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Item Dietary Phosphorus Levels Influence Protein-Derived Uremic Toxin Production in Nephrectomized Male Rats(MDPI, 2024-06-08) Cladis, Dennis P.; Burstad, Kendal M.; Biruete, Annabel; Jannasch, Amber H.; Cooper, Bruce R.; Hill Gallant, Kathleen M.; Nutrition and Dietetics, School of Health and Human SciencesGut microbiota-derived uremic toxins (UT) accumulate in patients with chronic kidney disease (CKD). Dietary phosphorus and protein restriction are common in CKD treatment, but the relationship between dietary phosphorus, a key nutrient for the gut microbiota, and protein-derived UT is poorly studied. Thus, we explored the relationship between dietary phosphorus and serum UT in CKD rats. For this exploratory study, we used serum samples from a larger study on the effects of dietary phosphorus on intestinal phosphorus absorption in nephrectomized (Nx, n = 22) or sham-operated (sham, n = 18) male Sprague Dawley rats. Rats were randomized to diet treatment groups of low or high phosphorus (0.1% or 1.2% w/w, respectively) for 1 week, with serum trimethylamine oxide (TMAO), indoxyl sulfate (IS), and p-cresol sulfate (pCS) analyzed by LC-MS. Nx rats had significantly higher levels of serum TMAO, IS, and pCS compared to sham rats (all p < 0.0001). IS showed a significant interaction between diet and CKD status, where serum IS was higher with the high-phosphorus diet in both Nx and sham rats, but to a greater extent in the Nx rats. Serum TMAO (p = 0.24) and pCS (p = 0.34) were not affected by dietary phosphorus levels. High dietary phosphorus intake for 1 week results in higher serum IS in both Nx and sham rats. The results of this exploratory study indicate that reducing dietary phosphorus intake in CKD may have beneficial effects on UT accumulation.Item Dietary Patterns and Hypothyroidism in U.S. Adult Population(MDPI, 2024-01-28) Alkhatib, Dana; Shi, Zumin; Ganji, Vijay; Nutrition and Dietetics, School of Health and Human SciencesThe thyroid gland produces hormones that are essential for various body functions. Hypothyroidism is defined as insufficient thyroid hormone production. Several studies have found associations between specific micronutrients and overall thyroid function; however, the amount of evidence regarding the relationship between dietary patterns and hypothyroidism among the U.S. population is limited. Data from three cycles of National Health and Nutrition Examination Surveys (NHANES), 2007–2008, 2009–2010, and 2011–2012, were used (n = 8317). Subjects with serum thyroid stimulating hormone >4.5 mIU/L or on levothyroxine were considered to have hypothyroidism. Age, sex, race/ethnicity, body mass index, and several lifestyle factors were considered as covariates. Three patterns were extracted using factor analysis. These were labeled as fat–processed grains–sugars–meats (FPSM), oils–nuts–potatoes–low-fat meats (ONPL), and fruits–whole grains–vegetables–dairy (FWVD) patterns. In a weighted multiple logistic regression, FPSM and ONPL were inversely associated with hypothyroidism (OR, 0.75; 95% CI, 0.57–1; p = 0.049 and OR, 0.81; 95% CI, 0.67–0.97; p = 0.025, respectively). However, FWVD demonstrated no association with hypothyroidism (p = 0.63). In conclusion, FPSM and ONPL patterns but not FWVD patterns were associated with hypothyroidism in U.S. adults. Nutrient deficiencies and their interactions may be linked to hypothyroidism.Item Sarcopenia and Mortality in Critically Ill COVID-19 Patients(MDPI, 2023-12-22) Yakti, Fatima Al Zahra; Abusalah, Lana; Ganji, Vijay; Nutrition and Dietetics, School of Health and Human SciencesCOVID-19 can manifest as either asymptomatic or progressing to a severe phase in some patients, which may require hospitalization. These patients may experience dyspnea and hypoxia, leading to the development of acute respiratory distress syndrome. Studies have reported an increased risk of severe sarcopenia in COVID-19 patients during and after recovery. This narrative review aimed to summarize and synthesize available studies on the association between sarcopenia and mortality in critically ill COVID-19 patients. A total of 22 studies conducted on hospitalized COVID-19 patients were included in this review. Of those, 17 studies reported a direct association, while 5 studies showed no association between sarcopenia and mortality in severe COVID-19 patients. It is important to maintain muscle quality and quantity in defense against COVID-19. The measurement of lean muscle mass should be included in the risk assessment of severely ill COVID-19 patients as part of the therapy plan.Item Parent/caregiver’s role in nutrition, physical activity, and food access among children diagnosed with spina bifida(IOS Press, 2023) Whelan, JoAnne L.; Armstrong, Cheryl L. H.; Schroyer, Rebecca; O’Neil, Joseph; Nutrition and Dietetics, School of Health and Human SciencesPurpose: This pilot study aimed to determine the parent/caregiver's role in nutrition/eating habits, physical activity behaviors, and food access among children diagnosed with spina bifida (SB). Methods: Parents/caregivers of children with SB were asked to participate at a single, outpatient SB clinic. Demographic, biomedical data, parent/caregiver nutrition knowledge, family nutrition and physical activity (FNPA), and food security survey scores were compared. Descriptive, regression, and correlational statistics were conducted for analysis via SPSS 29. Results: Of the 117 parents/caregivers surveyed, completed data suggested most were overweight/obese (average body mass index [BMI] of 30.63 kg/m2±8.40; n = 99) with an average nutrition knowledge score of 71% (17.83±3.33). As FNPA scores decreased, the patient/child's maximum BMI z scores increased (β= -0.043; confidence interval -0.079, -0.007; p = 0.020), suggesting the less active and/or less healthy eating habits, the higher body mass was noted for the child. Forty four percent of children (n = 99) were in the overweight/obese weight range based on maximum BMI z score. Conclusion: These findings suggest there is a need for parental/caregiver nutrition education to assist children with SB with meal and activity planning to achieve optimal health.Item Lack of Cultural and Language Concordant Nutrition Education for Hispanic/Latinx Individuals with CKD: A Call to Action(Wolters Kluwer, 2022) Perez, Luis M.; Biruete, Annabel; Nutrition and Dietetics, School of Health and Human SciencesItem Feeling gutted in chronic kidney disease (CKD): Gastrointestinal disorders and therapies to improve gastrointestinal health in individuals CKD, including those undergoing dialysis(Wiley, 2021-10-27) Biruete, Annabel; Shin, Andrea; Kistler, Brandon M.; Moe, Sharon M.; Nutrition and Dietetics, School of Health and Human SciencesChronic kidney disease (CKD) affects 9.1% of the population worldwide. CKD may lead to structural and functional gastrointestinal alterations, including impairment in the intestinal barrier, digestion and absorption of nutrients, motility, and changes to the gut microbiome. These changes can lead to increased gastrointestinal symptoms in people with CKD, even in early grades of kidney dysfunction. Gastrointestinal symptoms have been associated with lower quality of life and reduced nutritional status. Therefore, there has been considerable interest in improving gastrointestinal health in this clinical population. Gastrointestinal health can be influenced by lifestyle and medications, particularly in advanced grades of kidney dysfunction. Therapies focused on gastrointestinal health have been studied, including the use of probiotics, prebiotics, and synbiotics, yielding limited and conflicting results. This review summarizes the alterations in the gastrointestinal tract structure and function and provides an overview of potential nutritional interventions that kidney disease professionals can provide to improve gastrointestinal health in individuals with CKD.Item Home-delivered meals as an adjuvant to improve volume overload and clinical outcomes in hemodialysis(Oxford University Press, 2022-04-19) Perez, Luis M.; Biruete, Annabel; Wilund, Kenneth R.; Nutrition and Dietetics, School of Health and Human SciencesPatients on chronic hemodialysis are counseled to reduce dietary sodium intake to limit their thirst and consequent interdialytic weight gain (IDWG), chronic volume overload and hypertension. Low-sodium dietary trials in hemodialysis are sparse and mostly indicate that dietary education and behavioral counseling are ineffective in reducing sodium intake and IDWG. Additional nutritional restrictions and numerous barriers further complicate dietary adherence. A low-sodium diet may also reduce tissue sodium, which is positively associated with hypertension and left ventricular hypertrophy. A potential alternative or complementary approach to dietary counseling is home delivery of low-sodium meals. Low-sodium meal delivery has demonstrated benefits in patients with hypertension and congestive heart failure but has not been explored or implemented in patients undergoing hemodialysis. The objective of this review is to summarize current strategies to improve volume overload and provide a rationale for low-sodium meal delivery as a novel method to reduce volume-dependent hypertension and tissue sodium accumulation while improving quality of life and other clinical outcomes in patients undergoing hemodialysis.Item Effects of Animal Source Food Supplementation on Neurocognitive Outcomes of HIV-Affected Kenyan School-Aged Children: A Randomized, Double-blind, Controlled Intervention Trial(2016-10-10) Neumann, Charlotte G.; Loo, Kek Khee; Weiss, Robert E.; Sugar, Catherine; Chen, Qiaolin; Rizzo, Shemra; Ettyang, Grace; Ernst, Judith A.Assess the effects of animal source food (ASF) versus soy versus wheat biscuit supplementation on the neurocognitive performance of HIV-affected, nutritionally at-risk school-aged children in rural Kenya.Item Estimates of body composition in drug naive asymptomatic HIV-infected rural Kenyan women(2010-07-19) Ernst, Judith A.; Ettyang, G; Katschke, A; Lewis, B; Neumann, CTo compare methods that estimate body composition in drug naive asymptomatic HIV-infected rural Kenyan women enrolled in a randomized nutrition intervention field study that will determine if meat added to the diet prevents the loss of lean body massItem Zinc protoporphyrin in HIV+ drug naïve rural Kenyan women(2010-10-06) Ernst, Judith A.; Ettyang, G; Katschke, A; Neumann, CTo determine if ZPP/H is a good indicator of iron depletion in drug naïve asymptomatic HIV-infected rural Kenyan women who are of reproductive age and enrolled in a randomized nutrition intervention field study that will determine the impact of added meat, soy or wheat protein on iron status.