bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum endocannabinoids in the luteal phase of the menstrual cycle are associated with leptin and food cravings
Authors: Krishnan Sridevi , Agrawal Karan , Tryon Rebecca R , Welch Lucas C , Horn William F , Newman John W , Keim Nancy L
Published: November 2023

Objective

To evaluate the impact of circulating endocannabinoids on food craving, food intake behaviors, and satiety hormones across the menstrual cycle.

Methods

We studied 17 premenopausal women with regular menstrual cycles (23.2 ± 4.8 y, and BMI 22.4 ±1.9 kg/m2) during their late follicular and luteal phases. We measured fasting plasma estradiol, progesterone and leptin using electrochemiluminescence, and serum endocannabinoids using targeted LC‐MS/MS methods. Measured endocannabinoids and endocannabinoid‐like compounds included monoacylglycerol derivatives of arachidonate, linoleate and oleate (1‐ and 2‐AG, LG and OG, respectively), and acylethanolamides anandamide (AEA), stearoylethanolamide (SEA), oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and docosatetraenoylethanolamide (DEA). We used a food craving inventory during the luteal phase to record cravings for sweet‐tasting and fat‐rich foods. We used the same construct to evaluate habitual intake in the three‐month period prior to the study. Three‐factor eating questionnaire was used once during the study to evaluate cognitive restraint, disinhibition, and hunger in these women. Spearman's correlation analyses were used to identify associations between ovarian hormones, endocannabinoids, leptin and eating behaviors. Wilcoxon's rank tests were used to evaluate differences between the phases of the menstrual cycle.

Results

Serum endocannabinoids were not different between the two phases of the menstrual cycle (eg: 2‐AG: p = 0.38). Irrespective of phase, several endocannabinoids were inversely associated with estradiol (Eg: 2‐OG: r = −0.39, p = 0.02; 2‐AG: r = −0.30, p = 0.09). Also, disinhibition was inversely associated with leptin (r = −0.54, p <0.01), and positively associated with habitual intake of sweet‐rich foods (r = 0.45, p <0.01). While evaluating only the luteal phase, OEA was positively associated with craving fat‐rich foods (r=0.61, p=0.01). Endocannabinoids were inversely associated with leptin (1‐OG: r =−0.56, p=0.02; 1‐LG: r=−0.50, p=0.04; 2‐AG: r= −0.44, p= 0.07), and cognitive restraint (2‐AG: r =−0.49, p=0.04; AEA: r=−0.57, p=0.02), while cognitive restraint was positively associated with craving sweet‐rich foods (r=0.49, p=0.05). Both SEA and PEA were positively associated with circulating progesterone (r=0.60, p=0.01; r=0.52, p =0.03 respectively), while AEA and 2‐AG showed a positive trend with progesterone/estradiol ratio (r=0.45, p=0.07; r=0.42, p=0.09 respectively). These associations were not present in the follicular phase.

Conclusions

The association of endocannabinoids with leptin, progesterone and increased fat‐rich food craving during the luteal phase warrants further study into what role they play in food intake regulation during the menstrual cycle.

Support or Funding Information

USDA‐ARS‐CRIS Project 2032‐51530‐022‐00D
12 Weeks of Eating Almonds on Cognitive Function and Cardiometabolic Biomarkers ‐ A Study Protocol
Authors: Coates Alison , Morgillo Samantha , Yandell Catherine , Scholey Andrew , Buckley Jonathan , Hill Alison
Published: November 2023

Background

It is widely accepted that mood and mental functioning is linked to nutritional status, with growing evidence to support a role for tree nuts improving cognitive function and/or limiting cognitive decline.

Objective

To examine effects of eating almonds for 12 weeks compared with control snack foods on cognitive function and biomarkers of cardiovascular and metabolic health.

Experimental Design

Overweight/obese participants (target n=150) aged 50–80 years without mild cognitive impairment or depression will be recruited to participate in a randomised controlled parallel study. Habitual diets will have 15% of energy replaced with either almonds or energy matched snack foods (potato chips and cookies). At baseline and after 12 weeks, fasted assessments will be completed for multiple cognitive domains (memory, speed of processing, executive function), cardiovascular risk factors (blood pressure, arterial compliance, blood lipids) and metabolic biomarkers (body composition, glucose regulation and inflammation). Dietary compliance and weight stability will be assessed every 3 weeks and diet and activity profiles monitored through weighed foods diaries and activity diaries.

Results

Sixty‐one participants have enrolled to date (28M:33F) of whom 30% are on cholesterol lowering medication and 11% are on antihypertensive medication. The participants have a mean age 65± 8years, BMI 29.8 ± 3.6kg/m2, waist circumference 101 ± 11cm and SBP/DBP 132 ±14/ 76 ±8 mmHg. Participants have remained relatively weight stable (average change 0.4 ± 1.1 kg). Snack foods have been well tolerated with excellent compliance (>95%) in both groups.

Discussion

The intervention has been well tolerated and will provide information on the potential benefits of almonds for cognitive function and cardiometabolic health.

Support or Funding Information

Funding from the Almond Board of California
Healthy profits: An Interdisciplinary Retail Framework for Increasing the Sales of Healthy Foods
Authors: Wansink Brian
Published: November 2023

Disruptive layouts, modified shopping carts, suggestive signage, GPS signaling, island displays, and on‐line ordering presage an evolution in how healthy, sustainable foods will be sold at retail. Although these appear unrelated, they influence sales by altering how convenient (physically or cognitively), attractive (comparatively or absolutely), and normal (perceived or actual) it is to purchase a healthy target food. To alter how convenient, attractive, and normal (CAN) it is to purchase healthy products, retailers have creatively been altering their signage, structure, service. For researchers, this review offers an organizing framework that integrates behavioral economics and marketing to reconcile inconsistent past findings and identify key research paths. For managers, this review underscores how dozens of small, low cost, in‐store changes can surprisingly increase sales of entire food categories.
Effects of hydration on relational memory among preadolescent children
Authors: Westfall Daniel R. , Hassevoort Kelsey M. , Barnett Sasha , Covello Alicia R. , Bottin Jeanne H. , Perrier Erica T. , Cohen Neal J. , Hillman Charles H. , Khan Naiman A.
Published: November 2023

Background

Epidemiological data demonstrate that a majority of children in many industrialized countries are inadequately hydrated. However, the implications of water intake or hydration on children's physical and mental health remain understudied. Specifically, there is a gap in knowledge pertaining to the impact of changes in hydration and children's cognitive function.

Objective

The current study assessed the effects of changes in water consumption on relational memory among preadolescent children. In addition, we aimed to understand the within condition relationships between markers of hydration and children's memory performance.

Methods

A counter‐balanced crossover design was used. Children between 9–10 years (N=26, 11 females) underwent high (HIGH; 2L/d) and low (LOW; 1L/d) water conditions for 4d. Following each condition, children completed a spatial reconstruction task designed to assess hippocampal‐dependent relational memory. Urine osmolality was assessed using pooled samples collected during the 24‐hr period (24‐h UOsm) preceding cognitive testing.

Results

24‐h UOsm was significantly lower in the HIGH (393 ± 168 mOsm/kg) compared to LOW fluid intake condition (787 ± 206 mOsm/kg; p<0.01). Between condition analyses yielded no significant effects for relational memory performance (all p's > .117). However, within condition analyses revealed that 24‐h UOsm was correlated with relational memory performance. During the HIGH condition, higher 24‐h UOsm was associated with greater swap (r = .540, p = .004), misplacement (r = .429, p = .029), and edge resizing (r = .474, p = .014) errors. During the LOW condition, higher 24‐h UOsm was correlated with greater misplacement (r = .403, p = .041), edge resizing (r = .390, p = .049), and edge deflection (r = .478, p = .013) errors.

Conclusions

Although the intervention did not significantly change relational memory performance, lower urine osmolality, i.e. better hydration, was associated with superior relational memory within each condition. Comprehensive understanding of fluid modulation effects on children's cognitive performance will need to account for baseline hydration, a limitation of the present work.

Support or Funding Information

Supported by Danone Research
Quantifying the Association between Acute Leukemia and Serum Zinc, Copper, and Selenium
Authors: Kim Sangyoung , Babaei Mahsa , Sachdev Prageet Kaang , Beretvas Natasha , Freeland‐Graves Jeanne H.
Published: November 2023

Optimal levels of zinc (Zn), copper (Cu), and selenium (Se) are essential to perform a number of metabolic and physiological processes in humans. Levels of these minerals have been suggested to be altered in acute leukemia; but the results have inconsistent. The main objective of this research is to examine the relationship between the amount of the three trace elements, Zn, Cu, and Se, in the serum of patients with and without acute leukemia. For this purpose, a meta‐analysis was conducted to measure the concentration of these trace elements in patients with acute leukemia, as compared with healthy controls. Research papers published on this topic between 1977 and 2015 that met the criteria were included. Results showed a significantly positive correlation (p < .01) between serum copper levels (effect size = 1.72; 95% CI, 0.923–2.5193) with acute leukemia and a significant negative correlation (p < .05) for serum zinc levels (effect size = −1.38; 95% CI, −2.477–.2799). Results for serum selenium (effect size = −1.39; 95% CI, −2.826–.0556) only approached significance (p = .056). In conclusion, the meta‐analysis method suggests that patients with acute leukemia have elevated levels of serum copper and lower concentrations of serum zinc. A greater sample size may be necessary to determine if serum selenium is associated with acute leukemia.

Support or Funding Information

Bess Heflin Centennial Professorship in Nutrition
Hepcidin‐dependent iron mobilization is required for white to beige adipocyte conversion
Authors: Kim Jiyoung , Ozaki Grant , Okla Meshail , Lee Jaekwon , Chung Soonkyu
Published: November 2023

Beige adipocytes arise among subcutaneous white adipose tissue (WAT) in response to environmental stimuli such as b‐3 adrenergic receptor (ADRB3) activation. Beige adipocytes are specialized cells for thermogenesis due to the abundance in mitochondria and uncoupling protein 1 (UCP1) expression. Beige adipocytes are named after its brownish tint from mitochondrial‐iron, suggesting that iron metabolism must be coordinated with increased mitochondria during browning. Here, we hypothesized that systemic iron mobilization is necessary for beige conversion. C57BL6 mice were injected with either saline or ADRB3 signaling agonist CL316243 (CL) to stimulate WAT browning. CL injection converted subcutaneous WAT into beige fat evidenced by multilocular morphology, >60‐fold increase of UCP1, and increase of thermogenesis. Hepatic mRNA levels of hepcidin, the hormone that controls iron absorption and its tissue distribution, were decreased by 10‐fold with CL‐injection, suggesting that systemic iron redistribution is involved. Consistently, iron importers including transferrin receptor (TfR) and non‐transferrin‐bound iron importer zinc transporter (ZIP14), were substantially increased in CL‐injected subQ fat. The inhibition hepcidin downregulation by chronic inflammation significantly perturbed WAT browning upon CL stimulation. Furthermore, hepcidin‐deficient mice failed to trigger WAT browning due to lack of iron redistribution signaling. Taken together, this study is the first to demonstrate that hepcidin‐dependent systemic iron redistribution is intimately associated with WAT browning and thermogenic activation
Copper‐Induced Reversal of Fibrosis in Rat Model of Cardiac Hypertrophy is Associated with Enhanced Collagen Degradation by MMP‐2 Up‐Regulation
Authors: Liu Yinjie , Xiao Ying , Liu Jiaming , Han Pengfei , Feng Li , Kang Y. James
Published: November 2023

Our recent studies observed that trientine (TETA), a copper chelator, is capable of redistributing copper from plasma to the heart, leading to regression of cardiac fibrosis in rat model of pressure overload‐induced heart hypertrophy. The present study was undertaken to explore possible mechanisms by which copper repletion reverses cardiac fibrosis. Adult male Sprague‐Dawley rats were subjected to ascending aortic constriction (AAC) to induce pathological cardiac hypertrophy. Four months after the operation, cardiac hypertrophy along with fibrosis was fully developed as determined by pathological examination and Sirius red staining. At the same time, TETA at a dose of 4.38 mg/kg, twice a day, was administered orally for six weeks. At the end of the experiment, the expression and crosslinking of type I and III collagens were determined respectively by immunohistochemistry and Sircol collagen assay. Western blot was performed to detect the expressions of lysyl oxidase (LOX), MMP‐2 and MMP‐9. The results showed that the content and crosslinking of type I and III collagens were both significantly decreased after TETA treatment. The expression of MMP‐2 was up‐regulated, but the expressions of MMP‐9 and LOX were not changed. The data thus demonstrated that the reversal of cardiac fibrosis by TETA‐induced copper repletion is related at least in part to an enhanced collagen degradation process.

Support or Funding Information

This study is supported by National Science Foundation of China (81230004 and 81300109).
Nature of the proposed anti‐hyperglycemic chromium(III) malate
Authors: Vincent John B. , Smart Megan , Tannehill Haley , Brown Silas
Published: November 2023

Chromium(III) complexes have been explored as anti‐diabetic agents. Recently several rodent studies of diabetes and related conditions have used “chromium(III) malate” and shown that the compound exhibits anti‐hyperglycemic properties. Unfortunately, chromium(III) malate is poorly characterized; additionally, multiple synthetic procedures have been reported that appear to be inconsistent. Hence, the synthesis and characterization of chromium malate have been examined in detail. Infrared, UV/visible, NMR and EPR spectroscopies; magnetic susceptibility measurements; elemental analysis; and mass spectrometry were used to characterize chromium(III) malate. Mass spectrometric, magnetic susceptibility and EPR studies suggest that chromium(III) malate contains a trinuclear chromium(III) basic carboxylate type core with the formula [Cr3(malate)4O]−.

Support or Funding Information

Funding was provided as part of a National Science Foundation Research Experiences for Undergraduates (REU) award (CHE 1358971) to J.B.V. and Stephen A. Woski.
Efficacy of Various Vitamin D Correction Strategies in Saudi Adults and Children
Authors: Al‐Daghri Nasser , Abd‐Alrahman Sherif , Al‐Saleh Yousef , Aljohani Naji , Al‐Attas Omar , Alokail Majed
Published: November 2023

Background

Vitamin D deficiency is highly prevalent in the Saudi population and there are different strategies. This study aims to evaluate the efficacy of different strategies for vitamin D deficiency correction in Saudi adults and children.

Methods

A total of 1147 Saudi adults (N=159) and children (N=994) [434 boys (mean age 15.9±2.6 years), 560 girls (14.8±1.6), 59 men (39.9±9.8) and 94 women (42.2±10.6)], whose baseline serum 25(OH)D falls below 50nmol/l, were selected from different secondary school students in Riyadh, Saudi Arabia. They were grouped according to different vitamin D correction schemes: sun‐exposure, vitamin D‐fortified milk consumption, oral vitamin D supplementation (1000IU/day) for 6 months and control (advise). Repeat measurement of serum 25(OH)D was done after 6 months.

Results

Follow‐up results revealed that the prevalence of vitamin D deficiency significantly decreased after 6 months (23.9% at baseline versus 10.7% after 6 months; p<0.001) in the oral vitamin D supplementation group and this was not observed in other correction strategies. 6‐month oral vitamin D supplementation also showed significant associations between changes in improving total and HDL‐cholesterol in both adults and children. The milk group was the least effective strategy in adults and advise (control) group in children.

Conclusion

A 6‐month oral vitamin D supplementation was the most effective way to improve lipid profile and vitamin D status in both Saudi children and adults than sunlight exposure and vitamin D fortified dairy products consumption. The latter strategy is the least effective in adults and giving advice is the least effective in children, probably due to poor compliance.

Support or Funding Information

The study was funded by the Prince Mutaib Chair for Biomarkers of Osteoporosis, Vice Deanship of Research Chairs, King Saud University and Synergy Pharma (Dubai, UAE) for providing the supplements used (VitaD1000).
Nutritional status and stunting among pre‐school children in Bhutan: Findings of the 2015 National Nutrition Survey
Authors: Kang Yunhee , Campbell Rebecca K. , West Keith P.
Published: November 2023

The high prevalence of stunting along with the region's large population make South Asia home to about 40% of the world's stunted children. The prevalence, severity, and distribution of undernutrition or risk factors for stunting are relatively little known in Bhutan. A second Bhutan National Nutrition Survey (BNNS) was conducted in 2015 among children aged 0–59 months (n=1,506) and their households. Adjusting for survey design, we estimated nutritional status by Z‐scores of height‐for‐age (HAZ), weight‐for‐height (WHZ) and weight‐for‐age (WAZ) and prevalences of stunting, wasting, underweight, and overweight (WHZ>2) carried out linear and logistic regression analyses to identify child, caregiver and household characteristics associated linear growth and relative odds ratios (OR) of stunting. Mean (SE) HAZ, WHZ and WAZ was −0.81 (0.13), 0.10 (0.04) and −0.41 (0.05), and the prevalence of stunting, wasting, underweight and overweight was 21.2%, 2.5%, 7.3% and 2.6%, respectively. In univariate logistic regressions, risk of stunting was higher in rural than urban areas (26.1% vs. 16.0%; OR=1.86, 95% CI: 0.87, 4.00; p=0.07), in the East than West or Central regions (29.1% vs. 17.0%, OR=1.41, 95% CI: 0.82, 2.42; p=0.11) and varied in a dose‐response manner by SES, from 33.7% in the lowest fifth to 16.6% in the highest fifth (reference group) of a wealth index (OR range from 3.75 to 8.95). These associations were not significant on multivariable adjustment (p>0.10 for all). The risk of stunting significantly increased by age: 5% at <6 mo (OR=1), 17.1% at 6–23 mo (OR=3.59; 95% CI: 0.74, 17.4; p=0.07) and 24.9% at 24–59 mo (OR=6.12; 1.40, 26.9; p=0.03) and was far lower among children of university‐educated (6.6%; OR=0.05; 95% CI: 0.00, 0.89; p=0.05) than uneducated mothers (35.4%; OR=1). Despite a lower national risk of pre‐school stunting compared to other South Asian countries, strong age‐ and household wealth‐associated gradients in risk exist. Programs to prevent stunting may achieve the greatest impact among children in lowest household wealth and educated strata within the East region.

Support or Funding Information

UNICEF Regional Office for South Asia (ROSA), Kathmandu, Nepal
Secular trends in adult and adolescent maternal nutritional status and birth size from 2008–2012 in rural Bangladesh
Authors: Na Muzi , Shamim Abu Ahmed , Labrique Alain L. , Ali Hasmot , Wu Lee Shu‐Fune , Shaikh Saijuddin , Klemm Rolf D.W. , Christine Parul , West Keith P.
Published: November 2023

The aim of this study was to examine secular, including seasonal, trends in maternal nutritional status and birth size in a cohort of 7784 mother‐newborn pairs in northwest rural Bangladesh. Mothers had participated in a micronutrient supplementation trial from early pregnancy to ~3 months postpartum from 2008 to 2012. Eligible women were enrolled in the first trimester (TM, <12 weeks of gestation) and gave birth to live, term singletons (>=37 weeks gestational age). Weekly gestational weight gain and mid‐upper arm circumference (MUAC) change between 1st and 3rd TM, birth weight and length and weekly postpartum change in weight and MUAC from 1 mo to 3 mo postpartum were plotted by calendar month and year of birth throughout the period of study, for all maternal ages combined and stratified by age group (<19 vs >=19 yr). Changes in gestational weight gain and MUAC followed a seasonal pattern each year that peaked for women delivering in April–May (Δ=306~310 g/wk and 25.7~28.7 mm/wk, respectively) and reached a nadir for women delivering in ~Nov (Δ=195~216 g/wk, −35.3~−23.1 mm/wk, respectively). Mean birth weight and length were 2.64 kg and 47.2 cm across all years. Birth weight and length were lowest in December (~2.56 kg and ~46.5 cm) and highest in May–July (~2.70 kg and ~47.4 cm). Weight and MUAC change during lactation peaked for women delivering in Nov–Dec (42.0~50.0 kg/wk and 73.0~84.3 mm/wk), ebbed in February (−94.5~ −75.5 g/wk and −1.5~8.7 mm/wk). No year‐to‐year variance was observed in maternal changes in nutritional indicators or birth size. All seasonal patterns of maternal weight and MUAC change in pregnancy and lactation were similar in adult and adolescent ages; however, birth weight and length were significantly lower in children born to adolescent than adult mothers, possibly reflecting competing nutritional demands of a still‐growing mother and fetus in a marginally nourished setting. Striking seasonality in maternal gain and birth size fluctuations may pose varied short‐ and longer‐ term health risks for offspring throughout life.

Support or Funding Information

Bill & Melinda Gates Foundation (GH614)
Genome‐Nutrition Divergence: Evolving understandings of the malnutrition spectrum
Authors: Eaton Jake , Iannotti Lora
Published: November 2023

Humans adapted over 2.3 million years to a diet high in quality and diversity. The misalignment between global diets and the genome formed through evolution we refer to as nutrition‐genome divergence. We survey the human diet over time to characterize what constitutes a healthy diet and to contrast dietary quality in modern food systems. The dominance of cereal staples and ultra‐processed foods is highlighted. We then apply the lens of nutrition‐genome divergence to illuminate shared nutrient and food determinants and environmental risk factors of undernutrition and overnutrition – an overlapping category of determinants of malnutrition. Food systems shifts, including crop‐neutral agricultural policy, agroecology, and social policy are explored as a means to realign modern diets with the nutritional patterns on which we are adapted to thrive.

Support or Funding Information

None
Micro‐Farming of Palm Weevil Larvae (Akokono) for Economic Empowerment and Nutritional Impact
Authors: Parker Megan , Zobrist Stephanie , Tawiah Charlotte , Manu Grace , Mansen Kimberly , Soor Shobhita , Laar Amos , Kreis Katharine
Published: November 2023

Background

Due to the rising cost of and increasing demand for animal source proteins, coupled with increasing food insecurity and environmental pressures, edible insects have emerged as an especially relevant, low‐environmental impact, nutritious food source to feed the growing population in the 21st century.

Objective

In collaboration with partnering organizations, this small‐scale pilot study equipped 50 women with the materials to sustainably micro‐farm palm weevil larvae (Akokono) to examine the impact on household food security, diet diversity, and women's income and decision‐making.

Methods

The impact of the micro‐farming pilot was examined at baseline, midline, and endline over a period of 12 weeks using maternal recall of Akokono production and consumption, Household Food Insecurity Access Scale, Household Dietary Diversity Score, Child Dietary Diversity Score, income recall, and Women's Empowerment in Agriculture Indicators.

Results

The results presented herein represent changes between baseline and midline; analysis of endline results is pending. By midline, 80% of women reported eating Akokono, 80% of women reported feeding Akokono to their family, and 63% of children under five years had eaten Akokono on at least one occasion. Overall, household food security increased, although neither household nor child dietary diversity improved. With respect to women's empowerment indicators, women's income increased. Women's input into decision‐making for cash crops and Akokono farming improved from giving ‘input into some decisions’ to giving ‘input into most decisions.’ Women's input into the use of income generated from these activities increased from ‘no input’ or ‘input into some decisions’ to giving ‘input into most decisions.’ The majority of women who micro‐farmed Akokono consumed their harvest, fed their harvest to their family, and a minority began selling Akokono in the market.

Conclusion

Akokono farming increased women's involvement in decision‐making of farming activities, women's use of related income, and household food security. Additional research with increased sample size is warranted to confirm understanding of the potential impact of micro‐farming on diet indicators. Greater support is needed to improve women's involvement in Akokono marketing and sale activities.

Support or Funding Information

This project was supported by a grant from The Bill & Melinda Gates Foundation, Seattle, WA.
Dietary Protein Inadequacy among Women of Reproductive Age from Five Low‐Income Countries
Authors: Arsenault Joanne E. , Brown Kenneth H.
Published: November 2023

Women in low‐income countries have low micronutrient intake adequacy, but protein adequacy has not been assessed rigorously. A 2015 report from SPRING indicated that protein intake was generally adequate in most cohorts based on the mean protein intakes being above a threshold of % energy rather than high prevalence of usual intakes above estimated average requirements (EAR) per kg body weight. Moreover, protein quality was not considered.

We assessed dietary protein intake adequacy of women using existing quantitative dietary data from Bangladesh, Burkina Faso, Mozambique, Uganda, and Zambia. Food intakes were assessed by 24‐h recall, except in Bangladesh where 12‐h direct observation and weighing and 12‐h recall were used. Protein intakes were adjusted for fecal digestibility factors and amino acid scoring patterns using the Protein Digestibility Corrected Amino Acid Score (PDCAAS) method to estimate “available” protein (AP) intake. The distribution of usual intakes of AP per kg of body weight was obtained using 1–2 days of intake from each dataset, and the prevalence of inadequate intakes (PII) < EAR (0.66 g/kg, for non‐pregnant, non‐lactating, NPNL) was estimated using the National Cancer Institute usual intake model. For lactating women, the PII was estimated using 2 different EAR due to uncertainties about the age of the breastfeeding child or the protein requirement beyond 12 mo of lactation: 1) 0.66 g/kg/d and 2) 0.66 g/kg/d plus 10 g/d (additional need for 6–12 mo) divided by the average body weight of the women (0.84 – 0.89 g/kg/d).

For NPNL women, the PII was: 35% in Bangladesh, 32% in Burkina Faso during lean season, 16% in Burkina Faso during post‐harvest season, 23% in Zambia, 12% in Uganda, and 1% in Mozambique. For lactating women, the PII (using lower – higher EAR) was: 30–76% in Bangladesh, 26–53% in Burkina lean season, 14–36% in Burkina Faso post‐harvest season, 14–34% in Zambia, 9–29% in Uganda, and 1–15% in Mozambique. The mean PDCAAS of the diets was lower for Burkina Faso in the lean season (62% for NPNL and 59% for lactating) than for Bangladesh (71% for NPNL and 69% for lactating), likely due the lower protein quality of the main staple in Burkina Faso (sorghum 27%) than in Bangladesh (rice 56%) and the very low intake of animal‐source foods in both countries.

In summary, dietary protein inadequacy is evident in women residing in countries with diets reliant on main staples that are low in protein quality. This is of particular concern for lactating women (and likely for pregnant women in some of these settings) who have higher protein requirements.

Support or Funding Information

Partially funded by the Bill & Melinda Gates Foundation grant # OPP1128015.
Effectiveness of a 10‐wk Lifestyle Modification Program in Reducing Hypertension in Brazilian Free‐Living Adults
Authors: Burini Roberto Carlos , Kano Hugo Tadashi , Nakagaki Mariana Santoro , Figueira Tatiana Cristina , Burini Franz Homero Paganini
Published: November 2023

RATIONALE

High blood pressure (BP) is a strong, independent and etiologically relevant risk factor for cardiovascular diseases. Free distribution of more than 15 medications for HyPERtension and DIAbetes (HIPERDIA program) clearly shows the important role of drugs in the Brazilian Government's effort to tackle these two diseases. Each medicated BP subject has an estimated cost of US$ 39.50. However, drug therapy has been largely unsuccessful in halting and reversing the hypertension epidemic and more emphasis must be placed on primary prevention guidelines. BP is often associated with unhealthy lifestyles such as consumption of high fat and/or high‐salt diets and physical inactivity.

PURPOSE

To verify the effectiveness of a lifestyle modification program in reducing the hypertension in free‐living adults

METHODS

A lifestyle modification program(LSM) involving dietary counseling and regularly supervised physical activity(“Move for Health”) has been used here, since 1991, for NCDs primary care. Cross‐sectional analysis of clinical, anthropometric, dietary and physical activity data from 1317 subjects(2006–2016) was used to characterize the BP subjects at baseline. Next, a sub‐sample(n=453) were submitted to a 10‐wk LSM and repeated assessments. Statistical comparisons were defined by p=0.05.

RESULTS

The BP rate(higher than 140/90mmHg) was 51.2% for SBP and 42.7% for DBP. The top quartile of bood pressure(142.2/88.5mmHg) differed from the lower quartile (120.6/69.2mmHg) by being older and lower either, schooling, income, physical activity(IPAQ) and aerobic capacity(VO2max.). The p75 showed a low quality diet (HEI score) with more processed foods(higher CHO/fiber, sodium/potassium and saturated fat). They showed also a higher body fatness and prevalence of metabolic syndrome (MetS) along with MetS co‐morbidities of inflammation, peroxidation and insulin resistance but, without differences in the Framingham score. After 10 weeks of LSM the BP normalization achieved 17.8% for SBP and 9.3% for DBP with a net effectiveness of 8.5% and 2.4%, respectively. The reduction of BP was followed by increased aerobic conditioning and reduced intake of processed foods along with decreased values of BMI, abdominal fatness and co‐morbidities.

CONCLUSION

Based on the found effectiveness of this LSM and, if applyied nationwide it would save medications for 3.1 million of Brazilian hypertensives at an estimated saving of US$ 1.47 billion a year!

Support or Funding Information

Supported by FAPESP, CAPES and CNPq
Changing Food Environments and Health Outcomes: Quantifying the Nutrition Transition in Global Nutrition Research
Authors: Becker Haley V , Eaton Jacob C , Iannotti Lora L
Published: November 2023

Background

The last century has born witness to extensive changes in global food and activity environments, resulting in alterations of diet, nutritional status, physical activity behaviors, and related health outcomes, otherwise known as the nutrition transition. Previous efforts to quantify a country's stage in the nutrition transition have maintained only a regional focus, and no study has yet to systematically quantify the nutrition transition on a global scale. This study fills that gap by providing an objective measure of nutrition transition across countries of all income brackets with potential for global application.

Methods

Using data from the World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO), 52 countries were selected for analysis representing high‐, middle‐, and low‐income countries from each of the WHO Region Groupings. A ten‐point score was developed to identify each country's stage in the nutrition transition, resulting in Nutrition Transition Scores (NTSs) for each country. Correlations were calculated between NTSs and Gross Domestic Product (GDP) per capita.

Results

There was a significant, positive association between NTSs and GDP per capita (r=0.671, n=52, p<0.01). High‐income countries (HICs) had higher NTSs than low‐ and middle‐income countries (LMICs). The lowest NTSs were clustered in the African and Asian WHO‐designated regions; these include: Ethiopia, Madagascar, Zambia, Bangladesh, and Vietnam.

Conclusions

This study adds to the literature by highlighting correlated determinants of the nutrition transition, giving a clearer outlook on how countries develop in terms of the inputs and impacts on their food systems. Roughly half of the countries transitioning between the third and fourth stages scored near the 50th percentile for both stunting and obesity, representing a looming epidemic of the dual‐burden of malnutrition. Identifying a country's position in nutrition transition allows for more meaningful international comparisons of programs, policies, and research. As GDP per capita and NTSs were significantly, positively correlated, this warrants further investigation into the relationship between economic growth, globalization, and the resulting changes in food and activity environments.
Predicting and modeling follow‐up clinic visits (persistence) after bariatric surgery
Authors: Brazell Taler , Paynter Jonathan , Thomas Diana , Watts Krista , Cottam Daniel
Published: November 2023

Background

Bariatric surgery is known as one of the most effective interventions to manage weight for individuals with obesity. While mean weight loss is typically strong, there exists high variability in these results; not all patients achieve successful weight loss post‐surgery. Follow‐up clinical visits are a known predictor of patient success however little is known about the factors that influence follow‐up persistence.

Methods

We developed a class of one dimensional 2‐parameter linear discrete dynamical systems to predict the percent of patients that attend each follow up visit. These parameters biologically represent the half‐life in the drop off rate observed in the percent of patients attending follow up visits and their persistence plateau. To test whether the half‐life of persistence differs between surgeries, separate models were developed using data from 7 different types of bariatric surgery performed by the Bariatric Medicine Institute in Utah. Model parameters were determined by regressing between the percent of patients attending follow up visit number n, denoted by the variable, pn,− against the previous follow up visit, (pn−1). We then compared the discrete model simulations against the actual persistence data graphically to evaluate the quality of model calibration to observed data and computed the half‐life.

Results

There were seven types of surgeries (loop to duodenal switch, duodenal switch, sleeve, bypass, duodenal switch to bypass, bandication, and band) where the recursive relationship was found to modeled well by a linear discrete dynamical system pn=apn‐1+b. Parameter values specifically the half‐life differed based on surgery type (Table 1). The optimal half‐life was found in band and bandication while the highest drop in persistence was found in bypass surgeries.

Conclusions

To date, all models that examine persistence of clinic follow‐up visits post‐surgery and predictions of bariatric surgery success are statistical. Our deterministic system provides new mechanistic insights by characterizing persistence by two parameters. Our findings suggest that while gastric bypass has strong mean weight loss results, persistence for clinical follow up visits drops off early in comparison to gastric band. Furthermore, clinicians can estimate our discrete model parameters based on individual demographics to inform optimal surgery types and predict potential patient drop off pre‐surgery.

Half‐life of persistence derived from each surgery type

Surgery Type
Half‐Life

Loop DS
0.86587

DS
0.88248

Sleeve
0.80547

Bypass
0.79028

DS to Bypass
0.86417

Bandication
0.97439

Band
0.94337
Trunk‐to‐leg ratio in regions of extreme stunting prevalence in the Western Highlands of Guatemala: A comparative perspective and interpretation
Authors: Shiu Kimberly , Beintema Joni , Liem Windy Mulia , García‐Meza Rosario , Doak Collen , Orozco Monica , Solomons Noel W.
Published: November 2023

Background

CeSSIAM has an interest in the origins and biology of acquired linear growth retardation, also referred to as “stunting” or “chronic undernutrition.” Towards overcoming the tactile disadvantage of direct measuring tape assessment and the gluteal‐thickness artifact in sitting height, we developed a photographic approach to estimating differential body segment lengths: trunk vs leg. Current experience suggests photographic imaging to be easily reproducible, less invasive and more objective than the aforementioned techniques. Preliminary studies defined body segment lengths in normal‐height and modestly‐stunted Guatemalan preschoolers.

Objective

To document any further effects on the body‐segment ratios that might occur with the even more profound stunting occuring in the far western highlands of Guatemala.

Methods

The height and clothing‐adjusted weight of 212 individuals between 4 – 7 y from zones of established high stunting prevalence (combining La Estancia and Santa María Chiquimula {Com}) were measured. Two, partly‐overlapping samples of 102 children each were pair‐matched by age and sex to a previous series of equal numbers of affluent (Quetzaltenango City {Que}) and of poor urban children (Sololá {Sol}). The former sample was derived from matching by sequential enrollment (Com1) and the latter was enriched for stunting using the shortest children available for matching (Com2). A sagittal photograph was taken with a digital camera with the child in an erect posture with the Frankfort gaze standing on a stadiometer platform. After printing out the photo, the lengths of the trunk and the legs were measured in mm, allowing the generation of trunk‐to‐leg ratios.

Results

The stunting prevalence for the four respective series increased progressively: 5.9% (Que); 46.1% (Sol); 68.6% (Com1); and 87.3% (Com2). Children in the Com1 sample were 9.2% shorter on average than those in Que and 3.4% shorter than Sol. Those in the Com2 sample were 10.9% and 5.0% shorter, respectively. The median trunk‐to‐leg ratios across the four respective series were 0.76; 0.82; 0.81; and 0.82. This value declined to 0.85 for third degree stunting alone (n=52).

Conclusion

As stunting prevalence increases in a population, the median trunk‐to‐leg ratio initially falls to the 0.82 range and stabilizes thereafter, but in isolated third‐degree stunting, the median trunk‐to‐leg ratio reaches 0.85.
A Novel Distribution Method To Provide Micronutrients At A Community Level Improves Linear Growth In Young Guatemalan Children
Authors: Villanueva Lisa Maria , Palacios Ana M
Published: November 2023

The objective of this study was to test a novel and low‐cost distribution method to provide a 21 micronutrient‐fortified beverage (Chispuditos®) to improve the nutritional status of children with a Length/Height‐for‐age Z‐score (HAZ) ≤−1, in rural southwest Guatemala. Community woman leaders from 9 villages were identified and trained to provide coached guidance on nutrition, caregiving, parenting and early learning opportunities. The distribution mechanism consisted of groups of ~30 mothers organized by the community leader that met on a monthly basis at a point of convenience. The woman leader guided discussion and practice of the topics mentioned above among the peer group. Duration of meetings was approximately 30 minutes, and mother‐child dyads received a 24‐day supply of Chispuditos and instructions on how to prepare. Participants provided 1 Guatamalan Quetzal ($0.13 USD) to cover the complete cost of the community leader service. A total of 290 children from 6–72 months of age completed 21 months of receiving the fortified atole. A cross‐sectional analysis showed a significant improvement in mean HAZ scores: from −2.34 (0.89SD) to −1.95 (1.09SD), (p<0.01) and a significant reduction in the prevalence of stunting (from 58.3% to 46.0%, p<0.001). In conclusion, this community‐based low‐cost distribution model along with the nutrition intervention appears to be effective in improving linear growth in stunted children from rural southwest Guatemala.

Support or Funding Information

The Mathile Institute for the Advancement of Human Nutrition
Iron Status of Reproductive Age Women in Northern Ghana is Improved by Indigenous Hibiscus Sabdariffa Meal
Authors: Kubuga Clement Kubreziga , Song SuJin , Kennedy Gina , Lee Kyung Won , Song Won O.
Published: November 2023

In northern Ghana, iron deficiency anemia (IDA) is prevalent and severe among reproductive age women. Anemia is detrimental to women's health and pregnancy outcomes. Efficacy of supplementation and fortification have been tested to counter the problem, while little efforts have been reported with improving food systems utilizing native food sources to improve iron status in Ghana. Inhabitants are largely of low socioeconomic status, and consume monotonous diets consisting of staple cereals, legumes and vegetables with little or no animal products. Hibiscus Sabdariffa is a native plant high in iron concentration that is widely consumed in northern Ghana during wet seasons. We aimed to investigate the efficacy of standardized native Hibiscus Sabdariffa leaves meal (HSM) containing dry fish in improving iron status of reproductive age women through a 12‐wk community‐based feeding intervention during lean season. Reproductive age women (15–49 yrs, n=118) with children (6–23 mo) were recruited from five rural communities in two districts of Upper East region between May‐September, 2016. Study participants were assigned by district to either treatment (n=58 dyads) or control group (n=60 dyads). At baseline, sociodemographic characteristics, health information including malaria and ill health status were obtained from the participants using a questionnaire. The treatment group received 3 HSM/wk made from Hibiscus Sabdariffa leaves, groundnut, dawadawa, dried fish, iodied salt and water on feeding days by the women in their respective community health centers, whereas the control group received no interventions. HSM contained 25.7 mg of iron and 98.7 mg of protein/meal and the amount of consumption was determined by each subject. Hemoglobin (Hb) levels were measured on the field at baseline, midpoint (6 wk) and endpoint (12 wk) using Hemocue HB 201 analyzer. Women were mostly peasant farmers. Mean Hb values at baseline did not differ between the groups. Mean Hb values increased from baseline to endpoint in the intervention group (mean Δ=0.19g/dl, p trend=0.029) but not in the control group (mean Δ=0.05g/dl, p trend=0.660). The velocity of changes in Hb values were prominent between the midpoint to the endpoint between the two groups (p=0.046) after adjustment for malaria status, household wealth index, marital status, sex of household head, mother's age, and child's age. The HSM is efficacious in improving Hb levels in the treatment group. Future studies may be planned for longer than 12 weeks feeding trials including bioavailability, and multiple doses to determine the dose responses in a larger scale during a full spectrum of dry season.

Support or Funding Information

This study has been conducted with financial support from Borlaug Higher Education for Agricultural Research and Development (BHEARD) and Borlaug Leadership Enhancement in Agriculture Program (LEAP).
Mobilizing Markets: Community Efforts to Decrease Food Insecurity in Meadville, Pennsylvania
Authors: Martin Kerstin , Hinton Taylor , Anderson Darby , Schafer Elizabeth J , Dawson Rebecca Smullin
Published: November 2023

The rural town of Meadville, PA is considered a food dessert and issues of food insecurity are a root cause of numerous chronic health problems. In 2014, 26.1% of Meadville residents were living in poverty and nearly 13% have poor nutritional status as a result of food insecurity. Meadville is categorized as a food desert according to U.S. Department of Agriculture's quantitative definition of of a food desert. Seventy percent of adults within the Northwest part of Pennsylvania, which includes Meadville, were overweight or obese in 2014 and it is estimated that the childhood obesity rate is greater than 30%. In an effort to both increase access to fresh produce and reduce the obesity rate in Meadville, a comprehensive community wellness initiation was begun in 2014. To date community gardens have been started, a fresh fruits and vegetables program has been piloted in a local elementary school, and a mobile farmers market has begun. In this presentation, we will specifically discuss the design, implementation, and assessment of a the community garden project, the school programs, and the mobile farmers market that targeted a low‐income neighborhood. We will discuss the development of the survey instruments used to assess each of these initiatives and highlight how bringing fresh produce into a school and low‐income neighborhood increased social capital in addition to access to produce. Ultimately, we will show how the pilot mobile market (conducted during the summer of 2016) was used as a proof of concept idea for a larger scale mobile market that is being created in collaboration with the local bus company. All of the work we are doing is aimed at increasing access to fresh produce in Meadville in order to improve both community and individual health.

Support or Funding Information

By funding through a grant (anonymous) given to support the Allegheny College Community Wellness Initiative.
Impact of Health Workers Infant Feeding Practices Training on the Prevalence of Functional Constipation among Children at Six Years Old. A Cluster Randomized Field Trial
Authors: Sangalli Caroline Nicola , de Morais Mauro Batista , Vitolo Márcia Regina
Published: November 2023

Objective

To assess the impact of health workers training on infant feeding practices on the prevalence of functional constipation among children at six years old.

Methods

Cluster‐randomized field trial conducted in Porto Alegre, Brazil. Health care centers were randomized into intervention (n=9) and control (n=11) groups. The health workers in the intervention group received training on Ten Steps for infant health feeding and the outcomes were assessed for mother‐child pairs who received primary care at these centers. The prevalence of functional constipation were evaluated among children at 6 years old according Rome III criteria.

Results

The prevalence of functional constipation was lower in the intervention group compared to the control group (18.0% versus 28.9%; PR=0.62; 95%CI: 0.43–0.88, p<0.01). Specifically, the children from intervention group showed a 38% higher probability of not being constipated at 6 years old compared to children from control group. Furthermore, the number of children who presented history of retentive posturing and presence of large fecal mass in the rectum differ between the intervention and control groups (6.6% versus 19.0%; PR=0.34; 95%CI: 0.22–0.54 and 14.4% versus 23.2%; PR= 0.61; 95%CI: 0.43–0.88, respectively, p<0.01).

Conclusion

Health workers training on feeding practices in the first year of life had a positive impact on reduce the prevalence of functional constipation among low income children at six years old.

Support or Funding Information

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) Nº 14/2013‐47731/2013‐8.