Journal of Nutrition, Fasting and Health
Volume:12 Issue: 1, Winter 2024

Malnutrition, as defined by the World Health Organization (WHO), occurs when the body does not receive sufficient nutrients or energy to meet growth, maintenance, and functional needs. Severe malnutrition in children increases the risk of death, disease episodes, complications, and prolonged illnesses. Therefore, early nutritional support is crucial in pediatric critical care settings. In cases where oral feeding is not feasible, enteral feeding (EN) becomes necessary to provide adequate energy. However, despite its advantages, feeding intolerance remains a significant challenge. This study aims to determine the prevalence of feeding intolerance among critically ill children in the Pediatric Intensive Care Unit (PICU).  This cross-sectional study was conducted at the Akbar Pediatric Subspecialty Center's PICU in Mashhad, Iran between March and April 2022. The evaluation focused on nutritional adequacy and feeding intolerance.  A total of 72 patients were included in this study with a majority being girls. Approximately 30 percent of patients exhibited severe malnutrition based on their BMI Z-score (<-3). Boys were more affected than girls in this regard. Most patients received a combination of EN and parenteral nutrition (PN) to fulfill their energy and protein requirements successfully. In most cases, children consumed over 66% of their energy needs through these methods. Feeding intolerance primarily manifested as vomiting and regurgitation (47%), followed by high gastric residual volume (GRV) (36.1%) and abdominal distention (34.7%).  The findings from our study highlight the prevalence of malnutrition within PICU settings along with common complications associated with feeding intolerance such as vomiting and regurgitation. Standardizing a definition for feeding intolerance could prove beneficial for improving research protocols aimed at effectively managing this condition.

Obesity is still a health problem for humanity. Although the favorable role of exercise on weight loss has been reported. But the effect of the type of exercise is still unclear. The present study compared the effects of continuous exercise (CE) and interval exercise (IE) on fibrillin-1 and asprosin in obese male rats.  Forty- eight male rats were divided into six groups including 1) obese IE, 2) obese CE, 3) healthy IE, 4) healthy CE, 5) obese control and 6) healthy control. Groups 1- 4 performed exercises for 8 weeks and 72 hours. Insulin resistance index, fasting glucose, insulin, fibrillin-1 and asprosin were measured after the last training session. Data analysis was performed by Two-way analysis of variance and Kruskal-Wallis tests with SPSS software (P≤0.05).  There were significant differences in insulin resistance (P=0.001), fibrillin-1 gene expression (P=0.001), fasting glucose (P=0.001), asprosin serum levels (P=0.001), and insulin (P=0.002) levels between obese IE, obese CE, healthy IE, healthy CE, obese control and healthy control groups.  Although obesity increased fibrillin-1 and asprosin, but IE and CE decreased fibrillin-1 and asprosin. Thus, IE and CE can be used for controlling fibrillin-1 and asprosin levels. IE and CE can be considered as effective methods to reduce weight in obesity.

Fasting during Ramadan is a religious obligation and may pose a risk to diabetic patients. This study aimed to stratify diabetic patients based on the International Diabetes Federation- Diabetes and Ramadan International Alliance (IDF- DAR) guideline for the risk of fasting before Ramadan. 

A total of 317 diabetic patients attending the endocrinology clinic at Ghaem Hospital, Mashhad, Iran, participated in this cross-sectional study. The American Diabetic Association (ADA) criteria were applied to diagnose diabetes. Various parameters, including diabetes type and duration, complications, and risk factors were recorded to determine IDF-DAR-based risk. Then patients were stratified into high (IDF-DAR>6), medium (IDF-DAR: 3.5-6) and low (IDF-DAR: 0-3) risk groups accordingly. 

 Out of the 317 patients included in the study, 115 (36.3%) patients were categorized as low risk, 127 (40%) as moderate-risk, and 75 (23.7%) as high-risk groups. 

  According to the IDF-DAR guideline, majority of the patients fell into the low and moderate risk categories, suggesting that they should not be entirely exempted from fasting during the holy month of Ramadan. However, the validity of this patient stratification in various fasting populations needs to be evaluated through prospective longitudinal studies.

The emergence of the COVID-19 pandemic in December 2019 had a profound impact on global public health. This study investigates the effects of the coronavirus on dietary intake and physical activity among the Mashhad PERSIAN cohort population in Mashhad, Iran.  This nested cohort study was done among the PERSIAN Cohort Study in Mashhad University of Medical Sciences population who confirmed COVID-19 infection through PCR testing. Participants were assessed for physical activity using the International Physical Activity Questionnaire (IPAQ) short form, as well as changes in appetite and food intake during the COVID-19 infection. All measurements were compared during the disease period to pre-infection.  This study comprised 381 confirmed COVID-19 patients (average age of 42.51 ± 7.31 years) of which 154 (40.4%) were male. There was a significant reduction in the levels of vigorous and moderate physical activity, walking, and total sitting time (P<0.001 for all). Also, food intake was reduced during the COVID-19 infection compared to before the infection.  In summary, this study demonstrates a significant decrease in physical activity and food intake during COVID-19 infection.

Glioblastoma multiforme is the foremost common harmful tumor of the central nervous system that specifically influences the brain and is resistent to common therapies such as surgery, radiotherapy and chemotherapy. The aim of this study was to examine the viability of perseverance preparing and Nano-curcumin supplementation on the expression of miR-21 and P53 qualities in brain tumor tissue in a creature demonstrate of glioblastoma multiforme.  In this experiment, 35 8-week-old male Wistar rats were divided into seven groups with 5 rats each: healthy control group, 4-week-old healthy, control group cancer, 4-week-old cancer group and training group, Nano-curcumin group and training-Nano-curcumin group. Cancer cells were injected into the right frontal cortex of mice using a pump at a depth of 2.5 mm. One week later, mice entered the treadmill training program (4 weeks) and Nano-curcumin was administered orally at a dose of 80 mg/kg (28 days). Gene expression was measured using real-time fluorescent quantitative PCR and used for analysis.spss software.  The expression of miR-21 gene in the training group, Nano-curcumin, and training group Nano-curcumin was lower than that of the control cancer at 4 weeks (P = 0.001). Moreover, the expression of P53 gene in the Nano-curcumin training group and Nano-curcumin training group was higher in cancer cells and 4-week blood-eating cancer than in the control group (P = 0.001).  Endurance training and curcumin administration appear to reduce tumor growth in mice with brain tumors by modulating the expression of miR-21 and p53 genes.

Diabetes is one of the most common chronic diseases and one of the main causes of death all over the world. This study aimed to investigate the effect of consumption of saffron extract combined with aerobic exercise on glycemic indices in streptozotocin induced diabetic male rats with.  This experimental study was conducted on 40 adult male rats aged 10-12 weeks weighing 220-250g. Rats were randomly allocated to diabetic control, diabetic exercise, diabetic saffron, and diabetic exercise + saffron groups after the induction of diabetes. Moderate intensity exercise was administered five days a week for eight weeks. Before and after eight weeks glycemic indices were measured, and the data were analyzed with Kolmogorov-Smirnov, one-way analysis of variance, and Tukey's post hoc tests.  The results showed that fasting glucose in the saffron extract + aerobic exercise was significantly lower than the control and the aerobic training groups (p=0.014). Glycosylated hemoglobin in the saffron extract + aerobic exercise group was lower than the control group (p=0.001), and insulin resistance in the saffron group was lower than the control group with aerobic exercise (p=0.001).  Both an aerobic exercise and a consumption of saffron extract can probably prevent diabetes by reducing hyperglycemic indicators. Aerobic exercise and consumption of saffron extract co-administration can exert more beneficial effects.

 Numerous changes occurred in economic, social, and medical fields following the onset of Coronavirus (COVID-19), including lifestyle and dietary habits. This study examined dietary habits, physical activity, and individuals' anthropometric indices during quarantine due to the lack of research on quarantine's effects on lifestyle changes.  This cross-sectional study was conducted on adults based on inclusion and exclusion criteria during the COVID-19 quarantine period. Participants were asked to complete a 10- to 15-minute online survey regarding their experiences during the COVID-19 pandemic. Demographic variables and surveys related to eating habits, lifestyle behaviors, and the impact of COVID-19 on physical activity and health were investigated. SPSS 22.0 was used to analyze all data, and the significance level was less than 0.05.  A total of 630 participants were enrolled in this study, of whom 537 (85.2%) were women, and their mean age was 38.12 + 3.25 years (range: 19-58). The average of all anthropometric profiles, in general and gender-specific, was significantly higher during quarantine than before (P<0.001 for all). Moderate and high levels of activity were significantly higher before quarantine than during quarantine, while low levels of activity increased significantly during quarantine (P<0.001 for all). The most consumed food groups included fruits (72.9%) and meat (63.8%). Carbonated drinks (16.7%) and fats and oils (21%) were less consumed than other food groups. The most critical factors affecting BMI during quarantine included fat-free body weight before quarantine (importance coefficient (IC) = 0.4097), weight before quarantine (IC = 0.2398), and gender (IC = 0.4097).  Based on the results, quarantine probably increased obesity prevalence, altered diet habits, and decreased physical activity levels among individuals. Expanding health development programs is essential to promote healthy lifestyles in communities during quarantine.

Adequate nutrition is essential for the well-being of hospitalized patients. Assessing nutritional adequacy plays a crucial role in patient-centered care. The nutritionday (nDay) project, supported by ESPEN, conducts a global audit to evaluate nutritional risks. Imam Reza Teaching Hospital in Mashhad is one of the participating hospitals. This study examines the trend of nutritional adequacy in Imam Reza Teaching Hospital from nDay 2019 to 2021.  This cross-sectional study analyzed data from the nday database of Imam Reza Teaching Hospital in Mashhad, Iran, collected between 2019 and 2021. Written consent was obtained, and the study followed international standards and the nDay questionnaire. Factors such as nutritional routs, energy goals, and energy intake were considered. All statistical analyses were performed using the Statistical Package for Social Sciences version 19.0. The three-year trend of nutritional adequacy was compared, using the Chi-Square test. A total of 414 patients from 14 departments of Imam Reza Hospital were included in the study during 2019-2021. There was no significant trend of energy goal among the wards, during 2019-2021; except in women's burning, orthopedic surgery, and general surgery wards (P<0.001,<0.001,<0.001, respectively). There was a significant variation in energy intake, during 2019-2021 in men’s burning, oncology, cardiac surgery, gynecology surgery, and general surgery wards (P<0.001, <0.001, <0.001, <0.001, <0.001, respectively).  This study showed that burning and oncology patients didn’t receive their energy goal, which can indicate the importance of nutritional care in these patients.

Sausages are consisting of principal processed meat products including meat and other additives making special texture and flavor. Consumption of these products has increased nowadays.This study aimed to evaluation of sausage products by chemical, microbial, and histological properties that were manufactured and distributed in Qom province, Iran.  In this study, 100 samples of varied types of sausage products were randomly collected from Oct-2021 to Jun-2022. Chemical, microbial and histological techniques were applied for analysis of samples. All measurements were implemented in triplicate and the data were analysed statistically by SPSS 25 software.  The highest amounts of total fat, sodium nitrite and starch were observed in 40-50% meat sausages, as well as total protein and phosphate in 60-70%  meat sausages. Salmonella spp. and Eschericha coli as dangerous pathogens were not detected in collected samples. Total Bacterial Count, Coliform, Clostridium perfringens and Yeast and Mold  were lower than acceptable limit of Iranian National Standard  Organization(INSO 2303: 2021) (p<0.05). The results of the histological techniques showed that lymphatic, skin, peritoneal fat and plant tissue, trachea, bone, and hyaline cartilage were used in the production of sausage samples. with any significant statistical differences(p<0.05). The microbial properties of samples indicated suitable hygienic conditions of production and distribution. Due to the observation of high value of standard deviation in obtained results of chemical, microbial, and histological analysis, it was a strong consequence of dramatic variation existed in the processing and manufacturing conditions of collected sausage samples. However, the overall status in quality of production and distribution of analyzed sausage products were observed suitable.

Air pollution is the fourth leading cause of premature death after hypertension, smoking and malnutrition and is the second leading cause of death from non-communicable diseases after smoking (1-3).Increased air pollution can increase the vulnerability of the respiratory system, and poor air quality is a serious risk for acute and chronic respiratory diseases and cardiovascular disease. Also Exposure to air pollution causes underlying diseases such as high blood pressure, diabetes, cardiovascular and respiratory diseases, and as a result these underlying diseases increase the vulnerability to Coronavirus disease 2019 (4).People with the underlying disease and living in contaminated areas are at higher risk for coronary heart disease, and studies show that air pollution is a contributing factor to diseases such as the flu and covid-19. Airborne particles increase Coronavirus disease 2019 mortality by up to 6%, ozone up to 7% and nitrogen dioxide up to 15%. When different dust particles increase in the air and the virus spreads in the air; For example, The virus has more chance to spread to other people when talking, coughing and sneezing(5).