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Early childhood growth is associated with cognitive function. However, the independent associations of fat mass (FM) and fat-free mass (FFM) with cognitive function are not well understood. We investigated associations of FM and FFM at birth and 0–5 years accretion with cognitive function at 10 years. Healthy-term newborns were enrolled in this cohort. FM and FFM were measured at birth, 1·5, 2·5, 3·5, 4·5 and 6 months and 4 and 5 years. Cognitive function was assessed using the Peabody Picture Vocabulary Test (PPVT) at 10 years. FM and FFM accretions were computed using statistically independent conditional accretion from 0 to 3 months, 3 to 6 months, 6 months to 4 years and 4 to 5 years. Multiple linear regression was used to assess associations. At the 10-year follow-up, we assessed 318 children with a mean (sd) age of 9·8 (1·0) years. A 1 sd higher birth FFM was associated with a 0·14 sd (95 % CI 0·01, 0·28) higher PPVT at 10 years. FFM accretion from 0 to 3 and 3 to 6 months was associated with PPVT at 10 years: β = 0·5 sd (95 % CI 0·08, 0·93) and β = −0·48 sd (95 % CI −0·90, −0·07, respectively. FFM accretion after 6 months showed no association with PPVT. Neither FM at birth nor 0–5 years accretion showed an association with PPVT. Overall, birth FFM, but not FM, was associated with cognitive function at 10 years, while the association of FFM accretion and cognitive function varied across distinct developmental stages in infancy. The mechanisms underlying this varying association between body composition and cognitive function need further investigation.
School food has a major influence on children’s diet quality and has the potential to reduce diet inequalities and non-communicable disease risk. Funded by the UK Prevention Research Partnership, we have established a UK school food system network. The overarching aim was to build a community to work towards a more health-promoting food and nutrition system in UK schools. The network has brought together a team from a range of disciplines, while the inclusion of non-academic users and other stakeholders, such as pupils and parents, has allowed the co-development of research priorities and questions. This network has used a combination of workshops, working groups and pump-priming projects to explore the school food system, as well as creating a systems map of the UK school food system and conducting network analysis of the newly established network. Through understanding the current food system and building network expertise, we hope to advance research and policy around food in schools. Further funding has been achieved based on these findings, working in partnership with policymakers and schools, while a Nutrition Society Special Interest Group has been established to ensure maximum engagement and future sustainability of the network. This review will describe the key findings and progress to date based on the work of the network, as well as a summary of the current literature, identification of knowledge gaps and areas of debate, according to key elements of the school food system.
Since lack of culture-specific foods in dietary assessment methods may bias reported dietary intake, we identified foods and dishes consumed by residents not born in Sweden and describe consequences for reported foods and nutrient intake using a culturally adapted dietary assessment method. Design consisted of cross-sectional data collection using (semi-)qualitative methods of dietary assessment (and national diet survey instrument RiksmatenFlex) with subsequent longitudinal data collection using quantitative methods for method comparison (December 2020–January 2023). Three community-based research groups were recruited that consisted of mothers born in Sweden, Syria/Iraq, and Somalia, with a median age of 34, 37, and 36 years, respectively. Women born in Syria/Iraq and Somalia who had lived in Sweden for approximately 10 years, reported 78 foods to be added to RiksmatenFlex. In a subsequent study phase, 69% of these foods were reported by around 90% of the ethnic minority groups and contributed to 17% of their reported energy intake. However, differences between the three study groups in median self-reported energy intake remained (Sweden 7.19 MJ, Syria/Iraq 5.54 MJ, and Somalia 5.69 MJ). The groups also showed differences in relative energy contribution from fats and carbohydrates, as well as differences in energy intake from food groups such as bread and sweet snacks. We conclude that a dietary assessment instrument containing culture-specific foods could not resolve group differences in reported energy intake, although these foods provided content validity and contributed 17% of energy intake. The dietary habits collected in this study serve to develop new dietary assessment instruments.
This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of 3 months. The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between 1 January 2020 and 31 December 2023. The primary outcome is the percentage weight loss. Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 (49·56 %)), followed by balanced dietary guidance (139 (41·00 %)) and pharmacotherapy (32 (9·44 %)). The total percentage weight loss for patients who were followed up for 1 month, 2 months and 3 months was 4·98 (3·04, 6·29) %, 7·93 (5·42, 7·93) % and 10·71 (7·74, 13·83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥ 3 % and ≥ 5 % at 1 month (OR = 0·461, P < 0·05; OR = 0·349, P < 0·001). The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.
Childhood and puberty can affect metabolism, leading to tissue injury and malfunction later in life. The consumption of high-processed foods rich in salt and sugar is increasing in middle- and high-income countries, especially among young people. It is necessary to evaluate the effects of high salt and sugar levels in the youth on most injured organs during metabolic challenges. We aimed to investigate whether high-salt/sucrose intake affects whole-body development and leads to end-organ injury. Weaned male Wistar rats were divided into two groups: a control group fed a standard diet and tap water, and an experimental group (SS) fed a standard diet and a beverage containing 1·8 % NaCl and 20 % sucrose instead of tap water. The animals were treated for 60 d, starting after weaning at 21 d of age, after which the animals were subjected to glucose and insulin tolerance tests, urine collection and heart rate monitoring and euthanised for sample collection at 81 d of age. SS showed reduced body weight gain and increased food intake of sodium/sucrose solution. Interestingly, high-salt/sucrose intake led to increased body adiposity, liver lipid inclusion, heart rate and renal dysfunction. SS exhibits increased levels of PPAR alpha to counterbalance the hypertrophy of brown adipose tissue. Our findings reveal that the SS rat model exhibits non-obvious obesity with end-organ damage and preserved brown adipose tissue function. This model closely parallels human conditions with normal BMI but elevated visceral adiposity, providing a relevant tool for studying atypical metabolic disorders.
Anaemia affects more than 36 % of all pregnancies globally and is associated with significant maternal and neonatal morbidity and mortality. Iron deficiency is widely recognised as the most common nutritional cause of anaemia but other nutrient deficiencies are also implicated, including the B vitamin riboflavin, albeit its role is largely under-investigated and thus typically overlooked. Riboflavin, in its co-factor forms flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN), is required for numerous oxidation-reduction reactions, antioxidant function and in the metabolism of other B vitamins and iron. While clinical deficiency of riboflavin is largely confined to low-income countries, sub-clinical (functional) deficiency is much more widespread, including in high-income countries, and is particularly common among women of reproductive age and during pregnancy. Limited observational evidence from high-income populations suggests that suboptimal riboflavin status contributes to an increased risk of anaemia. Furthermore, randomised controlled trials in pregnant women from low- and middle-income countries have demonstrated beneficial effects of riboflavin on haematological status and anaemia. Various mechanisms have been proposed to explain the contribution of riboflavin deficiency to anaemia, with the strongest evidence pointing to an adverse effect on iron metabolism, given that riboflavin co-factors are required for the release of iron from storage ferritin in the production of red blood cells. Overall, this review investigates riboflavin intakes and status during pregnancy in different populations and evaluates the available evidence for the under-recognised role of riboflavin in the maintenance of haemoglobin concentrations together with its potential to protect against the development of anaemia during pregnancy.
Over recent decades, the commercial ultra-processed food industry has grown, making snacks high in energy, added sugar, saturated fat and sodium affordable and accessible to consumers. Dietary patterns high in ultra-processed snacks are concerning as this can result in negative health outcomes. This study aims to provide insight into available snack products in South African supermarkets, and the marketing thereof, which can be used to support policy development aimed at improving the healthfulness of the food supply and consumption patterns.
Design:
This was an observational cross-sectional, mixed-method study.
Setting:
Secondary data from six major supermarket chains (eight stores) in three different suburbs in Cape Town, South Africa was analysed to evaluate the nutritional composition of snack products (n 3837). The same eight supermarkets were revisited to obtain information on marketing via an observational checklist. Qualitative interviews were also conducted with store managers.
Results:
Majority (89 %) of the products assessed either contained non-sugar sweeteners or were high in sugar, saturated fat or sodium. These snack items that are high in nutrients of concern to limit were available at checkout areas in all stores and were found in high-traffic areas, and several in-store promotional strategies such as branded displays, special offers and combo-deals were commonly found.
Conclusion:
The current South African supermarket environment encourages consumers to purchase unhealthy snacks. Most snacks assessed in this study cannot be recommended for regular consumption due to the nutritional composition being high in nutrients linked to poor health outcomes. There is a need for regulation of the in-store marketing of unhealthy snacks in South Africa. Retail settings are potential intervention points for limiting exposure to these unhealthy products.
The liver has multiple functions such as detoxification, metabolism, synthesis and storage. Folate is a water-soluble vitamin B9, which participates in one-carbon transfer reactions, maintains methylation capacity and improves oxidative stress. Folic acid is a synthetic form commonly used as a dietary supplement. The liver is the main organ for storing and metabolising folate/folic acid, and the role of folate/folic acid in liver diseases has been widely studied. Deficiency of folate results in methylation capacity dysfunction and can induce liver disorders. However, adverse effects of excessive use of folic acid on the liver have also been reported. This review aims to explore the mechanism of folate/folic acid in different liver diseases, promote further research on folate/folic acid and contribute to its rational clinical application.
Dietary Mn intake may have a beneficial effect in reducing cancer risk; however, its association with thyroid cancer (TC) risk remains inadequately understood. Additionally, Mn was associated with inflammation markers. Thus, we examined whether dietary Mn intake emerges a protective role against TC and whether this preventative effect has an interaction with IL1 receptor type 1 (IL1R1) rs3917225. The prospective study was designed at National Cancer Center in Korea between October 2007 and December 2020 including 17 754 participants. We identified TC cases by following participants until December 2020. Mn intake was collected using a semiquantitative food frequency questionnaire (SQFFQ). Genotyping was performed to determine IL1R1 rs3917225. The hazard ratios (HR) and 95 % confidence interval (CI) were calculated with a Cox proportional hazards model. We ascertained 108 incident TC cases throughout follow-up duration. Dietary Mn intake was found to be inversely associated with TC risk (HR (95 % CI)=0·64 (0·44, 0·95)). However, IL1R1 rs3917225 seemed to modify this association; the protective effect was limited to G-allele carriers (HR = 0·30 (0·11, 0·86), P interaction=0·028). A higher dietary Mn was suggested to be a protective factor against TC. Additionally, we drew a potential biological interaction between Mn intake and IL1R1 rs3917225 with a greater effect among individuals with a minor allele. This implies that when considering the cancer-preventive role of Mn, it is important to account for the influence of inflammatory gene participation.
The Mediterranean-Dietary Approach to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet is a dietary pattern designed to prevent cognitive decline. Dietary adherence is assessed with the MIND diet scoring system, which is currently based on the American diet and serving sizes. It is known that serving sizes and consumed food products differ between countries. Existing literature lacks reporting on food products included within the MIND diet and weight or volume equivalents corresponding to MIND diet servings, impeding accurate comparisons across studies. This study sought to overcome these limitations by evaluating MIND food products consumed in the Dutch context and developing a scoring system based on consumed quantities in weight or volume amounts rather than in standard serving amounts. The third objective was to modify an existing Dutch brief FFQ (Eetscore-FFQ) to evaluate adherence to the MIND diet. We translated nine of the fifteen MIND food groups directly to grams and volumes using the United States Department of Agriculture measurement conversion table. For the remaining food groups, we employed indirect translation to align them as closely as possible to the original MIND diet. These translated quantities in weight and volumes amounts were subsequently rounded to the nearest Dutch household measures, resulting in the culturally adapted MIND-NL diet scoring. The development of the MIND-NL-Eetscore-FFQ, comprising seventy-two food items (forty-one questions), is described. Our adaption approach is reproducible and can be used to customize the MIND diet scoring system to other cultures.
Oxidative stress may be involved in the progression of hypothyroidism in patients with Hashimoto thyroiditis (HT). Vitamin C is a well-known powerful antioxidant. To our knowledge, whether vitamin C intake relates to hypothyroidism in patients with HT remains unclear. In this cross-sectional study based on the National Health and Nutrition Examination Survey, 2007–2012, we aimed to explore the relationship between total vitamin C intake and hypothyroidism in patients with HT, using multivariate logistic regression models and restricted cubic spline analyses. Our results showed a significant negative linear association between total vitamin C intake (log10-transformed data) and hypothyroidism in HT. Compared with those with the lowest quartile of total vitamin C intake (log10-transformed), participants with the highest quartile were at lower odds of having hypothyroidism (adjusted OR 0·40, 95 % CI: 0·18, 0·88, Ptrend = 0·027). This association was consistent in subgroups stratified by sex (Pfor interaction = 0·084) and age (≥ 60 years and < 60 years, Pfor interaction = 0·330). This study revealed that total vitamin C intake was inversely associated with hypothyroidism among individuals with HT, indicating that higher vitamin C intakes (4·57–1258·9 mg/d) may be associated with a lower likelihood of hypothyroidism among HT participants.
No study has validated questionnaires for assessing easily calculable diet quality scores in Japan. The Brief-type self-administered Diet History Questionnaire (BDHQ) is widely used to assess dietary intake in Japan, while the Meal-based Diet History Questionnaire (MDHQ) assesses dietary intake for each meal (breakfast, lunch, dinner and snacks) and overall dietary intake. This study examined the relative validity of the BDHQ and MDHQ for assessing three diet quality scores in Japanese adults. A total of 111 women and 111 men aged 30–76 years completed the web MDHQ and BDHQ, followed by 4-non-consective-day weighed dietary records. The diet quality scores examined included the Diet Quality Score for Japanese (DQSJ), Dietary Approaches to Stop Hypertension (DASH) score and Alternate Mediterranean Diet (AMED) score. The means of the three scores for overall diet from the BDHQ were not significantly different from those from the dietary records in both sexes, whereas those from the MDHQ were higher than those from the dietary records, except for the DASH and AMED in women. Pearson’s correlation coefficients between both questionnaires and dietary records were 0·57–0·63 for DQSJ, 0·49–0·57 for DASH and 0·31–0·49 for AMED across both sexes and both questionnaires. For each meal, Pearson’s correlation coefficients between the MDHQ and dietary records ranged from 0·01 (DASH for snacks in women) to 0·55 (DQSJ for breakfast in men), with a median of 0·35. This study showed that the ability of the BDHQ and MDHQ to rank individuals was good for DQSJ and DASH and acceptable for AMED.
The objectives of this experiment were to determine the digestible indispensable amino acid score (DIAAS) for eggs cooked in different forms and in traditional egg-bread or egg-hash brown combinations, and to test the hypothesis that DIAAS in eggs is greater than in breads or potatoes. Nine ileal cannulated gilts (average initial body weight: 51.1 ± 6.0 kg) were allotted to a 9 × 6 Youden square design with nine diets and six 7-day periods. Fried egg, boiled egg, scrambled egg, English muffin, Texas toast, and hash brown were included in the experiment. Six diets each contained one source of protein and three diets were combinations of fried eggs and English muffin, boiled eggs and Texas toast, or scrambled egg and hash brown. A nitrogen-free diet was also used and fed to all pigs in one period. The standardised ileal digestibility (SID) of crude protein (CP) and amino acids (AA) was calculated, and DIAAS was calculated for the individual ingredient and combined meals for children between 6 and 36 months and individuals older than 3 years. For both age groups, all cooked eggs had greater (P < 0.001) DIAAS compared with the other foods, and hash brown had greater (P < 0.001) DIAAS than both breads. All combined meals had DIAAS greater than 75 and there were no differences between measured and predicted DIAAS for the combined meals. In conclusion, eggs have ‘excellent’ protein quality for individuals older than 6 months and can compensate for the lower protein quality in plant-based foods, and DIAAS obtained from individual ingredients are additive in mixed meals.
The aim of this study was to investigate factors associated with reported need of weight loss support among adults with overweight or obesity in the general population.
Design:
A cross-sectional population study based on a survey questionnaire sent to a random population sample. Multivariate odds ratios for reported need of weight loss support were calculated for socio-economic, lifestyle and health indicators, in total and by gender and age group.
Setting:
Five counties in Sweden in 2022.
Participants:
The study includes 10 069 persons with overweight or obesity (BMI ≥ 25 kg/m2) aged 30–69 years. BMI was based on self-reported weight and height.
Results:
In total, about 20 % reported needing weight loss support. The factors most strongly associated with reported need of weight loss support were obesity and female gender. Lack of social support, economic difficulties, physical inactivity, poor self-rated health, musculoskeletal pain and depression were also associated with reported need of weight loss support, whereas diabetes and hypertension were not. Some differences in these associations were observed between age groups.
Conclusion:
Reported need of weight loss support is more common among women than among men and associated with obesity, lack of social support, economic difficulties, physical inactivity, poor self-rated health, musculoskeletal pain and depression in both genders. These factors are important for planning preventive and weight-control measures among adults with overweight or obesity.
Skeletal muscle is of great importance for human activity and quality of life, as its loss contributes greatly to immobilisation, especially for aged individuals. An increased dietary intake of antioxidant vitamins may be beneficial for muscle loss because of ageing. However, the quantitative relationship between total antioxidant capacity (TAC) of antioxidant vitamins and muscle mass is undetermined. Totally, 4009 participants from the National Health and Nutrition Examination Survey (NHANES) were included. Multivariate linear regression analysis was performed with demographic, lifestyle and dietary intake adjustment factors. The dose saturation effect was also determined by a saturation effect analysis. Subgroup analysis was performed for age and sex. In the fully adjusted model, per unit increase of dietary TAC was associated with an increase of 0·018 g/kg appendicular lean mass (95 % CI 0·007, 0·029), 0·014 g/kg trunk lean mass (95 % CI 0·004, 0·024) and 0·035 g/kg total lean mass (95 % CI 0·014, 0·055). TAC was associated with a decrease of 0·004 kg/kg total percent fat (95 % CI −0·006, −0·002), 0·005 kg/kg trunk percent fat (95 % CI −0·007, −0·002) and 0·003 kg/m2 BMI (95 % CI −0·006, −0·001) at the same time. Subgroup analysis indicated that women and adults < 50 years may experience the most significant association between TAC and skeletal muscle mass. We revealed a positive correlation between TAC and lean body mass and a negative association between TAC and body fat and BMI. Saturation values were found among people aged 40–59 years. Age and sex mediate these associations.
Beyond obesity, visceral adipose tissue (VAT) has emerged as an important predictor of chronic disease, but the role of diet quality patterns (DQP) in VAT development is not well defined. Therefore, we conducted a systematic review of how various DQP are associated with VAT via literature searches in PubMed and EMBASE. We included observational investigations in disease-free adults/adolescents that related DQP to VAT assessed by imaging methods. The studies were evaluated separately for a priori and a posteriori DQP and according to design differences. Study quality was assessed using the Risk of Bias in Non-randomised Studies of Interventions tool. Of the 1807 screened articles, thirty-five studies met the inclusion criteria. The majority of a priori indices, for example, the Healthy Eating Index, showed significant inverse associations with VAT, while only a small proportion of a posteriori patterns were related to VAT. Results did not differ substantially by the method of exposure and outcome assessment or between studies with (n 20) or without (n 15) body-size adjustment, but significant findings were more common in younger v. older individuals, USA v. other populations and investigations with moderate v. serious risk of bias. The heterogeneity of the existing literature limited the ability to quantify the magnitude of the associations across studies. These findings suggest that a high-quality diet, as assessed by a priori DQP, is generally inversely associated with VAT, but results for a posteriori DQP are less consistent. As associations persisted after adjusting for body size, diet quality may beneficially influence VAT beyond its association with obesity.
Ultra-processed foods (UPF), per the NOVA Classification, provide a major source of calories within modern food systems and are associated with poor health outcomes related to chronic inflammation. Dietary antioxidants play a key role in preventing disease; however, the relationship between the NOVA Classification and the total antioxidant content (TAC) of foods is not well characterised. We hypothesised that TAC would be highest in minimally processed food (MPF), lower in processed food (PRF) and lowest in UPF. TAC data for 3137 animal-based, mixed and plant-based food items were obtained from a published dataset. After data cleaning, 1946 food items and their TAC values were analysed using two hierarchal linear models (alpha: P < 0·05). MPF had the highest mean TAC (10·79 (sem 0·87) mmol/100 g) and were 11·31-fold and 10·72-fold higher than PRF and UPF, respectively (P = 0·023). Plant-based and mixed foods had a higher mean TAC (8·55 (sem 0·68) and 1·12 (sem 0·11) mmol/100 g, respectively) and were 22·67-fold and 2·98-fold higher compared with animal-based foods (P < 0·001). Food processing did not change mean TAC in mixed and animal-based foods; however, plant-based MPF had a higher mean TAC (11·49 (sem 0·93) mmol/100 g) and were 9·88-fold and 15·12-fold higher compared with plant-based PRF and UPF, respectively (P < 0·001). Mean TAC differed between NOVA processing groups for three categories of food: vegetables, beverages and beans, nuts and seeds (P < 0·001). Across all food items, and especially plant-based foods, mean TAC decreased with food processing. The lower TAC of UPF may at least partially explain why their consumption promotes inflammatory chronic disease.