bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood involvement in family food preparation and shopping and attitudes towards food: baseline results from Project Daire
Authors: Brennan Sarah F. , Lavelle Fiona , Moore Sarah E. , Dean Moira , McKinley Michelle C. , McCole Patrick , Hunter Ruth F. , Dunne Laura , O'Connell Niamh , Cardwell Chris R. , Elliott Chris T. , McCarthy Danielle , Woodside Jayne V.
Published: June 2020

Evidence suggests that dietary intake of UK children is currently suboptimal. It is therefore imperative to identify effective and sustainable methods of improving dietary habits and knowledge in this population, whilst also promoting the value of healthiness of food products beyond price. Schools are ideally placed to influence children's knowledge and health, and Project Daire, in partnership with schools, food industry partners and stakeholders, aims to improve children's knowledge of, and interest in, food to improve health, wellbeing and educational attainment.

Daire is a randomised-controlled, factorial design trial evaluating two interventions. In total, n = 880 Key Stage (KS) 1 and 2 pupils have been recruited from 18 primary schools in the North West of Northern Ireland and will be randomised to one of four 6-month intervention arms: i) ‘Engage’, ii) ‘Nourish’, iii) ‘Engage’ and ‘Nourish’ and iv) Delayed. ‘Engage’ is an age-appropriate, cross-curricular educational intervention on food, agriculture, science and careers linked to the current curriculum. ‘Nourish’ is an intervention aiming to alter schools’ food environments and increase exposure to local foods. Study outcomes include food knowledge, attitudes, trust, diet, behaviour, health and wellbeing and will be collected at baseline and six months. Qualitative data on teacher/pupil opinions will also be collected. The intervention phase is currently ongoing. We present baseline results from our involvement and food attitudes measure from all participating schools. Results were compared by Key Stage and sex using Pearson Chi-Squared test.

Baseline results from our food involvement and attitudes measure are presented for n = 880 KS1 (n = 454) and KS2 (n = 426) pupils. KS1 pupils were more likely to always or sometimes help with food shopping (89.0%) whilst KS2 pupils were more likely to always or sometimes help with food preparation (69.0%). A higher proportion of KS1 pupils reported liking to try new foods (66.1%) and that it was important that food looked (64.5%), tasted (71.1%) and smelled good (60.6%) compared with KS2 children (P < 0.01). Girls were more likely to always or sometimes help with food shopping (96.2%) and preparation (73%) when compared with boys; whilst a higher proportion of girls reported they liked to try new foods (48.2%) and that it was important that food looked (68%) smelled (50.5%) and tasted (71.8%) good compared with boys (P < 0.01).

Results suggest that involvement in food preparation and shopping, willingness to try new foods and attitudes towards food presentation varied by KS and sex in this cohort.
Basal anti-inflammatory responses in cultured endothelial cells exposed to two conjugated linoleic acids
Authors: Valenzuela Carina , Miles Elizabeth , Calder Philip
Published: June 2020

Conjugated linoleic acid (CLA) isomers have been shown to possess anti-atherosclerotic properties, which may be related to the downregulation of inflammatory pathways. Whether low concentrations of CLAs are able to affect basal, unstimulated endothelial cell (EC) responses is not clear. The aim of this study was to evaluate the effects of two CLAs (cis-9, trans-11 and trans-10, cis-12) on basal inflammatory responses by ECs.

EA.hy926 cells (HUVEC lineage) were cultured under standard conditions and exposed to CLAs (1 and 10 μM) for 48 hours. MTT assay was performed to determine cell viability; incorporation of FA was confirmed by gas chromatography; inflammatory mediators were assessed by multiplex immunoassay; the relative expression of genes encoding transcription factors and inflammatory cytokines was assessed through real-time PCR and static adhesion assay was used to evaluate monocyte attachment to the EC monolayer.

CLAs were incorporated into ECs in a dose-dependent manner. Pre-treatment with CLA9,11 (1 uM) significantly reduced unstimulated, basal concentrations of MCP-1 (p < 0.05), and CLA10,12 at 10 uM had the same effect (p < 0.05). Both CLAs at 10 uM increased the relative expression of NFκβ (p < 0.01 and p < 0.05, respectively), while decreasing the relative expression of PPARα (p < 0.0001), COX-2 (p < 0.0001) and IL-6 (p < 0.0001). In contrast, no effect was observed in the adhesion assay for either CLA.

These results suggest that both CLAs at a low concentration have a neutral or modest anti-inflammatory effect in basal conditions, which may influence endothelial function and risk of vascular disease. Interestingly, at these low CLA concentrations some pro-inflammatory genes are upregulated while others are down regulated. This suggests complex effects of CLAs on inflammatory pathways.
Obesity status may intervene in the relation between dietary fiber intake and gut microbiota diversity
Authors: Houttu Noora , Mokkala Kati , Laitinen Kirsi
Published: June 2020

High diversity is considered a property of gut microbiota that is beneficial for human health. A higher dietary fiber intake has been shown to increase gut microbiota diversity. Similarly, there is preliminary evidence that an excess adiposity relates to low diversity. Our objective was to investigate the relationship between dietary fiber intake and gut microbiota diversity whilst considering the overweight and obesity status. Overweight (n = 52, prepregnancy BMI ≥ 25 kg/m2) and obese (n = 47, BMI ≥ 30 kg/m2) women were studied in early pregnancy (a mean of 13 weeks of gestation). The mean daily fiber intake (g) was calculated from 3-day food diaries by computerized software. To evaluate the gut microbiota α-diversity we determined the divergence-based measure, phylogenetic diversity (PD), and the qualitative and quantitative species-based measures, Chao 1 and Shannon index, from 16S RNA gene sequencing using QIIME pipeline. Dietary fiber intake (mean ± SD: 19.7 ± 6.2 g) correlated directly with PD (rho = 0.33, P = 0.002) and Chao 1 index (rho = 0.31, P = 0.004), but not with Shannon index (rho = 0.20, P = 0.06) in all women. Instead, no correlation between BMI and microbiota diversity indexes were seen, except for obese women in whom the BMI correlated inversely with PD (rho = -0.31, P = 0.04). Interestingly, distinct associations between fiber intake and microbiota diversity were detected in overweight and obese women. Fiber intake correlated directly with PD (rho = 0.34, P = 0.02 vs. rho = 0.32, P = 0.04), the measure depicting the phylogenetic branch length, in both overweight and obese women, the correlation with Chao 1 (rho = 0.35, P = 0.02), which depicts the presence or absence of each taxon i.e. richness, was seen only in obese women. Nevertheless, no correlation was seen between fiber intake and Shannon index (rho = -0.004, P = 0.98 vs. rho = -0.18, P = 0.25), the measure depicting the presence and absence as well as the abundance of each taxon i.e. richness and evenness, either in overweight or obese pregnant women. We found direct correlations between dietary fiber intake and gut microbiota α-diversity but obesity status intervened in this relation. In contrast to overweight women, in obese women, the higher dietary intake was reflected in a higher gut microbiota diversity measured at the level of taxon richness, suggesting that particularly obese pregnant women may benefit from a higher dietary fiber intake.
Assessing the validity of RMR equations in healthy Danish community-dwelling older adults
Authors: Schacht Simon , Fahrenholtz Ida Lysdahl , Melin Anna , Holm Lars , Tetens Inge
Published: June 2020

Background

Estimating basal energy requirements is important in terms of assessing energy balance and targeting nutritional support. Assessing Resting Metabolic Rate (RMR) via indirect calorimetry is considered a reliable way of estimating basal energy requirements. Several RMR equations have been developed during the past century through indirect calorimetry, but only few have specifically focused on older adults (> 65 yrs). This may lessen the validity of the equations in relation to older adults, as body composition which is an important determinant for energy requirement changes considerably with age. Additional studies are therefore needed to assess the validity of available RMR equations in specific populations of older adults.

Aim

The aim of the present study was to investigate the validity of commonly available RMR equations in a group of older apparently healthy community-dwelling Danes (65 + y).

Methods

RMR was measured by indirect calorimetry (mRMR) in 42 older individuals (10 females and 32 males; 65–81 years) participating in the CALM intervention study. Oxygen consumption and carbon dioxide production was measured for 25 min using a ventilated open hood system (Oxycon Pro 4; Jeager, Hoechberg, Germany). Predicted RMR (pRMR) was calculated using four different equations; the Harris-Benedict (1919) (HB), the Mifflin et al. (1990), the Lührmann et al. (2002) and the Henry et al. (2005) equations. The ratio between mRMR and pRMR (RMRratio) as well as the predictive ability (percentage of individual pRMR within + /-10% of mRMR) were calculated as a measure of validity.

Results

RMRratio for both sexes combined was 0.95 ± 0.08 for HB, 0.97 ± 0.07 for Mifflin et al., 0.92 ± 0.06 for Lürhmann et al. and 0.94 ± 0.07 for the Henry equations, respectively. The predictive ability was 73.8% (78.1% males and 60.0% of females, p = 0.410) for the HB, 81.0% (81.3% of males, and 80.0% of females, p≈1.00) for the Mifflin et al., 54.8% (56.3% of males and 50.0% of females, p≈1.00) for the Lührmann et al. equation, and 59.5% (59.4% of males and 60.0% of females, p≈1.00) for the Henry equations, respectively.

Conclusion

In the present study, we found that the Mifflin equation was the most valid equations for predicting the RMR of older apparently healthy community-dwelling Danes. Generally, RMRratios and predictive ability were slightly lower for the H-B and Henry equations and lowest for the Lürhmann equation.
Available Starch: from food process control to lower glycemic response
Authors: Sophie Vinoy , Cesbron-Lavau Gautier , Meynier Alexandra , Goux Aurélie
Published: June 2020

Starch is one of the major sources of carbohydrates (CHO) contributing to about 50–70% of the daily energy intake in human diet. Processed foods contribute to an important part of daily energy intake, especially in occidental countries. During food processing, starch undergoes dramatic changes when heated in the presence of water or high pressure. The objective of this work was to evaluate the impact of controlling food processes on starch digestibility profile in cereal-based foods and the interest of preserving starch in its native, slowly digestible, form on in vivo metabolic fate.

Four different food processes were evaluated: extrusion, dry bread, soft cake and rotary-moulded biscuit. The resulting differences in gelatinization of each product translated to different SDS levels. Imaging techniques (X-ray diffraction, microtomography and electronic microscopy) were used to investigate the changes in SDS structure obtained through the different food processes. For in vivo evaluation, 12 healthy subjects were recruited and consumed a portion of 50 g of available CHOs of each product, in a crossover design. Glycemic and insulin responses were evaluated over 120 minutes in postprandial period.

We showed that rotary molding technology preserved starch in its intact form and provided the highest SDS content (28g/100g) when the three other technologies (dried bread, soft cake and extrusion) led to SDS content below 3g/100 g. In addition, the lowest SDS contents are explained by a higher level of starch structure disruption which translated in a shift from crystalline structure into amorphous one. These data were linked to in vivo results. The global analysis for GI indicated that a significant difference existed among the foods’ mean GI values (p < 0.0001). Rotary product showed the lowest GI values. The soft, the dried bread had medium GI and extruded product had the highest GI with 77. The global analysis for II indicated that a significant difference existed among the foods’ mean II values (p < 0.0001), with the same order as for GI values. In addition, a portion of rotary-molded biscuit decreased significantly the glycemic peak by 1 mM compared to the 3 other products.

Decrease of postprandial glycemia is a meaningful target in the prevention of metabolic diseases. This can be achieved through the modification of dietary factors such as starch digestibility.
Dietary assessment with the online platform MyFitnessPal: a reliable method?
Authors: Evenepoel Charlotte , Clevers Egbert , Deroover Lise , Matthys Christophe , Verbeke Kristin
Published: June 2020

A major challenge in dietary assessment is the manual pre-processing of dietary data. Digital food registration via online platforms that are coupled to large food databases can automate this process. The accuracy of such platforms depends on the quality of the associated food database. In this study we validated the database of MyFitnessPal (MFP) versus the Belgian food composition database Nubel.

Fifty participants collected a 4-day dietary record using MFP at 2 time points, T1 and T2. Nutrient intake values extracted from MFP at T1 were used as training set to define a cut-off for each parameter (energy intake (EI), carbohydrates (CH), fat (F), protein (P), fibre (Fi), sugar (S), cholesterol (Ch) and sodium (So)) by optimising correlation with Nubel calculated values. Application of these criteria to the values extracted at T2 (n = 2826) resulted in rejection rate of 2.8%. The remaining values were correlated (Pearson or Spearman) with the Nubel calculated values. Fixed and proportional biases were traced using Bland-Altman analysis and impact on sample size was estimated from a power simulation.

MFP demonstrated strong correlation with the Nubel database for EI (r = 0.95), CH (r = 0.90), F (r = 0.90), P (r = 0.88), Fi (r = 0.80) and S (r = 0.77), but weak correlations for Ch (ρ = 0.51) and So (ρ = 0.53); all p < 0.001. Bland-Altman analysis showed no fixed bias between both methods, whereas a proportional bias was found for cholesterol. A practical implication is a loss of statistical power by 5–10% for EI and macronutrients compared to the Nubel database and the need to increase sample size accordingly.

We conclude that dietary analysis with MFP is accurate and efficient for total energy intake, macronutrients, fibre and sugar, but not for cholesterol and sodium
Effect of folic acid supplementation during pregnancy on brain health of the child at 11 years: the FASSTT Offspring trial
Authors: Caffrey Aoife , Pentieva Kristina , McNulty Helene , Gaur Pramod , Talcott Joel B. , Witton Caroline , Cassidy Anthony , McLaughlin Marian , Lees-Murdock Diane J. , Irwin Rachelle E. , Walsh Colum P. , Prasad Girijesh
Published: June 2020

Periconceptional folic acid (FA) has an established role in the prevention of neural tube defects (NTDs), leading to global recommendations for FA supplementation before and in early pregnancy. However, it is unclear whether there are any benefits for offspring brain health arising from continued maternal FA supplementation beyond the first trimester. The aim of this study was to investigate the role of maternal folate nutrition during pregnancy in relation to cognitive performance and brain function in the offspring at 11 years. The children of mothers who had participated in a randomised trial of Folic Acid Supplementation in the Second and Third Trimesters (FASSTT) were investigated, providing a unique opportunity to examine offspring brain health in relation to maternal folate (the FASSTT Offspring trial; n = 68). Cognitive performance was assessed using the Wechsler Intelligence Scale for Children, Fourth UK Edition (WISC-IV). The WISC-IV measures Full Scale IQ and specific domains of cognitive performance: Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed. Brain function was measured using magnetoencephalography (MEG) in a subset of the child participants (n = 33). The results showed no significant difference in Full Scale IQ between the children of mothers who had received folic acid versus placebo during pregnancy (P = 0.993). Processing Speed subtest scores were however significantly higher in the folic acid group compared with placebo (Symbol Search: P = 0.046 and Cancellation: P = 0.011). The application of MEG analysis showed that at rest, there were differences in brain functioning with significantly lower overall power at Broad band [1–48Hz] (P = 0.041) and a trend (not significant) towards lower power in all other frequency bands (Theta, Mu, Beta, Low Gamma and High Gamma) in children from the FA group compared with placebo. Results for the responses to the language task (congruent and incongruent sentences) in children from the FA group showed significantly lower power within the Theta band [4–8Hz] and significantly higher power within high frequency bands i.e. Beta [13–30 Hz] and High Gamma [49–70 Hz]. This suggested more efficient language processing abilities in these children compared to children of mothers in the placebo group. The findings provide scientific evidence that continuing FA supplementation beyond the periconceptional period that is protective against NTDs, may be beneficial for brain health in the offspring. Furthermore, this study demonstrates that MEG is a useful tool for objective assessment of functional brain activity in healthy children in response to nutrition intervention.
May Body Adiposity Index be used as adiposity diagnostic marker?
Authors: Hamulka Jadwiga , Górnicka Magdalena , Nasuta Urszula , Frackiewicz Joanna , Białkowska Agnieszka , Drywień Małgorzata , Ciecierska Anna , Zielinska Monika A.
Published: June 2020

Body Adiposity Index (BAI) is the method of determining body fat content based on anthropometric measurements, proposed as an alternative to the BMI. Due to the fact that the hip circumference is taken into account in calculating BAI, it is suggested that this index better reflects the differences in women and men obesity than BMI. The aim of this study was to examine the association between BAI and other adiposity indices such as WHtR (Waist to Height Ratio), Body Mass Index (BMI), Waist Circumference (WC), sum of skinfolds, or adiposity tissue measured by bioelectrical impedance analysis (FM-BIA) among adults, independence of sex and age. The study group consisted of 336 adults (59% women, 41% men) aged 18–70 years, which was divided into two groups: 18–45 years (57%) and > 45 (43%) to further analysis. All anthropometric measurements: height (H), body weight (BW), WC, hip circumference (HC) skinfolds thickness were taken according to the standardized procedures, with light clothing and without shoes twice and averages were calculated. BIA was performed under standardized conditions according to the manufacturer's protocol (Maltron BioScan 920 ver.1.1). BAI was calculated as [HC (cm) / H (m)1.5 -18]. Linear regression was used to investigate the relationship between BAI and adiposity indices. BAI was positively associated with sex, age, BW, WC, FM-BIA, BMI, sum of 4 or 5 skinfolds and WHtR for all subjects, but the strongest with FM-BIA (β = 0.787, p < 0.001), BMI (β = 0.696, p < 0.001) or WHtR (β = 0.625, p < 0.00001) for total group. BAI correlation with BW, WC, FM-BIA, BMI or WHtR were stronger in women than in men, both for the total group and regards to age. The identified set of correlates explained (for above variables) 30–79%, of the total variation in BAI for women, and 15–49% for men. The stronger BAI correlation with sex was found in the older group (> 45 years old) than in younger (β = 0.582, p < 0.00001 vs. β = 0.372, p < 0.00001). In men aged > 45 years, stronger BAI correlations with the sum of 4 or 5 skinfolds were observed. The correlation between BAI and BW in men was weaker than in women regardless of age (β = 0.364, p < 0.00001 vs. β = 0.762, p < 0.00001). Considering strong correlation between BAI and fat content (FM-BIA), BMI, WHtR, WC and BW in women, it seems that BAI may be used to determine the content of adipose tissue or as a diagnostic marker, but in men its using need further research.
Plasma and Tissue Bioavailability and Blood Pressure Lowering Effects of Omega-3 Polyunsaturated Fatty Acids from Commonly Eaten, Naturally Enriched, Foods
Authors: Stanton Alice , Shortall Kathleen , El-Sayed Thora , Brennan Margaret , Buskandar Fahad , O'Donovan Fiona , James Kirstyn , Kennedy Jean , Hayes Heather , Owens Bronagh , Fahey Alan , Pender Niall , Moran Niamh , Williams David , Dolan Eamon
Published: June 2020

Greater consumption of oily fish, and elevated plasma levels of the long-chain marine-derived omega-3 polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have been strongly and consistently associated with a reduced incidence of heart attacks, strokes, cognitive decline, Alzheimer's disease and cancers. Despite international guidelines recommending eating oily fish at least once per week (> 250mg/day DHA and EPA), many people do not eat fish, and only a small minority of the world's population have optimal omega-3-PUFA plasma and tissue levels. Hence, in this project, we studied the bioavailability and blood pressure lowering effects of recently developed alternatives to oily fish, namely chicken-meat and eggs naturally enriched with algae-sourced omega-3-PUFAs.

This was a double-blinded, controlled, randomised trial. Using a 2X2 factorial design, 161 healthy participants were randomized to eat at least 3 portions/week of omega-3-PUFA enriched (or control) chicken-meat, and to eat at least 3 omega-3-PUFA enriched (or control) eggs/week, for 6 months.

Compared to control foods, eating enriched eggs, enriched chicken-meat and the combination for 6 months, resulted in plasma EPA increments (μg/g) of 3.1[2.8], 8.8[2.9]* & 4.7[2.9], plasma DHA increments (μg/g) of 5.1[3.7], 9.3[3.8]* & 13.1[3.9]*, and omega-3-index (sum of EPA + DHA as a percentage of total fatty acids in erythrocytes, %) increments of 0.9[0.3]*, 0.7[0.4]* & 1.5[0.4]*, respectively. Mean 24-hour ambulatory blood pressure (systolic/diastolic, mmHg) declined with the enriched foods 0.3[1.3]/-0.2[1.0], -0.7[1.4]/-1.4[1.0], & -1.9[1.4]/-2.9[1.0]*, respectively. Data provided as mean difference[SEM], and * denotes p < 0.05.

Regular consumption of omega-3-PUFA enriched chicken-meat and eggs resulted in statistically significant and clinically relevant increases in plasma and red cell levels of DHA and EPA. Both plasma and red cell bioavailability were similar to those previously described for oily fish. Furthermore, blood pressure, an important biomarker of cardiovascular health, decreased in those eating the omega-3-PUFA enriched foods. Omega-3-PUFA enriched chicken-meat and eggs offers consumers an attractive additional alternative to eating oily fish. Unlike many lifestyle interventions, long-term large population health benefits are not dependent on willingness of people to make long-lasting dietary changes, but on the widespread availability of a range of inexpensive, commonly eaten, naturally enriched foods.
Efficacy of different prediabetes program models in improving clinical outcomes in people with prediabetes
Authors: Al-Hamdan Rasha , McCullough Fiona , Avery Amanda , Al-Disi Dara , Al-Daghri Nasser
Published: June 2020

Background:

Educational programs in general seem to have a clinically significant beneficial effect among the T2DM population in terms of improved glycaemic control. However, few evaluations of interventions to delay or prevent type 2 diabetes mellitus (T2DM) in Saudi Arabia (SA) have been undertaken.

Objective:

The present study evaluates for the first time, the differences in the effectiveness of the different educational programs [intensive lifestyle modification (Group Education Program, GEP), supervised education through social media (WhatsApp Education Group, WEP) and standard care via PHCCs (Control Group, CG)], among Saudi females with pre-diabetes.

Methods:

This was a 6-month, multi-center, 3-arm cluster, randomised, controlled (1:1:1), multi-intervention study conducted from July 2018 until March of 2019 in Riyadh, SA. A total of 1140 females from SA were cluster randomised equally to three groups, out of which only 253 [N = 100 GEP, N = 84 WEP and N = 69 CG] received intervention. Participants completed questionnaires including demographic, dietary and physical activity data. Anthropometrics, blood samples and dietary intake were collected at baseline and 6 months. A total of 120 [37 CG (age 50.9 ± 7.1 years; body mass index (BMI) 31.6 ± 5.8kg/m2), 40 GEP (age 42.9 ± 12.2 years; BMI 34.8 ± 9.0kg/m2) and 43 WEP (age 43.7 ± 8.1 years; BMI 30 ± 5.1kg/m2)] participants completed the study.

Results:

Haemoglobin A1c (HbA1c; primary endpoint) significantly improved in all groups over time, with no difference in between-group comparisons. Between group comparisons adjusted for age revealed a clinically significant reduction in BMI in favour of GEP (p = 0.02) post-intervention. A clinically significant reduction was also observed in favour of GEP in terms of weight (p = 0.003), waist circumference (p = 0.017), systolic and diastolic blood pressure (p-values < 0.01), triglycerides (p < 0.001) and caloric intake (p < 0.005) over time.

Conclusion:

Prediabetes education programs of 6-month duration, whether delivered through an intensive lifestyle modification, social media or standard care, are equally efficacious in improving HbA1c levels among Saudi women with prediabetes, but intensive lifestyle is superior in terms of weight reduction and over-all cardiometabolic improvement.
Ultra-processed food intake and risk of type 2 diabetes in a French cohort of middle-aged adults
Authors: Srour Bernard , Fezeu Léopold K. , Kesse-Guyot Emmanuelle , Allès Benjamin , Méjean Caroline , Debras Charlotte , Druesne-Pecollo Nathalie , Chazelas Eloi , Deschasaux Mélanie , Hercberg Serge , Galan Pilar , Monteiro Carlos A. , Julia Chantal , Touvier Mathilde
Published: June 2020

Introduction:

The consumption of ultra-processed foods has been increasing during the last decades, and has been previously associated with increased risks of mortality and several chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia. The objective of this study is to assess the prospective associations between consumption of ultra-processed foods and the risk of type 2 diabetes (T2D).

Methods:

Overall, 104707 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records (5.7/subject in average), designed to register participants' usual consumption for 3300 different food items. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risk of type 2 diabetes were assessed using multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history and nutritional factors).

Results:

Ultra-processed sugary products, fruits and vegetables, and beverages were the highest contributors of the ultra-processed category (respectively 27.9, 18.5 and 15.6%). Ultra-processed food intake was associated with a higher risk of T2D (n = 821 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.15 (95% confidence interval 1.06 to 1.25); P = 0.0009, median follow-up: 6.0y, 582252 person-years). These results remained statistically significant after adjustment for other metabolic comorbidities, for several markers of the nutritional quality of the diet (red meat and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.

Conclusions:

In this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of type 2 diabetes. These results need to be confirmed in other populations and settings, and causality remains to be established. Various dimensions of processing such as nutritional composition of the final product, food additives, contact materials, and neoformed contaminants might play a role in these associations and further studies are needed to better understand their relative contribution. Meanwhile, public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

Study Registration: Clinicaltrials.gov NCT03335644.
A protocol for the development of a Core Outcome Set for PREgnancy Nutrition (PRENCOS)
Authors: Killeen Sarah Louise , O'Brien Eilleen C. , Geraghty Aisling A. , McAuliffe Fionnuala M.
Published: June 2020

Introduction:

Maternal nutrition during pregnancy is a modifiable risk factor for health. Heterogeneity in outcome reporting in studies evaluating nutrition in pregnancy limits their comparability and is a barrier for high quality evidence synthesis. A core outcome set (COS) is set of outcomes, which are agreed by consensus, to be a minimum standard to report within an area of research. The CoRe Outcomes in Women's and Newborn health (CROWN) initiative is an international initiative which supports the development of COSs for Women and Newborn health research. To date, there is no COS which specifically addresses the issues with outcome reporting in research on nutrition in pregnancy. Therefore, we present a study protocol for the development of a COS for maternal nutrition research in pregnancy.

Methods:

The COS is registered with the Core Outcomes for Measurement of Effectiveness Trials (COMET) registry. A systematic review will be conducted following PRISMA guidelines to identify studies evaluating maternal nutrition during pregnancy. Outcomes will be extracted from eligible studies and cataloged using the taxonomy of the COMET initiative. We will make efforts to supplement our findings with outcomes from other sources, including qualitative interviews with mothers. Secondly, a modified Delphi survey will be conducted with international stakeholders including healthcare professionals, researchers and mothers. Participants will be presented with the list of outcomes from step one and invited to rank the importance of including each outcome in the final COS using a 9-point Likert scale. We will complete descriptive statistics and in a second round of the survey, participants will receive feedback on their individual scores from round one, along with the average score each stakeholder group provided for each outcome. Based on this, participants will have the opportunity to change their scoring and will be encouraged to give a rationale for their final choice. Lastly, a face-face consensus meeting will be held with representatives from all stakeholder groups to finalise the COS.

Results:

We will identify the outcomes reported in maternal nutrition research. We will also determine the outcomes which are important to pregnant women and if these are missing from the literature. A final COS for nutrition research in pregnancy will be developed.

Discussion:

This COS will support the harmonisation of outcome selection and reporting in maternal nutrition research which is necessary for high quality evidence synthesis to support clinical practice and the nutritional care of pregnant women.
What can researchers learn from participant involvement? Insights from the ROLO Family Advisory Committee
Authors: Brien Eileen O. , Walsh Niamh , Geraghty Aisling , Byrne David , McAuliffe Fionnuala
Published: June 2020

Introduction:

Public and patient involvement (PPI) describes how researchers collaborate and engage with the public in order to make research more relevant to them. The ROLO Family Advisory Committee is a self-selected group of parents who are involved in the longitudinal follow-up of the ROLO Study. It was established in 2017 and the goal is to achieve a partnership between ROLO families and researchers, leading to improved research quality, relevance and outcomes. The aim of engaging with parents from the ROLO study is to understand key outcomes of importance for parents relating to their own health and their children's health and to gain insights into how the research agenda can be more relevant to parent and child needs.

Materials and Methods:

All parents involved with ROLO study were invited to join the ROLO Family Advisory Committee in 2017. Parents who had expressed interest in joining the committee were invited to attend annual ROLO Families Advisory Committee Meetings in 2018 and 2019. Parents were asked to discuss their opinions about current research projects and potential future projects. This was followed by an open discussion about relevant health questions. These meetings were either transcribed on the day or recorded with audio recordings transcribed verbatim and broad themes identified.

Results:

Mothers had greater concern for outcomes relating to their children than themselves. Parents were very interested in understanding the relationship between diet in pregnancy and child health and welcomed research regarding blood tests that could be predictors of future health. Parents had great concern for the effect social media has on child mental health and also wanted more studies conducted in the areas of fussy eating and how to ensure children consume a wide range of healthy foods. It was consistently highlighted that children and teenagers should understand healthy eating principles and ways to promote their physical and mental health.

Discussion:

Through the two focus groups, valuable insights were gained regarding what research parents consider relevant and future research questions. The ROLO agenda has certainly been enriched by PPI. We are seeking opportunities to enable research to be carried out in the areas discussed at the meetings.
The Role of Zinc in Depressed Pregnant and Non-Pregnant Women: A Systematic Review and Meta-Analysis
Authors: Page Nadine B. , Brown Anna M. , Pascoe Erin , Braithwaite Sally , Townsend Michelle L. , Herbert Jane S. , Davies Hilary , Hart Kathryn H. , Moore J. Bernadette
Published: June 2020

Perinatal depression is a depressive illness that affects 10–15% of women in the UK with an estimated cost of £1.8 billion/year. Zinc deficiency is associated with the development of mood disorders and zinc supplementation has been shown to help reduce the symptoms of depression. Women who are pregnant and breastfeeding are at risk of lower levels of zinc because of the high demand from the developing and feeding baby. However, studies in the perinatal period are limited. With a long-term aim of designing a randomised controlled trial (RCT) to examine if zinc supplementation reduces depressive symptoms in pregnant and lactating women;the objective of this review was to systematically evaluate previous RCTs assessing zinc supplementation and depressive symptoms, in order to establish a zinc dosing regimen with regards to Galenic formulation, unit dose and frequency. The review was conducted by independent reviewers in accordance with PRISMA guidelines and is registered at Prospero (CRD42017059205). The Allied and Complimentary Medicine, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, and Cochrane databases were searched since records began, with no restrictions, for intervention trials assessing Galenic formulation, unit dose and frequency of zinc supplementation to reduce the symptoms of depression. From a total of 66 identified records, 7 articles met the inclusion and exclusion criteria; all assessed the effect of zinc supplementation on mood. Risk of bias was independently assessed using the standard ‘Cochrane risk of bias tool’. Overall, 5 of the 7 papers were rated as high-quality trials; of the other two, one was rated poor and the other fair but both had a number of learning points. Preliminary findings indicate at the end of supplementing zinc, depression scores were reduced significantly. In one study, the Beck score decreased in the placebo group, but this reduction was not significant compared to the baseline. In two of the studies there was a significant correlation between serum zinc and self-reported mood questionnaires. Results also suggest that 25 mg zinc supplementation combined with antidepressant drugs can be effective in the treatment of major depression in women. This supports other work where researchers supplemented 25 mg of elemental zinc for 12 weeks or longer and found a reduction of symptoms in both pregnant and non-pregnant women. Thus, an early conclusion is that 25 mg of elemental zinc is an effective dose for improving low mood and is achievable in a trial setting.
Bioactive compounds and antioxidant capacity in fennel seeds influenced by pressurized liquid extraction
Authors: Repajić Maja , Tonković Petra , Kruk Valentina , Zorić Zoran , Elez Garofulić Ivona , Palčić Igor , Dragović-Uzelac Verica
Published: June 2020

Fennel (Foeniculum vulgare Mill.) is a well-known aromatic plant, widely used as spice and remedy herb. It provides many beneficial effects and is used as diuretic and expectorant, as well as for various dyspeptic disorders. Beside essential oils, fennel seeds are abundant with various phenols, which are known as strong antioxidants and thereby contribute to human health. Among different extraction methods for phenols isolation, pressurized liquid extraction (PLE) represents a novel technique with numerous advantages over conventional extraction approaches. Its efficiency manifests through combination of high temperature and pressure, enabling extraction time shortening, as well as decreased solvent consumption, thus being environment-friendly technique. In order to achieve maximum extraction yield, it is of great importance to select optimal PLE conditions, e.g., extraction temperature and time. Additionally, solvent selection also affects on content of targeted compounds, where phenols amount depends on polarity of solvent. Hence, the aim of this study was to examine the effect of temperature (75 and 100 °C), static time (5 and 10 min) and cycle number (1, 2 and 3) on total phenols (TP) and total flavonoids (TF) content, as well as the antioxidant capacity (AC) in fennel seeds using three-step exhaustive PLE. Firstly, grinded dry fennel seeds were subjected to PLE using non-polar solvent (hexane) under the mentioned conditions in order to remove seeds' lipid fraction. Afterwards, defatted samples were extracted with polar solvents by the increasing polarity: aqueous acetone solution (30 %, v/v) followed by aqueous methanol solution (30 %, v/v). Obtained acetone (AE) and methanol (ME) extracts (n = 24) were analyzed for TP (Folin-Ciocalteu method), TF (aluminium chloride colorimetric assay) and AC [ferric reducing antioxidant power (FRAP) method]. Multivariate analysis of variance (MANOVA) and Tukey's HSD test (p ≤ 0.05) were applied for statistical analysis of collected data. Expectedly, AE were described with higher values of analyzed parameters (grand means: TP = 416.18 mg/100 g, TF = 41.87 mg/100 g, AC = 359.57 mg AAE/100 g) in comparison with ME (grand means: TP = 80.25 mg/100 g, TF = 16.41 mg/100 g, AC = 96.13 mg AAE/100 g. Furthermore, all examined influences significantly affected TP, TF and AC in all samples, except temperature on TP in ME. Thus, conditions of 100 °C/10 min/3 cycles showed the greatest yield of tested parameters in AE, while 100 °C/5 min/1 cycle were sufficient for maximum TP and AC levels in ME. Regarding TF in ME, slightly longer extraction time was required to achieve the highest efficiency (100 °C/10 min/1 cycle).
Microbial production of essential and toxic compounds among oat-using CeD and NCGS patients
Authors: Hakkola Salla , Nylund Lotta , Yang Baoru , Kalliomäki Marko , Linderborg Kaisa
Published: June 2020

The recent development of diagnostic methods and current well-being trend have increased the awareness of gluten-related diseases, such as celiac disease (CeD) and non-celiac gluten sensitivity (NCGS), 1% and 6 % of general population, respectively. Currently for both CeD and NCGS, the only effective treatment is a life-long gluten-free diet, which makes adequate intake of fiber challenging. Despite of improving gut function, dietary fibers promote the growth of gut beneficial microbes. They are in charge of production of numerous compounds, which are essential for human health, such as enzymes and short chain fatty acids (SCFA). Moreover, dietary fiber has an effect on ammoniacal nitrogen levels and beta-glucuronidase activity, which are harmful for human in high concentrations. Gluten-free oats are an excellent source of dietary fiber and they have exceptionally good nutritional properties.

In this observational study, SCFA production, ammoniacal nitrogen levels and beta-glucuronidase activity of oat-using CeD patients, NCGS patients and healthy controls were compared. SPME-GC-MS method was developed for SCFA analysis and the other biomarkers were analyzed by spectrophotometer.

There were no significant differences between groups on propionic acid and butyric acid production, only the percentage of acetic acid of total SCFAs was higher in control group compared to NCGS group, (p = 0,03). Neither was there significant differences between groups in ammonia production or beta-glucuronidase activity.

It has been scientifically proven that pure oats are suitable for celiac disease and gluten-sensitive patients, but they are not commonly used outside of Scandinavia. Our results stated that oat-using CeD and NCGS patients, whose disease is in balance, have gut microbiota capable of healthy production of essential SCFAs and normal levels of harmful compounds.
Characterising the plant based component of the Irish diet in terms of its nutritional quality
Authors: Kent Gráinne , Kehoe Laura , McCarthy Róisín , McNulty Breige A. , Nugent Anne P. , Flynn Albert , Walton Janette
Published: June 2020

A diet rich in plant-based foods with fewer animal products may offer improved health and environmental benefits. There is little consensus on the definition for a plant-based diet in the literature with some defining it as one rich in vegetables, legumes, fruits, wholegrains, nuts and seeds, excluding animal foods and with heavy restrictions on processed foods. Other definitions make no reference to the inclusion/exclusion of processed foods and refer only to the exclusion of all animal foods from the total diet. This study aimed to examine the nutritional quality of the Irish diet using each of these plant-based diet definitions.

A 4-day semi-weighed food record collected food intake data from 1500 Irish adults (18–90y) in the National Adult Nutrition Survey (NANS). Nutrient intake was analysed using WISP© based on UK and Irish food composition databases. All foods and beverages consumed in the NANS were categorised (included/excluded) into the two definitions; 1.plant-based component of the diet and 2.total diet excluding all animal components. The plant-based component included vegetables, legumes, fruits, wholegrains, nuts and seeds and excluded all animal foods and processed foods. The second categorisation included all non-animal foods regardless of processing. Nutritional quality was assessed by estimating energy-adjusted intakes of macronutrients, saturated fat, free sugars, dietary fibre and sodium. Stastical analysis was conducted using SPSS© v24.

The plant-based component of the diet provided 309 ± 214kcal/d (1.3 ± 0.9MJ/d) comprising of 68% carbohydrate, 20% fat and 12% protein. Mean intakes of saturated fat and free sugars from the plant-based component of the diet were 5% of energy (%E) and 1%E, respectively. Mean intakes of dietary fibre and sodium were 70g/10MJ and 1855mg/10MJ, respectively.

Allowing for inclusion of processed foods, mean energy intake from the total diet excluding all animal foods was 1051 ± 411kcal/d (4.4 ± 1.7MJ/d) comprising of 66% carbohydrate, 23% fat and 10% protein. Mean intakes of saturated fat and free sugars were 7%E and 14%E, respectively. Mean intakes of dietary fibre and sodium were 40g/10MJ and 2642mg/10MJ, respectively.

Overall, the macronutrient profile of the plant-based component of the diet and the total diet excluding animal foods were similar. However, the plant-based component of the diet was of higher nutritional quality; providing lower intakes of saturated fat, free sugar and sodium and higher intakes of dietary fibre compared to the total diet excluding animal foods. This study highlights the variability in nutritional quality between different definitions of plant based-diets.
Application of the WHO nutrient profile model on food product data recorded for the Austrian project “Food in the Spotlight”
Authors: Meidlinger Bettina , Luipersbeck Christian , Bruckmüller Melanie U. , Dieminger-Schnürch Birgit , Bürger-Schwaninger Bernadette , Spitzbart Stefan , Schindler Karin , Fuchs Klemens , Wolf-Spitzer Alexandra
Published: June 2020

Introduction:

Children are exposed to marketing of foods with a high content of energy, fat, sugar and salt on a daily basis, which can have negative consequences via increasing children's preferences for those foods. An unhealthy diet can promote obesity and other noncommunicable diseases. The objective of this scientific work was to assess the applicability of the nutrient profile model (NPM) for food products available in the Austrian market. The model was developed by the WHO Regional Office for Europe to reduce the impact of marketing to children.

Material and Methods:

The NPM was applied to food product information, which was recorded for the project “Food in the Spotlight” (www.lebensmittellupe.at). Food products were assigned to food categories made by the WHO and the NPM was applied to identify products, which should not be allowed to be marketed to children. As the WHO NPM is flexible and can be adapted to the national context possible adaptations of the model to the Austrian market were developed.

Results:

Among those product groups which were included in Food in the Spotlight 0% of cocoa (n = 89), milk drinks with additional ingredients (e.g. strawberry milk, n = 111), soup pearl croutons (n = 13), ketchups (n = 79) and pestos (n = 119), 0.4% of soft drinks (Cola, lemonade etc., n = 454), 8% of pizza and pizza-like products (n = 274), 13% of yoghurt products with additional ingredients (n = 611), 18% of sugos (n = 193), 28% of fruit and vegetable purees (n = 36) and 33% of breakfast cereals (n = 678) were found to be eligible for marketing to children. Those 0.4% of soft drinks which would be allowed are two waters flavoured with aroma. Pure products such as whole milk and yoghurts with 3.5% fat would not be allowed because they exceed the thresholds for total fat. For those products with a packaging appealing to children and adolescents almost none passed the NPM.

Conclusion:

Our results showed, that before the NPM can be implemented in Austria, it is important to adapt the model to national dietary guidelines. Additionally, food categories could be modified to be more suitable for the Austrian market, as some products which are common in Austria could not be easily assigned to the WHO food categories. To adapt the WHO NPM to the national context cooperation between health experts and food manufacturers is necessary.