bluuebunny/crossref_metadata_2025 huggingface dataset:
Can we modify the Mediterranean diet for non-Mediterranean populations? Results from two randomised controlled trials.
Authors: Wade Alexandra , Davis Courtney , Dyer Kathryn , Hodgson Jonathan , Woodman Richard , Keage Hannah , Murphy Karen
Published: June 2020

The Mediterranean diet is rich in bioactive nutrients and may be effective at preventing cardiovascular disease and dementia. However, long-term sustainability could be limited in non-Mediterranean populations with different nutrient requirements and food preferences. To address this issue, our research group conducted two randomised controlled trials to examine whether the Mediterranean diet can be adapted to increase sustainability for an Australian population, while still providing cardiovascular and cognitive benefits. In our first trial (n = 41), we examined a Mediterranean diet designed to meet the calcium requirements of older adults by including 3–4 daily serves of dairy foods (milk, cheese and yoghurt) (MedDairy). In our second trial (n = 33), we tested a Mediterranean diet supplemented with 2–3 weekly serves of fresh, lean pork (MedPork), designed to provide an alternate source of protein. Both trials employed a low-fat control diet (LF) and a 24-week parallel crossover design, consisting of two 8-week intervention periods and an 8-week washout separating interventions. We found that the MedDairy intervention significantly increased dairy food (mean difference = 1.0 ± 0.2 serves, P < 0.001) and calcium intake (mean difference = 25.9 ± 6.8 mg/MJ, P < 0.001) compared to LF. Further, MedDairy led to greater improvements in morning home systolic blood pressure (mean difference = -1.6 ± 0.6 mmHg, P = 0.01), triglycerides (mean difference = -0.05 ± 0.02 mmol/L, P < 0.01), HDL (mean difference = 0.04 ± 0.01 mmol/L, P = < 0.01), and total cholesterol to HDL ratio (mean difference = -0.4 ± 0.10 mmol/L, P = < 0.001). The MedDairy intervention also led to greater improvements in processing speed (P = 0.04), a measure of cognitive function, as well as self-reported mood (P = 0.01). No significant differences were observed between MedPork and LF for blood pressure or other markers of cardiometabolic health. However, the MedPork intervention led to greater improvements in processing speed (P = 0.01) and mood (P = 0.03). Our findings demonstrate that a Mediterranean diet with added dairy foods is capable of delivering adequate calcium to ageing populations while providing cardiovascular and cognitive benefits. Further, a Mediterranean diet supplemented with fresh, lean pork offers comparable cardiovascular benefits to a low-fat diet and greater improvements to cognitive function and mood. Our findings are of particular relevance to non-Mediterranean populations at risk of cardiovascular disease and dementia, and offer two options for modifying the Mediterranean diet depending on dietary priorities.
Prevalence of malnutrition among refugee children traveling on “Balkan Route”
Authors: Spiroski Igor , Nikovska Danche Gudeva
Published: June 2020

Introduction:

Undernutrition indicates a lack of the necessary energy, macro or micronutrients in person's dietary intake. Overnutrition usually refers to existence of overweight and obesity. The objective of our study was to assess the prevalence of both undernutrition and overweight and obesity among refugee children population, traveling on so-called “Balkan route” from Syria and Iraq towards Western Europe, temporally situated in two transit centers in Macedonia, one at the south of the country (camp Gevgelija) and one at north (camp Tabanovce).

Methods:

Total of 99 children aged 0 to 19 years were measured for their height and weight. Of those children 35 were at the age of 0 to 5 years and 64 at the age of 5 to 19 years. WHO's child growth standards and references were used to assess the nutritional status of measured children. Undernutrition was defined through stunting and wasting, as below -2 standard deviations (SD) of the Height-for-age and Weight-for-height indexes. Overweight and obesity were defined as above + 1 and + 2 SD of the z-score for BMI-for-age index respectively for children age 5 to 19 and above + 2 and + 3 SD for Weight-for-height index for children up to 5 years of age.

Results:

Out of all children are 0–5, 26,5% were stunted (95% CI 10.2–42.8), 31,3% of them boys and 22.2% girls. In this population of children 5.9% were moderately wasted (95% CI 0–15.3), almost all of them boys. Among children age 5–19, 20.6% were below -2 SD of the index Height-for age (95% CI 9.8–31.4), 19.4% of them boys and 22.2% girls. There were no obese children under 5 in both transit centers in Macedonia, and 11.8% were overweight (95% CI 0–24.1). Out of all children age 5–19, 23.4% were considered overweight or obese (95% CI 12.3–34.6), 19.4% of them boys and 28.6% girls, and 3.1% obese (95% CI 0–8.2).

Conclusions

When compared to the prevalence of both undernutrition and overweight (including obesity) in children in Macedonia, refugee children have higher prevalence of stunting and wasting. Overnutrition coexisted with undernutrition in refugee children population, particularly among children age 5 to 19. Specific conditions and relatively small number of participants in the study should be taken into account when drawing general conclusions.
The folic acid and folates content in fortified fruit juices
Authors: Czarnowska-Kujawska Marta , Gujska Elzbieta , Michalak Joanna , Leończuk Dominika
Published: June 2020

Introduction

Folates are water-soluble vitamins of the great nutritional importance. Their deficiencyin the diet is common worldwide. Most people do not obtain sufficient folate amount in their diet by eating fresh vegetables, fruit, beans or whole grains. More and more products available on the market are fortified with the synthetic folic acid. Since the consequences of an excessive intake of this vitamin for the organism are not fully explained, there is a need to know its real contents in fortified products. Fruit juices fortified with folic acid can also be a good source of naturally occurring derivatives, folates. Folates, however, as a very unstable nutrient, may be degraded during the production process and storing to the form which has no biological function. Thus, it is crucial to have an appropriate information on the stability of folic acid and folates in fortified products and their retention during storage.

Objectives

The objective of this study was to quantify the total folic acid and folates content in fruit juices affected by the time of storage at room temperature. This will help to better understand the potential health value of fortified fruit juices.

Material and Methods

Five fortified fruit juices with the declared on the packaging folic acid content in the amount of 30 μg / 100 ml, were purchased at local supermarkets. Folic acid and folates were extracted in the 0.1 M phosphate buffer (pH = 7.0), followed by deconjugation with conjugase (rat plasma) and separated by HPLC after clean-up using SAX SPE cartridges.

Results

Folic acid content (90–140 μg/100 ml) significantly exceeded the value declared by the manufacturer. The 5CH3FH4 form in juices was found at the trace amounts. In two tested juices this content was 3.46 and 3.41 μg/100 ml. After seven months of storage folic acid content significantly decreased even 2–3 times (38–67 μg/100 ml) but these values were still higher than the value declared by the manufacturers. The 5CH3FH4 form content after storing was determined at a trace amounts.

The conducted research allowed to confirm that producers deliberately use “technological surpluses” for juices in order to minimize possible losses that may occur during the production process as well as during storage. Based on the obtained results, it can be concluded that the tested fruit juices can be a valuable source of folic acid. However, it should be considered whether their excessive amount will not have negative effects, instead of contributing to the prevention of many diseases.
Weight status, eating and sedentary behaviours in Maltese pre-school children living in a high-risk poverty area
Authors: Zarb Johann , de Caro John Xerri , Copperstone Claire
Published: June 2020

Introduction

Early eating behavioural traits could contribute to development of weight problems later in life. Evidence suggests children living in higher-poverty areas are at higher risk of overweight and obesity. The main objective was to investigate possible associations between weight status, eating and sedentary behaviours in pre-school children living in an area of high-poverty risk.

Materials and Methods

The children (3–4 years) and their parents living in a school district which is classified as being at a high risk of poverty were invited to participate for the study. Following consent, they were interviewed by telephone using The Child Eating Behaviours Questionnaire (CEBQ) in 2018. The CEBQ utilises a five-point Likert scale with scores computed for different eating behaviours. Anthropometric measures on the children were carried out in the schools.

Results

Response rate was 63.3% (n = 71), with 54.8% of parents possessing a secondary school education There was no significant association between parental education level and weight status using World Health Organisation (WHO), International Obesity Task Force (IOTF) and Center for Disease Control (CDC) criteria (p = 0.227, 0.373, 0,213 respectively). No significant relationship was found between children's weight status and gender (WHO; p = 0.800 & CDC; p = 0.655; IOTF; p = 0.804). 71.8 % of the children exceeded the 1-hour screen time daily recommended guidelines (National Institute for Health and Care Excellence, 2015) during weekdays while 47.9% exceeded the recommendations during weekends. Main sedentary behaviours were the use of smartphones/tablets (mean 72 min/day; 64 min/day; weekend, weekdays respectively) with a significant association found across this behaviour and all weight standard criteria (p = 0.013, 0.016 and 0.015 for WHO, CDC and IOTF respectively).

Food enjoyment varied significantly according to weight status (WHO: p = 0.001; CDC; 0.010; IOTF: p = 0.028). Lowest food fussiness scores were observed in normal weight children using WHO and CDC weight standard criteria and in the underweight category when using IOTF criteria and was significant across all weight criteria (p = WHO; 0.013/ CDC; 0.047/ IOTF; 0.024). Children with mean high food avoidance scores scored in a higher weight category (WHO: p = 0.003; IOTF: p = 0.013).

Discussion

In this small study, some eating behaviours were found to be linked to weight status suggesting further work required. Public health initiatives to reduce sedentary behaviours should also be targeted at younger age children. Larger studies comparing children in different socio economic regions and targeting the family and obesogenic environment are recommended for targeted early intervention.
The influence of a dietary advice on recurrent upper respiratory tract infections in children: a randomized controlled trial.
Authors: van der Gaag Ellen , Brandsema Ruben , van der Palen Job , Hummel Thalia
Published: June 2020

Introduction

Since there is no treatment for children suffering from upper respiratory tract infections (URTI) without immunological disorders, we searched for a possible tool to improve the health of these children.

We evaluated whether a dietary advice including standard supportive care, can decrease the number and duration of URTI compared to standard supportive care in children aged 1–4 years with recurrent URTI.

Material and Methods

Design: A multicenter randomized controlled trial, with an intervention group receiving the dietary advice plus standard supportive care and a control group receiving standard supportive care alone.

Setting: 3 Outpatient clinics in The Netherlands (urban and rural).

Patients: 118 Children aged 1–4 years with recurrent URTIs.

Intervention: A dietary advice consisting of five times per week green vegetables, 3 times per week beef, 300 mL whole milk per day, whole dairy butter on bread every day. Portion sizes are age appropriate. The intervention lasted for 6 months.

Results

Children in the intervention group had 4.8 (1.6–9.5) days per month with symptoms of an URTI in the last three months of the study, compared to 7.7 (4.0–12.3) in the control group (p = 0.03). The total number of URTIs during the study period of 6 months was 5,7 (± 0,55) versus 6.8 (± 0,49) respectively (p = 0.068). Total use of antibiotics was markedly reduced in the intervention group (p = 0.034), as well as the visits to the general practitioner (p = 0.031), therefore possibly reducing healthcare costs.

No adverse effects were observed in the lipid profiles, nor in growth parameters (weight, height, BMI).

Discussion and conclusions

This study shows a reduced number of days with symptoms of an URTI following a dietary advice consisting of green vegetables, beef and whole diary products. It did not significantly lower the number of infections. No adverse effects were observed.

Registration

This trial is registered in the Dutch Trial Register, NTR4898, www.trialregister.nl.
Weight loss, adherence, and dietary intakes of free-living adults consuming calorie-restricted diets varying in macronutrient composition: the POUNDS LOST Study
Authors: Champagne Catherine , Miketinas Derek , Sacks Frank , Bray George
Published: June 2020

Various diets have been examined as potential weight-loss treatment for individuals with overweight and obesity. POUNDS LOST was a 2-year randomized clinical trial examining effects of four calorie-restricted diets of varying macronutrient composition on weight loss in free-living adults with obesity. The main results demonstrated that reducing calories, regardless of macronutrient content, can reduce body weight. Participants were randomized to receive one of four diets: 1) 20% fat, 15% protein; 2)20% fat, 25% protein; 3) 40% fat, 15% protein; and 4) 40% fat, 25% protein. Eight hundred eleven (811) subjects participated in the trial and weight loss, as expected, varied considerably. Three hundred forty-five participants (54.8% female; 86.5% Caucasian, 12.4% African American, and 1.1% other) provided baseline and 6-month follow-up dietary data. Dietary adherence was defined as consuming within + 5% of the target macronutrient composition for fat and protein. Stepwise regression and cross-validation techniques were used to model weight loss as a function of the following predictors: age, dietary adherence, energy density change, and fiber intake. Additionally, we explored whether all four diet types were healthy using the Healthy Eating Index 2015 (USDA). At 6 months, participants assigned to each diet had lost an average of 6 kg. Mean weight loss among adherers however was -8.4 + 5.0 kg and also did not vary across diet-type. Change in energy density was positively associated with weight change while age, dietary adherence, and fiber intake were inversely associated with weight change. Fiber intake was the strongest predictor of weight change; on average, a 10 g increase in fiber intake was associated with 2.2 kg decrease in body weight after 6 months of the dietary intervention. Only 46 (13.3%) of the 345 participants who provided follow-up data (61% male, 93% Caucasian) met the criteria for adherence to both energy (± 10% of target) and macronutrient targets. A decrease in energy density was positively associated with weight change for each diet-type; however, this effect was most profound in the high-fat, average-protein diet. Healthy Eating Index 2015 scores for the diets consumed by the subjects were: LF/AP, 74.8 ± 9.7; LF/HP, 73.8 ± 12.4; HF/AP, 73.4 ± 13.0; and HF/HP, 74.2 ± 9.8, which exceeds the scores of most Americans. These results suggest that dietary factors may positively influence weight loss in addition to energy intake and macronutrient composition. Furthermore, modified macronutrient, calorie-reduced diets can indeed be healthy compared to current dietary habits of US adults.
Food futures: Storylines of dietary megatrends along the Shared Socioeconomic Pathways (SSPs)
Authors: Alessandrini Roberta , Bodirsky Benjamin Leon
Published: June 2020

Under- and over-nutrition are among the most important global health determinants, and the agro-food system is the main interface between human society and the natural world and thereby responsible for land cover change, water withdrawals, greenhouse gases, biodiversity loss and nutrient pollution.

We formulated five qualitative storylines of future dietary developments using the Shared Socioeconomic Pathways (SSPs), a tool widely used in the climate change research community. Our storylines diverge in respect to the main actors in the food system, the policy framework, the food supply chain organisation, consumer context, dietary composition, health systems and health outcomes in respect to under- and over-nutrition. We titled each storyline with combinations of iconic foods that would be representative of each future.

SSP1 = Minestrone and Enjera (sustainable diets). The civil society is the main actor in shaping the food system and diets are mainly unprocessed and plant-based. The health burden from under- and overnutrition is drastically reduced in societies all over the world.

SSP2 = Pizza Hawaii with a side salad and banana (middle of the plate). This is a continuation of the current trends. The food industry is the main actor of the food system providing highly marketed processed food. Undernutrition slowly declines in the least developed countries, but obesity and NCDs increase drastically in both LMIC and HIC.

SSP3 = Kohlroulade and instant noodles (rocky road). Populistic and monopolistic governments are the main actors in shaping the food system. Diets are made of traditional and unhealthy dishes. Obesity and micronutrient deficiencies coexist and the nutrition-related burden of disease is high.

SSP4 = Kaviar and beans (inequality). A small and wealthy elite is the key actor shaping the political and the global food system. Diets are luxurious, highly customised and marketed for wealthy, and consisting of cheap and simple ingredients for the vast majority. While the elite enjoys healthy and long lives, malnutrition and stunting remain widespread in LMICs; obesity and diet-related NCDs decline everywhere.

SSP5 = Artificial meat burger with a skinny milkshake (fossil fuel). A few large tech companies are the main actors shaping the food system. Algorithms based on big-data provide customised diets consisting of superfoods and new foods. Under-nutrition disappears, BMI converges to normal levels, while diet-related NCDs remain prevalent.

The existing storylines in the literature do not focus on the agro-food system and on health and nutrition outcomes. Our work contributes to the ongoing conversation on food futures.
A healthy plant-based diet from adolescence towards young adulthood: psychosocial determinants and nutrient intake/status correlates
Authors: Michels Nathalie
Published: June 2020

Introduction

New dietary recommendations focus on a plant-based diet. As dietary habits are formed during adolescence, knowledge on determinants of this food choice in this age-group can help prevention campaigns. Since an unbalanced choice in plant-based food might lead to nutrient deficiencies, it is also crucial to detect its association with nutrient intake and nutrient status.

Methods

In 2330 adolescents from the European HELENA study in 2006, a healthy plant-based diet index (hPDI) was calculated based on two 24 h recalls. In Belgium, 69 of them were remeasured in 2016 as young adults. The psychosocial determinants nutritional knowledge, advantages, awareness, social support, social norm, self-efficacy, barriers, availability and intention were tested by multiple linear regression. Nutrient status was determined by 16 markers in fasting blood. Linear regressions with hPDI as predictor and nutrient intake/status as outcome were adjusted for age, sex, socio-economic status, BMI, waist circumference, energy-intake, physical activity and smoking.

Results

There was a strong correlation in hPDI after 10 years (Spearman = 0.56, p < 0.001). Determinants for adolescents’ plant-based diet were in descending order being a girl(β = 0.245;p < 0.001), a higher BMI(β = 0.140;p < 0.001), knowing the advantages(β = 0.104;p < 0.001), having availability over healthy food(β = 0.100;p < 0.001), high self-efficacy(β = 0.087;p < 0.001), health awareness(β = 0.072,p = 0.004), younger age(β = -0.048;p = 0.015) and better nutritional knowledge(β = 0.046;p = 0.020). In adolescents, hPDI was associated with lower energy intake, especially less overall fat, cholesterol, saturated fatty acids, mono-unsaturated fatty acids, proteins and mono/di-saccharides but more fibre. In micronutrients, higher intake of calcium, iron, magnesium, potassium, zinc, copper, vitamin A, C, E, K but less vitamin B12 and D were detected. Concerning nutrient status, hPDI was related to higher low-density cholesterol, vitamin D, vitamin C and beta-carotene levels. In adults, hPDI was associated with lower energy intake, especially less overall fat, cholesterol, saturated fatty acids and mono-unsaturated fatty acids but more carbohydrates and fibre, magnesium and vitamin C; while not with nutrient status. Longitudinally, we confirmed the link with intake of more fiber, potassium and less cholesterol. Additionally, a longitudinal positive association with poly-unsaturated fat intake was seen.

Conclusion

Tracking of hPDI over 10 years proved the importance of targeting these determinants in adolescents. The hPDI was indeed generally linked to a healthier dietary intake, especially more fiber, a healthier fat choice and higher vitamin intake except for lower vitamin B12 and D. Nevertheless, the latter two were not reflected in more deficiencies and nutrient status differences were limited.
Cognitive restraint and history of weight-loss diet are associated with organic food consumption in a large population-based sample of adults
Authors: Péneau Sandrine , Virecoulon-Giudici Kelly , Baudry Julia , Méjean Caroline , Lairon Denis , Bénard Marc , Touvier Mathilde , Hercberg Serge , Hercberg Serge , Bellisle France , Kesse-Guyot Emmanuelle
Published: June 2020

Organic food consumption has risen in many countries during the past decades, but individual behaviors leading to these choices remain unclear.. The aim of this study was to evaluate the associations between cognitive restraint, weight loss diet history and organic food intake, in French adults. This cross-sectional analysis included 21,516 participants from the NutriNet-Santé cohort (26.4% male, mean age 55.3 years; SD = 13.8). Cognitive restraint was evaluated by the Three-Factor Eating Questionnaire and practice of weight-loss diet in the past years was assessed by an ad hoc questionnaire. Organic food intake of 17 food groups was assessed by the Organic-Food Frequency Questionnaire. Adjusted means of proportions of organic food intakes out of total food intakes were compared across quartiles of the cognitive restraint score and weight loss diet history. Analyses were adjusted for sociodemographic and lifestyle factors. Women with higher levels of cognitive restraint had in average a lower contribution of organic foods in their diet (26.5% in Q4 vs. 30.9% in Q1; p < 0.0001). In addition, women with a history of weight loss diet had in average a lower contribution of organic foods in their diet (27.1% in current/past vs. 28.5% in never dieters; p = 0.0012). Associations were observed in men for specific food groups. Overall, individuals, and in particular women, with higher cognitive restraint scores or with a history of weight loss diet consumed less organic food. Results suggest that it can be too complex to follow both weight control and organic food choice strategies at the same time.
Alcohol consumption in early adolescence is differently associated with sociodemographic and psychosocial factors according to gender (HBSC 2014, Wallonia, Belgium)
Authors: Pedroni Camille , Dujeu Maud , Lebacq Thérésa , Moreau Nathalie , Desnouck Véronique , Holmberg Emma , Godin Isabelle , Castetbon Katia
Published: June 2020

Introduction

During adolescence, while the body is still in development, alcohol consumption can cause irreversible damages. Well-being and family, social and school environment may influence alcohol consumption among adolescents. According to their gender, they may be more or less receptive to some of these influences. Our aim was to identify potential gender differences in the correlates of alcohol consumption in early adolescence.

Methods

Analyses were based on 4,714 10–14-year-old adolescents attending schools in Wallonia, and included in the 2014 Health Behaviour in School-aged Children (HBSC) cross-sectional survey. Information were collected through self-administered questionnaires. Alcohol consumption was defined as having drunk at least one day during the last 30 days before the survey. Gender-stratified associations were estimated using multivariable logistic regressions.

Results

Twenty percent of 10–14-year-old adolescents (boys: 21.6%; girls: 18.0%) reported having consumed alcohol during the past month. After adjustment, associations with age, frequency of contacts via social networks and frequency of outings with friends after class hours, were similar in both genders. Adolescents aged 13–14 years (vs. 10–12 years), those who communicated at least every week via social networks (vs. less than once a week) and those who met their friends at least once after class hours (vs. less than once a week) were more likely to consume alcohol.

Boys’ and girls’ 2nd-generation migrants and boys’ 1st-generation migrants (vs. natives) were less likely to have consumed alcohol in the past month. Furthermore, boys and girls with “low” Family Affluence Scale (FAS) and boys from “medium” FAS (vs. “high”) were less likely to have consumed alcohol.

In boys only, school satisfaction was significantly associated with alcohol consumption during the past month (vs. those who liked school a lot: those who liked school a bit (OR = 1.88 [1.13–0.84]) or did not like school very much (OR = 2.20 [1.32–3.66]) or did not like school at all (OR = 2.91 [1.69–5.02]).

In girls, family status (vs. two-parent families: stepfamilies (OR = 1.43 [1.05–1.95])) and life satisfaction (vs. “high”: “low” (OR = 1.63 [1.19–2.26])) were significantly associated with alcohol consumption.

Conclusion

Although both genders share common risk factors (age, peer relationships, migration status and socioeconomic status), some differences have been highlighted. In boys only, school satisfaction was inversely associated with alcohol consumption. High life satisfaction and living in two-parent families seemed to play a protective role in girls only. These results should help better identify adolescents to be targeted in campaigns preventing early alcohol consumption.
The association between Vitamin D deficiency and risk of pre-diabetes among older adults
Authors: Trussler Emily , Navon Julia , Pojednic Rachele , Metallinos-Katsaras Elizabeth
Published: June 2020

Introduction

Type 2 Diabetes Mellitus is one of the most common conditions affecting older adults, and is one of few diseases with a distinct liminal stage: prediabetes. Dietitians and healthcare practitioners currently recognize prediabetes as a lifestyle disease,and “reversing” it relies largely on dietary modifications and increased exercise.Some research suggests that vitamin D may also be a target since its deficiency has been tentatively linked to many chronic conditions,5 and a high prevalence has been observed among subjects with prediabetes and type 2 diabetes.6, 7 The purpose of this study was to examine the association between vitamin D deficiency and risk of pre-diabetes in people 50 + years of age living in the United States.

Materials and Methods

This was a cross-sectional analysis of the US National Health and Nutrition Examination Survey (2007–2012) subjects, ages 50 + years, free of kidney/liver diseases and diabetes. Outcome: Prediabetes, was defined as: HbA1c level 5.7–6.5%, or fasting plasma glucose level 100–125 mg/dL, or Oral Glucose Tolerance Test result 140–199 mg/dL, with no laboratory value in the diabetic range. Those with normal glucose tolerance (NGT) with no marker in the prediabetes/diabetes range were the comparison group. Exposure: subjects' vitamin D status was classified based on total serum 25(OH)D levels as follows: deficient = < 50 nmol/L, insufficient = 50–75 nmol/L, and sufficient = > 75 nmol/L. The final sample (n = 2,286) was sufficient to detect a 7% difference in odds of prediabetes (the average difference observed in the literature) with 80% power and 95% confidence. Multivariate logistic regression analysis included strata, cluster and weight variables. Models were adjusted for BMI, ethnicity, age and gender.

Results

The final sample was 2,286 subjects, predominantly white (80.4%) and female (56.6%), with a mean age of 62.3 years; 1,387 had prediabetes (59.1%) and 899 were NGT (40.9%). Vitamin D status was associated with pre-diabetes (p = 0.03). Those with vitamin D deficiency were more likely to have prediabetes compared to vitamin D sufficient individuals (crude OR = 1.48 95%CI 1.15–1.91), which remained significant after adjustment for ethnicity, BMI, age and gender (aOR = 1.39 95%CI 1.02–1.89). There was no effect modification by BMI, gender or ethnicity.

Discussion

Our results contributed to this existing literature by demonstrating that vitamin D status is associated with pre-diabetes in a nationally representative sample of older US adults.Vitamin D status was significantly associated with risk of prediabetes in Americans 50 + years of age. Prevention efforts should incorporate awareness of vitamin D.
Long-lasting behavioural consequences of neonatal iron deficiency in high-risk children
Authors: McCarthy Elaine , Murray Deirdre , Kenny Louise , Hourihane Jonathan , Irvine Alan , Kiely Mairead
Published: June 2020

Little consideration has been given to the long-term consequences of iron deficiency in new-born infants. Fetal iron accretion is compromised by multiple pregnancy complications including preterm birth, gestational diabetes mellitus and fetal growth restriction, while our work has identified increased risks from maternal lifestyle factors such as smoking and obesity for low iron stores at birth. Early-life events, including C-section delivery, also add to this cumulative risk of neonatal iron deficiency, predisposing infants to iron deficiency later in infancy and early childhood. This study aimed to investigate the effect of neonatal iron deficiency on neurological development up to 5 years of age in term-born participants of a maternal-infant birth cohort in Ireland. In the Cork BASELINE Birth Cohort, 697 maternal-infant dyads with prospectively collected lifestyle and clinical data from 15 weeks’ gestation had umbilical cord serum ferritin concentrations measured. Neurological assessments were performed at 2 (Bayley Scales of Infant Development and Child Behaviour Checklist [CBCL]) and 5 (Kaufman Brief Intelligence Test and CBCL) years of age. In the cohort, median [IQR] cord ferritin concentrations were 200.9 [139.0,265.8] μg/L; 7.5% had neonatal iron deficiency (< 76μg/L). Using the risk factors for neonatal iron deficiency that we previously identified (smoking, obesity, C-section delivery, SGA) in this cohort, as selection criteria, we conducted an a priori sensitivity analysis in 306 children. Of the 306 children identified as high-risk, 12.4% had neonatal iron deficiency. Those with neonatal iron deficiency had higher median [IQR] CBCL internal (9.0 [5.3,12.0] vs. 5.0 [3.0,10.0]), external (7.5 [4.0,14.8] vs. 5.0 [2.0,10.0]) and total problem (24.5 [15.3,40.8] vs. 16.0 [10.0,30.0], all P < 0.05) scores at 5 years compared to those without neonatal deficiency. This adverse effect was especially apparent in children of obese mothers (n = 85) who were iron deficient at birth, with a total problem score at 5 years of 42.0 [24.5,54.5] compared to 16.0 [8.8,29.3] in those not deficient (P = 0.008). Associations were robust to adjustment for confounding factors. No effect on cognition or intelligence at 2 or 5 years was observed in this cohort. This study has identified behavioural consequences of neonatal iron deficiency. Interventions targeting the fetal/neonatal period could, therefore, represent a key opportunity for prevention of iron deficiency and its associated long-term neurological consequences. A dual approach is required, comprising public health strategies targeting prevention, through improving nutrition and health in women, and the development of screening strategies for early detection of iron deficiency in new-borns.
Acceptability to parents of a baby-led approach to introducing solids
Authors: Bacchus Sabina , Taylor Rachael , Fleming Elizabeth , Williams Sheila , Wheeler Benjamin , Taylor Barry , Heath Anne-Louise
Published: June 2020

In Baby-Led Weaning (BLW), infants are offered foods they can pick up and feed themselves from the start of complementary feeding. Infants who are fully BLW are not spoonfed at all by their parents, feeding themselves all their foods instead. The Baby-Led Introduction to SolidS (BLISS) study was a randomised controlled trial of the effect of a modified version of BLW5 on infant growth, iron status, and risk of choking, and provides an opportunity to investigate parents’ experiences of using a baby-led approach to infant feeding. Complementary feeding methods are usually chosen by parents, so it is important to ascertain whether parents find a baby-led method of introducing solids acceptable if they are assigned to follow it. This is both to determine whether it would be feasible to randomise them to follow BLW in future randomised controlled trials and because, if beneficial effects of BLW are shown, policy makers need to know whether parents would find it acceptable to follow BLW. The aim of this analysis was to determine the acceptability to parents of a baby-led approach to complementary feeding when their infant was 7 to 12 months of age. In total, 206 participants were randomised to Control (n = 101) or BLISS (n = 105) groups in the third trimester of pregnancy. When the infants were 7, 8, 9, and 12 months of age, questionnaires were administered to determine parents’ happiness and frustration with their feeding method, and attitudes regarding its convenience, mess, and expense. Food cost was estimated using supermarket prices linked to a 3-day weighed diet record collected at 7 months of age. Both groups reported high levels of happiness and convenience, but also reported finding complementary feeding very frustrating. There were two significant differences between the groups – the BLISS group reported less messiness, and were more likely to perceive their method as expensive. The actual food cost per day was not statistically significantly different between the two groups (NZ$1.70 for BLISS, NZ$1.90 for Controls). In conclusion, parents did not find a baby-led approach to introducing solids any less acceptable than control parents found standard infant feeding. It is, therefore, feasible to run studies where parents are randomised to follow a baby-led approach to complementary feeding and, should health advantages to BLW be identified, parents are likely to find BLW acceptable to follow.
Adipose tatty acid composition and gene expression in obesity, and response to chronic marine omega-3 fatty acid supplementation.
Authors: Fisk Helena , Ayres Rob , Childs Caroline , Miles Elizabeth , Clarke-Harris Rebecca , Lillycrop Karen , Calder Philip
Published: June 2020

Introduction:

Obesity is an excess of adipose tissue (AT) and is linked with increased inflammation that enhances risk of type-2 diabetes and cardiovascular disease. The BIOCLAIMS study assessed the effect of obesity on AT fatty acid composition and gene expression, and the responses of these to chronic omega-3 FA supplementation.

Materials and methods:

AT biopsies were collected pre- and post-12 week supplementation with 1.1 g EPA + 0.8 g DHA/day or corn oil. The composition of FA in the total lipid extract of AT from 37 normal-weight and 44 obese subjects was assessed by gas chromatography, whole AT transcriptome from 10 normal-weight and 10 obese subjects was assessed by RNA-Sequencing, and selected gene expression in AT of 27 normal-weight and 38 obese subjects was assessed by qRT-PCR.

Results:

789 AT genes were differentially expressed (623 upregulated, 175 downregulated) in obesity compared to normal-weight (FC > 2, P < 0.05). Differentially expressed genes included EGFL6, MMP-7 and -9, 5-LOX, WNT3 and WNT10B, DACT2, CNR1, SLC27A2 and PLA2G7, and were associated with immune and inflammatory response, cell proliferation, activation and movement, Wnt signalling, remodelling and expansion, and lipid incorporation and degradation.

Chronic supplementation with EPA + DHA increased the concentration of AT EPA, DPA and DHA in normal-weight subjects (P < 0.01), and EPA in obese subjects (P = 0.006). EPA + DHA modulated the expression of 26 genes (14 upregulated, 12 downregulated) in normal-weight subjects and 7 genes (3 upregulated, 5 downregulated) in obese subjects (FC > 2, P < 0.05). Of note, EPA + DHA downregulated IGLV1-44, IGLV1-51, PROK2, and TREM1 in normal weight subjects (P < 0.05), and IGLV1-44, IGLV1-47, DACT2 and IDO1 obese subjects (P < 0.05). Genes of note upregulated by EPA + DHA included KCNH2, GCGR, SLC36A2 and FOXC2 in normal-weight subjects, and MAB21L1, LRRTM4, and COX-2, in obese subjects. Differentially expressed genes were associated with a decrease in complement activation and immunoglobulin secretion, negative regulation of cell proliferation, and positive regulation of remodelling, amino acid and glucose transport, and COX pathway metabolite synthesis.

Discussion:

These data indicate an altered AT transcription profile and gene expression in obesity suggesting enhanced immune and inflammatory response, tissue expansion and remodelling, and changes to lipid metabolism, as well as dysregulation in response to supplementary EPA + DHA at a gene expression level. EPA + DHA are able to modulate AT gene expression predominantly associated with reducing immune response, but obesity may involve resistance to the effects on tissue remodelling and nutrient transport.
UPLC-MS/MS characterization of phenolic constituents in fennel seed extracts (Foeniculum vulgare Mill.)
Authors: Zorić Zoran , Repajić Maja , Kruk Valentina , Levaj Branka , Bursać Kovačević Danijela , Landeka Jurčević Irena , Dragović-Uzelac Verica
Published: June 2020

Reports in the recent literature indicate that consumption of phytochemicals (e.g. plant polyphenols) has been associated with a wide range of health benefits. Fennel (Foeniculum vulgare Mill.) is common Mediterranean plant that has been widely used as medicinal and aromatic herb. Numerous studies reported the use of fennel extracts (plant or seed) due to its diversity of phenolic compounds to whom inhibitory effects against several diseases are prescribed. Hence, phenolic compounds isolated from fennel are of the great interest for the use in food, chemical and pharmaceutical industries.

In order to obtain the highest quality of the fennel extracts, the selection of an effective extraction procedure is required. Nowadays, innovative extraction techniques have been introduced for isolation of bioactive compounds from plant material, among which pressurized liquid extraction (PLE) was reported as automated extraction procedure that combines effects of elevated temperature and pressure to increase the efficiency of the extraction process. Improved efficiency is also achieved by selecting the right solvent and by optimizing processing conditions (temperature, static time, cycle number).

Thus, PLE was applied for the extraction of phenolic compounds from fennel seeds. The effects of exhaustive extraction (acetone followed by methanol) as well as extraction temperatures (75 and 100 °C), static time (5 and 10 min) and cycle number (1,2,3) on the phenolic compounds concentrations were evaluated. A total of 27 phenolic compounds were identified and characterized by UPLC-ESI-MS/MS whereas 6 different categories are distinguished: (1) simple phenolic acid derivatives, (2) hydroxycinnamoylquinic acid derivatives, (3) flavonoid diglycosides, (4) flavonoid O-rhamnoglucosides, (5) flavonoid glucuronides and (6) flavonoid glycosides. Phenolic compounds were identified by comparing retention time and m/z values obtained by MS and MS/MS with the mass spectra from corresponding standards whereas the quantification was made on the basis of their peak areas and comparison with calibration curve obtained with the corresponding standards. Obtained results indicated that hydroxycinnamoylquinic acid derivatives (10 compounds) and flavonoid glucuronides (3 compounds) were found as the most abundant phenolics in acetone and methanol extracts, respectively. Statistical analysis showed that optimized PLE conditions for the most effective extraction of phenolic compounds were as follows: 100 °C/10 min/3 cycles for acetone and 100 °C/5 min/3 cycles for methanol extracts. In conclusion, PLE might be considered as a rapid and effective extraction procedure that could be useful in production of fennel seeds extracts.
Anti-inflammatory dietary intervention improved metabolic profile and body composition of obese adults
Authors: Jovanović Gordana Kenđel , Žeželj Sandra Pavičić , Majanović Sanja Klobučar , Šutić Ines Mrakovčić , Krešić Greta
Published: June 2020

It has become evident that chronic low-grade inflammation associated with excess adipose tissue plays an important role in the etiology of insulin resistance and other obesity related metabolic disturbances. Weight loss intervention focusing on anti-inflammatory dietary modification might help to attenuate and eventually reverse these disturbances. In this random case-control nutrition intervention study we hypothesized that obese patients will improve their inflammatory and metabolic status together with body composition following anti-inflammatory diet during 24 weeks. Body composition parameters of 42 obese patients, who completed the study, were determined by bioelectrical impedance analysis (Seca®, mBCA 515 Medical Body Composition Analyzer). Their inflammatory status was assessed with high-sensitivity C-reactive protein (hs-CRP), and insulin resistance with HOMA index. The inflammatory potential of their diet was assessed by the Dietary Inflammatory Index (DII®), based on 37 food parameters which derived from 123-item food frequency questionnaire. A positive DII® designates a diet with pro-inflammatory potential, while negative DII® designates a diet with anti-inflammatory potential. Data and z-scores were analyzed with Statistica v13.3 (StatSoft Inc., Tulsa, USA) for baseline and study end parameters differences. Obtained results have shown that, at the end of study, the patients significantly reduced their body weight (-3.3 %, p < 0.001), BMI (-3.2 %, p < 0.001), waist circumference (-1.9 %, p < 0.001), total (-3.3 %, p < 0.001) and visceral body fat (-10.4 %, p < 0.001), total (-3.1 %, p < 0.001) and extracellular water (-2.9 %, p < 0.001). The patients also significantly reduced hs-CRP (-37.7 %, p = 0.0025). Although we observed noteworthy -10.7 % reduction of HOMA index, this finding did not reach statistical significance (p = 0.862). The inflammatory potential of patients’ diet changed significantly from -0.45 to -1.73 on average (p < 0.001). With presented dietary intervention study it could be concluded that the change of the diet toward more anti-inflammatory milieu had significant influence on body weight, total and visceral body fat reduction. Consequently, those changes could have been involved in observed significant improvement of their inflammatory status. However, mild reduction of insulin resistance and rather small study group pointed out the need for further studies with more comprehensive dietary intervention.
The effectiveness of a low-fat vegan diet for the prevention and management of type 2 diabetes: A systematic review
Authors: Webb Alex , Lane Katie
Published: June 2020

Global diabetes prevalence is projected to rise from 382 million in 2013 to 592 million in 2030 with type 2 diabetes (T2D) accounting for 90–95% of cases(1,2). Approximately 4.7 million people in the UK had diabetes in 2018, this is estimated to rise to over 5 million by 2025(2) costing the NHS £15.1bn by 2035(3).

Low-fat vegan (LFV) diets are associated with improvements in T2D biomarkers(4) however, to date no systematic review has evaluated the effectiveness of LFV diets in prevention and management of T2D. The aim of this study was to assess effects of LFV diets on T2D biomarkers in controlled trials for those with, or at risk of developing T2D.

The review followed the PRISMA checklist for systematic reviews and used Cochrane Collaboration search strategies, which support the identification of randomised controlled trials (RCT's)(5). Searches were conducted and titles and abstracts screened for relevance by two independent review authors (AW or KEL). Studies that evaluated a LFV diet to reduce the risk of, or manage T2D using controlled trials were included with publication range from January 2003 to June 2018.

Search criteria identified 130 articles, which reduced to 21 upon abstract and title screening. Further application of inclusion/exclusion criteria led to identification of six key studies. Four studies were RCT's, and two were cluster-controlled trials at corporate sites, one of which was randomised. In three of the studies participants were previously diagnosed with T2D, in two of the studies participants had a BMI ≥ 25 kg/m2 and/or were previously diagnosed with T2D, and one study had participants with BMI between 28 and 40 kg/m2. Four studies had a control group (non-intervention) two of which had a conventional diabetes diet (American Dietetic Association(6)) as a comparison group. Mean study length was 28.3 weeks; ranging from 16–74 weeks. An intention-to-treat and medication adjusted analysis was carried out; significant effects for BMI, body weight, HbA1c, fasting plasma glucose, LDL, HDL and total cholesterol were reported in most of the studies.

Results from this systematic review demonstrate that a LFV diet is an effective alternative therapy to improve T2D biomarkers in those with, or at elevated risk of developing the disease. The LFV diet showed consistent positive effects on T2D biomarkers. Its effects are comparable to conventional T2D diets and energy restrictive diets, despite absence of restrictions on energy intake or portion sizes.