Investigation Of Dietary Nutrition Status In Patients With Helicobacter Pylori Infection And Intervention Effect Of Cranberry Juice In Binzhou

ObjectionHelicobacter pylori?Hp?is a microaerophilic gram-negative bacterium,which is the main cause of gastrointestinal diseases,and it is recognized as a major source of gastrointestinal diseases.Hp is closely related to diet.Cranberry is rich in polyphenols.This study was to investigate the prevalence and influencing factors of Hp infection in Binzhou,analyze the dietary nutritional status in patients with Hp infection,and explore the inhibitory effect of cranberry juice on Hp.MethodsFrom July 2014 to June 2018,13,588 subjects,who completed the ¹⁴C-urea breath test(¹⁴C-UBT)or ¹³C-urea breath test(¹³C-UBT)in a hospital in Binzhou City,Shandong Province,China,were selected to participate in the study.Diagnostic criteria for Hp by delta-over-baseline?DOB?:more than 100 was considered as positive while less than 100was negative in the ¹⁴C-UBT test;DOB more than 4.0 was considered as positive while less than 4.0 was negative in the ¹³C-UBT test.The results of physical and clinical examination of all subjects were collected,and the association between Hp infection and possible influencing factors was analyzed.In addition,1,140 subjects who completed UBT were selected randomly.Dietary consumption by the selected subjects was collected via a 24-hour dietary recall for 3 days,and nutrient intake level and energy source were evaluated.The weekly dietary type and food consumption level of the subjects were collected via the food frequency questionnaire?FFQ?over the past?about 6 months?;and the dietary diversity score?DDS?of each subject was calculated by accumulating the type of food consumed within 7 days.Consuming one type gets one point;consuming two types gets two points;up to 9 points.Cranberry juice intervention study was carried out.According to the inclusion and exclusion criteria,399 subjects with Hp who was diagnosed via ¹³C-UBT from Binzhou ranging from 18 to 65 years of age were selected,and divided into high dose group A?two bottles of 27%of cranberry juice?,medium dose group B?one bottle of 27%of cranberry juice and one bottle of placebo?,low dose group C?two bottles of placebo?via the random number table.The results of physical examination of all subjects were collected before intervention and after 4 weeks of intervention,including height,weight,blood pressure,waist and hip circumference etc.The ¹³C-UBT was performed to evaluate the supplementary effect of cranberry juice.ResultsA total of 13,588 subjects were initially enrolled in the study,and the infection rate of Hp in Binzhou was 58.6%,and the infection rate of male and female was 59.5%and 54.7%respectively?P<0.05?.The infection rate of young group,middle-aged group and old group was 56.2%,59.2%and 60.7%respectively;and the infection rate of the old group was significantly higher than that of the young group?P<0.05?.The infection rate of the non-smoking group?57.6%?was significantly lower than that of the smoking group?61.9%??P<0.05?.The infection rate of non-drinking group was 56.4%,which was significantly lower than that of the drinking group?61.5%??P<0.05?.The infection rate of low-weight,normal weight,overweight and obese groups was 57.8%,55.7%,59.7%and 60.8%,respectively.The infection rates of overweight and obese groups were significantly higher than that of normal group?P all<0.05?.The infection rate of subjects with hypertension,abnormal blood sugar,fatty liver and metabolic syndrome was 61.4%,61.0%,59.7%and61.7%respectively,all significantly higher than that of health subjects?P all<0.05?.After correcting the confounding factors,smoking,drinking,overweight,obesity and hypertension were risk factors for Hp infection.Nutritional status analysis showed that the amount of average energy intake in the Hp-infected group was 1980.14 kcal/d,significantly higher than that in the non-infected group?1822.57kcal/d??P<0.05?;the level of average carbohydrate in the Hp-infected group was 287.51g/d,significantly higher than that in non-infected group?253.81g/d??P<0.05?;and the level of average fat in the Hp-infected group was 62.50 g/d,significantly higher than that in non-infected group 59.69g/d?P<0.05?.The level of average thiamin,riboflavin,nicotinic acid and ascorbic acid in the Hp-infected group was 0.84mg/d,0.96mg/d,11.12mg/d and 72.98mg/d respectively,significantly lower than that in non-infected group?P all<0.05?.The level of average potassium and calcium in the Hp-infected group was1588.28mg/d and 320.17mg/d respectively,all significantly lower than that in non-infected group?P<0.05?;The level of average vegetables and fruits in the Hp-infected group was287.30g/d and 90.41g/d respectively,significantly lower than that in non-infected group?P all<0.05?.The dietary diversity score of non-infected group was 7.58,significantly higher than that in the infected group?P<0.05?.The results of the intervention study using cranberry juice showed that the conversion rate back to negative DOB of group A,group B and group C was 17.7%,16.1%and 22.6%respectively,at 14 days of intervention?P>0.05?,and after 28 days the conversion rate back to negative DOB of group A,group B and group C was 20.5%,16.2%and 24.0%respectively.There was no significant change among the three groups?P>0.05?.After intervention,the conversion rate back to negative DOB of group A,group B and group C had no significant difference compared with that before intervention.Before supplementary intervention the Hp colonization density of group A,group B and group C was 13.35,13.05and 16.00,respectively,and there was no significant change among the three groups?P>0.05?;after 28 days,the Hp colonization density of group A,group B and group C was11.40,12.00 and 11.20,respectively,and there was no significant change among the three groups?P>0.05?.The Hp colonization density after intervention had significant difference compared with that before intervention in group A,group B and group C?P all<0.05?.ConclusionHp infection rate is high in Binzhou,which is related to sex,age,nutritional status and hypertension.For Hp-infected group,the consumption level of energy,carbohydrate and fat is higher,the consumption level of the vegetable and the fruit is lower,and the dietary structure is single.In a short time,supplementation of cranberry juice did not significantly improve the conversion rate back to negative DOB for Hp infection.