Abstract:The aging of the population and the transformation of the disease spectrum result in enhanced national awareness of nutrition and health and a surge in the needs of health maintenance and promotion in people with different medical conditions and/or different physiological status. However, the current nutrition and health products cannot meet such needs, which has seriously restricted the development of medical nutriology. Luckily, China boasts a long culture of health via traditional diet regimens with a rich resources of edible animals and plants, which can be a treasure house of food and nutrition with great potential. In this paper, the developmental potential and orientation of health promotion cuisine as a tool of nutritional management was firstly proposed and discussed, in a view to inject new momentum into the development of nutrition and health industry.

Abstract:Objective To analyze the nutritional status and its influencing factors of elderly trauma patients in perioperative period so as to provide scientific basis for early nutritional intervention and clinical diagnosis and treatment, promote clinical outcomes and prognosis, and improve their quality of life. Methods A total of 103 elderly trauma patients admitted in West China Hospital of Sichuan University from January 2021 to December 2021 were included in the study. The results of laboratory examinations and body composition data were recorded to describe the nutritional status of elderly trauma patients in multiple dimensions. According to the evaluation results of mini nutritional assessment-short form (MNA-SF), they were divided into nutritional risk group (n=46) and normal nutrition group (n=57). The nutritional status and the influencing factors were studied in the elderly trauma patients. SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test, rank sum test or Chi-square test was employed for intergroup comparison. Multivariate stepwise logistic regression for binary variables was performed to analyze influencing factors of nutritional status in elderly trauma patients. Results The results of MNA-SF showed there were 57 patients with good nutritional status, 39 with potential malnutrition, and 7 with malnutrition, with an incidence of nutritional risk of 44.66% (46/103). Elderly trauma patients also had nutritional problems such as insufficient energy intake, high blood glucose, high body fat, reduced skeletal muscle mass and low body protein level. Logistic regression analysis indicated that high body fat (OR=0.126,95%CI 0.022-0.707; P=0.019), low serum albumin level (OR=3.579,95%CI 1.365-9.388; P=0.010) and low skeletal muscle mass index (OR=4.757,95%CI 1.854-12.209; P=0.001) were significantly associated with nutritional risk in elderly trauma patients. The length of hospital stay was prolonged in the patients with nutritional risk (Z=-2.908, P=0.004) and those with low serum albumin level (Z=-3.511, P<0.001). Conclusion Elderly trauma patients had many nutritional problems and are at high nutritional risk, which is associated with the length of hospital stay. Monitoring of nutritional status should be carried out, especially in those with low body fat, serum albumin and skeletal muscle mass index. Timely nutritional support should be given to improve their nutritional status and prognosis.

Abstract:Objective To investigate the effects of social/population factors, dietary patterns, and folate biochemical level on serum homocysteine(HCY) level in the elderly. Methods A total of 4319 elderly people (≥60 years) in Baodi District of Tianjin were selected as the subjects. Serum HCY >15 μmol/L was defined as hyperhomocysteine (HHCY), and the elderly were divided into HHCY group (n=1 477) and non-HHCY group (n=2 842). Dietary information was collected by food frequency method, dietary patterns were extracted by principal component analysis, and the effects of different dietary patterns on serum folate and HCY levels were analyzed. SPSS 25.0 was used for statistical analysis. Student′s t-test, One-way ANOVA or Chi-square test was employed for intergroup comparison based on data types. Results Compared with the non-HHCY group, the HHCY group was older with more males, higher BMI, and lower serum folate levels (all P<0.05). Three dietary patterns were extracted in the principal component analysis, among which the ovo-lacto vegetarian dietary pattern was beneficial to a decrease in serum HCY level and an increase of serum folate level (all P<0.001). The animal pattern was associated with a decreased serum folate level (P<0.001), but not significantly with serum HCY level. Beans dietary pattern was associated with the decrease of serum HCY (P<0.05), but not significantly with serum folate level. Conclusion It is suggested that the rural elderly in Tianjin should increase the intake of vegetables, fruits, eggs, dairy products, nuts and seeds, soybeans and other legumes in their daily diet but moderately reduce the intake of animal food and fried food, which is beneficial to reduce HCY and protect the cardiovascular and cerebrovascular health.

Abstract:Objective To evaluate the diet quality of the elderly in rural area of Chengdu using Chinese Diet Balance Index (DBI-16). Methods The elderly were randomly selected for diet survey and the diet quality was evaluated using DBI-16. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test,χ² test or Fisher exact test depending on data type.Results This study included 1 275 elderly patients totally. Among them, 1 214(95.22%)had under-intake of food recommended to be “eaten often,” “eaten more” or “eaten in moderation,” with 465 (36.47%) having medium or high level of insufficiency; 1 049 (82.27%) had over-intake of food recommended to be “eaten less” “eaten none” or “eaten in moderation”, with 202 (15.84%) having medium or high level of over-intake. As many as 1 272 (99.69%) elderly people experienced dietary imbalance, with 725 (56.86%) being of medium and high imbalance. The analysis of the food intake of each group found that the elderly in this region had dietary problems such as imbalanced intake of staple food, low intake of vegetables, fruits and milk legumes, too much intake of animal foods, low food diversity, and too much intake of pure energy foods (alcohol and sugar). Conclusion The elderly in this region showed a high proportion of dietary imbalances. It is recommended to increase the intake of fresh vegetables and fruits, dairy and soy products, increase food diversity, reduce the intake of pure energy foods, and to keep the intake of animal foods in an appropriate range. The targeted health education should be conducted for this population to improve the diet quality.

Abstract:Objective To evaluate the reliability, validity and acceptability of the Community Comprehensive Health Assessment (CGA) scale for the elderly people in Beijing. Methods From August 2020 to January 2021,1 983 elderly people living in 3 districts of Beijing were selected by convenient sampling and surveyed with CGA scale. And finally, 1 980 questionnaires were validly recovered. Kronbach α (Cronbach′s α) coefficient was used to evaluate the internal consistency of the scale. Intragroup correlation coefficient (ICC) was employed to analyze the test-retest reliability and evaluator reliability of the scale. Pearson correlation coefficient was used for item analysis of the scale. Exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the structural validity of the scale. Pearson correlation coefficient was employed to evaluate the calibration validity of the scale. Critical ratio was used to evaluate the sensitivity of the scale. The acceptability of the scale was evaluated by the effective recovery rate and filling time of the scale. SPSS 22.0 and AMOS 22.0 software were used for statistical analysis. Results The Cronbach′s α coefficient of the total scale, and ICC coefficients of retest reliability and evaluator reliability were 0.849,0.837 and 0.899, respectively, and the Cronbach′s α coefficient of all dimensions, and ICC coefficients of retest reliability and evaluator reliability ranged from 0.467 to 0.833, from 0.579 to 0.910, and from 0.280 to 0.860, respectively. The results of item analysis showed that the Pearson correlation coefficient r between the score of each item and that of its corresponding dimension was 0.241-0.934 (all P<0.01), and the correlation coefficient r with the total score of the scale was 0.018-0.631. Except for items 5-5, the differences were statistically significant (all P<0.01). The sampling suitability of Kaiser Meyer Olki, which reflects the structural validity, was 0.737, and the Chi-square value of Bartlett′s test was 14 420.98 (P<0.001). Exploratory factor analysis showed that there were 13 common factors extracted from the scale, and the cumulative variance contribution rate was 55.65%. The confirmatory factor analysis indicated that the goodness of fit index, incremental fit index, comparative fit index, normed fit index and parsimony goodness of fit index were 0.961,0.927, 0.926,0.903 and 0.753, respectively, and the root mean square error of approximation was 0.039, which were in line with the standard of fitting values, and the model structure was well fitted. Except for the prevalence of chronic diseases and social support, the other dimensions were significantly positively correlated with the calibration scale (all P<0.05). The critical ratio of each dimension was 8.09-28.10 (all P<0.01), indicating that each dimension of the scale had good sensitivity. The filling time of the scale was (12.8±4.8) min, and the effective recovery rate was 99.1%(1980/2000). Conclusion This CGA scale is internal consistent, retest and inter-rater reliable, with good content validity, structural validity, calibration validity, discriminant validity and excellent acceptability, and thus can be used to evaluate the comprehensive health status of the elderly in the community.

Abstract:Objective To explore the correlation between serum vitamin levels and clinical pathology and other factors in lung cancer. Methods The clinical data of 549 inpatients with pulmonary nodules/lung occupation in a large-scale general hospital from September 2020 to May 2022 were retrospectively analyzed. The differences in serum vitamin levels were compared between patients with benign and malignant pulmonary nodules and among those with different pathological types of lung cancer. Logistic regression analysis was used to evaluate the correlation between serum vitamin levels and the risk of lung cancer of different pathological types. SPSS statistics 26.0 was used for statistical analysis. Data comparison between 2 groups was performed using student′s t test, Wilcoxon test or Chi-square test depending on data types. Results Among the 549 subjected patients, 29 cases (5.3%) were diagnosed as benign lung nodules by pathology and clinical diagnosis, 56 cases (10.2%) as small-cell lung cancer (SCLC), 464 cases (84.5%) of non-small-cell lung cancer (NSCLC). Compared with the patients with benign lung nodules, the serum levels of vitamin A, vitamin B₁, vitamin C and vitamin D were significantly lower in lung cancer patients (all P<0.01). For the lung cancer patients, the serum vitamin A and vitamin C levels were obviously lower in the females (both P<0.01). The serum vitamin B₂ and vitamin D levels were notably lower in the SCLC patients than the NSCLC patients (both P<0.05). In the NSCLC patients, the vitamin C level was notably lower in the adenocarcinoma patients than those with squamous cell carcinoma (P<0.05). The serum levels of vitamin A, vitamin B₂, and vitamin D were remarkably lower in the patients with intermediate and advanced NSCLC (stage Ⅲ and Ⅳ) than those with early NSCLC (all P<0.05). Logistic regression analysis showed that serum vitamin A deficiency (OR=0.220,95%CI 0.126-0.385; P<0.001) and vitamin B₁ deficiency (OR=0.963,95%CI 0.938-0.988; P=0.004) were independent risk factors for lung cancer. Serum vitamin A deficiency (OR=2.433,95%CI 1.007-5.878; P=0.048) and vitamin B₂ deficiency (OR=1.780,95%CI 1.115-2.843; P=0.016) were independent risk factors for SCLC. Serum vitamin C deficiency (OR=0.932,95%CI 0.889-0.977;P=0.004) and vitamin D deficiency (OR=0.967,95%CI 0.948-0.986; P<0.001) can be used as an independent risk factor for advanced NSCLC. Conclusion Vitamin deficiency is quite common in patients hospitalized due to lung cancer. Some serum vitamin indicators may be independent risk factors for the development and progression of lung cancer.

Abstract:Objective To investigate the prevalence of frailty in inpatients with lung cancer and analyze its influencing factors. Methods From December 2021 to April 2022, inpatients with lung cancer in Peking Union Medical College Hospital who met the inclusion and exclusion criteria were consecutively enrolled. Their data concerning demography, medical history, nutrition and laboratory tests were collected. Fried frailty phenotype was used to assess frailty status, Nutritional Risk Screening 2002 to screen nutritional risks, and multi-frequency bioelectric impedance analysis to determine body composition. Stata/SE 16.0 was used for data analysis. Depending on data type, comparison between groups was performed using χ²test or analysis of variance.Results A total of 109 lung cancer inpatients were included, among whom 39 cases (35.8%) were of frailty, 45 cases (41.3%) of pre-frailty, and 25 cases (22.9%) of non-frailty. The prevalence of frailty was significantly higher in patients with small cell lung cancer, comorbidities and nutritional risks (χ²=6.38,14.25,12.02; all P<0.05). Multivariate logistic regression analysis showed that the number of comorbidities, muscle mass, Eastern Cooperative Oncology Group performance status, and serum albumin were independent influencing factors of frailty and pre-frailty(β=0.653, -0.980,1.169, -0.128；all P＜0.05). Conclusion Frailty or pre-frailty is common in inpatients with lung cancer. The comorbidities, nutritional status, muscle mass and physical function are strongly associated with frailty status.

Abstract:Objective To investigate the correlation of body mass index (BMI) and body composition with cognitive function in the elderly population. Methods A total of 391 elderly patients who visited the nutritional clinic of our medical center from January to December 2021 were recruited as the research objects. Montreal Cognitive Assessment (MoCA) scale was used to assess the patients, and according to the results, the patients were divided into normal group (≥26), mild group (17-26) and moderate-severe group (≤17). Their height and weight were measured and BMI was calculated. Multi-frequency bioelectrical impedance analysis (MF-BIA) was used to obtain body composition, and the correlation of BMI and body composition with cognitive function was analyzed. When the diagnostic grade of cognitive impairment (CI) was used as the dependent variable, BMI and related body composition were regarded as the independent variables, multivariate logistic regression analysis was carried out after the adjustment of confounding factors such as hypertension and diabetes. SPSS statistics 25.0 was used for statistical analysis. Data comparison between two groups was performed using LSD-t test, Fisher exact test or χ²test depending on data type. Results There were significant differences in BMI, body fat percentage (PBF) and waist-hip ratio (WHR) among the normal group, mild group and moderate-severe group (P<0.05). The body fat mass (BFM) and visceral fat area (VFA) showed an increasing trend with the increase of the severity of cognitive dysfunction in the 3 groups [(22.45±4.97) vs (26.97±5.54) vs (31.10±3.45) kg; (104.42 ±26.73) vs (125.57±29.58) vs (177.01±25.26) cm²; P<0.05] . The moderate-severe group had significantly lower soft lean mass (SLM), skeletal muscle mass (SMM) and basal metabolic rate (BMR) when compared with the normal and mild groups [(37.97±8.16) vs (48.06±8.00) and (47.70±9.44) kg, (21.42±5.60) vs (28.14±5.11) and(28.00±6.04) kg,(1 238.95±205.84) vs(1 469.33±182.12) and(1 463.94±215.27) kcal; all P<0.05). The results of multivariate logistic regression analysis showed that the obesity group had a higher risk of CI than the normal weight group (OR=2.145, P<0.05); the WHR exceeding standard group showed a higher risk of CI than the normal WHR group (OR=21.475, P<0.05); the PBF Q2, Q3 and Q4 groups had a higher risk of CI when compared with the PBF Q1 group (OR=14.324,22.298 and 39.175; P<0.05); and the BFM Q3 group and Q4 group presented a higher risk of CI than the BFM Q1 group (OR=14.588,26.239; P<0.05). Conclusion BMI and obesity are correlated with the occurrence of cognitive dysfunction in the elderly.

Abstract:Objective To investigate the correlation between serum lipids and expression levels of β-Amyloid protein (Aβ) and Tau in brain, and determine the intervention effect of medium-chain fatty acid (MCFA) in APP/PS1 mice, so as to provide a theoretical basis for exploring the mechanism of MCFA in the prevention and treatment of Alzheimer′s disease (AD). Methods Seventeen 4-week-old APP/PS1 transgenic mice were randomly divided into MCFA group (n=9) and long-chain fatty acid (LCFA) group (n=8), and 9 littermates of negative wild-type mice served as wide type (WT) group. Mice in each group were fed with diets prepared by different fatty acids until they were 36 weeks old, then the blood samples were collected to measure the serum lipids, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and the brain tissues were harvested to detect the expression levels of Aβ precursor protein (APP), Aβ and Tau protein in the cerebral cortex and hippocampus. SPSS statistics 22.0 was used for statistical analysis. Data comparison between the two groups was performed using student′s t test for measurement data. Pearson correlation analysis was used to analyze the correlation between blood lipids and the protein levels of Aβ and Tau. Results The serum levels of TC and TG and the protein levels of Aβ and Tau in the cerebral cortex and hippocampus were significantly lower in the MCFA group than the LCFA group (P<0.01). Correlation analysis indicated that serum TG was positively correlated with the Aβ level in the cortex(r=0.399; P<0.05), while serum TC was positively correlated with the expression level of Aβ in both cortex and hippocampus (r=0.715,0.748; P<0.01), and with the expression level of Tau in the hippocampus (r=0.603; P<0.05). Conclusion MCFA reduces Aβ deposition and Tau phosphorylation in the brain probably through regulating lipid metabolism, especially decreasing TC level in APP/PS1 transgenic mice, and thus plays a role in the prevention and treatment of AD.

Abstract:Objective To investigate whether rhubarb anthraquinones can activate the insulin signaling pathway in HepG2 cells in the presence and absence of insulin resistance. Methods After an insulin resistance model of HepG2 cells was constructed using aldosterone (ALD), whether rhubarb anthraquinones (including rhein, chrysophanol, emodin and aloe-emodin) at concentrations of 2.5-20 μmol/L could activate the insulin signaling pathway in HepG2 cells was investigated by detecting cellular activity with Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay. Contents of cellular glucose and glycogen levels were measured with glucose and glycogen content assay kit, respectively, and protein expression levels of phosphorylated protein kinase B/protein kinase B (p-Akt/Akt) and phospho-glycogen synthase kinase3β/glycogen synthase kinase-3β (p-GSK-3β/GSK-3β) were determined with Western blotting. SPSS statistics 20.0 was used for data analysis. Student′s t test or ANOVA was employed for intergroup comparison. Results Rhein, chrysophanol, emodin and aloe-emodin of 2.5-20 μmol/L had no significant effect on the survival of HepG2 cells (P>0.05). However, they increased the ratios of p-Akt/Akt and p-GSK-3β/GSK-3β in the presence and absence of insulin resistance(P<0.05). Further studies also found that the relative glucose content was reduced in the rhein, chrysophanol and emodin treatment groups (P<0.05), but no such change was seen in the aloe-emodin treatment group (P>0.05). The relative glycogen content was decreased in all the rhein, chrysophanol, emodin and aloe-emodin treatment groups (P<0.05). Both rhein and emodin were able to reverse the ALD-induced reduction of glycogen granules in HepG2 cells. Conclusion Rhubarb anthraquinones (rhein, chrysophanol, emodin and aloe-emodin) activate the glycogen synthesis pathway in HepG2 cells in the presence and absence of insulin resistance.

Abstract:Objective To observe the effects of Akkermansia muciniphila (AKK) on lipid metabolism and inflammatory factors in ApoE knockout (ApoE^-/-) mice fed with high-fat diet. Methods Healthy SPF male C57BL/6J and ApoE^-/- mice (4 weeks old) were selected and fed with high-fat diet. Six weeks later, 20 ApoE^-/- mice with an average weight higher than 10% of that of C57BL/6J mice were selected and numbered randomly, and those with odd number were divided into the model group (n=10) and those with even number into the AKK intervention group (n=10). And another 10 C57BL/6J mice served as control group. The mice in the control group and the model group were intragastrically administrated with glycerol preparation without AKK, and those out of the AKK intervention group were given glycerol preparation containing 1×10⁹CFU AKK, 0.1 ml each time, once per day. After intragastric administration for 4 weeks, fasting body weight was measured. Serum and epididymal adipose tissues were collected from each group. Serum levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), interleukin-1 (IL-1), IL-6, IL-8, IL-10, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein-1 (MCP-1) were detected. The weight of epididymal adipose tissue was weighed, and the morphology was observed after HE staining to calculate the average size of epididymal adipose tissue cells. SPSS statistics 26.0 was used for data analysis. One-way analysis of variance was used for comparison among multiple groups. Results After 4 weeks of intragastric administration of AKK, the fasting body weight, epididymal fat weight and body fat percentage were decreased in the AKK intervention group than the model group, though the differences not significant (P>0.05). The AKK intervention group had significantly lower TG (0.85±0.17 vs 1.65±0.15 and 1.08±0.09 mmol/L) and LDL-C levels (3.20±0.85 vs 6.47±0.87 and 4.89±0.56 mmol/L), and obviously higher HDL-C (919.89±116.19 vs 433.59±183.85 and 721.11±222.70 mmol/L) when compared with the model group and the control group (all P<0.05). The TC level was notably lower in the intervention group than the model group (3.00±0.64 vs 5.12±0.71 mmol/L, P<0.05). For the inflammatory factors, the levels of IL-1 (74.10±25.28 vs 191.42±31.36 and 123.91±25.29 pg/ml), IL-6 (63.10±9.53 vs 100.76±11.42 and 77.76±8.20 pg/ml), IL-8 (64.34±10.36 vs 104.59±8.46 and 82.64±11.79 pg/ml), CRP (88.85±24.33 vs 172.53±25.41 and 122.72±22.08 ng/ml), TNF-α (372.30±47.05 vs 674.53±62.18 and 509.97±54.50 pg/ml) and MCP-1 (11.90±1.58 vs 25.18±2.03 and 18.59±2.11 pg/ml) in the AKK group were remarkably lower than those in the model group and control group (all P<0.05). The IL-8 level was in a trend of increasing, but no statistical differences were seen among the 3 groups (P>0.05). HE staining showed that the average area of epididymal adipocytes was significantly smaller in the AKK intervention group than the model group (330.45±55.84 vs 879.58±36.74 μm², P<0.05), and regular cell morphology and increased number of adipocytes in a single field of vision were also observed. Conclusion AKK improves dyslipidemia and reduces serum inflammatory factors in obese ApoE^-/- mice fed with high-fat diet.

Abstract:As the population ages, cardiovascular disease (CVD) has become the most common disease in the world and the main cause of death among the elderly. Inflammation and oxidative stress are the main causes of aging-related CVD. Polyphenols, rich in fruits and vegetables, are known as natural antioxidants with anti-inflammatory and antioxidant effects. This paper reviews the biological characteristics, and anti-inflammatory and antioxidant function of polyphenols to provide new insights and theoretical support for delaying and preventing the development of CVD.

Abstract:Branched-chain amino acids play an important role in regulating glucose and lipid metabolism, protein synthesis, and lifespan. Many studies have reported that the level of circulating branched-chain amino acids or their dietary intake is closely associated with life expectancy, sarcopenia, obesity, and diabetes mellitus. In different animal models, branched-chain amino acids and lifespan are often found to have opposite effects. This paper reviews the biological characteristics of branched-chain amino acids and their two opposite functions and mechanisms in regulating lifespan to provide new insight into and a reasonable basis for the intervention of branched-chain amino acids on aging.

Abstract:The prevalence of diabetes mellitus in the elderly has been increasing with the aging of the population. Older diabetes people are at a higher risk for malnutrition, and may be more likely to develop frailty. The development of diabetes is associated with progression of frailty, which lead to adverse effect on clinical outcomes. Early identification of frailty and rational nutritional support for the elderly diabetes patients can slow or reverse the process of frailty, improve the quality of life, and reduce the medical burden. This review aims to summarize the current research progress on nutritional management for the frail elderly with diabetes mellitus.