bluuebunny/crossref_metadata_2025 huggingface dataset:
B vitamin intake in early adulthood and cognition in late midlife: CARDIA
Authors: Qin Bo , Xun Pengcheng , Zhu Na , Jacobs David , Steffen Lyn , Daviglus Martha , Van Horn Linda , Reis Jared , Loria Catherine , Liu Kiang , He Ka
Published: June 2021

Epidemiologic evidence regarding B vitamin intake in association with cognitive function in late midlife is limited. We hypothesized that higher intake of B vitamins predicted better cognition in late midlife. This study comprised a community‐based multicenter cohort of black and white men and women aged 18–30 years in 1985–1986 (Y0) from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The CARDIA diet history at Y0 was used to assess nutrient intake, including dietary and supplemental B vitamins‐ thiamine, riboflavin, niacin and folic acid. Cognitive function was measured once at Y25 by Rey auditory‐verbal learning (RAVLT) for verbal memory, Digit symbol substitution test (DSST) for psychomotor speed, and modified Stroop interference test for executive function. After multivariate adjustment, the highest quintile (Q5) of riboflavin intake (median 5.4 mg/day) was significantly associated with 0.71 more words recalled in RAVLT (p=0.001 vs Q1, median 1.3 mg/day). 10 mg/day of niacin was associated with 0.3 more digits in DSST, the highest quintile of niacin intake predicted 3.6 more digits in DSST (p<0.001 vs Q1). We found a threshold association of folic acid intake with memory (0.6 word for Q5 vs Q1, p=0.001). In conclusion, higher intake of B vitamins in early adulthood was associated with better cognitive function in late midlife.

Grant Funding Source: UNC Chapel Hill start‐up funding, Lineberger Cancer Center
Fish intake and cognitive function in Chinese older adults: the China Health and Nutrition Survey (CHNS)
Authors: Qin Bo , Mendez Michelle Ann
Published: June 2021

Primary prevention to reduce cognitive decline is of great public health significance. Epidemiologic evidence on associations between fish intake and cognitive function in older adults is mixed, with limited data from China. We hypothesized that higher fish intake would predict better cognition in Chinese older adults. This study comprised a household‐based cohort of older adults (≥55y) who undertook cognitive function tests in 2000 and 2004 within the China Health and Nutrition Survey (CHNS). Three‐day 24‐ hour dietary recalls were used to assess fish intake in 2000. Outcomes were immediate and delayed memory measured by a 10 word verbal‐learning task, and working memory by the serial 7 subtraction test. After multivariate adjustment for age, gender, education, total energy intake, physical activity, alcohol drinking, smoking and respective cognitive scores in 2000, fish intakes ≥1 serving/wk was associated with 0.34 more words recalled in the delayed recall task in 2004 (p=0.023), and 0.34 higher serial 7 test scores (p=0.002), each compared with fish intake <1 serving/wk. In exploratory analysis, we found that hypertension modified the relation between fish intake and delayed memory. There was a stronger association of fish intake with delayed memory among subjects with hypertension (0.85 words, p=0.022). In conclusion, higher fish intakes predicted better cognition 4 years later in Chinese older adults.

Grant Funding Source: UNC Chapel Hill start‐up funding, Lineberger Cancer Center
Characteristics and Barriers Associated with Participation in the Supplemental Nutrition Assistance Program (SNAP) Participants by Persons Living with HIV
Authors: Hatsu Irene , Campa Adriana , Baum Marianna K , Thomlison Barbara , Johnson Paulette , Huffman Fatma
Published: June 2021

Objective

SNAP serves 50 million Americans. For HIV‐infected people in poverty, SNAP participation provides nutritional support for the management of HIV disease. The objective of this study was to characterize barriers for participation in SNAP in this population.

Methods

After consenting 175 participants, questionnaires on sociodemographics and lifestyle were collected. SPSS was used for analyses.

Results

Participants were 66% male, 74% African‐American and 70% received SNAP. Antiretroviral use (OR=15.2, 95%CI:4.3–52.7,p<0.001), income<$1000/month (OR=5.28,95%CI:1.6–17.0,p=0.006) and US‐born (OR=16.50,95%CI:3.6–75.5, p<0.001) were associated with SNAP participation; 27% of nonparticipants cited denial of application as the main reason for not participating in SNAP. Recent incarceration (17.4%) and being unaware of eligibility or living or living in a shelter (15.4%) were barriers to participation.

Conclusion

SNAP participation is high in this HIV‐infected cohort; however, recent incarceration and living in a shelter are barriers that are distinct to this population. Outreach programs targeting low income HIV‐infected persons should consider these barriers and develop strategies to overcome them.
Microalbuminuria and hypertension among Turkish immigrants in the Netherlands with type 2 diabetes
Authors: Sukram Shiryn , Zarini Gustavo G , Shaban Lemia , Huffman Fatma G
Published: June 2021

The study examined the association of microalbuminuria (MAU), as determined by albumin‐to‐creatinine ratio (ACR), with hypertension (HTN) among Turkish immigrants with type 2 diabetes (T2D). A total of 110 participants, physician‐diagnosed with T2D, aged 30 years and older were recruited from multiple sources from The Hague, Netherlands in a cross‐sectional design. Systolic blood pressure and diastolic blood pressure were measured using automated office blood pressure equipment. Urine albumin was measured by immunoturbidimetric assay. Urine creatinine was determined using the Jaffe method. MAU was defined as ACR ≥ 3.5 mg/mmol for females and/or ACR ≥ 2.5 mg/mmol for males. MAU was present in 21% of Turkish immigrants with T2D. Adjusted logistic regression analysis indicated that the odds of having MAU were 6.6 times higher in hypertensive than those that were normotensive (P = 0.03; 95% confidence interval [CI]: 1.19, 36.4). These findings suggest that HTN and MAU may be assessed as a standard of care for T2D management for this population. Prospective studies of diabetes outcomes are recommended to further verify these findings.
Vitamin D intake of adults differs by income, gender, and ethnicity in the United States, 2007–2010
Authors: Moore Carolyn E , Radcliffe John , Liu Yan
Published: June 2021

Total, dietary and supplemental vitamin D intakes in the US were compared by poverty income ratio (PIR), ethnicity, and gender using dietary intake and dietary supplement use from 24‐h recalls and supplement questionnaires of the 2007–2010 National Health and Nutrition Examination Surveys (NHANES). Statistical analyses of weighted data were performed (SAS V 9.2) to estimate means ± SE. Ethnic intake differences controlling for age, gender and PIR were assessed by ANCOVA. Total (dietary and supplement) vitamin D intake was greater in the high versus the medium PIR category, 10.6 ± 0.4 vs 8.1±0.3 ug/d, respectively. Total vitamin D intake of Whites (11.7±0.9 ug/d) was greater than Hispanics (8.9±0.4 ug/d) and Blacks (8.02±0.6 ug/d). Although dietary and total vitamin D intake did not differ by gender, supplemental vitamin D intake by females (5.8±0.4 ug/d) was greater than males (4.4±0.6). Adults19–30 y had the lowest (6.4 ± 0.2 ug/d) vitamin D intake (77% did not meet the EAR). Adults >; 70 y had the highest (16.8±1.4 ug/d) vitamin D intake (49% did not meet the EAR). Increasing supplementation use and fortification of foods with vitamin D is warranted. Funding: TWU Chancellor's Research Fellowship
Factors associated with not using antenatal iron/folic acid supplements in Indonesia: the 2002/2003 and 2007 Indonesia Demographic and Health Survey
Authors: Titaley Christiana Rialine , Dibley Michael J
Published: June 2021

Objective

To examine factors associated with non use of antenatal iron/folic acid (IFA) supplements in Indonesia.

Methods

This study used data from two most recent Indonesia Demographic and Health Survey (IDHS), the 2002/2003 and 2007 IDHS and providing survival information of 26,591 most recent deliveries over 5 years, prior to each survey. The outcome variable was non use of IFA supplements. Using logistic regression we examined the role of external environment, predisposing, enabling, need factors, and previous utilization of maternal care services in non use of antenatal IFA supplements.

Results

Amongst external environmental factors, mothers from outer Java‐Bali Region and rural areas had increased odds for not using antenatal IFA supplements. For the predisposing factors, the odds increased along with the reduction of household wealth index and parental education. Enabling factors associated with increased odds for non use of IFA supplements included mothers reporting money to pay health services (OR=1.28, p<0.001) and distance to health services (OR=1.20, p=0.03) was a major problem. Our study also demonstrated the importance of antenatal care as a distribution channel of IFA supplements.

Conclusion

Efforts to increase the use of antenatal IFA supplements should be conducted comprehensively by addressing the significant predictors of IFA utilization, as found in this study.

Research Support:

None
Your neighborhood is not my neighborhood: a mapped comparison of the neighborhoods of public housing developments with other neighborhoods in Boston
Authors: ElShourbagy Sanae Yu , Farmer Grant W , Bowen Deborah
Published: June 2021

Components of a neighborhood provide insight into people's daily life and needs. Limited food access can subsequently adversely affect health status. Challenges to environmental accessibility to healthy foods and transportation are drivers of obesity. Therefore, the immediate environment of people who live in public housing developments may not be conducive for residents to purchase and eat healthy foods, and be physically active. Mapping Boston's public housing developments with ArcGIS (Geographic Information Systems) and defining key asset characteristics of the neighborhoods surrounding them is a powerful strategy to visually depict regions which are known as “food deserts” due to the limited accessibility to healthy foods. Food deserts proximal to public housing developments may then be major factors in the occurrence of obesity in urban at‐risk populations. We demonstrate the relevant differences between neighborhoods containing public housing developments and those which do not. We further use mapping to present an accessible picture of a complex urban public health issue: the interaction between type of neighborhood and differential access to healthy nutrition and activity options.CDCU48DP001922

Grant Funding Source: CDCU48DP001922
Different Settings, Common Solution: A Healthy Menu Designation Program in Restaurants and Institutions
Authors: Biediger‐Friedman Lesli , Sosa Erica T , Shields Kathleen
Published: June 2021

¡Por Vida! (PV) is a healthy menu logo and recognition program originally developed for restaurants in 2010 but expanded to institutional food services in 2011. This study objective was to compare PV implementation across these two settings. Data collected included an environmental assessment, patron awareness survey, and key informant interviews. Participants included key stakeholders, 5 restaurant brands with locations throughout the city,5 institutions, and patrons at participating institutions and restaurants. Results from the patron survey suggest that visibility of the PV logo was important in food selection; however, 58.5% of institutional patrons saw the logo when ordering, but 87% indicated no impact on food choice. Of restaurant patrons seeing the logo, 74.6% selected PV items. The environmental assessment indicated a variety of marketing techniques in both settings and frequency of marketing techniques across all sites were observed. Greater frequency of the PV logo and supporting information was observed in the institutional settings. Lastly, restaurant stakeholders indicated a need for more information of the PV program. Both settings requested additional training and support. Institutions reported initiating their own PV promotions. In conclusion, positive findings were observed in both settings; key differences were observed in implementation, marketing, and patron behavior.
Increased healthy food purchasing associated with exposure to carry‐out intervention in low‐income urban setting
Authors: Lee‐Kwan Seung Hee , Yong Rachel , Bleich Sara N , Gittelsohn Joel
Published: June 2021

Americans are eating out more frequently. This is particularly true in low‐income urban settings where residents commonly purchase foods at carry‐outs (non‐franchised food establishments selling ready to‐eat food and beverages for off‐premise consumption). Baltimore Healthy Carry‐outs, a three phase multi‐component environmental intervention, was conducted in four carry‐outs, with another four as matching comparisons (Feb – Sept 2011). To assess impact, intervention exposure assessment was conducted (n=186) and exposure scores were created to reflect the 24 intervention strategies. Linear and logistic regression analyses using cluster robust variance were used. Intervention carry‐out customers purchased 4.5 varieties of promoted healthy items while comparison customers purchased less than 1 item (p<0.001). There was a strong dose response relationship between the combined intervention exposure score (range 0–24) and the frequency of healthy food purchased (beta 0.38, CI 0.26–0.49). Among customers exposed to the intervention, there were increased odds of purchasing specific healthy food items, such as a turkey club sandwich (OR 1.54, p<0.0001), fruit cup (OR 1.37, p<0.0001), or cooked greens (OR 1.30, p<0.0001). An environmental intervention at carry‐outs was shown to effectively increase healthy food purchasing frequency among consumers.

Grant Funding Source: Johns Hopkins Center for a Livable Future and Diabetes Research & Training Center
Children's response to food price and warning interventions when purchasing snack foods
Authors: Cash Sean B , Adamowicz Wiktor L. , Allen Shannon , McAlister Anna R.
Published: June 2021

Objective

The process by which children make food purchasing decisions is not well understood, despite some evidence that children have considerable autonomous purchasing power, and that much of it is directed toward food. Of particular interest is the extent to which proposed “fat taxes” and inclusion of additional information may influence children's food purchases and consumption, and what developmental measures best predict responsiveness to such interventions.

Methods

Incentive‐compatible purchase experiments involving snack foods conducted with 10–12 year olds in after‐school problems in Edmonton, Alberta, accompanied by 6 measures of child development.

Results

Participating children show responsiveness to price of snack food items in the experimental setting.

Conclusion and comment

The ability to influence children's food purchasing choices depends on their attending to price differences and point‐of‐purchase information. The role of children's autonomous purchasing decisions has largely been ignored by practitioners and researchers to date, but is key to understanding the complete picture of modern children's diets. Research support was provided by the Agriculture and Agri‐Food Canada Research Network on Consumer and Market Demand.
Identifying healthy foods for promotion in an urban corner store intervention
Authors: Liu Debra , Budd Nadine , Cuccia Alison , Jock Brittany , Jeffries Jayne , Katz Fred , Gittelsohn Joel
Published: June 2021

In Baltimore City, 33% and 35% of adults are either overweight or obese, respectively. Interventions aimed at improving the food environment, particularly in corner stores, have been shown to increase access to healthier foods in low‐income settings. It is important to identify healthy foods for such programs through formative research, which helps interventionists understand the target population's food needs in order to develop culturally appropriate strategies. Both structured and unstructured pile sorts with healthier foods and beverages were conducted with 33 (15 females, 18 males) low‐income African American adult residents of Baltimore City, in order to better understand how individuals categorize these items and their likelihood to purchase them at corner stores. Multi‐dimensional scaling and average‐link cluster analysis (stress=0.141) using Visual Anthropac identified 3 groups: (1) drinks, (2) dairy products and (3) fruits, vegetables, and fiber foods. Reduced‐fat cheese, 1% milk and baked chips were ranked low in likelihood to buy across all rankings, while fruits such as grapes and bananas were ranked high. These results were used to create the phases for a corner store intervention.

Funded by National Heart, Lung & Blood Institute (Grant #1R21HL102812–01A1).
Frequency and manner of usage of pulse crops in school meals in Michigan
Authors: Waldrop Megan E. , Rueda Janice M.W.
Published: June 2021

Obesity remains a health concern among US school children, and as of 2009, the prevalence of obesity among children in the state of Michigan was 11.9%. School lunches offer an opportunity to introduce healthy and nutritious foods into the diets of children. Pulse crops, which include dry beans, dry peas, lentils and chickpeas, are low cost sources of both dietary fiber and potassium, which have been identified by the USDA as Nutrients of Concern. The aim of this study was to identify usage patterns of pulse crops in Michigan school food service. School lunch menus were obtained for elementary, middle and high schools of 13 Michigan school districts for the month of May 2012. Districts varied in enrollment size, proportion of students eligible for free and reduced meals, and food service provider type. Frequency and type of usage of pulse crops was analyzed and differences among district characteristics were assessed. Results indicate the frequency of use of pulse crops in school meals in Michigan is very low and only slightly variable. These results demonstrate that, despite the economic and nutritional advantages pulse crops offer school meals, they remain underutilized.
A longitudinal study on infant and young child feeding (IYCF) trajectories identifies maternal and household capacities that influence the effectiveness of a behavior change communications (BCC) intervention in Bangladesh
Authors: Zongrone A A , Roopnaraine T , Bhuiyan MI , Afsana K , Pelto GH , Rasmussen KM , Stoltzfus RJ , Saha K , Menon P
Published: June 2021

Many factors influence the effectiveness of BCC interventions, including delivery of the intervention, feasibility of changing the specific behaviors, and recipient capacities. A qualitative study was conducted in the context of a BCC intervention to study the role of maternal capacities (MC) and household capacities (HC) in shaping breastfeeding (BF) and complementary feeding (CF) practices. Interviews were conducted with mothers, fathers, and grandmothers in 17 households in 2 sub‐districts during 2 critical IYCF periods: 0–6 mo and 7–11 mo. Text data, transcribed from interviews, were coded and analyzed using NVivo 10. IYCF trajectories varied across children and most children maintained sub‐optimal trajectories from 0–11 mo. A few shifted from suboptimal BF to optimal CF, and others from optimal BF to suboptimal CF. Caregiver beliefs around specific practices, issues of time management, control over resources, autonomy, program exposure, as well as individual caregivers’ and children's vulnerabilities and strengths emerged as factors that influence how participants responded to the intervention. Identifying and implementing approaches that address the important role of capacities to respond to interventions should be priorities for programs that want to enhance their impact. Support: Alive & Thrive, funded by the Bill & Melinda Gates Foundation and managed by FHI360; NIH (5T32HD007331).
Vitamin and Micronutrient Intakes among Women of Reproductive Age in Vietnam
Authors: Ramakrishnan Usha , Nguyen P H , Copeland E , Lowe A E , Strizich G , Nguyen H , Pham H , Truong T , Nguyen S , Reinhart G A , Harding K B , Neufeld L M , Martorell R
Published: June 2021

Micronutrient deficiencies are a public health concern in Vietnam negatively affecting maternal and child health outcomes. However, information on micronutrient intake among women of reproductive age (WRA) is lacking. Data from a survey of 5011 WRA participating in preconceptional micronutrient supplementation trial (PRECONCEPT) in Thai Nguyen province was used to identify food sources and estimate the adequacy and determinants of micronutrient intakes. Dietary intake was assessed using a validated 107‐item food‐frequency questionnaire. Starchy staples were the main source of iron and zinc (33% and 50%, respectively) with only a small proportion from meat (9% and 17%, respectively). The primary source of folate and vitamin A were vegetables; vitamin B12 came from meat and eggs. Median intake of most micronutrients were within recommended daily intake, but inadequate intakes were identified for iron (41%), zinc (7.0%), folate (54%), vitamins B12 (62%) and A (32%). Socioeconomic status was the main determinant of micronutrient intakes. WRA in the wealthiest quintile consumed 26% more iron, 19% more zinc, 36% more folate, 82% more vitamin B12 and 47% more vitamin A compared to those in the poorest quintile. Targeted efforts to promote the consumption of local nutrient rich foods along with educational programs and social development are needed.

Funding: The Mathile Inst. and the MI.
Cesarean delivery and maternal knowledge are important predictors of early breastfeeding practices in Bangladesh, Ethiopia and Vietnam
Authors: Begum Khadija , Dewey Kathryn G. , Peerson Janet , Saha Kuntal K. , Ali Disha , Nguyen Phuong H. , Rawat Rahul , Menon Purnima
Published: June 2021

Early breastfeeding (BF) practices have major health consequences. We compared predictors of early BF practices among children <24 mo of age in Bangladesh (BD), Ethiopia (ET) and Vietnam (VN), using data from baseline household surveys conducted in 2010. Multivariable logistic regression models were used to model predictors of early initiation (< 1 h) of breastfeeding (EIBF), no prelacteal feeding (NPF) and 0–3 day exclusive BF (D3EBF). Rates of EIBF, NPF and D3EBF were 64%, 52% and 47% in BD, 67%, 91% and 85% in ET and 59%, 43% and 33% in VN, respectively. Cesarean delivery was related to lower EIBF in all 3 countries (OR; 95% CI: 0.44; 0.27–0.72 in BD; 0.04; 0.01–0.28 in ET and 0.08; 0.05–0.11 in VN). Poor awareness of optimal BF initiation timing was related to low rates of EIBF (OR; 95% CI: 0.25; 0.19–0.33 in BD; 0.03; 0.02–0.06 in ET and 0.18; 0.14–0.23 in VN). Other factors linked to lower EIBF in at least 2 countries were fewer children <5 y in the household, minority religious affiliation, mother's age >;25 y and lower knowledge of colostrum feeding. Similar predictors were found for NPF and D3EBF, including Cesarean delivery in VN and poor awareness of EIBF (for NPF) in BD and ET.

Rates of early BF practices are suboptimal in all 3 settings and should be improved via interventions prior to and at the time of birth, regardless of mode of delivery care. Funding: Bill & Melinda Gates Foundation through Alive & Thrive, managed by FHI 360.

Grant Funding Source: Bill & Melinda Gates Foundation through Alive & Thrive
Serum thyroglobulin concentration as an index of iodine status in adults
Authors: Skeaff Sheila A , Thomson Christine D , Parnell Winsome R
Published: June 2021

Thyroglobulin (Tg) is a precursor of thyroid hormone and shows promise as an index of iodine status. The 2008/09 New Zealand (NZ) Adult Nutrition Survey used a multi‐stage, stratified, probability‐proportionate to size sampling method to obtain a representative sample of adults 15 years and older. Participants were visited in their own home where socio‐demographic, dietary, biochemical (i.e. spot urine and blood sample), and anthropometric data were collected. The median (25th, 75th percentile) urinary iodine concentration (UIC) of NZ adults (n=3033) was 57 (34, 95) μg/L, which falls between 50–99 μg/L indicating mild iodine deficiency. The median (25th, 75th percentile) Tg concentration was 15.3 (8.3, 26.3) μg/L, which falls between 10.0–19.9 μg/L confirming mild iodine deficiency. Participants of NZ European and Other ethnicity had a lower Tg concentration than Maori and Pacific People (12.8 vs 16.2 and 15.1 μg/L, respectively; P=0.002). The Tg concentration of participants with a UIC <100 μg/L was 13.9 μg/L, which was significantly higher than those with a UIC ≥100 μg/L (10.4 μg/L; P<0.001). The serum Tg concentration of iodine deficient NZ adults was elevated. This study provides evidence that Tg can be used to assess iodine status in adult populations. The NZ Ministry of Health funded the Adult Nutrition Survey. The results presented in this paper are the work of the authors.
Very low micronutrient intake adequacy of young children in rural Bangladesh is explained by limited diversity of nutrientrich foods
Authors: Arsenault Joanne E , Yakes Elizabeth A , Islam M Munirul , Hossain Mohammad B , Ahmed Tahmeed , Hotz Christine , Lewis Bess , Rahman A Shafiqur , Jamil Kazi M , Brown Kenneth H
Published: June 2021

Documentation of micronutrient intake inadequacies among children in developing countries is important for planning food‐based interventions. This study quantified and assessed adequacy of micronutrient intakes of young children in rural Bangladesh. We measured 24‐h dietary intakes on two non‐consecutive days in a representative sample of 480 children ages 24–48 months using weighed food records and recall in homes. We calculated the probability of adequacy of usual intakes of 11 micronutrients, an overall mean probability of micronutrient adequacy (MA), and evaluated dietary diversity by counting the total number of nine food groups consumed. The relationship between overall adequacy of micronutrient intakes and dietary diversity scores or food group indicators was determinate using multivariate regression analyses. The overall mean prevalence of MA was 43% ± 16%. Fewer than 10% of children had adequate intakes of calcium, folate, and vitamin A, and < 50% of children had adequate intakes of iron, riboflavin, and vitamin B–12. Overall MA was primarily explained by energy intake and diet diversity. Food groups that explained variance in MA were dairy, eggs, meats, and vitamin A‐rich fruits and vegetables. Micronutrient adequacy among young children in rural Bangladesh is alarmingly low, and targeted food‐based interventions are warranted.
Decline in Childhood Iron Deficiency After Interruption of Malaria Transmission in Highland Kenya
Authors: Cusick Sarah Eastman , Frosch Anne E. P. , Ondigo Bartholomew N. , Ayodo George A. , John Chandy C.
Published: June 2021

In malaria‐endemic areas, recurrent malaria may contribute to functional iron deficiency (ID) in children. In a highland area of Kenya, we previously showed that children <5 y had increased hemoglobin (Hb) levels after interruption of malaria transmission from April 2007 to July 2008. In the present study, we sought to determine prevalence of ID and its relationship to changes in Hb in these children. Iron status markers were measured in 189 children aged 4–59 mos in plasma samples collected in May 2007 and July 2008. Indicative of improved iron status, median (IQ range) plasma ferritin (PF) increased from 17.0 μg/L (9.7, 25.6) to 22.6 μg/L (13.1, 34.7; P < 0.001), while median (IQ range) soluble transferrin receptor decreased from 5.8 mg/L (4.8, 7.5) to 5.0 mg/L (4.1, 6.3; P < 0.001). ID prevalence (PF <12 μg/L or PF <30 μg/L if C‐reactive protein >; 10 mg/L) decreased from 34.4% to 23.8% (P = 0.005), and prevalence of ID + anemia (Hb < 11.0 g/dL) declined from 25.6% to 11.6% (P < 0.001). Children with ID in 2007 had a greater increase in Hb (mean, g/dL [95% CI], 1.15 [0.72, 1.57]) than children without ID (0.51 [0.26, 0.76], P=0.007). In this highland area, prevalence of ID in children decreased after interruption of malaria transmission, and this decrease contributed in part to a concurrent increase in Hb levels. Malaria elimination could lead to a decrease in ID and ID‐related anemia in malaria‐endemic areas. Support: NIAID U01 AI056270.
Dietary intake of polyunsaturated fatty acids and C‐reactive protein in persons with Human Immunodeficiency Virus Infection
Authors: Poudel‐Tandukar Kalpana , Poudel Krishna C.
Published: June 2021

Background

C‐reactive protein (CRP) has been associated with disease progression in HIV‐positive people. Polyunsaturated fatty acids (PUFA) are known to be inversely related to CRP in people without HIV. We tested the hypothesis of an independent relationship between PUFA and CRP in a HIV‐positive people.

Methods

A cross‐sectional study was conducted among 250 HIV‐positive people aged 20 to 60 years residing in Nepal. Serum high‐sensitivity CRP concentrations were measured by the latex agglutination nephelometry method. Dietary intake was assessed using two nonconsecutive 24‐hour dietary recalls. The relationship between PUFA and CRP were assessed using multiple regression analysis.

Results

Multivariate‐adjusted mean values of serum CRP concentrations decreased with increased intake of PUFA. The mean values of serum CRP concentrations in the first, second, and third tertiles of PUFA were 1.73 mg/L, 1.32 mg/L, and 1.26 mg/L, respectively (P for trend=0.11). The mean values of serum CRP concentrations in the first, second, and third tertiles of PUFA in women were 1.93 mg/L, 1.62 mg/L, and 1.09 mg/L, respectively (P for trend=0.04). No clear association was seen between PUFA and CRP in men.

Conclusion

The higher intakes of PUFA may have a beneficial role against inflammation in HIV‐positive people.

Source of research support: Grant‐in‐Aid for Young Scientists (B) (22790581), Japan.
Zinc status and its association with C‐reactive protein and leptin levels in pediatric patients with Prader‐Willi syndrome
Authors: Buraso Chutdanaiphakorn , Wattanasirichaigoon Duangrurdee , Sae‐Chew Pattarana , Phoonlapdacha Phanphen , Dumrongwongsiri Oraporn , Sangcakul Areeporn , Suthutvoravut Umaporn , Chongviriyaphan Nalinee
Published: June 2021

Zinc (Zn) is essential for normal growth and development in children. Patients with Prader‐Willi syndrome (PWS) have morbid obesity and short stature. We conducted this cross‐sectional study to determine levels of plasma Zn, leptin, soluble leptin receptor (leptin sR), and serum C‐reactive protein (CRP) in pediatric patients with PWS.

We enrolled 3 groups of children aged 2–15 years: 12 diagnosed with PWS, 18 with exogenous obesity, and 18 healthy with normal weight for height as controls. Levels of plasma Zn, leptin, leptin sR and serum CRP were measured.

The PWS group had lower plasma Zn than the exogenous obesity and control groups (9.0±1.5, 12.1±3.1, 15.0±2.9 μmol/L, respectively; p=0.006 and p<0.001). Zn deficiency was found in 83.3%, 38.9%, and none of those in the PWS, exogenous obesity, and control groups. The PWS group had higher CRP than the other 2 groups (7.1, 2.3, 1 mg/L, respectively; p=0.001 and p<0.001). The PWS group had higher leptin but lower leptin sR levels than the other 2 groups. Plasma Zn had negative correlations with CRP and leptin.

In conclusion, pediatric patients with PWS had Zn deficiency, increased CRP levels, and leptin resistance. The results from our study suggest that pediatric patients with PWS have a risk of inflammatory process that may be associated with Zn deficiency.

This study was funded by the Nutrition Association of Thailand (Nestle Nutrition Institute Research Award)
The effects of neighborhood and individual level covariates on individual dietary patterns: the Jackson Heart Study
Authors: Manjourides Justin , Hickson DeMarc , Talegawkar Sameera , Liu Jiankang , Tucker Katherine L
Published: June 2021

Dietary patterns consisting of combinations of food used to represent overall nutrient intake, have recently been used to better capture the overall nutritional habits of an individual and their effects on risk of cardiovascular disease. Relationships between neighborhood and individual level covariates and dietary patterns have not been examined in an African American (AA) population. Using multilevel modeling, we examined cross‐sectional relationships between neighborhood socio‐economic factors, availability of fast food restaurants and previously defined dietary patterns, while adjusting for age, sex, education, BMI, smoking status, and physical activity. The three dietary patterns, derived via factor analysis, used in this analysis are named “southern,” “fast food,” and “prudent.” Two neighborhood factors were inversely associated with the prudent diet, including the density of the AA population (p=0.02), and a summary index measure of neighborhood advantage (higher scores correspond to greater neighborhood advantage) (p<0.001). This advantage index is also inversely associated with the southern dietary pattern (p=0.03). Of particular interest is that we saw no neighborhood‐level covariate associations, including proximity to fast food restaurants, with the fast food pattern, suggesting that proximity to fast food restaurants may not influence dietary intake in this population.
Rice consumption is associated with better nutrient intake and diet quality in adults: National Health and Nutrition Examination Survey (NHANES) 2005–2010
Authors: O'Neil Carol E. , Nicklas Theresa A , Fulgoni Victor L
Published: June 2021

NHANES data (2005–2010) were used to assess the association of rice consumption by adults (19+yrs; N=14,386) with nutrient intake and diet quality. Rice consumption groups were <0.25, >;0.25 to <0.5, >;0.5 to <1.0, and >;1.0 oz eq of usual intake of rice. Diet quality (using the Healthy Eating Index [HEI]) was calculated. Covariate adjusted least square means ± SE were determined and quartile trends examined. Significant (p < 0.001) positive trends (beta coefficient across rice quartiles) were seen for fiber (0.57 g), thiamine (0.09 mg), niacin (1.03 mg), folate (58.2 μg DFE), copper (0.05 mg), magnesium (11.8 mg), iron (1.0 mg), and sodium (119 mg). Significant negative trends were seen for total and added sugars (−1.3 and −5.1 g, respectively); total, solid, and saturated fats (−3.3, −3.9, and −1.8 g, respectively), and calcium (−41 mg). HEI also showed a positive trend with rice consumption (2.25 points). HEI component scores for whole fruit (0.11); dark green/orange vegetables (0.25), total grains (0.10), meat/beans (0.24), and oils (0.14) were higher (p<0.01) in rice consumers. HEI component scores for saturated fats (0.64), SoFAAS (1.24) were higher suggesting more favorable intake, but sodium (−0.25) was lower. Overall, consumption of rice should be encouraged to improve nutrient intake and diet quality. Nutrition education can provide ways to reduce sodium added to rice dishes. Support: USDA & Rice Federation
Acid‐lowering Agent Use and Vitamin B12 Status Among Puerto Rican Adults
Authors: Xiao Rui , Reeves Katherine W. , Bertone‐Johnson Elizabeth , Noel Sabrina E. , Tucker Katherine L.
Published: June 2021

Vitamin B12 deficiency affects approximately 6% of adults over 60 years of age and is associated with several chronic diseases. Puerto Ricans are the second largest Hispanic subgroup in the US and have been identified as having excess chronic conditions. Prior studies suggest that use of acid‐lowering agents (ALAs) may be associated with increased risk of vitamin B12 deficiency, but this relationship has not been examined among Puerto Ricans. We conducted a cross‐sectional analysis to evaluate the relationship between ALA use and vitamin B12 status among 1390 Puerto Rican adults aged 45–75 years. Serum B12 and methylmalonic acid (MMA) concentrations were assayed from blood samples. B12 deficiency was defined as Serum B12 < 200 pg/mL or < 350 pg/mL plus MMA >; 270 pM/ml. The prevalence of B12 deficiency was 8.2%, but greater in older than in younger adults (11.8% for 60–75 y, and 7.2% for 45–60 y). Current ALA users tended to have lower serum B12 concentrations as compared to nonusers (P=0.25), but ALA use was not significantly associated with prevalence of B12 deficiency in the full sample. When examined in non‐supplement users (n=1343), vitamin B12 deficiency is prevalent in this population and may be aggravated by ALA use without concomitant use of vitamin B12 supplements.

This study was supported by the National Institutes of Health grants P01 AG023394 and P50 HL105185.

Grant Funding Source: National Institutes of Health grants P01 AG023394 and P50 HL105185
Trajectories of an unhealthy dietary pattern from 1991 to 2006 and diabetes in Chinese adults: A new approach to study longitudinal diet
Authors: Ruvalcaba Carolina Batis , Popkin Barry
Published: June 2021

We used an innovative technique to capture trajectories of a dietary pattern and assess their relationship to diabetes. We included 4780 adults with 3 to 6 waves of diet data (1991 to 2006) and HbA1c measure in 2009 from the China Health and Nutrition Survey. Diet was assessed by a household food inventory and three 24‐h recalls. We used Reduced Rank Regression (SAS 9.3) to identify a dietary pattern in 2006 that positively predicted HbA1c (high in wheat flour, buns & breads, cookies, pastries & deep‐fried wheat, corn, and soy‐milk; and low in rice, fresh leafy vegetables and lard & butter). A score for this pattern was estimated for each subject at each wave. We used Latent class trajectory analysis (Mplus 6) to group subjects that share similar trajectories of their dietary pattern's score over time. We estimated the prevalence ratio (PR) for diabetes (HbA1c ≥6.5) adjusting by age, gender, geographical region and education:

The results provide insights into how the trajectory of an unhealthy dietary pattern affects diabetes. The highest prevalence was among those that started high and increase their score over time (# 2); whereas those that started even higher, but had an important decrease over time (# 5) had a prevalence close to those that remained low the entire follow‐up (# 1).

Trajectory
PR (95% CI)

#
intercept
slope

1
−1.2
0.03
1

2
1.8
0.08
2.3 (1.5, 3.6)

3
1.4
0.00
1.9 (1.4, 4.5)

4
0.0
0.02
1.3 (0.9, 1.8)

5
2.9
−0.19
1.2 (0.7, 2.3)

Grant Funding Source: CONACYT (grant 212018), NIH (R01‐ HD30880), the Fogarty International Center (D43‐TW009077)
Dietary Supplement Label Database (DSLD) Will Capture Information from Dietary Supplement (DS) Labels
Authors: Saldanha Leila G , Dwyer Johanna T , Bailen Richard A , Chang Florence F , Andrews Karen W , Bailey Regan L , Betz Joseph M , Burt Vicki L , Costello Rebecca B , Emenaker Nancy J , Gahche Jaime J , Hardy Constance J , Pehrsson Pamela R , Roseland Janet M
Published: June 2021

>;50,000 different DS products are offered for sale in the U.S. and ~50% of adults consume DS regularly.

Objective

To develop a public and user searchable database containing label information from virtually all DS products offered for sale in the U.S., with a Web‐based user interface providing ready access to the data.

Method

An ad hoc Federal Working Group provides guidance on the collection, classification, and handling of information from DS labels.

Results

Database information reflects what is printed on product labels and is publicly available through the National Library of Medicine (NLM) web portal. The name and form of active and inactive ingredients, amount(s) of active ingredient(s), and information about the manufacturer/distributor of products, label claims, warning statements, and percent of daily value will be captured, along with a photograph of the label. Software applications will eventually be added that will permit simple and enhanced search options enabling users to locate specific terms in any DS label field, along with a user interface designed to help users quickly find and sort information and links to other databases such as MedlinePlus®, PubMed® and NIH fact sheets.

Conclusion

DSLD will serve as a resource for population‐based surveys and other epidemiological studies. Funding: Office of Dietary Supplements and National Library of Medicine, National Institutes of Health
USDA Food Patterns Equivalents Database 2007–08
Authors: Bowman Shanthy , Friday James , Thoerig Rachel , Clemens John , Moshfegh Alanna
Published: June 2021

The Dietary Guidelines for Americans, 2010 provide recommendations on how much to eat from the USDA Food Patterns Groups such as Grains, Dairy, Fruits, Vegetables, and Protein Foods. The research objective was to develop the USDA Food Patterns Equivalents Database 2007–08 for the foods in What We Eat In America, the dietary component of the National Health and Nutrition Examination Survey 2007–08, by retooling the methodology that was used to create the MyPyramid Equivalents Database 2003–04. The retooling steps included consolidating the weights of one cup of fruits and vegetables such that similar types of fruits and vegetables will have the same weights; using 16 grams of flour as the basis for defining one ounce equivalent of grains for grain products made of flour and using 28.35 grams as one ounce equivalent of grains for breakfast cereals and grains; estimating added sugars equivalents from the total sugar values of the foods that are defined as added sugars; and defining the amount of alcoholic beverages that contain 14 grams of ethanol as one drink. Selected, day 1 mean intake estimates for individuals 2 years of age and over were: fruits, one cup equivalent of which one‐third came from fruit juice; vegetables, 1.4 cup equivalents of which about one‐fourth was from potatoes and one‐fifth from tomatoes; and dairy, 1.7 cup equivalents. The new methodology simplified the process, without affecting the quality of the data.
Trends in consumption and purchases of products sweetened with caloric and low‐calorie sweeteners among U.S. households, 2000–2010
Authors: Piernas Carmen , Ng Shu Wen , Popkin Barry M
Published: June 2021

Current food databases might not capture rapid changes in the food supply, such as increased use of both caloric (CS) and low‐calorie sweeteners (LCS) in products.

Using the Nielsen Homescan longitudinal dataset 2000–10 (n=523,445) and NHANES 2003–10 (n=36,802), we explored trends in purchases and intake of foods and beverages containing LCS, CS or both (LCS+CS) among U.S. households (HH); as well as SES and HH predictors of these patterns. We estimated percapita intake and purchases (ml/day); and % consumers and % HHs purchasing products containing LCS, CS or LCS+CS. We estimated change in purchases associated with SES and HH variables using average marginal effects from random‐effects longitudinal models.

From 2000–2011, trends in per capita intake and purchases decreased for CS products, but increased for LCS products. In particular, per capita and % HH purchasing LCS+CS products increased among all types of HH and particularly among HH with children. Factors such as African‐American HH; Hispanic HH and presence of children were associated with increased % of CS purchases (+11%; +4%; +3% resp., P<0.001) and decreased % of LCS daily beverage purchases (−14%; −6%; −2% resp., P<0.001). Higher income was associated with decreased CS (−2.4%, P<0.001) and increased LCS +1.3%, P<0.001) daily beverage purchases.

We found unique trends in products containing LCS+CS, which are rising particularly among HH with children.

Grant Funding Source: Robert Wood Johnson Foundation Grant 70017; National Institutes of Health R01‐HD030880 R01‐ HL104580 R01‐HL114091 R01‐HL108427
Use of human milk in U.S. advanced care neonatal units
Authors: Perrine Cria G , Scanlon Kelley S
Published: June 2021

Objective

The American Academy of Pediatrics recommends all preterm infants receive human milk.

Methods

We analyzed CDC's national Maternity Practices in Infant Nutrition and Care (mPINC) survey from 2007, 2009, and 2011 to describe the prevalence of infants in U.S. advanced care (special/level2 or intensive/level 3 NICU) neonatal units routinely receiving human milk, and the use of any donor milk in these units. mPINC is a census of all facilities providing maternity care, so no statistical tests were done.

Results

In 2007, 21.2% of hospitals reported most infants (≥90%) were routinely provided human milk in advanced care units, compared to 26.7% in 2009 and 30.8% in 2011. States in the northwest and northeast had a higher prevalence of hospitals routinely providing human milk to most infants in advanced care units. In 2007, 11.5% of hospitals providing advanced care used banked donor milk, compared to 14.4% in 2009 and 22.0% in 2011. Most of this increase occurred in intensive care units (25.1% 2007 vs. 45.2% 2011). There was substantial geographic variation in the prevalence of advanced care units using donor milk; generally the prevalence was higher in the west and in states with a milk bank in the state or neighboring state.

Conclusion

The use of human milk in U.S. advanced care neonatal units is increasing; however, only one‐third of these units are routinely providing human milk to most infants.
Effects of 8‐week body weight control program in public health center on self‐reported fatigue in Korean adult obese women
Authors: Chang Kyung Ja , Park So Yoon , You Jeong Soon
Published: June 2021

It was reported that self‐reported fatigue of women was higher compared to men and obesity per se lead to fatigue. So we investigated the effects of 8‐week body weight control program in public health center on self‐reported fatigue in obese women. The volunteer subjects (n=20) whose percent body fat was over 30 and lived in Incheon metropolitan city. Body composition was measured using Inbody 720 and serum lipid profiles and adipokines level were analyzed using automatic analyzer and ELISA, respectively. Self‐reported fatigue was determined using questionnaire of ‘subjective symptoms of fatigue test’ and higher fatigue scores indicate heavier self‐reported fatigue. After 8 weeks, average 2.7 kg body weight and 2.0 % body fat was decreased. Serum lipid profiles and adipokines level were not changed significantly after the program. There were significantly improved differences in physical fatigue score (p<0.05), mental fatigue score (p<0.01) and total fatigue score (p<0.05) between before and after the program. Especially, there were significantly decreased differences in the physical fatigue score of question such as “weary eyes” and “head feel heavy”, mental fatigue score of question such as “feel annoyance” and “not have confidence” and nervous fatigue score of question such as “feel dizzy” and “feel anyhow” between before and after the program These results suggest that 8‐week body weight control program in public health center had a positive effect on self‐reported fatigue as well as body composition.
Motivation to lose weight and the interaction of environmental factors
Authors: Thaw Andrew Kurt , Redhead Megan
Published: June 2021

Motivation is a difficult factor to measure precisely, yet is often touted as a key factor in successful weight loss. Researchers seeking to maintain motivation through goal setting and reinforcement schedules report enhanced success and maintenance of weight loss. Additionally, recent research has pointed to a role for environmental factors in regulating eating behavior and weight management. In the current study we use self‐reports of motivation as well as environmental cues to examine the possible interaction of these two variables during an 8‐week weight loss program. Results indicate that the highest levels of motivation are correlated with successful weight loss. Furthermore, environmental cues can be equally effective in leading to weight loss. The authors conclude that while there is no synergistic effect of combining high motivation with environmental factors, the interaction of these variables is apparent when motivation is moderate or low. There is perhaps a ceiling effect seen with high motivation. However, environmental cues may be employed to enhance or compensate for moderate to low levels of motivation to result in successful weight loss.