http://localhost:8080/xmlui/handle/123456789/10630 Wed, 08 Apr 2026 21:07:38 GMT 2026-04-08T21:07:38Z http://localhost:8080/xmlui/handle/123456789/10645 Title: Seafood Toxicant Exposure During Pregnancy, Lactation, and Childhood and Child Outcomes: A Scoping Review Authors: Trivedi, Rupal; K Spill, Maureen; Saha, Sanjoy; C Thoerig, Rachel; S Davis, Julie; J MacFarlane, Amanda Abstract: ABSTRACT Determining dietary recommendations for seafood consumed during pregnancy, lactation, and childhood requires consideration of the known nutritional benefits and potential harm due to toxicant exposure as they relate to child outcomes. This study aimed to describe the scope of the evidence associated with seafood-related toxicant exposure and child outcomes and to identify toxicant–outcome pairs that may have sufficient evidence to conduct a systematic review. We included studies examining seafood toxicant exposure during pregnancy, lactation, and childhood, and child outcomes. In total, 81 studies were included: 69 studies on exposure during pregnancy and lactation and 14 on exposure during childhood. The number of studies varied by toxicant and exposure population (maternal; child): mercury (n ¼ 49; 7), methylmercury (n ¼ 13; 3), polychlorinated biphenyls (PCBs; n ¼ 11; 1), selenium (n ¼ 11; 1), lead (n ¼ 9; 3), perfluoroalkyl and polyfluoroalkyl substances (n ¼ 8; 2), dichlorodiphenyltrichloroethane (n ¼ 5; 1), arsenic (n ¼ 4; 4), cadmium (n ¼ 4; 4), zinc (n ¼ 3; 2), polybrominated diphenyl ethers (n ¼ 3; 1), dioxin-like compounds (n ¼ 3; 0), iron (n ¼ 2; 1), and magnesium (n ¼ 1; 1). No studies examined polybrominated biphenyls, polycyclic aromatic hydrocarbons, iodine, aldrin, dieldrin, chlordane, chlorpyrifos, or microplastic exposures. Outcomes also varied by exposure population (maternal;child): neurodevelopment (n ¼ 35; 9), child exposure biomarkers (n ¼ 22; 4), growth (n ¼ 17; 1), other adverse events (n ¼ 4; 0), cardiometabolic (n ¼ 3; 2), chronic disease indicators (n ¼ 2; 0), and immunerelated (n ¼ 1; 2). Twelve maternal toxicant–outcome pairs had 3 studies, including mercury, methylmercury, lead, PCBs, perfluoroalkyl and polyfluoroalkyl substances, and arsenic as exposures and neurodevelopment, child exposure biomarkers, growth, and cardiometabolic as outcomes. For child exposure, only mercury and neurodevelopment had 3 studies. In conclusion, this scoping review shows relevant evidence for 14 of the 22 toxicants. Only 12 maternal and 1 child toxicant–outcome pairs, the majority of which examined maternal (methyl)mercury exposure, had 3 studies, our cutoff for consideration for systematic review. This scoping review indicates a paucity of research examining seafood toxicants beyond mercury and exposure during childhood. Systematic reviews are required to evaluate the associations for each toxicant–outcome pairs. The protocol was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/FQZTA). Keywords: seafood, toxicants, pregnancy, lactation, childhood, child outcomes, scoping review Tue, 10 Dec 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/10645 2024-12-10T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10644 Title: Associations Between Maternal Polychlorinated Biphenyls (PCBs) Exposure from Seafood Consumption during Pregnancy and Lactation and Child Growth: A Systematic Review and Meta-Analysis Authors: A Balalian, Arin; K Spil, Maureen; C Thoerig, Rachel; Trived, Rupal; Saha, Sanjoy; J Foste, Margaret; J MacFarlane, Amanda Abstract: ABSTRACT Beyond its nutritional benefits, seafood is a source of toxicant exposure including polychlorinated biphenyls (PCB). The association of PCB exposure from seafood intake during pregnancy and/or lactation (PL) and child growth outcomes is uncertain. This systematic review investigated the evidence and quantified the association between PCB exposure during PL from seafood intake and child growth outcomes. Embase, PubMed, and CENTRAL databases were searched from their inception for peer-reviewed English articles. Records were screened independently by 2 researchers at title and abstract, and then full-text levels. Studies were included if they: 1) were conducted in a country with a high Human Development Index, 2) measured maternal PCB exposure directly, 3) assessed the relationship between PCB and seafood exposures or PCB or seafood associations with a child growth outcome, and 4) were randomized or nonrandomized interventions, cohort, or nested case-control studies. Pooled partial correlations (rp) were calculated using random-effects models for studies with sufficient data and narratively for the remaining studies. Cochrane ROBINS-E and GRADE tools were used to assess risk of bias and certainty of evidence, respectively. Child growth outcomes included birthweight, birth length, head and chest circumference at birth, and small for gestational age (SGA). Seven studies were included. PCB exposure during PL was weakly but significantly associated with lower birthweight [rp ¼ 0.07; 95% confidence interval (CI): 0.12, 0.02; n ¼ 5], but showed no association with birth length (rp ¼ 0.04; 95% CI: 0.09, 0.02; n ¼ 4) and head circumference (rp ¼ 0.03, 95% CI: 0.09, 0.03; n ¼ 3). Studies on SGA and chest circumference yielded inconclusive results. The certainty of the evidence was low or very low because of the risk of bias from confounding, missing data, and exposure misclassification. The evidence suggests minimal to no link between PCB exposure from seafood during PL on child growth outcomes but with low to very low certainty. This trial was registered at PROSPERO as CRD42023493302. Keywords: polychlorinated biphenyls, PCB, child growth, birthweight, pregnancy, lactation Sat, 30 Nov 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/10644 2024-11-30T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10643 Title: Nutritional Optimization of the Surgical Patient: A Narrative Review Authors: Heutlinger, Olivia; Acharya, Nischal; Tedesco, Amanda; Ramesh, Ashish; Smith, Brian; T Nguyen, Ninh; E Wischmeyer, Paul Abstract: ABSTRACT An increasing body of literature supports the clinical benefit of nutritional assessment and optimization in surgical patients; however, this data has yet to be consolidated in a practical fashion for use by surgeons. In this narrative review, we concisely aggregate emerging data to highlight the role of nutritional optimization as a promising, practical perioperative intervention to reduce complications and improve outcomes in surgical patients. This review of the surgical nutrition literature was conducted via large database review. There were no distinct inclusion/exclusion criteria for this review; however, we focused on adult populations using up-to-date literature from high-quality systematic reviews or randomized controlled trials when available. Current perioperative management focuses on the mitigation of intraoperative and immediate postoperative complications. Well-defined risk calculators attempt to stratify patient surgical risk preoperatively to reduce adverse events directly related to surgical procedures, such as hemorrhage, cardiopulmonary compromise, or infection. However, there is a lack of standardization of prognostic tools, nutritional protocols, and guidelines governing the assessment, composition, and administration of nutritional supplementation. Substantial data exist demonstrating the clinical benefit in the operative setting. In this work, we provide a fundamental primer for surgeons to understand the clinical importance of nutritional optimization along with practical prognostic tools and recommendations for use in their practice. While the extent to which nutritional optimization improves patient outcomes is debatable, the evidence clearly demonstrates a clinically meaningful benefit. Evaluating nutritional status differs based on disease severity and etiology of presentation, thus surgeons must select the appropriate prognostic tools to assess their patients during the perioperative period. This information will catalyze subsequent work with a multidisciplinary team to provide personalized dietary plans for patients and spark research to establish protocols for specific presentations. Keywords: nutritional optimization, surgical nutrition, nutritional screening tools, perioperative nutrition guidelines, perioperative nutrition screening Fri, 29 Nov 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/10643 2024-11-29T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10642 Title: Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Authors: Viscardi, Gabrielle; Back, Songhee; Ahmed, Amna; Yang, Shuting; Blanco Mejia, Sonia; WC Kendal, Cyril Abstract: ABSTRACT Despite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plantpredominant diets, controversies around the effects of soy foods, especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women. This systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women. MEDLINE, Embase, and Cochrane Library were searched through August 2024 for randomized trials 3-mo investigating soy isoflavones compared with non-isoflavone controls in postmenopausal women. Outcomes included endometrial thickness (ET), vaginal maturation index (VMI), follicle-stimulating hormone (FSH), and estradiol. Independent authors extracted data and assessed risk of bias. Grading of Recommendations, Assessment, Development and Evaluation was used to assess certainty of evidence. We included 40 trials (52 trial comparisons, n ¼ 3285) assessing the effect of a median reported dose of 75 mg/d of soy isoflavones in substitution for non-isoflavone controls over a median of 24 wk. Soy isoflavones had no statistically significant effect on any measure of estrogenicity; ET [mean difference, –0.22 mm (95% confidence interval, –0.45, 0.01 mm), PMD ¼ 0.059], VMI [2.31 (–2.14, 6.75), PMD ¼ 0.310], FSH [–0.02 IU/L (–2.39, 2.35 IU/L), PMD ¼ 0.987], and estradiol [1.61 pmol/L (–1.17, 4.38 pmol/L), PMD ¼ 0.256]. The certainty of evidence was high to moderate for all outcomes. Current evidence suggests that soy isoflavones do not exhibit estrogenic effects compared with non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women. This synthesis supports that soy isoflavones likely act as selective estrogen receptor modulators, differing clinically from the hormone estrogen. Addressing public health concerns may promote soy foods as high-quality plant protein sources with low environmental impact and cost, particularly benefiting postmenopausal women and aligning with sustainable dietary patterns and guidelines. This study was registered in PROSPERO as CRD42023439239. Keywords: soy isoflavones, soy foods, postmenopause, women, endometrial thickness, vaginal maturation index, follicle-stimulating hormone, estradiol, meta-analysis, systematic review Sun, 20 Oct 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/10642 2024-10-20T00:00:00Z