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The human gut microbiota can biosynthesize essential micronutrients such as B-vitamins and is also known for its metabolic cooperative behaviour. The present study characterises such B-vitamin biosynthesizers, their biosynthetic pathways, explores their prevalence and abundance, examines how lifestyle or diet affects them in multiple Indian cohorts and compares it with the Chinese cohort. To achieve this, publicly available faecal metagenome data of healthy individuals from multiple Indian (two urban and three tribal populations) and a Chinese cohort were analysed. The distribution of prevalence and abundance of B-vitamin biosynthesizers showed similar profiles to that of the entire gut community of the Indian cohort, and there were 28 B-vitamin biosynthesizers that had modest or higher prevalence and abundance. The omnivorous diet affected only the prevalence of a few B-vitamin biosynthesizers; however, lifestyle and/or location affected both prevalence and abundance. A comparison with the Chinese cohort showed that fourteen B-vitamin biosynthesizers were significantly more prevalent and abundant in Chinese as compared with Indian samples (False Discovery Rate (FDR) <= 0·05). The metabolic potential of the entire gut community for B-vitamin production showed that within India, the tribal cohort has a higher abundance of B-vitamin biosynthesis pathways as compared with two urban cohorts namely, Bhopal and Kasargod, and comparison with the Chinese cohort revealed a higher abundance in the latter group. Potential metabolic cooperative behaviour of the Indian gut microbiome for biosynthesis of the B-vitamins showed multiple pairs of species showed theoretical complementarity for complete biosynthetic pathways genes of thiamine, riboflavin, niacin and pantothenate.
Front-of-package warning labels introduced in Mexico in 2020 included disclaimers that caution against allowing children to consume products with non-sugary sweeteners and caffeine. We examined the awareness and use of the disclaimers among Mexican adults and youth 1 month after the regulation was implemented. We also investigated their impact on the perceived healthfulness of industrialised beverages designed for children.
Design:
Data on the awareness and use of the disclaimers were analysed. Two between-subjects experiments examined the effect of a sweetener disclaimer (Experiment 1, youth and adults) or a caffeine disclaimer (Experiment 2, only adults) on the perceived healthfulness of industrialised beverages. Interactions between experimental conditions and demographic characteristics were tested.
Setting:
Online survey in 2020.
Participants:
Mexican adults (≥18 years, n 2108) and youth (10–17 years, n 1790).
Results:
Most participants (>80 %) had seen the disclaimers at least rarely, and over 60 % used them sometimes or frequently. The sweetener disclaimer led to a lower perceived healthfulness of a fruit drink (adults: 2·74 ± 1·44; youth: 2·04 ± 0·96) compared with the no-disclaimer condition (adults: 3·17 ± 1·54; youth: 2·32 ± 0·96) (t’s: >4·0, P values: <0·001). This effect was larger among older adults and male youth. The caffeine disclaimer did not affect adult’s perceived healthfulness of a caffeinated drink (t = 0·861, P value = 0·3894).
Conclusions:
There were high awareness and use of the sweeteners and caffeine disclaimers shortly after the warning labels were implemented. The sweetener disclaimer appears to be helping consumers modify their perceptions regarding industrialised beverages for children. Findings may help decision-makers improve the regulation and better target communication strategies.
Systolic blood pressure (SBP) is significantly associated with body composition in children and adolescents. However, which one of the components of body composition is the dominant contributor to SBP in children and adolescents remains unclear. We, therefore, aimed to determine the dominant contributor to SBP among components of body composition in a large cohort of American children and adolescents derived from the National Health and Nutrition Examination Survey with cross-sectional analysis. In total, 13 618 children and adolescents (median age 13 years; 6107 girls) with available data on whole-body dual-emission X-ray absorptiometry measurements were included. Multiple linear regression showed that SBP was associated with higher total fat-free mass in boys (β = 0·49, P < 0·001) and girls (β = 0·47, P < 0·001) and with higher total fat mass only in boys (β = 0·12, P < 0·001) after adjustment for covariates. When taking fat distribution into consideration, SBP was associated with higher trunk fat mass (boys: β = 0·28, P < 0·001; girls: β = 0·15, P < 0·001) but negatively associated with leg fat mass (Boys: β = −0·14, P < 0·001; Girls: β = −0·11, P < 0·001), in both boys and girls. Dominance analysis showed that total fat-free mass was the dominant contributor to SBP (boys: 49 %; girls: 55·3 %), followed by trunk fat mass (boys: 32·1 %; girls: 26·9 %); leg fat mass contributed the least to SBP in boys (18·9 %) and girls (17·8 %). Our findings indicated that total fat-free mass was not only associated with SBP but also the most dominant contributor to SBP variation in American children and adolescents.
To review and synthesize studies on household food security in South Africa.
Design:
Systematic mapping review of metrics (methodological review).
Setting:
Electronic databases, including EBSCOHost, Scopus and Web of Science, were searched for studies and reports on household food security in South Africa, reporting household food security published between 1999 and 2021. Searching, selecting and reporting were performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.
Participants:
South African households
Results:
Forty-eight articles reporting on six national surveys (one repeated annually since 2002) and forty sub-national studies meeting the inclusion criteria were selected. Various metrics, with different recall periods and ways of categorizing food security levels, were identified. Surveys that used similar metrics showed that the percentage of South African households that have experienced food insecurity and hunger has decreased over the review period yet remains concerning. However, the multitude of metrics used to assess the different components and levels of food security limits the comparability of the results to evaluate the scope and scale of the problem.
Conclusions:
There is growing support for developing multi-variable approaches for food security research in sub-Saharan Africa. Future research should focus on finding the most appropriate combination of complementary metrics that would allow comparable data while holistically capturing food security and providing insight into the causes and consequences.
To assess the feasibility of a food-based diabetes self-management education and support (DSMES) intervention delivered to persons with type 2 diabetes (T2DM) and food insecurity.
Design:
This single arm pre-/post convergent mixed methods study tested the feasibility of a 3-month intervention using food boxes, recipes, DSMES and dietitian visits. Feasibility benchmarks assessed were acceptability (> 50 % participants satisfied), demand (> 50 % used program components) and implementation (75 % adherence, 80 % retention). Assessments included: self-reported food security, health-related quality of life, diabetes self-efficacy, socio-demographic and dietary intake, height, weight, and HbA1c and one in-depth interview with participants and key staff. Enrollment, recruitment and retention rates were summarised; qualitative data were analysed using structured thematic analysis (participant interviews) and key point summaries (staff interviews). Quantitative/qualitative data integration was conducted using a joint display.
Setting:
Food bank and Federally Qualified Health Center in the Southwestern U.S.
Participants:
English- or Spanish-speaking adults with T2DM and food insecurity.
Results:
In total, 247 patients with T2DM and food insecurity were recruited, seventy-one expressed interest and twenty-five consented. Twenty-one participants completed study measurements. 71 % (n 15) received six home food deliveries and ≥ 1 dietitian visit. A priori benchmarks were approached or met within each feasibility criterion – most participants found the intervention to be acceptable, used most or all intervention components, and reported some challenges within intervention implementation (e.g. timing of food deliveries). Data integration provided deeper understanding of reported intervention implementation challenges, yet high adherence to the intervention.
Conclusions:
The intervention was feasible. Next steps include a clinical trial to establish intervention efficacy.
The present paper provides an overview of the approach to developing food-based dietary recommendations in the UK. UK dietary recommendations are based on independent advice from the Scientific Advisory Committee on Nutrition (SACN). SACN's remit includes specific reference to the nutrient content of individual foods and advice on diet as a whole, including the definition of a balanced diet. SACN's approach is set out in its Framework for Evaluating Evidence and its assessments are supported by the data provided by the National Diet and Nutrition Survey. SACN's risk assessments have primarily focused on energy requirements, macro and micronutrients and/or the needs of specific population groups. However, dietary patterns or individual foods and health outcomes have been considered where sufficient evidence is available. An example of this is SACN's risk assessment on carbohydrates and health, which included consideration of evidence on sugar-sweetened beverages and the resulting dietary recommendations on free sugars and sugar-sweetened beverages led to a range of policies to reduce sugar intake in the UK, including the soft drinks industry levy. SACN has also recently published a position statement on processed foods and health. Government dietary advice is encapsulated in the UK's national food model, the Eatwell Guide. The Eatwell Guide shows the proportions in which different food groups should be consumed to have a well-balanced, healthier, more sustainable diet, to help meet nutrient requirements and reduce the risk of chronic disease. Any substantive change to government dietary advice is likely to lead to a review of the national food model.
Undernutrition in elders remains under-detected, under-treated, and under-resourced and leads to further weight loss, increased infections, and delay in recovery from illness as well as increased hospital admissions and length of stay. The reports of the findings were fragmented and inconsistent in Ethiopia. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of undernutrition and its association with dietary diversity among older persons in Ethiopia. Online databases (Medline, PubMed, Scopus, and Science Direct), Google, Google Scholar, and other grey literature were used to search articles until the date of publication. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity using Stata version 14.0 software. Out of 522 studies accessed, 14 met our criteria and were included in the study. A total of 7218 older people (aged above 60 years old) were included in the study. The pooled proportion of undernutrition among older persons in Ethiopia was 20⋅6 % (95 % CI 17⋅3, 23⋅8). Elders who consumed low dietary diversity scores were strongly associated with undernutrition among older persons. Therefore, promoting appropriate intervention strategies for elders to improve dietary diversity practices and nutritional status is crucial.
This review discusses epigenetic mechanisms and the relationship of infertility in men and women in relation to parameters pertaining to nutrition. The prevalence of infertility worldwide is 8–12 %, and one out of every eight couples receives medical treatment. Epigenetic mechanisms, aging, environmental factors, dietary energy and nutrients and non-nutrient compounds; more or less energy intake, and methionine come into play in the occurrence of infertility. It also interacts with vitamins B12, D and B6, biotin, choline, selenium, zinc, folic acid, resveratrol, quercetin and similar factors. To understand the molecular mechanisms regulating the expression of genes that affect infertility, the environment, the role of genotype, age, health, nutrition and changes in the individual's epigenotype must first be considered. This will pave the way for the identification of the unknown causes of infertility. Insufficient or excessive intake of energy and certain macro and micronutrients may contribute to the occurrence of infertility as well. In addition, it is reported that 5–10 % of body weight loss, moderate physical activity and nutritional interventions for improvement in insulin sensitivity contribute to the development of fertility. Processes that pertain to epigenetics carry alterations which are inherited yet not encoded via the DNA sequence. Nutrition is believed to have an impact over the epigenetic mechanisms which are effective in the pathogenesis of several diseases like infertility. Epigenetic mechanisms of individuals with infertility are different from healthy individuals. Infertility is associated with epigenetic mechanisms, nutrients, bioactive components and numerous other factors.
This review aims to investigate the relationship between the health impact of whole grains mediated via the interaction with intestinal microbiota and intestinal barrier function with special interest on tryptophan metabolism, focusing on the role of the intestinal microbiota and their impact on barrier function. Consuming various types of whole grains can lead to the growth of different microbiota species, which in turn leads to the production of diverse metabolites, including those derived from tryptophan metabolism, although the impact of whole grains on intestinal microbiota composition results remains inconclusive and vary among different studies. Whole grains can exert an influence on tryptophan metabolism through interactions with the intestinal microbiota, and the presence of fibre in whole grains plays a notable role in establishing this connection. The impact of whole grains on intestinal barrier function is closely related to their effects on the composition and activity of intestinal microbiota, and SCFA and tryptophan metabolites serve as potential links connecting whole grains, intestinal microbiota and the intestinal barrier function. Tryptophan metabolites affect various aspects of the intestinal barrier, such as immune balance, mucus and microbial barrier, tight junction complexes and the differentiation and proliferation of epithelial cells. Despite the encouraging discoveries in this area of research, the evidence regarding the effects of whole grain consumption on intestine-related activity remains limited. Hence, we can conclude that we are just starting to understand the actual complexity of the intestinal factors mediating in part the health impacts of whole grain cereals.
Accumulating evidence shows associations between rapid eating and overweight. Modifying eating rate might be a potential weight management strategy without imposing additional dietary restrictions. A comprehensive understanding of factors associated with eating speed will help with designing effective interventions. The aim of this review was to synthesise the current state of knowledge on the factors associated with eating rate. The socio-ecological model (SEM) was utilised to scaffold the identified factors. A comprehensive literature search of eleven databases was conducted to identify factors associated with eating rate. The 104 studies that met the inclusion criteria were heterogeneous in design and methods of eating rate measurement. We identified thirty-nine factors that were independently linked to eating speed and mapped them onto the individual, social and environmental levels of the SEM. The majority of the reported factors pertained to the individual characteristics (n = 20) including demographics, cognitive/psychological factors and habitual food oral processing behaviours. Social factors (n = 11) included eating companions, social and cultural norms, and family structure. Environmental factors (n = 8) included food texture and presentation, methods of consumption or background sounds. Measures of body weight, food form and characteristics, food oral processing behaviours and gender, age and ethnicity were the most researched and consistent factors associated with eating rate. A number of other novel and underresearched factors emerged, but these require replication and further research. We highlight directions for further research in this space and potential evidence-based candidates for interventions targeting eating rate.
Certain nutritional practices may reduce menstrual-related symptoms, but there is no current consensus on what foods/supplements are sufficiently evidenced to warrant promotion to reduce menstrual symptoms of naturally menstruating individuals. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two online databases were searched for published experimental studies that investigated the effects of foods/supplements on menstrual-related symptoms in eumenorrhoeic women. Extracted data and study characteristics were tabulated and grouped on the basis of food/supplement intervention and dosage compared with UK dietary reference values (DRV) and safe upper limits. In total, twenty-eight studies and twenty-one different foods/supplement interventions were included in the review. None of the studies reported a negative effect on symptoms, twenty-three reported a positive effect and five had no effect. Eighteen different ways of measuring menstrual-related symptoms were described across the studies. The results indicate a lack of consistency in studies to confidently provide information to eumenorrheic, naturally menstruating women regarding the use of foods/supplements to reduce menstrual symptoms. Determination of menstrual-related symptoms varied along with dose and duration of food or supplements provided. These data provide some evidence for the use of vitamin D, calcium, zinc and curcumin to reduce menstrual-related symptoms of non-hormonal contraceptive users, on an individual basis; however, further investigation is required prior to implementation with a focus on robust protocols to determine and measure changes in menstrual symptoms, with interventions adhering to DRV and safe upper limits.
This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.
Food insecurity – when individuals or households have difficulty accessing sufficient, safe, culturally appropriate and nutritious food due to lack of money or other resources – is a global public health concern. Levels of food insecurity have increased across the UK in recent years, due in part to a decade of austerity, widespread loss of income during the COVID-19 pandemic and the more recent cost-of-living crisis, leading to rising use of food banks. The stress of living with uncertain access to food and going periods without food is damaging to physical and mental health. Food insecurity is linked to both obesity and malnutrition, as often the most readily available foods are processed, high in fats, sugars and salt, but low in essential nutrients for health. While recognising that many of the drivers of food insecurity, and health inequalities more broadly (i.e. the social determinants of health) lie outside the health service, it is increasingly acknowledged that the National Health Service – and primary care in particular – has a key role to play in mitigating health inequalities. This review considers the potential role of healthcare in mitigating food insecurity, with a focus on primary care settings. Recent initiatives in Scotland, such as community links workers and general practitioner practice-attached financial advice workers, have shown promise as part of a more community-oriented approach to primary care, which can mitigate the effects of food insecurity. However, a more ‘upstream’ response is required, including ‘cash first’ interventions as part of broader national strategies to end the need for food banks.
Aligning with the United Nations Convention on the Rights of the Child, amplification of children’s voice in food practice research aims to inform initiatives that cater to children’s needs and thus improve nutritional outcomes. The aim of this study was to describe children’s (aged 6–11 years) involvement across qualitative research investigating their food practice perspectives.
Design:
A scoping review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). Six electronic databases were searched up until March 2023 (Cochrane, CINAHL, Embase, ERIC, Medline and PsychInfo). The Wellcome Framework for young people’s involvement in health research guided data extraction. Data were described according to inclusiveness, geography, food-related study topic, research stage and method, and child involvement.
Results:
The search identified 120 peer-reviewed studies (134 papers). Active participation was only seen within research implementation stages (i.e. data collection (n 134), analysis (n 31), dissemination (n 9) and re-design (n 7)). More passive forms of participation were identified in research design stages (i.e. agenda setting, resourcing and design). Studies that utilised participatory research methodologies and developmentally appropriate and engaging methods (e.g. PhotoVoice) saw more active participation by children.
Conclusion:
This review identified a lack of opportunities for children’s active participation in all stages of food practice research. Without a radical shift towards providing these opportunities, food and nutrition initiatives, policies or further research that do not meet the needs of children’s food-related worlds will continue to be developed. Instead, researchers and their institutions need to advocate for and, where possible, provide voluntary opportunities for children to actively participate in food practice research.
Hypercholesterolaemia is a major risk factor for CVD. Fish intake is associated with lower risk of CVD, whereas supplementation with n-3 long-chain PUFA (LC-PUFA) has little effect on the cholesterol concentration. We therefore investigated if cetoleic acid (CA), a long-chain MUFA (LC-MUFA) found especially in pelagic fish species, could lower the circulating total cholesterol (TC) concentration in rodents. A systematic literature search was performed using the databases PubMed, Web of Science and Embase, structured around the population (rodents), intervention (CA-rich fish oils or concentrates), comparator (diets not containing CA) and the primary outcome (circulating TC). Articles were assessed for risk of bias using the SYRCLE’s tool. A meta-analysis was conducted in Review Manager v. 5.4.1 (the Cochrane Collaboration) to determine the effectiveness of consuming diets containing CA-rich fish oils or concentrates on the circulating TC concentration. Twelve articles were included in the systematic review and meta-analysis, with data from 288 rodents. Consumption of CA-rich fish oils and concentrates resulted in a significantly lower circulating TC concentration relative to comparator groups (mean difference −0·65 mmol/l, 95 % CI (−0·93, −0·37), P < 0·00001), with high statistical heterogeneity (I2 = 87 %). The risk of bias is unclear since few of the entries in the SYRCLE’s tool were addressed. To conclude, intake of CA-rich fish oils and concentrates prevents high cholesterol concentration in rodents and should be further investigated as functional dietary ingredients or supplements to reduce the risk for developing CVD in humans.
Diets deficient in fibre are reported globally. The associated health risks of insufficient dietary fibre are sufficiently grave to necessitate large-scale interventions to increase population intake levels. The Danish Whole Grain Partnership (DWP) is a public–private enterprise model that successfully augmented whole-grain intake in the Danish population. The potential transferability of the DWP model to Slovenia, Romania and Bosnia-Herzegovina has recently been explored. Here, we outline the feasibility of adopting the approach in the UK. Drawing on the collaborative experience of DWP partners, academics from the Healthy Soil, Healthy Food, Healthy People (H3) project and food industry representatives (Food and Drink Federation), this article examines the transferability of the DWP approach to increase whole grain and/or fibre intake in the UK. Specific consideration is given to the UK’s political, regulatory and socio-economic context. We note key political, regulatory, social and cultural challenges to transferring the success of DWP to the UK, highlighting the particular challenge of increasing fibre consumption among low socio-economic status groups – which were also most resistant to interventions in Denmark. Wholesale transfer of the DWP model to the UK is considered unlikely given the absence of the key ‘success factors’ present in Denmark. However, the DWP provides a template against which a UK-centric approach can be developed. In the absence of a clear regulatory context for whole grain in the UK, fibre should be prioritised and public–private partnerships supported to increase the availability and acceptability of fibre-rich foods.
Dietary intake of long-chain n-3 PUFA (n-3 PUFA), particularly EPA and DHA, has been associated with psychological well-being, but little is known about the n-3 PUFA intake of homeless youth. The current study determined the association between depression and anxiety symptoms and n-3 PUFA intake and erythrocytes status in homeless youth. Totally, 114 homeless youth aged 18–24 years were recruited from a drop-in centre. n-3 PUFA dietary intake was assessed using an FFQ, and erythrocytes status was determined by gas chromatography (GC). Linear regression models were used to determine the relationship between psychological well-being and n-3 PUFA intake and status. The mean intakes of EPA and DHA for all participants (0·06 ± 0·13 g/d and 0·11 ± 0·24 g/d) were well below recommended levels, and mean erythrocytes EPA + DHA (n-3 index) in the cohort (2·42 %) was lower than reported for healthy, housed adolescents and those with clinical depression. There was no association of n-3 PUFA intake and erythrocytes status with either depression or anxiety. However, the relationships of depression with dietary EPA (P = 0·017) and DHA (P = 0·008), as well as erythrocytes DHA (P = 0·007) and n 3-index (P = 0·009), were significantly moderated by sex even after adjusting for confounders. Specifically, among females, as the intake and status of these n-3 PUFA decreased, depression increased. Our findings show poor dietary intake and low erythrocytes status of n-3 PUFA among homeless youth, which is associated with depressive symptoms among females.