Asia Pacific Journal Of Clinical Nutrition[JOURNAL]
Sun
200 papers
A new method for developing an efficient, regional semi-quantitative food frequency questionnaire.
Liu D, Guo X, Chen H … +2 more , Zheng R, Liu Q
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738732 · Full text
BACKGROUND AND OBJECTIVES: To establish a new method for developing an efficient and region-specific semi-quantitative food frequency questionnaire (SQFFQ), and to make it a simple, effective and widely applicable measur...
BACKGROUND AND OBJECTIVES: To establish a new method for developing an efficient and region-specific semi-quantitative food frequency questionnaire (SQFFQ), and to make it a simple, effective and widely applicable measurement tool, this study takes Xi'an City, Shaanxi Province as a case study. METHODS AND STUDY DESIGN: For 129 common food items, an initial food frequency questionnaire (FFQ) and a 24-hour dietary recall survey (24hDR) are constructed, and a variety of methods are combined to improve the convenience and credibility of the questionnaire itself in the inspection process, and the reliability and validity test are carried out. RESULTS: A total of 367 questionnaires are collected in study, including FFQ and 24hDR at various correction stages, in a three-month interval, and finally a semi-quantitative food frequency questionnaire containing 104 food items is obtained. The Pearson correlation coefficient of SQFFQ1 and SQFFQ2 ranges from 0.60-0.75, and the Spearman and Kendall correlation coefficients range from 0.50-0.89, and the corre-lation coefficient increases slightly after logarithmic transformation by logarithmic transformation, and the CCC correlation coefficient increases to 0.5-0.95. On average, more than 80% of subjects are classified as identical or adjacent tertiles per SQFFQ result. The Pearson, Spearman, Kendall, CCC correlation coefficients between 24hDR and SQFFQ2 range from 0.50-0.90, and on average more than 75% of participants are in the same or adjacent energy and nutrient tertiles in SQFFQ2 versus 24hDR results. CONCLUSIONS: The semi-quantitative food frequency questionnaire for dietary pattern surveys in Xi'an, Shaanxi can effectively assess nutrient intake in dietary nutrient correlation studies.
Association between Dietary Index for Gut Microbiota (DI-GM) and non-alcoholic fatty liver disease (NAFLD): Evidence from NHANES 1999-2018.
Xue Y, Zhang J
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738731 · Full text
BACKGROUND AND OBJECTIVES: Gut microbiota and liver are closely linked, and disruption of the gut-liver axis has been associated with various conditions, including non-alcoholic fatty liver disease (NAFLD). The Die-tary...
BACKGROUND AND OBJECTIVES: Gut microbiota and liver are closely linked, and disruption of the gut-liver axis has been associated with various conditions, including non-alcoholic fatty liver disease (NAFLD). The Die-tary Index for Gut Microbiota (DI-GM), a recently developed measure of gut microbiota variety, has not been researched in connection with NAFLD. METHODS AND STUDY DESIGN: We conducted a cross-sectional analysis of 12,910 eligible participants aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018 by adjusting for covariates. Dietary recall data were used to calculate the DI-GM (including components beneficial and unfavorable to gut microbiota). Multiple logistic regression and subgroup analyses were used. RESULTS: A total of 12,910 patients were included in the study, of whom 4673 (36.2%) were identified as NAFLD. Each point increase in DI-GM was associated with an 8% decrease in the prevalence of NAFLD (OR = 0.92, 95% CI = 0.90, 0.94, p <0.001), the associations remained significant after adjusting for potential confounders (OR = 0.92, 95% CI = 0.89, 0.95, p <0.001). After grouping DI-GM, in the fully adjusted model, participants with DI-GM ≥ 6 were significantly negatively associated with the prevalence of NAFLD (OR = 0.71, 95% CI = 0.61, 0.82, p <0.001) compared to participants with DI-GM ≤3 group with adjustment for potential confounders. After subgroup analyses and sensitivity analyses, the relationship between DI-GM and NAFLD remained robust. CONCLUSIONS: Our findings indicate an inverse association between the newly proposed DI-GM and the presence of NAFLD in adult Americans, offering a novel perspective on NAFLD research.
Association between low vitamin B-12 status and latent tuberculosis infection among adults.
Jiang L, Yan T, Zhang X … +7 more , Liu C, Yan Q, Chai Y, Li Y, Tan Y, Gao X, Wang Q
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738730 · Full text
BACKGROUND AND OBJECTIVES: Tuberculosis (TB) remains a major public health threat worldwide, but most of the presumed infected individuals remain asymptomatic and contain Mycobacterium tuberculosis (MTB) in a latent tube...
BACKGROUND AND OBJECTIVES: Tuberculosis (TB) remains a major public health threat worldwide, but most of the presumed infected individuals remain asymptomatic and contain Mycobacterium tuberculosis (MTB) in a latent tuberculosis infection (LTBI), and some of them will progress to active tuberculosis. Vitamin B-12 is crucial to maintain immune function, and play a role in the metabolism of MTB, while few studies investigated the impact of vitamin B-12 deficiency on tuberculosis. Therefore, we carried out the study to explore the association between vitamin B-12 deficiency and LTBI using the National Health and Nutrition Examination Surveys (NHANES). METHODS AND STUDY DESIGN: A cross-sectional study was conducted by using data from NHANES 2011-2012. Adults (aged ≥18 years) who had available data on serum Vitamin B-12, serum Methylmalonic Acid (MMA) and QuantiFERON-TB Gold In-Tube (QFT-GIT) results were included in the analysis. Multivariable logistic regression was used to assess the association between Vitamin B-12 deficiency and LTBI. RESULTS: A total of 4773 subjects were included in the present study, of whom 479 were screened as LTBI. The LTBI group had a higher proportion of participants with low Vitamin B-12 status. After adjusting for the possible confounders, Vitamin B-12 deficiency was independently associated with a 37% increased odds ratio of LTBI in the participants (OR: 1.37; 95% CI: 1.01-1.85). Similar correlations remained in subjects aged ≥35 years and female subjects by further stratified analysis. CONCLUSIONS: Vitamin B-12 deficiency was significantly associated with higher prevalence of LTBI in US adults. Maintenance of optimal Vitamin B-12 status has potential benefits for LTBI prevention. Future studies are needed to assess the roles and clinical implications of Vitamin B-12 in MTB infection.
The relationship between riboflavin and hypertension with MTHFR C677T in older adults in northern China: a case-control study.
Zhang L, Wang Z, Wu T … +7 more , Chen X, Duan H, Wang D, Li Z, He R, Huang G, Li W
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738729 · Full text
BACKGROUND AND OBJECTIVES: The incidence of hypertension is higher in individuals with the methylenetetra-hydrofolate reductase (MTHFR) 677TT genotype. Riboflavin serves as a coenzyme of MTHFR, but its role in hypertensi...
BACKGROUND AND OBJECTIVES: The incidence of hypertension is higher in individuals with the methylenetetra-hydrofolate reductase (MTHFR) 677TT genotype. Riboflavin serves as a coenzyme of MTHFR, but its role in hypertension prevalence is poorly understood. This study aimed to explore the relationship between riboflavin levels and hypertension and the impact of genotype on this relationship. METHODS AND STUDY DESIGN: The case-control study used data from the Tianjin Elderly Nutrition and Cognition study, with 200 hypertensive patients and 200 matched non-hypertensive controls. It collected questionnaires, clinical data, and measured blood riboflavin levels using the dried blood spot technique. Conditional logistic regression analyzed varia-bles related to hypertension prevalence, with effects assessed by odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The hypertensive group had significantly lower riboflavin concentration than the non-hypertensive group (p<0.001). The regression analysis indicated that regardless of adjustment for sociodemographic characteristics, riboflavin concentration was negatively associated with the prevalence of hypertension. In the multivariable model, the OR was 0.607 [95%CI, 0.507-0.727], p<0.001. Additionally, we found an interaction between MTHFR genotype and riboflavin status. Compared with the combined TT genotype and below-median riboflavin levels as the reference category, the CC genotype and above-median riboflavin levels decreased the prevalence of hypertension (OR, 0.189 [95%CI, 0.071-0.501], p=0.001). CONCLUSIONS: In conclusion, riboflavin status impacts the development of hypertension. There is also interaction between the MTHFR genotype and riboflavin. Specifically, low riboflavin status increases the prevalence of hypertension when combined with the MTHFR 677TT genotype.
Effects of early versus late enteral nutrition on the nutritional status of surgical intensive care unit patients: A retrospective observational study.
Chao PC, Lin FC, Liao HH … +2 more , Chou LR, Lee CR
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738728 · Full text
BACKGROUND AND OBJECTIVES: We retrospectively evaluated the efficacy and safety of early enteral nutrition (within 48 h) and late enteral nutrition (after 48 h; control) in improving the nutritional status of surgical in...
BACKGROUND AND OBJECTIVES: We retrospectively evaluated the efficacy and safety of early enteral nutrition (within 48 h) and late enteral nutrition (after 48 h; control) in improving the nutritional status of surgical intensive care unit patients. METHODS AND STUDY DESIGN: This single-center, retrospective, observational study was conducted using data from 82 patients (age > 18 years) who were admitted to surgical intensive care units between June and November 2019. Patients who received enteral nutrition for >7 days were included in this study, and those who received total parenteral nutrition or palliative care were excluded. RESULTS: The early and late enteral nutrition groups comprised 41 patients each. Early enteral nutrition significantly increased the actual intake of calories and protein (p < 0.0001) as well as the length of stay in the surgical in-tensive care unit (p = 0.047) and hospital (p = 0.028). Late enteral nutrition significantly reduced albumin concentration (p < 0.05), hemoglobin concentration (p < 0.05), and lymphocyte count (p < 0.05) but significantly increased weight loss (p < 0.05). However, no significant between-group difference was observed in mortality rate. CONCLUSIONS: Early enteral nutrition improves the nutritional status of surgical intensive care unit patients. It shortens overall hospitalization duration and increases actual calorie and protein intake at dis-charge. Thus, early enteral nutrition is recommended for critically ill patients.
Multivitamin-mineral supplementation prevents acute upper respiratory tract infections.
Wang F, Kang J, Wei W … +4 more , Bao Y, Chen A, Deng F, Yu K
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738727 · Full text
BACKGROUND AND OBJECTIVES: Large-scale studies on the role of multivitamin-mineral (MVM) supplementation in preventing and managing acute respiratory infections (AURIs) are limited in Chinese populations. This study eval...
BACKGROUND AND OBJECTIVES: Large-scale studies on the role of multivitamin-mineral (MVM) supplementation in preventing and managing acute respiratory infections (AURIs) are limited in Chinese populations. This study evaluated the impact of routine MVM use on AURI prevalence and symptom severity in a community-based Chinese cohort. METHODS AND STUDY DESIGN: This retrospective study was conducted among community-based populations across China (n=3,415). Using a structured questionnaire, participants self-reported epi-sodes of AURIs over three months. Based on regular use of MVM for at least 3 months, eligible participants were categorized into the MVM group and the control group. The impact of MVM on the frequency and severity of AURIs was assessed. Rigorous methodological approaches were applied to minimize potential biases. RESULTS: The period prevalence of AURIs was significantly lower in the MVM group (29.9%) compared to controls (45.6%), odds ratio (OR) =0.508 (p<0.001). After propensity score matching, demographic and lifestyle factors were comparable between groups. The period prevalence of AURIs was 31.7% and 44.8% in the MVM and control groups (OR=0.572, p<0.001). Subgroup analysis indicated the protective effect of MVM supplementation was particularly significant among participants aged ≥45 years (OR=0.407, p<0.001). The MVM group reported lower prevalence of nasal congestion (OR=0.624, p<0.001), sore throat (OR=0.575, p<0.001), headache (OR=0.642, p<0.001), diarrhea (OR=0.718, 0.026), sneezing (OR=0.651, p=0.002), and fatigue (OR=0.694, p=0.004) relative to the control group. CONCLUSIONS: Daily MVM supplementation for at least 3 months reduced the period prevalence of the common cold and influenza and may contribute to enhanced immune resilience in the Chinese population.
Comparison of time-restricted eating and a six-meal diet: Effects on body composition and biochemical parameters.
Yüzbaşıoğlu M, Özder A
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738726 · Full text
BACKGROUND AND OBJECTIVES: Obesity and obesity-related diseases is increasing worldwide. The widely accepted approach in the dietary treatment of obesity is the calorie-restricted six meal diet; however, alternative appr...
BACKGROUND AND OBJECTIVES: Obesity and obesity-related diseases is increasing worldwide. The widely accepted approach in the dietary treatment of obesity is the calorie-restricted six meal diet; however, alternative approaches are needed. This study aimed to compare time-restricted eating (TRE), a method that can be easily conveyed and applied in overcoming obesity, to six meals diet. METHODS AND STUDY DESIGN: A total of 174 participants aged 18-65, BMI>25 kg/m2 were included, with 88 participants in the time-restricted eating group and 86 participants in the six-meal group. Diet lists with similar calorie, macro counts suitable for their respective groups were prepared. Anthropometric measurements, blood pressure, blood tests were analyzed before the study and at the end of the 8-week. RESULTS: More weight loss [MD: 1.17 kg, (95% CI: 0.23-2.06), Cohen's d=0.42], higher decrease in BMI [MD: 0.41 kg/m2 (95% CI: -0.77 to -0.06), Cohen's d=0.39] , decrease in waist-to-hip ratio [MD: 0.008 (95% CI: -0.016-0.000), Cohen's d=0.35], decrease in obesity degree [MD: 2.35 (95% CI: -3.99 to -0.70), Cohen's d=0.50] were observed in the time-restricted eating group (p<0.05). In the six meals group, decrease in LDL values was higher compared to the time-restricted eating group [p<0.05, MD:0.23 mmol/L (95% Cl:0.41-15.79), Cohen's d=0.36]. More participants preferred to continue TRE (p<0.001). CONCLUSIONS: TRE resulted in greater weight loss, body fat reduction, and improved metabolic parameters, proving more effective for weight management. The six-meal diet was superior for LDL reduction. Both approaches yielded positive outcomes, with TRE emerging as an alternative weight loss strategy.
Systematic evaluation of risk prediction models for feeding intolerance in ICU patients during enteral nutrition.
Huang X, Zhong L, Li C … +1 more , Tang Y
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738725 · Full text
BACKGROUND AND OBJECTIVES: It has been found that ICU patients may encounter various complications during enteral nutrition (EN). Of these, feeding intolerance (FI) is a common issue that often necessitates the reduction...
BACKGROUND AND OBJECTIVES: It has been found that ICU patients may encounter various complications during enteral nutrition (EN). Of these, feeding intolerance (FI) is a common issue that often necessitates the reduction or cessation of EN. This study aims to evaluate risk prediction models for feeding intolerance (FI) in critically ill patients receiving EN by searching major public databases. METHODS AND STUDY DESIGN: We searched for relevant studies in Embase, PubMed, Web of Science, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and cqvip.com up until January 2024. Two researchers independently conducted the screening and data extraction processes, and the quality of the literature was assessed using bias risk assessment tools. RESULTS: A total of 13 references were included, and the subjects included patients with sepsis, pancreatitis or cerebral apoplexy; the incidence of FI was 35.2%-49.3%. The studies discussed the predictive performance of various models, with 11 studies reporting on their accuracy and calibration. The models demonstrated the area under the curve (AUC) of the receiver operating characteristic (ROC) curve or the concordance index (C-index) between 0.70 and 0.91, sensitivity from 0.81 to 0.93, and specificity from 0.68 to 0.83. CONCLUSIONS: There is a critical need for risk prediction models for FI in critically ill patients on EN that are both internally and externally validated and exhibit high performance.
Effects of FSMP on nutrition status and sarcopenia among nutritional risk cancer patients: A randomized, double-blind, placebo-controlled study.
Fu J, Yu K, Zhang Y … +2 more , Bao Y, Li S
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738724 · Full text
BACKGROUND AND OBJECTIVES: Cancer patients at nutritional risk have a worse prognosis, but this can be improved by nutritional support. Food for special medical purposes (FSMP), as a new form of nutritional support, need...
BACKGROUND AND OBJECTIVES: Cancer patients at nutritional risk have a worse prognosis, but this can be improved by nutritional support. Food for special medical purposes (FSMP), as a new form of nutritional support, needs to be further evaluated for its safety and efficacy in these patients. Our study elucidate the impact of FSMP on nutritional status and sarcopenia among nutritional risk cancer outpatients by assessing the NRS2002 score, exercise performance, muscle mass, and inflammatory factors pre- and postintervention. METHODS AND STUDY DESIGN: We conducted a single-centre, double-blind, randomized controlled interventional study. Patients from the oncology clinic with nutritional risk were randomly allocated to the control group or the FSMP group and received oral intervention for 8 weeks. The primary outcome was improvement in nutritional risk, while the secondary outcomes were improvements in sarcopenia prevalence and physical performance indicators. Other outcomes included alterations in calf circumference, hsCRP, 25(OH)VD3, Alb. etc. A linear mixed-effects model was used to compare the prepost-intervention changes in these results. RESULTS: Thirty-six cancer patients were included, 25 completed the study. The percentage of patients at nutritional risk after intervention in the FSMP group was significantly lower than the control group (Χ2=4.186, p=0.041). The FSMP group demonstrated significant improvements in the TUG test, gait speed, grip strength, and upper-limb muscle mass. However, there was no significant improvement in the rate of sarcopenia. Moreover, calf circumference, hsCRP, 25(OH)VD3, Alb exhibited no significant changes. CONCLUSIONS: FSMP can effectively improve the nutritional status, physical performance and upper-limb muscle mass of cancer patients.
Prognostic factors and nutritional support in menopausal women with chronic heart failure.
Ma L, Yang Z
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738723 · Full text
BACKGROUND AND OBJECTIVES: Menopausal women with chronic heart failure (CHF) exhibit unique physiolog-ical characteristics and prognostic features. The aim of this study is to analyze the significant predictive factors f...
BACKGROUND AND OBJECTIVES: Menopausal women with chronic heart failure (CHF) exhibit unique physiolog-ical characteristics and prognostic features. The aim of this study is to analyze the significant predictive factors for the prognosis of chronic heart failure in menopausal women and the impact of different nutritional interventions on prognosis. METHODS AND STUDY DESIGN: A total of 270 menopausal women with CHF were enrolled in the study and divided into two groups based on the nutritional intervention received. Analyze the significant predictive factors of all-cause mortality, readmission rate, deterioration of cardiac function, deterioration of nutritional status, and deterioration of quality of life, as well as the impact of nutritional interven-tion on these prognoses. Build a risk score model based on significant factors in the prognostic model. Evaluate the predictive ability of the model through the ROC curve. RESULTS: Multivariate logistic regression analysis showed that NYHA grading BNP, eGFR, The level of estradiol (E2) and nutritional intervention are signif-icant influencing factors in multiple prognostic indicators, among which the enhanced nutritional support and micronutrient supplementation program in nutritional intervention have a significant protective effect on poor prognosis. The constructed nutritional risk model has good discriminative ability and robustness in predicting prognosis. CONCLUSIONS: This study identified menopausal characteristics, NYHA classification, BNP, eGFR, and estradiol levels as important prognostic predictors in menopausal women with CHF. Enhanced nutritional support and micronutrient supplementation significantly improved patient prognosis. The risk model based on nutritional intervention provides scientific basis for the management strategy of chronic heart failure in menopausal women.
Occurrence and predictors of refeeding syndrome in adult patients receiving parenteral nutrition at a Malaysian teaching hospital: A retrospective study.
Ng TW, Abu Hassan Shaari NA, Sadu Singh BK … +1 more , Premakumar CM
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738722 · Full text
BACKGROUND AND OBJECTIVES: Refeeding syndrome (RS) is a potentially life-threatening condition character-ised by significant electrolyte and fluid imbalances, posing a considerable risk in patients undergoing parenteral...
BACKGROUND AND OBJECTIVES: Refeeding syndrome (RS) is a potentially life-threatening condition character-ised by significant electrolyte and fluid imbalances, posing a considerable risk in patients undergoing parenteral nutrition (PN) therapy. This study aimed to determine the occurrence, risk factors, severity, and complications of RS in a teaching hospital in Malaysia. METHODS AND STUDY DESIGN: A retrospective observational study was conducted using universal sampling from October to December 2023. Data were collected for adult patients receiving PN for more than 48 hours between July 2022 and July 2023 at Hospital Canselor Tuanku Muhriz. RESULTS: Among 90 patients included, 30 (33.3%) developed RS. Upon consideration of interaction terms due to collinerity of variables, a statistically significant correlation was observed between pre-existing electrolyte derangements and RS occurrence (p = 0.001). Phosphate levels showed the most significant decline post-PN initiation (43%), followed by potassium (19%) and magnesium (17%), primarily within the first 24 hours. No significant associations were found between BMI, fasting duration, unintentional weight loss, or medication history and RS. However, fasting for more than five days (AOR 2.8, 95% CI 0.4-17.7) and ≥10% unintentional weight loss (AOR 1.8, 95% CI 0.4-7.7) increased the likelihood of RS. CONCLUSIONS: RS is prevalent among adult PN patients, predominantly with mild severity. Pre-existing electrolyte abnormalities, especially in phosphate levels, were robust predictors. Larger studies are needed to better elucidate the associations between risk factors and RS in the local population.
Impact of fatty diets on blood pressure: A systematic review and meta-analysis.
Zang T, Hassan W, Javaid F … +3 more , Shabbir R, Shahzadi A, Ahmed H
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738721 · Full text
BACKGROUND AND OBJECTIVES: Hypertension is a major risk factor for cardiovascular diseases, with dietary fats playing a critical role in its regulation. While unsaturated fats are associated with blood pressure (BP) redu...
BACKGROUND AND OBJECTIVES: Hypertension is a major risk factor for cardiovascular diseases, with dietary fats playing a critical role in its regulation. While unsaturated fats are associated with blood pressure (BP) reduction, saturated and trans fats may exacerbate hypertension. This systematic review and meta-analysis aimed to evaluate the impact of various fatty diets on systolic (SBP) and diastolic blood pressure (DBP) and identify dietary patterns most effective for BP management. METHODS AND STUDY DESIGN: A comprehensive search of MEDLINE and ClinicalTrials.gov (inception to February 2025) identified randomized clinical trials and observational studies assessing dietary fats' effects on BP. Twenty-five studies (n=14,522 participants) met inclusion criteria. Data were analyzed to estimate mean differences (MDs) with 95% confidence intervals (CIs). Funnel plots were generated to assess publication bias. Risk of bias was assessed using the RevMan Web tool, and sensitivity analyses were conducted. RESULTS: Food-based oil diets significantly reduced SBP and DBP (MD: -18.43 and -12.90 mm Hg). Low-fat and unsaturated fat-enriched diets lowered SBP (-6.91 and -4.46 mm Hg) and DBP (-3.78 and -0.74 mm Hg). The DASH diet had moderate effects (SBP: -3.83, DBP: -2.18 mm Hg). Omega-3 and high-fat diets showed smaller reductions. Saturated fat restriction had minimal impact. CONCLUSIONS: Food-based fatty oil diets had the greatest BP reduction, while low-fat, unsatu-rated fat-enriched, and DASH diets (fat-based variation) showed moderate effects. High-fat and omega-3 diets had smaller impacts, emphasizing diet's role in BP management.
The development of nutrition and dietetics education and accreditation system in Indonesia and various countries: A narrative review.
Tsani AFA, Susetyowati, Arjuna T … +3 more , Nur Hidayah R, Dieny FF, Putri FAA
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738720 · Full text
The education and accreditation system of dietitian-nutritionists has gone through various changes throughout the years. These systems are important to produce competent nutrition professionals. Standardization attempts...
The education and accreditation system of dietitian-nutritionists has gone through various changes throughout the years. These systems are important to produce competent nutrition professionals. Standardization attempts have been done internationally by the International Confederation of Dietetic Associations. Many countries have developed their own standards to educate and accredit nutrition professionals to ensure the quality of the nutrition and dietetic profession. Through internet and database searching, this paper aims to review and describe the education requirements and accreditation system of nutrition professionals in Indonesia and compare it to other countries including the United States, United Kingdom, Australia, Japan, South Korea, Malaysia, Philippines, Thailand, and Singapore. Most countries, including Indonesia, require a minimum of bachelor's degree to be a nutritionist and a dietitian, whereas the US requires a minimum of master's degree. In Indonesia, there is also an additional one-year training program after completing the undergraduate study that need to be taken if an individual wants to register as a dietitian or nutritionist, while other countries have included this similar program to their undergraduate or master course. A certification exam to be a dietitian or nutritionist is required by Indonesia, the US, Japan, South Korea, Philippines, and Thailand, while the remaining others do not. In conclusion, differences in dietetic education and accreditation system were found. Indonesia's nutrition and dietetic education system already meet the International Confederation of Dietetic Associations standard and on par with some countries reviewed here. However, further improvements are still needed.
Efficacy of different interventions for nonalcoholic fatty liver disease: A meta-analysis of lifestyle modifications, silymarin, and medications.
Zhang Z, Li S, Sun J
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738719 · Full text
BACKGROUND AND OBJECTIVES: To compare the effectiveness of silymarin or its combination with lifestyle modifications, Mediterranean hypocaloric diets, and medications for improving nonalcoholic fatty liver disease (NAFLD...
BACKGROUND AND OBJECTIVES: To compare the effectiveness of silymarin or its combination with lifestyle modifications, Mediterranean hypocaloric diets, and medications for improving nonalcoholic fatty liver disease (NAFLD). METHODS AND STUDY DESIGN: PubMed, Embase, Cochrane Library, Web of Science, and Clin-icalTrails.gov were used to identify relevant studies. The treatment arm was silymarin or its combination with Mediterranean hypocaloric diets, medications, or lifestyle modifications. The comparators were placebo, Mediterranean hypocaloric diets, medications, and lifestyle modifications. RESULTS: This meta-analysis included 25 studies with 2283 patients. Total cholesterol levels were reduced by silymarin+Mediterranean hypocaloric diets (SMD: -0.39 (-0.81, 0.03), p=0.072) or medications [SMD: -1.12 (-1.67, -0.58), p<0.001]. Triglyceride levels were decreased by silymarin combined with the medication [SMD: -0.92 (-1.98, 0.14), p=0.080]. Low-density lipoprotein cholesterol levels were reduced by silymarin alone [SMD: -0.25 (-0.48, -0.03), p=0.027]. The combination of silymarin with Mediterranean hypocaloric diets [SMD: -0.47 (-0.90, -0.04), p=0.031] or lifestyle modifications [SMD: -0.88 (-1.09, -0.66), p<0.0001] decreased alanine aminotransferase levels. Aspartate aminotransferase levels were reduced by a combination of silymarin and life-style modifications [SMD: -0.72 (-1.49, 0.05), p=0.061] or medications [SMD: -1.41 (-2.24, -0.59), p=0.005]. Silymarin (2.5 times) or silymarin plus lifestyle modifications (39%) reduced the hepatic steatosis rate in patients with NAFLD. The silymarin use increased the rate of patients with adverse effects [RR:1.98 (1.11, 3.54)]; gastrointestinal problems were the most common adverse effects. CONCLUSIONS: Despite the overall advantages of therapies, different interventions showed different effects on markers in patients with NAFLD. These results highlight the need for more research to fully comprehend the features of the intervention.
Association between triglyceride glucose index and atrial fibrillation: A systematic review and meta-analysis.
Chen Q, Zhao J, Wang W
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738718 · Full text
BACKGROUND AND OBJECTIVES: Previous studies have demonstrated that insulin resistance (IR) is associated with atrial fibrillation (AF). As a reliable indicator of IR, the triglyceride glucose (TyG) index has been extensi...
BACKGROUND AND OBJECTIVES: Previous studies have demonstrated that insulin resistance (IR) is associated with atrial fibrillation (AF). As a reliable indicator of IR, the triglyceride glucose (TyG) index has been extensively studied in relation to AF. We aimed to investigate the relationship between the TyG index and AF through a systematic review and meta-analysis. METHODS AND STUDY DESIGN: We systematically searched studies published up to August 2024 in online databases including PubMed, Embase, Web of Science, Wan-fang, and the China National Knowledge Internet database. Seventeen studies involving 57,213 patients were included in the analysis. A random-effects model and exposure-effect analysis were used to calculate the pooled effect estimate and compute the linear trend. RESULTS: A significantly higher TyG index was observed in AF patients (standardized mean difference [SMD]: 0.78; 95% CI: 0.43- 1.13; p<0.001). The TyG index was associated with the risk of AF in both continuous analysis (odds ratio [OR]: 1.80; 95% CI: 1.50-2.17; p<0.001) and category analysis (odds ratio [OR]: 1.98; 95% CI: 1.35-2.91]; p<0.001). Exposure-effect analysis confirmed a linear positive relationship between the TyG index and the risk of AF (plinearity = 0.006). CONCLUSIONS: The TyG index is associated with an increased risk of AF, including pure AF, post-operative AF and AF recurrence after ablation. Further studies are needed to confirm the causal relationship between the TyG index and AF.
Micronutrient status of patients with diabetic foot: A systematic review.
Batarbekova S, Zhunussova D, Derbissalina G … +7 more , Bekbergenova Z, Maksimova N, Umbetzhanova A, Kelimberdiyeva E, Kassymova R, Kuanyshbayeva G, Imangaliyeva A
Asia Pac J Clin Nutr · 2025 Aug · PMID 40738717 · Full text
BACKGROUND AND OBJECTIVES: Micronutrient status encompasses a range of indicators that reflect the levels and balance of macro- and microelements, as well as vitamins within the body. These essential substances, required...
BACKGROUND AND OBJECTIVES: Micronutrient status encompasses a range of indicators that reflect the levels and balance of macro- and microelements, as well as vitamins within the body. These essential substances, required in minimal amounts, are crucial for supporting normal physiological processes, immune system functioning, and tissue repair. The aim of this systematic review is to summarize data on the deficiency or excess of microelements, macroelements, and vitamins in patients with diabetic foot ulcers. METHODS AND STUDY DESIGN: Databases were searched for studies on vitamin, macronutrient, micronutrient levels and their impact on the course, treatment and healing of diabetic foot ulcers. The Cochrane Risk of Bias tool was employed for assessing randomized trials, while the Newcastle-Ottawa Scale was utilized for evaluating observa-tional studies in terms of quality and bias risk. RESULTS: The findings revealed a notable correlation between deficiencies in vitamins D, C, A and the severity of clinical symptoms. Low vitamin D levels were linked to elevated proinflammatory cytokines. Higher concentrations of folate and vitamin B-12 were associated with improved ulcer healing, supplementation with zinc and magnesium contributed to a reduction in ulcer size. Inadequate intake of zinc, vitamins E, C was found to compromise antioxidant defences. Elevated ferritin levels may serve as an indicator of inflammation. CONCLUSIONS: The most important task is to adjust the in-take of micronutrients to maintain balance and prevent deficiency and excess, which is important in the complex therapy of patients.
Commentary: Underweight in adults: Time for ethnic-specific criteria?
Rathod H, Rajeev LN
Asia Pac J Clin Nutr · 2025 Jun · PMID 40419408 · Full text
The classification for underweight adults, defined as a body mass index (BMI; <18.5 kg/m²) by the World Health Organization (WHO), has been consistent globally with respect to populations. Although the WHO has recognized...
The classification for underweight adults, defined as a body mass index (BMI; <18.5 kg/m²) by the World Health Organization (WHO), has been consistent globally with respect to populations. Although the WHO has recognized that body composition and health risks differ according to ethnicity by offering adjusted BMI cut-offs for overweight and obesity (23-24.9 kg/m² for overweight and ≥25 kg/m² for obesity) in Asian-populations, the underweight threshold has strangely not been modified. Because there is evidence of unique physiological and metabolic profiles of Asian populations the applicability of this uniformity to Asian populations remains as an important question.
Role of TyG, TyG-BMI and METS-IR in osteoporosis risk among older men: a retrospective cohort study.
Zeng J, Li T, Pan Z … +8 more , Liu Q, He J, Cai X, Gong M, Deng X, Gong Y, Li N, Li C
Asia Pac J Clin Nutr · 2025 Jun · PMID 40419407 · Full text
BACKGROUND AND OBJECTIVES: Obese and diabetic individuals tend to have insulin resistance, but are less like-ly to develop osteoporosis. The association of triglyceride-glucose (TyG) related indices with osteoporosis rem...
BACKGROUND AND OBJECTIVES: Obese and diabetic individuals tend to have insulin resistance, but are less like-ly to develop osteoporosis. The association of triglyceride-glucose (TyG) related indices with osteoporosis remains controversial, and longitudinal evidence exploring the male osteoporosis (MOP) is limited. This study aims to examine TyG, TyG-body mass index (TyG-BMI) and the metabolic score for insulin resistance (METS-IR) with osteoporosis risk among older men. METHODS AND STUDY DESIGN: A cohort study based on 1622 middle-aged and older men in 2015 was conducted, and followed up until 2022. Participants with oste-oporosis and admittedly secondary risk factors were excluded. TyG, TyG-BMI, METS-IR and corresponding quantiles were calculated. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence interval (CI). Receiver operating characteristic (ROC) curve was applied to estimate their performance in osteoporosis screening. RESULTS: 72 of 1622 participants were newly developed OP during the 9317 person-years. The adjusted HRs of TyG, TyG-BMI, and METS-IR for MOP were 0.573 (95%CI 0.336-0.976), 0.991 (95%CI 0.984-0.999) and 0.929 (95%CI 0.892-0.968), respectively, and pre-sented at linear dose-response relationships. Subgroup analysis showed that the estimated benefit for MOP incidence was consistent among participants aged more than 70 years and related to BMI and eating mount of milk, fresh fruit and vegetables. No difference was found in the area under ROC curve for screening osteo-porosis, ranging from 0.585 to 0.617. CONCLUSIONS: TyG and relevant indices were associated with the inci-dence of osteoporosis in the senile men, and the relationship was thought to correlate with BMI and nutritional behaviors.
Factors influencing thyroid volume and comparative analysis of thyroid volume correction methods in children aged 8-10 years in Gansu, China.
Fei X, Wang Y, He A … +3 more , Zhu X, Dou Y, Sun W
Asia Pac J Clin Nutr · 2025 Jun · PMID 40419406 · Full text
BACKGROUND AND OBJECTIVES: This study aimed to analyze the relationship between thyroid volume (TVOL) and physical development of children, and explore the suitable TVOL correction methods. METHODS AND STUDY DESIGN: 1500...
BACKGROUND AND OBJECTIVES: This study aimed to analyze the relationship between thyroid volume (TVOL) and physical development of children, and explore the suitable TVOL correction methods. METHODS AND STUDY DESIGN: 1500 children aged 8-10 years from Gansu province northwest China were selected. The height (H), weight (W), urine iodine of children was measured and their thyroid was examined by ultrasound. Body mass index (BMI), body surface area (BSA) and TVOL were calculated (BSA calculated by three formulas). The relationship between TVOL and age, sex, physical development was analyzed. The applicability of TVOL correction methods including BMI corrected volume (BMIV), BSA corrected volume (BSAV), weight and height corrected volume indicator (WHVI) and height corrected volume indicator (HVI) were compared. RESULTS: Median urinary iodine concentrations of children aged 8, 9, 10 years were 166.6 μg/L, 167.2 μg/L and 178.8 μg/L respectively. The rate of iodine deficiency was 20.3%, the rate of thyroid goiter was 3.2%. Physical development indexes (height, weight, BMI and BSA) and TVOL increased with age. Also, physical development indexes (height, weight, BMI and BSA) of boys were higher than girls (p <0.05). Only BSAV1 had no correlation with all physical development indexes (p >0.05). The TVOL P97 (97th percentile) of children aged 8, 9, 10 years were 4.4 ml, 4.9 ml, 6.5 ml, the values were 4.6 mL, 4.7 mL, 5.9 mL after BSAV1 corrected. The difference between TVOL and BSAV1 ranges from -0.37% to 0.36%. CONCLUSIONS: The thyroid volume is not only affected by age, but it is also affected by physical development. Thyroid goiter should be assessed based on age and physical development. The formula BSAV1=TVOL/ (W0.425×H0.725×71.84×10-4) was a suitable TVOL correction method.
Validity of single vs. multiple FFQs in ranking nutrient intake among Japanese adults: the Tohoku Medical Megabank Project.
Ogino M, Takachi R, Ishihara J … +18 more , Sugawara S, Hoshina Y, Kito K, Nakadate M, Maruya S, Suzuki A, Matsuno T, Obara T, Ishikuro M, Ueno F, Noda A, Aizawa M, Takahashi I, Yonezawa Y, Yamashita T, Suzuki S, Murakami K, Kuriyama S
Asia Pac J Clin Nutr · 2025 Jun · PMID 40419405 · Full text
BACKGROUND AND OBJECTIVES: Repeating food frequency questionnaires (FFQs) within the same population was reported to improve the validity of correlation coefficient (CC). However, the enhancement of validity in ranking a...
BACKGROUND AND OBJECTIVES: Repeating food frequency questionnaires (FFQs) within the same population was reported to improve the validity of correlation coefficient (CC). However, the enhancement of validity in ranking agreement remains underreported. Herein, we assessed the validity of energy and nutrient intake es-timates using single and multiple FFQs and their ability to rank individuals. METHODS AND STUDY DESIGN: 213 men and women aged ≥20 years were recruited from the residents participating in the Tohoku Medical Mega-bank Project (TMM) cohort studies; three FFQs were conducted in November each year from 2019 to 2021, with 12-day weighted food records (WFRs) as the reference method. Spearman's rank CCs were calculated between single or multiple FFQs estimates and those obtained through the 12-day WFR. Additionally, the ranking agreement was compared based on cross-classification. RESULTS: CCs between intake estimated using a single FFQ and 12-day WFR were moderate for several nutrients, with median CCs of 0.52 for men and 0.48 for women. CCs for multiple FFQs were slightly higher than that of single FFQ, with median CCs of 0.59 for men and 0.56 for women. Regardless of the number of FFQs, the proportion of subjects classified into the opposite extreme category was ≤5% for most nutrients. CONCLUSIONS: A single FFQ used for adults in the TMM cohort studies showed moderate validity. Estimates from multiple FFQs improved the accuracy slightly; nevertheless, this indicates that relying on a single FFQ is unlikely to result in a serious misclassifica-tion compared to using intake data from multiple FFQs over a relatively short period.
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