Authors:Beaulieu; Sandrine, Vachon, Annick, Plourde, Mélanie First page: 2 Abstract: Coenzyme Q10 (CoQ10), a lipid involved in ATP synthesis, exhibits very limited oral absorption, and its endogenous production decreases with ageing and with the occurrence of oxidative stress. Our group previously showed that monoglycerides omega-3 (MAG-OM3) increase OM3 plasma concentrations. Since CoQ10 is liposoluble, we hypothesised that its 48 h pharmacokinetics is higher when provided with MAG-OM3 compared to CoQ10 alone (in powder form) or added to rice oil (a neutral triacylglycerol oil). A randomised triple-blind crossover study was performed with fifteen men and fifteen women consuming the three supplements providing 200 mg of CoQ10 in a random order. Blood samples were collected before (t = 0) and 1, 3, 5, 6, 7, 8, 10, 11, 24 and 48 h after the supplement intake. Plasma total CoQ10 concentrations were analysed on ultrahigh-performance liquid chromatography coupled to a tandem mass spectrometer (UPLC-MS/MS). Participants were 26⋅1 ± 4⋅8 years old. When CoQ10 was provided with rice or MAG-OM3 oils, the 48 h area under the curve (AUC 0–48 h) was approximately two times higher compared to when provided without an oil. The delta max concentration (ΔCmax) of plasma CoQ10 was, respectively, 2 (MAG-OM3) and 2⋅5 (rice oil) times higher compared to CoQ10 alone. There was a significant sex by treatment interaction (P = 0⋅0250) for the AUC 0–6 h supporting that in postprandial, men and women do not respond the same way to the different supplement. Women had a higher CoQ10 concentration 48 h after the single-dose intake compared to men. We conclude that CoQ10 supplements must be provided with lipids, and their kinetics is different between men and women. PubDate: 2022-01-18 DOI: 10.1017/jns.2021.106
Authors:Terminel-Zaragoza; Ricardo, Vega-López, Sonia, Ulloa-Mercado, Gabriela, Serna-Gutiérrez, Araceli, Gortares-Moroyoqui, Pablo, Díaz-Tenorio, Lourdes, Rentería-Mexía, Ana First page: 3 Abstract: There is a lack of region-adapted tools to evaluate diet as a risk factor for cardiovascular disease (CVD) in adolescents. The study aim was to evaluate the reproducibility and validity of a paper-based and region-adapted food frequency questionnaire (FFQ) designed to assess CVD-related food and nutrient intakes of adolescents from Northwest México. The study design was cross-sectional. The FFQ was developed in a two-step process: prototype designing and a pilot test, with re-tested in a 3-month period, along with two administrations of 24 h-recall (24 hR). Pearson's and intra-class correlation coefficients (PCC and ICC) were assessed. Bland–Altman plots, limits of agreement and quintile classifications were carried out. Participants (n 221) were 53·8 % male, 18·5 ± 0·4 years old. Reproducibility had a median PCC = 0·66 for processed meats, ranging from 0·40 (saturated fat) to 0·74 (fish & shellfish), P = 0·001. ICC ranged from 0·53 (saturated fat) to 0·80 (sodium; and nuts, seeds and legumes), P = 0·001. Validity comparing FFQ1 v. 24 hR mean, PCCs ranged from 0·12 (P = 0·06) to 0·95 (P = 0·001), and ICC from 0·20 (P = 0·048) to 0·88 (P = 0·001); comparing FFQ2 v. 24 hR mean, PCCs ranged from 0·07 (P = 0·25) to 0·46 (P = 0·001), and ICC from 0·15 (P = 0·106) to 0·58 (P = 0·001). The FFQ overestimated the intake of all food groups and nutrients (P < 0·05), while Cohen's κ showed coefficients lower than 0·20. The proposed FFQ represents a moderately validated tool to estimate CVD-related food and nutrient intakes as a risk factor, which can be used in combination with multiple administrations of 24 hRs, as a critical mean in future interventions intended to reduce cardiometabolic risk in adolescents. PubDate: 2022-02-02 DOI: 10.1017/jns.2022.1
Authors:Rai; Rajesh Kumar, Kumar, Sandhya S., Kumar, Chandan First page: 4 Abstract: Recognising the importance of infant and young child feeding practices during the first 2 years of life, the World Health Organization's Global Nutrition Monitoring Framework developed a minimum dietary diversity (MDD) indicator for feeding children aged 6–23 months. MDD is defined as the consumption of food items from five or more groups out of a total of eight food groups. Food intake from less than five food groups is considered minimum dietary diversity failure (MDDF). Using the nationally representative National Family Health Survey (NFHS) dataset, the present study assessed the trend in MDDF between 2005–6 and 2015–16 and the factors associated with MDDF among children aged 6–23 months during 2015–16. The NFHS conducted in 2005–6 and 2015–16 covered a sample of 14 419 and 74 078 children aged 6–23 months, respectively. Overall, the MDDF reduced from 87⋅4 % (95 % confidence interval (95 % CI) 86⋅8 %, 87⋅9 %) in 2005–6 to 80⋅6 % (95 % CI 80⋅1 %, 81⋅0 %) in 2015–16. Multivariable logistic regression analysis revealed that increased child's age, second and third birth order children, higher maternal age and education, mass media exposure of mothers and more than four antenatal care visits had a negative association with the MDDF. Children living in rural areas and residing in high-focus states of India were observed with higher odds of experiencing MDDF. Exposure to community healthcare services was negatively associated with MDDF, and anaemic children were more likely to have MDDF. Socioeconomic status of mothers and children and encouragement of maternal and child healthcare use could be helpful in devising context-specific intervention to mitigate MDDF. PubDate: 2022-02-04 DOI: 10.1017/jns.2022.2
Authors:Dunière; Lysiane, Renaud, Justin B., Steele, Michael A., Achard, Caroline S., Forano, Evelyne, Chaucheyras-Durand, Frédérique First page: 5 Abstract: Colostrum quality is of paramount importance in the management of optimal ruminant growth and infectious disease prevention in early life. Live yeast supplementation effect during the last month of gestation was evaluated on ewes’ colostrum composition. Two groups of ewes (n = 14) carrying twin lambs were constituted and twins were separated into groups (mothered or artificially fed) 12 h after birth. Nutrient, oligosaccharides (OS), IgG and lactoferrin concentrations were measured over 72 h after lambing, and bacterial community was described in colostrum collected at parturition (T0). Immune passive transfer was evaluated through IgG measurement in lamb serum. In both groups, colostral nutrient, OS concentrations and IgG concentrations in colostrum and lamb serum decreased over time (P < 0⋅01), except for lactose, which slightly increased (P < 0⋅001), and lactoferrin, which remained stable. Bacterial population was stable over time with high relative abundances of Aerococcaceae, Corynebacteriaceae, Moraxellaceae and Staphylococcaceae in T0 colostrum. No effect of supplementation was observed in nutrient and lactoferrin concentrations. In supplemented ewes, the level of colostral IgG was higher at T0 and a higher level of serum IgG was observed in lambs born from supplemented mothers and artificially fed, while no effect of supplementation was observed in the mothered lamb groups. Using a metabolomic approach, we showed that supplementation affected OS composition with significantly higher levels of colostral Neu-5Gc compounds up to 5 h after birth. No effect of supplementation was observed on bacterial composition. Our data suggest that live yeast supplementation offsets the negative impact of early separation and incomplete colostrum feeding in neonate lambs. PubDate: 2022-02-07 DOI: 10.1017/jns.2022.3
Authors:Nyakundi; Patrick Nyamemba, Kiio, Juliana, Munyaka, Ann Wambui First page: 6 Abstract: Information on consumption patterns of iron- and ascorbate-rich foods and their influence on iron status among women of childbearing age (WCA) is scarce in Kenya despite iron deficiency being rampant. The present study investigated consumption patterns of iron- and ascorbate-rich foods on iron status among WCA in Kapsabet Ward, Kenya. The study adopted a cross-sectional analytical design. A sample of 160 respondents was systematically selected proportionately in the eight villages. Consumption patterns of iron- and ascorbate-rich foods were assessed using a modified 7-d Food Frequency Questionnaire. Venous blood (2 ml) was drawn from participants. Serum ferritin and C-reactive proteins were measured by enzyme immunoassay. Consumption patterns of iron- and ascorbate-rich foods were analysed using descriptive statistics. Multivariable regression was conducted to investigate the association between iron- and ascorbate-rich foods consumption and iron status. Confounding variables such as consumption of foods high phytate levels, milk and milk products, recent major blood losses and parasitic infections were controlled for during analysis. The prevalence of iron deficiency among the WCA was 45⋅0 %. Iron-rich foods were rarely ( PubDate: 2022-02-08 DOI: 10.1017/jns.2022.5
Authors:Khatti-Dizabadi; Freshteh, Yazdani-Charati, Jamshid, Amani, Reza, Mostafavi, Firoozeh First page: 7 Abstract: Increasing fruit and vegetable (F&V) intake has a protective role against chronic conditions such as cardiovascular disease, cancer and diabetes. The present study aimed to validate an instrument for measuring the perception of effective factors on consumption behaviour of F&V based on Pender's health promotion model (HPM).This cross-sectional validation survey has consisted of five steps: literature review in order to plan and develop an instrument, face validity assessment, content validity assessment, reliability assessment and construct validity assessment with the cooperation of experts in health education, nutritionists and the target group (government employees). In the present study, reliability and validity of constructs were determined through Cronbach's alpha and exploratory factor analysis, respectively, in SPSS 22. The mean impact score was acceptable for 96·42 % of items in face validity. The mean scores of content validity ratio (CVR), content validity index (CVI) and reliability were 0·92, 0·97 and 0·96, respectively. According to the principal component analysis with varimax rotation, 104 items were identified in 15 factors contributing to 61·17 % of the model cumulative variance. Given the favourable scores of the research instrument in face validity, content validity and reliability as well as its ability to predict the extracted factors from the model, it can be used as a suitable instrument in future studies. PubDate: 2022-02-09 DOI: 10.1017/jns.2021.90
Authors:Anato; Anchamo First page: 8 Abstract: Child undernutrition is widespread in low- and middle-income countries and is linked with weakened immunity and increased risks of morbidity and mortality. Ethiopia has made a marked reduction in stunting, but there has, however, been little progress in wasting reduction and limited evidence in food insecure areas may hamper the design of effective interventions. Therefore, the aim of the present study was to determine the contributing factors to persistent high prevalence of wasting among 6–59-month-old children. A community-based cross-sectional study was employed in February to March 2020, and included 384 mother–child pairs. Data were collected using a structured interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were conducted. The overall prevalence of wasting was 12⋅8 % (95 % CI 9⋅1, 16⋅1); with 5⋅8 % severely wasted. Factors significantly associated with wasting were child age 6–23 (v. 24–59 months), delayed initiation of breast-feeding, diarrhoeal illness in the last 2 weeks, poor dietary diversity and low socioeconomic status. The present findings support that aligning poverty reduction interventions and healthcare services is important to accelerate wasting reduction more equitably and achieve the World Health Assembly's target and SDG goal #2 in the coming years. Improving accessibility and affordability of nutritious foods and early diagnosis and treatment of childhood morbidity are critical to address childhood wasting in the context of food insecure areas. PubDate: 2022-02-09 DOI: 10.1017/jns.2022.8
Authors:Tonheim; Live Edvardsen, Austad, Elisabeth, Torheim, Liv Elin, Henjum, Sigrun First page: 9 Abstract: Objective: To assess and compare the macronutrient and salt content in meat and dairy substitutes available on the Norwegian market. Design: Comparison between substitute products and two groups of meat and dairy products where one group represented the healthiest option (Keyhole) and one the most used option (Regular). Kruskal–Wallis test with pairwise comparison was conducted on categories with more than two groups, and Mann–Whitney U test was conducted on categories with two groups. Setting: Online stores in Norway. Hundred and two meat substitute products and 173 milk and dairy substitute products on sale spring and autumn 2020 were assessed; additionally, ninety-eight equivalent meat products and 105 milk and dairy products. Results: While Keyhole and Regular meat did not contain fibre, meat substitutes contained 3⋅5–5⋅0 g fibre per 100 g. The saturated fat content in meat substitutes was on average 1⋅9 times lower than in Keyhole products and 5⋅8 times lower than in Regular products. Milk and dairy substitutes contained 3⋅2 and 3⋅4 times less protein than Keyhole and Regular products, respectively. Conclusions: The study results indicate that meat and dairy substitutes on the Norwegian market vary in nutritional composition. Compared to Keyhole and Regular, substitutes contained lower levels of saturated fat, meat substitutes contained higher levels of fibre and milk and dairy substitutes less protein. Future studies should include content of micronutrients for a more comprehensive assessment. PubDate: 2022-02-10 DOI: 10.1017/jns.2022.6
Authors:Márquez-Herrera; Roxana M., Cortés-Sanabria, Laura, Cueto-Manzano, Alfonso M., Martínez-Ramírez, Héctor R., Rojas-Campos, Enrique, Orozco-González, Claudia N., González-Palacios, Aaron First page: 10 Abstract: The aim of the present study was to develop and validate a test to evaluate dietitian's clinical competence (CC) about nutritional care in patients with early chronic kidney disease (CKD). The study was conducted through five steps: (1) CC and its dimensions were defined; (2) test items were elaborated, and choice of response format and scoring system was selected; (3) content and face validity were established; (4) test was subjected to a pilot test and those items with inadequate performance were removed; (5) criterion validity and internal consistency for final validation were established. A 120-items test was developed and applied to 207 dietitians for validation. Dietitians with previous CKD training obtained higher scores than those with no training, confirming the test validity criterion. According to item analysis, Cronbach's α was 0⋅85, difficulty index 0⋅61 ± 0⋅22, discrimination index 0⋅26 ± 0⋅15 and inter-item correlation 0⋅19 ± 0⋅11, displaying adequate internal consistency. PubDate: 2022-02-15 DOI: 10.1017/jns.2022.4
Authors:Farapti; Farapti, Buanasita, Annas, Atmaka, Dominikus R., Setyaningtyas, Stefania W., Adriani, Merryana, Rejeki, Purwo S., Yamaoka, Yoshio, Miftahussurur, Muhammad First page: 11 Abstract: Increasing potassium and reducing sodium intake have been identified as a priority intervention to reduce non-communicable diseases. A low sodium high potassium (LSHP) healthy diet can be a predictor of overall dietary quality and is associated with higher diet costs. The present study was a randomised controlled-feeding trial, formulating menus of low sodium and potassium-rich healthy diet and comparing with usual diet (a control diet based on typical Indonesian diet) to assess the association of potassium intake in the menus with other nutritional contents and diet cost. Totally seventy menus, which consisted of LSHP diets and the usual diets for a 7-d cycle, were composed from the analysis of the Indonesian food composition database. The correlation coefficient of the potassium content of all menus with nutritional quality and diet cost was analysed using the Pearson test. Multiple linear regression analysis was performed to determine the most important nutrient in determining diet cost. A comparison of nutrition quality and diet cost from the two menus was analysed using the independent t-test. LSHP diet had significantly higher carbohydrate, protein, fibre, magnesium, calcium, vitamin C, potassium density and diet cost but lower total fat, saturated fat and energy density than the usual diet (P < 0⋅05). Furthermore, there was a strong positive correlation between fibre, potassium and diet cost (coefficient correlation of>0⋅8). Potassium is a nutrient that is closely related to diet quality although the cost of the diet often may inhibit its intake. A targeted and effective strategy is required to provide affordable food for achieving a sustainable nutrient-rich diet. PubDate: 2022-02-16 DOI: 10.1017/jns.2021.104
Authors:Gholizadeh; Mohammad, Setayesh, Leila, Yarizadeh, Habib, Mirzababaei, Atieh, Clark, Cain C. T., Mirzaei, Khadijeh First page: 12 Abstract: The co-existence of overweight or obesity with concurrent deficiency of one or more nutrients is referred to as double burden of malnutrition (DBM), and numerous mental health impairments have been associated with a variety of nutrient deficiencies. Although DBM is relevant for several health outcomes, the ubiquitous involvement of vitamin D across multiple systems and tissues suggests D insufficiency as a viable target for nutritional modification. The present study aimed to evaluate the contribution of DBM and mental health among adult women. Study participants included 300 women, aged 18–59 years, who presented to one of the 25 health centres in Tehran. Participants with a body mass index (BMI) of greater than 25 kg/m2 and a plasma concentration of 25-hydroxy vitamin D [25(OH)D] of>20 ng/ml were considered to have DBM. The 147-item food frequency questionnaire was used to estimate their dietary intake. Mental health status was assessed using the depression, anxiety and stress scales-21 (DASS-21). The mean ± standard deviation age, weight and BMI of the participants were 36⋅49 ± 8⋅38, 80⋅89 ± 12⋅45 kg and 31⋅04 ± 4⋅31 kg/m2, respectively. DBM was significantly associated with stress, after adjusting for potential confounders, including age, energy and marital status in model 1 (OR = 1⋅28, 95 % confidence interval (CI) 1⋅00, 1⋅65, P < 0⋅04) v. the crude model (OR = 1⋅22; 95 % CI 0⋅96, 1⋅55, P = 0⋅09). No significant association was seen among DBM and DASS-21 outcomes. In this cross-sectional study, stress and DBM were significantly associated. While vitamin D insufficiency was associated with mental health and obesity in opposing directions. Elucidation of whether vitamin D supplementation can improve mental health impairments requires further evaluation. PubDate: 2022-02-21 DOI: 10.1017/jns.2022.7
Authors:Fraser; David R. First page: 13 Abstract: Since the discovery of vitamin D, it has been accepted that its physiological supply is either from food or by endogenous synthesis in skin exposed to solar UV light. Yet vitamin D is a component of very few foods and its supply as a natural nutrient is unable to maintain good vitamin D status for human populations. One aspect of vitamin D physiology that has been ignored is that the mechanisms for its transport and processing from these two sources are quite different. Excess intake of vitamin D causes hypercalcaemic toxicity. However, experiments with different animal species have shown that long-term supply of oral vitamin D in apparently non-toxic amounts causes atherosclerosis in large arteries. A mechanism for this toxicity is proposed. Alternative strategies for addressing widespread vitamin D deficiency by food fortification should be considered in light of the angiotoxicity caused by oral vitamin D in animal experiments. PubDate: 2022-02-21 DOI: 10.1017/jns.2022.11
Authors:Khatri; Yunus First page: 14 Abstract: Objective: To explore food consumption and subsequent behavioural changes amongst PASC suffers associated with alterations in taste and smell. Design: A qualitative study involving five focus groups. Setting: Birmingham and Leicester, England, United Kingdom. Participants: Forty-seven Post-Acute Sequelae of COVID-19 sufferers. Results: Shifts in taste and odour were very common with disgusting or unpleasant notes being perceived in many foods, including animal products rich in protein. Food consumption patterns varied affecting nutrition status, individuals weight, types of foods consumed, cooking habits, coping mechanisms, anxieties, family and social interactions. Individuals expressed the need to taste something or experience normal tastes and flavour. Low pH foods, highly processed foods which may contain large amounts of refined sugars as well as cold processed food were the preferred items for consumption. Conclusion: Olfactory dysfunction was related to the consumption of nutrients that require moderation and to the quality of life. Intervention at an early stage is necessary in order to help avoid such complications and thus, this work informs medical practitioners and health workers of the variety of food choices that are more acceptable for people suffering from altered tastes and odour perception. PubDate: 2022-02-18 DOI: 10.1017/jns.2022.19
Authors:So; Daniel, Yao, Chu K., Gibson, Peter R., Muir, Jane G. First page: 15 Abstract: Resistant starch 2 (RS2) may offer therapeutic value to irritable bowel syndrome (IBS) patients particularly in combination with minimally fermented fibre, but tolerability data are lacking. The present study evaluated the tolerability of RS2, sugarcane bagasse and their combination in IBS patients and healthy controls. Following baseline, participants consumed the fibres in escalating doses lasting 3 d each: RS2 (10, 15 and 20 g/d); sugarcane bagasse (5, 10 and 15 g/d); and their combination (20, 25 and 30 g/d). Gastrointestinal symptoms were assessed daily. Six IBS patients and five controls were recruited. No differences in overall symptoms from baseline were found across the fibre doses (IBS, P = 0⋅586; controls, P = 0⋅687). For IBS patients, all RS2 doses led to increased bloating. One IBS patient did not tolerate the low combination dose and another the high sugarcane bagasse dose. Supplementation of RS2 ≤ 20 g/d caused mild symptoms and was generally tolerated in IBS patients even when combined with minimally fermented fibre. PubDate: 2022-02-21 DOI: 10.1017/jns.2022.9
Authors:Guarneiri; Liana L., Paton, Chad M., Cooper, Jamie A. First page: 16 Abstract: Substantial evidence suggests that regular tree nut consumption does not lead to changes in body weight (BW). However, these studies used a variety of dietary substitution instructions which may confound the interpretation of prior BW outcomes. The purpose of the present study was to examine the impact of daily pecan consumption, with or without isocaloric substitution instructions, on BW and composition. This was an 8-week randomised, controlled trial with three treatments: a nut-free control group (n 32) and two pecan groups. ADD (n 30) consumed pecans (68 g/d) as part of a free-living diet, and SUB (n 31) substituted the pecans (68 g/d) for isocaloric foods from their habitual diet. BW and total body fat percentage (BF) were measured, and theoretical changes in these outcomes if pecans were consumed without compensation were determined. BW increased in all groups across the intervention, and there was a trend (P = 0⋅09) for an increase in ADD (1⋅1 ± 0⋅2 kg) and SUB (0⋅9 ± 0⋅3 kg) compared to control (0⋅3 ± 0⋅2 kg). In addition, there was increased BF in SUB (1⋅0 ± 0⋅3 %; P = 0⋅005) but not ADD (0⋅1 ± 0⋅2 %) or control (−0⋅2 ± 0⋅3 %) There was a large difference in the actual v. theoretical change in BW regardless of pecan treatment (actual: 1⋅1 ± 0⋅2 and 0⋅9 ± 0⋅3 v. theoretical: 3⋅3 ± 0⋅0 and 3⋅2 ± 0⋅0 kg in ADD and SUB, respectively; P < 0⋅001). Furthermore, there was a difference in actual v. theoretical change in BF in ADD (0⋅1 ± 0⋅2 v. 1⋅2 ± 0⋅1 %; P = 0⋅002) but not SUB or control. In conclusion, daily pecan consumption for 8 weeks did not result in significant weight gain, regardless of dietary substitution instructions. PubDate: 2022-03-07 DOI: 10.1017/jns.2022.14
Authors:Rizzo; Gianluca, Feraco, Alessandra, Storz, Maximilian Andreas, Lombardo, Mauro First page: 17 Abstract:Soy is a key food in human nutrition. It is widely used in eastern traditional cuisine and it has recently diffused among self-conscious and vegetarian diets. The success of soy mainly depends on versatility and supposed healthy properties of soy foods and soy components. Meanwhile, the possible influence on endocrine system, in particular by isoflavones, raised concerns among some researchers. The present paper aims to conduct a review of available data on the effect of soy, soy foods and soy components on women's fertility and related outcomes. Eleven interventional studies, eleven observational studies and one meta-analysis have been selected from the results of queries. A weak, not clinically relevant effect has been highlighted on cycle length and hormonal status. However, a suggestive positive influence has been shown among women with fertility issues and during assisted reproductive technologies. Overall, soy and soy components consumption do not seem to perturb healthy women's fertility and can have a favourable effect among subjects seeking pregnancy. However, because of the paucity of studies exploring the impact of soy intake on women's fertility, as well as the limited population sample size, the frequently incomplete specimens’ collection to investigate all cycle phases and the insufficient characterisation of participants, the evidence is suggestive and it needs further in-depth research taking into account all these aspects. PubDate: 2022-03-07 DOI: 10.1017/jns.2022.15
Authors:Løvschal; Line B., Høgh, Stinne, Bergholt, Thomas, Maslin, Kate, Shawe, Jill, Hegaard, Hanne K., de Wolff, Mie G. First page: 19 Abstract: In 2013, the Danish Health Authorities recommended a change in prophylactic iron supplementation to 40–50 mg/d from gestational week 10. Hence, the aims of the present study were (1) to estimate the prevalence of women who follow the Danish recommendation on iron supplementation during the last 3 weeks of the first trimester of pregnancy and (2) to identify potential sociodemographic, reproductive and health-related pre-pregnancy predictors for iron supplementation during the first trimester. We conducted a cross-sectional study with data from the hospital-based Copenhagen Pregnancy Cohort. Characteristics were analysed by descriptive statistics and multivariable logistic regression analysis was performed to examine the associations between predictors and iron supplementation during the last 3 weeks of the first trimester. The study population consisted of 23 533 pregnant women attending antenatal care at Copenhagen University Hospital - Rigshospitalet from October 2013 to May 2019. The prevalence of iron supplementation according to recommendations was 49⋅1 %. The pre-pregnancy factors of ≥40 years of age, the educational level below a higher degree and a vegetarian or vegan diet were identified as predictors for iron supplementation during the first trimester of pregnancy. Approximately half of the women were supplemented with the recommended dose of iron during the first trimester of pregnancy. We identified pre-pregnancy predictors associated with iron supplementation. Interventions that target women of reproductive age are needed. An enhanced focus on iron supplementation during pregnancy should be incorporated in pre-pregnancy and interpregnancy counselling. PubDate: 2022-03-08 DOI: 10.1017/jns.2022.18
Authors:Belete; Kefyalew T., Daba, Derese B., Shallo, Seifadin A., Yebassa, Mecha A., Danusa, Kababa T., Gadisa, Diriba A. First page: 20 Abstract: Dietary diversity is one of the eight core indicators of infant and young child feeding (IYCF) practices. It is also a proxy for nutrient adequacy of the diet of individuals. There are minimal studies showing the level of dietary practice in urban and rural settings comparably. Hence, the present study intended to assess and compare differences in the level of dietary diversity and its contributing factors in urban and rural settings of the West Shoa zone of Oromia, Ethiopia. A community-based comparative cross-sectional study was conducted among 674 pairs of mothers/caregivers and children aged 6–23 months using a multistage sampling technique. Data were analysed and descriptive summaries were presented with tables, charts and graphs. A linear regression analysis was used to identify factors that were associated with the level of dietary diversity. The dietary diversity score (DDS) was 26⋅1 % (95 % CI 22⋅8, 29⋅5) both in urban and rural (P < 0⋅001), and also the minimum meal frequency was 56⋅5 % (95 % CI 52⋅7, 60⋅2) (P < 0⋅038). Child from merchant mother, own production of foods at the household level and frequent advice of IYCF practices during Post natal care (PNC) visit in urban residents, maternal secondary educational level, living with caregiver only, having a merchant father, advice of IYCF practice during PNC visit and utilisation of horse as a means of transportation in rural were positively associated with the level of dietary diversity. Generally, infant and young children who received the recommended dietary diversity and the minimum meal frequency were low in the study area both in the urban and rural settings. PubDate: 2022-03-17 DOI: 10.1017/jns.2022.17
Authors:Wolever; Thomas M.S., Jenkins, Alexandra L., Campbell, Janice E., Ezatagha, Adish, Dhillon, Simarata, Johnson, Jodee, Schuette, John, Chen, Yumin, Chu, YiFang First page: 21 Abstract: Dietary starch contains rapidly (RAG) and slowly available glucose (SAG). To establish the relationships between the RAG:SAG ratio and postprandial glucose, insulin and hunger, we measured postprandial responses elicited by test meals varying in the RAG:SAG ratio in n 160 healthy adults, each of whom participated in one of four randomised cross-over studies (n 40 each): a pilot trial comparing six chews (RAG:SAG ratio 2·4–42·7) and three studies comparing a test granola (TG1-3, RAG:SAG ratio 4·5–5·2) with a control granola (CG1–3, RAG:SAG ratio 54·8–69·3). Within studies, test meals were matched for fat, protein and available carbohydrate. Blood glucose, serum insulin and subjective hunger were measured for 3 h. Data were subjected to repeated-measures analysis of variance (ANOVA). The relationships between the RAG:SAG ratio and postprandial end points were determined by regression analysis. In the pilot trial, 0–2 h glucose incremental areas under the curve (iAUC0–2; primary end point) varied across the six chews (P = 0·014) with each 50 % reduction in the RAG:SAG ratio reducing relative glucose response by 4·0 %. TGs1-3 elicited significantly lower glucose iAUC0–2 than CGs1–3 by 17, 18 and 17 %, respectively (similar to the 15 % reduction predicted by the pilot trial). The combined means ± sem (n 120) for TC and CG were glucose iAUC0–2, 98 ± 4 v. 118 ± 4 mmol × min/l (P < 0·001), and insulin iAUC0–2, 153 ± 9 v. 184 ± 11 nmol × h/l (P < 0·001), respectively. Neither postprandial hunger nor glucose or hunger increments 2 h after eating differed significantly between TG and CG. We concluded that TGs with RAG:SAG ratios 54. However, compared with CG, TG did not reduce postprandial hunger or delay the return of glucose or hunger to baseline. PubDate: 2022-03-17 DOI: 10.1017/jns.2022.22
Authors:Coumans; Juul M. J., Lechner, Lilian, Bolman, Catherine A. W., Oenema, Anke First page: 22 Abstract: The present study explored whether motivational constructs for diet and physical activity (PA) cluster and how these motivational constructs relate to dietary and PA behaviour. Data of 1142 participants were used from a randomised controlled trial examining the effects of a web-based diet and PA promotion intervention based on self-determination theory and motivational interviewing. Motivation was assessed using the Treatment Self-Regulation Questionnaire and Behavioural Regulation in Exercise Questionnaire. The dietary outcomes were measured using an adapted Food Frequency Questionnaire. PA was assessed using the Short QUestionnaire to ASsess Health. Spearman rank-order correlations showed large correlation coefficients (rs ≥ 0⋅63) between similar motivational constructs between the two lifestyle domains, except for intrinsic motivation where a medium correlation coefficient was found (rs = 0⋅41). Furthermore, the exploratory factor analysis illustrated that more self-determined forms of motivation seem to be more domain-specific. In contrast, non-self-determined forms of motivation seem to be domain-independent. Last, regression analyses demonstrated that intrinsic motivation towards PA was the only motivational construct significantly positively associated with all PA sub-behaviours (standardised regression coefficients ranging from 0⋅17 to 0⋅28, all P < 0⋅0125). Intrinsic motivation to eat healthily was significantly positively associated with fruits, vegetables and fish intake (standardised regression coefficients ranging from 0⋅11 to 0⋅16, all P < 0⋅0125), but not with unhealthy snacks. Insight of this exploratory study is useful for understanding the interrelationships of motivational induced behaviours, the development of interventions targeting multiple behaviours, and the construction of questionnaires. PubDate: 2022-03-17 DOI: 10.1017/jns.2022.12
Authors:Jima; Beshada Rago, Hassen, Hamid Yimem, Bahwere, Paluku, Gebreyesus, Seifu Hagos First page: 23 Abstract: Mid-upper arm circumference (MUAC) is an age-sensitive anthropometric measurement in infants. However, exact age is difficult to know, particularly in low-income countries. We evaluated the diagnostic accuracy of an age-independent mid-upper arm circumference-to-length (MUAC/L) ratio measurement in detecting wasting among infants aged 1–6 months in Ethiopia. A facility-based diagnostic accuracy study was conducted on 467 in-patient infants aged 1–6 months from March to May 2019. The receiver operating characteristic (ROC) curve was used to evaluate the ability of MUAC/L to detect wasting. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive and negative predictive values were calculated. The magnitude of severe wasting was 21⋅6 % and moderate wasting was 13⋅0 %. The area under the ROC curve (AUC) of MUAC/L was 0⋅77 (95 % CI 0⋅73, 0⋅81) for detecting moderate wasting and 0⋅92 (95 % CI 0⋅89, 0⋅94) for detecting severe wasting. MUAC/L had a sensitivity of 91⋅1 % (95 % CI 81⋅3, 94⋅4), a specificity of 84⋅7 % (95 % CI 80⋅6, 88⋅2), a positive likelihood ratio of 5⋅82 (95 % CI 4⋅53, 7⋅48) and a negative likelihood ratio of 0⋅13 (95 % CI 0⋅07, 0⋅22) in total infants. The optimal MUAC/L cut-off was PubDate: 2022-03-21 DOI: 10.1017/jns.2022.21
Authors:Berhane; Anteneh, Fikadu, Tewodros, Belachew, Tefera First page: 24 Abstract: Despite the high burden of neural tube defects (NTD) in eastern Ethiopia, there is no evidence that it is related to maternal dietary practice. The aim of the present study was to compare dietary practice between women who gave birth to newborns with and without NTDs. A comparative cross-sectional study was performed on a total of 276 (138 in each group) mothers who delivered neonates with or without NTD. Study participants were selected from three hospitals found in the eastern part of Ethiopia. The dietary practice was determined using the indicators including meal frequency, dietary diversity score (DDS), food variety score (FVS) and consumption of animal source food (ASF) generated from the dietary data collected using validated and pre-tested Food Frequency Questionnaire (FFQ). A multivariable logistic regression model was fitted to isolate independent predictors of dietary practices. The prevalence of good dietary practice was 29 % (95 % CI 23·6 %, 34·3 %). There was a significant difference in dietary practices (P = 0·034), in FVS (P = 0·01), in DDS (P = 0·045) between the two groups. In multivariable logistic regression, independent predictors of having good dietary practice were: not being the mother of a newborn with NTDs [adjusted odds ratio (AOR) 2·1, 95 % CI 1·07, 4·1], being from a rural residence area (AOR 0·29, 95 % CI 0·1, 0·7) and being illiterate (AOR 0·16, 95 % CI 0·03, 0·8). The present study found that dietary practice is associated with the development of NTDs. Nutrition education, food fortification and supplementation are needed to address this issue, and further research is needed to explore the mechanism. PubDate: 2022-03-21 DOI: 10.1017/jns.2022.20
Authors:Wongniyomkaset; Warisara, Rungraung, Numphung, Muangpracha, Niramol, Winuprasith, Thunnalin, Trachootham, Dunyaporn First page: 25 Abstract: Complete nutrition drinks with a low glycemic index (GI) provide nutritional support and prevent hyperglycaemia. The present study identified GI and factors predicting individual glucose response to a new complete nutrition drink. A randomised cross-over controlled trial was conducted in eighteen healthy volunteers (FPG < 100 mg/dl). Complete nutrition drinks containing retrograded starch, glucose solution and white bread were assigned in a random sequence with 14-day wash-out intervals. Plasma glucose and insulin levels were measured from baseline to 180 min after consuming each food. Results show the adjusted GIs of the drink was 48.2 ± 10.4 and 46.7 ± 12.7 with glucose and white bread as the reference, respectively. While the drink has low GI ( PubDate: 2022-04-01 DOI: 10.1017/jns.2022.23
Authors:Tell; Maria Norburg, Hedin, Katarina, Nilsson, Mats, Golsäter, Marie, Lingfors, Hans First page: 26 Abstract: There is limited knowledge about the associations between intakes of different foods and inconsistency in the literature of the relation between the quality of food intake and bodyweight in adolescents. The aim of this study is to explore how healthy self-reported food intakes are associated with each other and with overweight/obesity in adolescents. This is a cross-sectional study of seven cohorts of adolescents (n 13 451) who turned sixteen from 2009/2010 up to 2015/2016 and responded to a health questionnaire used by the School Health Services in southeast Sweden. Associations between intakes of ten self-reported foods as well as between food intakes and weight groups based on the International Obesity Task Force standards (isoBMI) were explored by multivariable logistic regression. Healthy intakes of different foods were mostly associated with each other with the strongest association between a high intake of fruit and a high intake of vegetables (odds ratio (OR) = 25 (95 % confidence interval (CI) 20⋅0–33⋅1)). A low-frequency intake of sweets/snacks (OR = 2⋅35 (95 % CI 1⋅84–3⋅00)) was associated with overweight/obesity as well as a healthy choice of butter/margarine (≤40 % fat) (OR = 1⋅82 (95 % CI 1⋅39 to 2⋅41)), but a high-frequency intake of vegetables was negatively associated with overweight/obesity 0⋅77 (0⋅62–0⋅95). To promote health and achieve a healthy weight among adolescents, it is important to take both diet quality and total food amount into consideration. PubDate: 2022-04-07 DOI: 10.1017/jns.2022.24
Authors:Freitas; Jade Veloso, Crispim, Sandra Patricia, Araujo, Marina Campos First page: 27 Abstract: The development of technologies for children's dietary assessment shows important potential for reducing the occurrence of inherent errors in traditional methods. The present study aimed to describe the development of a mobile app for the dietary assessment of Brazilian schoolchildren. The mobile app assesses schoolchildren's diet with self-report by their parents or guardians in the home environment, through multiple-pass 24-hour recall coupled with a food propensity questionnaire; and by an adult in the school environment, through a food record. The tool presents a database of food items usually consumed by Brazilian schoolchildren, including modes of preparation, probing foods and types of food quantification such as digital photos of household measurements and food portions. The CADE app (food consumption at home and at school) contains 2125 food items, 9 options for preparation methods and 18 options for probing items. There are 75 options for household measurements, also including 26 digital photos of four types of household measurements and 440 photos of portion sizes of 90 foods from the Brazilian Manual of Child Food Portion Quantification. Some innovative features include an interface to take photos of the child's meals and report seconds and leftover food consumption, besides the possibility of receiving notifications on the mobile device to remember to report the diet. The CADE app can assist the standardisation and automation of dietary data collection from schoolchildren, support food and nutrition data in childhood and promote research in nutritional epidemiology while reducing data collection costs. PubDate: 2022-04-11 DOI: 10.1017/jns.2022.25
Authors:Ketema; Bezawit, Bosha, Tafese, Feleke, Fentaw Wassie First page: 28 Abstract: Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6–23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6–23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6–23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6–23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area. PubDate: 2022-04-18 DOI: 10.1017/jns.2022.26
Authors:Ishitsuka; Kazue, Asakura, Keiko, Sasaki, Satoshi First page: 29 Abstract: Dietary supplements can be used to compensate for an inadequate diet. However, some studies indicate that supplement users consume healthier diets than non-users, although such data are lacking in Japanese children. The aim of the present study was to investigate the food and nutrient intake of dietary supplement users among school-aged children in Japan. A nationwide school dietary survey was conducted at fourteen elementary schools and thirteen junior high schools in twelve prefectures in Japan. Three-day non-consecutive semi-weighed dietary records were obtained on two weekdays and one weekend day. Analysis of covariance was performed to investigate differences in food and nutrient intake from meals consumed at school and outside of school between dietary supplement users and non-users, adjusted for socio-demographic and health-related characteristics. Of the 910 children included in this analysis, 80 (8⋅8 %) reported supplement use. Based on 3-d dietary records, dietary supplement users consumed higher mean amounts of oils and lower amounts of fruits and vegetables than non-users. In school lunches, users consumed significantly higher amounts of oils and lower amounts of protein than non-users. In meals consumed outside of school, dietary supplement users consumed significantly higher amounts of confectioneries and lower amounts of fruits and vegetables, folate, vitamin C and dietary fibre than non-users. Collectively, our findings indicate that dietary supplement users consumed less healthy diets than non-users. Additional studies are warranted to confirm these results and identify factors contributing to poorer dietary habits in supplement users. PubDate: 2022-04-22 DOI: 10.1017/jns.2021.96
Authors:Stanzione; Joseph R., Boullata, Joseph I., Bruneau, Michael L., Volpe, Stella L. First page: 30 Abstract: Recommendations for protein intake are based on total body weight; however, these recommendations do not consider lean body mass (LBM). The purpose of the present study was to identify the average protein intake in g/kg LBM in a group of healthy Masters Athletes (≥26 years of age, exercising ≥2 d/week). Data were obtained from a cross-sectional study. Body weight (kg), height (cm) and LBM via dual-energy X-ray absorptiometry were measured. Dietary intake was measured using a 2005 Block Food Frequency Questionnaire. The average energy intake, the percent energy from protein and the average protein intake in g/kg LBM were calculated. Differences between protein intake and the US Recommended Dietary Allowance (US RDA) (0⋅8 g/kg body weight) were determined. Alpha levels were set a priori to P < 0⋅05. A total of 176 participants (94 women, 82 men; 39 ± 11 years of age; body mass index: 24⋅6 ± 3⋅4 kg/m2) were analysed. The average energy intake, the percent protein energy and the average protein intake were 7996⋅9 ± 110⋅9 kilojoules (kJ)/d (1,910⋅4 ± 26⋅5 kcal), 15⋅5 ± 2⋅6 % and 1⋅43 ± 0⋅53 g/kg LBM, respectively. No differences existed between women and men for protein intake/kg LBM. Both sexes had significantly higher protein intakes than the US RDA (P < 0⋅001). We identified the average protein intake (g/kg LBM) in healthy Masters Athletes that may contribute to evolving perspectives on the determination of protein needs. The present study helps establish the relationship between protein intake and LBM so that we may further increase our accuracy when developing future protein recommendations. PubDate: 2022-04-27 DOI: 10.1017/jns.2022.10
Authors:Rijnaarts; Iris, de Roos, Nicole M., Wang, Taojun, Zoetendal, Erwin G., Top, Jan, Timmer, Marielle, Hogenelst, Koen, Bouwman, Emily P., Witteman, Ben, de Wit, Nicole First page: 31 Abstract: Constipation can greatly impact the quality of life (QoL), which can be relieved by dietary fibres; however, preserving a higher fibre intake remains a challenge. We investigated the effects of a personalised dietary advice (PDA) on fibre intake and mild constipation complaints. A total number of twenty-five adults with mild constipation complaints were included in a 4-week observation period followed by a 4-week personalised intervention. The PDA provided high-fibre alternatives via a web tool. In weeks 1, 4 and 8, dietary intake, constipation complaints and QoL were assessed. Furthermore, participants collected a faecal sample at weeks 1, 4 and 8 to determine microbiota diversity and composition, and short-chain fatty acids (SCFA). Participants completed questions daily for 8 weeks regarding abdominal complaints, stool frequency and stool consistency. Fibre intake in week 8 was significantly higher compared to week 1 (Δ = 5·7 ± 6·7 g, P < 0·001) and week 4 (Δ = 5·2 ± 6·4 g, P < 0·001). Constipation severity and QoL significantly improved at week 8 compared to the observation period (P < 0·001). A higher fibre intake significantly reduced constipation severity (β = −0·031 (−0·05; −0·01), P = 0·001) and the QoL (β = −0·022 (−0·04; −0·01), P = 0·009). Stool consistency (P = 0·040) and abdominal pain (P = 0·030) improved significantly during the intervention period (P = 0·040), but stool frequency did not. Average microbial alpha diversity and composition and SCFA concentrations did not change over time, but indicated individual-specific dynamics. Several SCFAs were associated with constipation complaints. To conclude, a PDA effectively increased fibre intake and subsequently reduced constipation complaints, indicating that guided dietary adjustments are important and feasible in the treatment of mild constipation complaints. PubDate: 2022-04-28 DOI: 10.1017/jns.2022.27
Authors:Al-Hamad; Areej, MacNevin, Shannan, Daher-Nashif, Suhad First page: 32 Abstract: The present study explored nursing and medical students’ perceptions of food security, their access to healthy food and the circumstances that affect their access to healthy food in Qatar. The photovoice method was adopted in the present study. Students submitted their photos pertaining to food security and their access to healthy food in Qatar. Afterwards, the students completed an online synchronous semi-structured interview. The interviews were transcribed verbatim and thematically analysed. After the data analysis, a focus group discussion was conducted for member checking. The present study is a collaborative project between two universities in Qatar: The University of Calgary in Qatar (UCQ) and Qatar University (QU). Undergraduate students (seven nursing students and nine medical students) were recruited, asked to collect photos and interviewed. Four themes emerged from the data. First, food retail environments promoted unhealthy eating. Second, fast food under stressful circumstances: a sense of comfort. Third, food as a symbol of culture and socialisation. Finally, the paradox of access to affordable and healthy food in Qatar. Undergraduate students highlighted various circumstances that affect their perceptions of food security and their access to healthy food in Qatar. Future research that aims at understanding the facilitators and barriers to access healthy food at the university campus may help to improve nutrition interventions targeting those students. Future initiatives should focus on leveraging various resources to assist universities in tailoring their food initiatives to suit their students’ local needs. PubDate: 2022-04-29 DOI: 10.1017/jns.2022.28
Authors:Kibemo; Berhanu, Mulugeta, Afework, Hailu, Dejene, Gelaw, Baye First page: 33 Abstract: Undernutrition in children is a challenging problem in developing countries, including Ethiopia. Stunting is the most prevalent form of undernutrition. The majority of studies on childhood stunting and its associated factors focused on children, maternal and socioeconomic components. However, a few studies reported poor WaSH status and antibiotic exposure as environmental risk factors for child stunting, and the case of socio-demographic factors also lacks consistency. Concerning this, there is a lack of information in Ethiopia. Therefore, the present study assessed the association of socio-demographic, WaSH, and antibiotic exposure with stunting among under-five children. A cross-sectional study was conducted involving 340 mother–child pairs. Anthropometric data were collected using standard and calibrated height and weight scales. For factorial data, an interviewer-guided standard questionnaire was used. Logistic regression analyses were used to identify factors determining childhood stunting. In the present study, the prevalence of stunting, underweight and wasting was 14⋅7 % (95 % CI 10⋅9, 18⋅5), 4⋅4 % (95 % CI 2⋅4, 6⋅8) and 2⋅1 % (95 % CI 0⋅6, 3⋅5), respectively. Low dietary diversity, being born from a mother with an education level of secondary school, and belonging to a female-headed household were positively associated (P < 0⋅05) with stunting. The prevalence of overall undernutrition was lower (21⋅2 %) in the study area. Stunting was significantly associated with dietary diversity, maternal educational level and sex of households head. The government policy should focus on enhancing the dietary diversity of households, and encouraging women's education. PubDate: 2022-05-05 DOI: 10.1017/jns.2022.29
Authors:Bahrami; Alireza, Shirani, Pedram, Sohouli, Mohammadhassan, Nasab, Saeede Jaafari, Rafiee, Pegah, Naja, Farah, Sheikhimobarakeh, Zahra, Hejazi, Ehsan First page: 34 Abstract: Despite mounting evidence that dietary factors might have a protective role against risk of cancer, few studies have assessed the relationship between diet diversity with colorectal cancer (CRC) and colorectal adenoma (CRA). Thus, we examined the relationship between dietary diversity score (DDS) and the odds of CRC and CRA. Overall, 129 CRC diagnosed patients, 130 CRA diagnosed cases and 240 healthy hospitalised controls were studied. DDS was calculated based on information on the usual diet that was assessed by a valid and reliable food frequency questionnaire (FFQ). Multivariate logistic regression was used to estimate the relationship between DDS and odds of colorectal cancer and adenoma. After adjusting for potential confounders, the diversity of grains is associated with the increased odds of CRC (ORgrains: 2·96 (1·05–8·32); P = 0·032), while the diversity of vegetables and fruits are associated with decreased odds of CRC (ORvegetables: 0·31 (0·16–0·62); P = 0·001, ORfruits: 0·37 (0·23–0·61); P < 0·001). The diversity of vegetables, fruits and dairy are inversely associated with odds of CRA (ORvegetables: 0·41 (0·21–0·78); P = 0·007, ORfruits: 0·58 (0·36–0·93); P = 0·021, ORdairies: 0·56 (0·37–0·83); P = 0·004). Also, higher DDS was related to decreased odds of both CRC (OR: 0·41 (0·23–0·72); P for trend = 0·002) and CRA (OR: 0·36 (0·21–0·65); P for trend = 0·001). Our results indicated that higher dietary diversity and particularly a diet varied in fruits and vegetables may reduce the odds of CRC and CRA. Also, the consumption of dairy products may decrease the odds of CRC, whereas the consumption of grains may increase the odds of CRC. PubDate: 2022-05-10 DOI: 10.1017/jns.2022.30
Authors:Petchoo; Jaruneth, Kaewchutima, Narisara, Tangsuphoom, Nattapol First page: 35 Abstract:Food waste globally affects food security and sustainability. There currently are few studies focusing on food waste in schools. The present study aimed to determine the meal quality and plate waste in school lunch programme in Thailand. This cross-sectional study was conducted in canteens of representing kindergarten and elementary schools in Southern Thailand within their real-life context. The assessment was carried out over five consecutive school days in July–August 2020 for each school, at which two types of menus, including rice with side dish and one-dish meal were served. Waste collection and quantification were conducted by selective aggregate weighing, according to the Food Loss and Waste Protocol. All lunch menus contained excess rice but insufficient meats, fruits, vegetables and eggs, regarding the national lunch standard. For each serving portion, 7–33 % rice, 9–22 % meats, 7–65 % vegetables, 1–19 % fruits and 3–14 % eggs were discarded. Plate waste from rice with side dish menus (10–29 %) was more than one-dish meals (7–17 %). By estimation, each kindergartener generated 71⋅4 g plate waste daily, accounting for the caloric and monetary values of 146 kcal and 0⋅16 US dollar. The amount of plate waste and the respective caloric and monetary losses were less obvious at the elementary school. Plate waste affected the adequacy of food intakes of schoolchildren from lunch meals. The data obtained from the present study will be useful for planning and implementation of school lunch programme in Thailand and countries with similar context. PubDate: 2022-05-12 DOI: 10.1017/jns.2022.31
Authors:Sayed; Shabihul Fatma, Nagarajan, Sumathi First page: 36 Abstract: The present study was conducted to determine nutritional anaemia using haemoglobin levels of female nursing undergraduates studying at Farasan Island with the purpose to intervene at a point, before the potential problems become serious later in life. In total, 130 apparently healthy, female students of Department of Nursing were recruited by a random sampling method to collect information on socio-demographic, lifestyle and anthropogenic characteristics, and dietary habits including breakfast skipping. Haemoglobin content was estimated using Sahli's Haemoglobinometer and observations were interpreted as per WHO's criteria for anaemia. Body mass index (BMI) was recorded using a digital weighing machine. Correlation between haemoglobin concentration, breakfast skipping and body mass index of study participants was assessed by Pearson's correlation. Data analyses were done using Origin software. Overall, 51⋅6 % (n = 67) students were all together anaemic with 28⋅5 % (n = 37) had mild anaemia, 15⋅4 % (n = 20) moderate and 7⋅69 % (n = 10) had severe anaemia. Of these, 20⋅8 % (n = 27) were underweight, 63⋅8 % (n = 83) normal weight and 15⋅4 % (n = 20) were above normal weight (over weight and obese). The Hb content showed a positive correlation with the BMI and exhibited an increasing trend with increase in the BMI among study participants (P < 0⋅05). Questionnaire analyses revealed that the majority (96⋅9 %, n = 126) of students were taking junk food as bulk of their meal. A strong negative correlation was recorded between Hb contents and breakfast skipping tendencies (r = −0⋅987, P < 0⋅05). Findings of the present study are of high significance for public health professionals and educators to prioritise actions that could motivate these future nurses to adapt healthy lifestyles to strategically combat nutritional anaemia. PubDate: 2022-05-24 DOI: 10.1017/jns.2022.33
Authors:Admasu; Jatani, Egata, Gudina, Bassore, Dereje Getahun, Feleke, Fentaw Wassie First page: 37 Abstract: Introduction: Optimal breast-feeding practices make a major contribution to the promotion of healthy growth and development through much prevention of diarrheal and respiratory diseases which majorly cause morbidity and mortality in under-five children. However, breast-feeding practices remain suboptimality in Ethiopia. Objective: The study objective was to determine the effect of maternal nutrition education on early initiation and exclusive breast-feeding practice in the Hawela Tulla sub-city. Methods: A cluster randomised, parallel-group, single-blinded trial was used. About 310 pregnant women (155 for the intervention group and 155 for the control group) were included. Result: An early initiation of breast-feeding was significantly higher among women who received breast-feeding education than those who did not receive (104(72·7 %) v. 85(59·9 %), P = 0·022) and exclusive breast-feeding practice was also significantly higher among women who received breast-feeding education than those who did not receive (106(74·1 %) v. 86(60·6 %), P = 0·015). Breast-feeding education [AORs 1·55, 95 % CI (1·02, 2·36)], institutional delivery [AOR 2·29, 95 % CI (1·21, 4·35)], vaginal delivery [AOR 2·85, 95 % CI (1·61, 5·41)] and pre-lacteal feeding [AOR 0·47, 95 % CI (0·25, 0·85)] were predictors of early initiation of breast-feeding. Breast-feeding education [AOR 1·72, 95 % CI (1·12, 2·64)] and institutional delivery [AOR 2·36, 95 % CI (1·28, 4·33)] were also determinants of exclusive breast-feeding practices. Conclusion: Breast-feeding education improved early initiation of breast-feeding and exclusive breast-feeding practices. Providing sustained education to women regarding early initiation and exclusive breast-feeding practice should be strengthened. PubDate: 2022-05-30 DOI: 10.1017/jns.2022.36
Authors:Asai; Atsushi, Suzuki, Fumihiko, Tsujiguchi, Hiromasa, Hara, Akinori, Miyagi, Sakae, Kannon, Takayuki, Suzuki, Keita, Nakamura, Masaharu, Shimizu, Yukari, Nguyen, Thao Thi Thu, Pham, Kim Oanh, Kasahara, Tomoko, Nakai, Shingo, Hayashi, Koichiro, Shibata, Aki, Amatsu, Takashi, Konoshita, Tadashi, Kambayashi, Yasuhiro, Tsuboi, Hirohito, Tajima, Atsushi, Nakamura, Hiroyuki First page: 38 Abstract:Although chronic pain (CP) is classified as inflammatory or non-inflammatory, the involvement of fatty acid intake in this process has not yet been examined in detail. Therefore, the present study investigated whether the relationship between CP and fatty acid intake differs between high and low C-reactive protein (CRP) levels in middle-aged and elderly individuals in the Shika study. One-thousand and seven males and 1216 females with mean ages of 68⋅78 and 69⋅65 years, respectively, participated in the present study. CRP was quantified by blood sampling from participants who responded to a CP questionnaire. The brief-type self-administered diet history questionnaire (BDHQ) was used to assess fatty acid intake. Interactions were observed between CP and CRP on monounsaturated fatty acids (MUFA) and eicosadienoic acid in a two-way analysis of covariance adjusted for sex, age, lack of exercise, lack of sleep, current smoking and drinking status, and BMI. MUFA (OR 1⋅359) and eicosadienoic acid (OR 1⋅072) were identified as significant independent variables for CP in a multiple logistic regression analysis, but only in the low CRP group. Only a high intake of MUFA and eicosadienoic acid was associated with chronic neck/shoulder/upper limb pain without elevated CRP. In psychogenic and neuropathic pain without elevated CRP, an increased intake of MUFA and eicosadienoic acid, a family member of n-6 fatty acids, appears to affect CP. Further longitudinal studies are needed to elucidate this relationship. PubDate: 2022-06-01 DOI: 10.1017/jns.2022.37
Authors:Quezada-Pinedo; Hugo G., Cassel, Florian, Muckenthaler, Martina U., Gassmann, Max, Huicho, Luis, Reiss, Irwin K., Duijts, Liesbeth, Gaillard, Romy, Vermeulen, Marijn J. First page: 39 Abstract: We studied ethnic differences in terms of iron status during pregnancy between Dutch women and other ethnicities and explore to what extent these differences can be explained by environmental factors. This cross-sectional population-based study (2002–2006) was embedded in the Generation R study and included a total of 4737 pregnant women from seven ethnic groups (Dutch, Turkish, Moroccan, Cape Verdean, Surinamese-Hindustani, Surinamese-Creole and Antillean). Ethnicity was defined according to the Dutch classification of ethnic background. Ferritin, iron and transferrin were measured in early pregnancy. The overall prevalence of iron deficiency was 7 %, ranging from 4 % in both Dutch and Surinamese-Creoles, to 18 % in Turkish, Moroccan and Surinamese-Hindustani women. Iron overload was most prevalent in Surinamese-Creole (11 %) and Dutch (9 %) women. Socioeconomic factors accounted for 5–36 % of the differences. Income was the strongest socioeconomic factor in the Cape Verdean and Surinamese-Hindustani groups and parity for the Turkish and Moroccan groups. Lifestyle determinants accounted for 8–14 % of the differences. In all groups, the strongest lifestyle factor was folic acid use, being associated with higher iron status. In conclusion, in our population, both iron deficiency and iron overload were common in early pregnancy. Our data suggest that ethnic differences in terms of socioeconomic and lifestyle factors only partly drive the large ethnic differences in iron status. Our data support the development of more specific prevention programmes based on further exploration of socioeconomic inequities, modifiable risk and genetic factors in specific ethnic subgroups, as well as the need for individual screening of iron status before supplementation. PubDate: 2022-06-01 DOI: 10.1017/jns.2022.35
Authors:Sallinen; Taisa, Viitasalo, Anna, Lintu, Niina, Väistö, Juuso, Soininen, Sonja, Jalkanen, Henna, Haapala, Eero A., Mikkonen, Santtu, Schwab, Ursula, Lakka, Timo A., Eloranta, Aino-Maija First page: 40 Abstract: We aimed to investigate the effects of a long-term, individualised, family-based lifestyle intervention on food consumption and nutrient intake from childhood to adolescence. We conducted an 8-year diet and physical activity intervention study in a population sample of children aged 7–9 years at baseline in 2007–2009. We allocated the participants to the intervention group (n 306) and the control group (n 198). We assessed diet by 4-d food records at baseline, 2-year follow-up and 8-year follow-up. We analysed the data using linear mixed-effects models adjusted for age at baseline and sex. The consumption of vegetables and vegetable oil-based spreads (fat ≥60 %) increased in the intervention group but did not change in the control group (P < 0⋅001 for time×group interaction). The consumption of fruits and berries increased in the intervention group but decreased in the control group (P = 0⋅036). The consumption of high-fat cheese (P = 0⋅029), butter-based spreads (P = 0⋅001) and salty snacks (P = 0⋅028) increased less, and the consumption of low-fat cheese (P = 0⋅004) increased more in the intervention group than in the control group. Saturated fat intake (P = 0⋅001) increased less, and the intakes of dietary fibre (P = 0⋅003), vitamin D (P = 0⋅042) and vitamin E (P = 0⋅027) increased more in the intervention group than in the control group. The intakes of vitamin C (P < 0⋅001) and folate (P = 0⋅001) increased in the intervention group but decreased in the control group. To conclude, individualised, family-based lifestyle intervention altered food choices towards more recommended diet and resulted in enhanced diet quality from childhood to adolescence. PubDate: 2022-06-02 DOI: 10.1017/jns.2022.13
Authors:Elsahoryi; Nour A., Cardwell, Christopher, Gilchrist, Sarah, Woodside, Jayne V. First page: 41 Abstract:Beetroot juice (BRJ) has been demonstrated to decrease blood pressure (BP) due to the high inorganic nitrate content. This pilot randomized crossover trial aimed to investigate the effect of two different high nitrate vegetable juices on plasma nitrate concentrations and BP in healthy adults. Eighteen healthy volunteers were randomized to receive 115 ml of BRJ or 250 ml of green leafy vegetable juice for 7 d which contained similar amounts of nitrate (340 mg) daily. Blood samples were collected, and clinic BP measured at baseline and at the end of each juice consumption. Daily home BP assessment was conducted 2 h after juice consumption. Nitrate and nitrite concentrations were analysed using a commercially available kit on a Triturus automated ELISA analyser. Hills and Armitage analysis was used for the two-period crossover design and paired sample t-tests were performed to compare within-group changes. Plasma nitrate and nitrite concentrations significantly increased and there was a significant reduction in clinic and home systolic blood pressure (SBP) mean during the BRJ period (P-values 0⋅004 and 0⋅002, respectively). Home diastolic blood pressure (DBP) reduced significantly during green leafy vegetable juice consumption week (P-value 0⋅03). The difference between groups did not reach statistical significance during the formal crossover analysis adjusted for period effects. BRJ and green leafy vegetable juice may reduce SBP or DBP, but there was no statistically significant difference between the two juices, although this was only a pilot study. PubDate: 2022-06-06 DOI: 10.1017/jns.2022.34
Authors:Tafese; Zelalem, Berhan, Yifru, Stoecker, Barbara J. First page: 42 Abstract: Alcohol abuse among women is a public health importance that may impair prenatal and postnatal growth. Tella is among the most common homemade alcoholic beverages in rural Ethiopia, but little is known about the magnitude of tella intake during pregnancy and lactation or its effects on child growth. The present study investigated associations between maternal tella intake and the growth of their children. A cross-sectional mixed-methods study was conducted with mothers (n 228) and their 12–36-month-old children and with key informants (n 12). Tella intake during most recent pregnancy and lactation was estimated retrospectively by glasses per drinking event and frequency of events. Nearly 80 % of mothers had consumed some amount of tella during their most recent pregnancy and lactation. Furthermore, 72 % of children had tasted or drunk tella at some time during their life. Stunting was 42 % and was significantly associated with maternal tella consumption at least every other day during pregnancy (adjusted odds ratio (AOR) 4⋅97, 95 % confidence interval (CI) 2⋅20, 11⋅25), male sex (AOR 2⋅31, 95 % CI 1⋅27, 4⋅19), two or more under-5-year-old children in the household (AOR 3⋅52, 95 % CI 1⋅49, 8⋅33) and family size>5 (AOR 1⋅84, 95 % CI 1⋅01, 3⋅36). Underweight was 24⋅6 % and was associated with the child drinking tella with their mother (AOR 4⋅23, 95 % CI 1⋅99, 8⋅97), being male (AOR 3⋅73, 95 % CI 1⋅73, 7⋅94), having ≥3 diarrhoeal episodes in the last 3 months (AOR 11⋅83, 95 % CI 4⋅22, 33⋅14) and being in the older age group (AOR 2⋅98, 95 % CI 1⋅09, 8⋅13). The associations between tella intake and child growth suggest the need to mitigate the effects of tella on child anthropometry. PubDate: 2022-06-06 DOI: 10.1017/jns.2022.40
Authors:Sulley; Issahaku, Saaka, Mahama First page: 43 Abstract: The recent exponential increase in caesarean section (CS) rates in many countries including Ghana requires an understanding of the potential long-term consequences on child health. The present study investigated the relationship between CS delivery and risk of childhood overweight/obesity. A retrospective cohort study was conducted from October 2019 to March 2020 in Ghana. Using multi-stage sampling, 553 mother–child pairs aged 6–23 months were selected from ten health facilities during child welfare clinic (CWC) services. We assessed the association between delivery mode (caesarean v. vaginal) and subsequent body mass index for age (BMI/age Z-score) using hierarchical multivariable linear regression analysis. The prevalence of overweight/obesity (BMI/age Z-score> +2 sd) in children was 3⋅6 %. After adjusting for maternal gestational weight gain, macrosomia and child feeding practices, children who were born through CS had mean BAZ which was 0⋅105 standard units significantly higher than their colleagues who were delivered through normal vaginal [beta coefficient (β) 0⋅105, (95 % CI 0⋅03, 0⋅55)]. CS birth was also associated with 3⋅2 times higher odds of overweight/obesity than vaginal delivery (AOR 3⋅23; 95 % CI 1⋅14, 9⋅13). Consequently, CS delivery was associated positively with increased body mass (adiposity) in the study sample. The association between CS delivery and risk of childhood obesity was attenuated after adjusting for macrosomia. These results would be important for informing clinicians and expectant mothers in considering CS delivery. PubDate: 2022-06-08 DOI: 10.1017/jns.2022.39
Authors:Cherian; Laurel, Agarwal, Puja, Holland, Thomas, Schneider, Julie, Aggarwal, Neelum First page: 44 Abstract: The present study examines the association of diet with depressive symptoms among stroke survivors from a community cohort of older adults. Depression is common after stroke. A healthy diet has previously been associated with fewer depressive symptoms in older individuals, but it is unknown if this effect is also seen in stroke survivors. Eighty-six participants from the Memory and Aging Project with a history of stroke at their study baseline enrolment, complete dietary data and two or more assessments for depression were included in this observational prospective cohort analysis. Depressive symptoms were assessed annually with a 10-item version of the Center for Epidemiologic Studies Depression scale. Diet was assessed using a validated food-frequency questionnaire administered at baseline. Diet scores were based on analysis of participants’ reported intakes of 144 food items. A generalised estimating equation (GEE) model was applied to examine the association of diet score with depressive symptoms. The study participants had a mean age of 82 ± 7⋅17 years and 14⋅42 ± 2⋅61 years of education, and 82⋅56 % were female. Western diet score was positively associated with depressive symptoms over time (diet score tertile 3 v. tertile 1: β = 0⋅22, se = 0⋅09, P = 0⋅02; P for trend = 0⋅022). Interaction with sex suggested a stronger effect in females. A Western diet was associated with more post-stroke depressive symptoms, suggesting nutrition is important not only for reducing cerebrovascular risk, but for protecting post-stoke mental health as well. PubDate: 2022-06-09 DOI: 10.1017/jns.2022.38
Authors:Van; Duong T. T., Trijsburg, Laura, Do, Ha T. P., Kurotani, Kayo, Feskens, Edith J. M., Talsma, Elise F. First page: 45 Abstract: Poor dietary quality is a major contributor to malnutrition and disease burden in Vietnam, necessitating the development of a tool for improving dietary quality. Food-based dietary guidelines (FBDGs) have been proposed to do this by providing specific, culturally appropriate and actionable recommendations. We developed the Vietnamese Healthy Eating Index (VHEI) to assess the adherence to the 2016–2020 Vietnamese FBDGs and the dietary quality of the general Vietnamese population. This VHEI consists of eight component scores, ‘grains’, ‘protein foods’, ‘vegetables’, ‘fruits’, ‘dairy’, ‘fats and oils’, ‘sugar and sweets’ and ‘salt and sauces’, representing the recommendations in the FBDGs. Each component score ranges from 0 to 10, resulting in a total VHEI score between 0 (lowest adherence) and 80 (highest adherence). The VHEI was calculated using dietary intake data from the Vietnamese General Nutrition Survey 2009–2010 (n = 8225 households). Associations of the VHEI with socio-demographic characteristics, energy and nutrient intakes and food group consumptions were examined. The results showed that the mean and standard deviation score of the VHEI was 43⋅3 ± 8⋅1. The component ‘sugar and sweets’ scored the highest (9⋅8 ± 1⋅1), whereas the component ‘dairy’ scored the lowest (0⋅6 ± 1⋅6). The intake of micronutrients was positively associated with the total VHEI, both before and after adjustment for energy intake. In conclusion, the VHEI is a valuable measure of dietary quality for the Vietnamese population regarding their adherence to the FBDGs. PubDate: 2022-06-09 DOI: 10.1017/jns.2022.44
Authors:Næss-Andresen; Marthe-Lise, Jenum, Anne Karen, Berg, Jens Petter, Falk, Ragnhild Sørum, Sletner, Line First page: 46 Abstract: Worldwide, there are limited data on the prevalence of postpartum anaemia and iron status. The aims of the present study were to assess the prevalence of anaemia and iron deficiency (ID) by three iron indicators 14 weeks postpartum, their relations to haemoglobin (Hb) and associations with ethnicity and clinical factors in a multi-ethnic population. We conducted a population-based cohort study of 573 women followed from early pregnancy. The prevalence of postpartum anaemia (Hb PubDate: 2022-06-13 DOI: 10.1017/jns.2022.45
Authors:Koeder; Christian, Husain, Sarah, Kranz, Ragna-Marie, Anand, Corinna, Alzughayyar, Dima, Schoch, Nora, Hahn, Andreas, Englert, Heike First page: 47 Abstract: Common carotid intima-media thickness (ccIMT) progression is a risk marker for cardiovascular disease (CVD), whereas healthy lifestyle habits are associated with lower ccIMT. The objective of the present study was to test whether a healthy lifestyle intervention can beneficially affect ccIMT progression. A community-based non-randomised, controlled lifestyle intervention was conducted, focusing on a predominantly plant-based diet (strongest emphasis), physical activity, stress management and social health. Assessments of ccIMT were made at baseline, 6 months and 1 year. Participants had an average age of 57 years and were recruited from the general population in rural northwest Germany (intervention: n 114; control: n 87). From baseline to 1 year, mean ccIMT significantly increased in both the intervention (0⋅026 [95 % CI 0⋅012, 0⋅039] mm) and control group (0⋅045 [95 % CI 0⋅033, 0⋅056] mm). The 1-year trajectory of mean ccIMT was lower in the intervention group (P = 0⋅022; adjusted for baseline). In a subgroup analysis with participants with high baseline mean ccIMT (≥0⋅800 mm), mean ccIMT non-significantly decreased in the intervention group (−0⋅016 [95 % CI −0⋅050, 0⋅017] mm; n 18) and significantly increased in the control group (0⋅065 [95 % CI 0⋅033, 0⋅096] mm; n 12). In the subgroup, the 1-year trajectory of mean ccIMT was significantly lower in the intervention group (between-group difference: −0⋅051 [95 % CI −0⋅075, −0⋅027] mm; P < 0⋅001; adjusted for baseline). The results indicate that healthy lifestyle changes may beneficially affect ccIMT within 1 year, particularly if baseline ccIMT is high. PubDate: 2022-06-13 DOI: 10.1017/jns.2022.46
Authors:Begashaw; Beyene, Tariku, Zerihun, Berhane, Anteneh First page: 48 Abstract: Periconceptional folic acid supplementation is effective in the prevention of neural tube defects (NTDs). The aim of the present study was to determine the level of knowledge about the benefits of preconceptional folic acid supplementation in a sample of women of childbearing age and its associated factors. A cross-sectional community-based study design was carried out on a total of 441 women of childbearing age. Questionnaires included knowledge of preconception of folic acid supplements and socio-demographic characteristics. The χ2 was used to compare categorical data. Multivariate logistic regression was used to isolate the predictive variables and examined individually by calculating the adjusted odds ratio. Statistical significance is declared as P < 0·05. We found that 35·1 % (n 155) knew preconceptional folic acid supplementation could prevent NTDs, and 3·8 % (n 17) knew the right time to take preconceptional folic acid supplementation and only 1·7 % (n 7) who had a history of NTDs. Attended secondary education (OR 2·7; 95 % CI 1·1, 6·0, P = 0·017), governmental employee (OR 3·5; 95 % CI 2·3, 17·8, P < 0·001), current pregnancy status (OR 3·0; 95 % CI 2·1, 4·2, P = 0·043), history of visiting the antenatal care service during pregnancy (OR 2·9; 95 % CI 1·07, 7·8, P = 0·03), history of taking folic acid supplement (OR 4·5; 95 % CI 2·9, 7·1, P < 0·001) were associated. More than half of the participant women did not know about preconception of folic acid supplements that reduce the risk of NTDs. Identification of the level of knowledge on preconception of folic acid may allow for targeted educational or other interventions to further encourage folic acid use. PubDate: 2022-06-20 DOI: 10.1017/jns.2022.32
Authors:Yen; Tan Shot, Htet, Min Kyaw, Lukito, Widjaja, Bardosono, Saptawati, Setiabudy, Rianto, Basuki, Endang S., Wibudi, Aris, Martianto, Drajat, Subekti, Imam, Fahmida, Umi First page: 49 Abstract: Dietary patterns high in fibre and green leafy vegetables have shown an inverse association with lower risks of type 2 diabetes mellitus and improved glycaemic control. The study aimed to investigate the effects of increased vegetable intake and conventional diabetes diet on glycaemic control among type 2 diabetic patients. White-collar workers from one telecommunication company with type 2 diabetes were assigned to two treatment groups by cluster randomisation. Individuals with known type 2 diabetes and poor glycaemic control (HbA1c ≥8 g%) were eligible and a total of 84 subjects were recruited. Subjects in the intervention group (n 41) were offered to attend seminars and intensive coaching weekly to encourage them to increase raw vegetable intake. The control group (n 40) followed the conventional diet according to the guidelines of the Indonesian Society of Endocrinology. Glycated haemoglobin (HbA1c), plasma lipids, blood pressure, vegetable intake and anthropometric measurements were assessed at baseline and end line of 12 weeks intervention. A regression analysis was conducted using differences in HbA1C between baseline and 12 weeks as the dependent variable. Student's t test was conducted for the changes of biochemical indicators from baseline to end line during the period of 12 weeks intervention. Glycaemic control improved in the intervention group and mean HbA1C, fasting blood glucose and post-prandial blood glucose in the intervention group decreased significantly along with body weight, waist circumference and total cholesterol. The finding suggested that the intervention which emphasised raw vegetable intake contributed to improved glycaemic control among Indonesian adults with type 2 diabetes mellitus. PubDate: 2022-06-21 DOI: 10.1017/jns.2022.41
Authors:van Meurs; Tim, Oude Groeniger, Joost, de Koster, Willem, van der Waal, Jeroen First page: 50 Abstract: Unhealthy diets are a major threat to population health and are especially prevalent among those with a low socioeconomic status (SES). Health promotion initiatives often rely on nutrition information interventions (NIIs), but are usually less effective among adults with a low SES than in their high-SES counterparts. Explanations for this lower effectiveness are set out in extant studies. These have been conducted across a wide range of disciplines and subject fields and using a variety of methodological approaches. We have therefore conducted a scoping review to identify and synthesise the following: (1) explanations suggested in studies carried out in high-income countries for why NIIs are (in)effective among adults with a low SES and (2) whether these suggested explanations were studied empirically. Eight databases were searched for relevant studies published since 2009 across various disciplines. This identified 4951 papers, 27 of which were included in our review after screening. Only fifteen of these proposed an explanation for the (in)effectiveness of NIIs among adults with a low SES. The following four main themes were uncovered: health literacy, economic resources, social resources and convenience. Ten studies tested their explanations empirically, but the results were inconsistent. The reasons why NIIs are (in)effective among low-SES adults are therefore still largely unclear. Also, current literature predominantly relies on individualistic explanations, most notably focusing on psychological and economic attributes. Consequently, if the effectiveness of NIIs among low-SES populations is to be improved, future studies should examine a wider range of explanations and test them systematically and empirically. PubDate: 2022-06-23 DOI: 10.1017/jns.2022.42
Authors:Bird; Julia K., Barron, Rebecca, Pigat, Sandrine, Bruins, Maaike J. First page: 51 Abstract: The objective of the present study was to evaluate the contribution of voluntary fortified foods and supplements to reducing micronutrient shortfalls in the UK population. A secondary analysis of the UK National Diet and Nutrition Survey was conducted (2012/13–2013/14, N 2546, 1·5–95 years). Micronutrient intakes were derived from food consumption intake data and food composition data and calculated as the proportion below or above the Dietary Reference Values for males and females of different age groups, for those on a base diet only, users of fortified foods but no supplements and users of fortified foods and supplements. Of the population consuming a base diet only, 21–45 % and 5–29 % fell below the Estimated Average Requirement (EAR) for minerals and vitamins, respectively. About 3–13 % fewer consumers of fortified foods fell below the EAR for vitamins and minerals. Supplements barely reduced the prevalence of intakes below the EAR. Among supplement non-users and users, 99 and 96 % failed to meet the reference intakes for vitamin D. More women than men were at risk of inadequacies of micronutrient intakes. The prevalence of inadequacies declined with increasing age. Voluntary fortified foods but not supplements made a meaningful contribution to intakes of vitamin and minerals, without risk of unacceptably high intakes. These insights may help the UK to define approaches to address micronutrients of concern in vulnerable groups. PubDate: 2022-06-23 DOI: 10.1017/jns.2022.47
Authors:Janssen; Jolien M. M., van der Velde, Laura A., Kiefte-de Jong, Jessica C. First page: 52 Abstract: Food insecurity is an important public health concern; however, research into this phenomenon within the Netherlands is limited. Food insecurity is not solely related to individual factors, but can also be influenced by various factors in the social and physical environment. Therefore, this study aimed to identify determinants of food insecurity within the personal, social and physical environment, based on the social ecological model (SEM), and to identify their relative importance for experiencing food insecurity. The study population consisted of 307 participants living in disadvantaged neighbourhoods of the Dutch city The Hague, of which approximately one-quarter were food insecure. Participant characteristics showing bivariate associations P < 0⋅20 were placed in a predetermined level of the SEM, after which a multivariate logistic regression was performed for each level and the Nagelkerke pseudo R2 was presented. Determinants of food insecurity were BMI, gross monthly income, highest educational attainment, smoking status, diet quality, employment status, marital status and religion (P < 0⋅05). The results showed that 29⋅7 % of the total variance in food insecurity status was explained by all included determinants together. The personal, social and physical environment explained 20⋅6, 14⋅0 and 2⋅4 % of the total variance, respectively. Our findings suggest that determinants within the personal environment are most important for explaining differences in experienced food insecurity. The present study contributes to furthering the knowledge about the relative importance of the personal, social and physical environment, indicating that determinants within the personal environment may be most promising for developing targeted interventions to reduce food insecurity. PubDate: 2022-06-29 DOI: 10.1017/jns.2022.48
Authors:Al-Biltagi; Mohammed, Faysal, Wafaa, Alabdulrazzaq, Fatoumah, Alsabea, Hassan, Bassil, Ziad, Chamseddine, Fadi, Chokr, Imad, El-Beleidy, Ahmed, Ezzat, Mostafa, Farrah, Antoine, Mizyed, Mohammad, Sayed, Ashraf Othman Saleh, Talib, Hussam Abu, Wali, Yasser First page: 53 Abstract: The transition of foods during toddlerhood and the suboptimal diets consumed in the Middle East make children susceptible to malnutrition and micronutrient deficiencies. Based on international recommendations, coupled with the merits of clinical studies on the application of young child formula (YCF), a group of fourteen experts from the Middle East reached a consensus on improving the nutritional status of toddlers. The recommendations put forth by the expert panel comprised twelve statements related to the relevance of YCF in young children; the impact of YCF on their nutritional parameters and functional outcomes; characteristics of the currently available YCF and its ideal composition; strategies to supply adequate nutrition in young children and educational needs of parents and healthcare professionals (HCPs). This consensus aims to serve as a guide to HCPs and parents, focusing on improving the nutritional balance in toddlers in the Middle Eastern region. The panellists considere YCF to be one of the potential solutions to improve the nutritional status of young children in the region. Other strategies to improve the nutritional status of young children include fortified cow's milk and cereals, vitamin and mineral supplements, early introduction of meat and fish, and the inclusion of diverse foods in children's diets. PubDate: 2022-07-08 DOI: 10.1017/jns.2022.54
Authors:Tan; Libo, Zhang, Yanqi, Wang, Hui, Haberer, Heleena First page: 54 Abstract: Maternal obesity may compromise the micronutrient status of the offspring. Vitamin A (VA) is an essential micronutrient during neonatal development. Its active metabolite, retinoic acid (RA), is a key regulator of VA homeostasis, which also regulates adipose tissue (AT) development in obese adults. However, its role on VA status and AT metabolism in neonates was unknown and it was determined in the present study. Pregnant Sprague-Dawley rats were randomised to a normal fat diet (NFD) or a high fat diet (HFD). From postnatal day 5 (P5) to P20, half of the HFD pups received oral RA every 3 d (HFDRA group). NFD pups and the remaining HFD pups (HFD group) received placebo. Six hours after dosing on P8, P14 and P20, n 4 pups per group were euthanised for different measures. It was found that total retinol concentration in neonatal liver and lung was significantly lower in the HFD group than the NFD group, while the concentrations were significantly increased in the HFDRA group. The HFD group exhibited significantly higher body weight (BW) gain, AT mass, serum leptin and adiponectin, and gene expression of these adipokines in white adipose tissue compared with the NFD group; these measures were significantly reduced in the HFDRA group. BAT UCP2 and UCP3 gene expression were significantly higher in pups receiving RA. In conclusion, repeated RA treatment during the suckling period improved the tissue VA status of neonates exposed to maternal obesity. RA also exerted a regulatory effect on neonatal obesity development by reducing BW gain and adiposity and modulating AT metabolism. PubDate: 2022-07-08 DOI: 10.1017/jns.2022.53
Authors:Kudo; Maya, Hayashi, Misa, Sun, Boju, Wu, Lili, Liu, Tonghua, Gao, Ming First page: 55 Abstract: Excess body weight and hyperlipidaemia cause severe health problems and have social implications. Amycenone is an active substance extracted from Yamabushitake mushrooms with no reports of its activity against excess body weight and hyperlipidaemia. This research clarifies the effects and mechanisms of action of amycenone on the inhibition of body weight excess and hyperlipidaemia attenuation using KK-Ay mice. Amycenone or water was administered to 8-week-old male KK-Ay mice by gavage for 8 weeks. Their body weight and food intake were recorded during the experiment. At the end of the experimental period, the mice were dissected, and blood samples, lipid metabolism-related organs and tissues were collected and stored for further analysis. Amycenone treatment suppressed body weight gain and improved serum levels of fasting blood glucose and non-esterified fatty acids. Additionally, serum and hepatic cholesterol and triacylglycerol levels were reduced after this treatment, whereas the phosphorylation levels of AMPK, PKA and HSL increased and the expression level of FAS decreased. The protein level of C/EBPβ and gene expression level of Cpt1 were higher in the perirenal adipose tissue of amycenone-treated KK-Ay mice. Furthermore, amycenone phosphorylated AMPK, PKA and ACC, and PPARγ expression was lower in the mesenteric adipose tissue. The phosphorylation levels of AMPK, LKB1, PKA and ACC were also induced, and FAS expression level was reduced in the liver of the amycenone-treated group. Amycenone could reduce excess body weight and attenuate hyperlipidaemia in KK-Ay mice by inhibiting lipogenesis and promoting lipolysis through lipid metabolism pathway stimulation and fatty acid β-oxidation acceleration. PubDate: 2022-07-11 DOI: 10.1017/jns.2022.43
Authors:Kayes; Lucy, Mullan, Karen R., Woodside, Jayne V. First page: 56 Abstract: Iodine is required for thyroid hormone synthesis and fetal neurogenesis. Recent population studies in the United Kingdom (UK) have found iodine deficiency among schoolgirls, women of child-bearing age and pregnant women. This review explores knowledge and awareness of iodine among women of child-bearing age and healthcare professionals (HCPs) in the UK, set within a global context. We aimed to identify gaps in iodine knowledge in the current UK setting of iodine deficiency without iodine fortification and where iodine is not included in antenatal guidelines. The search terms ‘iodine knowledge’ and ‘iodine awareness’ were used to identify relevant papers. Iodine knowledge is poor among women of child-bearing age in the UK according to four studies using questionnaires and qualitative methods. They were unsure of dietary sources of iodine and were not consistently provided with relevant information from HCPs during clinical care. Midwives have been recognised as the main providers of dietary information during pregnancy and, although they recognised the importance of their role in providing nutrition advice, they did not feel equipped to do so and lacked confidence in addressing nutritional concerns. Globally, there was a similar lack of knowledge, however, this was somewhat improved by the inclusion of iodine in antenatal care guidelines. Midwives’ knowledge of iodine was poor, as was knowledge among women of child-bearing age. Improved HCP knowledge and effective communication of information to pregnant women and women planning to conceive may help to improve iodine status which is of particular concern in pregnancy. PubDate: 2022-07-08 DOI: 10.1017/jns.2022.50
Authors:Beba; Mohammad, Seif-Barghi, Tohid, Shab-Bidar, Sakineh, Yarizadeh, Habib, Tijani, Aliyu Jibril, Clark, Cain C. T., Djafarian, Kurosh First page: 57 Abstract: For an optimal performance, soccer players and referees need to consume a high-quality diet. The Healthy Eating Index (HEI) is a tool that can estimate diet quality and has been shown to be associated with body composition. The aims of the present study were first to determine the HEI-2015 score of the diets consumed by athletes and second its association with different body composition parameters of athletes. We conducted a cross-sectional study on 198 soccer players and referees. Dietary intakes were recorded using a validated food frequency questionnaire (FFQ), and HEI scores were calculated. Body composition parameters were measured using the bioelectrical impedance analysis. The mean score for the HEI-2015 was 65⋅04. A multiple linear regression model showed significant associations of the HEI-2015 score with percent body fat (PBF), percent muscle mass (PMM), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in male soccer players aged 0⋅05). PubDate: 2022-07-11 DOI: 10.1017/jns.2022.49
Authors:Berhane; Anteneh, Belachew, Tefera First page: 58 Abstract: The present study examined the effect of picture-based nutrition education on knowledge and adherence to pre-conception iron–folic acid supplement (IFAS) in Ethiopia, a country where there is a high burden of neural tube defects (NTDs) and anaemia. In eastern Ethiopia, a parallel randomised controlled trial design was employed among women planning to get pregnant. The interventional arm (n 122) received a preconception picture-based nutrition education and counselling along with an IFAS and the control arm (n 122) received only a preconception IFAS. The effects of the intervention between-group differences were assessed using a χ2 and independent sample t-test. Bivariate and multivariable linear regression model was fitted to detect independent variables affecting the outcome. The outcome measures regarding the knowledge and adherence to the IFAS intake during the three months of the intervention period were deteremined. It was observed that large proportion of women in the intervention group (42⋅6 %) had an adherence to IFAS compared to the control group (3⋅3 %); (P < 0⋅0001). Based on bivariate and multivariable linear regression analyses, among NTDs affecting pregnancy, the history of spontaneous abortion and knowledge were independently associated with adherence to the IFAS (P < 0⋅05). Preconception nutrition education with regular follow-ups could be effective in improving knowledge and adherence to the IFAS intake. This intervention is very short, simple, cost-effective and has the potential for adaptation development to a large-scale implementation in the existing healthcare system in Ethiopia to prevent NTDs and adverse birth outcomes among women who plan to get pregnant. This clinical trial was registered on 6 April 2021 under the ClinicalTrials.gov with an identifier number PACTR202104543567379. PubDate: 2022-07-13 DOI: 10.1017/jns.2022.51
Authors:Cheikh Ismail; Leila, Osaili, Tareq M., Mohamad, Maysm N., Zakaria, Hala, Ali, Aaesha, Tarek, Asma, Ashfaq, Alizeh, Al Abdouli, Mohamed A., Saleh, Sheima T., Daour, Rameez Al, AlRajaby, Radhiya, Stojanovska, Lily, Al Dhaheri, Ayesha S. First page: 59 Abstract: Camel milk has been consumed for centuries due to its medicinal and healing properties. The present study aims to investigate the consumption patterns of camel milk and perceived benefits and risks among adults in the United Arab Emirates. A self-administered online questionnaire was developed in English and Arabic languages and was completed online by 852 adults. Socio-demographic characteristics, camel milk consumption patterns and perceived knowledge of the benefits and risks of camel milk were investigated. About 60 % of the participants have tried drinking camel milk, but only a quarter (25⋅1 %) were regular consumers. The most consumed camel milk products after fresh milk were yoghurt and flavoured milk. The most popular additions to camel milk were honey, turmeric and sugar. Most consumers had less than one cup of camel milk per day (57⋅0 %). Camel milk consumers preferred it over other types of milk due to its nutritional value (66⋅4 %) and medicinal properties (39⋅3 %). Among consumers, 58⋅4 % reported consuming unpasteurised camel milk. Reasons included the belief that it is fresher (87⋅2 %), better for the immune system (41⋅6 %), and higher in nutrients (39⋅2 %). Overall, participants had inadequate knowledge about the health benefits of camel milk (7⋅11 ± 5⋅3 out of 25). Males and camel milk consumers had a significantly higher knowledge about the health benefits of camel milk compared to females and non-consumers (P < 0⋅05). Although positive perceptions were common, misperceptions appear to be prevalent among non-consumers. Consuming unpasteurised camel milk is a major public health concern, thus national regulations are essential. PubDate: 2022-07-21 DOI: 10.1017/jns.2022.55
Authors:Turki; Saoussen, Bouzekri, Khaoula, Trabelsi, Tarek, El Ati, Jalila First page: 60 Abstract: Tunisia recorded the highest rate of COVID-19 positive cases and deaths in Africa but no studies assessed the impact of the pandemic on eating patterns as in the case of several countries. The objective of the present study was to investigate the perception of changes in food habits, appetite and body weight in Tunisian adults of both genders aged 20–74 years old. A cross-sectional study has been carried out with a non-probabilistic sampling method based on an online self-administered survey. Of overall 1082 adults included in the study, 57⋅8 % reported a change in their eating habits: 21⋅2 % an increase in their consumption of fresh fruits, vegetables, pulses, pasta and bread, while 36⋅6 % an increase of homemade cakes and biscuits, sweets, processed meat, sugary drinks and alcoholic drinks. In addition, tea, coffee and herbal tea have been reported as excessively consumed during the lockdown period. More than half experienced appetite variations (34⋅6 % increased appetite and 23⋅0 % appetite loss). Inequality detrimental to women was reported regarding eating habit changes (women consumed more unhealthier foods than men). Elderly subjects (over 60 years) were less likely to negatively change food habits in comparison with young adults (20–25 years), while ungraduated respondents were more prone to negatively change their food habits. Almost half reported weight gain. As the negative influence of the lockdown period on eating habits with the increase of obesity risk has been detected, health policy may be advised to focus on using mass media campaigns to promote healthy eating habits, in particular for illiterate and young people. PubDate: 2022-07-13 DOI: 10.1017/jns.2022.58
Authors:Scully; Helena, Laird, Eamon, Healy, Martin, Crowley, Vivion, Walsh, James Bernard, McCarroll, Kevin First page: 61 Abstract: Vitamin D is essential for bone and muscle health with adequate status in childhood crucial for normal skeletal development. We aimed to investigate vitamin D status in a convenience sample (n = 1226) of Irish children (aged 1–17 years) who had serum 25-hydroxyvitamin D (25(OH)D) tested by request of their GP at a Dublin Hospital between 2014 and 2020. We examined predictors including age, sex, season and socioeconomic status (SES). Vitamin D deficiency (12 v. ≤12 years (24 % v. 16 %, P = 0⋅033). The greatest predictor was SES (disadvantaged v. affluent, OR 2⋅18, CI 1⋅34, 3⋅53, P = 0⋅002), followed by female sex (OR 1⋅57, CI 1⋅15, 2⋅14, P = 0⋅005) and winter season (October to February, OR 1⋅40, CI 1⋅07, 1⋅84, P = 0⋅015). A quarter of our sample of children were deficient, rising to one-third in those in disadvantaged areas. Females and those aged over 12 years had a higher prevalence of deficiency. Public health strategies to improve vitamin D status in Irish children, including systematic food fortification may need to be considered to address this issue. PubDate: 2022-07-25 DOI: 10.1017/jns.2022.57
Authors:Cui; Yong, Cai, Hui, Gao, Yutang, Dai, Qi, Yang, Gong, Zheng, Wei, Shu, Xiao-Ou First page: 62 Abstract: The role of dietary factors in osteoporotic fractures (OFs) in women is not fully elucidated. We investigated the associations between incidence of OF and dietary calcium, magnesium and soy isoflavone intake in a longitudinal study of 48 584 postmenopausal women. Multivariable Cox regression was applied to derive hazard ratios (HRs) and 95 % confidence intervals (CIs) to evaluate associations between dietary intake, based on the averages of two assessments that took place with a median interval of 2⋅4 years, and fracture risk. The average age of study participants is 61⋅4 years (range 43⋅3–76⋅7 years) at study entry. During a median follow-up of 10⋅1 years, 4⋅3 % participants experienced OF. Compared with daily calcium intake ≤400 mg/d, higher calcium intake (>400 mg/d) was significantly associated with about a 40–50 % reduction of OF risk among women with a calcium/magnesium (Ca/Mg) intake ratio ≥1⋅7. Among women with prior fracture history, high soy isoflavone intake was associated with reduced OF risk; the HR was 0⋅72 (95 % CI 0⋅55, 0⋅93) for the highest (>42⋅0 mg/d) v. lowest ( PubDate: 2022-08-01 DOI: 10.1017/jns.2022.52
Authors:Tafese; Zelalem, Reta, Fekadu, Mulugeta, Biruk, Anato, Anchamo First page: 63 Abstract: Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother–child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of PubDate: 2022-08-03 DOI: 10.1017/jns.2022.61
Authors:Houghtaling; Bailey, Cater, Melissa, Pradhananga, Nila, Holston, Denise First page: 64 Abstract: Marketing influences consumers’ dietary purchases. However, little is known about marketing environments in Supplemental Nutrition Assistance Program (SNAP)-authorised stores. The present study explored SNAP-authorised store marketing environments in Louisiana by rurality, store ownership and store type (n 42). Sampling methods were designed to include randomly selected stores in each geographic area of the state. The GroPromo was used to measure placement, promotion, and child-focused aspects of marketing strategies used for healthier (fruits and vegetables) and less healthy products (chips, candy, sugar-sweetened beverages, child-focused cereal) in medium- and high-prominence marketing areas. In using multivariate analysis of variance (MANOVA) (P < 0⋅05) for data analysis, variations in GroPromo scores were found among SNAP-authorised stores by rurality (P < 0⋅05) and store ownership (P < 0⋅001); no differences were found by store type (P> 0⋅05). Future research, practice and policy strategies are required to understand the influence of marketing environments on SNAP participants’ dietary quality and to design responsive public health interventions. PubDate: 2022-08-04 DOI: 10.1017/jns.2022.60
Authors:Matthes; Katarina L., Hartmann, Christina, Siegrist, Michael, Burnier, Michel, Bochud, Murielle, Zwahlen, Marcel, Bender, Nicole, Staub, Kaspar First page: 65 Abstract: Excess weight is caused by multiple factors and has increased sharply in Switzerland since the 1990s. Its consequences represent a major challenge for Switzerland, both in terms of health and the economy. Until now, there has been no cross-dataset overview study on excess weight in adults in Switzerland. Therefore, our aim was to conduct the first synthesis on excess weight in Switzerland. We included all existing nationwide Swiss studies (eight total), which included information on body mass index (BMI). Mixed multinomial logistic regression analyses were performed to assess the associations between different socio-demographic, lifestyle cofactors and the World Health Organization (WHO) categories for BMI. Along with lifestyle factors, socio-demographic factors were among the strongest determinants of BMI. In addition, self-rated health status was significantly lower for underweight, pre-obese and obese men and women than for normal weight persons. The present study is the first to synthesise all nationwide evidence on the importance of several socio-demographic and lifestyle factors as risk factors for excess weight. In particular, the highlighted importance of lifestyle factors for excess weight opens up the opportunity for further public health interventions. PubDate: 2022-08-10 DOI: 10.1017/jns.2022.66
Authors:Fujimura; Maya S., Conkle, Joel, Van Wyk, Marjorie, Jimba, Masamine First page: 66 Abstract: The poor assessment of child malnutrition impacts both national-level trends and prioritisation of regions and vulnerable groups based on malnutrition burden. Namibia has reported a high prevalence of malnutrition among children younger than 5 years of age. The present study's aim was to identify the optimal methods for estimating child stunting and wasting prevalence in Namibia using two datasets with suspected poor data quality: Namibia Demographic and Health Surveys (NDHS) (1992–2013) and Namibia Household Income and Expenditure Survey (NHIES), 2015/16. This comparative secondary data analysis used two prevalence estimation methods: WHO flags and PROBIT. WHO flags is the standard analysis method for most national household surveys, while the PROBIT method is recommended for poor quality anthropometry. In NHIES (n 4960), the prevalence of stunting (n 4780) was 30·3 and 20·9 % for the WHO flags and PROBIT estimates, respectively, and the national wasting prevalence (n 4637) was 11·2 and 4·2 %, respectively. The trends in nutritional status from NDHS and NHIES showed improvement across WHO flags and PROBIT until 2013; however, from 2013 to 2016, PROBIT showed smaller increases in stunting and wasting prevalence (2·5 and 0·6 percentage points) than WHO flags (6·6 and 5·0 percentage points). PROBIT identified the Khoisan ethnic group and Northern geographical regions with the highest stunting and wasting prevalence, while WHO flags identified similar prevalence across most groups and regions. The present study supports the recommendation to use PROBIT when poor data quality is suspected for constructing trends, and for targeting regions and vulnerable groups. PubDate: 2022-08-15 DOI: 10.1017/jns.2022.67
Authors:Edmondson; Emma K., Shea, Judy A., Gregory, Emily F., Roberto, Christina A., Garcia, Stephanie M., Kwon, Jeemin, Virudachalam, Senbagam First page: 67 Abstract: Objective: To characterise perceptions of the Philadelphia Beverage Tax among low-income parents. Design: We conducted semi-structured interviews and administered demographic questions via telephone. We based the interview guide and initial codebook on a conceptual model illustrating perceived fairness and effectiveness as essential for successfully adopting food policies. We performed thematic analysis using NVivo 12. Setting: We recruited from a primary care paediatrics clinic in Philadelphia, Pennsylvania from July to August 2020. Participants: Philadelphia parents/caregivers of 2- to 11-year-old children with Medicaid insurance. Results: Participants were predominantly African American (97 %), female (100 %), and had annual household incomes PubDate: 2022-08-22 DOI: 10.1017/jns.2022.64
Authors:Itani; Rita, Mattar, Lama, Kharroubi, Samer, Bosqui, Tania, Diab-El-Harake, Marwa, Jomaa, Lamis First page: 68 Abstract: The present study aimed to assess the prevalence of food insecurity (FI) among college students and explore its association with indicators of mental and psychosocial health. Data were collected using a cross-sectional online survey from college students in different universities in Lebanon during the Spring 2021 semester. FI was assessed using the validated eight-item food insecurity experience scale. The mental health of college students was assessed using validated screening tools for depression, anxiety and well-being, namely the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder-7 (GAD-7) and the World Health Organization (WHO-5) index, respectively. Multiple linear regression models were conducted to assess the relationship of FI with PHQ-9, GAD-7 and WHO-5 scores. A total of 745 students completed the online survey. Approximately 39 % of students in the sample were experiencing FI of which 27·4, 8·1, and 3·5 % were experiencing mild, moderate and severe FI , respectively. Low maternal education, low household monthly income and high levels of stress were significant correlates of FI among college students (P-trend < 0·001). In addition, 22·6 and 34·4 % of students showed severe symptoms of depression and anxiety, respectively. Regression models showed that FI was associated with higher scores on PHQ-9 and GAD-7 (β = 2·45; 95 % CI [1·41, 3·49]) and (β = 1·4; 95 % CI [1·1, 2·2], respectively) and lower scores on WHO-5 (β = −4·84; 95 % CI [−8·2, −1·5]). In conclusion, a remarkable proportion of college students reported experiencing different forms of FI, which was associated with poorer mental health and well-being outcomes. Public health programmes and interventions are needed to mitigate FI and improve student health-related outcomes. PubDate: 2022-08-23 DOI: 10.1017/jns.2022.68
Authors:Desalegn; Tsion A., Gebremedhin, Samson, Stoecker, Barbara J. First page: 69 Abstract: Ethiopia recently scaled up the implementation of a school feeding program (SFP) as a targeted intervention for protecting disadvantaged school children from hunger and food insecurity. However, the contribution of the program to advancing the nutritional status of children has not been adequately explored. We assessed the effect of SFP on the anthropometric and haemoglobin status of school children in Sidama Region, Southern Ethiopia. Our prospective cohort study compared the height-for-age z-score (HAZ), BMI-for-age z-score (BAZ) and haemoglobin concentration of SFP beneficiary (n 240) and non-beneficiary (n 240) children, 10–14 years of age. The children were recruited from 8 SFP implementing and 8 control schools using a multistage sampling procedure and were followed for an academic year. The SFP intervention and control schools were matched one-to-one based on agro ecological features and geographical proximity. Exposure, outcome and pertinent extraneous variables were collected through baseline and end-line surveys. Multilevel difference-in-differences (DID) analysis was used to measure the net effect on the outcomes of interest. In the multivariable DID model adjusted for potential confounders including maternal and paternal literacy, household monthly income, wealth index and household food insecurity, the SFP did not show significant effects on the haemoglobin concentration (β = 0⋅251, 95 % confidence interval (CI): −0⋅238, 0⋅739), BAZ (β = 0⋅121, 95 % CI: −0⋅163, 0⋅405) and HAZ (β = −0⋅291, 95 % CI: −0⋅640, 0⋅588) of children. PubDate: 2022-08-24 DOI: 10.1017/jns.2022.73
Authors:Derbie; Liyu, Oumer, Abdu, Ayele, Ketema, Berhane, Anteneh First page: 70 Abstract: As the world's aging population grows, nutrition and health issues are becoming a major concern. The aim of the present study was to identify the factors associated with nutritional status among old age population. A community-based cross-sectional study was employed among randomly selected 739 elders over the age of 60 in Dire Dawa City administration, eastern Ethiopia. The validated full mini nutritional assessment tool and appetite test (SNAQ) was used to assess the nutritional status of the study population. Considering the ranked nature of the data, a bivariate and multivariable ordinal logistic regression model (under the generalised linear model) was conducted, with crude and adjusted odds ratios reported along with 95 % confidence intervals. Statistically significant associations are declared at P-value less than 0⋅05. In this study, 22 % (95 % CI: 19 %, 25 %) of elders were malnourished. Participants with>75 years old (AOR 4⋅95; 95 % CI 1⋅54, 8⋅4), being female (AOR 1⋅6; 95 % CI 1⋅1, 2⋅2), illiterate (AOR 1⋅5; 95 % CI 1⋅01, 2⋅2), severe depression (AOR 13⋅9; 95 % CI 8⋅2, 23⋅7) and with poor appetite (AOR 3⋅3; 95 % CI 2⋅3, 4⋅8) were important predictors of malnutrition among older age group. We found that the prevalence of malnutrition and the risk of malnutrition is a public health concern that warrants intervention in the area. Advanced age, illiteracy, depression and poor appetite were important risk factors for malnutrition among older age group. The identified risk factors will guide public health professionals and programmes in the design, implementation of interventions to improve the nutritional status of older age group. PubDate: 2022-08-26 DOI: 10.1017/jns.2022.62
Authors:El Shikieri; Ahlam Badreldin First page: 71 Abstract: This study on adolescents was intended to assess the prevalence of disordered eating attitudes and the nutritional status of adolescent girls in Saudi Arabia. Disordered eating attitudes and behaviour were assessed using the EAT-26. The type of eating disorder (ED) was determined using Diagnostic statistical manual of mental disorders, fifth edition. The nutritional status of the adolescent girls was determined by measuring their weight and height twice using standard protocols. The BMI-for-age and height-for-age were defined using WHO growth charts. Comparisons between adolescent girls with and without EDs were conducted using SPSS version 26. Eating disorders (EDs) were prevalent among 10⋅2 % of these girls. Other specified feeding or EDs were the most prevalent ED (7⋅6 %), followed by unspecified feeding or eating disorder (2⋅4 %). Anorexia nervosa was common among 0⋅3 % of the girls. The eating disordered adolescents were either overweight (7⋅7 %), obese (10⋅3 %), stunted (7⋅7 %) or severely stunted (2⋅6 %). ANOVA revealed that the BMI-for-age was influenced by age (P = 0⋅028), the type of ED (P = 0⋅019) and the EAT-26 (P < 0⋅0001). Pearson's correlation showed that the EAT-26 score increased significantly with the BMI (r 0⋅22, P = 0⋅0001), height (r 0⋅12, P = 0⋅019) and weight (r 0⋅22, P = 0⋅0001). The early detection of EDs among adolescents is highly recommended to reduce the risk associated with future impaired health status. Nutrition professionals must target adolescents, teachers and parents and provide nutritional education about the early signs and symptoms of ED and the benefits of following a healthy dietary pattern. PubDate: 2022-08-26 DOI: 10.1017/jns.2022.71
Authors:Alemu; Wudineh Dessie, Bulta, Alemu Lelago, Doda, Mesfin Bibiso, Kanido, Camerun Kastro First page: 72 Abstract: In the present study, the levels and probable public health risks of selected metals (Fe, Mn, Cu, Zn, Ni, Cd and Pb) in nine wheat flour samples collected from Amhara, Oromia, South region, and the Strategic Food Reserve Agency were determined using FAAS and compared with results of prior studies and critical level. The wet digestion method using 65 % HNO3 and 72 % HClO4 in 300°C for 3 h was used when preparing the sample. Validation of the optimised digestion method was assessed using the spiking method, and an acceptable percent recovery from all metals. The levels of Fe, Cu, Mn, Zn, Ni and Cd ranged between 8⋅5297 and 11⋅1535, 1⋅633 and 4⋅2346, 3⋅1875 and 8⋅5313, 2⋅3589 and 2⋅7719, 0⋅154 and 0⋅854, and 0⋅0411 and 0⋅216 mg/kg, respectively, for Ethiopian wheat flour, while the level of Fe, Cu, Mn, Zn, Ni, Cd and Pb were ranged between 8⋅0099 and 8⋅1089, 1⋅663 and 1⋅6691, 4⋅5625 and 4⋅6250, 2⋅3015 and 2⋅3072, 0⋅9423 and 1⋅1346, 0⋅1593 and 0⋅1606, and 0⋅13 and 0⋅1381 mg/kg, respectively, for imported wheat flour. However, Pb had a concentration of less than 0⋅043 mg/kg for Ethiopian wheat flour. Findings indicate that Ethiopian wheat is comparatively higher in Fe, Mn, Cu, Zn and Cd, but lower in Ni and Pb than imports. From the result of the study, it can be concluded that the level of heavy metals determined in this study was within the permissible limit, and no probable health risk because both the Hazard quotient (HQ) and the Hazard Index (HI) are found to be below 1⋅0 regarding study metals. PubDate: 2022-08-26 DOI: 10.1017/jns.2022.70
Authors:Yiannakou; Ioanna, Pickering, R. Taylor, Yuan, Mengjie, Singer, Martha R., Moore, Lynn L. First page: 73 Abstract: Some consider potatoes to be unhealthy vegetables that may contribute to adverse cardiometabolic health outcomes. We evaluated the association between potato consumption (including fried and non-fried types) and three key cardiometabolic outcomes among middle-aged and older adults in the Framingham Offspring Study. We included 2523 subjects ≥30 years of age with available dietary data from 3-d food records. Cox-proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for hypertension, type 2 diabetes or impaired fasting glucose (T2DM/IFG), and elevated triglycerides, adjusting for anthropometric, demographic and lifestyle factors. In the present study, 36 % of potatoes consumed were baked, 28 % fried, 14 % mashed, 9 % boiled and the rest cooked in other ways. Overall, higher total potato intake (≥4 v. PubDate: 2022-09-02 DOI: 10.1017/jns.2022.65
Authors:Krishnakumar; Illathu Madhavamenon, Jaja-Chimedza, Asha, Joseph, Ashil, Balakrishnan, Abhilash, Maliakel, Balu, Swick, Andrew First page: 74 Abstract:Fisetin, a polyphenol found in several fruits and vegetables, has shown potential health benefits in many pre-clinical studies for neuroprotection, cardioprotection, chemoprevention, diabetes, inflammation and oxidative stress. However, the clinical effectiveness of fisetin may be limited by its poor bioavailability when ingested. Using a novel green technology of Hybrid-FENUMAT™, a food-grade fisetin formulation (FF-20) was developed through encapsulation of fisetin micelles into fenugreek galactomannan (FG) hydrogel scaffold to improve its physical characteristics and bioavailability. This is the first human pharmacokinetic study of fisetin following a single-dose, comparative, double-blinded, cross-over protocol, supplementing with FF-20 and unformulated fisetin (UF). Fifteen healthy volunteers were given a single dose of 1000 mg UF or 1000 mg FF-20 (delivering 192 mg fisetin) with a 10-d washout period between each dose. Blood samples were taken at 0⋅5, 1, 2, 3, 5, 8 and 12 h after both days of supplementation to quantify fisetin and geraldol, an active metabolite. The plasma concentration of fisetin when individuals consumed FF-20 was 26⋅9-fold greater than UF as determined by the area under the curve over 12 h [AUC0–12 h (FF-20) = 341⋅4 v. AUC0–12 h (UF) = 12⋅67]. The maximum plasma concentration (Cmax) was also more than twenty-three times higher when supplemented with FF-20 (238⋅2 ng/ml) compared to UF (9⋅97 ng/ml). The encapsulation also reduced the amount of conversion of fisetin to geraldol. No adverse events were reported during the study. Therefore, the encapsulation of fisetin into FG dietary fibre hydrogel scaffold could improve its delivery and bioavailability in human subjects. PubDate: 2022-09-09 DOI: 10.1017/jns.2022.72
Authors:Rush; Elaine C., Plank, Lindsay D., Lubree, Himangi, Bhat, Dattatray S., Ganpule, Anjali, Yajnik, Chittaranjan S. First page: 75 Abstract: Maternal size, weight gain in pregnancy, fetal gender, environment and gestational age are known determinants of birth weight. It is not clear which component of maternal weight or gained weight during pregnancy influences birth weight. We evaluated the association of maternal total body water measured by the deuterium dilution technique (TBW-D2O) at 17 and 34 weeks of gestation with birth weight. A secondary aim was to examine the utility of bioimpedance spectroscopy (BIS) to determine total body water (TBW-BIS) in pregnancy. At 17 and 34 weeks of pregnancy, ninety-nine women (fifty-one rural and forty-eight urban) from Pune, India had measurements of body weight, TBW-D2O, TBW-BIS and offspring birth weight. At 17 weeks of gestation, average weights for rural and urban women were 45⋅5 ± 4⋅8 (sd) and 50⋅7 ± 7⋅8 kg (P < 0⋅0001), respectively. Maternal weight gains over the subsequent 17 weeks for rural and urban women were 6⋅0 ± 2⋅2 and 7⋅5 ± 2⋅8 kg (P = 0⋅003) and water gains were 4⋅0 ± 2⋅4 and 4⋅8 ± 2⋅8 kg (P = 0⋅092), respectively. In both rural and urban women, birth weight was positively, and independently, associated with gestation and parity. Only for rural women, between 17 and 34 weeks, was an increase in dry mass (weight minus TBW-D2O) or a decrease in TBW-D2O as a percentage of total weight associated with a higher birth weight. At both 17 and 34 weeks, TBW-BIS increasingly underestimated TBW-D2O as the water space increased. Differences in body composition during pregnancy between rural and urban environments and possible impacts of nutrition transition on maternal body composition and fetal growth were demonstrated. PubDate: 2022-09-09 DOI: 10.1017/jns.2022.75
Authors:Chan; Virginia, Davies, Alyse, Wellard-Cole, Lyndal, Allman-Farinelli, Margaret First page: 76 Abstract: The present study examined the association of contextual factors (social and food preparation location) with the energy density of meals and snacks consumed in a sample of young Australian adults (18–30 years old) identified using wearable camera technology. Over three consecutive days, a subsample of young adults wore a wearable camera that captured images in 30 s intervals. Eating episodes from 133 participants were annotated for preparation location and social context (covering social interaction and screen use). Over the same period, participants completed daily 24 h recalls. The nutritional composition of meals and snacks was calculated by matching the items identified in the camera to the 24 h recall using time and date stamps. Self-reported data (weight and height) was used to calculate body mass index and (residential postcode) to assign socio-economic status. The association of context and demographic factors with energy density was determined using a mixed linear regression model employing the bootstrap method with bias-corrected and accelerated. In total, 1817 eating episodes were included in the analysis (n 8 preparation unclear and n 15 food components could not be identified excluded). Food prepared within the home was 1⋅1 kJ/g less energy-dense than other preparation locations. Lunches (CI −1⋅7 to −0⋅3) and dinners (CI −1⋅6 to −0⋅5) were both 1⋅0 kJ/g lower in energy density than breakfasts. Snacks were 3⋅5 kJ/g (CI 2⋅8–4⋅1) more energy-dense than breakfasts. Food prepared outside the home and food consumption during snacking appear to be adversely contributing to energy-dense food intake. PubDate: 2022-09-14 DOI: 10.1017/jns.2022.76
Authors:Papakonstantinou; Emilia, Magriplis, Emmanuella, Katsaros, George, Glinou, Dimitra, Sofiadis, Manolis, Skoulidi, Virginia, Zampelas, Antonis First page: 77 Abstract:High sugar intake has been associated with adverse effects on health, with some types of breakfast being highly linked to overweight and obesity. The aim was to compare the effects of four sugar-free breakfast items, apricot jam with white bread (JWB), white bread (WB), cocoa with fat-free milk (CM), and dried cranberry cereal bar (CB), compared to d-glucose on the glycaemic responses. Using a cross-over design, twelve healthy individuals (25 ± 4 years; BMI 22 ± 2 kg/m2) received isoglucidic test meals (25 g of available carbohydrate) and 25 g glucose reference, in random order. Glycaemic index/load (GI/GL) were calculated, and capillary blood glucose samples were collected at 0–120 min after meal consumption. Subjective appetite was assessed with visual analogue scales. Sugar-free apricot jam and cocoa powder contained traces of available carbohydrates and were consumed along with bread and fat-free milk, respectively. JWB and WB were classified as medium GI, low-to-medium GL; CM as medium GI, low GL; and CB as high GI, low-to-medium GL. Subjective hunger was lower after JWB, fullness was higher after CM and pleasure was higher after CB (P for all < 0⋅05). In conclusion, sugar-free apricot jam with and without WB and cocoa powder with fat-free milk are suitable healthy breakfast options leading to improved glycaemic and subjective appetite responses. PubDate: 2022-09-14 DOI: 10.1017/jns.2022.74
Authors:Mahdi; Sajedeh, Mazidi, Mohsen, Davies, Ian G., Beigrezaei, Sara, Mozaffari-Khosravi, Hassan, Mirzaei, Masoud, Lane, Katie E., Khayyatzadeh, Sayyed Saeid First page: 78 Abstract: Worldwide type 2 diabetes (T2D) prevalence is increasing dramatically. The present study aimed to evaluate the association between dietary habits and T2D in an Iranian adult population using a cross-sectional analysis of the Shahedieh cohort study. Participants were adults aged 35–70 years (n 9261) from Zarch and Shahedieh, Yazd, Iran, who attended the baseline phase of the Shahedieh cohort study. Dietary habits including meal frequency, fried-food consumption, adding salt to prepared meals and grilled-food consumption were assessed by a standard questionnaire. T2D was defined as fasting plasma glucose (FPG) ≥126 mg/dl according to the American Diabetes Association. Multiple logistic regression assessed the association between dietary habits and T2D. Individuals who consumed a meal more than six times per day compared to three times per day had greater odds for T2D (OR 2⋅503, 95 % CI 1⋅651, 3⋅793). These associations remained significant in a fully adjusted model. There was a significant association between greater intakes of fried foods and prevalence of T2D (OR 1⋅294, 95 % CI 1⋅004, 1⋅668) in the adjusted model. No significant associations were observed between other dietary habits (adding salt to prepared meals and grilled-food consumption) and odds of T2D in all crude and adjusted models. In conclusion, we have highlighted the association between meal and fried-food consumption frequencies with risk of T2D. Large longitudinal studies in different ethnicities are needed to confirm these associations. PubDate: 2022-09-19 DOI: 10.1017/jns.2022.56
Authors:Wong; Tommy Hon Ting, Burlutsky, George, Gopinath, Bamini, Flood, Victoria M., Mitchell, Paul, Louie, Jimmy Chun Yu First page: 79 Abstract: The present study aimed to assess the longitudinal associations of coffee and tea consumption with metabolic syndrome and its component conditions in a group of Australian older adults who participated in the Blue Mountains Eye Study (n 2554, mean age: 64 years, 43 % female). Participants’ coffee and tea intake were measured using a validated food frequency questionnaire. Hazard ratios (HRs) over a 10-year period were estimated using Cox hazard regression models adjusting for lifestyle factors. Results showed that coffee consumption was not associated with the incidence of metabolic syndrome, high fasting glucose, high triglycerides, central obesity, high blood pressure and low HDL-cholesterol (HDL-C). Tea consumption was not associated with incidence of metabolic syndrome and the component conditions except for the risk of having low HDL-C, in which a nominally inverse association was observed (multivariate-adjusted HR at 2–3 cups/d: 0⋅48, 95 % CI 0⋅26, 0⋅87, P = 0⋅016; 4 cups/d or more: 0⋅50, 95 % CI 0⋅27, 0⋅93, P = 0⋅029). After stratifying for fruit consumption (Pinteraction between tea and fruit = 0⋅007), consuming four cups of tea per day was nominally associated with lower incidence of metabolic syndrome among those with high fruit consumption (multivariable-adjusted HR: 0⋅44, 95 % CI 0⋅20, 0⋅93, P = 0⋅033). Our results did not support a significant association between tea and coffee consumption and metabolic syndrome. Tea consumption may be associated with a lower risk of having low HDL-C, while high tea and fruit consumption together may be associated with a lower risk of developing metabolic syndrome. PubDate: 2022-09-21 DOI: 10.1017/jns.2022.78
Authors:Saapiire; Ferguson, Dogoli, Richard, Mahama, Saaka First page: 80 Abstract: Anaemia in pregnancy remains a critical public health concern in many countries including Ghana and it poses severe consequences in the short to long-term for women and their unborn babies. Although antenatal care (ANC) is largely provided for pregnant women, the extent its utilisation protects against anaemia in pregnancy remains largely understudied. The study assessed the adequacy of ANC services utilisation and its effect on anaemia among pregnant women in the Wa Municipality of Ghana. A facility-based cross-sectional survey was conducted. Probability proportionate to size sampling and systematic random sampling were used to select the facilities and 353 respondents. While 80⋅2 % of the pregnant women reported having received a sufficient number of ANC services provided, the prevalence of the overall ANC adequacy was only 44⋅2 %. After adjusting for potential confounders, pregnant women who could not achieve adequate ANC attendance were 2⋅3 times more likely to be anaemic in the third trimester of gestation AOR = 2⋅26 (95 % CI 1⋅05, 4⋅89), compared to their counterparts who maintained adequate ANC attendance. Adequate ANC attendance was a consistent and significant predictor of anaemia in pregnancy in the third trimester. Health and nutrition education on the need for early initiation of ANC attendance and support for the consumption of diversified diets are two possible interventions that can help contain anaemia in pregnancy. PubDate: 2022-09-21 DOI: 10.1017/jns.2022.80
Authors:Anato; Anchamo, Baye, Kaleab, Stoecker, Barbara J. First page: 81 Abstract: In Ethiopia, information is limited about energy and micronutrient intakes from complementary foods consumed by children in Productive Safety Net Program districts. Therefore, we assessed feeding practices and intakes of energy and selected micronutrients from complementary foods of children aged 6–23 months in a food insecure rural area of Ethiopia. Energy and micronutrient intakes were estimated from multiple-pass 24 h recall. Data were collected using a structured questionnaire. Only 1⋅9 % of children in the age range 6–8 months met recommended minimum dietary diversity of ≥5 food groups; this value slightly increased to 4 and 10⋅1 % in the older age groups (9–11 months and 12–23 months, respectively). Overwhelmingly, none of the children (9–11 months) did get the minimum acceptable diet (Children receiving minimum acceptable diet were 4 and 2⋅6 % in 6–8 months and 12–23 months, respectively). The overall prevalence of stunting was 34 % in younger children (6–8 months) and 51 % in older children aged 12–23 months. Median energy and selected micronutrient intakes from complementary foods were below corresponding WHO recommendations assuming average breast-milk amount and composition. The worst shortfalls were for vitamins A and C and for Ca. In contrast, median iron, protein and niacin intakes and densities were above the WHO recommendation. Caretakers and community leaders in the study setting need nutrition education on IYCF-related practices and on the importance of men's involvement in IYCF. Ensuring the accessibility and affordability of animal source foods (ASFs), fruits and vegetables, and feasible complementary foods is critical to address the quality of complementary feedings. This can be achieved through promoting nutrition-sensitive agriculture such as poultry and home gardening in this setting. PubDate: 2022-09-27 DOI: 10.1017/jns.2022.79
Authors:Crimarco; Anthony, Landry, Matthew J., Carter, Matthew M., Gardner, Christopher D. First page: 82 Abstract: Alternative plant-based meats have grown in popularity with consumers recently and researchers are examining the potential health effects, or risks, from consuming these products. Because there have been no studies to date that have specifically assessed the health effects of plant-based meats on biomarkers of inflammation, the purpose of this work was to conduct a secondary analysis of the Study With Appetizing Plantfood – Meat Eating Alternatives Trial (SWAP-MEAT). SWAP-MEAT was a randomised crossover trial that involved generally healthy adults eating 2 or more servings of plant-based meats per day for 8 weeks (i.e. Plant phase) followed by 2 or more servings of animal meats per day for 8 weeks (i.e. Animal phase). Results of linear mixed-effects models indicated only 4 out of 92 biomarkers reached statistical significance. The results were contrary to our hypothesis, since we expected relative improvements in biomarkers of inflammation from the plant-based meats. PubDate: 2022-09-23 DOI: 10.1017/jns.2022.84
Authors:Albar; Salwa Ali First page: 83 Abstract: A global target of increasing exclusive breast-feeding (EBF) to at least 50 % by the year 2025 was set by the WHO for infants under 6 months. The lowest prevalence in the world was found in the Eastern Mediterranean region in 2010–18 and little is known about the status of mothers’ feeding practices in Saudi Arabia. The present study aimed to assess mothers’ actual feeding and weaning practices used with their infants by the mothers’ different age groups. The present study was conducted among 247 mothers of infants aged 4–12 months who were attending public well-baby clinics. Quantitative data were obtained by nutritionists using an electronic semi-structured questionnaire about mothers’ feeding practices. Only 5·3 % of mothers engaged in EBF, 44·9 % breast-fed their infants after an hour of birth, while 92·7 % of infants had ever been breast-fed. The average intent/plan to continue breast-feeding was 4·9(±3·1) months. Younger mothers introduced weaning food around 4 weeks earlier than older mothers (mean differences were −0·4, 95 % CI −0·71, −0·13; P = 0·031). A total of 64·3 % of infants received complementary feeding before completing 17 weeks. Maternal age group and delivery mode were the only factors associated with the early introduction of complementary feeding. A total of 69·2 % of the mothers believed that ‘it is a good time’ and 61·1 % felt that ‘infants are hungry and need other sources of food’. Online sources and family advice were the top sources of information on mothers’ feeding practices. Provision of professional advice about EBF and optimal weaning practices are significant areas for improvement in terms of compliance with recommended infant feeding practices. PubDate: 2022-09-23 DOI: 10.1017/jns.2022.85
Authors:Khusun; Helda, Monsivais, Pablo, Anggraini, Roselynne, Februhartanty, Judhiastuty, Mognard, Elise, Alem, Yasmine, Noor, Mohd Ismail, Karim, Norimah, Laporte, Cyrille, Poulain, Jean-Pierre, Drewnowski, Adam First page: 84 Abstract: The ongoing nutrition transition in lower- and middle-income countries (LMIC) in South East Asia may have a positive impact on protein nutrition. This study assessed the diversity of plant and animal protein food sources in relation to essential amino acid (EAA) adequacy in a population-based sample (N 1665) in Indonesia. Dietary intakes from in-person 24 h recalls provided data on energy and protein intakes (in g/d) from plants (grains, legumes), meat, poultry and fish, and eggs and dairy. Protein diversity scores were based on the number of protein food sources over 24 h. EAA scores were the ratio of amino acid intakes to recommended values. Protein diversity and EAA scores were then compared across multiple socio-demographic indices. Analysis of variance and χ2 tests were used to test for differences among groups. Energy intakes were 1678 kcal/d for men and 1435 kcal/d for women. Average protein intakes (and prevalence of inadequacy) were 59⋅4 g/d (41⋅7 %) for men and 51⋅5 g/d (51⋅1 %) for women. In regression analyses, higher protein diversity scores were associated with higher protein intakes, more animal protein and less plant protein and with higher EAA scores. Lower protein diversity scores were associated with lower intakes of lysine, leucine and valine relative to requirements, as well as with lower EAA, rural settings, less wealth and less modernisation. Greater diversity of animal protein food sources, observed among groups of higher socio-economic status, was linked to better amino acid adequacy and protein nutrition. PubDate: 2022-09-28 DOI: 10.1017/jns.2022.82
Authors:Scott; Judith L., Vijayakumar, Aswathy, Woodside, Jayne V., Neville, Charlotte E. First page: 85 Abstract: Traditional methods of dietary assessment are prone to measurement error, with energy intake often under-reported. The 24-h recall is widely used in dietary assessment, however, its reliance on self-report without verification of consumption can result in inaccuracies in true nutrient intake. Wearable cameras may provide a complementary approach to improve self-report accuracy by providing an objective and passive measure of food consumption. The purpose of the present study was to determine whether a wearable camera improves the accuracy of a 24-h recall compared with a 24-h recall alone in twenty adults aged 18–65 years. The study also explored limitations associated with wearable cameras. Participants wore the camera for 1 d and a 24-h recall was then conducted the following day, before and after viewing the camera images. Dietary data were analysed using Nutritics dietary analysis software, while eating habits were assessed by a self-report questionnaire. Energy and nutrient intakes were compared between the recall alone and the camera-assisted recall. Results showed a significant increase in mean energy intake with the camera-assisted recall compared with the recall alone (9677⋅8 ± 2708⋅0 kJ/d v. 9304⋅6 ± 2588⋅5 kJ/d, respectively, P = 0⋅003). Intakes of carbohydrates, total sugars and saturated fats were also significantly higher with the camera-assisted recall. In terms of challenges, there were occasionally technological issues such as proper positioning of the camera by the participants. In conclusion, reporting of energy and nutrient intake may be enhanced when a traditional method of dietary assessment, the 24-h recall, is assisted by a wearable camera. PubDate: 2022-09-27 DOI: 10.1017/jns.2022.81
Authors:Chaparro; M. Pia, Lopez, Miguel A., Hernandez, Julie, Brewer, Jessica D., Santos, Maria P., Paz-Soldan, Valerie A. First page: 86 Abstract: The objective of the present study was to assess the association between the observed and perceived food environment and food insecurity among households with children PubDate: 2022-09-30 DOI: 10.1017/jns.2022.88
Authors:Desalegn; Tsion A., Gebremedhin, Samson, Stoecker, Barbara J. First page: 87 Abstract: The Home-grown School Feeding Program (HG-SFP) is a model designed to provide school meals to students using foods sourced from local markets. HG-SFP recently has been incorporated as one of the strategies of educational development in Ethiopia aiming to address hunger and food insecurity problems of school children. Yet, evaluation of the successes and challenges of the program has been limited evaluated. The purpose of the present study was to explore the successes and challenges of the SFP in Sidama Region, Southern Ethiopia. This exploratory qualitative study collected data from eight schools targeted for HG-SFP through key informant interviews and focus group discussions (FGDs). A total of sixteen FGDs and twenty-one in-depth interviews were conducted. Purposive sampling was used to include study participants based on their potential relevance in delivering in-depth information. The findings of the present study showed that HG-SFP was successful in improving class attendance and academic performance of school children. In addition, the program had a contribution in saving the parents’ money and time as a result of the food provided. With regard to SFP challenges, lack of permanent clean water provision, delay in ration delivery, poor-quality food provision, inadequate amount of food allocated for the academic year, lack of necessary infrastructure for the program, and lack of training in sanitation and hygiene for cooks were among the major challenges identified. Therefore, program challenges need high-level attention in order to make the school feeding program more successful in Sidama Region, Ethiopia. PubDate: 2022-09-30 DOI: 10.1017/jns.2022.77
Authors:Sisay; Binyam Girma, Afework, Tsion, Jima, Beshada Rago, Gebru, Nardos Wondafrash, Zebene, Addisalem, Hassen, Hamid Y. First page: 88 Abstract: Dietary diversity in children may be influenced not only by individual circumstances but also by the features of the community in which they live. Our study aimed to assess community and individual-level determinants of minimum dietary diversity among children aged 6–23 months in Ethiopia. We included 2960 children aged 6–23 months from the recent Ethiopia Demographic and Health Survey. A minimum dietary diversity was defined as the consumption of at least five food groups out of the eight reference food groups within 24 h by children aged 6–23 months. Multilevel logistic regression was used to investigate the drivers of minimum dietary diversity in Ethiopian children aged 6–23 months. About 12⋅5 % of children met the bare minimum of dietary diversification. Age of the child (9–11 months AOR, 3⋅3 (95 % CI 1⋅8, 5⋅6), 12–17 months AOR, 4⋅0 (95 % CI 2⋅4, 6⋅7), 18–23 months AOR, 3⋅5 (95 % CI 2⋅0, 5⋅8)), caregiver listening radio at least once a week AOR, 1⋅6 (95 % CI 1⋅1, 2⋅4) and wealth quantiles (Second AOR, 1⋅8 (95 % CI 1⋅1, 3⋅1), Fourth AOR, 2⋅9 (95 % CI 1⋅6, 5⋅2) and Highest AOR, 2⋅2 (95 % CI 1⋅1, 4⋅2)) were individual characteristics associated with dietary diversity. Place of residence was the only community-level characteristic associated with children's dietary diversity (Rural AOR, 0⋅4 (95 % CI 0⋅2, 0⋅6)). The minimum dietary diversity among Ethiopian children is suboptimal. Nutrition programmes aimed at enhancing dietary diversity should be strengthened in this population, particularly for those from poor families and residing in rural areas. PubDate: 2022-10-06 DOI: 10.1017/jns.2022.87
Authors:Klevay; Leslie M. First page: 89 Abstract: The classical deficiency diseases have nearly disappeared from the industrialised world and are thought to be found largely in sub-Saharan Africa and South Asia. More than 80 collected medical articles, mostly from Europe and North America, describe more than 9000 people with low concentrations of copper in organs or tissues or impaired metabolic pathways dependent on copper. More than a dozen articles reveal improved anatomy, chemistry or physiology in more than 1000 patients from supplements containing copper. These criteria are diagnostic of deficiency according to The Oxford Textbook of Medicine. Alzheimer's disease, ischaemic heart disease and osteoporosis receive major emphasis here. However, impaired vision, myelodysplastic syndrome and peripheral neuropathy are mentioned. Copper deficiency probably causes some common, contemporaneous diseases. Advice is provided about opportunities for research. Seemingly authoritative statements concerning the rarity of nutritional deficiency in developed countries are wrong. PubDate: 2022-10-11 DOI: 10.1017/jns.2022.83
Authors:Jisso; Meskerem, Tesfaye, Tizalegn, Biadgilign, Sibhatu, Tareke, Amare Abera, Zerfu, Tadesse Alemu First page: 92 Abstract: Little is known about the relation between the women empowerment in agriculture index, and health and nutrition outcomes among under-five children in Ethiopia. The study's objective was to examine women's empowerment in agriculture and its association with the nutritional status of children (6–59 months) in rural, cash crop producing, and resource-limited settings of Ethiopia. A community-based cross-sectional study was conducted employing 422 households; having women of reproductive age group and children under-five. Stratified simple random sampling was used to identify households; a simple random sampling was used to select villages and households. Women empowerment in agriculture was measured by the abbreviated women empowerment in agriculture index. Even if the overall multi-dimensional five domains of empowerment index (5DE) was not a significant predictor of nutritional status in children (P> 0⋅05), sub-indicators had a pivotal role in child nutritional status. Disempowerment in decisions about input into production [AOR = 8⋅85], empowerment on control of income [AOR = 0⋅35] and availability of livestock [AOR = 0⋅38] were predictors of child stunting, whereas women's disempowerment in production decisions seems beneficiary for wasting, disempowered women have 84 % less likely to have wasted child than empowered women [AOR = 0⋅16]. Dietary and agricultural diversity [particularly livestock farming], and women's empowerment in production decisions were predictors of better nutritional outcomes in children. Therefore, a concentrated effort is needed towards strengthening the multi-dimensional empowerment of women in agriculture emphasising women's input into production decisions, dietary and agricultural diversification, mainly livestock farming. PubDate: 2022-10-20 DOI: 10.1017/jns.2022.86
Authors:Storz; Maximilian A., Ronco, Alvaro L., Hannibal, Luciana First page: 93 Abstract: Contemporary diets in Western countries are largely acid-inducing and deficient in potassium alkali salts, resulting in low-grade metabolic acidosis. The chronic consumption of acidogenic diets abundant in animal-based foods (meats, dairy, cheese and eggs) poses a substantial challenge to the human body's buffering capacities and chronic retention of acid wherein the progressive loss of bicarbonate stores can cause cellular and tissue damage. An elevated dietary acid load (DAL) has been associated with systemic inflammation and other adverse metabolic conditions. In this narrative review, we examine DAL quantification methods and index observational and clinical evidence on the role of plant-based diets, chiefly vegetarian and vegan, in reducing DAL. Quantitation of protein and amino acid composition and of intake of alkalising organic potassium salts and magnesium show that plant-based diets are most effective at reducing DAL. Results from clinical studies and recommendations in the form of expert committee opinions suggest that for a number of common illnesses, wherein metabolic acidosis is a contributing factor, the regular inclusion of plant-based foods offers measurable benefits for disease prevention and management. Based on available evidence, dietary shifts toward plant-based nutrition effectively reduces dietary-induced, low-grade metabolic acidosis. PubDate: 2022-10-31 DOI: 10.1017/jns.2022.93
Authors:Kucuk; Bahar, Berg, Rigmor C. First page: 94 Abstract:Alternate day fasting (ADF) with consumption of calories up to 25 % of the daily energy intake on fast days is one of the most used intermittent fasting regimens and promoted as a promising, alternative approach for treating obesity. Feelings of appetite are critical for adherence to dietary approaches, and therefore the success of dietary interventions. This systematic review aimed to assess the effects of a minimum of 8 weeks of ADF on subjective feelings of appetite and body weight for adults with overweight and obesity. We conducted the review in accordance with the Cochrane guidelines, including systematic searches in four databases. Because of the high level of clinical and methodological heterogeneity, a narrative approach was used to synthesise the results. Eight studies with a total of 456 participants met the eligibility criteria: three randomised controlled trials and five uncontrolled before-after studies. Seven of the studies had high risk of bias. Feelings of appetite were assessed by hunger in eight studies, fullness in seven studies, satisfaction in four studies and desire to eat in one study. All the studies assessed weight loss. The certainty of the evidence was rated low or very low for all outcomes, thus no firm conclusions can be drawn about the potential benefits of ADF on subjective feelings of appetite and body weight. Despite the high interest in ADF, good quality evidence is still needed to determine its effectiveness and if offered in clinical practice, ADF should be offered cautiously while concomitantly evaluated. PubDate: 2022-10-31 DOI: 10.1017/jns.2022.90
Authors:Smith; Taryn J., Sitthideth, Dalaphone, Tan, Xiuping, Arnold, Charles D., Kounnavong, Sengchanh, Hess, Sonja Y. First page: 95 Abstract: Access to and utilisation of antenatal care (ANC) is important for optimising health and nutrition during pregnancy. This study aimed to assess adherence to and factors associated with ANC and antenatal supplement use among Laotian women, and consider culturally appropriate strategies to increase micronutrient intakes. Mother–child (aged 21 d to PubDate: 2022-10-28 DOI: 10.1017/jns.2022.94
Authors:Tegegne; Mekonnen, Abate, Kalkidan Hassen, Belachew, Tefera First page: 96 Abstract: Anaemia remains among the most prevalent nutritional problems among children in developing countries. In Ethiopia, more than half of children PubDate: 2022-11-02 DOI: 10.1017/jns.2022.63
Authors:Agaba; Monicah, Azupogo, Fusta, Brouwer, Inge D. First page: 97 Abstract: A mother's nutritional status and participation in household decision-making, a proxy for empowerment, are known determinants of improved nutrition and health outcomes for infants and young children; however, little is known about the association among adolescents. We examined the association between maternal nutritional status, decision-making autonomy and adolescent girls’ nutritional status. We analysed data of 711 mother–adolescent girl pairs aged 10–17 years from the Mion District, Ghana. Maternal nutritional status and decision-making autonomy were the independent variables while the outcomes were adolescent girls’ nutritional status as defined by anaemia, stunting and body mass index-for-age Z-score categories. Girl-level (age, menarche status and the frequency of animal-source food consumption), mother-level (age, education level, and monthly earnings) and household-level (wealth index, food security status and family size) covariates were adjusted for in the analysis. All associations were examined with hierarchical survey logistic regression. There was no association between maternal height and adolescent girls being anaemic, underweight or overweight/obese. Increasing maternal height reduced the odds of being stunted [adjusted odds ratio (OR) 0⋅92, 95 % CI (0⋅89, 0⋅95)] for the adolescent girl. Maternal overweight/obesity was positively associated with the girl being anaemic [OR 1⋅35, 95 % CI (1⋅06, 1⋅72)]. The adolescent girl was more than five times likely to be thin [OR 5⋅28, 95 % CI (1⋅64–17⋅04)] when the mother was underweight. Maternal decision-making autonomy was inversely associated with stunting [OR 0⋅88, 95 % CI (0⋅79, 0⋅99)] among the girls. Our findings suggest that intergenerational linkages of a mother's nutritional status are not limited to childhood but also during adolescence. PubDate: 2022-11-02 DOI: 10.1017/jns.2022.95
Authors:Sabir; Zoya, Rosendahl-Riise, Hanne, Dierkes, Jutta, Dahl, Helene, Hjartåker, Anette First page: 98 Abstract: All dietary assessment methods inevitably introduce measurement errors, which should ideally be considered during data analysis and interpretation. Methodological studies should be conducted to address how well a given assessment method captures dietary intake and to highlight the extent and direction of the measurement error. Within a subgroup of the Hordaland Health Study (HUSK3), we examined the relative validity of a web-based food frequency questionnaire (WebFFQ) by comparing its estimates of mean daily intake of nutrients and foods with estimated mean daily intakes from repeated administrations of 24-hour dietary recall interviews (24-HDRs). Men and women born between 1950 and 1951 were recruited from HUSK3. The participants (n = 67) completed a WebFFQ and three non-consecutive 24-HDRs over the course of a year. Relative validity was assessed using Spearman's rank correlation, crosstab analysis and Bland–Altman plots. Linear regression models were used to compute the calibration coefficients. The estimated correlation coefficients were acceptable or strong for all nutrients and foods except iodine (rs = 0⋅19). The highest correlation coefficient was found for juice (rs = 0⋅71), whereas the lowest correlation coefficient was found for iodine (rs = 0⋅19). Cross-classification by quartiles categorised more than 72 % of the participants into the same or adjacent quartiles using the two methods. Few data points fell outside the limits of agreement in the Bland–Altman plots. Calibration coefficients ranged from 0⋅10 (wholegrain) to 0⋅81 (alcohol). Our findings suggest that the WebFFQ has reasonable ranking abilities for all the included nutrients and foods, except for iodine. PubDate: 2022-11-04 DOI: 10.1017/jns.2022.97
Authors:Pashayee-Khamene; Fereshteh, Hajimohammadebrahim-Ketabforoush, Melika, Saber-Firoozi, Mahdi, Hatami, Behzad, Naseri, Kaveh, Karimi, Sara, Ahmadzadeh, Saleheh, Kord, Hamed, Saadati, Saeede, Hekmatdoost, Azita First page: 99 Abstract: Since conducting a long-term randomised clinical trial is not logical and feasible to find the optimum dosage of salt intake in patients with cirrhosis, cohort studies are the best design to assess the long-term effects of dietary salt on the survival of cirrhotic patients. This cohort study aimed to evaluate the association between dietary intake of salt and mortality risk in cirrhotic patients. The present study was designed as a cohort in three referral hospitals in Iran in 2018. One hundred and twenty-one patients aged between 20 and 70 years with established cirrhosis were recruited. Dietary intakes, demographic data and disease severity were evaluated at the baseline. Participants were followed up annually. Crude survival was greater in patients with low-to-moderate salt consumption rather than in those with high consumption, and in non-consumers [34⋅26 (95 % CI 33⋅04, 35⋅49) v. 30⋅41 (95 % CI 27⋅13, 33⋅69) v. 32⋅72 (95 % CI 30⋅63, 34⋅80), P = 0⋅028; log-rank test]. Using the Cox proportional hazard model, it was shown that the risk of mortality in the high-salt consumption category was approximately 126 % higher than that of the reference category (non-consumers) [HR value 2⋅26, (95 % CI 0⋅91, 5⋅63)], while this risk for the low-to-moderate consumption group was about 28 % lower than the reference category [HR value 0⋅72, (95 % CI 0⋅26, 1⋅99), P-trend = 0⋅04]. In conclusion, a high daily dietary intake of salt might increase the rate of mortality and moderate salt restriction (instead of elimination of salt) decreases the risk of death. PubDate: 2022-11-08 DOI: 10.1017/jns.2022.69
Authors:Tuttiett; Esme R., Ioannou, Elysa, Wijnhoven, Hanneke A.H., Corfe, Bernard M., Williams, Elizabeth A. First page: 100 Abstract: Adequate dietary protein intake is important in human subjects for maintaining muscle turnover, determining the protein content of tissues and thus the preservation of muscle mass and function as we age. A screening tool to assess if an older individual is likely to have a lower dietary protein intake (predicted probability of protein intake ≤1⋅0 g/kg per d), has been developed for a Netherlands dietary profile, but this has not been validated in a UK population. This study aimed to adapt and then validate the protein screening tool for use in a UK population. Amendment of the tool was undertaken using data from UK BioBank and the UK National Diet and Nutrition Survey to reflect protein sources in the UK diet. Validation of the amended version of the protein screener screening tool was conducted using protein intake derived from a food frequency questionnaire (FFQ) in a sample of UK adults (n = 184) (age range 18–91 years) as the reference standard. Using the FFQ, 40 % of respondents (n = 74) reported a protein intake of ≤1⋅0 g per kg body mass. The discriminative accuracy of the amended screener was tested using receiver operating characteristic (ROC) curves. The area under the curve for the ROC was 0⋅731 (95 % CI 0⋅657, 0⋅805), indicating that the amended screener may be a valid tool to screen for individuals consuming ≤1⋅0 g/kg adjusted BM/d in an adult UK population. This protein screener tool is a potential method to screen individuals with a likelihood of habitually consuming protein intakes of ≤1⋅0 g/kg per d. Further validation is needed using a more robust dietary intake methodology and for specific groups, such as older adults. The screener may be applicable across healthcare, clinical and research applications. PubDate: 2022-11-10 DOI: 10.1017/jns.2022.96
Open Access journal
Soy is a key food in human nutrition. It is widely used in eastern traditional cuisine and it has recently diffused among self-conscious and vegetarian diets. The success of soy mainly depends on versatility and supposed healthy properties of soy foods and soy components. Meanwhile, the possible influence on endocrine system, in particular by isoflavones, raised concerns among some researchers. The present paper aims to conduct a review of available data on the effect of soy, soy foods and soy components on women's fertility and related outcomes. Eleven interventional studies, eleven observational studies and one meta-analysis have been selected from the results of queries. A weak, not clinically relevant effect has been highlighted on cycle length and hormonal status. However, a suggestive positive influence has been shown among women with fertility issues and during assisted reproductive technologies. Overall, soy and soy components consumption do not seem to perturb healthy women's fertility and can have a favourable effect among subjects seeking pregnancy. However, because of the paucity of studies exploring the impact of soy intake on women's fertility, as well as the limited population sample size, the frequently incomplete specimens’ collection to investigate all cycle phases and the insufficient characterisation of participants, the evidence is suggestive and it needs further in-depth research taking into account all these aspects.
Food waste globally affects food security and sustainability. There currently are few studies focusing on food waste in schools. The present study aimed to determine the meal quality and plate waste in school lunch programme in Thailand. This cross-sectional study was conducted in canteens of representing kindergarten and elementary schools in Southern Thailand within their real-life context. The assessment was carried out over five consecutive school days in July–August 2020 for each school, at which two types of menus, including rice with side dish and one-dish meal were served. Waste collection and quantification were conducted by selective aggregate weighing, according to the Food Loss and Waste Protocol. All lunch menus contained excess rice but insufficient meats, fruits, vegetables and eggs, regarding the national lunch standard. For each serving portion, 7–33 % rice, 9–22 % meats, 7–65 % vegetables, 1–19 % fruits and 3–14 % eggs were discarded. Plate waste from rice with side dish menus (10–29 %) was more than one-dish meals (7–17 %). By estimation, each kindergartener generated 71⋅4 g plate waste daily, accounting for the caloric and monetary values of 146 kcal and 0⋅16 US dollar. The amount of plate waste and the respective caloric and monetary losses were less obvious at the elementary school. Plate waste affected the adequacy of food intakes of schoolchildren from lunch meals. The data obtained from the present study will be useful for planning and implementation of school lunch programme in Thailand and countries with similar context.
Although chronic pain (CP) is classified as inflammatory or non-inflammatory, the involvement of fatty acid intake in this process has not yet been examined in detail. Therefore, the present study investigated whether the relationship between CP and fatty acid intake differs between high and low C-reactive protein (CRP) levels in middle-aged and elderly individuals in the Shika study. One-thousand and seven males and 1216 females with mean ages of 68⋅78 and 69⋅65 years, respectively, participated in the present study. CRP was quantified by blood sampling from participants who responded to a CP questionnaire. The brief-type self-administered diet history questionnaire (BDHQ) was used to assess fatty acid intake. Interactions were observed between CP and CRP on monounsaturated fatty acids (MUFA) and eicosadienoic acid in a two-way analysis of covariance adjusted for sex, age, lack of exercise, lack of sleep, current smoking and drinking status, and BMI. MUFA (OR 1⋅359) and eicosadienoic acid (OR 1⋅072) were identified as significant independent variables for CP in a multiple logistic regression analysis, but only in the low CRP group. Only a high intake of MUFA and eicosadienoic acid was associated with chronic neck/shoulder/upper limb pain without elevated CRP. In psychogenic and neuropathic pain without elevated CRP, an increased intake of MUFA and eicosadienoic acid, a family member of n-6 fatty acids, appears to affect CP. Further longitudinal studies are needed to elucidate this relationship.
Beetroot juice (BRJ) has been demonstrated to decrease blood pressure (BP) due to the high inorganic nitrate content. This pilot randomized crossover trial aimed to investigate the effect of two different high nitrate vegetable juices on plasma nitrate concentrations and BP in healthy adults. Eighteen healthy volunteers were randomized to receive 115 ml of BRJ or 250 ml of green leafy vegetable juice for 7 d which contained similar amounts of nitrate (340 mg) daily. Blood samples were collected, and clinic BP measured at baseline and at the end of each juice consumption. Daily home BP assessment was conducted 2 h after juice consumption. Nitrate and nitrite concentrations were analysed using a commercially available kit on a Triturus automated ELISA analyser. Hills and Armitage analysis was used for the two-period crossover design and paired sample t-tests were performed to compare within-group changes. Plasma nitrate and nitrite concentrations significantly increased and there was a significant reduction in clinic and home systolic blood pressure (SBP) mean during the BRJ period (P-values 0⋅004 and 0⋅002, respectively). Home diastolic blood pressure (DBP) reduced significantly during green leafy vegetable juice consumption week (P-value 0⋅03). The difference between groups did not reach statistical significance during the formal crossover analysis adjusted for period effects. BRJ and green leafy vegetable juice may reduce SBP or DBP, but there was no statistically significant difference between the two juices, although this was only a pilot study.
Fisetin, a polyphenol found in several fruits and vegetables, has shown potential health benefits in many pre-clinical studies for neuroprotection, cardioprotection, chemoprevention, diabetes, inflammation and oxidative stress. However, the clinical effectiveness of fisetin may be limited by its poor bioavailability when ingested. Using a novel green technology of Hybrid-FENUMAT™, a food-grade fisetin formulation (FF-20) was developed through encapsulation of fisetin micelles into fenugreek galactomannan (FG) hydrogel scaffold to improve its physical characteristics and bioavailability. This is the first human pharmacokinetic study of fisetin following a single-dose, comparative, double-blinded, cross-over protocol, supplementing with FF-20 and unformulated fisetin (UF). Fifteen healthy volunteers were given a single dose of 1000 mg UF or 1000 mg FF-20 (delivering 192 mg fisetin) with a 10-d washout period between each dose. Blood samples were taken at 0⋅5, 1, 2, 3, 5, 8 and 12 h after both days of supplementation to quantify fisetin and geraldol, an active metabolite. The plasma concentration of fisetin when individuals consumed FF-20 was 26⋅9-fold greater than UF as determined by the area under the curve over 12 h [AUC0–12 h (FF-20) = 341⋅4 v. AUC0–12 h (UF) = 12⋅67]. The maximum plasma concentration (Cmax) was also more than twenty-three times higher when supplemented with FF-20 (238⋅2 ng/ml) compared to UF (9⋅97 ng/ml). The encapsulation also reduced the amount of conversion of fisetin to geraldol. No adverse events were reported during the study. Therefore, the encapsulation of fisetin into FG dietary fibre hydrogel scaffold could improve its delivery and bioavailability in human subjects.
High sugar intake has been associated with adverse effects on health, with some types of breakfast being highly linked to overweight and obesity. The aim was to compare the effects of four sugar-free breakfast items, apricot jam with white bread (JWB), white bread (WB), cocoa with fat-free milk (CM), and dried cranberry cereal bar (CB), compared to d-glucose on the glycaemic responses. Using a cross-over design, twelve healthy individuals (25 ± 4 years; BMI 22 ± 2 kg/m2) received isoglucidic test meals (25 g of available carbohydrate) and 25 g glucose reference, in random order. Glycaemic index/load (GI/GL) were calculated, and capillary blood glucose samples were collected at 0–120 min after meal consumption. Subjective appetite was assessed with visual analogue scales. Sugar-free apricot jam and cocoa powder contained traces of available carbohydrates and were consumed along with bread and fat-free milk, respectively. JWB and WB were classified as medium GI, low-to-medium GL; CM as medium GI, low GL; and CB as high GI, low-to-medium GL. Subjective hunger was lower after JWB, fullness was higher after CM and pleasure was higher after CB (P for all < 0⋅05). In conclusion, sugar-free apricot jam with and without WB and cocoa powder with fat-free milk are suitable healthy breakfast options leading to improved glycaemic and subjective appetite responses.
Alternate day fasting (ADF) with consumption of calories up to 25 % of the daily energy intake on fast days is one of the most used intermittent fasting regimens and promoted as a promising, alternative approach for treating obesity. Feelings of appetite are critical for adherence to dietary approaches, and therefore the success of dietary interventions. This systematic review aimed to assess the effects of a minimum of 8 weeks of ADF on subjective feelings of appetite and body weight for adults with overweight and obesity. We conducted the review in accordance with the Cochrane guidelines, including systematic searches in four databases. Because of the high level of clinical and methodological heterogeneity, a narrative approach was used to synthesise the results. Eight studies with a total of 456 participants met the eligibility criteria: three randomised controlled trials and five uncontrolled before-after studies. Seven of the studies had high risk of bias. Feelings of appetite were assessed by hunger in eight studies, fullness in seven studies, satisfaction in four studies and desire to eat in one study. All the studies assessed weight loss. The certainty of the evidence was rated low or very low for all outcomes, thus no firm conclusions can be drawn about the potential benefits of ADF on subjective feelings of appetite and body weight. Despite the high interest in ADF, good quality evidence is still needed to determine its effectiveness and if offered in clinical practice, ADF should be offered cautiously while concomitantly evaluated.
