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The effects of palm oil on serum lipid profiles: A systematic review and meta-analysis

Background and Objectives: Current guidelines recommend reducing intake of diets rich in saturated fats and replacing it with diets rich in unsaturated fats. Palm oil contains a high amount of saturated fatty acids, but its effect on serum lipid levels is unclear. The study aimed to compare the effects of palm oil consumption with other edible oils rich in monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) on serum lipid profiles. Methods and Study Design: We searched Medline, Embase, Cochrane Central Registry of Controlled Trials and CINAHL. Clinical trials were eligible if they compared palm oil-rich diets with diets rich in MUFAs or PUFAs. We pooled results of included studies using a random effects model and assessed the quality of the evidence and certainty of conclusions using the GRADE approach. Results: Intake of palm oil intake compared to oils rich in MUFA was associated with increased levels of total cholesterol (TC) [mean difference (MD)=0.27 mmol/L; 95% CI 0.08 to 0.45], LDL-C (MD=0.20 mmol/L; 95% CI 0.02 to 0.37) and HDL-C (MD=0.06 mmol/L; 95% CI 0.02 to 0.10). Similarly, for comparison with oils rich in PUFAs, palm oil showed increased in TC (MD=0.38 mmol/L; 95% CI 0.14 to 0.62), LDL-C (MD= 0.44 mmol/L; 95% CI 0.01 to 0.88) and HDL-C (MD=0.08 mmol/L; 95% CI 0.03 to 0.13). For both comparisons, there were no significant effects on triglycerides. Conclusions: Even though palm oil increases marginally the level of serum lipids, the evidence is mostly of low to moderate quality.

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Dietary saturated fats and apolipoprotein B48 levels are similarly associated with cognitive decline in healthy older aged Australians

Background and Objectives: As the incidence and prevalence of Alzheimer's disease increases, so does the body of epidemiological and clinical research that suggests a relationship between dietary fatty acids, in particular saturates, and cognitive decline. In this study, we investigated the association between serum apolipoprotein B48 (apoB48), saturated fatty acid intake and consumption behaviour, and cognitive performance, in healthy, older aged Australians. Methods and Study Design: We retrospectively analysed fasted serum apoB48 concentrations, food frequency questionnaire, and cognitive performance data collected from 147 participants (98F|49M) over the age of 50. We used Spearman's correlations and a nested domain model to evaluate the relationship between serum apoB48, dietary behaviour and measures of cognitive performance. Results: Overall, we found that higher fasted apoB48 concentrations, and/or dietary behaviours which led to increased dietary consumption of diets high in saturated fatty acids, were inversely associated with cognition. Interestingly however, dietary behaviour patterns of saturated fatty acid consumption and serum apoB48 were linked with better secondary memory and perceptual speed, respectively. Conclusions: This is the first time that fasted apoB48 has been implicated as a biomarker for cognitive decline and Alzheimer's disease risk.

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Interpersonal communication campaign promoting knowledge, attitude, intention, and consumption of iron folic acid tablets and iron rich foods among pregnant Indonesian women

Background and Objectives: Indonesia's community health delivery system offers services such as prenatal care and supplementation. Despite accessibility to these services, compliance with supplementation is low, and childhood stunting rates remain high. To address undernutrition, a National Nutrition Communication Campaign (NNCC) - using interpersonal communication (IPC) strategies - was implemented to promote consumption of iron-folic acid (IFA) supplements and iron-rich foods (ATIKA). The purpose of this study was to understand how participation in IPC activities influenced knowledge, attitude/intention, and consumption of IFA supplements and ATIKA among pregnant Indonesian women. Methods and Study Design: Cross-sectional data came from 766 pregnant women that participated in a survey that was based on the constructs from the Theory of Planned Behavior and Health Belief Model. Adjusted linear and logistic regression models were conducted to analyze the differences between self-reported IPC participants and non-IPC participants. Approximately 20% of women were exposed to the IFA portion of the IPC campaign, and 18% were exposed to the ATIKA portion. Results: Women that were exposed to the campaign reported significantly higher knowledge of IFA tablets and ATIKA, and improved attitudes/intentions towards IFA, compared to non-exposed women. Exposure was not associated with actual consumption behaviors. Conclusions: These findings suggest that exposure to a low-intensity intervention can increase knowledge but may not be sufficient to impact behavior. As such, future efforts to reduce stunting through improved maternal nutrition should seek to increase exposure, address barriers, understand perceived susceptibility, and improve self-efficacy in order to expand intervention reach in Indonesia.

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Very low birth weight preterm infant complications where parenteral nutrition is soy or fish oil-based: A retrospective study in Shanghai

Background and Objectives: To examine whether a parenteral mixed lipid emulsion containing fish oil reduces the incidence of cholestasis, retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW, birth weight ＜1500 g) infants. Methods and Study Design: This retrospective study was conducted in the neonatal intensive care unit of the Children's Hospital of Fudan University. Patients received either a soybean and medium-chain oil (MCT)-based lipid emulsion (Lipofundin) or a mixed lipid emulsion consisting of soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) as parenteral nutrition. The primary outcomes were cholestasis, ROP and BPD, and the secondary outcomes were necrotizing enterocolitis (NEC) and sepsis. Results: A total of 149 premature infants (78 in the soybean oil group and 71 in the fish oil group) were included in this study. Multivariate logistic regression analysis showed that gestational age was associated with the incidence of ROP [odds ratio: 0.446, 95% confidence interval (CI): 0.332-0.576, p＜0.001] and BPD [odds ratio: 0.428, 95% CI: 0.316-0.555, p＜0.001]. The type of lipid emulsion had no statistically significant effect on any other neonatal morbidity. Conclusions: Both fish oil-containing and soybean oil-based parenteral lipid emulsions are safe and well-tolerated by preterm infants. However, the use of the SMOF lipid emulsion did not significantly reduce the incidence of cholestasis, ROP and BPD in VLBW infants.

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Effects of rapid growth in early childhood on metabolic and cardiovascular diseases among preschool-aged children

Background and Objectives: To investigate whether the tempo of weight gain of children during infancy (from birth up to two years of age) or childhood (between two and five years old) is associated with metabolic and cardiovascular disease. Methods and Study Design: Cluster sampling was employed to obtain a random sample of preschool children. In total, 1450 children aged five to six years participated in this survey. We obtained data on body weight, height, blood pressure (BP), and serum levels of total cholesterol, triglycerides, glucose, and uric acid, as well as anthropometry at birth and at age 2. Results: The prevalence of obesity at five years old was 14.5%. At five years of age, children with rapid growth (change in body mass index, BMI z-score ＞0.67) during infancy had a higher odds ratio (OR) of childhood obesity (OR: 2.97 [95% CI: 2.15-4.11]) compared to children with non-rapid growth (change in BMI z-score ≤0.67). Also, children with rapid growth during childhood had a higher OR of childhood obesity (OR: 17.90 [95% CI: 12.31-26.04]), higher systolic BP (OR: 2.38 [95% CI: 1.68-3.39]), higher diastolic BP (OR: 2.42 [95% CI: 1.53-3.83]), and higher triglycerides (OR: 4.09 [95% CI: 1.47-11.33]) or hyperuricemia (OR: 2.23 [95% CI: 1.51-3.29]). Conclusions: Rapid growth in early childhood is associated with risk factors for both cardiovascular outcomes and metabolic outcomes among preschool children. Developing effective prevention and intervention programs for pre-school children might be important to reduce incidence of long-term metabolic and cardiovascular disease as adults.

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Vitamin A status and recurrent respiratory infection among Chinese children: A nationally representative survey

Background and Objectives: Vitamin A is involved in immune function, vision, reproduction, and cell differentiation and is essential for child growth. Vitamin A deficiency (VAD) contributes significantly to mortality and morbidity in developing countries. This study assessed the current vitamin A status in Chinese children. Methods and Study Design: A cross-sectional survey was conducted in 26 provinces in China between 2015 and 2018, and 277,064 children aged 0-14 years were enrolled. Data on sociodemographic factors and dietary supplements were obtained through interviews with their parents. Serum vitamin A concentrations were measured using HPLC. To reduce the sampling error, a weighted distribution was produced to estimate the distribution of serum vitamin A concentration in Chinese children. A new method was used calculate the CI. Results: The results revealed that 10.4% (23.9 million) (95% CI: 10.1%-10.8%) of Chinese children aged 0-14 years were at risk of suffering from subclinical VAD (SVAD) (＜0.2 mg/L). Sick children, especially those with recurrent respiratory infections (21.3%, 95% CI: 20.5%-22.2%), were vulnerable to SVAD. A high prevalence of SVAD was observed in western and northeastern areas in China. Serum vitamin A concentrations in ethnic minority groups were significantly lower than those in Han Chinese children (p＜0.01). Conclusions: VAD is still a moderate public health problem in Chinese children, especially in those with respiratory symptoms. Regular consumption of vitamin A-rich foods should be promoted through nutrition education for parents.

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Improving the iron status of school children through a school noon meal programme with meals prepared using a multiple micronutrient-fortified salt in Tamil Nadu, India

Background and Objectives: To improve the iron status of school children through noon meals prepared using a multiple micronutrient-fortified salt. Methods and Study Design: Children from a randomly selected school who consumed (intervention) and did not consume (reference) a noon meal prepared using a multiple micronutrient- fortified salt were studied over 1 year. A pre-post-test design for children aged 5-17 years in reference (n=100) and intervention (n=128) groups was used. Levels of serum ferritin, soluble transferrin receptor (sTfR), alpha glycoprotein (AGP), and C-reactive protein (CRP) were assessed at baseline and at 1 year. In a subsample, urinary iodine was assessed. Results: sTfR decreased in the intervention group (-0.80 mg/L) but increased in the reference group (0.47 mg/L) at 1 year (p=0.0001).Body iron stores (BIS) increased in the intervention group (0.09 mg/kg body weight) and decreased (-0.58 mg/kg body weight) in the reference group at 1 year (p=0.028).These findings indicate an increase in iron deficiency in the reference group and a decrease in the intervention group. However, no changes in serum ferritin and urinary iodine were observed in either group or between groups. Conclusions: Iron status can be improved in schoolchildren in Tamil Nadu by increasing the amount of micronutrients in the fortified salt used for preparing noon-time school meals.

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Toddler neurodevelopment is associated with ganglioside intake but not serum ganglioside

Background and Objectives: Gangliosides (GAs) are important components of neural tissue and cell membrane. This study aims to investigate the association between toddlers' neurodevelopment, dietary GA intake, and serum GA concentration. Methods and Study Design: A cross-sectional study was conducted in Beijing and Xuchang, Henan Province in China. 110 eligible healthy toddlers aged 24-48 months were recruited. Food frequency questionnaire (FFQ) and 24-h dietary recall were used to collect dietary information. Blood serum samples obtained from participants were used to perform GA composition analysis with high-performance liquid chromatography-mass spectrometry (HPLC-MS). The neurodevelopment level was assessed with the Gesell Developmental Scale (GDS). Results: Dietary ganglioside GD3, total GA, and seafood intake were identified to be associated with the gross motor developmental quotient (DQ). An inverse association was revealed between the fine motor DQ and fruit intake. No correlation was detected between serum GA concentration and DQ. Conclusions: Dietary GA intake but not serum GA concentration is associated with neurodevelopment. Further prospective studies are needed to probe the relationships between the recommended dietary GA intake and toddlers.

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Iron status is linked to disease severity after avian influenza virus H7N9 infection

Background and Objectives: The high mortality rate of H7N9 strain of avian influenza virus (AIV) infected patients has been a major clinical concern. Iron overload increases the susceptibility of host for several kinds of microbial infection. However, the study on patients' iron and ferritin status associated with clinical outcome of AIVH7N9 virus infection is poorly understood, and in order to explain the linkage we carried out this study. Methods and Study Design: We retrospectively collected serum from 46 patients infected with H7N9 virus from the hospital in Hangzhou city, Zhejiang province of China in 2013. We measured the level of serum iron and ferritin by Enzyme-Linked Immunosorbent Assay (ELISA). The correlation analysis of iron and ferritin with disease severity was done by SPSS 16.0 and MedCalc Software. Results: After H7N9 infection, there is a reduction in iron level and an increase in ferritin, hepcidin and C-reactive protein (CRP) level in patient's serum compared to those of the control (p＜0.001), and there's little correlation between procalcitonin (PCT) level and H7N9 infection. At week 1 and week 2 post-infection, serum iron level is much lower and ferritin level is much higher in the patients who died later than those in the patients who survived. The sensitivity, specificity, and Area Under the Curve (AUC) of the assay was calculated with MedCalc software and they were 85.5%, 65.9% and 0.803 for iron and 84.9%, 80.7% and 0.900 for ferritin, 95.2%, 51.1% and 0.684 for PCT and 100%, 94.6% and 0.988 for CRP, respectively. Conclusions: Our study found that low serum iron and high serum ferritin levels are correlated with the disease severity of H7N9-infected patients and can predict fatal outcomes.

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Potential role of iodine excess in papillary thyroid cancer and benign thyroid tumor: A case-control study

Background and Objectives: The relationship between nutritional status of iodine and thyroid tumor is unclear. We investigated the association between urinary iodine concentration and thyroid function in patients with papillary thyroid cancer, benign thyroid tumor and healthy individuals. Methods and Study Design: We compared the biomarkers of thyroid function and urinary iodine concentration within and between each group. A regression analysis was used to identify risk factors for papillary thyroid cancer. Correlation analysis was performed to determine whether any significant correlation exists between urinary iodine concentration and thyroid function biomarkers. Results: The iodine nutrition statuses of these three groups were adequate (median urinary iodine concentration= 100-199 μg/L). However, the median urinary iodine concentration of papillary thyroid cancer (174.7 μg/L) and benign thyroid tumor (165.04 μg/L) groups was significantly higher than that of the healthy control group (135.8 μg/L) (p＜0.05). The regression analysis showed that thyroglobulin antibody was an independent risk factor for papillary thyroid cancer. After adjusting for age and gender, the association between thyroglobulin antibody and urinary iodine concentration was significant (β: 0.002; p＜0.05). In subgroup analyses, significant correlations was noted only in the papillary thyroid cancer group (adjusted β: 0.002; 95% confidence interval: 0.000- 0.003). Conclusions: Excessive iodine in patients with thyroid tumors may affect thyroglobulin antibody, which may be an independent risk factor for papillary thyroid cancer.