Autism spectrum disorder (ASD) can be diagnosed as early as 18 months old, but more reliably after two years. Notably, no laboratory test exists to identify mothers at higher risk of having a child who will later be diagnosed with ASD or to identify at-risk infants before the manifestation of symptoms. One frequently described risk factor for neurodevelopmental disorders is vitamin B12 and folate deficiency, which results in macrocytic anemias.
We evaluated whether increased mean corpuscular volume (MCV), an indicator of macrocytic anemias in the mother or child, is associated with increased odds of a subsequent ASD diagnosis. Maternal mean MCV (mMCV) was calculated from any value in the year before birth, and the mMCV for the child was calculated from any MCV value from birth until the end of the follow-up time. Odds ratios with 95% confidence intervals were estimated from logistic regression models.
A total of 3798 mothers (984 cases—ASD/2814 controls) and 9633 children (3206 cases—ASD/6427 controls) had at least one MCV value. The mMCV for the mother one year before birth was not associated with a later diagnosis of ASD in their children. In children, compared to the reference group (mMCV 76 femtoliters (fL)), an mMCV of 81 fL, 84 fL, and 91 fL was increased odds of ASD of 26%, 38%, and 32%, respectively.
The MCV can be a potential inexpensive biomarker to identify a subset of children at risk of ASD or other developmental disorders; this exploratory study can inform larger studies to determine the clinical utility of MCV.
Iron deficiency is a major global public health concern associated with various adverse outcomes.
This study utilized the Global Burden of Disease Study 2021 (GBD 2021) to analyze the contemporary burden of iron deficiency-associated diseases. We conducted an epidemiological analysis using Bayesian age-period-cohort methods for forecasting, decomposition analysis to assess the impact of aging, population growth, and epidemiological shifts, and slope/concentration indices to assess health inequalities.
Between 1990 and 2021, disability-adjusted life years (DALYs) due to iron deficiency increased (2021: 34,519,623, 95% uncertainty interval [UI]: 23,607,706.06–48,762,323.14), despite a decline in age-standardized rates (ASR) (451.58 per 100,000; 95% UI: 308.48–639.42) with an estimated annual percentage change of –0.87 (95% confidence interval [CI]: –0.91 to –0.83). The burden was highest in low socio-demographic index regions, with 13,893,312.7 DALYs (95% UI: 9,567,547.98–19,440,905.71), an ASR of 735.34 per 100,000 (95% UI: 506.01–1027.57), and an annual percentage change (EAPC) of –1.36 (95% CI: –1.41 to –1.32). Deaths totaled 18,628.31 (95% UI: 9082.46–27,243.01), with a mortality rate of 1.77 per 100,000 (95% UI: 0.86–2.60), primarily from maternal health disorders and dietary iron deficiency. Population growth and epidemiological shifts were key contributors to the disease burden.
These findings highlight the persistent global burden of iron deficiency and the need for targeted interventions, particularly in low socio-demographic index regions.
Suboptimal hydration status has increasingly been recognized as a risk factor for the progression of chronic diseases. A nationwide survey conducted in China found that 82% of children aged 6 to 17 years failed to meet the recommended daily total water intake of 1600–2500 mL. On average, boys consumed 1603 ± 731 mL per day, while girls consumed 1487 ± 661 mL per day, placing them at a higher risk of dehydration. Worldwide studies have suggested associations between dehydration and chronic kidney disease, steatotic liver disease, and cardiovascular diseases in adults. However, there is a lack of evidence concerning hydration status and target organ damage in the pediatric population. Only a limited number of studies have suggested that suboptimal hydration status is associated with transient renal impairment, an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD), and decreased ventricular structure and function in children. This article reviews the association between hydration status and target organ damage in both adult and pediatric populations and summarizes tailored water intake recommendations for Chinese children. We aim to advance research on hydration status and kidney, liver, and cardiovascular health, especially in the pediatric population.
Clinical and epidemiological evidence supports sodium reduction as an effective strategy to lower blood pressure and reduce the risk of stroke, cardiovascular disease, and overall mortality. High sodium (salt) intake is a well-established contributor to elevated blood pressure and adverse cardiovascular outcomes. The World Health Organization (WHO) recommends that adults should consume less than 5 g of table salt per day; however, the global average intake is estimated at around 10.78 g/day. The primary sources of dietary sodium vary by region: in high-income countries, the majority of salt intake comes from processed foods and meals prepared outside the home, while in many low-and middle-income countries, sodium is mainly added during home cooking or comes from condiments such as soy sauce and fish sauce. This review discusses the effects of high dietary sodium on blood pressure and vascular health, along with global consumption trends, regional disparities, and key nutritional sources. In addition to reducing sodium, adopting a salt-sensitive, whole-diet approach, such as increasing fruit and vegetable intake to boost potassium, can further protect cardiovascular health. Potassium-enriched, low-sodium salt substitutes are increasingly used in food production. Emerging strategies, including flavor enhancers, bitter blockers, spatial salt distribution, and microencapsulation, also help enhance saltiness perception while lowering sodium content. The review also summarizes national guidelines and those by the WHO, highlights selected country strategies, and calls for coordinated global and national efforts to reduce sodium intake and improve cardiovascular health worldwide.
Pressure injuries (PIs) are a significant issue for international healthcare systems. Particularly common among older adults with reduced mobility, PIs represent a considerable socio-healthcare burden, which deeply impacts the psychological well-being of patients. Malnutrition is one of the main risk factors for the development of PIs, as malnutrition hinders healing and increases the risk of complications. For these reasons, implementing appropriate nutritional interventions, often underestimated in clinical practice, is crucial to manage PIs effectively. This study primarily aimed to identify and synthesize the best scientific evidence on nutritional interventions to prevent, facilitate, or improve the healing of PIs in an adult population. Additionally, both qualitative and quantitative outcomes were analyzed.
A narrative literature review was conducted using the PubMed–Medline, Scopus, and Google Scholar databases to potentially include potential studies. The scientific validity of the study was ensured using the Scale for the Assessment of Narrative Review Articles (SANRA) and the pre-registration of the OSF database was performed using the PICOS method, which is employed in numerous studies of this type. Randomized controlled trials (RCTs) published within the last 10 years and in English were included.
Out of the 1507 records identified, 8 RCTs were included, published between May 2014 and May 2023. One study focused on patient education and self-care in nutrition related to PIs, while the remaining seven focused on intensive nutritional interventions or the administration of dietary supplements to treat PIs directly. Positive therapeutic effects were observed using collagen peptides, vitamin C, and arginine. Furthermore, the topical application of fish oil showed a protective effect.
This study found that targeted nutritional interventions have a direct positive impact on PIs and an indirect effect on care, reducing complications and the duration of intensive care and healing times for PIs. Future systematic studies are recommended to broaden the understanding of the studied care framework.
Substantial experimental evidence has demonstrated that selenium, an essential micronutrient with pleiotropic physiological effects, also promotes dual antioxidant and anti-inflammatory effects. Meanwhile, the epidemiological association between dietary selenium consumption and mortality risk in diabetic kidney disease (DKD) remains underexplored. This investigation demonstrated a significant association between selenium intake and all-cause mortality among adult populations with DKD.
This study analyzed data from 2183 individuals diagnosed with DKD, obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2014. The mortality rate was determined through linkage to the National Death Index until December 31, 2015. The hazard ratios (HRs) and their corresponding 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards regression models. Kaplan–Meier survival curves were generated to examine the association between survival probabilities and selenium intake.
A total of 1063 mortalities were recorded over an average follow-up period of 8 years. All-cause mortality decreased with higher selenium intake levels. Adjusted for demographic variables, dietary habits, lifestyle factors, glucose regulation, and significant comorbidities, higher selenium intake was associated with improved all-cause mortality among DKD patients (adjusted HR = 0.705, 95% CI: 0.551–0.901). A significant overall association was observed between selenium intake and all-cause mortality risk, as evidenced by restricted cubic spline (RCS) analysis (poverall < 0.001; pnonlinearity = 0.397).
Higher dietary selenium intake was significantly associated with lower risk of all-cause mortality after multivariable adjustment for confounders among individuals with DKD.
This study aimed to determine whether administering intravenous vitamin C in patients with malignant neoplasm is associated with increased survival outcomes compared to no intravenous vitamin C administration.
The primary search was conducted using MEDLINE (via PubMed), Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception to October 13, 2024. Results were collected from randomized clinical trials and cohort studies that compared intravenous vitamin C and blank controls or placebo in patients with malignant neoplasm. Two reviewers independently assessed the data extraction process and the risk of bias, while the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. A frequentist framework was used as the primary analysis approach.
A total of 8 studies with 2722 adult participants were included. The vitamin C dose ranged from 2.5 g/d to 1.5 g/kg of body weight per day, with the treatment duration ranging from 9 days to 1 year. The primary outcome was overall survival, with progression-free survival as a secondary measure. Intravenous vitamin C was associated with a significantly longer median overall survival (pooled estimated median survival ratio: 1.83; 95% confidence interval: 1.40–2.40; p < 0.001; moderate certainty), and a trend towards improved progression-free survival (pooled estimated median survival ratio: 1.80; 95% confidence interval: 0.95–3.41; p = 0.073). Subgroup analyses of overall survival showed higher median survival ratios with vitamin C doses <1 g/kg (vs. ≥1 g/kg), in non-Chinese regions (vs. Chinese regions), with non-chemotherapy combinations (vs. chemotherapy combinations), and in cohort studies (vs. randomized controlled trials).
The administration of intravenous vitamin C to adults with malignant neoplasm was associated with a longer median overall survival compared to no vitamin C administration. The current evidence indicates a moderate degree of certainty for considering intravenous vitamin C as a standard of care in managing malignant neoplasms.
CRD42024600634, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024600634.