Prognostic value of obesity in patients with cancer treated with immune checkpoint inhibitors: An updated meta‑analysis and systematic review

Accumulating interest has been surging over the past few years regarding the effects of obesity on immunotherapy. In addition to the body mass index (BMI), imaging-quantified body fat compartments have been investigated. The present study aimed to evaluate the predictive value of the BMI and computed tomography (CT)-based body fat in patients with cancer receiving immunotherapy. For this purpose, the PubMed, MEDLINE, EMBASE and Cochrane databases were searched from January 2017 to July 2022. Clinical studies evaluating the association between BMI or body fat and survival of patients with cancer treated with immune checkpoint inhibitors (ICIs) were included. In total, 15 studies reporting on the BMI were included in the meta-analysis and 16 studies evaluating body fat were included in the systematic review. According to the classification of the World Health Organization, overweight and obese patients with ICI treatment showed improved overall survival [overweight vs. normal: Hazard ratio (HR)=0.79, 95% confidence interval (CI)=0.64-0.98, P=0.03; obese vs. normal: HR=0.75, 95% CI=0.60-0.94, P=0.013] and progression-free survival (overweight vs. normal: HR=0.82, 95% CI=0.70-0.97, P=0.02; obese vs. normal: HR=0.81, 95% CI=0.65-1.02, P=0.07). Among the articles investigating the effect of body fat composition on the efficacy of immunotherapy, a number of studies included various CT analysis techniques and cutoffs to define body fat composition. Associations of body fat with survival were contradictory in different patients with cancer treated with immunotherapy. Obesity was associated with better survival in patients with cancer treated with ICIs. Further analyses are required to demonstrate the prognostic value of body fat in patients with cancer immunotherapy.

The Effect of Short-Wavelength White LED Illumination throughout the Night on the Milk Fatty Acid Profile of High-Yielding Dairy Cows

Fatty acid levels in milk vary between day and night milking. Many dairy cows are still kept under white light-emitting diode (W-LED) illumination throughout the night, although it is known to disrupt endogenous circadian rhythms. We investigated the effects of whole-night W-LED illumination (125 lux) on milk yield and circadian composition, compared to a natural light−dark (LD) cycle of 10 h light. Mid−late lactation cows (n = 34) that were exposed to natural LD cycle showed circadian variation in milk fat composition, characterized by higher health-promoting monounsaturated fatty acid (MUFA; 24.2 ± 0.4 vs. 23.2 ± 0.4 g/100 g fat, p < 0.001) and lower saturated fatty acid levels (71.2 ± 0.4 vs. 72.5 ± 0.4, p < 0.001) at 13:30 h (day milk) than at 03:30 h (night milk). Compared to natural LD (n = 16), W-LED (n = 18) did not affect milk production or milk fat yields, yet abolished the milking time variation in milk fat composition towards a less healthy fatty acid profile. This lowered MUFA levels of day milk (23.8 ± 0.4 vs. 26.7 ± 0.4, p < 0.01). Therefore, W-LED has no commercial advantage over the tested natural LD cycle, and conversely, even shows circadian disruption. Accordingly, a natural LD cycle of 10 h light is preferable over W-LED from the perspective of cost savings, the cows’ well-being, and preserving the natural milk fat profile, as the nutritional value of the day milk is slightly higher.

Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis

The level of injury is linked with biochemical alterations and limitations in physical activity among individuals with spinal cord injury (SCI), which are crucial determinants of body composition. We searched five electronic databases from inception until 22 July 2021. The pooled effect estimates were computed using random-effects models, and heterogeneity was calculated using I² statistics and the chi-squared test. Study quality was assessed using the Newcastle–Ottawa Scale. We pooled 40 studies comprising 4872 individuals with SCI (3991 males, 825 females, and 56 sex-unknown) in addition to chronic SCI (median injury duration 12.3 y, IQR 8.03–14.8). Individuals with tetraplegia had a higher fat percentage (weighted mean difference (WMD) 1.9%, 95% CI 0.6, 3.1) and lower lean mass (WMD −3.0 kg, 95% CI −5.9, −0.2) compared to those with paraplegia. Those with tetraplegia also had higher indicators of central adiposity (WMD, visceral adipose tissue area 0.24 dm² 95% CI 0.05, 0.43 and volume 1.05 L 95% CI 0.14, 1.95), whereas body mass index was lower in individuals with tetraplegia than paraplegia (WMD −0.9 kg/mg², 95% CI −1.4, −0.5). Sex, age, and injury characteristics were observed to be sources of heterogeneity. Thus, individuals with tetraplegia have higher fat composition compared to paraplegia. Anthropometric measures, such as body mass index, may be inaccurate in describing adiposity in SCI individuals.

Mapping of fatty acid composition with free-breathing MR spectroscopic imaging and compressed sensing

Nonalcoholic fatty liver disease (NAFLD) is a growing health problem, and a major challenge in NAFLD management is identifying which patients are at risk of progression to more serious disease. Simple measurements of liver fat content are not strong predictors of clinical outcome, but biomarkers related to fatty acid composition (ie, saturated vs. unsaturated fat) may be more effective. MR spectroscopic imaging (MRSI) methods allow spatially resolved, whole-liver measurements of chemical composition but are traditionally limited by slow acquisition times. In this work we present an accelerated MRSI acquisition based on spin echo single point imaging (SE-SPI), which, using appropriate sampling and compressed sensing reconstruction, allows free-breathing acquisition in a mouse model of fatty liver disease. After validating the technique's performance in oil/water phantoms, we imaged mice that had received a normal diet or a methionine and choline deficient (MCD) diet, some of which also received supplemental injections of iron to mimic hepatic iron overload. SE-SPI was more resistant to the line-broadening effects of iron than single-voxel spectroscopy measurements, and was consistently able to measure the amplitudes of low-intensity spectral peaks that are important to characterizing fatty acid composition. In particular, in the mice receiving the MCD diet, SE-SPI showed a significant decrease in a metric associated with unsaturated fat, which is consistent with the literature. This or other related metrics may therefore offer more a specific biomarker of liver health than fat content alone. This preclinical study is an important precursor to clinical testing of the proposed method. MR-based quantification of fatty acid composition may allow for improved characterization of non-alcoholic fatty liver disease. A spectroscopic imaging method with appropriate sampling strategy allows whole-liver mapping of fat composition metrics in a free-breathing mouse model. Changes in metrics like the surrogate unsaturation index (UIs) are visible in mice receiving a diet which induces fat accumulation in the liver, as compared to a normal diet; such metrics may prove useful in future clinical studies of liver disease.

A High Dietary Incorporation Level of Chlorella vulgaris Improves the Nutritional Value of Pork Fat without Impairing the Performance of Finishing Pigs

Simple Summary

Pork is one of the most consumed meats worldwide but its production and quality are facing significant challenges, including feeding sustainability and the unhealthy image of fat. In fact, corn, and soybean, the two main conventional feedstuffs for pig production, are in unsustainable competition with the human food supply and biofuel industry. Moreover, the nutritional value of pork lipids is small due to their low contents of the beneficial n-3 polyunsaturated fatty acids and lipid-soluble antioxidants. The inclusion of microalgae in pig diets represents a promising approach for the development of sustainable pork production and the improvement of its quality. The current study aimed to investigate the impact of Chlorella vulgaris as ingredient (5% in the diet), alone and in combination with carbohydrases, on growth performance, carcass characteristics and pork quality traits in finishing pigs. Our data indicate that the use of 5% C. vulgaris in finishing pig diets does not impair animal growth and ameliorates the nutritional value of pork. Therefore, C. vulgaris could be used advantageously as an alternative sustainable ingredient in swine feeding.

Abstract

The influence of a high inclusion level of Chlorella vulgaris, individually and supplemented with two carbohydrase mixtures, in finishing pig diets was assessed on zootechnical performance, carcass characteristics, pork quality traits and nutritional value of pork fat. Forty crossbred entire male pigs, sons of Large White × Landrace sows crossed with Pietrain boars, with an initial live weight of 59.1 ± 5.69 kg were used in this trial. Swines were randomly assigned to one of four dietary treatments (n = 10): cereal and soybean meal-based diet (control), control diet with 5% C. vulgaris (CV), CV diet supplemented with 0.005% Rovabio^® Excel AP (CV + R) and CV diet supplemented with 0.01% of a four-CAZyme mixture (CV + M). Animals were slaughtered, after the finishing period, with a BW of 101 ± 1.9 kg. Growth performance, carcass characteristics and meat quality traits were not influenced (p > 0.05) by the incorporation of C. vulgaris in the diets. However, the inclusion of the microalga in finishing pig diets increased some lipid-soluble antioxidant pigments and n-3 PUFA, and decreased the n-6:n-3 ratio of fatty acids, thus ameliorating the nutritional value of pork fat. Moreover, the supplementation of diets with the carbohydrase mixtures did not change (p > 0.05) neither animal performance nor meat quality traits, indicating their inefficacy in the increase of digestive utilization of C. vulgaris by pigs under these experimental conditions. It is concluded that the use of C. vulgaris in finishing pig diets, at this high incorporation level, improves the nutritional value of pork fat without compromising pig performance.

Respiratory quotient: Effects of fatty acid composition

Respiratory quotient (RQ) is commonly used to infer which substrates are oxidized, with glucose yielding RQ = 1 and fat normally thought to yield an average of RQ = 0.71. Because fat depot compositions differ among species, we examined how the various common fatty acids affect RQ. RQs ranged from less than 0.7 (e.g., stearic acid) to greater than 0.76 (e.g., docosahexaenoic acid). Furthermore, we conducted a survey of the fatty acid composition of fuel lipids of several vertebrate taxa to determine how the RQ for lipid oxidation during fasting should vary among species. Our survey indicates that most fasting vertebrates from terrestrial ecosystems oxidizing fat should have RQs equaling approximately 0.71, as normally expected. However, some fasting animals in aquatic or marine systems-particularly fish-should have RQs as high as 0.73 when oxidizing only fat. Selective mobilization of fatty acids increased the lipid RQ, but probably by a negligible amount. We conclude that researchers should take habitat and taxon into account when choosing a value for lipid RQ, and preferably should use fatty acid composition for their study species to determine an appropriate RQ for lipids. In the absence of species-specific fatty acid composition data, we suggest assuming a lipid RQ of 0.725 for cold-water fish.

Survival of Phortica variegata experimentally and naturally infected with Thelazia callipaeda

Knowledge of the effects that Thelazia callipaeda (Spirurida, Thelaziidae) infection has on the survival of its vector Phortica variegata (Drosophilidae, Steganinae) is scarce. The present study aimed to: (a) assess the rate of infection between experimentally infected (EI) and not experimentally infected (NEI) flies and (b) determine how T. callipaeda infection may affect the survival of P. variegata. In addition, fat composition was evaluated in flies that died during overwintering. Molecular analysis showed that T. callipaeda prevalence in flies that died before experimental infection, plus those from the NEI group, is 0.75% (i.e. 11 out of 1462 individuals). The EI group showed a significantly higher positivity to T. callipaeda (i.e. 51 out of 682 individuals; 7.48%) compared with the NEI group (i.e. 9 out of 750 individuals; 1.2%). Thelazia callipaeda DNA was detected until 147 days after experimental infection. This demonstrates that larvae of this eyeworm may survive in the fly for a significant period of the winter. Fat composition analysis showed that flies produced more unsaturated than saturated fatty acids during diapause, probably because unsaturated fatty acids remain in a liquid state at lower temperatures, providing anti-freeze properties to survive winter.

Milk fatty acid profile from cows fed with mixed rations and different access time to pastureland during early lactation

Milk fatty acid (FA) profiles were determined in Holstein cows (n = 27) fed total mixed rations (TMR) ad libitum (G0) or diet composed by TMR (50% dry matter [DM] offered) plus grazing of pasture with 6 hr of access time to paddock in one session (G1) or 9 hr in two sessions (G2) at 45 days in milk (DIM). Moreover, milk FA was determined at 65 DIM when G0 cows turned out to G1 diet without adaptation period (Post-G0), G1 remained as controls. Milk FA was quantified using gas chromatography and mass spectrometry. Preformed FA at 45 DIM was greater (+27%) for G2 than G0 cows (p < .05). Stearic acid (C18:0) was 30% greater for G2 cows (p < .05). De novo FA was lowest for G2 cows (p < .05). Conjugated linoleic acid (CLA) did not differ (p < .12), while vaccenic acid (C18:1trans) was twofold greater for grazing treatments (p < .01). Linolenic acid [C18:3(n-3)] was greatest for G2 and lowest for G0 cows (p < .01). Omega 6 FA was greater for G0 than grazing cows, mainly due to linoleic acid [18:2cis(n-6); p < .05]. These results determined that n-6/n-3 ratio was almost threefold greater for G0 than grazing cows (p < .001). When diet of G0 cows changed to include pasture (Post-G0), preformed FA increased (p < .05), explained mainly by the increase (p < .05) of stearic (C18:0) and C18:1trans, while de novo FA tended to decrease (p < .1). Moreover, the amount of CLA and C18:3(n-3) tended to increase (p < .1) in Post-G0 cows. Offering 50% of dietary DM from pasture modified milk FA profile in early lactation potentially beneficial for human health. When TMR-fed cows were turned out to 50% pasture, milk FA profile reflected dietary change without need of an adaptation period.