bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of Iron Deficient Diets (with or without LC‐PUFA) on the Offspring Brain Lipid and Eicosanoid Metabolism during Pre‐Postnatal Development
Authors: Rioux France Marie , Jougleux Jean‐Luc , Surette Marc E , Fiset Sylvain
Published: November 2023

Objectives

We previously found that an iron deficient diet (ID) devoid in long chain polyunsaturated fatty acids (LC‐PUFA, n‐6:n‐3=59:1) fed to pregnant and lactating guinea pigs resulted in a large spectrum of auditory alterations in the peripheral neurophysiology in the offspring. Unexpectedly, we found that adding physiological amount of LC‐PUFA (n‐6:n‐3=11:1) to this ID diet induced minor impairments. The aim of the present study was to evaluate the impact of the (ID) diets (with or without LC‐PUFA) on Δ6‐desaturase expression, COX II protein and prostaglandin levels in the brain of these pups.

Methods

In experiment 1, female guinea pigs were fed an iron sufficient (IS) or iron deficient (ID) diet devoid in LC‐PUFA during the gestation and lactation periods. In experiment 2, female guinea pigs were fed the IS or ID diet in the presence of physiological quantities of LC‐PUFA. After weaning, from postnatal day 9 (PNd9) onward, the IS and IS+LC‐PUFA diets were given to pups in experiment 1 and 2, respectively. Brains and other tissues were collected on PNd24.

Summary of results

In both experiments, the brain COX II protein levels were unaffected in the ID and ID+LC‐PUFA siblings. In experiment 2, however, PGE2 brain concentrations were reduced in ID+LC‐PUFA compared to IS+LC‐PUFA pups. Similarly, the offspring born to dams fed the ID+LC‐PUFA diet also exhibited a trend for a reduced brain Δ6‐desaturase expression.

Conclusion

These experiments are showing that the addition of LC‐PUFA to a diet know to induce a mild iron deficiency have an impact on specific markers of brain lipid‐eisosanoid metabolism. However, the physiological outcomes of these central nervous system changes are unknown.

Support or Funding Information

Funded by the Canadian Institutes of Health Research
Gastrointestinal Tolerance of Formula Supplemented with Oligosaccharides
Authors: Kajzer Janice , Oliver Jeffery , Marriage Barbara
Published: November 2023

Objective

Human milk oligosaccharides (HMOs) are the third largest solid component in mature human milk. The objective of this study was to evaluate gastrointestinal tolerance of infants fed infant formula supplemented with short‐chain fructooligosaccharides (scFOS) and 2‐fucosyllactose (2′FL).

Methods

We conducted a prospective, randomized, multi‐center, double‐blinded, controlled 3‐arm tolerance study in full term, singleton infants (birth weight ≥ 2490g) enrolled between 0 and 8 days of age. At enrollment, formula‐fed infants were randomized to one of two experimental milk‐based infant formulas with a caloric density of 643 kcal/L. Experimental Formula 1 (EF1) did not contain oligosaccharides (n=42) and Experimental Formula 2 (EF2) contained 2g/L scFOS and 0.2g/L 2′FL (n=46). The 2 formula groups were compared with a human milk‐fed (HM) reference group (n=43). Infants were exclusively fed formula or human milk from enrollment until 35 days of age. Data related to intake, stool patterns, anthropometrics and parental questionnaires were collected. The primary outcome was average mean rank stool consistency (MRSC) from Study Day 1 to Visit 3. MRSC was calculated from stool records (1=watery, 2=loose/mushy, 3=soft, 4=formed, 5=hard).

Results

Thirty‐six (86%) subjects in the EF1 group, 41 (89%) in the EF2 group and 42 (98%) in the HM group completed the study. There were no differences among groups for gender, ethnicity, race, gestational age, birth weight or age at enrollment. Reported results are from the protocol evaluable analysis. From Study Day 1 to Visit 3, there were no differences in MRSC among the three feeding groups. MRSC was 2.37 ± 0.10, 2.15 ± 0.10 and 2.06 ± 0.08 for the EF1, EF2 and HM groups respectively. There were also no differences among groups for predominant stool consistency from Study Day 1 to Visit 3. The average number of stools per day for the HM group was significantly greater than EF1 (p<0.0001) and EF2 (p<0.0001) from Study Day 1 to Visit 3. At Visit 3, there were no differences between groups for average volume of study formula intake, number of study formula feedings per day, anthropometric data or percent feedings with spit‐up/vomit.

Conclusion

An experimental formula containing 2′FL and scFOS was well tolerated in young infants as evidenced by stool consistency, formula intake, anthropometric data and percent feedings with spit‐up/vomit similar to that of infants fed formula without oligosaccharides or HM.

Support or Funding Information

This study was funded by Abbott Nutrition, Abbott Laboratories, Columbus, OH.
The Effect of Zinc Supplementation during Pregnancy and Youth on Child Growth up to 5 Years: A Systematic Review and Meta‐Analysis
Authors: Pimpin Laura , Liu Enju , Shulkin Masha , Duggan Christopher , Fawzi Wafaie , Mozaffarian Dariush
Published: November 2023

BACKGROUND

Zinc supplementation promotes linear growth in children up to age 5 years. However, there has been no recent review of effects of both maternal and child supplementation trials on multiple anthropometric measure.

OBJECTIVE

To determine the effect of zinc supplementation during pregnancy, lactation and childhood on height (cm), height‐for‐age z‐score (HAZ) and birth weight (kg) up to age 5 years.

METHODS

We searched PubMed, EMBASE, the Cochrane Library, and Web of Science without restriction on publication year, setting, or language for randomized clinical trials examining effects of zinc supplementation lasting at least 3 months in pregnant or lactating women, or children under 5 on our outcomes of interest. Manuscript inclusions and data extractions were performed independently and in duplicate. Study quality was evaluated by the Cochrane Risk of Bias tool. Pooled weighted mean differences (MDs) were calculated by random and fixed effects meta‐analysis, with heterogeneity assessed by the I2 statistic and publication bias by Egger's test.

RESULTS

We identified 66 trials including 16 of pregnancy, 0 of lactation, 50 of child supplementation including 24,498 unique participants. Mean (SD) age at supplementation was 24.4 (4.4) years for pregnant women and 9.6 (3.1) months for children. Mean supplementation duration was 6.5 (2.1) and 7.1 (3.1) months, and average dose was 27.1 (8.7) and 8.9 (SD 5.6) mg/day, in maternal and child supplementation, respectively. Control was most often placebo (59% of studies), followed by iron with or without folate (27%) and other micronutrients (14%). In pooled analyses, child zinc supplementation increased child height by 0.69 cm (N=36 trials; MD=0.69, 95%CI=0.14, 1.25, P=0.02) and HAZ by 0.09 units (N=38 trials; MD=0.09, 95%CI=0.07, 0.12, P=0.001). Maternal supplementation did not significantly increase child height (N=3 trials; MD=0.65 cm, 95%CI=0.25, 0.40; P=0.70),HAZ (N=3; MD=−0.151, 95%CI=−0.31, 0.01;P=0.06), or birth weight (N=14 trials; MD=0.07 kg, 95%CI=−0.16,0.29; P=0.554). Heterogeneity in these analyses was generally high (I2: 80 to 100%) and was not explained by differences in population stunting status, zinc dose, control type, duration of supplementation, or rural vs. urban residence (P‐interaction from 0.21 to 0.40). There was a suggestion of a decreasing effect size for studies with a longer follow‐up duration (P=0.09). Quality ratings were moderate to high for most (82%) studies.

CONCLUSION

Child but not maternal zinc supplementation increases height and HAZ in children up to 5 years; fewer trials during pregnancy may limit power to detect effects. These novel findings inform the design of evidence‐informed zinc supplementation policies to improve linear growth of children and reduce rates of stunting globally.

Support or Funding Information

Bill & Melinda Gates Foundation
Effects of Consuming Bifidobacterium longum subspecies infantis on intestinal microbiota in exclusively breastfed term infants
Authors: Smilowitz Jennifer T , Fineberg Annette , Underwood Mark
Published: November 2023

Universally, for the first six months of life, Bifidobacterium longum subspecies infantis (B. infantis) is the dominant strain of intestinal bacteria in infants delivered vaginally and exclusively breastfed. In developed nations, infants delivered by cesarean section or vaginally have lower levels of intestinal B. infantis than infants born in developing nations. Additionally, the dominance of intestinal B. infantis is found in fewer infants of developed than of developing nations. The objective of the Infant Microbiota and Probiotic Intake (IMPRINT) Study was to determine if the daily consumption of B. infantis for 21 consecutive days by exclusively breastfed infants would increase levels of B. infantis during and one month post‐supplementation. Before Day 6 of life, women and their infants delivered vaginally or by cesarean section, were randomized into a lactation consultation (LC) group or lactation consultation plus B. infantis (LC+Bi) group. Infants in the LC+Bi group were fed daily 1×10^10 colony forming units of B. infantis that was mixed with 5 mL of their mother's breastmilk starting on Day 7 and ending on Day 27 of life. Mothers collected two fecal samples (before Day 6, Day 60), five milk samples (Days 7, 14, 21, 32, 60) and infant fecal samples (before Day 6, Days 10, 14, 21, 25, 29, 32, 40, 50, 60). Mothers filled out in‐depth health questionnaires, weekly health questionnaires and daily logs about their infants’ diet and intestinal symptoms. Fecal samples were analyzed for B. infantis by quantitative polymerase chain reaction. The fecal level of B. infantis was significantly higher in infants in the LC+Bi compared with infants in the LS group. B. infantis was well‐tolerated and did not result in any adverse events. This study is the first to demonstrate increasing intestinal bacteria toward a dominance of B. infantis with an exogenous source of B. infantis in term breastfed infants.

Support or Funding Information

Evolve Biosystems Inc.
Milk osteopontin regulates immune responses in mice stimulated by lipopolysaccharide (LPS)
Authors: Jiang Rulan , Prell Christine , Lönnerdal Bo
Published: November 2023

Osteopontin (OPN) is a highly acidic phosphorylated glycoprotein. It is a pleiotropic protein and has been reported to be involved in a wide range of biological processes including initiation of immune responses, biomineralization, cell survival and cell proliferation. OPN appears in most bodily fluids and is present high concentration in human milk. However, the functions of milk OPN remain to be defined. OPN expression was found in mouse mammary glands and it is present at a high level in mouse milk. Therefore, mouse pups fed by wild type (control) or OPN knockout (OPN‐deficient group) dams were utilized to investigate functions of milk OPN on immune responses in early life. To examine effects of milk OPN on immune responses, mouse pups (D20, D30 and D40) were treated with an intraperitoneal injection of E. coli LPS, serotype O111:B4 (1.25 mg/kg, Sigma) in sterile saline. Mouse pups were then euthanized and plasma samples were collected for cytokine measurement (ELISA assays, R&D Systems) at different time points (0.5, 1, 2, 4, 8 & 24 h). Diarrhea symptoms were seen starting at 4 h and body weight was reduced by around 12.5% in all groups at 24 h. Plasma OPN and TNF‐α were significantly up‐regulated in both control and OPN‐deficient groups after LPS injection, but a considerably higher increase in plasma OPN and TNF‐α was observed in the OPN‐deficient group, indicating that milk OPN has anti‐inflammatory properties upon LPS administration. Similarly, plasma IFN‐γ was dramatically enhanced in response to the LPS challenge in both control and OPN‐deficient groups, but the control group showed a significantly higher increase in IFN‐γ. In conclusion, milk OPN may contribute to resistance to LPS administration (bacterial infection) by altering immune responses.

Support or Funding Information

Supported by Mead Johnson Nutrition.
Consumption of a Corn‐Sugar Based Infant Formula Is Associated with Higher C‐peptide Secretion Compared to Lactose Based Formula among Exclusively Formula Fed Infants
Authors: Young Bridget E , Tang Minghua , Griese Kayla , Krebs Nancy F
Published: November 2023

Lactose is the predominant source of the carbohydrate (CHO) in human milk, and provides approximately 40% of infant calories. In contrast, the CHO source provided in infant formula varies widely among types and brands of commercial infant formulas for healthy term infants. Common sources of CHO in US infant formulas include lactose, various formulations of corn sugar (corn syrup, corn syrup solids, maltodextrin, glucose syrup, etc.), sucrose, and starch. Lactose is a disaccharide of glucose and galactose which has a lower glycemic index than the various formulations of corn sugar which are all varying polymer lengths of glucose. The young infants’ pancreatic response to exclusive consumption of these various non‐lactose CHO sources has not been studied.

C‐peptide is secreted in equimolar amounts to insulin and provides a stable marker of endogenous insulin secretion. We conducted a cross‐sectional pilot study to compare urinary C‐peptide in exclusively formula fed infants who consumed an infant formula with 100% of CHO from corn‐sugar to infants who habitually consumed a formula with 100% of CHO from lactose. Infant urine samples were collected in a standardized manner. Formula choice had been determined by parents. Urinary C‐peptide to creatinine ratio was measured.

Twenty seven infants were studied; 12 from the corn‐sugar and 15 from the lactose‐based group. Infants were on average 5.4 ± 0.5 months of age. The two groups did not differ in terms of infant sex, birth weight, weight gain, or anthropometric z‐scores at the time of study. Mean (± SD) urinary c‐peptide to creatinine ratio was 2.3 ± 4.2 ng/g for the lactose group vs 8.4 ± 11.8 for the corn‐sugar group (p = 0.08).

These preliminary results suggest that further research is warranted to determine the short and long‐term effects of non‐lactose based CHO exposure on pancreatic and metabolic function in young infants. Given the prevalence of corn‐sugar based infant formulas on the US market, the long‐term effects of CHO source on infant metabolic function and programming need to be determined.

Support or Funding Information

University of Colorado CCTSI UL1 RR025780; NIH‐NIDDK K24‐DK083772; National Pork Board; National Cattlemen's Beef Association; American Heart Association; Abbott Nutrition
Application of the new “Guidelines, for sale and distribution of prepared and processed foods and beverages in schools” in the National School System, during the lunch in Mexico
Authors: del Carmen Morales Ruán María , Shamah‐Levy Teresa , Jimenez‐Aguilar Alejandra
Published: November 2023

Objective

To evaluate school snack consumption in the context of the Guidelines to establish basis for public policy to preventing child obesity.

Methods

A descriptive study was performed in 110 public elementary schools in Mexico. A questionnaire about breakfast in the home and lunch in the school was applied to 182 children from 46 schools. Additionally the food and beverages intake was observed during the lunch time.

Results

The 82.4% of children reported to breakfast or eat something prior attending to the school. The 19.9% of the children are beneficiaries of the DIF (Family Integral Development System) scholar breakfast program from which 68% reported eating it.

The 67.9% of children told to take a lunch with them to the school. Only 10.6% mentioned to include a daily fruit in such lunch and 36.7% reported to have it once or twice per week. The 48.7% reported to never include vegetables in their lunch, and 37.3% only once/twice per week. The 43.3% informed to carry pure water with them, 8.5% industrialized sweetened beverages or soft drinks and 24.5% industrialized juices.

Conclusions

The inclusion of pure water and fruits in the children's lunch has being accomplished, however reinforcement in public policies aimed to guide about healthy food consumption in children is still required.

Support or Funding Information

Supported by Bloomberg Philanthropies
Wellness Program at the Workplace Promotes Healthy Eating Lifestyle: Analysis of Employee Wellness Data in a Longitudinal Retrospective Study
Authors: Soliman Ghada A. , Kim Jungyoon , Lee Jung‐Min , High Robin , Wehbi Nizar K , Canedy James T.
Published: November 2023

Introduction

A majority of work places offers wellness programs to their employees. To determine the effectiveness of wellness programs in improving participants’ behavior towards healthy choices; we investigated the impact of Nebraska‐based Wellness Programs on employees’ consumption of food groups.

Methods

Workplace wellness health‐risk questionnaires were collected from 16153 employees who participated in Nebraska‐based wellness programs across several organizations for three years during 2004 through 2013. Changes in intakes of fruits, vegetables, and whole grain from their first to the third year were compared among participants to determine the impact of the wellness programs on desirable behavior towards healthier food choices. McNemar test was used to compute the p‐values for the paired data.

Results

The percentage of employees who increased their consumption of fruits (14%) was significantly greater than the percentage of those who decreased their intake (10%, p<0.001). Similarly, the percentage of participants who showed a desirable behavioral change in increasing vegetable intake (14%) was significantly greater than the percentage of participants who showed an undesirable behavioral change (10%, p<0.001). Additionally, the percentage of participants who increased their consumption of dark green leafy vegetables (12%) was also significantly greater than that of those who decreased their intake (7%, p<0.001). There was a slight difference between the percentage of participants in regards to the number of servings of grains (5% versus 6%, p<0.001). However, the percentage of participants who increased their intake of whole grains (15%) was significantly greater than percentage of participants who consumed mainly refined grains (11%, p<0.001).

Conclusions

The Wellness management program has positive impact on increasing the number of participants who select healthier food choices such as increasing the intake of fruits, vegetables, dark green vegetables, and whole grains in a 3‐year follow‐up program.
Development of a nutrition Entrustable Professional Activity for pediatric residents
Authors: Manders Aaron J. , Ireland Kathy A. , Schumacher Daniel J. , Collier Sharon B. , Distler Catherine L. , Lenders Carine M.
Published: November 2023

Objective

Describe the process of developing a nutrition Enstrustable Professional Activity (EPA) for pediatric residents in the Boston Combined Residency Program (Boston Medical Center and Boston Children's Hospital).

Introduction

The top three causes of mortality in the United States are nutrition‐related and preventable. Unfortunately, most physicians feel unprepared to address nutrition‐related conditions, even those that are common in pediatric practice. The American Association of Medical Colleges (AAMC) has developed an educational framework that includes competencies (physician descriptors) and EPA (work descriptors) to train and assess residents, which can be used to support inter‐professional medical residents training in nutrition, metabolism, and lifestyle behaviors.

Methods

After establishing the need for improved nutrition training for residents, a meeting was scheduled with residency educators to write a proposal to improve residency training in pediatric nutrition in February 2014. Funding was obtained in December 2014. EPA were defined as an important method to improve resident training in nutrition. A multidisciplinary group of health care professionals was identified and composed of registered dietitians, physician educators, a pediatric resident, and a physician nutrition specialist. We used the approached described in Cate (2013) to guide our creation of a full EPA description. A focus group approach rather than a Delphi method approach was used in meetings. Several face‐to‐face and telephonic meetings, with later work being done individually and reviewed by the group until completion of the EPA.

Results

The group identified the five major components that needed to be addressed to create a pediatric nutrition EPA: (1) Target resident population, (2) Target patient population, (3) Target location of care, (4) EPA structure and presentation, and (5) Logistics. Challenges during development included defining the scope of the EPA, appreciating and properly balancing the content requirements with the limitations of the EPA structure, and potential barriers to implementing an EPA in practice. The end result of this process was the development of the first nutrition EPA for pediatrics, titled, “manage pediatric nutrition in the ambulatory setting.”

Discussion

The creation of the EPA was the first step in establishing nutrition as an entrustable professional activity for residents. This is the first EPA for pediatric residents focused primarily on nutrition. The development of an EPA is a complicated process that requires a team with sufficient and varied expertise, and adequate resources are needed for its implementation.

Support or Funding Information

Support from New Balance Foundation
Integrating Food Insecurity Assessment in Medical School Curriculum as an Important Health Indicator
Authors: Uhley Virginia , Farr A. Celeste
Published: November 2023

Food insecurity is associated with an increase in chronic disease risk and negative health outcomes. Gaining an understanding of how to assess for food insecurity is an important skill for health care professionals to integrate into their clinical practice. Medical students need to have the opportunity to learn how to integrate the assessment of food insecurity within the context of the doctor‐patient relationship and clinical assessment. The implementation of the Affordable Care Act will increase the probability that more individuals at risk for food insecurity will enter the health care system, further emphasizing the need for this important assessment skill.

To integrate the assessment of food insecurity into our medical school curriculum, we developed and implemented problem‐based longitudinal clinical patient case scenarios and a lecture based presentation in partnership with our local Health department which identified community health programs that were designed to help address food insecurity into our second year Promotion and Maintenance of Health course. We present here an overview of this innovative curriculum. Medical students were required to review their assigned case scenario and to assess their patient's nutrition risks and identify community health resources that would help support their patient's nutrition and health needs. A review of our medical student's completed case responses indicated that this case‐based approach was successful in allowing our student's the opportunity to integrate food insecurity into a clinical assessment and further they were able to incorporate community resources to help address the social determinants of the health of their assigned patients.

We conclude that providing problem‐based longitudinal clinical case scenarios is an effective way to integrate skill based food insecurity and associated social determinants of health assessment into the medical school curriculum.
Interprofessional Clinical Training of Nutrition and Dental Students/Residents: Examining Drug‐ Nutrient/Dietary Supplement Interactions and their Impact on Diet/Nutrition and Oral Health
Authors: Ziegler Jane , Spivack Evan , Heir Gary , Radler Diane Rigassio , Touger‐Decker Riva
Published: November 2023

Objective

To describe an interprofessional model to train students in the dental school clinic setting on exploration of drug‐diet/nutrient interactions.

Methods

Students and residents from the Rutgers’ Department of Nutritional Sciences, School of Health Related Professions and the School of Dental Medicine engage in interprofessional patient care. Nutrition and dental students/residents review patients’ medical histories, physical findings, medications, dietary supplements and chief complaints as a team under the guidance of dental and nutrition faculty. Using live patients or case studies, students/residents engage in interprofessional collaborative practice to identify potential medication‐ dietary supplement interactions that impact nutrition/diet status and oral health. Detailed diet histories and diagnostic test results are evaluated to determine potential deficiencies or interactions and appropriate interventions.

Summary of Results

Interprofessional approaches to practice provide role modeling for students/residents to emulate as they enter the practice setting. Effective interprofessional training integrates a variety of approaches; identification of drug, dietary supplement interactions and patient history, along with physical and diagnostic findings that impact diet/nutrition status and the orofacial region allows dental and nutrition students/residents to actively engage in learning while providing patients with comprehensive care in the dental school clinics. Students/residents learn collaborative decision‐making, problem solving and team‐based communication to deliver best practices.

Conclusion

Collaborative interprofessional team training and practice during clinical rotations allows students/residents to learn and appreciate the distinctive perspectives, knowledge and skills other disciplines bring to patient care. Student/resident feedback has been consistently positive.

Support or Funding Information

N/A
Understanding Nutrition‐related Care in General Pediatric Outpatient Clinical Settings from the Pediatric Provider Perspective: A Qualitative Study
Authors: Kaar Jill Landsbaugh , Schievelbein Sara , Gonzalez‐Pacheco Paola , Caponigro Kelly , Graham Alishia , Goodell L. Suzanne , Thompson Darcy A
Published: November 2023

Objective

Nutrition counseling continues to be a concern for pediatric providers. This study aims to provide an in‐depth understanding of the experiences of general pediatric providers regarding nutrition‐related care.

Methods

Individual semi‐structured qualitative interviews were conducted with outpatient generalist pediatric providers recruited from a children's hospital and local pediatric clinics using a purposive sampling technique. Interviews were conducted in‐person or via telephone, recorded, and transcribed. A thematic approach was used for data analysis.

Results

23 in‐depth interviews were completed, of which 14 providers’ reported no formal nutrition training during their medical education. Providers reported spending an average of 3.9 minutes of clinical visit time on nutrition topics with their patients. Four themes emerged from the data including 1) provider's insecurity regarding nutrition counseling; 2) lack of training in nutrition care; 3) lack of tools to assist providers in delivering nutrition care; and 4) cultural competency related to food. Providers in our sample defined nutrition care as the process of giving parents advice regarding the specific age related nutritional information needed for their child and further agreed it is their role to educate patients and families on what is appropriate nutrition. Nutritional concerns most often discussed include; types of formula, food allergies, supplement use, picky eating or perceived inadequate intake. Providers reported a need to build confidence in their ability to counsel their patients on nutrition topics. To do this effectively and efficiently, they noted a specific need for easy to use tools. Pediatric providers also reported that many nutrition related topics interrelate with family cultures and dynamics.

Conclusions

To improve nutrition counseling in the general pediatric clinics, providers need targeted training and counseling tools that fit within their existing framework. In order to achieve this, training modules need to be designed on specific nutrition topics as well as include topics on cultural competency. Additionally, novel tools that can be utilized quickly to educate patients on nutrition topics are essential for clinicians.

Support or Funding Information

University of Colorado School of Medicine, Department of Pediatrics‐ Medical Education
The Supplemental Nutrition Assistance Program Education (SNAP‐Ed) Elementary School Students had Self‐Reported and Observed Behavior Changes
Authors: McCullough Lauren , Farrell Vanessa , Hartz Vern , LeGros Theresa , Jacobs Laurel , Misner Scottie
Published: November 2023

The Supplemental Nutrition Assistance Program Education (SNAP‐Ed) provides multi‐level obesity prevention interventions in the school setting. The SNAP‐Ed goals for Arizona are to ensure that SNAP‐eligible youth: 1) meet the dietary recommendations for fruit and vegetable consumption, 2) meet dietary recommendations for calcium from low‐fat or fat‐free diary, 3) make half of grains consumed whole grains, and 4) engage in the recommended amount of physical activity (PA) per a day (60 minutes). Interventions in schools may include: nutrition and PA education, taste testing of fruits and vegetables, Local Wellness Policy development, implementation, and revision support. These interventions aim to change student nutrition and PA behaviors. A youth and a teacher survey were used to support interpretation of behavior changes and strengthen the quality of findings.

A randomized cohort of students in 4th and 5th grade school classrooms were recruited to participate in youth surveys that assessed nutrition and PA behavior. The youth surveys were administered in the Fall and Spring of 2014–2015. Youth surveys were matched to the students; 536 students took the pre‐survey and 543 took the post survey. Unmatched surveys were excluded for a sample size of 382. Paired t‐tests were used for continuous variables, and the McNemar test was applied to binary data. A multiple choice questionnaire was also given to the 4th and 5th grade teachers in the Spring (N=12), post‐intervention, to assess the teachers’ observations of students’ behaviors. Descriptive statistics were reported for items related to teacher observations of students’ behaviors. Teachers that participated in the teacher questionnaire may or may not have received a SNAP‐Ed intervention in their classroom, during the 2014–15 school year.

The youth survey analysis found a significant increase in whole grain consumption (17%, p<0.05) and total PA minutes per day (11% p<0.05). The teacher questionnaire analysis showed that 42% of teachers observed an increase in students’ whole grain consumption and 67% observed students being more physically active.

The low sample size for the teacher questionnaire and the unmatched teachers with classrooms were limitations to interpreting the results; however, teacher observations identified trends related to the significant findings of the youth survey. The surveys given to the students and teachers both supported the finding of increased consumption of whole grains and PA among youth in SNAP‐Ed participating schools. Using multiple surveys to assess perceived and observed behavior changes, can strengthen the interpretation of the results and identify trends.
Prevalence of Excess Sodium Intake in the United States, NHANES 2009–2012
Authors: Jackson Sandra L , King Sallyann Coleman , Zhao Lixia , Cogswell Mary E
Published: November 2023

Objective

To inform the 2015 Dietary Guidelines for Americans, the Dietary Guidelines Advisory Committee (DGAC) reviewed the scientific evidence and recommended consuming a healthy dietary pattern including less than 2300 mg dietary sodium/day or the “age‐appropriate Dietary Reference Intake (DRI) amount” in relation to calories. The objective of the present study was to examine the prevalence of excess sodium intake among Americans ages 2 and older, and among hypertensive adults.

Design

Data were analyzed from 14,728 participants aged 2 years and older in the 2009–2012 National Health and Nutrition Examination Survey(NHANES).

Results

A majority of US children (81%) and adults (89%) consumed >2300 mg sodium/day. More than 90% of US children exceeded the DRI upper intake level for their age. Among adults, 80% of women and 98% of men exceeded 2300 mg sodium per day, and among hypertensive adults, 86%. Total sodium intake was higher among males than females (p<0.001), but sodium density did not differ significantly by sex (p=0.50).

Conclusions

The DGAC emphasized expanding efforts to reduce the amount of sodium added to foods during commercial processing and preparation. Given the high prevalence of excess sodium in take in the US, population‐wide strategies such as these are needed.
Diet quality during pregnancy is inversely associated with prepregnancy weight status
Authors: Shin Dayeon , Lee Kyung Won , Song Won O.
Published: November 2023

Background

Prepregnancy overweight and obesity are determinants of excessive gestational weight gain and thus pregnancy complications and poor health outcomes. The association of prepregnancy weight status with diet quality during pregnancy remains unclear.

Objective

We aimed to investigate the relation between prepregnancy weight status and diet quality during pregnancy.

Methods

The study was based on 795 U.S. pregnant women in National Health and Nutrition Examination Survey (NHANES) 2003–2012. Prepregnancy weight status was classified by <18.5 (underweight), 18.5–24.9 (normal), 25.0–29.9 (overweight), and ≥30 kg/m2 (obese). Diet quality during pregnancy was assessed by the Healthy Eating Index (HEI)‐2010 based on a 24‐hour recall. Multiple logistic regressions were used to estimate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the association between prepregnancy BMI and diet quality during pregnancy assessed by the HEI‐2010 after controlling for maternal sociodemographic characteristics and physical activity during pregnancy.

Results

For all pregnant women in this study, the mean HEI‐2010 was 50.7 (± 0.9). Women with obese prepregnancy BMI had significantly lower HEI‐2010 compared to underweight and normal prepregnancy BMI groups, respectively (45.8 ± 1.6 vs. 52.4 ± 1.7, 52.3 ± 1.6). In an unadjusted model, women with prepregnancy obesity BMI had increased odds for being in the lowest tertile of HEI‐2010 compared to those with normal prepregnancy BMI (OR 4.99; 95% CI 2.19–11.37). The inverse association between prepregnancy obesity status and diet quality persisted even after controlling for physical activity levels (AOR 5.50; 95% CI 2.05–14.77).

Conclusion

Prepregnancy weight status was inversely associated with diet quality during pregnancy. Our findings suggest that women with overweight and obese prepregnancy BMI need to be targeted for nutritional interventions during pregnancy.
Current Data on Manganese in Foods and in U.S. Diets from the U.S. Food and Drug Administration's Total Diet Study
Authors: Spungen Judith H , Pouillot Régis , Hoffman‐Pennesi Dana , Briguglio Stephanie , Wirtz Mark
Published: November 2023

The U.S. Food and Drug Administration's Total Diet Study (TDS) program monitors concentrations of manganese, other nutrient minerals, and a variety of toxic substances in foods representative of U.S. diets. These data are available to the public on the TDS website. FDA's most recent TDS‐based intake estimates for manganese, published in 2002, were based on TDS data generated from 1991–1996. We recently initiated a program to update intake estimates for manganese and other TDS analytes using data generated from 2007–2012. Inductively coupled plasma atomic emission spectroscopy (ICP‐AES) was used to determine manganese concentrations in each of 259 foods collected under the TDS program. Of 6143 TDS food samples, 1694 (27.6%) had manganese concentrations below the limit of detection (LOD). We estimated lower bound mean manganese concentrations in TDS foods assuming that samples in which manganese was not detected contained zero manganese, and we estimated upper bound mean manganese concentrations assuming that samples with non‐detected manganese concentrations had concentrations equal to the LOD. We also used a zero‐inflated distribution model to estimate means and confidence intervals for manganese in TDS foods based on clustered data. We merged each set of manganese concentration data with food consumption data from the 2007–2008, 2009–2010, and 2011–2012 cycles of the National Health and Nutrition Examination Survey (NHANES) dietary component, What We Eat In America (WWEIA) and then estimated usual intakes of manganese by U.S. population subgroups using PC‐Side software (v. 1.0, Iowa State University). Proportions of NHANES/WWEIA respondents with manganese intakes greater than the Tolerable Upper Intake Level were low (< 1%) for most subgroups, but high (≥ 5%) among children ages 1 – 3 years and 4 – 8 years. Over 40% of manganese intake was provided by cereals and grain products. Other major contributors to manganese intake were pizza and other mixed dishes (likely due to the grain components) and tea. The updated TDS manganese data and intake estimates based on these data provide key information on manganese in U.S. foods and diets.

Support or Funding Information

U.S. Food and Drug Administration
Characterizing sandwich consumption patterns among children age 2–19 years, What We Eat in America. NHANES 2009–2012
Authors: Hoy Katherine , Goldman Joseph D. , Sebastian Rhonda S. , Enns Cecilia Wilkinson , Moshfegh Alanna J.
Published: November 2023

Sandwich consumption is commonplace in the American diet. Previous research has shown that almost one‐half of adults eat a sandwich on a given day, yet little is known about children's sandwich consumption. The purpose of this study is to describe sandwich intake among children by eating occasion (breakfast, lunch, dinner, snack) and location of eating (at home versus away from home) and to determine which other food/beverage categories were commonly consumed along with a sandwich. One day of dietary intake data for children age 2–19 years (n=6,412) in What We Eat in America (WWEIA), NHANES 2009–2012 was analyzed. Determination of sandwich reporting status was based on whether the individual reported any items that were coded either as single‐code sandwiches or as components of a sandwich combination. Eating occasion names were designated by the respondent. The WWEIA food categories were used to describe items consumed at eating occasions that contained sandwiches (sandwich occasions). Overall, sandwiches were reported by 48% of children: 7% reported eating a sandwich at breakfast, 30% at lunch, 17% at dinner, and 6% at snack occasions. Whereas 53% of all sandwiches reported by children were consumed at home, 59% of lunch sandwiches were consumed away from home. Vegetables were eaten at 25% of sandwich occasions with French fries accounting for 2 out of every 3 vegetable reports. Fruit was included at 18% of sandwich meals, and savory snacks were included at 15%. Beverage categories frequently consumed by children at sandwich occasions included sweetened beverages (29%), plain water (15%), plain milk (13%), flavored milk (9%), and 100% juice (9%). At 12% of children's sandwich occasions, the sandwich was consumed alone, without any other foods or beverages. These results can inform nutrition education and policy initiatives directed at promoting healthful food choices by children.
Improved Muscle Function After Diet Intervention With Leucine‐enriched Whey And Antioxidants In Antioxidant Deficient Aged Mice
Authors: van Dijk Miriam , Dijk Francina , van Bunschoten Annelies , van Dartel Dorien , van Norren Klaske , Walrand Stephane , Jourdan Marion , Verlaan Sjors , Luiking Yvette
Published: November 2023

Background and aim

Inadequacies of micronutrients with antioxidant‐properties are common among older adults and have been associated with sarcopenia and with impaired muscle health. The aim of this study was two‐fold: 1) to investigate if low levels of micronutrients with antioxidant‐properties (AOX) had a negative impact on muscle function in mature mice and 2) to study if nutritional interventions with AOX and/or leucine‐enriched whey protein could improve it.

Methods

18‐months‐old mice were fed an AOX‐deficient diet (vitamin A/E 600/5 IU/kg, Se 0.04, Zn 2.5 mg/kg=LOWOX) or a casein‐based AIN‐93‐M control diet (CTRL) for 7 months. During the last 3 months, the LOWOX mice were randomized to 4 nutritional interventions: a) continued LOWOX, b) supplementation with vitamin A/E 8000/600 IU/kg, Se 2, Zn 35 mg/kg (AOX), c) substitution of casein protein with leucine‐enriched whey protein (PROT) or d) a combination of both (TOTAL). Parameters of sarcopenia (muscle mass, grip strength and ex‐vivo muscle function), muscle fatigue (ex‐vivo exercise‐protocol), general oxidative status (liver malondialdehyde (MDA)) and muscle mitochondrial dynamics were measured by RT‐PCR.

Results

After 7 months LOWOX mice showed lower muscle strength and more muscle fatigue compared to CTRL. AOX mice displayed improved liver MDA, improved grip strength, less muscle fatigue and improved mitochondrial dynamics compared to LOWOX mice (P<0.05). Compared to LOWOX mice, the PROT group showed higher muscle power and grip strength, and less muscle fatigue (P<0.05). The TOTAL group showed the combined effects of both interventions compared to the LOWOX group (P<0.05).

Conclusions

AOX‐deficiency has a negative impact on muscle strength and fatigue, possibly due to impaired mitochondrial dynamics. Supplementation of micronutrients with antioxidant properties in combination with a diet containing leucine‐enriched whey protein is an effective and optimal strategy to improve general state of fitness and muscle quality in aged antioxidant deficient mice. These findings are also relevant for human aging, especially the elderly and frail or sarcopenic population that often suffers from antioxidant deficiencies, increased oxidative stress and loss of muscle quality.
Changes in Nutrient Intakes by Age among U.S. Adults: Estimates from What We Eat in America, National Health and Nutrition Examination Survey 2009–2012
Authors: Mishra Suruchi , Goldman Joseph D , Sahyoun Nadine R , Moshfegh Alanna J
Published: November 2023

Objective

As adults age, there is a decrease in energy requirement while the needs for nutrients remain the same or even increase. The aim of this research is to examine nutrient intake from foods and beverages across various age groups of US adults aged 19 years and over.

Methods

Nationally representative dietary intake data of adults aged 19 years and over (N=10,686) participating in What We Eat in America, NHANES 2009–2012 were analyzed. Two days of dietary intake data were collected using the USDA Automated Multiple‐Pass Method. The first day was an in person 24‐hr recall followed by a telephone recall administered 3–10 days later. Nutrient density measured as nutrient intake per 1,000 calories was compared by age/gender groups (19–30 years, 31–50 years, 51–70 years, and 71+ years) for nutrients identified as the shortfall nutrients (vitamins A, D, E, C, folate, calcium, magnesium, fiber and potassium) in the Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Proportions of adults with usual intakes below the Dietary Reference Intakes (DRIs) were estimated using National Cancer Institute (NCI) Method.

Results

On a given day energy intake decreased and nutrient densities for dietary fiber, vitamins A, D, E, magnesium and potassium increased with age (p<0.001). Nutrient densities increased among older adults aged 71 years and over as compared to younger adults aged 19–30 years for dietary fiber (by at least 2.0 g/1,000 kcal), vitamin A (by at least 131 μg RAE/1,000 kcal), vitamin D (by at least 0.9 μg/1,000 kcal) and vitamin E (by at least 0.5 mg/1,000 kcal), magnesium (by at least 23 mg/1,000 kcal) and potassium (by at least 336 mg/1,000 kcal) (p<0.001). However, as compared to younger adults aged 19–30 years about a similar proportion of older adults aged 71 years and over were not meeting their Estimated Average Requirement (EAR) for vitamins D and E and a greater proportion were not meeting their EAR for calcium and magnesium.

Conclusion

While nutrient densities increased with age for some nutrients, diets of older adults should be more nutrient dense to meet their EAR for selected nutrients.
Omega‐3 Dietary Fatty Acids Improve Spatial Learning and Memory But Do Not Alter the Escalation of Alcohol Drinking
Authors: Byerley Lauri O , Reppel Jonathan E. , Pahng Amanda R. , Edwards Scott R.
Published: November 2023

The transition from recreational alcohol use to alcoholism is associated with an escalation of alcohol drinking as well as cognitive deficits. This process may be mediated via specific brain regions associated with both learning and reward. Dietary omega‐3 fatty acids incorporate into the cell membrane and are important signaling mediators that may potentially alter memory mechanisms and/or escalation of drinking. Male Wistar rats (approximately 300 g) were divided into two groups and fed a diet with an omega‐6:omega‐3 ratio of 19.6:1 (fat source of corn oil) or 4.3:1 (fat source of walnuts & corn oil) for 8.5 weeks. Then, for seven weeks, in three intermittent 24‐hour sessions per week, a 20% ethanol solution was added to the home cage along with water in a two‐bottle choice procedure. Alcohol intake escalated at a rate of 0.4–0.5 g/day or 3.5 kcal/day. The omega‐3‐rich diet did not alter alcohol intake escalation (Total alcohol consumed: Corn Oil Group: 46.5 ± 0.7 g/kg; Walnut Group: 42.0 ± 0.7 g/kg). For both groups, total caloric intake was significantly higher on the days alcohol (A) was consumed than on the days alcohol was not consumed (NA) (Corn Oil: NA 86.5 ± 5.4, A 118.5 ± 23.3 kcal/day; Walnut: NA 79.2 ± 8.4, A 106.5 ± 16.8 kcal/day). On drinking days, alcohol was approximately 39 ± 10% of the total calories consumed. The animals significantly reduced their food intake (15 ± 7%) to compensate for the additional alcohol calories, but the reduction was not adequate to balance the increase in alcohol calories consumed. On the days off (no alcohol consumed), the animals did not eat more food to compensate for the dietary calories lost on the days they consumed alcohol. While the omega‐3‐rich diet did not affect alcohol intake, it did significantly improve spatial learning and memory (69.6% vs. 60.5% spontaneous alternation in the Y‐maze in Walnut vs. Corn Oil Groups, respectively) but not anxiety‐like behavior or locomotor activity. We are currently investigating the differential ability of the two diets to alter brain regional lipid and intracellular signaling profiles. In conclusion, a diet higher in omega‐3 fatty acids improved memory function but did not affect alcohol drinking.