bluuebunny/crossref_metadata_2025 huggingface dataset:
Child Stunting and Maternal Undernutrition in Two Rural Ethiopian Communities Five Years after the Initiation of the National Nutrition Program
Authors: Lombamo Getahun Ersino , Henry Carol J , Regassa Nigatu , Zello Gordon A
Published: November 2023

Addressing maternal and child undernutrition is one of the strategic objectives and a priority area agenda for the National Nutrition Program of Ethiopia. We estimated the burden of maternal and child undernutrition in two rural communities (Halaba & Zeway) of Ethiopia and compared outcomes with regional/national reports as well as explored their associations with factors such as gender, socioeconomic‐demographic factors and access‐utilization of health services. In a cross‐sectional study between March and June 2013, we used interviewer administered questionnaire to collect data from mothers in addition to various anthropometric measurements from both mothers and their <5yrs of age children in rural communities of Halaba, south Ethiopia, and Zeway, Oromiya region (n=630 mother‐child pairs, total). Findings showed that maternal undernutrition (% BMI<18.5) ranged from moderate (14%, Zeway) to high (22%, Halaba). We also found alarming levels of stunting and underweight (54% stunting, 36% underweight, in Halaba) and (42% stunting, 21% underweight, in Zeway) among children. Up to 95% of Halaba and 85% of Zeway mothers reported consumption patterns that were ‘same as usual’ or ‘less than usual’ during their most recent pregnancy compared to times of none‐pregnancy/lactation. Up 61% also reported abstaining from consumption of certain nutritious foods for cultural reasons. Factors such as gender and socio‐economic‐demographic structure of the household, including imbalance of power, physiological density, household size and dietary habits during pregnancy showed significant associations with maternal and child undernutrition (p<0.05), warranting further investigation. The observed levels of child and maternal undernutrition, particularly in Halaba areas were unexpected and of serious concern, given that a national nutrition program administered by the government has been in place for some time. This baseline study provides insights to policy and decision makers to revise and/or strengthen the nutrition programs designed to target vulnerable segments of the population in these regions.

Support or Funding Information

The research was supported by the International Development Research Centre (IDRC) and the Department of Foreign Affairs Trade and Development (DFATD), Government of Canada, through the Canadian International Food Security Research Fund (CIFSRF).
Food Sources of Fiber and Micronutrients of Concern in Diets of Young Children
Authors: O'Neill Lynda M , Reidy Kathleen C , Deming Denise M
Published: November 2023

The Feeding Infants and Toddlers Study (FITS), 2008, identified iron and zinc as the nutrient gaps for infants and vitamin E, potassium and fiber as the nutrient gaps for toddlers, whereas sodium was reported as being consumed in excess among toddlers and preschoolers. Many studies have found vitamin D to be a dietary shortfall during early childhood. Data from FITS was used to assess the relative contributions of foods to said nutrients. Dietary intake interviews (24‐hr recalls) were carried out by telephone with parents or primary caregivers of infants 6–11 months (n=505), toddlers 12–23 months (n=925), and preschoolers 24–47 months (n=1,461). Reported foods and supplements were assigned to one of 71 food groups based on nutrient similarities and uses. Food mixtures were disaggregated into their constituent ingredients and ingredients were classified into one of the 71 groups. The population percentage contribution of each of these foods to total nutrient intake was determined for each nutrient and age group. Infant cereal was the leading source of iron in infants, providing 41% of their iron intake. Infant cereal was also the second source of zinc for infants, providing 16% of their zinc intake, with infant formula being the highest source, providing 48% of zinc intake. The top sources of fiber for all ages were grain products, which provided 14% of infants’ intake and 11% of toddlers’ and preschoolers’ intakes. Salt and seasonings were the major sources of sodium for all children, contributing approximately 20% of their sodium intake. Milk, all types combined, was the major source of potassium for all ages, contributing 46% to 32% of potassium intake, with 100% juice, potatoes and bananas making up the next three sources for both toddlers and preschoolers. Dietary supplements were the leading contributor to vitamin E for toddlers and preschoolers, contributing 22% and 44% of intake, respectively. Milk and butter/margarine were also in the top 5 sources of vitamin E for toddlers and preschoolers. Peanut butter and salty snacks were top sources of vitamin E for preschoolers (5% each) and ready‐to‐eat (RTE) cereals for toddlers (5%). Milk was the major source of vitamin D for all ages, contributing 47% to 74% of vitamin D intakes, depending on age, followed by supplements, which provided 14% to 39% of intake. Overall, supplements and foods that are typically fortified made substantial contributions to micronutrient intakes. Caregivers should be strongly advised to choose lower sodium food options and not depend on supplements for mineral and vitamin intakes. Instead, they should be encouraged to provide a wide variety of nutrient dense foods, which would instill healthy eating habits from the beginning.

Support or Funding Information

Nestle
Effect of Food Allergies on Growth in Children
Authors: Rhodes Katie , Crook Tina , Phelps Josh , Hakkak Reza
Published: November 2023

Food allergies result in a food elimination, which can lead to inadequate nutrient intake if not substituted properly. Allergen elimination has been shown to correlate with inadequate growth, especially when the allergen is milk. The purpose of this study was to determine if height and Body Mass Index (BMI) could be affected by the presence of a food allergy. A parent questionnaire was used to determine characteristics of 650 children, ages 0–17 years, who had been seen in a pediatric allergy clinic. Independent‐samples t‐tests were used to determine if differences existed between mean height and BMI z‐scores in the following groups: 1) participants with food allergies compared to those without food allergies, 2) participants ages 0–5 compared to those ages 6–17, 3) participants with milk allergy compared to those with other food allergies, and 4) participants with a milk and/or soy allergy compared to those with other food allergies. Significant differences were found between the following variables: 1) mean BMI z‐scores between participants with food allergies (M= 0.5769, SD= 1.2152) compared to those without food allergies (M= 0.8021, SD= 1.1593); p= 0.023, two‐tailed, 2) mean length/height z‐scores between those with a milk allergy (M= −0.4000, SD= 1.3024) compared to those with other food allergies (M= 0.10137, SD= 1.5322); p= 0.002, two‐tailed, and 3) mean length/height z‐scores between those with a milk and/or soy allergy (M= −0.3931, SD= 1.3469) compared to those with other food allergies, (M= 0.1426, SD= 1.5124); p= 0.001, two‐tailed. Our findings suggest the presence of a milk and/or soy allergy impacts linear growth. This highlights the importance of providing appropriate nutrition education to families and children with food allergies in order to avoid nutrient deficiencies, thus improving growth outcomes.

Support or Funding Information

Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences
Maternal diet quality during pregnancy and fetal growth outcomes: a pilot study of lower‐income pregnant women
Authors: Leung Cindy W , Epel Elissa S , Bush Nicole R , Coleman‐Phox Kimberly , Adler Nancy E , Laraia Barbara A
Published: November 2023

The effect of a healthy diet during pregnancy may have a stronger impact on pregnancy and birth outcomes and more public health relevance than the examination of any individual dietary component alone. The objective of our study was to examine the associations between overall diet quality during pregnancy, using a modified Alternate Healthy Eating Index (AHEIP)‐2010 for pregnancy, and fetal growth outcomes in a sample of 91 lower‐income, racially and ethnically diverse, overweight and obese pregnant women enrolled in an 8‐week behavioral intervention program in early pregnancy. Outcomes included birth length, weight, and weight‐for‐length Z‐scores estimated using WHO Child Growth Standards. Out of 110 points, the mean AHEIP‐2010 score in our sample was 44.8 ± 0.9. Adjusting for sociodemographic and health characteristics, infants born to women in the top tertile of AHEIP‐2010 had higher birth weight Z‐scores (β=0.79, 95% CI 0.31, 1.27, P‐trend=0.002) and higher birth length Z‐scores (β=1.17, 95% CI 0.04, 2.29, P‐trend=0.05) compared to the bottom tertile. Associations with birth weight were associated with higher intakes fruit, whole grains, and long‐chain fats, and lower intakes sugar‐sweetened beverages and fruit juice, and red/processed meat. Overall dietary quality during pregnancy, encompassing multiple healthful behaviors, was positively associated with infant birth weight and length, but not infant adiposity as measured by weight‐for‐length.

Support or Funding Information

This study was supported by the National Institutes of Health grants (U01 HL097973 and K99 HD084758 to C.W. Leung).
The Correlation Between Dairy Product Consumption and Gastrointestinal Bleed, Ovarian Cancer, and Diabetes in Infants: A Meta‐Analysis Approach
Authors: Kelly‐Newton Stashauna L , Tulp Orien L , Einstein George P
Published: November 2023

The incidences of gastrointestinal bleeds, ovarian cancer and Diabetes in infants have recently increased. In one study, during the second six months of life, infants who were fed whole cow's milk experienced a 30% increase in intestinal bleeds and significant iron loss in stools. This is presumed to be linked to the consumption of the protein casein found in mammalian milk. Casein is the name for a family of phosphoproteins (αS1, αS2, β, κ). These proteins are found in mammalian milk, making up 80% of the proteins in cow's milk and between 20% and 45% of the proteins in human milk. Casein may be considered a potentially dangerous carcinogen. The study intends to utilize a Meta‐analysis approach for data interpretation. It intends to show a correlation between the consumption of dairy products and the correlating incidence of gastrointestinal bleeds in infants, ovarian cancers and Diabetes Mellitus. One study found that the consumption of cow's milk was associated with weakened immune function in children, which may lead to recurring infections. High circulating levels of growth factors, such as IGF‐1 and VEGF, are found in cow's milk, which are linked to carcinogens. Another Asian population's study discovered that the incidence of cancer is 1 in 100,000 compared to 1 in 12 in the West. Together these imply a correlation between diary consumption and cancers and other diseases given that there is little to no dairy consumption in the traditional Asian diet but abundant dairy consumption in the Western diet. Evaluating the data will lead to more reformed dietary approaches and further highlight the role that cow's milk and other dairy products may play in the prevalence and incidence of ovarian cancer, gastrointestinal bleed in infants and the incidence Diabetes Mellitus.

Support or Funding Information

Supported by Institutional Resources of USAT and the Einstein Institute
Exclusive Breastfeeding DurationandRisk of Anemia inInfants and Young Children
Authors: Li Duo , Wang Fenglei , Liu Huijuan , Guan Yuhong , Huang Tao , Zheng Jusheng
Published: November 2023

Objective

To assess the association of exclusive breastfeeding duration with risk of anemia in infants of 12 months and children aged 48–71 months in mainland China.

Methods

65256 children enrolled in the Jiaxing Birth Cohort provided detailed breastfeeding information and anthropometry data at 1, 3, and 6 months of age. Hemoglobin was measured in 28105 children at 12 months and in 36128 children within 48–71 months thereafter. Anemia was defined as hemoglobin concentrations <110 g/L for children aged <60 months and <115 g/L for children aged ≥60 months.

Results

Overall anemia prevalence at 12 months and 48–71 months was 24.9% and 10.0%, respectively. Exclusive breastfeeding≥6 months, but not 3–5 months, was significantly associated with a higher risk of anemia in infants at 12 months age (OR: 1.17; 95% CI: 1.04–1.31), compared with exclusive breastfeeding<3 months. While for young children of 48–71 months of age, it was only marginally significant (OR: 1.14; 95% CI: 0.99–1.30).Prolonged exclusive breastfeeding duration was also associated with a decreased hemoglobin concentration of −0.60 g/L (95% CI: −1.12‐‐0.07) for infants at 12 months ageand −0.97 g/L (95% CI: −1.41‐‐0.53) for young children of 48–71 months of age.

Conclusions

Exclusive breastfeeding ≥6 months was associated with an increased risk of anemia in infants aged 12 months and lower hemoglobin concentrations in both infants and young children aged 48–71 months. Parents should be vigilant to prevent infant anemia and iron deficiency in infants exclusively breastfed for longer than 6 months.

Support or Funding Information

This study was funded by the Ph.D. Programs Foundation of Ministry of Education of China (J20130084).
The Importance of Vitamin A Supplementation Dose, Frequency and Duration On All‐Cause Mortality in Children under 5 Years
Authors: Pimpin Laura , Kranz Sarah , Fawzi Wafaie , Duggan Christopher , Mozaffarian Dariush
Published: November 2023

BACKGROUND

Prior meta‐analyses indicated that Vitamin A supplementation reduces child mortality, but the influence of dose, frequency and duration are unclear.

OBJECTIVE

To investigate the effect of Vitamin A supplementation dose, frequency and duration on all‐cause mortality in children up to 5 years.

METHODS

We identified and extracted de novo information on all individual publications included in the most recent and relevant meta‐analysis. We included any study using the standard WHO Vitamin A dose (50,000 International Unit (IU) < 6 months old, 100,000 IU 6–11 months, 200,000 IU >12 months). We extracted information on study identifiers, dose and frequency of vitamin A supplementation, number of participants, and numbers of deaths, as well as the original estimate of effects and associated uncertainty. We conducted univariate and multi‐variate meta‐regression on frequency of doses (per year), duration of supplementation (years) and total age‐standardized dose (IU). We conducted sensitivity analyses with and without one large controversial trial (DEVTA).

RESULTS

We identified 16 trials including 204,494 children aged 33 months (SD 14.5) on average at randomization. Frequency of supplementation ranged from 4 times a year to once in 2 years. Duration of supplementation ranged from 5 months to 5 years (mean=18.5; SD 13.8). Total age‐standardized cumulative dose ranged from 200,000 to 1,400,000 IU. Overall, vitamin A compared to none reduced mortality by 26% (95%CI 13, 37); P=0.001. Increasing frequency of supplementation, per dose per year OR=1.04 95%CI=0.95, 1.14; P=0.368 did not affect the protective effect of Vitamin A on mortality. Similarly, neither did increasing the duration of supplementation (per year) OR=1.01 95%CI=0.66, 1.54; P=0.951 nor the total age‐adjusted cumulative dose (total IU) OR=1.00 95%CI=0.99, 1.00; P=0.368.Multivariate analyses showed similar results. The inclusion or exclusion of the DEVTA trial to the analyses did not affect the overall results.

CONCLUSION

The results confirmed beneficial effect of vitamin A supplementation in children less than 5 years, without significant influence of dose frequency, duration of dosing or age‐standardized total dose within these ranges. These novel findings can help inform the development and efficiency of Vitamin A supplementation policies.

Support or Funding Information

Bill & Melinda Gates Foundation
Nutrient and food group intakes of the Korean preschoolers according to growth status
Authors: Kang Minji , Shim Jae Eun , Paik Hee‐Young
Published: November 2023

Dietary habits such as nutrient and food intake are one of the most important factors for growth status, especially in early childhood population. This study was conducted to compare the intakes of nutrients and food groups in according to the growth status using data from national survey. The study included 1,665 subjects aged 2–5 years with 24h diet recall and anthropometric data who participated in the 2009–2013 Korea National Health and Nutrition Examination Survey. Growth status of children was assessed by weight for height (WFH) and height for age (HFA). Children were classified into three groups based on the percentiles of children's WFH and HFA compared to 15th and 85th percentiles of the WHO Child Growth Standard 2 to 5 years. The nutrient and food group intake were compared according to growth status adjusted for potentially confounding variables. In total, 4.2% children were classified as the low WFH group (<15th percentile) and 25.2% children were classified as the high WFH group (≥85th percentile). The low WFH group consumed significantly lower intake of several micronutrients such as sodium, thiamin, riboflavin, and vitamin C, compared with the high WFH group. When compared the food group intake according to the WFH status, cereals and fruits intake were lower and nuts & seeds and fishes & shellfishes were higher in the low WFH group than in the high WFH group. In total, 14.0% children were classified as the low HFA group (<15th percentile) and 10.7% children were classified as the high HFA group (≥85th percentile). The low HFA group had a significantly lower intake of energy and iron, compared with the high HFA group. No significant differences in food group intake according to the HFA status. Further studies are needed to assess the effects of eating habits on the growth and health in Korean early childhood population.

Support or Funding Information

This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT & Future Planning(grant no. 2013R1A1A2057600)
Fatty acid composition in feeds and plasma of Canadian premature infants
Authors: Friel James , Mackay Dylan , Hossain Zakir
Published: November 2023

The objective of this exploratory study was to investigate how the fatty acid (FA) composition of different food sources for preterm infants including: breast milk (BM), formula (F), human milk fortifiers (HMFs) and total parenteral nutrition (TPN) impacted preterm infant's plasma FA. The associations between FA content of plasma with antioxidant enzyme activity and cognition were also evaluated.

Methods

Thirty‐two premature infants were included in this study. Five different feeds (BM, F, BM + F, BM + HMF and TPN) were provided. Foods and preterm infant plasma samples were collected at the same time on the same day biweekly where possible. Separation and identification of the plasma and food FA methyl esters were performed by gas‐liquid chromatography. Antioxidant enzymes were measured. The Bayley Scale of Infant Development version III was used to evaluate cognition.

Results

In food sources, BM contained significantly lower oleic acid (C18:1n9) (p<0.01), linoleic acid (C18:2n6) (p<0.01), a‐linoleic acid (C18:3n3) (p<0.01), arachidonic acid (AA) (C20:4n6) (p<0.05) and docosahexaenoic acid (DHA) (C22:6n3) (p<0.05) compared with the F. Palmitic acid (C16:0) was significantly higher (p<0.05) in the BM + HMF compared with the BM. Stearic acid (C18:0) was significantly higher (p<0.05) in the BM + F and BM + HMF compared with the BM. In the plasma lauric acid (C12:0) (p<0.05) and myristic acid (C14:0) (p<0.001) were higher in the BM fed babies compared to the F and TPN fed groups. Antioxidant enzymes, activities and cognition scores did not differ by feeding groups, however the study may not have been powered to detect these differences.

Conclusion

The type, and therefore quality, of fatty acids that are fed to premature infants is an important consideration as differences in feed fatty acids were seen in some plasma fatty acids in the study.

Support or Funding Information

CIHR
Analysis of Maillard reaction products, carboxymethyllysine, furosine, hydroxymethylfurfural, furan and acrylamide during processing infant formula
Authors: Lee Hyun‐Min , Yang Sung‐Yong , Lee Kwang‐Won
Published: November 2023

Infant formulas based on milk are consisted of additives such as protein, lipid, carbohydrate, vitamin and other fortifying agents. Because of series of heating and final drying process, infant formulas are prone to generate heat‐induced glycation (or Maillard reaction) products. Therefore N‐carboxymethyllysine (CML) was analyzed as a marker of advanced glycation endproducts (AGEs). HPLC/FLD method with o‐phthalaldehyde pre‐column‐derivatization was employed to determine CML. Furosine and 5‐hydroxymethylfurfural (HMF) as a indicator of initial and intermediate stage of glycation respectively, were analyzed by HPLC‐DAD. In addition, furan and acrylamide which can be generated during heat treatment with infant formula. Furan was analyzed by using SPME‐GC/MS, and GC/MS was employed for analyzing acrylamide. Samples were taken at each thermal treatment in manufacturing processes of infant formula. CML and furosine level increased with process, and final drying process caused the largest increase of these variables. However, HMF level was independent of serial processes. Furan and acrylamide were not detected in samples. Therefore, CML and furosine are proposed as a marker when monitoring glycation level during heat processes in infant formula.
PreliminaryData From an Evidence‐Based Nutrition Education and Cooking Family Meals Program for Moderately Low‐Income Families with Children Aged 4–10 Years Old
Authors: Rogers Catherine Ann , Pratt Keeley , Kennel Julie , Gunther Carolyn
Published: November 2023

Background & Objective

Family meals have become a growing area of research due to the potential positive impact on child diet and weight status. Despite this, relatively few efforts have been made to design and test evidence‐based interventions rooted in theory to equip families – particularly those with school aged children and in economic need – with the necessary resources to overcome barriers to establishing healthy mealtime routines. The objective of this study was to design, implement, and assess the feasibility and limited effectiveness of a 10‐week, evidence‐based nutrition education and cooking family meals intervention (Simple Suppers) aligned with the Social Cognitive Theory and aimed at instilling healthy family meal time routines for improved child diet quality and weight status.

Methods

The SS program includes 10 weekly lessons delivered over the dinner hour and targets moderately low‐income families with children aged 4–10 yrs. The interactive program aims to instill positive eating behaviors through skill building, role modeling, facilitation, and goal‐setting. Lesson components include: parent education on strategies to overcome barriers to family meals; child education that engages children in hands on food preparation; and group family meal. SS, a multiple cohort (3) study, was implemented as a pre‐ and post‐test quasi‐experimental design with waitlist control at a city‐wide faith‐based community center in Columbus, OH. The primary study outcomes included child BMI z‐score and biometrics (systolic and diastolic blood pressure), as well as family meal frequency and related variables (weekly frequency of meals offered at home (dinner and breakfast) and fast food meal purchases), which were assessed at baseline, 10 week post‐test, and 20 week follow‐up through home visits with participants.

Results

Baseline assessments were completed on cohorts 1 and 2 (81 families). Among child participants, 70% were female and 66.3% were African American. Twenty eight percent of child participants were 4–5 yr, 48% 608 yr, and 24% 9–10 yr. Mean (SD) child BMI z‐score was 0.72 (0.12). Mean (SD) baseline systolic and diastolic blood pressure was 1.38 (1.3) and 1.17 (1.3), respectively. Among caretaker participants, 82.7% worked full‐ or part‐time and 56.4% graduated from college. Mean (SD) baseline weekly frequency of family dinners per week was 3.7 (1.08), breakfast was 2.6 (1.29), and fast food was 3.8 (0.84). Post‐test and follow‐up data will be collected in winter 2015 and spring 2016.

Conclusion

Results from this study will be utilized to determine the limited effectiveness of a community‐based family meals intervention to improve child diet quality and weight status, which may inform the design of future scale‐up studies.

Support or Funding Information

Cardinal Health Foundation

The Ohio State University, Department of Human Sciences Seed Grant
Effect of Prospera program in nutritional status in its beneficiaries in San Luis Potosi state, Mexico
Authors: Nasu Lucia Cuevas , Shamah‐Levy Teresa , Gaona‐Pineda Elsa Berenice , Mendez‐Gomez Ignacio
Published: November 2023

Objective

Assessing the impact in nutritional status on Prospera program beneficiaries versus non‐beneficiaries, in San Luis Potosí, Mexico. Fourteen months after its implementation.

Methods

A comparative study was done in two follow‐ups with a panel data. The target population was integrated by Prospera beneficiaries (n=390) and a control group (n=354 children non‐beneficiaries). The stunting, low weight and wasting (<‐2 SD of z‐score) prevalence's were obtained according to OMS 2006, and the BMI z‐score was calculated (> plus 2 SD of z‐score). In order to assessing the effect of the intervention the Difference‐in‐Differences method combined with kernel matching and Epanechnikov function were used, the estimation of standard errors was done using Bootstrap method.

Results

Prospera shown a weak protector effect (p‐value 0.191) in low weight‐for‐height, this is to say a decrease in wasting prevalence was observed related with control group who has shown an increase by the end of the study. In contrast, a positive impact on obesity prevalence in beneficiaries versus non‐beneficiaries (p‐value 0.077) was found.

Conclusions

Prospera program has a small but positive effect in the decreasing of current malnutrition and obesity and its containment. It is imperative redouble efforts in Prospera program, given the harmful effects on health and capability development to eradicate malnutrition in San Luis Potosí in years to come.

Support or Funding Information

Supported by FOMIX, SLP‐COPOCYT

Project: FMSLP‐213‐CO2‐208475
Therapeutic nutritional effect of regular ingestion of non‐caloric sweeteners over regular ingestion of sucrose
Authors: Contreras Irazu , Diaz‐Sanchez Ariel Job , Gonzalez‐Rangel Jessica , Guzman‐Frias Noe , Sanchez‐Delgado Marcela , Estrada Jose Antonio
Published: November 2023

This study evaluated the nutritional effects of regular ingestion of non‐caloric sweeteners over ingestion of sucrose, since presently these products are used not only as a therapeutic tool for non‐communicable diseases with the purpose to control body weight, but are also consumed in the daily diet without having precise knowledge of their benefits or risks. In order to determine if ingestion of non‐caloric sweeteners provides an increased benefit in reduction of weight and body fat percentage compared to ingestion of sucrose, we applied 240 validated sweetener intake self‐report questionnaires, where we found that non‐caloric sweetener are regularly ingested in beverages and industrialized foods, without consumers knowing it. Subsequently, 48 subjects under nutritional supervision were asked to ingest non‐caloric sweeteners for 4 weeks. Subjects were divided into three groups of 16 individuals each: sucralose, steviol glycosides and sucrose. 27 subjects completed the protocol (11 sucralose, 12 steviol glycosides and 8 sucrose). All subjects had a customized diet, according to individual needs. We concluded that ingestion of the commercial non‐caloric sweeteners stevia and sucralose can lead to a decrease in body weight when individuals are under nutritional supervision, although the individuals who ingested sucrose under nutritional monitoring showed no significant change, neither in their final weight nor in body fat percentage. Our results suggest that sweetener intake, promotes reduction in body weight and body fat under controlled conditions. It would be important to determine the effect of sweetener intake in humans without nutritional supervision.

Support or Funding Information

Consejo Mexiquense de Ciencia y Tecnologia
Characterization of Fatty Acid and Mineral Composition of Selected Seeds, Nuts and Oils in Tanzania
Authors: Valentini Kelly , Jumbe Theresia , Pickens Austin , Adjepong Mary , Li Wei , Kinabo Joyce , Fenton Jenifer
Published: November 2023

Fatty acids (FA) and minerals have crucial roles in growth and development. These nutrients can be found in seeds, nuts and oils. However, Tanzanian diets are mainly starchy and cereal‐based with the intake of fats below recommended levels. Tanzania is the home to several seeds, nuts and oils but the FA profiles and mineral level of these foods are poorly described. Additionally, dietary intake of fats and oils in many Tanzanian meals is typically low due to the cost associated with meat and refined oil. Therefore it is prudent to identify potential low‐cost dietary alternatives that provide similar nutritional benefits. The objective of this study was to identify fatty acid composition of several seeds, nuts, and oils available in Kilosa, Tanzania, which can be incorporated in children's diets based on their nutrient content. Four types of seeds and three oils commonly found in the area were analyzed for their fatty acid composition by gas chromatography (GC‐MS) using selected ion monitoring for enhanced sensitivity. Then, seeds were digested with nitric acid and hydrogen peroxide in a microwave and mineral levels were detected with atomic absorption spectroscopy. Concentrations of fatty acids and minerals are reported as mg/g food grade oil or amount of freeze‐dried seed material, respectively. A substantial amount of linoleic acid (essential fatty acid) was found in sunflower oil (10.52mg/g) and pumpkin seeds (12.31mg/g). Further, red palm oil (8.95mg/g) and pumpkin seeds (5.30mg/g) had substantial amounts of oleic acid. Higher values of saturated fatty acids were found in coconut (3.52mg/g), red palm oil (7.49mg/g) and a commercial vegetable oil (7.43mg/g). The most abundant mineral was potassium in oyster nut (2.13mg/g), pumpkin seeds (3.40mg/g) and coconut (3.20mg/g). Pumpkin seeds with shells had higher iron levels (0.11mg/g) compared to seeds without shells (0.08mg/g). These seeds and oils are thus good sources of the essential fatty acids as well as other fatty acid and minerals which are important for proper growth and development. Thus recommendations on how they can be incorporated both in the diets and as snacks in this population can be made based on their nutrient content.

Support or Funding Information

This study was funded by iAGRI/USAID.
Front‐of‐Pack Labelling is Positively Associated With Degree of Product Processing and Innovation
Authors: Christoforou Anthea , Tarasuk Valerie
Published: November 2023

Front‐of‐pack nutritional labelling is pervasive in the North American grocery channel. This labelling is voluntary and existing research has shown nutritional quality to be a weak predictor of its use by manufacturers. Insofar as Front‐of‐pack nutritional references influence consumer purchasing, better understanding of what drives this practice by manufacturers is needed.

Our goal was to elucidate the conditions under which manufacturers display nutritional assertions and claims such as ‘natural’ and organic. Specifically, we examined how these Front‐of‐pack references relate to the degree of food processing and to product innovation, considering the labelling on foods designed explicitly as substitutes for traditional counterparts. Front‐of‐pack labelling was recorded from all packaged foods (n=20520 unique products) in 3 major Toronto grocery stores, representing 71% of the total Canadian retail market‐share. All foods were coded for degree of processing using the International Food Information Council's classification system, and further categorized as substitute or traditional counterparts if these had 1) immediate interchangeability within the diet and 2) inherently different formulation (e.g. butter and margarine). Multinomial logistic regression analyses were used to assess the relationship between the extent and nature of Front‐of‐pack references and product processing. 41% of products had some Front‐of‐pack nutritional labelling, 20% were labelled as ‘natural’, and 7% were labelled as organic. Highly processed, ready‐to‐eat products comprised 37% of our sample and half bore nutritional references. These products were more likely than less processed foods to bear organic (OR=1.12 95%CI:1.02, 1.41), ‘natural’ (OR=1.56 95%CI:1.39, 1.75), and nutritional references (OR=1.86 95%CI: 1.70, 2.05), and to make references to the absence or reduction in negative nutrients (OR= 4.03 95%CI:3.52, 4.62) (e.g. sodium, trans fat). Foods identified as substitutes for traditional foods were much more likely than other products to have Front‐of‐pack labels (OR=2.91 95%CI:2.55, 3.32), and to make reference to vitamin or mineral formulations (OR= 2.20 95%CI:1.91, 2.54). Within substitute pairs, substitutes were 2.2 times more likely than their traditional counterparts to have Front‐of‐pack nutritional labels. Taken together, these findings raise questions about the extent to which Front‐of‐pack labelling serves to complement corresponding public health efforts to improve dietary intakes of whole, fresh foods and lend support to calls for a mandatory, standardized system of Front‐of‐pack labelling across all prepackaged foods.

Support or Funding Information

Canadian Institutes of Health Research Operating Grant (MOP ‐102655)
A Qualitative Study of Factors Related to Cardiometabolic Risk in Rural Men
Authors: Graham Meredith L , Morgan Emily H , Seguin Rebecca A
Published: November 2023

Background

Rural men are known to have poor health behaviors, which contribute to their elevated burden of cardiometabolic disorders in the United States. Although regular physical activity, healthy eating, and avoiding tobacco can reduce cardiometabolic risk, little is known about how to engage rural men in health promotion programs. To bridge this gap in evidence, we investigate knowledge of modifiable cardiometabolic risk factors among rural men in the western United States, identify their concerns related to heart health and motivation to reduce risk, and explore individual, social, and community‐level influences on heart‐healthy behaviors.

Methods

We conducted seven focus groups with 54 sedentary, overweight/obese men aged 43–88 residing in government‐designated “medically underserved” rural Montana towns in September and October 2014. All sessions were audio‐recorded and transcribed verbatim. Transcripts were coded and analyzed thematically using Nvivo software. Participants also completed a brief questionnaire about personal characteristics and health behaviors. These data were explored descriptively.

Results

Despite their weight and activity status, no participants reported to be in poor health. Many men described health relative to self‐reliance and the ability to participate in outdoor recreation; concern with health appeared to be related to age. Participants were generally knowledgeable of heart‐healthy behaviors, but many felt fatalistic about their own risk. Catalysts for behavior change included a serious medical event in the household and desire to reduce aging‐associated functional decline. Barriers to adopting and maintaining healthy eating and physical activity habits and abstaining from tobacco included normative beliefs around masculinity and individual liberty, the limited social universe of small towns, winter weather, time constraints, and preferences for unhealthy foods. Facilitators included behavioral self‐monitoring, exercising with a partner, and opportunities for preferred activities.

Conclusions

These findings provide important insight about influences on rural men's health behaviors and provide guidance for possible intervention strategies to promote cardiometabolic health.

Support or Funding Information

Strong Hearts, Healthy Communities is funded by the National Heart, Lung and Blood Institute. Grant Number: R01 HL120702
Food Label Use is associated with Dietary Quality and Dietary Patterns among Latinos with Type 2 Diabetes
Authors: SAMUEL GRACE KOLLANNOOR , Segura‐Pérez Sofia , Shebl Fatma M , Hawley Nicola , Damio Grace , Chhabra Jyoti , Vega‐López Sonia , Fernandez Maria Luz , Pérez‐Escamilla Rafael
Published: November 2023

Background

Diet management is one of the cornerstones of type 2 diabetes care. Therefore, food label (FL) use is likely to be key in helping individuals with type 2 diabetes in making healthier food choices.

Objective

The aims of the study were to identify 1) determinants of FL use, and 2) the association between FL use and diet among Latinos with type 2 diabetes.

Methods

Secondary analyses of baseline data from Latino adults (N=203) with type 2 diabetes and a HbA1c ≥7% who participated in the DIALBEST randomized controlled trial were conduted. Dietary quality was measured using the Healthy Eating Index (HEI)‐2010 score calculated from a single 24hr recall. Dietary patterns were derived from the past 12 months’ dietary intake assessed using a food frequency questionnaire (FFQ). FL use was self‐reported. Multivariable logistic regression was used to identify independent determinants associated with FL use. Quantile regressions were conducted between FL use and HEI‐2010 (from 10th to 90th percentiles). Additionally, median regression was carried out to examine the association between FL use and dietary patterns’ factor scores.

Results

Respondent's education level, diabetes‐related knowledge and English speaking were positively associated with FL use. Whereas at lower percentiles (10th to 70th) FL use was not associatied with improved dietary quality, this association was statistically significant in the 80th (p=0.004) and 90th (p<0.001) percentiles. Similarly, FFQ data suggested that FL users were more likely to follow a “healthy dietary pattern” (p=0.003) and less likely to follow a “fried snacks pattern” (p=0.048) compared to non‐FL users.

Conclusion

FL use was associated with improved dietary intake in participants with type 2 diabetes. FL‐based educational interventions may reduce the prevailing racial/ethnic health disparities among Latinos with type 2 diabetes.

Support or Funding Information

This study was funded by the Connecticut NIH Export Center for Eliminating Health Disparities among Latinos (NIH‐ NCMHD grant # P20MD001765)
Anemia Prevalence and Hemoglobin Concentrations Improve in Young Children After 6 Months of Supplementation with a 21 Micronutrient‐Fortified Cereal and Legume Premix in a Rural Community in Retalhuleu, Guatemala
Authors: Reinhart Gregory A , Palacios Ana M , de Ponce Silvia , Alfonso Victor
Published: November 2023

The main objective of this study was to evaluate the impact of a community‐based nutrition intervention using a fortified corn and soy premix on the reduction of anemia and improvement in hemoglobin concentrations in 6 to 76 month old children that live in Santa Cruz Muluá, a rural community in Retalhuleu, Guatemala. The children were provided a daily serving of an atole, Chispuditos®, fortified with 21 vitamins and minerals containing 12 mg iron via iron glycinate, 0.5 mg pyridoxine, 160 mg folic acid, 0.9 mcg vitamin B12, and 40 mg vitamin C. Children were screened and invited to participate in the nutrition program if they had height‐for‐age Z score (HAZ) <‐1SD and if parents agreed to participate and signed an informed consent. A total of 588 children were identified and received a daily portion of 18.75g of dry product that was mixed with either milk or water and consumed as a beverage. Hemoglobin concentrations were determined prior to and after 6 months of receiving the nutritional intervention. At baseline, close to half of the children suffered from anemia (43.3%), and after 6 months the prevalence of anemia decreased to 36.7%, p<0.001. Furthermore, mean hemoglobin concentrations significantly improved from 10.8 g/dL to 11.4g/dL, p<0.001. A mild but non‐significant improvement was observed in mean HAZ (−2.38 to −2.31SD, p=0.293) and mean weight‐for‐height Z scores (−0.10 to −0.07, p=0.680). Chispuditos, a well‐accepted and culturally appropriate method of providing micronutrients to children at risk of developing micronutrient deficiencies in this community in Retalhuleu, Guatemala, has proven effective in reducing anemia and improving hemoglobin concentrations in this population within 6 months.

Support or Funding Information

This project is sponsored by The Mathile Institute for the Advancement of Human Nutrition
Current Nutrition Screening & Assessment Practices in Use According to Members of the Texas and Arkansas Academy of Nutrition and Dietetics
Authors: Hurlimann Tiffany , Phelps Josh , Crook Tina , Hakkak Reza
Published: November 2023

Registered dietitians use nutrition screening tools and assessments to identify patients at risk for malnutrition in acute care settings. According to the Joint Commission, identifying patients at risk of malnutrition can aid in improving patient health outcomes, reducing hospital stays and healthcare costs. The purpose of this study was to determine which nutrition screening and assessment tools are currently being implemented by registered dietitians in healthcare settings in Texas and Arkansas. This was a cross‐sectional study; data were obtained from 31 dietitians through an anonymous 34‐question survey powered by Survey Monkey. The survey included questions about current nutrition screening and assessment practices. The survey link and description of the study were sent out through emails or (e‐blasts) from the President of the East Texas Academy of Nutrition and Dietetics, the Communication's Chair of the Dallas Academy of Nutrition and Dietetics and the Executive Director of the Arkansas Academy of Nutrition and Dietetics. Descriptive statistics were used to analyze survey data and describe participants’ pooled responses. All data were analyzed using Survey Monkey analysis tools. Approximately 58% of participants were unfamiliar with the consensus statement regarding malnutrition from the Academy of Nutrition and Dietetics (AND) and the American Society for Parenteral and Enteral Nutrition (ASPEN). A variety of validated and non‐validated nutrition screening and assessment tools are in use in healthcare settings in Texas and Arkansas. Results did not indicate consistent use of screening or assessment tools across settings. This study did not show complete compliance with screening patients within 24 hours of admission to a hospital. It can be concluded that there needs to be more consistency with nutrition screening and assessment for the different patient populations. Participant response varied from using both validated and non‐validated nutrition screening and assessment tools. Further research could determine if validated nutrition screening and assessment tools are actually needed to assess patients for malnutrition in the hospital setting due to lack of consistency with using validated tools. Additional questions can be addressed in further research regarding time, resources, and training to determine why validated tools are not being used.

Support or Funding Information

Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences
Assessing the Nutrition Curriculum at Boston University School of Medicine
Authors: Ireland Kathy A , Manders Aaron , Lenders Carine
Published: November 2023

Background

For the past several years, there has been a national charge to increase inter‐professional nutrition education in the medical school curricula. The Nutrition Vertical Integration Group (VIG) at Boston University School of Medicine (BUSM) has facilitated the integration of medical nutrition in the 4‐year medical school curriculum. However, the quality and quantity of instruction has been difficult to evaluate.

Objectives

1) To determine how many of the nutrition knowledge objectives set forth by the Nutrition VIG at BUSM are taught and tested on in the 4‐year curriculum. 2) To determine course directors’ opinions on the desirability of each nutrition knowledge objective in the curriculum.

Methods

The Nutrition VIG at BUSM developed a list of 80 medical student nutrition knowledge objectives to be taught in the 4‐year curriculum. Seventy‐seven of objectives were based off of the 146 nutrition learning knowledge objectives for medical students set forth by the National Academic Award (NAA) Program's Nutrition Curriculum Guide for Training Physicians and 3 original objectives on food security were also added. The Nutrition VIG conducted a survey of BUSM course directors to determine which objectives were currently being taught and on which students were being tested. The survey also assessed course directors’ opinions toward the desirability to integrate nutrition topics into the BUSM curriculum. The survey was administered during pre‐clerkship and clerkship subcommittee meetings and was available online for those who were not able to complete it during meetings.

Results

Eighteen of 26 (69%) of the course directors responded to the survey. They reported teaching 63 of the 80 (78%) objectives but were only testing students on 48 of 80 (60%) objectives. Fourteen of the 18 (78%) course directors answered questions about the desirability of the objectives in the curriculum. For each of the 80 objectives, at least 92% of respondents reported that the objective was either a desired or necessary part of the curriculum.

Discussion

The results of this survey show that that the majority of BUSM nutrition knowledge objectives were covered in the BUSM curriculum. These findings are surprising, especially given that BUSM students indicate that they do not feel prepared to counsel their patients about nutrition. This gap raises question to the effectiveness of these nutrition knowledge objectives in the curriculum.

Conclusion

Further studies are needed to determine whether current nutrition objectives improve medical student preparedness to assess and counsel patients about nutrition.

Support or Funding Information

With support from the Allen Foundation and New Balance Foundation