a deceased donor in our centre between 2008 and 2018. Results: Overall, 83 patients were enrolled and were subsequently stratified according to their pre-operative BMI into three groups: patients with normal body weight (n = 53), patients with overweight (n = 23), patients with obesity (n = 7). Overall tumour recurrence was 12%. BMI failed to predict the 5-year recurrence-free survival (p = 0.55), risk of tumour recurrence (p = 0.314) and overall 5-year survival (p = 0.19) in liver recipients. Conclusions: BMI was proven to be an unreliable surrogate measure of obesity for predicting oncological outcomes among liver recipients. Other obesity indices should be referenced to assess cancer-related prognosis more accurately in these groups of patients. Full article

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16 pages, 1583 KiB

Open AccessSystematic Review

Comparative Efficacy and Safety of Glucagon-like Peptide-1 Receptor Agonists in Children and Adolescents with Obesity or Overweight: A Systematic Review and Network Meta-Analysis

by Ligang Liu, Hekai Shi, Yufei Shi, Anlin Wang, Nuojin Guo, Heqing Tao and Milap C. Nahata

Pharmaceuticals 2024, 17(7), 828; https://doi.org/10.3390/ph17070828 - 24 Jun 2024

Viewed by 297

Abstract

Four glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been used in children and adolescents with obesity or overweight. This network meta-analysis was conducted to compare the efficacy and safety of these regimens. Embase, PubMed, and Scopus were searched on March 2023 and updated in June 2024 for eligible randomized controlled trials (RCTs). The primary efficacy outcomes were mean difference in actual body weight, BMI (body mass index), BMI z score, and waist circumference. Safety outcomes included nausea, vomiting, diarrhea, abdominal pain, injection-site reaction, and hypoglycemia. Eleven RCTs with 953 participants were eligible. Semaglutide exhibited greater effects in reducing weight, BMI, and BMI z score versus the placebo. Semaglutide was associated with greater weight loss and BMI z score reduction in comparison with exenatide, liraglutide, and dulaglutide. Semaglutide also significantly decreased BMI than exenatide. None of the four GLP-1 RAs were associated with higher risks of diarrhea, headache, and abdominal pain versus the placebo. Liraglutide was more likely to cause nausea, vomiting, hypoglycemia, and injection-site reactions than the placebo. Liraglutide also had higher odds of causing injection-site reactions than other GLP-1 RAs. Semaglutide appeared to be the most effective and safe option among four GLP-1 RAs in children and adolescents with obesity or overweight. Full article

(This article belongs to the Section Pharmacology)

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20 pages, 3160 KiB

Open AccessReview

The Impact of Vitamin D and L-Cysteine Co-Supplementation on Upregulating Glutathione and Vitamin D-Metabolizing Genes and in the Treatment of Circulating 25-Hydroxy Vitamin D Deficiency

by Sushil K. Jain, Jeffrey Justin Margret, Steven A. Abrams, Steven N. Levine and Kamal Bhusal

Nutrients 2024, 16(13), 2004; https://doi.org/10.3390/nu16132004 - 24 Jun 2024

Viewed by 344

Abstract

Vitamin D receptors are expressed in many organs and tissues, which suggests that vitamin D (VD) affects physiological functions beyond its role in maintaining bone health. Deficiency or inadequacy of 25(OH)VD is widespread globally. Population studies demonstrate that a positive association exists between a high incidence of VD deficiency and a high incidence of chronic diseases, including dementia, diabetes, and heart disease. However, many subjects have difficulty achieving the required circulating levels of 25(OH)VD even after high-dose VD supplementation, and randomized controlled clinical trials have reported limited therapeutic success post-VD supplementation. Thus, there is a discordance between the benefits of VD supplementation and the prevention of chronic diseases in those with VD deficiency. Why this dissociation exists is currently under debate and is of significant public interest. This review discusses the downregulation of VD-metabolizing genes needed to convert consumed VD into 25(OH)VD to enable its metabolic action exhibited by subjects with metabolic syndrome, obesity, and other chronic diseases. Research findings indicate a positive correlation between the levels of 25(OH)VD and glutathione (GSH) in both healthy and diabetic individuals. Cell culture and animal experiments reveal a novel mechanism through which the status of GSH can positively impact the expression of VD metabolism genes. This review highlights that for better success, VD deficiency needs to be corrected at multiple levels: (i) VD supplements and/or VD-rich foods need to be consumed to provide adequate VD, and (ii) the body needs to be able to upregulate VD-metabolizing genes to convert VD into 25(OH)VD and then to 1,25(OH)2VD to enhance its metabolic action. This review outlines the association between 25(OH)VD deficiency/inadequacy and decreased GSH levels, highlighting the positive impact of combined VD+LC supplementation on upregulating GSH, VD-metabolizing genes, and VDR. These effects have the potential to enhance 25(OH)VD levels and its therapeutic efficacy. Full article

(This article belongs to the Section Nutrition and Public Health)

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8 pages, 493 KiB

Open AccessBrief Report

Evaluating the Impact of a Virtual Health Coaching Lifestyle Program on Weight Loss after Sleeve Gastrectomy: A Prospective Study

by Kristina Strauss, Rachel Sauls, Michelle K. Alencar and Kelly E. Johnson

Healthcare 2024, 12(13), 1256; https://doi.org/10.3390/healthcare12131256 - 24 Jun 2024

Viewed by 256

Abstract

Bariatric surgery (BS) is a leading treatment for obesity; however, adverse side effects (e.g., pain and infection) can deter patients or affect weight maintenance. This study investigates how a post-operative virtual health coaching lifestyle program, monitoring virtual weekly goal progress made by patients, affects weight loss after BS, specifically sleeve gastrectomy. Patients recruited for this 6-month study were classified with a BMI > 30 kg/m² 90 days post-operatively. Patients were prescribed lifestyle support delivered by certified health and wellness coaches (InHealth Lifestyle Therapeutics™). Demographic variables (e.g., age, weight, height, and gender) were obtained and compared according to initial, 3-, 6-month, and current weight through repeated measures ANOVA and post hoc comparison. Thirty-eight adult participants were included, with a mean age of 52 years ± 12.9 and with a majority (n = 35; 97%) of them being female. There were significant differences in weight reported across all five time points (p < 0.05), with the greatest weight difference seen between the initial (250.3 ± 45.5 lbs.) and final time points (226.7± 40.4 lbs.). This study suggests post-operative virtual health coaching can enhance weight loss outcomes after sleeve gastrectomy. Further research is needed to assess the long-term effects and cost-effectiveness of such a form of coaching for bariatric surgery patients. Full article

(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)

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19 pages, 7569 KiB

Open AccessArticle

The Lipid-Metabolism-Associated Anti-Obesity Properties of Rapeseed Diacylglycerol Oil

by Yilin Mao, Danhong Zheng, Lin He and Jing Chen

Nutrients 2024, 16(13), 2003; https://doi.org/10.3390/nu16132003 - 24 Jun 2024

Viewed by 240

Abstract

To investigate the effects of rapeseed diacylglycerol oil (RDG) intake on lipid accumulation and metabolism in C57BL/6J mice, obese mice were fed a high-fat diet in which 45% of the total energy content came from RDG (RDGM group) or rapeseed triacylglycerol oil (RTGM group). This diet intervention was conducted for 12 weeks following the establishment of the obese mouse model. By the end of the experiment, the serum glucose levels of the mice in the RTGM and RDGM groups were 13.0 ± 1.3 mmol/L and 9.7 ± 1.5 mmol/L, respectively. Meanwhile, the serum triglyceride level in the RDGM group was 26.3% lower than that in the RTGM group. The weight-loss effect in the RDGM group was accompanied by a significant decrease in the white adipose tissue (WAT) index. The RDG intervention did not significantly change the antioxidant and anti-inflammatory properties of the rapeseed oil in vivo. The RDG diet improved the liver lipid metabolism abnormalities induced by a high-fat diet, leading to decreased liver damage index values (AST and ALT). Additionally, compared to that in the RTGM group, the expression of the adipogenic genes PPAR-γ and DGAT decreased in both the liver and intestine by 21.7% and 16.7% and by 38.7% and 47.2%, respectively, in the RDGM group. Further, most lipolytic genes in BAT showed no significant change after the RDG intervention. This implies that RDG regulates lipid metabolism by altering the expression of adipogenic genes in the liver, intestine, and adipose tissue, thereby reducing the accumulation of WAT. Furthermore, the RDG diet enhanced gut flora diversity, increasing the relative levels of unclassified Muribaculaceae and decreasing the levels of Dubosiella and Faecalibaculum in the mouse gut, potentially accelerating lipid metabolism. Thus, a three-month RDG diet intervention in obese mice exhibited benefits in regulating the somatotype, serum obesity-related indices, gut flora structure, and lipid metabolism in the adipose tissue, liver, and intestine. Full article

(This article belongs to the Section Nutrition and Obesity)

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24 pages, 3534 KiB

Open AccessArticle

Environmental Enrichment Prevents Gut Dysbiosis Progression and Enhances Glucose Metabolism in High-Fat Diet-Induced Obese Mice

by Rubiceli Manzo, Luigui Gallardo-Becerra, Sol Díaz de León-Guerrero, Tomas Villaseñor, Fernanda Cornejo-Granados, Jonathan Salazar-León, Adrian Ochoa-Leyva, Gustavo Pedraza-Alva and Leonor Pérez-Martínez

Int. J. Mol. Sci. 2024, 25(13), 6904; https://doi.org/10.3390/ijms25136904 (registering DOI) - 24 Jun 2024

Viewed by 403

Abstract

Obesity is a global health concern implicated in numerous chronic degenerative diseases, including type 2 diabetes, dyslipidemia, and neurodegenerative disorders. It is characterized by chronic low-grade inflammation, gut microbiota dysbiosis, insulin resistance, glucose intolerance, and lipid metabolism disturbances. Here, we investigated the therapeutic potential of environmental enrichment (EE) to prevent the progression of gut dysbiosis in mice with high-fat diet (HFD)-induced metabolic syndrome. C57BL/6 male mice with obesity and metabolic syndrome, continuously fed with an HFD, were exposed to EE. We analyzed the gut microbiota of the mice by sequencing the 16s rRNA gene at different intervals, including on day 0 and 12 and 24 weeks after EE exposure. Fasting glucose levels, glucose tolerance, insulin resistance, food intake, weight gain, lipid profile, hepatic steatosis, and inflammatory mediators were evaluated in serum, adipose tissue, and the colon. We demonstrate that EE intervention prevents the progression of HFD-induced dysbiosis, reducing taxa associated with metabolic syndrome (Tepidimicrobium, Acidaminobacteraceae, and Fusibacter) while promoting those linked to healthy physiology (Syntrophococcus sucrumutans, Dehalobacterium, Prevotella, and Butyricimonas). Furthermore, EE enhances intestinal barrier integrity, increases mucin-producing goblet cell population, and upregulates Muc2 expression in the colon. These alterations correlate with reduced systemic lipopolysaccharide levels and attenuated colon inflammation, resulting in normalized glucose metabolism, diminished adipose tissue inflammation, reduced liver steatosis, improved lipid profiles, and a significant reduction in body weight gain despite mice’s continued HFD consumption. Our findings highlight EE as a promising anti-inflammatory strategy for managing obesity-related metabolic dysregulation and suggest its potential in developing probiotics targeting EE-modulated microbial taxa. Full article

(This article belongs to the Special Issue Strategies to Counteract Oxidative Stress and Inflammation in Chronic-Degenerative Diseases 3.0)

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12 pages, 269 KiB

Open AccessReview

Overweight and Obesity in Adults with Type 1 Diabetes: A Growing Challenge

by Sanja Klobučar, Dijana Detel, Miljenka Igrec, Ajda Bergoč, Valentina Rahelić and Dario Rahelić

Diabetology 2024, 5(3), 234-245; https://doi.org/10.3390/diabetology5030018 - 24 Jun 2024

Viewed by 230

Abstract

The prevalence of obesity in adults with type 1 diabetes is increasing and reflects the rates of the general adult population. The coexistence of overweight or obesity and type 1 diabetes poses a major challenge to effective glycemic and weight management. In addition, individuals living with T1D and overweight or obesity are at greater cardiometabolic risk and are more prone to develop chronic complications in comparison to normal weight individuals with type 1 diabetes. Although obesity represents a growing challenge in the type 1 diabetes population, awareness of this issue is still low. This review provides a summary of current data on prevalence trends, causes, current strategies, and challenges in managing obesity in adults with type 1 diabetes. Full article

15 pages, 575 KiB

Open AccessArticle

More Adult Women than Men at High Cardiometabolic Risk Reported Worse Lifestyles and Self-Reported Health Status in the COVID-19 Lockdown

by Alejandro Oncina-Cánovas, Laura Compañ-Gabucio, Jesús Vioque, Miguel Ruiz-Canela, Dolores Corella, Jordi Salas-Salvadó, Montserrat Fitó, Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Dora Romaguera, José López-Miranda, Ramón Estruch, Francisco J. Tinahones, José Lapetra, Jacqueline Álvarez-Pérez, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín-Sánchez, Virginia Esteve-Luque, Miguel Delgado-Rodríguez, María Ortiz-Ramos, Josep Vidal, Clotilde Vázquez, Lidia Daimiel, Emilio Ros, Cristina Razquin, Indira Paz-Graniel, Jose V. Sorlí, Olga Castañer, Antonio García-Rios, Laura Torres-Collado, Olga Fernández-Barceló, María Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Naomi Cano-Ibáñez, Lucas Tojal-Sierra, Víctor J. Simón-Frapolli, Silvia Carlos, Sangeetha Shyam, Rebeca Fernández-Carrión, Albert Goday, Jose David Torres-Peña, Sandra González-Palacios, Sonia Eguaras, Nancy Babio, María Dolores Zomeño and Manuela García-de-la-Hera Show full author list Hide full author list

Nutrients 2024, 16(13), 2000; https://doi.org/10.3390/nu16132000 - 24 Jun 2024

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Abstract

Background: The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown. Methods: We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data. Results: The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001). Conclusions: The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status. Full article

(This article belongs to the Section Clinical Nutrition)

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16 pages, 948 KiB

Open AccessArticle

Evaluating Double-Duty Actions in Rwanda’s Secondary Cities

by Sophia Demekas, Helen Prytherch, Francine Bayisenge, Straton Habumugisha, Klaus Kraemer, Jimena Monroy-Gomez, Immaculée Nabacu, Cornelia Speich, Innocente Turinimigisha and Dominique Barjolle

Nutrients 2024, 16(13), 1998; https://doi.org/10.3390/nu16131998 - 23 Jun 2024

Viewed by 395

Abstract

The double burden of malnutrition (DBM) is escalating in low- and middle-income countries (LMICs), including in Rwanda, most notably in urbanizing areas. The 2019–2020 Rwanda Demographic Health Survey (DHS) revealed that 33% of children under 5 years old are stunted while 42% of women in urban areas are overweight or obese. This coexistence has contributed to a surge in non-communicable diseases (NCDs), particularly in secondary cities. Using the World Health Organization’s (WHOs) “double-duty action” (DDA) concept, this study aims to identify and evaluate interventions with double-duty potential in Rwanda’s Rusizi and Rubavu districts and generate key recommendations for their improvement. A desk review of national policies pinpointed four programs with the greatest DDA potential: early childhood development (ECD) centers, the school feeding program, farmer field schools (FFS), and the provision of nutrition-sensitive direct support. In-person interviews with key stakeholders assessed the implementation of each program and a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was used to generate context-specific recommendations for their improvement. The main finding of this research is that Rwanda’s potential to address the DBM can be improved across multiple sectors by implementing a few key changes: targeting beliefs surrounding nutrition, improving trainings for community educators, enhancing parent–particularly father–involvement, and engaging in close monitoring and follow-up. These findings offer actionable streps that governments and nutrition stakeholders can take to improve similar interventions in other rapidly urbanizing LMICs. Full article

(This article belongs to the Section Nutritional Policies and Education for Health Promotion)

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13 pages, 1731 KiB

Open AccessArticle

Influence of Adherence to the Mediterranean Diet and Level of Physical Activity with Liver Steatosis in People Aged > 50 Years and with a BMI > 25 kg/m²: Association with Biochemical Markers

by Laura Cano-Lallave, Jaime Ruiz-Tovar, Lucia Martin-de-Bernardo, Malena Martinez-Oribe, Cristina Rodriguez-Obispo, Sara Carrascosa-Corrochano, Ana Martín-Nieto, Isabel Baeza, Marta Gonzalez-Ramos, Marta Benito and Isabel Olazabal

Nutrients 2024, 16(13), 1996; https://doi.org/10.3390/nu16131996 - 23 Jun 2024

Viewed by 408

Abstract

Background: The main objective of this study is to determine the accuracy of different biochemical markers of hepatic steatosis and to correlate liver steatosis with adherence to the Mediterranean diet and level of physical activity. Methods: A cross-sectional study was carried out, including subjects over 50 years of age, with a BMI > 25 kg/m², but excluding any patient with documented hepatic pathology other than hepatic steatosis. Participants were divided into two groups: patients with hepatic steatosis diagnosed by ultrasound (SG) and a control group of individuals without hepatic steatosis (CG). The level of physical activity was recorded by the IPAQ-SF questionnaire and the adherence to the Mediterranean diet was recorded using the PREDIMED questionnaire. Biochemical markers analyzed included the Hepatic steatosis index (HSI), AST-to-Platelet ratio (APRI) and Fibrosis-4 (FIB-4). Results: A total of 116 patients were included, 71 belonging to the SG and 45 to the CG. A total of 58.6% of the patients showed low adherence to the Mediterranean diet, 35.4% moderate adherence and 6% high adherence. The median estimated physical activity was 495 METS, with most participants reporting light activity. In the SG, significantly higher HSI values were observed (p < 0.001). A cut-off point of a HSI of 40 was established, with a sensitivity of 73.2% and a specificity of 65.8%. Significantly higher FIB-4 values (p = 0.039) were also observed in the SG. A cut-off point of FIB-4 was set at 0.27, with a sensitivity of 69% and a specificity of 57.9%. Patients in the SG showed lower scores in the PREDIMED. Patients in the SG tended to show lower METS scores. However, the higher number of patients with intense activity in the CG group stands out (p = 0.008). Conclusions: The HSI and FIB-4 showed a significant correlation with liver steatosis. Hepatic steatosis is associated with low adherence to the Mediterranean diet and patients with hepatic steatosis tended to have lower METS scores. Full article

(This article belongs to the Special Issue The Role of Nutrition in Applied Physiology)

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14 pages, 1070 KiB

Open AccessArticle

The Effect of the Lacticaseibacillus paracasei BEPC22 and Lactiplantibacillus plantarum BELP53 Combination (BN-202M) on Body Fat Percentage Loss in Overweight Individuals: A Randomized, Double-Blind, Placebo-Controlled Study

by Han-Seul Kwon, Seok-Jin Kim, Kum-Joo Shin, Sanghoon Kim, Jongbok Yun, Jaewoong Bae, Hyun-Ji Tak, Na-Rae Lee and Hyeong-Jun Kim

Nutrients 2024, 16(13), 1993; https://doi.org/10.3390/nu16131993 - 23 Jun 2024

Viewed by 287

Abstract

BN-202M is derived from humans and consists of two strains, Lacticaseibacillus paracasei BEPC22 and Lactiplantibacillus plantarum BELP53. Body fat reduction effect and safety of BN-202M were assessed in overweight participants. A total of 150 participants were randomly assigned to the BN-202M and placebo groups at a 1:1 ratio. Dual-energy X-ray absorptiometry was used to objectively measure body fat. After 12 weeks of oral administration, the body fat percentage (−0.10 ± 1.32% vs. 0.48 ± 1.10%; p = 0.009) and body fat mass (−0.24 ± 1.19 kg vs. 0.23 ± 1.05 kg; p = 0.023) of the BN-202M group decreased significantly compared to those of the placebo group. The body weight (−0.58 kg, p = 0.004) and body mass index (BMI; −0.23, p = 0.003) was found to decrease significantly at 12 weeks in the BN-202M group, but not in the placebo group. Metabolome analysis revealed that β-alanine, 3-aminoisobutyric acid, glutamic acid, and octopamine decreased in the weight-decreased BN-202M post-intake group. In the gut microbiota analysis, Akkermansia showed a statistically significant increase in the BN-202M group post-intake compared to the placebo group. No serious adverse events were observed in either group. These results suggest that BN-202M is safe and effective for reducing body fat and weight. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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