BACKGROUND: Preeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia.
METHODS: This study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants\' usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs).
RESULTS: The mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P < 0.001). Similarly, the highest quartile of DDS had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.09, 95% CI [0.03, 0.31]) (P = 0.001).
CONCLUSIONS: Our findings suggest that maintaining a high-quality and diverse diet is associated with a lower risk of preeclampsia. Further studies are needed to confirm these associations and explore potential causal relationships.

South China Mountain Region has a well-developed water system with the most abundant water in China. Untreated natural water is the main source of drinking water for the local people. This study aimed to investigate the hydrochemical characteristics and trace element concentrations of natural water in the mountainous regions of South China. In this study, 116 water samples were collected. Traditional hydrochemical methods, water quality index (WQI), hazard index (HI), and nutrient speciation of trace elements (NSTE) were used for analysis. In general, the hydrochemical type was mainly Ca-HCO3- type. The hydrochemical characteristics were mainly influenced by the weathering of calcite and silicate rocks. Overall total dissolved solids (TDS) were low, indicating mainly soft and very soft water. The water that met the standards for mineral water had an average concentration of 59.69 mg/L for Sr (strontium) and an average concentration of 0.46 mg/L for H2SiO3 (silicic acid). Although the water quality index (WQI) indicated that 91.3% of the water samples in the study area were of good quality (WQI < 25), 2.58% of the water samples had significant non-carcinogenic risk (HI > 1) due to the high As and Pb concentrations. The water in the study area contributed significantly to human intake of Sr, Cr, and V, accounting for 8.4, 8.3, and 7.7% of the required daily intake for adults, respectively. It is recommended that a comprehensive water quality evaluation system be constructed to ensure that mountain water is managed for development and safe to drink.

We present the case of a 35-y-old woman with short bowel syndrome secondary to extensive intestinal resection with associated chronic kidney disease who was undergoing hemodialysis. This patient required permanent supplementation with intradialytic parenteral nutrition because of a high-output end-jejunostomy. The patient was a candidate for treatment with teduglutide, a glucagon-like peptide 2 analog, intending to increase intestinal absorption. A complete nutritional assessment was performed using bioelectrical impedance vector analysis. Teduglutide treatment was successful, and after a 1-y follow-up, the patient had considerably reduced end-jejunostomy output (reduction of 6 L/d) and an improved nutritional status (9.1 kg weight gain, 1.4 kg fat-free mass gain, and a 2.2-degree increase in bioimpedance phase angle). However, we have been unable to reduce intradialytic parenteral nutrition, which the patient requires thrice weekly. No significant secondary effects have occurred because of teduglutide administration. This may be the first reported use of teduglutide in a patient with short bowel syndrome undergoing hemodialysis who was monitored using bioelectrical impedance data during follow-up.

Dietary quality and patterns have been associated with reduced incidence and increased colorectal cancer (CRC) survival. Two validated scores representing the quality of diet defined respectively by their content in micronutrients (nutritional quality index (INQ)) and antioxidant (dietary antioxidant index (DAI)) were used for assessing dietary quality. INQ standardizes all micronutrients using the recommended values and adjusts nutrients intakes based on total energy. Major dietary antioxidants are standardized based on the global mean and then divided by the global standard deviation to calculate the DAI. We hypothesize that a quality diet with higher scores of DAI can reduce CRC odds.
In this hospital-based case-control study, 207 definite CRC cases and 220 controls met the inclusion criteria. Cases and controls were frequency-matched for age (±5 years) and sex. A 168-item semi-quantitative food frequency questionnaire was completed. Adjusted and unadjusted odds ratios (OR) and 95% confidence intervals (CI) were reported in logistic and multivariable regression models.
DAI as a continuous (OR = 0.91, 95% CI: 0.85-0.98) and as a categorical (OR = 0.58, 95% CI: 0.37-0.92) variable and the INQs of vitamin A (OR = 0.30, 95% CI: 0.10-0.89), riboflavin (OR = 0.55, 95% CI: 0.32-0.94), magnesium (OR = 0.37, 95% CI: 0.18-0.77) and selenium (ORmultiple adjusted = 0.55, 95% CI: 0.36-0.86) in the regression crude models, and multivariable adjustments significantly have a protective association in reducing the odds of CRC (all p-values <0.05).
It can be concluded that dietary antioxidants, including vitamins A, C, E, zinc, selenium, and manganese from a high-quality diet, including vegetables, whole grains, and fruits, can significantly reduce CRC incidence.

BACKGROUND: Breast cancer is the leading cause of cancer-related mortality among women around the world. The relationship between the inflammatory potential of diet and breast cancer has been studied extensively, but results remain inconsistent. This study aimed to investigate the association between the dietary inflammatory index (DII) and odds of breast cancer.
METHODS: This case-control study includes 180 women with breast cancer and 360 healthy women randomly selected from those referred to Shohadaye Tajrish hospital in Tehran, Iran. The DII scores were computed based on a 168-item food frequency questionnaire (FFQ) assessed based on dietary intake. After adjusting the potential confounders, logistic regression models were used to estimate multivariable odds ratios (ORs).
RESULTS: The positive association was found between DII and breast cancer risk. A higher level of DII was associated with a higher risk of developing breast cancer after being adjusted for age (OR: 2.11, 95% CI: 1.01-4.46, P = 0.04). Additional adjustments for BMI, alcohol consumption, smoking, pregnancy number, abortion number, breastfeeding duration, menopause age, and total calorie intake did not change the results (OR: 5.02, 95% CI: 1.43-17.58, P = 0.01).
CONCLUSIONS: Following a pro-inflammatory diet was associated with an increased risk of BC. Further longitudinal studies are warranted.

UNASSIGNED: Hereditary Ataxias (HAs) comprise a wide spectrum of genetically determined neurodegenerative diseases with progressive ataxia as the main symptom. Few studies have evaluated nutritional profile in HA patients and most of these focused on specific ataxia subtypes. The objectives of this study were: (1) to investigate whether hereditary ataxias were associated with changes in energy expenditure, body composition and dietary intake; (2) to verify differences in these variables according to ataxia subtype, sex, age, and disease severity.
UNASSIGNED: Thirty-eight hereditary ataxia patients from two neurology centers in Northeastern Brazil and 38 controls were evaluated. Body composition was assessed with bio-impedance analysis and dietary intake was estimated with a validated questionnaire (24-hour dietary recall).
UNASSIGNED: Mean body mass index (BMI) was lower in HA compared to controls (p = 0.032). Hereditary ataxia patients showed lower protein intake, higher frequency of dysphagia and higher incidence of nausea and diarrhea. The difference in average estimated caloric intake did not reach statistical significance (2359kcal ± 622 in patients × 2713kcal ± 804 in controls, p = 0.08). Disease severity measured by the SARA scale was not associated with BMI, nor was ataxia subtype (autosomal dominant × non-autosomal dominant ataxias).
UNASSIGNED: Hereditary ataxia patients have lower BMI compared to healthy controls. There was no difference in this cohort between dominant or non-dominant ataxia regarding BMI. Weight loss may be a common finding among hereditary ataxias and may affect the quality of life in these patients.

Background: The relationship between dietary antioxidants and breast cancer (BrCa) has been investigated in various studies. As a limitation, they generally investigate the relationship between one specific antioxidant and the risk/odds of BrCa, and synergistic or inhibitory effects are less considered. Dietary antioxidant index (DAI) is a reliable nutritional tool that evaluates total nutritional antioxidant capacity and is validated with serum total antioxidant capacity (TAC) and Malondialdehyde (MDA). Our study aimed to investigate the association between the DAI and the odds of BrCa and the correlation between the DAI and pathobiological markers. We hypnotized a correlation between DAI and pathobiological markers, and there is an association between DAI and the odds of BrCa.Methods: Our study included 145 incidence cases of BrCa and 148 hospital-based controls. Controls were randomly selected from patients attending the same center and were frequency-matched on age (±10 years). DAI was calculated based on a valid semi-quantitative 168-item food frequency questionnaire data. DAI standardizes intake of major dietary antioxidants, including vitamins A, E, C, selenium, zinc, and magnesium, and presents them as summarized scores.Results: Modeling with multivariable regressions adjusting for major confounders including age, education, body mass index, occupation, alcohol, smoking, pregnancy, history of cancer, menarche age, metabolic equivalent of task, hormone replacement therapy, and total energy intake, there was a significant association between odds of BrCa and DAI (odds ratio = 0.18; 95% confidence interval:0.09-0.37; p-value= <0.01). After multiple controls, there was a significant and weak reverse correlation between DAI and the number of lymph node(s) (correlation coefficient= -.140; p-value = 0.05).Conclusion: Our study supports the hypothesis that dietary antioxidants intake is associated with a reduced odds of BrCa. Evidently, DAI can reveal these relationships better than a single study of antioxidants. However, further studies are needed to confirm or refute these results.

BACKGROUND: Diet quality plays an important role in the prevention of diabetes-related complications in people with type 2 diabetes mellitus (T2DM). However, evidence is scarce on how diet quality typically changes over time after diagnosis. The present study aimed to describe how the diet quality of individuals newly diagnosed with T2DM changes over a 12-month period and to identify factors associated with diet quality changes.
METHODS: A 12-month prospective, observational case-series study was undertaken. Two-hundred and twenty-five Australian adults (56% men) newly diagnosed with T2DM were recruited from the Diabetes Australia national database. Participants completed five interviewer-administered surveys over 12 months: baseline, 3, 6, 9 and 12 months. Demographic, physical and health characteristics, and dietary intake data were collected at each timepoint. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) scoring tool. To assess changes in DASH, energy, fruit and vegetable intake over time, repeated measure analyses of variance were used. Multivariate repeated measures models investigated characteristics associated with these dietary changes.
RESULTS: The mean DASH score of the sample remained stable at 24.0 across the 12 months. Very few participants (6.8%) improved diet quality consistently across the study period. No associations between DASH, energy, fruit or vegetable intake over time and characteristics were observed.
CONCLUSIONS: This observational study suggests that without dedicated interventions (the natural course), most people newly diagnosed with T2DM will not achieve meaningful diet quality change. The development of cost-effective interventions to achieve sustained diet quality change early after diagnosis are warranted.

BACKGROUND: Patients with multiple sclerosis (MS) had a 1.5-fold increase in cardiovascular diseases (CVD) mortality, compared with those without MS. Therefore, the aim of this study was to assess the CVD risk in MS patients by multiple cardiometabolic indexes and to investigate associated factors.
METHODS: The MS group included 57 patients matched for age and sex to 57 healthy controls. They were evaluated for physical activity, smoking, anthropometric indices, blood pressure, and plasma biomarkers. Framingham risk score (FRS) and multiple cardiovascular risk indexes were calculated. Clinical course of disease, age at onset, disease duration, disease-modifying therapy, relapse rate, EDSS, physical and functional impairment were investigated.
RESULTS: The mean age was 34.6 years old. The majority (89.5%) in the MS group had a RRMS clinical course and a mild level of disability (EDSS=1.0). WC (p = 0.022) and FM% (p = 0.007) were different between the MS and control groups. The FRS was higher in the MS group (10% versus 0%) and this was related with high prevalence of dyslipidemia (43.8% versus 36.8%). The atherogenic index of plasma (AIP) (0.013) and Castelli risk indexes I (CRI-I) (p = 0.017) and II (CRI-II) (p = 0.008) and non-HDL-C (p = 0.044) were higher in the MS group.
CONCLUSIONS: MS patients, with controlled disease course, have a higher cardiovascular risk than comparable healthy individuals. We emphasize that the use of FRS, and the monitoring of CRI-I and II, as well as AIP, are important lipid markers to manage CVD risk in individuals with MS.

The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (n = 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (p < 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.