Nevin Manimala

Front Nutr. 2025 Jun 23;12:1560617. doi: 10.3389/fnut.2025.1560617. eCollection 2025.

ABSTRACT

BACKGROUND: Sarcopenia is a systemic disease characterized by a decline in muscle mass and function. It is associated with adverse health outcomes, and younger patients are at higher risk. Thus, early identification and prevention of high-risk factors are crucial. The uric acid to high-density lipoprotein ratio (UHR) is a novel marker of inflammation and metabolism, but studies on its association with sarcopenia are currently lacking.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were utilized. Weighted multivariate logistic regression analysis was performed to explore the association between UHR and sarcopenia. Causal mediation analysis was conducted to investigate the mediating role of oxidative stress factors and systemic inflammatory markers in the UHR-sarcopenia relationship. Subgroup analysis and interaction tests were performed to identify high-risk populations for the positive association between UHR and sarcopenia. Restricted cubic spline (RCS) explored potential non-linear relationships between UHR and sarcopenia. Weighted multivariate Cox proportional hazards regression analysis assessed the relationship between UHR and all-cause mortality in sarcopenia patients.

RESULTS: A total of 10,308 adult participants aged ≥ 20 years were included in the study, with 901 diagnosed with sarcopenia. The weighted multivariate logistic regression analysis showed a significant positive association between UHR and sarcopenia after adjusting for all confounding factors (OR = 1.057; 95% CI: 1.037-1.077; P < 0.001). Total bilirubin mediated -8.53% of the association between UHR and sarcopenia (95% CI: -13.42% to -5.91%; P < 0.001). The subgroup analysis and interaction test results indicate that the positive association between the two variables is relatively stable across different populations. RCS analysis revealed no significant non-linear relationship between UHR and sarcopenia (P = 0.167). Weighted multivariate Cox proportional hazards regression analysis showed a significant positive association between UHR and all-cause mortality in sarcopenia patients (HR = 1.053; 95% CI: 1.024-1.083; P < 0.001) in the unadjusted model. However, after adjusting for all covariates, UHR maintained a positive association with all-cause mortality in sarcopenia patients (HR = 1.023; 95% CI: 0.990-1.056), though this association did not reach statistical significance (P = 0.173).

CONCLUSION: Elevated UHR shows a significant association with sarcopenia prevalence and exhibits a positive association trend with all-cause mortality among affected individuals. These findings suggest that UHR may serve as a potential indicator for sarcopenia risk assessment. Further prospective studies are warranted to validate its clinical utility for early screening and intervention strategies.

PMID:40626224 | PMC:PMC12229869 | DOI:10.3389/fnut.2025.1560617

Front Nutr. 2025 Jun 20;12:1612021. doi: 10.3389/fnut.2025.1612021. eCollection 2025.

ABSTRACT

BACKGROUND: Coronary heart disease (CHD) is a major global health burden, and emerging evidence suggested that probiotics could improve cardiovascular health by modulating gut microbiota and lipid profiles. However, the efficacy of probiotics remains elusive, indicating the necessity of conducting this meta-analysis.

METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, EMBASE, and Web of Science databases for retrieving randomized controlled trials (RCTs) on probiotics’ effects on lipid profiles (low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG)) in CHD patients. Inclusion and exclusion criteria concentrated on English-language RCTs, and data on study characteristics were extracted. Study quality was assessed using Cochrane and NHLBI tools, and statistical analysis was conducted via R 4.3.2 software.

RESULTS: The literature search identified 263 records, yielding 6 RCTs, 5 of which were included in the meta-analyses. For LDL level (n = 278), both fixed-effects and random-effects models exhibited an overall effect size of 1.25 units [95% confidence interval (CI): -0.62 to 3.12] with a low heterogeneity (I ² = 0%), while probiotics-based monotherapy achieved a mean difference (MD) of 13.4105 (95% CI: -8.0670 to 34.8879) versus an MD of 1.1578 for combination therapy (95% CI: -0.7146 to 3.0302). For HDL level (n = 278), the fixed-effects model yielded an MD of -3.8107 (95% CI: -4.2490 to -3.3724) versus an MD of -2.3119 for the random-effects model (95% CI: -4.2290 to -0.3949) with a moderate heterogeneity (I ² = 61.6%). Combination therapy demonstrated an MD of -2.9848 (95% CI: -4.7965 to -1.1732), while monotherapy exhibited a non-significant MD of 0.9115 (95% CI: -3.5084 to 5.3314). TG analysis yielded a common effect size of 17.95, with a minimal-to-moderate heterogeneity (I ² = 0 to 84.7%).

CONCLUSION: Probiotics, particularly monotherapy for LDL and combination therapy for HDL, exhibited potential to improve lipid profiles in CHD patients. However, further research is needed to address existing limitations and confirm efficacy.

PMID:40626219 | PMC:PMC12231435 | DOI:10.3389/fnut.2025.1612021

Front Nutr. 2025 Jun 23;12:1576705. doi: 10.3389/fnut.2025.1576705. eCollection 2025.

ABSTRACT

BACKGROUND: Recent studies have indicated that vitamin D and folate are essential for muscle health and each is independently linked to the prevalence of sarcopenia. However, the potential synergistic effects of vitamin D and folate on sarcopenia have not been extensively studied. This study aims to investigate both the individual and joint associations of serum 25-hydroxyvitamin D [25(OH)D] and folate concentrations with the risk of sarcopenia.

METHODS: This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES), covering the years 2011-2018. Multivariable logistic regression models were used to determine individual and joint associations of serum 25(OH)D and folate with sarcopenia. Additionally, the relative excess risk due to interaction (RERI) was estimated to assess additivity.

RESULTS: A significant inverse relationship was observed between serum 25(OH)D and folate levels in relation to sarcopenia. Specifically, among participants with 25(OH)D levels < 50 nmol/L, the odds ratios (ORs) for sarcopenia were 0.67 [95% confidence interval (CI): 0.56-0.81] for those with 25(OH)D levels between 50 and 75 nmol/L, and 0.61 (95% CI: 0.48, 0.77) for those with levels > 75 nmol/L. Similarly, when comparing participants in the lowest tertile of folate, the ORs for sarcopenia were 0.74 (95% CI: 0.61, 0.89) for the second tertile and 0.72 (95% CI: 0.59, 0.88) for the third tertile. Among individuals with fasting blood glucose levels < 7.0 mmol/L, those with both low levels of 25(OH)D and folate exhibited a significantly higher risk of sarcopenia compared to those with high levels of 25(OH)D and folate. Furthermore, the RERI was statistically significant.

CONCLUSION: In the present study, a synergistic interaction between 25(OH)D and folate was observed in relation to the risk of sarcopenia. These findings contribute new insights into the nutritional factors associated with sarcopenia and pave the way for future longitudinal studies to further explore this association.

PMID:40626218 | PMC:PMC12229844 | DOI:10.3389/fnut.2025.1576705

Front Nutr. 2025 Jun 20;12:1596300. doi: 10.3389/fnut.2025.1596300. eCollection 2025.

ABSTRACT

AIM: Chronic inflammation plays a significant role in the progression of non-alcoholic fatty liver disease (NAFLD). Adopting an anti-inflammatory diet can help prevent or mitigate NAFLD and its associated complications. This meta-analysis builds on previous research by examining the association between the Dietary Inflammatory Index (DII) and NAFLD risk, incorporating additional studies and employing rigorous evidence assessment.

METHODS: We systematically searched major databases (Cochrane Library, PubMed, Web of Science, and Scopus) from inception to June 2024 for English-language observational studies examining the association between DII and NAFLD prevalence. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models for studies with significant heterogeneity; otherwise, fixed-effects models were applied. Subgroup analyses were conducted to explore heterogeneity based on body mass index (BMI), DII definition, sample size, geographical region, age, and NAFLD diagnostic criteria. Evidence certainty was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The study was registered in PROSPERO (CRD42023430798).

RESULTS: Eleven studies (9 cross-sectional with 14 effect sizes and 2 cohort with 2 effect sizes) were analyzed. Higher DII scores were significantly associated with increased NAFLD risk, with a pooled OR of 1.56 (95% CI: 1.24-1.95; p < 0.001) in cross-sectional studies and an HR of 0.21 (95% CI: 0.12-0.30; p < 0.0001) in cohort studies. Subgroup analyses confirmed consistency across BMI ≥ 25, energy-adjusted DII or DII, studies in Asia and Europe, and participants <46 years, with reduced heterogeneity (I² < 50%) in these categories. GRADE rated the certainty of evidence as “very low.”

CONCLUSION: Anti-inflammatory diets can reduce NAFLD risk. However, high-quality studies are needed to confirm this association.

PMID:40626217 | PMC:PMC12231496 | DOI:10.3389/fnut.2025.1596300

Nutr Metab (Lond). 2025 Jul 7;22(1):72. doi: 10.1186/s12986-025-00970-9.

ABSTRACT

AIMS: Observational studies have reported an association between dietary factors and endometriosis, but the causality remains unknown. The study aimed to investigate the potential causal association between dietary factors and endometriosis using Mendelian randomization (MR).

METHODS: We performed a two-sample MR analysis to investigate the effects of 18 diet-related exposure factors (alcoholic drinks per week, alcohol intake frequency, processed meat intake, poultry intake, beef intake, non-oily fish intake, oily fish intake, pork intake, lamb/mutton intake, bread intake, cheese intake, cooked vegetable intake, tea intake, fresh fruit intake, cereal intake, salad/raw vegetable intake, coffee intake, dried fruit intake) on the risk of endometriosis using summary statistics from the genome-wide association study (GWAS). The inverse variance weighted (IVW) method was used to deduce the causal association between dietary factors and endometriosis, and sensitivity analyses were further performed.

RESULTS: Processed meat intake (OR = 0.550; 95%CI:0.314-0.965; p = 0.037) and salad / raw vegetable intake (OR = 0.346; 95%CI:0.127-0.943; p = 0.038) were discovered as protective factors for endometriosis. Heterogeneity test revealed no significant heterogeneity (processed meat intake: p_IVW=0.607, p_MR-Egger=0.548; salad / raw vegetable intake: p_IVW=0.678, p_MR-Egger=0.620). MR-Egger regression test didn’t support any evidence for horizontal pleiotropy (processed meat intake: p for intercept = 0.865; salad / raw vegetable intake: p for intercept = 0.725). No causal relationship was found between other dietary intakes and endometriosis.

CONCLUSION: These findings suggest that processed meat intake and salad/raw vegetable intake are associated with a decreased risk of endometriosis, but further investigation is required.

PMID:40624721 | DOI:10.1186/s12986-025-00970-9

J Health Popul Nutr. 2025 Jul 7;44(1):240. doi: 10.1186/s41043-025-00996-y.

ABSTRACT

Violent armed conflict befell Nigeria in 2009 in form of Boko Haram terrorism and insurgency, and has been extended and sustained in all nooks and crannies of the country by banditry, kidnapping for ransom, herder-farmer clash and unknown gunmen attack or ethnic militia. On the other hand, between 2009 and 2024, Nigeria has suffered two economic recessions. This study interrogated the association between the sustained violent armed conflict with the attendant environmental shock and insecurity with the related deaths and economic health in Nigeria (2004-2020), covering the pre-Boko Haram years (2004-2007) and the Boko Haram operation years (2009-2019). The longitudinal study regressed the secondary data on violent armed conflict related deaths in Nigeria against % value added to gross domestic product by agriculture for 2004-2020 and against the prevalence of undernourishment for 2004-2019. Results showed that increase in battle related deaths led to statistically significant decrease in value added to national productivity by agriculture, forestry, and fishing. Prevalence of undernourishment increased significantly with increase in battle-related deaths. The study concluded that violent armed conflicts had significant negative impacts on environmental security in Nigeria and recommended that policymaking and direction be guided as such in order to stem the tide.

PMID:40624711 | DOI:10.1186/s41043-025-00996-y

BMC Psychol. 2025 Jul 7;13(1):746. doi: 10.1186/s40359-025-03078-0.

ABSTRACT

BACKGROUND: The cognitive-behavioral model of prolonged grief [1] posits that the interaction between autobiographical memory deficits, negative cognitions, and avoidance contributes to the onset and persistence of prolonged grief. This study tested the model’s assumptions with respect to symptoms of Prolonged Grief Disorder (PGD), Post-Traumatic Stress Disorder (PTSD), and depression in bereaved groups who experienced expected and unexpected loss, separately.

METHODS: The study sample comprised 728 Turkish individuals who had lost a first-degree family member. A set of self-report measures was administered to participants, including the Prolonged Grief Disorder Scale (PG-13-Revised), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Patient Health Questionnaire-9 (PHQ-9), the Grief Cognitions Questionnaire (GCQ-SF), the Depressive and Anxious Avoidance in Prolonged Grief Questionnaire (DAAPGQ), and the Experienced Unrealness Scale (EUS).

RESULTS: Our findings indicate that while variables within the cognitive-behavioral model exhibit moderate to strong intercorrelations, they nonetheless represent statistically distinct constructs. These variables significantly explain the variance in symptoms of PTSD, depression, particularly PGD, in groups confronted with expected and unexpected loss. While negative cognitions and avoidance were significantly associated with all three outcomes, “a sense of unrealness” (representing autobiographical memory deficits) was significantly related only to PGD.

CONCLUSION: These results support the cross-cultural applicability of the cognitive-behavioral model and suggest that it can be used to explain the development of grief-related outcomes, such as PTSD and depression, beyond PGD symptoms. Although the cognitive model variables negative grief cognition and avoidance showed significant associations with grief-related outcomes, a sense of unrealness appeared to be specific to PGD only. It is considered that taking this finding into account in clinical practice may be beneficial.

PMID:40624708 | DOI:10.1186/s40359-025-03078-0

Arthritis Res Ther. 2025 Jul 7;27(1):139. doi: 10.1186/s13075-025-03605-9.

ABSTRACT

OBJECTIVES: Hepatitis C virus (HCV) can be associated with sicca manifestations. To study the effect of direct-acting antivirals (DAAs) on sicca manifestations in HCV-infected patients and the difference between those patients and others with HCV without dryness & Sjögren’s disease (SjD).

METHODS: We studied 60 patients in 3 groups: Group 1 (20 HCV + sicca), group 2 (20 HCV without sicca), and group 3 (20 SjD). Groups 1 and 2 received DAAs according to the Egyptian Ministry of Health protocols and were evaluated before and after treatment. Group 3 was evaluated once. Our study evaluated the patients by both subjective and objective methods.

RESULTS: All HCV cases had sustained viral response (SVR). Comparing the characteristics of groups 1 (before treatment) & 3: Group 1 had a higher frequency of RF, cryoglobulins, and polyclonal-hypergammaglobulinemia (P-values 0.021, 0.003, and ˂0.001 respectively). Group 3 had higher scores of VAS dry eye, VAS dry mouth, VAS fatigue, and VAS pain than group 1 (P-values ˂0.001 in all). Group 3 also had a higher frequency of Anti-Ro and Anti-La (P-values < 0.001). Group-1 before DAAs treatment had higher markers denoting B-cell hyperactivity [higher Rheumatoid factor (RF), cryoglobulins, and beta2-microglobulins (β2M)] compared to group-2 which improved markedly after SVR. This supports that group 1 is further ahead in the direction of lymphoproliferation. Group 1 patients after SVR showed marked improvement in VAS dry eye, VAS dry mouth, VAS fatigue, VAS pain, ESSPRI, and ESSDAI (P-values ˂0.003, ˂0.002, ˂0.016, ˂0.001, ˂0.002, and ˂0.014 respectively). There was a significant improvement in RF, and serum β2M levels (after SVR), (P-values ˂0.013, and 0.001 respectively). Group 1 is further ahead in the direction of lymphoproliferation than group 2 with higher statistically significant serum β2M and polyclonal serum protein electrophoresis (P-values 0.006 and 0.047 respectively).

CONCLUSION: HCV patients with sicca manifestations treated by DAAs showed significant clinical and immunological improvements. The difference between group 1 (before and after SVR) and group 3 supports the notion that they are two different entities, with different characteristic features. Sicca manifestations improved after the eradication of HCV.

PMID:40624706 | DOI:10.1186/s13075-025-03605-9

BMC Nurs. 2025 Jul 7;24(1):863. doi: 10.1186/s12912-025-03533-8.

ABSTRACT

BACKGROUND: Nurses are the core workforce responsible for coordinating and delivering patient care, playing a critical role in ensuring patient safety and enhancing healthcare quality. However, when confronted with multiple patient demands, scarce medical resources, and heavy workloads, nurses’ subjective perceptions of workload may trigger specific psychological response mechanisms, which in turn negatively affect their work status and nursing behavior.

AIM: This study aimed to explore the impact of nurses’ perceived workload on missed nursing care and presenteeism, and to examine the mediating roles of occupational stress and emotional intelligence in these relationships.

METHODS: A cross-sectional study design was employed. Between May and October 2024, 730 questionnaires were distributed, with 706 valid responses collected, resulting in an effective response rate of 96.7%. Descriptive statistics and Pearson correlation analyses were conducted using SPSS 27.0. Structural equation modeling was performed using AMOS 25.0, and mediation effects were tested via the bootstrap method.

RESULTS: The results showed that nurses’ perceived workload was not directly associated with missed nursing care(β = 0.04, P>0.05) or presenteeismββ = 0.13, P>0.05). However, occupational stress played a significant mediating role in the relationship between perceived workload and missed nursing care (PW → OS, β = 0.96, P < 0.001; OS → MNC, β = 0.59, P < 0.001), as well as in the relationship between perceived workload and presenteeism (PW → OS, β = 0.96, P < 0.001; OS → PRE, β = 0.55, P < 0.001). Similarly, emotional intelligence served as a significant mediator in the relationship between perceived workload and missed nursing care (PW → EI, β = -0.56, P < 0.001; EI → MNC, β = -0.25, P < 0.001), and also in the relationship between perceived workload and presenteeism (PW → EI, β = -0.56, P < 0.001; EI → PRE, β = -0.13, P < 0.001).

CONCLUSIONS: Nurses’ perceived workload does not directly lead to missed nursing care or presenteeism; rather, it mainly influences their work status and nursing behavior indirectly through either occupational stress or emotional intelligence.

IMPLICATIONS FOR NURSING MANAGEMENT: When optimizing the work environment and human resource allocation, nursing managers should not only focus on the distribution of objective workload but also pay close attention to nurses’ perceived workload and the development of their psychological coping mechanisms.

PMID:40624705 | DOI:10.1186/s12912-025-03533-8

BMC Nutr. 2025 Jul 7;11(1):136. doi: 10.1186/s40795-025-01108-z.

ABSTRACT

INTRODUCTION: With the substantial growth rate of the Black immigrant population in the US, the impact of colonization on the diets of Black Americans and disproportionately high rates of chronic diseases among individuals with African descent, studies should place more emphasis on ethnicity when investigating nutrition-related risk factors. This study examined the relationship between variations in citizenship level and diet quality among adult subjects with African descent.

METHODS: We analyzed data from 1,198 adults with African descent in NHANES 2015-2016. A ‘citizenship level’ scale was developed using principal component analysis, incorporating years lived in the US, country of birth, and citizenship status. Diet quality was assessed using HEI scores. Associations between citizenship level, sex, age, income, and diet quality (poor, moderate, or good) were examined using a Monte Carlo simulation of Fisher’s exact tests. Linear regression models were employed to examine the relationship between citizenship level and continuous HEI scores, adjusting for sex, age, and income, with stratified analyses conducted for each demographic subgroup.

RESULTS: Fisher’s exact tests revealed that the level of US citizenship, sex, age, and income level were all significantly associated with the categorical level of diet quality (HEI). Linear regression analysis demonstrated that a lower level of US citizenship was significantly associated with higher HEI scores, indicative of better diet quality (p < 0.001), even after adjusting for sex, age, and income. This relationship persisted across most demographic subgroups but appeared stronger among males and those in the lowest income bracket. The relationship was also significant for younger adults but not for adults aged 65 and older.

CONCLUSIONS: Studies suggest a need for more inclusive and culturally tailored nutrition interventions. To minimize the negative impact of colonization and US assimilation on diet quality, future studies should consider stratifying groups based on the heterogeneity of this population and interventions that utilize traditional dietary patterns of the African diaspora as tools to improve the quality of life among people of African descent.

PMID:40624702 | DOI:10.1186/s40795-025-01108-z