bluuebunny/crossref_metadata_2025 huggingface dataset:
Interesterification of a commonly consumed palm-based hard fat blend does not affect postprandial lipoprotein metabolism in healthy older adults
Authors: Hall Wendy , Mills Charlotte , Gray Robert , Harding Scott , Fielding Barbara , Bruce Johanna , Le Roy Caroline , Berry Sarah
Published: June 2020

Interesterified (IE) fats are widely used to replace partially-hydrogenated fats as hard fats with functional and sensory properties needed for spreads/margarines, baked goods, and confectionary, while avoiding the health hazards of trans fats. Detailed mechanistic work to determine the metabolic effects of interesterification of commonly-consumed hard fats has not yet been done. Earlier studies using fats less commonly consumed have shown either neutral or a lowering effect on postprandial lipaemia. We investigated postprandial lipaemia, lipoprotein remodelling, and triacylglycerol-rich lipoprotein (TRL) fraction apolipoprotein concentrations following a common IE blend of palm oil/kernel fractions versus its non-IE counterpart, alongside a reference monounsaturated (MUFA) oil. A 3-armed, double blind, randomized controlled trial (clinicaltrials.gov NCT03191513) in healthy adults (n = 20; 10 men, 10 women) aged 45–75 y, assessed effects of single meals (897 kcal, 50 g fat, 16 g protein, 88 g carbohydrate) on postprandial plasma triacylglycerol (TAG) concentrations, lipoprotein profiles, and TRL fraction apolipoprotein B48 and TAG concentrations. Test fats were IE 80:20 palm stearin/palm kernel fat, the equivalent non-IE fat, and a high-MUFA reference oil (rapeseed oil, RO). Blood was collected at baseline and hourly for 8 h. Linear mixed modelling was performed, adjusting for treatment order and baseline values (ver. 24.0; SPSS Inc., Chicago, IL, USA). Total 8 h incremental area under the curves (iAUC) for plasma TAG concentrations were lower following IE and non-IE compared with RO (mean difference in iAUC: non-IE vs. RO -1.8 mmol/L.h (95% CI -3.3, -0.2); IE vs. RO -2.6 mmol/L.h (95% CI -5.3, 0.0)), but iAUCs for IE and non-IE were not significantly different. There were no differences between IE and non-IE for chylomicron fraction apoB48 concentrations nor TAG:apoB48 ratio. No differences were observed between IE and non-IE for lipoprotein (VLDL, HDL, LDL) particle size or sub-class particle concentrations. However, LDL particle diameters were reduced at 5 and 6 h following IE vs RO (P < 0.05). XXL- (including chylomicron remnants and VLDL particles), XL- and L-VLDL particle concentrations (average diameters > 75, 64, and 53.6 nm respectively) were higher following IE and non-IE vs. RO at 6 h (P < 0.05) and 8 h postprandially (P < 0.005–0.05). In conclusion, both IE and non-IE palmitic acid-rich fats generated a greater preponderance of pro-atherogenic large TRL remnant particles in the late postprandial phase relative to an oleic acid-rich oil. However, the process of interesterification did not modify postprandial TAG response or lipoprotein metabolism.
Examination of protein intakes at 2-years and weight status and body composition at 5-years in the Cork BASELINE Birth Cohort
Authors: Hennessy Áine , Chaoimh Carol ní , McCarthy Elaine , Murray Deirdre , Kiely Mairead
Published: June 2020

Dietary protein is critical for normal growth and development through its contribution of essential amino acids. In high-resource settings, protein intakes are generally adequate. Previous studies have suggested that higher protein intakes in infancy and early childhood are associated with higher body mass index in later childhood.

This analysis was performed in a subgroup of 2-year-old children (n = 468) with detailed dietary intake data (2-d weighed food record) participating in an extensively-characterised, prospective birth cohort, the Cork BASELINE Birth Cohort Study (n = 2183). Body weight and height were measured at 2- and 5-years, and indices of body composition (fat mass, fat free mass) were obtained at 5 years in a subgroup of 295 children. Total protein intake was estimated at 2-years and the contribution of animal and plant sources to total protein intake was quantified. Children were split into thirds of protein intake (as % total energy, %TE) and anthropometry and body composition at 5 years was compared across groups. The relationship between protein intake (total and animal sources) and BMI-SDS, fat mass index-SDS and fat free mass index-SDS was explored in multivariate linear regression models, adjusted for common confounders (energy intake, gestational age, duration of breastfeeding, birthweight-SDS, maternal education).

Mean (SD) daily protein intake was 41.3 (11.2) g/d, representing 16.1 %TE (girls: 16.2 %TE; boys: 15.9 %TE, P = 0.202) and all children met EFSA average requirement and population reference intake thresholds. Meat (25%), cows’ milk (22%), breads (7%), yoghurt (6%), breakfast cereals (6%) and cheese (5%) were key sources of protein intake in toddlers. The majority of dietary protein intake was from animal sources (69%).

Girls with high %TE from protein [mean (SD): 19.7 (2.6) %TE] were significantly heavier and taller at 5 years than their counterparts [low: 13.1 (1.4) %TE; medium: 16.0 (0.7) %TE], and had significantly higher fat free mass, fat free mass index and total body bone area (indicative of body size), but not fat mass. When adjusted for confounders in multivariate regression models, no association was observed between total protein intake and BMI-SDS, fat mass index-SDS or fat free mass index-SDS at 5 years.

Children with high animal protein intakes (as %TE) had significantly higher fat free mass than their low and medium group counterparts; however, when adjusted for height and other confounders, no association was observed.

Protein intakes in early childhood were associated with larger body size, but not BMI or body composition at 5-years.
Visual stimulation with food pictures in regulation of hunger hormones and nutrient deposition
Authors: Duszka Kalina , Baierl Andreas , Reichel Martin , Gregor András , Ogris Manfred , König Jürgen
Published: June 2020

Food cues modulate hunger and dictate nutritional choices. The omnipresent stimulus of palatable food promotes the epidemics of obesity and metabolic diseases. The aim of our study was to investigate the impact of visual stimulation with food pictures on appetite-related hormones as well as the functionality of the secreted hormones and its impact on macronutrient uptake and deposition in healthy subjects. Additionally, we sought to identify differences in response to visual food cues of total and active ghrelin to and to a meal followed by the stimulation.

Healthy, non-obese participants were recruited for two two-day studies. During the first study, the subjects were shown random non-food pictures on the first day and pictures of appetizing foods on the second day of the study. The second study followed the same schedule and additionally, following the picture session, the participants were asked to drink a milkshake. The subjects reported subjective hunger. Levels of glucose, triglycerides and hunger-related hormones were measured in blood. In addition, an animal study was performed, during which 4 hours fasted mice were submitted to visual and olfactory stimulation using chow, while not being able to access the food. Following the stimulation, oral glucose tolerance test was performed, gene expression and blood total, as well as acylated ghrelin, were measured.

Exposure to food pictures affected participant's blood glucose and incretin levels. Concentrations of several hormones in the blood were interdependent and in case of ghrelin and GIP as well as ghrelin and GLP-1 this co-occurrence relied on the visual cues. Changes of total ghrelin concentration following food stimulation was highly individual and participants could be grouped as ghrelin responders or non-responders. The responders showed upregulated total ghrelin and their total ghrelin levels correlated with food picture score revealing that in ghrelin non-responders reaction to food pictures was diminished. The concentration of active ghrelin decreased following a meal but was not affected by exposure to the pictures of food. Protein content and color intensity of food pictures correlated reversely with participants’ rating of the pictures. Sensory stimulation of mice resulted in increased blood glucose levels.

We conclude that observation of food pictures significantly influences blood glucose levels and concentration of several appetite-related hormones. The protein content of the observed foods and green color intensity in pictures may serve as a predictor of subjective attractiveness of the presented meal.
Nutrient content of products purchased following the implementation of the “Healthier Vending Policy” in Ireland.
Authors: Porter Olivia , Stanley Isobel , Lawless Agatha , O'Brien Sarah , Kelleher Cecily C. , Murrin Celine M. , Bel-Serrat Silvia
Published: June 2020

Introduction

The food environment influences food choices made by populations. On-the-go snacking has become an integral part of modern Irish life and must be considered when shaping such environments, considering that the Republic of Ireland population consume an average of 2.5 snacks daily, with 22% of snacking occasions occurring outside the home. This has driven the increased prevalence of snack food vending machines which typically stock unhealthy products that are high in energy, fat and sugar. The Health Service Executive (HSE) implemented the Healthier Vending Policy in 2015 to increase the availability of healthier products across HSE premises. This research examined the nutrient content of snacks and beverages purchased in vending machines on HSE premises following the implementation of the HSE Healthier Vending Policy.

Materials and Methods

Vending machines product and sales data were obtained from two vending machines companies at baseline in 2015 and following policy implementation in 2016. Product labels and online product information were used to obtain the energy and nutrient contents. The products were assigned to a snack or beverage category; nuts, mints, cereal bars, chocolates, sweets, crisps, waters, juices, carbonated drinks and other. New variables were computed, descriptive analyses were undertaken and Wilcoxon-signed rank tests performed using SPSS Statistics 24. Statistical significance was set at p < 0.05.

Results

Snacks and beverages sold in 295 vending machines across 89 HSE premises were analysed. There were statistically significant decreases in median energy sold per packet (9.7%) and per 100 g (7.1%) following policy implementation. Reductions in total fat (53.2%), saturated fat (32.4%), sugar (10.0%) and sodium (20.0%) sold also occurred. When snacks were analysed separately the findings were less positive, as a statistically significant increase in energy sold per packet and an increase in total fat sold per 100 g occurred. The findings in relation to beverages were mixed. The effect of the policy varied across snack categories, with particularly large reductions in energy sold per packet in carbonated drinks (54.0%) and cereal bars (44.2%).

Discussion

Adecrease in the amount of energy, total fat, saturated fat, sugar and sodium sold was observed following the implementation of the policy. The HSE Healthier Vending Policy seemed to promote a healthier environment. It is recommended that this policy continues to be implemented and is reviewed to ensure the best possible outcomes nationally. It is also advisable to bring this policy to other settings to combat obesogenic environments and promote public health.
Delivery of a 3-month Mediterranean diet and physical activity lifestyle intervention via artificial-intelligence chatbot, can achieve behaviour change: MedLiPal pilot-study
Authors: Murphy Karen , Davis Courtney , Curtis Rachel , Maher Carol
Published: June 2020

Poor diet and physical inactivity are leading modifiable causes of death and chronic disease. Robust evidence confirms that the Mediterranean diet (MedDiet) reduces mortality and cardiovascular disease risk, and promotes healthy longevity. However, MedDiet interventions are typically resource intensive, requiring regular face-to-face visits, in a one-on-one or small group setting. The rapid growth of Artificial-Intelligence (chatbot) technology has created new possibilities for low-cost, personalised health behaviour programs. We aimed to assess whether a 12-week MedDiet and physical activity intervention delivered entirely via technology (chatbot, website, wrist-worn activity tracker) could result in health behaviour change in 30 adults aged 57 ± 8 years. Volunteers’ height, body weight, waist circumference and blood pressure were measured in clinic at baseline, week 6 and 12. Introduction of the MedDiet and physical activity recommendations were conducted through a website with short videos and written sections assisted by the chatbot. Participants were encouraged to interact with the chatbot program at least weekly for 12-weeks. The MedDiet component of the program was modelled on the MedLey trial, whilst physical activity used step count goal-setting using a Garmin Vivofit 4 wrist-worn tracker. Diet and self-reported physical activity outcomes were measured using the 14-point MedDiet questionnaire and Active Australia Survey. The study achieved 93% retention over the 12-weeks and with excellent user engagement and satisfaction. There was a significant increase in the MedDiet score from 3 ± 3.5 (out of 14) at baseline, to 11 ± 3 at weeks 6 and 12, (p < 0.001). Weekly moderate-to-vigorous physical activity minutes increased from 135 ± 196 at baseline, to 210 ± 233 and 300 ± 433 mins, at weeks 6 and 12, respectively, (p < 0.001). Waist circumference decreased from 99 ± 28 to 98 ± 27 and 96 ± 25 cm, at weeks 6 and 12, respectively, (p < 0.001). BMI decreased from 29 ± 10 to 28 ± 9 at week 6 and 28 ± 10 at week 12 (P < 0.05). There was no change in blood pressure. Our pilot data confirm that the chatbot together with informational website and wearable intervention approach achieved excellent user satisfaction and preliminary efficacy of behaviour change across a 12-week period. Further research employing a randomized-controlled design, and high quality outcome measures is warranted to confirm efficacy and sustainability of behaviour change. However, these early results suggest that this innovative, comprehensive chatbot-based approach may be an appealing and feasible strategy suitable for mass-dissemination to assist dietary and physical activity related behaviour, leading to a widespread reduction in risk factors for chronic disease.
A Tailored Habits-based Dietary Intervention Combined With Oral Rehabilitation on Partially Dentate Older Adults: Nutritional Impact
Authors: McCrum Leigh-Ann , Mckenna Gerry , Woodside Jayne , McGowan Laura , Watson Sinead
Published: June 2020

Introduction

Replacing missing teeth alone is not enough to engender dietary behaviour change amongst older adults. Whilst there is a body of evidence to support oral rehabilitation in conjunction with dietary advice, this is currently limited to edentate patients even though the majority of older adults are now partially dentate. One approach proven to change long-term food behaviours but is novel in this population is habit-formation. Consequently, this study developed and tested a habit-based tailored dietary intervention, in conjunction with oral rehabilitation amongst partially dentate older adults.

Materials and methods

A pilot randomised control trial was conducted on 57 partially dentate older patients. Participants were randomised to an intervention group (habits-based dietary intervention) or a control group and followed up for 8 months. The intervention group attended four meetings with a trained researcher to target habit-formation around 3 dietary domains (fruit/vegetables, wholegrains, healthy proteins). The primary outcome measure was self-reported automaticity for developing healthy habits and habit formation was assessed using the Self-Report Behavioural Automaticity Index (SRBAI). Preliminary analysis was conducted on n = 36 participants between baseline and 8 month follow up.

Results

Preliminary results showed that SRBAI scores and self-reported frequency of days doing habits in the intervention group for all tailored dietary habits was significant between baseline and follow up visits (p < 0.001). There were moderate positive correlations between automaticity and habit adherence (Fruit/vegetables rho = 0.43, p = 0.09: Wholegrains rho = 0.44, p = 0.08: Healthy Proteins rho = 0.52, p = 0.03) for the intervention group. Automaticity trends were increased in the intervention group for all 3 dietary habits compared to the control group but, other than wholegrain (p = 0.005), between group differences were non-significant (p > 0.05). BMI decreased in the intervention group (29.6 to 28.7 kg/m2) compared to a non-significant increase in the control group (27.7 to 27.8 kg/m2) (p = 0.08). There were slight increases in Mini Nutritional Assessment mean change scores (0.19 intervention: 0.32 control) for both groups, however between-group differences were not statistically significant (p = 0.9). Greater improvements in food intake around dietary habits were observed in the intervention group (Fruit/vegetables:108 g Fibre 4g: Protein 11g) compared to the control group (Fruit/vegetables -17g: Fibre 2g: Protein -4g).

Discussion

Preliminary results demonstrate the success of a habit-based dietary intervention coupled with oral rehabilitation in positively influencing dietary behaviours and other nutritional outcomes in partially dentate older adults.
Loss of adipose tissue mass during chemotherapy predicts reduced survival in patients with colorectal cancer treated with palliative intent
Authors: Sullivan Erin Stella , Daly Louise E. , Bhuachalla Éadaoin B Ní , Cushen Samantha J. , Power Derek G. , Ryan Aoife M
Published: June 2020

Obesity is an established risk factor for colorectal cancer (CRC), however little is known about changes in body composition during chemotherapy and its impact on survival. The aim of this study was to examine in patients with CRC: (1) The prevalence of abnormal body composition phenotypes, (2) The impact of baseline body composition on overall survival, (3) Changes in body composition throughout treatment and its impact on overall survival.

A prospective study of adult CRC patients undergoing chemotherapy between 2012–2016 was conducted. Longitudinal changes in body composition were examined using computed tomography (CT) images at two timepoints (interval 7 months, IQR: 5–9 months) using paired t-tests. Sarcopenia and low muscle attenuation (MA) were defined using published cut-offs. Cox proportional-hazards models were used to estimate mortality hazard ratios, adjusted for known prognostic covariates – stage, age, sex, performance status & systemic inflammation.

In total, 268 patients were recruited (66% male, mean age 63 years) and 51% were undergoing chemotherapy with a palliative intent. At baseline, 4% were underweight (BMI < 20 kg/m2), 38% had a normal BMI, and 58% were overweight/obese. Despite this, 38% had cancer cachexia, 34% were sarcopenic and 43% had low MA. Neither sarcopenia, sarcopenic obesity nor cachexia at baseline predicted survival. Over 100 days, 68% were muscle stable (± 1 kg), while 25% lost > 1 kg and 7% gained > 1 kg. Fat mass remained stable ± 1 kg in 49%, while 28% lost > 1 kg and 23% gained > 1 kg. When adjusted for known prognostic covariates, baseline BMI (20–25 kg/m2) in those having palliative chemotherapy was independently associated with reduced survival compared to those with BMI indicating overweight (BMI 25–30 kg/m2) [HR: 1.80 (95% CI: 1.04–3.14), p = 0.037]. In those undergoing chemotherapy with palliative intent, a loss of > 6.4% subcutaneous fat (Q1 SAT) over 100 days was predictive of poor survival versus those with small losses, remaining stable or gaining SAT (Q2-4), independent of changes in muscle mass [HR: 2.22 (95% CI: 1.07–4.62), p = 0.033].

Patients with CRC, particularly those treated with a palliative intent, experience significant losses in muscle and fat mass during chemotherapy. Loss of SAT mass during palliative chemotherapy is prognostic of poor survival, independent of changes in muscle mass. Baseline BMI in the overweight range confers a survival advantage. Nutritional strategies to prevent or attenuate weight loss during chemotherapy are advisable especially in the context of advanced CRC.
Developing food-based dietary guidelines for 1–5 year old children: a protocol for use in population health globally
Authors: Lyons O.C. , McNulty H. , Kerr M.A. , Ward F. , Livingstone M.B.E. , Saul I. , Flynn M.A.T.
Published: June 2020

Early childhood is a well-established critical period for growth and development, potentially impacting on life-long health. Healthy dietary habits formed during the transition from a predominantly milk-based to a food-based diet track into later life. Globally, there is no established process for developing food-based dietary guidelines (FBDG) for 1–5 year old children. This study aims to establish a protocol for developing FBDG for 1–5 year old children for use in population health globally.

Foods consumed by > 10% of consumers aged 1–5 years (at each eating occasion) were identified by secondary analysis of the Irish National Pre-School Nutrition Survey (NPNS; 2012). Consultations were held with registered dietitians to update the NPNS data and reflect current dietary habits. Dietary modelling, based on healthy eating principles, was conducted on boys (n30) and girls (n30) at five percentiles on the World Health Organisation (WHO) growth charts (0.4th; 25th; 50th; 75th; 99.6th) and at six age time-points (1y; 1.5y; 2y; 3y; 4y and 5y). Intake targets were identified for energy, macronutrients and 6 key micronutrients. For those with inadequate nutrient intakes, key contributing foods were identified and used in the modelling.

Dietary modelling yielded 640 four-day food intake patterns. For 1–3 year olds, especially those < 25th growth percentile, iron was identified as an at-risk nutrient as the intake target was not achieved. For all 1–5 year olds, vitamin D was identified as an at-risk nutrient. Red meat and iron-fortified cereal (> 12mg/100g) were identified as key contributors to iron intake. A combination of red meat (30 g, 3 days/week) and iron-fortified cereal (30 g, 5 days/week) resolved inadequate iron intakes for 1–3 year olds, except those < 25th growth percentile. For those children, the additional inclusion of 4 mg iron from use of iron-fortified milk (1.2mg/100mL) or a low-dose iron supplement (7 mg, 4 days/week) resulted in adequate iron intakes. For all children aged 1–5 years, vitamin D intakes improved by including a daily 5μg vitamin D supplement, but still did not reach the intake target.

Worldwide, significant resources are invested in assessing growth and development of 1–5 year olds. This study provides a protocol for developing FBDG to meet nutritional needs of 1–5 year olds at various growth parameters (age and percentiles), using WHO charts. This enables the provision of practical food-based interventions to nutritionally vulnerable children. Using national dietary data, this approach can be applied for developing FBDG specific to a country's needs.
Early infant feeding practices in Ireland; current and secular analyses of infant feeding in two prospective birth cohort studies
Authors: Hemmingway Andrea , Fisher Dawn , Berkery Teresa , Kiely Mairead E
Published: June 2020

Recognised as the optimum infant feeding method, breastfeeding affords substantial health benefits to mother and infant. Exclusive breastfeeding is recommended to 6 months, with continuation thereafter. In Ireland, data indicates that 60% breastfeed to any extent at hospital discharge and 40% do so at 3 months. However, nationally collected data is limited in detail, particularly with regard to breastfeeding continuation. The ongoing Cork-based COMBINE birth cohort study recruited 456 participants between 2015 and 2017. Through interviewer-led questionnaires, research midwives collected feeding data at hospital discharge, 1, 2, 4, 6 and 9 months of age. Infant feeding was classed as breast (breastmilk as main milk source), combination (both breastmilk and infant formula daily) or infant formula only feeding. Adherence to the World Health Organisation (WHO) recommendation to exclusively breastfeed (breastmilk only, no infant formula, supplementary fluids or solid foods) was examined longitudinally. To explore secular changes, breastfeeding rates in COMBINE were compared to the BASELINE birth cohort study, which recruited participants (n = 2116) between 2008 and 2011 in the same setting. In COMBINE, 75% of mothers provided any breastmilk (breast or combination) at hospital discharge, of whom 44% breastfed only. Two-fifths (40%), one-third (33%) and one-quarter (24%) breastfed at 1, 4 and 6 months, respectively. Combination feeding of breastmilk and infant formula was prevalent at discharge (31%) and 1 month (20%). Advice from healthcare professionals (31%) and concern baby was hungry (30%) were commonly reported reasons for this practice and throughout the study, mothers who combination fed were more likely to stop breastfeeding altogether than those who breastfed (all P < 0.001). Infant formula only feeding increased from 25% at discharge to 40% at 1 month, 49% at 2 months and 74% at 9 months. Half (45%) of mothers who breastfed did so for less than 4 months and insufficient milk/growth faltering was the most commonly cited reason for cessation (27%). The rate of WHO-defined exclusive breastfeeding was 40% from birth to discharge, 22% to 1 month, 15% to 4 months and 2% to 6 months. The breastfeeding (breastmilk as main milk source) rate at discharge did not differ between our two birth cohorts (44 vs. 40%, P = 0.23), but was significantly higher in COMBINE compared to BASELINE at 2 (36 vs. 27%) and 6 (24 vs. 12%) months (both P < 0.05). While these data provide evidence of some progress towards longer breastfeeding durations, there remains much scope to improve infant feeding practices in Ireland.
A prospective investigation of plant foods, dietary fibre and ischaemic heart disease in the EPIC cohort
Authors: Perez-Cornago Aurora , Crowe Francesca L. , Appleby Paul N. , Key Timothy J
Published: June 2020

Introduction

There is evidence that plant-based diets might be associated with a lower risk of IHD; however, previous studies have not reported on intake of subtypes of fruit and vegetables and sources of dietary fibre. This study aims to assess the associations of major plant foods, their subtypes and dietary fibre with risk of ischaemic heart disease (IHD) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD Consortium.

Material and methods

We conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment. Dietary intake was assessed using validated questionnaires and calibrated with 24-hour recall data. Cox regression models, adjusted for IHD risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

During a mean of 12.6 years follow-up, we documented 8504 myocardial infarction cases or deaths from IHD. Participants consuming at least eight portions (80 grams each) of fruits and vegetables a day had a 10% lower risk of IHD (HR 0.90, 95% CI: 0.82–0.98) compared with those consuming fewer than three portions a day. The risk of IHD was 6% (95% CI 0.90–0.99; P-trend = 0.009) lower for a 200 g/day higher intake of fruit and vegetables combined, 3% (0.95–1.00; P-trend = 0.021) lower for a 100 g/ day higher fruit intake, and 8% (0.86–0.97; P-trend = 0.006) lower for a 50 g/ day higher intake of bananas. Moreover, risk of IHD was 9% (0.83–0.99; P-trend = 0.032) lower for a 10g/ day higher intake of nuts and seeds, and 10% (0.82–0.98; P-trend = 0.020) lower for a 10g/ day higher intake of total dietary fibre. No associations were observed between legumes, total vegetables and other subtypes of fruit and vegetables and IHD risk.

Discussion

The results from this large prospective study suggest that higher intakes of fruit and vegetables combined, total fruit, bananas, nuts and seeds, and total fibre are associated with a lower risk of IHD. Given the observational design of this study, causality and potential mechanisms should be further investigated.
Effect of almonds consumption on anthropometric measurements and blood parameters in overweight and obese females in a weight reduction program
Authors: Ünal Sabiha İrem , Pekcan Ayla Gulden
Published: June 2020

Nuts are good sources of dietary fiber, magnesium, polyunsaturated fats, vitamin E, and antioxidants, all of which may have health benefits and associated with increased sensations of satiety and could have beneficial effects on weight control. This study aims to determine the effects of a balanced hypocaloric almond (30 g/day) enriched diet (AED) compared to a balanced hypocaloric almond free diet (AFD) on anthropometric measurements and blood parameters. Study was a 3-months, randomized, controlled trial with four serial measurements on 32 overweight and obese (BMI: ≥ 25 kg/m2) women, aged 25–50 years. The subjects were randomly divided into two groups (16 AED and 16 AFD). Individualized hypocaloric diets of AED considering the energy recommendation, 30 g/day of almonds was added as a snack. Demographic characteristics, nutritional habits, physical activity levels of subjects were determined by a questionnaire. 24-hour dietary intakes for 3 consecutive days (one day week-end) were recorded at the beginning, 1rd, 2nd, and 3rd months of the study. Anthropometric measurements (height, body weight, waist, hip and neck circumferences) were taken and body composition was determined by Bioelectrical Impedance Analysis (BIA), BMI, waist/hip circumference ratio (WHR) and waist circumference/height ratio (WHtR) were calculated. Fasting blood glucose, insulin level, HbA1c, HOMA-IR, total cholesterol, triglycerides, serum iron, haemoglobin, TSH, CRP were determined prior to and at the end (3rd month) of the study. At the beginning of the study no statistically significant difference was found between anthropometric measurements of the groups (p > 0.05). Body weight, BMI, waist, hip circumferences, WHR, WHtR, percentage of body fat, body fat mass were decreased significantly in almond and control groups compared with the beginning and 1rd, 2nd., 3rd months of the study (p = 0.001). Significant reductions in HbA1c and LDL-cholesterol levels were determined in almond group (p < 0.05). Statistically significant differences were found in insulin, HDL-cholesterol, triglycerides and HOMA-IR levels compared to the prior and end of study in both groups (p < 0.05). Balanced hypocaloric diet caused weight loss and improvements in anthropometric and blood parameters in both groups, but better improvement was determined with almond enriched diet. Almonds as a snack could be recommended as a healthy choice in weight reduction diets. Almonds fiber and protein content may have beneficial effects on weight reduction.
Factors that Influence Stunting in Children Aged 6–59 Months in Kapiri-Mposhi District, Zambia
Authors: Chipili Given , Msuya John
Published: June 2020

Stunting has remained a challenge in Zambia. Poor nutrition in early life of children below the age five has a great effect on stunting. This paper looked at other factors that can influence stunting among children aged 6–59 months. A cross-sectional survey was conducted in Kapiri-Mposhi district among 100 children aged 6–59 months. This study was part of the macro study Implementation of Nutrition-sensitive Agriculture in the Central Province of Zambia.” We looked at four factors, which included, the Mothers age, level of mother's education, Family size and marital status. These factors where compared to the nutrition status of children (Stunting). We used descriptive and binary logistic regression analysis to assess the factors that influence stunting. The prevalence of stunting was found to be 21%, wasting was 9% and underweight was 2%.This study found that Children who were born from teenage mothers were likely to be stunted (P < 0.02) than those from older mothers. In addition, we also found that there was a significant relationship between family size and stunting (P < 0.01). Most families that had over eight member were likely to have stunted children than those we had less. This study did not find any association between the mother's level of education or marital status and stunting in Kapiri-Mposhi district. Family size and mother's age are associated to stunting in Kapiri-Mposhi district.
Diet quality as a predictor of healthy and cardiometabolic disease-free life expectancy between ages 50 to 85
Authors: Lagström Hanna , Stenholm Sari , Akbararly Tasnime , Pentti Jaana , Vahtera Jussi , Kivimäki Mika , Head Jenny
Published: June 2020

Poor dietary quality is one of the leading modifiable risk factor for premature mortality worldwide. People live longer than ever, but spend more years with illness and disability although the ultimate goal is to increase healthy years of life. Less research has considered the role of dietary habits in relation to health or cardiometabolic disesase-free life expectancy (LE). This study investigate the association of diet quality with healthy and cardiometabolic disease-free LE between ages 50 and 85. The study comprised 8,075 participants of the Whitehall II study. Diet quality was assessed with Alternative Healthy Eating Index (AHEI) 2010 at phases 3, 5 and 7 and took the measure of diet closest to age of 50 years for each participant. We utilized repeat measures of self-rated health and cardiometabolic disease from the first observation when participants were aged 50 years or older. In the analyses the AHEI-2010 total score was categorized in to quintiles, where the lowest quintile represents unhealthiest diet quality and highest quintiles healthiest diet. Multistate life table models were used to estimate healthy and cardiometabolic disease-free LE from age 50 to 85 years for each category of AHEI-2010 quintiles and three occupational position group. Participants in the highest AHEI-2010 quintile lived 3.6 years longer in good health and 2.7 years longer without cardiometabolic diseases than participants in the lowest quintile of the AHEI-2010. Higher diet quality associated with an increased healthy and cardiometabolic disease-free LE was observed across different occupational positions: Men in highest occupational position and highest AHEI-2010 quintile lived 9.4 years longer with good health compared to lowest occupational position and lowest AHEI-2010 quintile and for women the corresponding difference was 8.2 years. In terms of proportion of years spent without cardiometabolic diseases ranged from 77% (high occupational position and highest AHEI-2010) to 57% (low occupational position and lowest AHEI-2010) in men and from 82% to 70% in women. The difference in years lived healthy across AHEI-2010 quintiles was most remarkable in persons with low occupation status. Healthier dietary habits are associated with longer healthy and longer cardiometabolic disease-free LE between ages 50 and 85. Attention to poor diet should be paid especially among people in the lowest occupational position.
Patterns of daily energy drink consumption differ by gender among Belgian adolescents
Authors: Lebacq Theresa , Dujeu Maud , Pedroni Camille , Moreau Nathalie , Desnouck Véronique , Holmberg Emma , Godin Isabelle , Castetbon Katia
Published: June 2020

Over the past decade, energy drinks (ED) have become increasingly popular among adolescents. Due to their high content in caffeine, sugar and other energy-promoting components, frequent ED consumption may have adverse health effects, like cardiovascular symptoms, sleep impairment, and nervousness. Previous studies have shown that ED consumption was more frequent among males. To extend this knowledge, our analysis examined how sociodemographic and lifestyle determinants of frequent ED consumption may differ by gender among Belgian adolescents. This study was based on data self-reported by 9,119 12–19 year-old French-speaking Belgian adolescents in secondary school, within the 2014 cross-sectional Health Behaviour in School-Aged Children survey. Pupils reporting they usually consumed ED once a day or more were considered as “high ED consumers”. Sociodemographic and lifestyle characteristics were described in relation to ED consumption, for boys and girls separately. We used multiple logistic regression models, stratified by gender, to assess the associations between the sociodemographic and lifestyle variables, with high ED consumption. Daily ED consumption was reported by 7.9% of boys and 4.6% of girls. In both genders, the proportion of high ED consumers was significantly higher among adolescents of grades 1–3, those of lower family affluence, in first- and second-generation immigrants, those watching TV more than 6 hours/day, those reporting later bedtimes, and those consuming soft drinks daily. In girls only, higher percentages were observed in girls from single- (7.6%) or blended-families (5.2%), than in girls from two-parent families (3.5%). In boys only, this percentage was higher among adolescents meeting physical activity recommendations (14.5% vs 6.5%). Multivariate analyses showed that high ED consumption was associated with lower grades, long screen time, later bedtimes, and daily soft drink consumption in both genders. In girls only, adolescents from single-parent families were more likely to consume ED daily (OR 1.70; 95% CI 1.23–2.37) (vs. two-parent families). In boys only, first-generation immigrants (OR 1.53; 95% CI 1.06–2.21) (vs. natives) and youth sufficiently physically active (OR 2.19; 95% CI 1.65–2.90) were more likely to consume ED daily. High ED consumption was more frequent among boys and showed gender-specific patterns, with associations with family structure in girls only, and with migration status and physical activity in boys only. Our findings provide evidence about patterns of high ED consumption among adolescents and should be used to inform the development of prevention strategies.
Tea Flavonoids and Risk of Cardiovascular and All-Cause Mortality: A Systematic Review and Meta-Analysis
Authors: Wang Ding Ding , Cassidy Aedin , Ferruzzi Mario G. , Jacques Paul , Johnson Elizabeth , Zhao Naisi , Shams-White Marissa , Karlsen Micaela , Wallace Taylor C. , Chung Mei
Published: June 2020

There is increasing evidence that both black and green tea are beneficial for prevention of cardiovascular disease (CVD). We conducted a systematic review and meta-analysis evaluating the effects of tea flavonoids on cardiovascular (CVD) and all-cause mortality outcomes.Searches across five databases including PubMed and Embase were conducted through November 2018 to identify randomized controlled trials (RCTs) and prospective cohort studies reporting cardiovascular and all-cause mortality outcomes. Two investigators independently conducted abstract and full-text screenings, data extractions, and risk of bias (ROB) assessments using the Nutrition Evidence Library Bias Assessment Tool (NEL BAT). Mixed-effects dose-response meta-regression and standard random-effects meta-analyses for outcomes with ≥ 4 studies were performed. 0 RCTs and 38 prospective cohort studies were included in the systematic review. NEL BAT scores ranged from 0–15 (0 being the lowest risk). Our linear meta-regression model showed that each cup increase in daily tea consumption (about 280 mg and 338 mg of total flavonoids for black and green tea, respectively) was associated with 3–4% lower risk of CVD mortality (predicted adjusted RR = 0.96; CI 0.93–0.99 for green tea and RR = 0.97; CI 0.94–0.99 for black tea). Furthermore, eachcup increase in daily tea consumption was associated a 2% lower risk of all-cause mortality (predicted adjusted relative risk (RR) = 0.98; 95% CI 0.97–0.99 for black tea and RR = 0.98; CI 0.96–0.99 for green tea, respectively). Two studies reported multivariable Cox regression analysis results for the relationship between black tea intake and risks of all-cause mortality outcomes. The results from these two studies were combined with our linear meta-regression result in a random-effects model meta-analysis and showed that each cup increase in daily black tea consumption was associated with an average of 3% lower risk of all-cause mortality (pooled adjusted RR = 0.97; 95% CI 0.87- 1.00) with large heterogeneity (I2 = 81.4%; p = 0.005). Current evidence indicates that increased tea consumption may reduce cardiovascular and all-cause mortality in a dose-response manner. This systematic review was registered on PROSPERO.
Risk factors for undernutrition among children 0–59 months of age in Myanmar
Authors: Kang Yunhee , Kim Jihye
Published: June 2020

Prevalence of childhood stunting in Myanmar is one of the highest in the South-East Asia countries. Cross-sectional data from the Demographic Health Survey 2015–16 were used to examine risk factors for stunting, wasting, and underweight among children aged 0–59 months. The prevalence of stunting (height-for-age z-score < -2), wasting (weight-for-height z-score < -2), and underweight (weight-for-age z-score < -2) was 29.0%, 7.3%, and 19.2%, respectively. Accounting for cluster design and sampling weights, multivariable logistic regression was conducted with 35 household, maternal, and child characteristics. Current pregnancy and maternal height < 145 cm, and child's small birth size recalled by mother, home delivery, and older child age (ref: 0–5 months) predicted both stunting and underweight. Child's large birth size was protective for all stunting, wasting, and underweight. Maternal BMI < 18.5 kg/m2 was a common risk factor for wasting and underweight. Lower wealth quintiles, maternal engagement in non-agricultural occupation, and male child predicted stunting only. Younger child age and not receiving vitamin-A supplementation in the last 6-month was risk factor for wasting only. Regional variation was also seen with a higher odds of stunting in West-South Region, North-East States, and West States, compared to Central Regions. In Myanmar, socioeconomic-demographic factors, poor maternal nutritional status, and living in certain geographic location are affecting children's undernutrition. It is recommended that intervening growth faltering focusing on the 1000 days of life; ensuring optimum maternal nutrition during and before pregnancy and at adolescence; societal support for mothers in poverty or engaged in non-agriculture; and understanding region-specific undernutrition pathways.
The phenomenon of zinc deficiency among children in China aged 3–5 years old
Authors: Bi Ye , Yang Zhenyu , Pang Xuehong , Duan Yifan , Lai Jianqiang , Jiang Shan , Wang Jie , Zhang Huanmei
Published: June 2020

Introduction

zinc is an essential micro-nutrient for growth and proper immune function. Yet there are limited data available on the prevalence of zinc deficiency among children aged 3–5 at the country level. This information will enable health planners to determine the need for zinc intervention activities and to stimulate further research into these areas.

materials and methods

The data on children aged 3–5 were extracted from the Chinese National Nutrition and Health Surveillance in 2013. By multi-stage stratified cluster randomly sampling method, 30 children aged 3–5 years old were selected from each region for this study from 55 counties in China to analyze serum zinc. Finally, 1472 children aged 3–5 years were included in the study. The concentration of serum zinc was determined by high resolution inductively coupled plasm mass spectrometry. High and low level quality control samples were used, measured value was (1.63 ± 0.04)mg/l and (2.80 ± 0.06)mg/l, respectively. CV of quality control samples were 1.69%~2.45%. The zinc deficiency was defined as serum zinc level < 70μg/dl with the standard of WHO.

Results

serum zinc means of children aged 3–5 years was (95.3 ± 18.2)μg/dl and 3.9% children with zinc deficiency. serum zinc means level in urban children was (98.9 ± 17.6)μg/dl, and (91.6 ± 18.2)μg/dl in rural area. we showed that the serum zinc deficiency rate was higher in rural children (5.5%) than urban children (2.4%), and there were significant differences between these two areas. serum zinc means level in boys aged 3–5 years was (95.3 ± 18.7)μg/dl, and (95.3 ± 17.8)μg/dl in girls aged 3–5 years old. The prevalence of zinc deficiency was 1.5%, 6.6% and 1.8% in 3~,4~,5~ years old urban boys, respectively; 6.8%, 7.7% and 4.0% in rural boys, respectively. The prevalence of zinc deficiency was 2.3%, 0.8% and 1.7% in 3~,4~,5~ years old urban girls, respectively; 4.1%, 7.0% and 4.0% in rural girls, respectively. And there were differences between urban and rural areas in girls of 4~.5 years.

Discussion

The zinc level of children aged 3–5 years in China has been improved compared with ten years ago, but the zinc deficiency of rural children is still lower than that of urban children, especially those aged 4 to 5 years in rural areas, so we should pay more attention to this group.
Early life factors and their relevance to intima-media thickness of the common carotid artery in early adulthood
Authors: Nyasordzi Juliana , Penczynski Katharina , Remer Thomas , Buyken Anette
Published: June 2020

Introduction

Early life factors may predispose an offspring to cardiovascular risk factors in later life. It is plausible a range of exposures in early life may be involved in this predisposition, which may extend to “healthy” populations in Western populations.

We examined the association between a number of early life factors with the carotid intima-media thickness (IMT), a surrogate marker of atherosclerosis, in early adulthood of a healthy German population.

Methods

We studied term participants (n = 265) of the DONALD Study, with a bilateral sonographic measurement of the IMT in young adulthood (18–40 years) and data on early life factors (maternal and paternal age at child birth, birth weight (including appropriateness of birth weight- for gestational age), gestational weight gain and full breastfeeding (breastfeeding > 17weeks). Sonographic IMT measurements were performed on the left and right common carotid artery using a minimum of 4 measurements. Mean IMT values were obtained averaging the measurements from both sides, an overall average obtained from 8 and 16 measurement of both sides was used for this analysis. Information on gestation and birth were abstracted from the “Mutterpass”, maternal and paternal age at birth were inquired at study entry and breastfeeding information was assessed prospectively. Prospective association between early life factors and IMT were analyzed using multivariable linear regression models, considering age at IMT measurement, physician taking the measurement, in addition: birth year, first born status, maternal and paternal educational status, maternal overweight, presence of smokers in the household tested for potential confounding.

Results

Mean adult IMT was 0.56mm ± 0.03, range: 0.41mm-0.78 mm. Maternal age at child birth was of prospective relevance for IMT in young adulthood, however, this association was sex specific: Increased maternal age at child birth was independently associated with an increased IMT among female offspring during young adulthood (β 0.029, SE 0.009) mm/decade, P = 0.003) only, this was not mediated by adult waist circumference. None of the remaining early life factors showed relevance for adult IMT levels among males and females in early adulthood.

Conclusion

This study suggests that advanced maternal age at child birth is of prospective relevance for IMT levels in younger adulthood in a healthy Western population. This association appears to be sex specific, with maternal age at child birth positively associated with IMT in females in early adulthood only.