A systematic review and meta-analysis of diet and nutrient intake in adults with irritable bowel syndrome

BACKGROUND

Numerous individual and environmental factors including diet may play an important role in the pathophysiology of irritable bowel syndrome (IBS). It is unclear to what degree dietary intake is affected in individuals with IBS. We aimed to perform a systematic review and meta-analysis to summarize dietary intake of adults with IBS and to compare dietary intake between adults with IBS and non-IBS controls.

METHODS

Ovid MEDLINE, Embase, Cochrane, CINAHL, and Scopus were searched through February 2023 for clinical trials and observational studies measuring usual diet in adults with IBS. Pooled weighted averages were estimated for total energy, macronutrient, and micronutrient data. Mean differences (MD) in nutrient intake were estimated for adults with IBS versus non-IBS controls using a random effects model. Heterogeneity was assessed by the inconsistency index (I2).

KEY RESULTS

Sixty-three full-text articles were included in the review of which 29 studies included both IBS and control subjects. Nutrients not meeting the recommended intake level for any dietary reference values in the IBS population were fiber and vitamin D. Meta-regression by female proportion was positively correlated with total fat intake and negatively correlated with carbohydrate intake. Comparisons between participants with IBS and controls showed significantly lower fiber intake in participants with IBS with high heterogeneity (MD: -1.8; 95% CI: -3.0, -0.6; I2 = 85%).

CONCLUSIONS AND INFERENCES

This review suggests that fiber and vitamin D intake is suboptimal in IBS; however, overall dietary intake does not appear to be comprised. Causes and consequences of reduced fiber in IBS deserve further study. Results of this systematic review and meta-analysis suggest that fiber and vitamin D intake is suboptimal in IBS. However, overall intake of other macro- and micronutrients does not appear to be compromised. Causes and consequences of reduced fiber and Vitamin D intake in IBS deserve further study.

The imprecision of micronutrient requirement values: the example of vitamin D

Food, not nutrients, is the fundamental unit in nutrition. Nutrient requirement values and recommended daily intakes have long been determined and organized in tables by several regulators. These figures, however, overlook the complexity of mixing different foods in a diet and the mediation by human gut microbiota on digestion, metabolism, and health. The microbiome molecular mechanisms and its potential influence on nutrient requirements are far from clear. Guidelines should depend on the sort of intake, along with the dietary habits, rather than focusing on single nutrients. Despite many decades of attempts to investigate the proximate nutrient composition of foods consumed by different world populations, there are still neither standardization of food composition databases nor harmonized dietary intake methods of assessment of nutrients. No all-inclusive attempt was yet made to emphasize the requirements of the various micronutrients, phytonutrients, and non-nutrients on gut microbiota and vice versa, and thereafter reflected into dietary guidelines. New multifaceted methods have been advanced to reevaluate the way nutrients and nutrient requirements are assessed within the intricate biological systems. Our main goal here was to enhance the fact that existing food guidelines hold inherent strengths and limitations but fail, in many aspects, namely, in not taking into account essential geographical, ethnic and cultural differences, and the different stages of life, infant nutrition, and the microbiota impact on several micronutrient requirements. Vitamin D is given as an illustration on present inaccuracy of its requirements. Defining dietary reference intakes is therefore an ongoing process specific for each population.

Zinc status or supplementation and its relation to soil-transmitted helminthiasis in children: A systematic review

Soil-transmitted helminths (STHs) parasitic infection is known as one of the most common infections around the world affecting more than a quarter of the world's population. The relationship between STH infections and micronutrient deficiencies are closely related and often coexist among the affected population. The study, therefore, aimed to summarise the available literature focusing on the effect of zinc status/deficiency or supplementation on STH infection or reinfection in children. For this purpose, we adopted a systematic approach and searched the existing literature on PubMed, Scopus, and Cochrane Library databases. A search term was entered to retrieve the available data. A total of 12 articles were included in this review after applying the inclusion/exclusion criteria. Most of the included studies reported a lower zinc status in children affected with any parasitic infection. Regarding the effect of zinc status and supplementation on parasitic infection in children, we found only a few studies (n = 4) with inconsistent result findings. This review reported that children infected with STH have lower zinc levels; however, a limited number of studies showed the effect of zinc supplements on the risk of STH warrants the need for further studies in this regard.

Diagnostic and therapeutic value of intracellular biomarker testing in chronic pain

Aim: Micronutrient and metabolic compound supplementation as a method of treating chronic pain is not well understood. Case: A 58 year-old woman presented with refractory painful neuropathy. She did not respond to conservative treatment and was seeking spinal cord stimulator implantation. She underwent a biomarker panel that revealed low intracellular levels of multiple compounds. As she supplemented her deficiencies, her symptoms fully resolved, and the implant was no longer indicated. Discussion: Micronutrient and metabolic compound testing could potentially expand non-invasive treatment options for patients with refractory chronic pain. Caution should be exercised given limited regulatory oversight in the supplement industry and actively ongoing nutritional research. Conclusion: Biomarker testing panels may be a useful adjunct in the management of refractory neuropathic pain.

Associations between cardiorespiratory fitness and lifestyle-related factors with DNA methylation-based ageing clocks in older men: WASEDA'S Health Study

DNA methylation-based age estimators (DNAm ageing clocks) are currently one of the most promising biomarkers for predicting biological age. However, the relationships between cardiorespiratory fitness (CRF), measured directly by expiratory gas analysis, and DNAm ageing clocks are largely unknown. We investigated the relationships between CRF and the age-adjusted value from the residuals of the regression of DNAm ageing clock to chronological age (DNAmAgeAcceleration: DNAmAgeAccel) and attempted to determine the relative contribution of CRF to DNAmAgeAccel in the presence of other lifestyle factors. DNA samples from 144 Japanese men aged 65-72 years were used to appraise first- (i.e., DNAmHorvath and DNAmHannum) and second- (i.e., DNAmPhenoAge, DNAmGrimAge, and DNAmFitAge) generation DNAm ageing clocks. Various surveys and measurements were conducted, including physical fitness, body composition, blood biochemical parameters, nutrient intake, smoking, alcohol consumption, disease status, sleep status, and chronotype. Both oxygen uptake at ventilatory threshold (VO2 /kg at VT) and peak oxygen uptake (VO2 /kg at Peak) showed a significant negative correlation with GrimAgeAccel, even after adjustments for chronological age and smoking and drinking status. Notably, VO2 /kg at VT and VO2 /kg at Peak above the reference value were also associated with delayed GrimAgeAccel. Multiple regression analysis showed that calf circumference, serum triglyceride, carbohydrate intake, and smoking status, rather than CRF, contributed more to GrimAgeAccel and FitAgeAccel. In conclusion, although the contribution of CRF to GrimAgeAccel and FitAgeAccel is relatively low compared to lifestyle-related factors such as smoking, the results suggest that the maintenance of CRF is associated with delayed biological ageing in older men.

Wild edible yams from Madagascar: New insights into nutritional composition support their use for food security and conservation

Yams (Dioscorea species) are an important food resource in Madagascar, where both cultivated winged yam (D. alata) and wild edible yams are consumed. However, there is limited knowledge on the nutrient composition of wild edible yams in Madagascar, and on how they compare with the cultivated winged yam. Therefore, in this study, nine wild edible yam species, one with two subspecies from Madagascar (D. bako, D. buckleyana, D. irodensis, D. maciba, D. orangeana, D. pteropoda, D. sambiranensis subsp. bardotiae and subsp. sambiranensis, D. seriflora, and Dioscorea species Ovy valiha), were analyzed for their nutrient composition, compared with cultivated D. alata. They include 6/6 of the most favored wild edible yam species in Madagascar. New nutrient composition data (protein, carbohydrate/starch, energy, lipid, β-carotene, and minerals) are presented for these nine wild edible yam species. The results show that they contain comparable levels of lipids and starch to D. alata, but none are better sources of protein than D. alata. The results show that D. irodensis contains a significantly higher β-carotene content when compared to all other edible yams analyzed, and that D. buckleyana, D. irodensis, and D. sambiranensis subsp. bardotiae have a higher calcium content than cultivated D. alata, while all nine wild edible yam species analyzed contain a higher iron content, compared to cultivated D. alata. The nutrient composition data presented could provide new incentives to conserve wild edible yams and inform on strategies to select Dioscorea species for sustainable cultivation and use, providing opportunities to enhance future food security in Madagascar.

A blueprint for fortification planning and programming: Lessons learned from an analytical review of existing fortification frameworks

With multiple food fortification frameworks, countries can find it challenging to determine optimal methods for planning and implementing food fortification programmes to combat vitamin and mineral deficiencies, especially without additional technical support. To address this challenge, this study aimed to review existing frameworks to determine consistencies, differences, strengths, and weaknesses across the frameworks, and based on the review findings, formulate an enhanced and streamlined fortification framework. Nineteen frameworks were ultimately examined following a comprehensive literature review and key informant interviews. Generally, the reviewed frameworks amply describe motives and methods for the determination of fortification need and feasibility, industry engagement/quality assurance and quality control, and impact evaluations/surveillance. However, there was limited inclusion or discussion throughout the reviewed frameworks around harmonization of fortification with existing micronutrient interventions; fortification policy and/or strategy; enforcement, incentives, and penalties to ensure producer compliance with industry standards; and periodic fortification programme review and reassessment. The findings were used to develop a comprehensive Fortification Blueprint that aims to provide structured guidance and a library of tools and resources to fortification programme managers and key stakeholders to ensure optimal and sustainable programme design.

Variation and genetic basis of mineral content in potato tubers and prospects for genomic selection

Malnutrition is a major public health concern in many parts of the world. Among other nutrients, minerals are necessary in the human diet. Potato tubers are a good source of minerals; they contribute 18% of the recommended dietary allowance of potassium; 6% of copper, phosphorus, and magnesium; and 2% of calcium and zinc. Increased public interest in improving the nutritional value of foods has prompted the evaluation of mineral content in tubers of advanced genotypes from the Texas A&M Potato Breeding Program and the investigation of the genetics underlying mineral composition in tubers. The objectives of this study were to i) assess phenotypic variation for mineral content in tubers of advanced potato genotypes, ii) identify genomic regions associated with tuber mineral content, and iii) obtain genomic-estimated breeding values. A panel of 214 advanced potato genotypes and reference varieties was phenotyped in three field environments in Texas for the content of 12 minerals in tubers and genotyped using the Infinium Illumina 22K V3 single nucleotide polymorphism (SNP) Array. There was significant variation between potato genotypes for all minerals evaluated except iron. As a market group, red-skinned potatoes had the highest amount of minerals, whereas russets had the lowest mineral content. Reds had significantly higher P, K, S, and Zn than russets and significantly higher P and Mg than chippers. Russets had significantly higher Ca, Mg, and Na than chippers. However, the chippers had significantly higher K than the russets. A genome-wide association study for mineral content using GWASpoly identified three quantitative trait loci (QTL) associated with potassium and manganese content on chromosome 5 and two QTL associated with zinc content on chromosome 7. The loci identified will contribute to a better understanding of the genetic basis of mineral content in potatoes. Genomic-estimated breeding values for mineral macro and micronutrients in tubers obtained with StageWise will guide the selection of parents and the advancement of genotypes in the breeding program to increase mineral content in potato tubers.

Malnutrition, Functional Decline, and Institutionalization in Older Adults after Hospital Discharge Following Community-Acquired Pneumonia

BACKGROUND AND AIMS

Community-acquired pneumonia (CAP) is a major threat to older adults, but mid-term implications are poorly described. The aim was to analyze functional decline, institutionalization, malnutrition, and risk factors after hospital admission for CAP.

METHODS

This prospective observational study included patients over 65 years discharged after CAP between May 2019 and July 2021. We performed a comprehensive geriatric assessment and a general nutritional assessment 30-60 days after CAP. This included the MNA and blood test with trace elements and vitamins. The main outcomes were functional decline, institutionalization, and malnutrition. Multivariate logistic regression was used for the analyses.

RESULTS

In total, 144 patients of 77.15 ± 7.91 years, 55.6% male, and 9% previously institutionalized were analyzed. At hospital admission, the Charlson Comorbidity Index (CCI) was 1.5 ± 1.6, the Pneumonia Severity Index was 98.1 ± 25.9, and the previous Barthel Index (BI) was 93.06 ± 17.13. Hospital stay was 9.72 ± 7.88 days. After 44.6 ± 14.4 days, 48.6% patients showed functional decline and 19.4% were institutionalized. Age (OR 1.17; CI 95% 1.09-1.26), previous institutionalization (29.1; 3.7-224.7), BI (1.09; 1.05-1.14), CCI (1.5; 1.1-2.1), and length of stay (1.1, 1.02-1.18) were independently associated with functional decline. The only predictors of new institutionalization were previous BI (0.96; 0.93-0.99) and length of stay (1.06; 1.00-1.13). The MNA indicated malnutrition in 28% of the community-dwelling patients and 67.9% of those institutionalized, with risk of malnutrition being 45.7% and 9.5%, respectively, after an average of 44.6 days of CAP diagnosis. The predictors of malnutrition were previous institutionalization (10.62; 2.20-51.21), BI (0.95; 0.92-0.98), and length of stay (1.12; 1.04-1.20). Micronutrient deficiencies were mainly zinc (61.8%), vitamin D (54.5%), and vitamin C (45.1%). An MNA score < 17 points or hypoalbuminemia showed good specificity to identify these deficiencies.

CONCLUSIONS

After CAP admission, functional decline, institutionalization, and malnutrition rates were high. Longer hospital stay was a common risk factor for all outcomes. The presence of hypoalbuminemia or an MNA < 17 in older patients should prompt suspicion of deficiencies in micronutrients, such as vitamin D, C, and zinc.

A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition

BACKGROUND

Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients.

OBJECTIVE

This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries.

METHOD

Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method.

RESULTS

In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status.

CONCLUSIONS

There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.

Type and Frequency in Use of Nutraceutical and Micronutrient Supplementation for the Management of Polycystic Ovary Syndrome: A Systematic Scoping Review

Lifestyle strategies are considered first-line treatment for the management of polycystic ovary syndrome (PCOS). However, complementary therapies, including nutrient supplementation, have been identified as a potential adjunct therapy. Therefore, we systematically mapped the available literature to identify the type and frequency of the use of nutraceutical and micronutrient supplementation for the management of PCOS features. A systematic search of the literature was conducted using CINAHL, Cochrane reviews, Medline, PsycINFO, Scopus and LILACS. All types of study designs were included if they reported on the use of nutraceuticals and/or micronutrient supplementation on features of PCOS in women aged ≥18 years. A total of 344 articles were included. Forty-one supplements were identified, with the most frequently investigated being inositols (n = 86), vitamin D (n = 53), N-acetylcysteine (n = 27) and omega-3 fatty acids (n = 25). Reproductive outcomes were the most commonly reported (n = 285; 83%), followed by metabolic (n = 229; 67%), anthropometric (n = 197; 57%) and psychological (n = 8; 2%). Our results identified that nutraceutical and micronutrient supplementation require further investigation of psychological outcomes in women with PCOS. Moreover, adequately powered primary studies are warranted to investigate therapeutic doses needed for clinical benefits.

Association between dietary intake and risk of Parkinson's disease: cross-sectional analysis of survey data from NHANES 2007-2016

Background

While dietary factors have shown an association with Parkinson's disease (PD), the available data remains a subject of ongoing debate and controversy.

Aim

We sought to evaluate potential relationships between dietary consumption of nutrients and micronutrients and risk of PD in a large sample.

Methods

Cross-sectional data were retrospectively analyzed for 10,651 adults aged 40-80 years that had been collected in the US between 2007 and 2016 as a component of the nationwide National Health and Nutrition Examination Survey. Aspects of dietary intake were compared between those who reported having specific PD medication regimens or not when they completed the survey, and potential associations between diet and risk of PD were explored using binomial logistic regression. We employed Propensity Score Matching (PSM) to minimize the impact of potential confounding factors, thus enhancing the reliability of the results. Additionally, subgroup analysis based on gender and age was conducted to investigate these relationships.

Results

Higher dietary intake of iron was linked to greater PD risk [odds ratio (OR) 1.065, 95% confidence interval (CI) 1.019-1.114, p = 0.006], whereas risk decreased with higher intake of vitamin K (OR 0.999, 95% CI 0.998-1.000, p = 0.024) or vitamin C (OR 0.998, 95% CI 0.996-0.999, p = 0.039). Even after applying PSM, the connection between dietary iron intake and dietary vitamin C intake with PD risk remained substantial. Subgroup analysis results revealed a significant positive association between dietary intake of iron from food and the PD risk, which was evident among individuals under 60 years of age and among males.

Conclusion

The intake of micronutrients can influence risk of PD, which should be verified and explored further in prospective samples with other dietary habits and ethnic backgrounds.

Is Dietary (Food) Supplement Intake Reported in European National Nutrition Surveys?

Dietary (food) supplements (DSs) have seen a sharp increase in use and popularity in recent years. Information on DS consumption is vital for national nutrition monitoring. The objective of this study was to investigate whether DS intake was reported in the National Nutrition Surveys (NNSs) in all European countries. NNSs reporting DS use were retrieved via literature review (i.e., PubMed, Google Scholar, Scopus), scientific and organizational publications (EFSA), or open-published government and other official reports. Included were the European NNSs referring to adults, published in English, French, or German, post-2000. Out of the 53 European countries, 30 recorded DS intake. Among them, related findings on the percentage of DS intake were published in 21 cases, 5 of them written in the local language. DS use varied by nation, with Finland and Denmark having the greatest (over 50%) and Italy having the lowest percentage (5%). In terms of comprehensive reported data on DS consumption in Europe and the investigation of the contribution of DSs to total nutrient intake, there is a need for improvement. Common DS categories should be defined upon agreement among the involved scientific parties to allow for comparable data and estimations between surveys.

Molecular cytogenetic identification and nutritional composition evaluation of newly synthesized Triticum turgidum-Triticum boeoticum amphiploids (AABBAbAb)

Triticum boeoticum Boiss. (AbAb, 2n = 2x = 14) is a wheat-related species with the blue aleurone trait. In this study, 18 synthetic Triticum turgidum-Triticum boeoticum amphiploids were identified, which were derived from crosses between T. boeoticum and T. turgidum. Three probes (Oligo-pTa535, Oligo-pSc119.2, and Oligo-pTa713) for multicolor fluorescence in situ hybridization (mc-FISH) were combined with genomic in situ hybridization (GISH) to identify chromosomal composition. Seven nutritional indices (anthocyanins, protein, total essential amino acids TEAA, Fe, Zn, Mn and Cu) were measured, and the nutritional components of 18 synthetic amphiploids were comprehensively ranked by principal component analysis (PCA). The results showed that all three synthetic amphiploids used for cytological identification contained 42 chromosomes, including 14 A, 14 B, and 14 Ab chromosomes. The average anthocyanin content was 82.830 μg/g to 207.606 μg/g in the whole meal of the 17 blue-grained lines (Syn-ABAb-1 to Syn-ABAb-17), which was obviously higher than that in the yellow-grained line Syn-ABAb-18 (6.346 μg/g). The crude protein content was between 154.406 and 180.517 g/kg, and the EAA content was 40.193-63.558 mg/g. The Fe, Zn, Mn and Cu levels in the 17 blue-grained lines were 60.55 to 97.41 mg/kg, 60.55-97.41 mg/kg, 35.11 to 65.20 mg/kg and 5.74 to 7.22 mg/kg, respectively, which were higher than those in the yellow-grained line. The contribution of the first three principal components reached 84%. The first principal component was mainly anthocyanins, Fe, Zn and Mn. The second principal component contained protein and amino acids, and the third component contained only Cu. The top 5 Triticum turgidum-Triticum boeoticum amphiploids were Syn-ABAb-11, Syn-ABAb-17, Syn-ABAb-5, Syn-ABAb-8 and Syn-ABAb-4. These amphidiploids exhibited the potential to serve as candidates for hybridization with common wheat, as indicated by comprehensive score rankings, toward enhancing the nutritional quality of wheat.

Characterization of Triticum turgidum sspp. durum, turanicum, and polonicum grown in Central Italy in relation to technological and nutritional aspects

Introduction

Wheat is a staple food, with the two most common species being Triticum aestivum and Triticum turgidum ssp. durum. Moreover, the latter, T. turgidum, includes other tetraploid subspecies, among which the sspp. turanicum (Khorasan wheat) and polonicum (Polish wheat), whose importance has increased in the last decades, representing alternative crops for marginal areas, in addition to being a source of genetic diversity.

Methods

In this work, different accessions of these three subspecies of T. turgidum have been grown in 2 years in the same environment and have been characterized for technological properties and factors affecting nutritional quality, such as fiber amount and the content of micro- and macro-nutrients in grains, and for root morphological traits.

Results

These analyses allowed the identification, in particular, of a Polish wheat accession showing better technological performances, a higher amount of positive micro- and macro-elements, and a lower amount of toxic cadmium. The modern variety Svevo and the Polish Pol2 showed the lowest and the highest shoot:root ratio, respectively. The high shoot:root ratio in Pol2 was mainly attributable to the decrease in root growth. Although Pol2 had a lower root biomass, its particular root morphology made it more efficient for nutrient uptake, as evident from the greater accumulation of micro- and macro-nutrients.

Discussion

These results underline that it is not possible to draw general conclusions about the difference between primitive and modern wheats, but rather a case-by-case approach should be chosen.

Effects of sources and routes of administration of vitamins A, D and copper on postnatal status of these micronutrients in piglets

Twenty-six nulliparous sows were fed conventional gestation and lactation diets supplemented (N = 13) or not (N = 13) with extra daily supplements of 25-hydroxy-cholecalciferol (25-OH-D3; 4 ĸIU), β-carotene (24 ĸIU), and copper (Cu)-proteinate (45 mg) from day 90 of gestation to 21 d of lactation (L21). In each litter, 10 piglets were divided into 5 pairs received, at 2 (L2) and 8 d (L8) of age, one of the five combinations of micronutrient sources and routes of administration (N = 260 piglets total). These neonatal treatments (N = 26 pairs or 52 piglets each) consisted of oral vitamin D3, retinol acetate and CuSO4 (T1); oral 25-OH-D3, β-carotene, and Cu proteinate (T2); exposure to ultraviolet light (UVB), oral retinol palmitate and Cu gluconate (T3); intramuscular vitamin D3 and retinyl propionate and oral Cu acetate (T4); oral saline (CTRL). Oral or intramuscular provisions corresponded to 12 mg of Cu and 70 and 12 ĸIU of vitamins A and D, respectively. Blood samples were collected from all piglets at L2, L8, and L21 for determination of serum Cu, retinol, and 25-OH-D3. Body weight was measured at birth, L2, L8, and L21. Piglets were weaned at L21, and liver and blood samples were collected 2 d later to evaluate oxidative enzymes in blood and liver and hepatic ATP concentrations and expression of genes associated with antioxidant status. Sow treatments had marginal or no impacts on Cu, retinol, 25-OH-D3, or antioxidant status in piglet blood serum and liver. However, when supplements were given to piglets, hepatic Cu was 38% greater in for all treated piglets compared to CTRL (P < 0.01), hepatic retinol was 3 times higher in T1 than in CTRL (P < 0.01) and intermediate for other treatments whereas serum 25-OH-D3 was markedly increased with T2 and T3 at L8 and L21, respectively, compared to CTRL (Piglet treatment × Age interaction, P < 0.01). Concerning antioxidant activities, glutathione peroxidase, and superoxide dismutase were increased (P < 0.03) in plasma of T2 piglets whereas the highest values (P < 0.03) for indicators of oxidative damage to proteins were observed in T4 piglets. The study revealed that oral Cu proteinate from T2, oral retinol acetate from T1, oral 25-hydroxy-cholecalciferol from T2, and UVB light exposure from T3 were the most efficient ways of increasing the postnatal status of these micronutrients in suckling piglets and this may have some impacts on their peri-weaning antioxidant status.

Nutrition, Immune Function, and Infectious Disease in Military Personnel: A Narrative Review

Consuming a diet that meets energy demands and provides essential nutrients promotes a healthy immune system, while both under- and over-nutrition have been associated with immune dysfunction. Military personnel comprise a unique population who frequently endure multi-stressor environments, predisposing them to immune decrements. Additionally, 49% and 22% of active duty U.S. military personnel are classified as overweight and obese, respectively. A literature search on PubMed was conducted to identify studies, reports, review papers, and references within those sources relevant to the topic area. Military personnel experiencing either under- or over-nutrition can suffer from degraded health, readiness, and performance. Insufficient intake of nutrients during military operations increases infection risk and negatively impacts infection recovery. Energy, protein, iron, zinc, and vitamins C and D are nutritional areas of concern that may impact immune competence in a multi-stressor environment. Over-nutrition can promote accretion of excess body fat and obesity, which contributes to a chronic inflammatory state that coincides with immune impairments. Prioritizing efforts to optimize nutrient intake is one approach for reducing disease burden and improving readiness. This review discusses nutritional concerns concomitant to multi-stressor environments that impact immune function, and the relevance of obesity to infectious disease risk in the military population.

Refeeding Syndrome in Pediatric Age, An Unknown Disease: A Narrative Review

Refeeding syndrome (RS) is characterized by electrolyte imbalances that can occur in malnourished and abruptly refed patients. Typical features of RS are hypophosphatemia, hypokalemia, hypomagnesemia, and thiamine deficiency. It is a potentially life-threatening condition that can affect both adults and children, although there is scarce evidence in the pediatric literature. The sudden increase in food intake causes a shift in the body's metabolism and electrolyte balance, leading to symptoms such as weakness, seizures, and even heart failure. A proper management with progressive increase in nutrients is essential to prevent the onset of this condition and ensure the best possible outcomes. Moreover, an estimated incidence of up to 7.4% has been observed in pediatric intensive care unit patients receiving nutritional support, alone or as an adjunct. To prevent RS, it is important to carefully monitor feeding resumption, particularly in severely malnourished individuals. A proper strategy should start with small amounts of low-calorie fluids and gradually increasing the calorie content and amount of food over several days. Close monitoring of electrolyte levels is critical and prophylactic use of dietary supplements such as thiamine may be required to correct any imbalances that may occur. In this narrative review, we aim to provide a comprehensive understanding of RS in pediatric clinical practice and provide a possible management algorithm.

Micronutrient gaps during the complementary feeding period in seven countries in Southeast Asia: A Comprehensive Nutrient Gap Assessment

The complementary feeding period is a critical stage of child development when micronutrient needs are high and challenging to meet. Understanding if specific micronutrient gaps exist during this period is critical for effective programming. A Comprehensive Nutrient Gap Assessment (CONGA) was conducted in seven countries in Southeast Asia to estimate gaps in micronutrients commonly lacking in the diets of children aged 6-23 months and to establish the certainty of available evidence for each identified gap. Sixty-eight evidence sources were identified during this analysis, and 310 micronutrient-specific data points were identified across all seven countries. Data points varied in recency, representativeness and evidence type. The CONGA methodology enabled the estimation of a gap burden rating for each micronutrient in each country, as well as a rating of their evidence certainty. Micronutrient gaps were identified in vitamin D, zinc and iron and a potential gap was identified in calcium during the complementary feeding period in the region. Evidence relevant to intake and deficiency of folate, vitamin B12 , thiamine, niacin, vitamin C and vitamin B6 was limited across the region. Proven strategies to address these gaps include increasing the availability and consumption of nutrient-dense foods, micronutrient supplementation, large-scale fortification of staple foods and condiments and point-of-use fortification through multiple micronutrient powders and fortified speciality foods. More recent data on micronutrient availability, intake and deficiency is urgently needed in Southeast Asia.

Biology of Anemia: A Public Health Perspective

Our goal is to present recent progress in understanding the biological mechanisms underlying anemia from a public health perspective. We describe important advances in understanding common causes of anemia and their interactions, including iron deficiency (ID), lack of other micronutrients, infection, inflammation, and genetic conditions. ID develops if the iron circulating in the blood cannot provide the amounts required for red blood cell production and tissue needs. ID anemia develops as iron-limited red blood cell production fails to maintain the hemoglobin concentration above the threshold used to define anemia. Globally, absolute ID (absent or reduced body iron stores that do not meet the need for iron of an individual but may respond to iron supplementation) contributes to only a limited proportion of anemia. Functional ID (adequate or increased iron stores that cannot meet the need for iron because of the effects of infection or inflammation and does not respond to iron supplementation) is frequently responsible for anemia in low- and middle-income countries. Absolute and functional ID may coexist. We highlight continued improvement in understanding the roles of infections and inflammation in causing a large proportion of anemia. Deficiencies of nutrients other than iron are less common but important in some settings. The importance of genetic conditions as causes of anemia depends upon the specific inherited red blood cell abnormalities and their prevalence in the settings examined. From a public health perspective, each setting has a distinctive composition of components underlying the common causes of anemia. We emphasize the coincidence between regions with a high prevalence of anemia attributed to ID (both absolute and functional), those with endemic infections, and those with widespread genetic conditions affecting red blood cells, especially in sub-Saharan Africa and regions in Asia and Oceania.

Vitamin E deficiency in childhood: a narrative review

Vitamin E is an important nutrient from the earliest stages of life. It plays key roles as an antioxidant and in the maintenance of the immune system, among others. Vitamin E deficiency (VED), which occurs more frequently in children, is rarely addressed in the literature. This narrative review aims to summarise the chemistry, biology, serum indicators and clinical trials that have evaluated the impact of fortification and other relevant aspects of vitamin E, in addition to the prevalence of its deficiency, in children worldwide. Vitamin E intake in recommended amounts is essential for this nutrient to perform its functions in the body. Serum α-tocopherol is the most widely used biochemical indicator to assess the prevalence of VED. VED has been associated with symptoms secondary to fat malabsorption and may lead to peripheral neuropathy and increased erythrocyte haemolysis. Reduced concentrations of α-tocopherol may be caused by the combination of diets with low amounts of vitamin E and inadequate consumption of fats, proteins and calories. The lowest prevalence of VED was found in Asia and the highest in North America and Brazil. High proportions of VED provide evidence that this nutritional deficiency is a public health problem in children and still little addressed in the international scientific literature. The planning, evaluation and implementation of health policies aimed at combatting VED in the paediatric population are extremely important.

Food sources of zinc and nutritional status with usual dietary zinc intake in Korean toddlers and preschool children

BACKGROUND/OBJECTIVES

This study aimed to evaluate the food sources of zinc and the usual intake of dietary zinc among Korean toddlers and preschool children.

SUBJECTS/METHODS

A total of 2,679 children aged 1-5 years was selected from the 2009-2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. Dietary data collected from a single 24-h recall were used to evaluate the food sources of zinc. To estimate usual zinc intake, the distribution obtained from single 24-h recall data in the total sample was adjusted using the ratio of within-to-between-person variance in zinc intake obtained from 2-day 24-h recall sub-sample data of the 2009 KNHANES. The proportion of children with usual zinc intake below the estimated average requirement (EAR) and above the tolerable upper intake level (UL) was assessed.

RESULTS

The main sources of zinc in Korean children were grains, dairy products, and meat. The mean usual intakes of zinc among all individuals, those aged 1-2 yrs, and those aged 3-5 yrs were 5.50, 5.01, and 5.83 mg/d, respectively. In all participants, 1.1% of the children consumed zinc below the EAR, whereas 10.7% exceeded the UL. The proportion of children with excessive zinc intake was 25.6% in the 1-2 yrs age group and 0.6% in the 3-5 yrs age group.

CONCLUSIONS

According to the current UL, the risk of excessive zinc intake appears to be high among Korean toddlers. Future studies that monitor the health effects of excessive zinc intake are needed to appropriately guide zinc intake in children.

Photosynthetically active radiation is required for seedling growth promotion by volcanic dacitic tuff breccia (Azomite)

A plant's growth and development are shaped by its genome and the capacity to negotiate its environment for access to light, water, and nutrients. There is a vital need to understand the interactions between the plant, its physical environment, and the fertilizers used in agriculture. In this study, a commercially available volcanic ash fertilizer, Azomite®, characterized as dacitic (rhyolitic) tuff breccia, was tested for its effect on promoting early seedling vigor. Early growth and photomorphogenesis processes are well studied in Arabidopsis. Seedling assays under different light conditions were used to dissect the underlying mechanisms involved. These assays are well established and can be translated to agriculturally important crop plants. The volcanic ash fertilizer was tested at different concentrations on seedlings grown on basic media lacking sucrose either in continuous darkness (Dc), continuous Red (Rc), Far-Red (FRc), or White Light (WLc). Micronutrients in the volcanic ash significantly increased seedling growth under Rc and WLc, but not under Dc and FRc, indicating that photosynthetically active radiation was required for the observed growth increase. Furthermore, red-light photoreceptor mutant, phyB-9, lacked the growth response, and higher amount of fertilizer reduced growth in all conditions tested. These data suggest that light triggers the ability of the seedling to utilize micronutrients in volcanic ash in a dose-dependent manner. The methods described here can be used to establish mechanisms of activity of various nutrient inputs and, coupled with whole-genome expression profiling, can lead to better insights into optimizing nutrient field applications to improve crop production.

Interspecific differences in plasma carotenoid profiles in nestlings of three sympatric vulture species

Carotenoids are diet-based micronutrients important in health and coloration signaling. Related species with similar diets can differ in the kinds and levels of circulating carotenoids, which suggests specific physiological mechanisms to efficiently utilize these micronutrients, regardless of their availability. We explored whether diet and parental provisioning of unusual sources of carotenoids (fresh vegetal matter and vertebrate feces) can explain the occurrence and concentrations of carotenoids in the cinereous vulture Aegypius monachus, griffon vulture Gyps fulvus, and Egyptian vulture Neophron percnopterus nestlings, even when these pigments appear to not be deposited in their integumentary system. A greater diversity of wild prey in diet could be behind the profile of higher concentrations of carotenoids in the Egyptian vulture, the species with carotenoid-dependent coloration during adulthood, while differences in diet composition between cinereous and griffon vultures do not translate to different carotenoid profiles. The carotenoid profile appears to not be related to the ingestion of unusual matter rich in these compounds, although the infrequent occurrence of lycopene and unidentified γ-carotene-like compounds suggest that these vultures may be exploiting vegetal matter that left no identifiable unconsumed remains in the nest of Egyptian vultures. The consumption of green plant material by griffon vultures does not result in especially high levels of carotenoids when compared to the carotenoids found in cinereous vultures, which do not consume green plant material. Ungulate feces were not provisioned to Egyptian vulture nestlings, despite the fact they contain carotenoids that adults need for appropriate coloration. Overall, this study indicates that diet differences alone appear insufficient to explain contrasting interspecific carotenoid profiles, especially since all types of food consumed are considered to be poor in carotenoids, except vegetable matter. We suggest that nestling Egyptian vultures are comparatively efficient in uptaking carotenoids present in low concentrations in food when these compounds are not deposited in their integument, which suggests allocation to other functions.

Micronutrient Deficiency in Inherited Metabolic Disorders Requiring Diet Regimen: A Brief Critical Review

Many inherited metabolic disorders (IMDs), including disorders of amino acid, fatty acid, and carbohydrate metabolism, are treated with a dietary reduction or exclusion of certain macronutrients, putting one at risk of a reduced intake of micronutrients. In this review, we aim to provide available evidence on the most common micronutrient deficits related to specific dietary approaches and on the management of their deficiency, in the meanwhile discussing the main critical points of each nutritional supplementation. The emerging concepts are that a great heterogeneity in clinical practice exists, as well as no univocal evidence on the most common micronutrient abnormalities. In phenylketonuria, for example, micronutrients are recommended to be supplemented through protein substitutes; however, not all formulas are equally supplemented and some of them are not added with micronutrients. Data on pyridoxine and riboflavin status in these patients are particularly scarce. In long-chain fatty acid oxidation disorders, no specific recommendations on micronutrient supplementation are available. Regarding carbohydrate metabolism disorders, the difficult-to-ascertain sugar content in supplementation formulas is still a matter of concern. A ketogenic diet may predispose one to both oligoelement deficits and their overload, and therefore deserves specific formulations. In conclusion, our overview points out the lack of unanimous approaches to micronutrient deficiencies, the need for specific formulations for IMDs, and the necessity of high-quality studies, particularly for some under-investigated deficits.

Adoption of a Short-Term (4-Week) Vegan Diet as Part of 'Veganuary' Significantly Reduces Saturated Fatty Acid (SFA), Cholesterol, B12, and Iodine Intake in Omnivorous Individuals-An Observational Study

Global veganism campaigns like 'Veganuary' have gained popularity. We conducted an observational study to assess the impact of a 4-week vegan diet during 'Veganuary' on nutrient intake, status, knowledge, and motivations for veganism. Data were collected before and after 'Veganuary', using Food Frequency Questionnaires (FFQs) to estimate dietary intake. Micronutrient knowledge and motivation were assessed through questionnaires. A total of 154 UK adults aged 18-60 years (2019: n81; 2020: n73) participated. Groups were vegetarians and omnivores committed to a 4-week vegan diet during 'Veganuary'. Control groups were vegans and omnivores who did not transition. Short-term vegan diets significantly decreased intake of iodine, B12, cholesterol, and saturated fatty acids (SFAs) in omnivores. Micronutrient knowledge was low, and motivation for veganism varied. Short-term vegan diets reduce macro- and micronutrient intake in omnivores. Veganuary participants could benefit from nutritional guidance or supplementation. Attention is required for UK micronutrient intake and knowledge. Motivations for vegan pledges may influence diets, warranting further research.

Dietary Intake of Masters Athletes: A Systematic Review

Dietary practices of masters athletes (MAs) may promote healthy ageing; however, they are poorly understood. The aims of this systematic review were to synthesise the literature on the dietary intakes of MAs and undertake comparisons between younger (35-50 years) and older (>50 years) MAs and the general population. A search was conducted across seven databases to identify relevant publications for screening and data extraction. Averages for energy intake (EI), macronutrients, and micronutrients were compared with data from the 2011-2012 Australian Health Survey (general population). Twenty-six studies (n = 2819) were included. Energy intake was higher for older (8908 kJ/d versus 7792 kJ/d) but not younger MAs (9073 kJ/d versus 8872 kJ/d) versus the general population. Younger versus older male MAs had higher energy and macronutrient intakes. Energy intake for older was comparable to younger female MAs (7819 kJ/d versus 7485 kJ/d), but older had higher protein, lower carbohydrate, and higher micronutrient intakes. Micronutrient intake was higher in MAs than the general population. Similar EIs for older MAs and younger general population may indicate potential for a higher-quality diet. Younger female MAs may restrict or misreport EI, requiring further investigation. There is a need for more comprehensive assessments of dietary intake in MAs to ascertain diet quality in relation to health.

Micronutrient Status in Adult Crohn's Disease during Clinical Remission: A Systematic Review

Adults with Crohn's disease (CD) may be at risk of micronutrient insufficiency in clinical remission through restrictive eating, malabsorption, abnormal losses or inflammation. This systematic review synthesises the literature on micronutrient insufficiency in CD in clinical remission in terms of the prevalence of low circulating micronutrient concentrations and as a comparison against a healthy control (HC). Studies were included if the population was predominantly in remission. A total of 42 studies met the inclusion criteria; 12 were rated as low quality, leaving 30 studies covering 21 micronutrients of medium/high quality that were included in the synthesis. Vitamins D and B12 were the most frequently reported nutrients (8 and 11); there were few eligible studies for the remaining micronutrients. The prevalence studies were consistent in reporting individuals with low Vitamins A, B6, B12 and C, β-carotene, D, Magnesium, Selenium and Zinc. The comparator studies were inconsistent in finding differences with CD populations; Vitamin D, the most reported nutrient, was only lower than the HC in one-quarter of the studies. Adult CD populations are likely to contain individuals with low levels of one or more micronutrients, with the most substantial evidence for Vitamins D and B12. The studies on other micronutrients are of insufficient number, standardisation and quality to inform practice.

To Eat or Not to Eat?-Food Safety Aspects of Essential Metals in Seafood

The popularity of seafoods is high due to their superb dietary properties and healthy composition. However, it is crucial to understand whether they adequately contribute to our essential nutritional needs. Small amounts of essential metals are indispensable in the human body to proper physiological functioning; their deficiency can manifest in various sets of symptoms that can only be eliminated with their intake during treatment or nutrition. However, the excessive consumption of metals can induce undesirable effects, or even toxicosis. Shellfish, oyster, and squid samples were collected directly from a fish market. After sample preparation, the concentration of essential metals (cobalt, chromium, copper, manganese, molybdenum, nickel, and zinc) was detected by Inductively Coupled Plasma Optical Emission Spectrometry. The results were analyzed statistically using ANOVA and two-sample t-tests. The average concentration of the investigated essential elements and the calculated burden based on the consumption were below the Recommended Dietary Allowances and Tolerable Upper Intake Levels. Based on these results, the trace element contents of the investigated seafoods do not cover the necessary recommended daily intake of them, but their consumption poses no health hazard due to their low levels.

A Systematic Review and Meta-Analysis Exploring Variations in Copper Levels between Individuals with Malaria and Uninfected Controls

Micronutrient insufficiency has been implicated in malaria pathogenesis. However, the role of copper in malaria remains inconclusive. This study aimed to investigate the association between copper levels and malaria pathogenesis, providing a deeper understanding of copper's role in the disease. A systematic review was conducted following the registered protocol in PROSPERO (CRD42023439732). Multiple databases, including Embase, MEDLINE, Ovid, PubMed, Scopus, and Google Scholar, were searched for relevant studies reporting blood copper levels in patients with malaria. The Joanna Briggs Institute critical appraisal checklist was used for assessing methodological quality. Qualitative and quantitative syntheses were employed, organizing, and summarizing the findings of the included studies. To calculate the standardized mean difference (Hedge's g) and 95% confidence intervals (CIs), a random-effects model was used. After screening the databases, 16 studies were included. Most studies (52.9%) reported that individuals with malaria had significantly higher copper levels than uninfected controls. The meta-analysis, based on 16 studies, showed no significant difference in copper levels between patients with malaria and uninfected controls overall (p = 0.39; Hedges' g, 0.38; 95% CI, -0.48 to 1.25; I2, 98.73%). Subgroup analysis showed a significant difference in copper levels between patients with malaria and uninfected controls among studies conducted in Asia (p < 0.01; Hedges' g, 1.74; 95% CI, 1.04 to 2.44; I2, 90.88%; five studies) and studies employing plasma blood samples (p < 0.01; Hedges' g, 1.13; 95% CI, 0.60 to 2.07; I2, 93.11%; four studies). The qualitative synthesis of the reviewed studies suggests a complex relationship between copper levels and malaria. The meta-analysis results showed no significant difference in copper levels between patients with malaria and uninfected controls overall. However, subgroup analyses based on various factors, including continent and blood sample type, showed copper level variations. These findings highlight the need for further research to better understand the role of copper in malaria pathogenesis by considering geographical factors and the blood sample type used for copper level measurement.

Bioactive role of vitamins as a key modulator of oxidative stress, cellular damage and comorbidities associated with spinal cord injury (SCI)

Introduction: Spinal cord injury (SCI) cause significant disability and impact the quality of life of those affected by it. The nutritional status and diet are fundamental to diminish the progression of complications; vitamins modulate the inflammatory response and oxidative stress, promote blood-spinal cord barrier preservation and the prompt recovery of homeostasis. A deep knowledge of the benefits achieved from vitamins in patients with SCI are summarized. Information of dosage, time, and effects of vitamins in these patients are also displayed. Vitamins have been extensively investigated; however, more clinical trials are needed to clarify the scope of vitamin supplementation.Objective: The objective of this review was to offer relevant therapeutic information based on vitamins supplementation for SCI patients.Methods: Basic and clinical studies that have implemented the use of vitamins in SCI were considered. They were selected from the year 2000-2022 from three databases: PubMed, Science Direct and Google Scholar.Results: Consistent benefits in clinical trials were shown in those who were supplemented with vitamin D (prevents osteoporosis and improves physical performance variables), B3 (improves lipid profile) and B12 (neurological prophylaxis of chronic SCI damage) mainly. On the other hand, improvement related to neuroprotection, damage modulation (vitamin A) and its prophylaxis were associated to B complex vitamins supplementation; the studies who reported positive results are displayed in this review.Discussion: Physicians should become familiar with relevant information that can support conventional treatment in patients with SCI, such as the use of vitamins, a viable option that can improve outcomes in patients with this condition.

The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants

Premature infants, given their limited reserves, heightened energy requirements, and susceptibility to nutritional deficits, require specialized care.

AIM

To examine the complex interplay between nutrition and neurodevelopment in premature infants, underscoring the critical need for tailored nutritional approaches to support optimal brain growth and function.

DATA SOURCES

PubMed and MeSH and keywords: preterm, early nutrition, macronutrients, micronutrients, human milk, human milk oligosaccharides, probiotics AND neurodevelopment or neurodevelopment outcomes. Recent articles were selected according to the authors' judgment of their relevance. Specific nutrients, including macro (amino acids, glucose, and lipids) and micronutrients, play an important role in promoting neurodevelopment. Early and aggressive nutrition has shown promise, as has recognizing glucose as the primary energy source for the developing brain. Long-chain polyunsaturated fatty acids, such as DHA, contribute to brain maturation, while the benefits of human milk, human milk oligosaccharides, and probiotics on neurodevelopment via the gut-brain axis are explored. This intricate interplay between the gut microbiota and the central nervous system highlights human milk oligosaccharides' role in early brain maturation.

CONCLUSIONS

Individualized nutritional approaches and comprehensive nutrient strategies are paramount to enhancing neurodevelopment in premature infants, underscoring human milk's potential as the gold standard of nutrition for preterm infants.

The effect of selenium supplementation in pregnant women on maternal, fetal, and newborn outcomes: a systematic review and meta-analysis

OBJECTIVE

Low maternal selenium status has been associated with poor pregnancy outcomes, including preterm birth. This study aimed to evaluate available evidence of the effects of selenium supplementation during pregnancy on preterm birth and related maternal, fetal, and newborn outcomes.

DATA SOURCES

MEDLINE, Embase, CINAHL, Global Index Medicus, and the Cochrane Library were systematically searched on June 23, 2022, without language or time restrictions.

STUDY ELIGIBILITY CRITERIA

Randomized controlled trials and nonrandomized interventional studies were included if they compared the effects of selenium supplementation with placebo or no treatment among pregnant women. The review protocol was registered in the International Prospective Register of Systematic Reviews (identification number: CRD42022383669).

METHODS

For outcomes reported by ≥1 study, a meta-analysis was conducted. Because of the small number of studies and high clinical heterogeneity between populations, random-effects models were used. The Risk of Bias 2 and Risk Of Bias In Non-randomized Studies - of Interventions tools were used to assess study quality, and Grading of Recommendations Assessment, Development, and Evaluation analysis was used to determine the certainty of evidence for each outcome.

RESULTS

Literature searches identified 5105 unique records, and 32 studies met the eligibility criteria. Of note, 11 reports were not included for analysis following research integrity assessments. Moreover, 10 trials and 3 observational studies met the inclusion criteria; however, only 8 trials (1851 women) and 1 prospective cohort study (71,728 women) reported on at least 1 review outcome. Our results could not determine the effect of selenium supplementation on preterm birth at <37 weeks of gestation (relative risk, 0.65; 95% confidence interval, 0.26-1.63; very low certainty evidence) and <34 weeks of gestation (relative risk, 1.05; 95% confidence interval, 0.59-1.44; very low certainty evidence).

CONCLUSION

There is limited evidence on the effects of selenium supplementation during pregnancy. Further trials, with larger sample sizes, more representative populations, and reliable assessment of maternal selenium status at trial entry, are required.

From farm to fork: future supply chains need to measure and trade nutrient content

In the future, 8-10 billion people will need to be fed by our agriculture and food production system. Moreover, currently up to five billion people are already affected by malnutrition including undernutrition, inadequate consumption of micronutrients, and overweight. A healthy and sustainable diet will therefore play a pivotal role in our future, but most food products are traded and consumed based only on techno-functional or gustatory properties. We wish to stimulate a debate on the urgent need for multidisciplinary research and education to realize future diets with enhanced nutritional profiles. In particular, there is a need to better measure and understand the factors that influence the nutrients of food products along the global supply chains.

Protective Effects of Micronutrient Supplements, Phytochemicals and Phytochemical-Rich Beverages and Foods Against DNA Damage in Humans: A Systematic Review of Randomized Controlled Trials and Prospective Studies

Accumulation of deoxyribonucleic acid (DNA) damage diminishes cellular health, increases risk of developmental and degenerative diseases, and accelerates aging. Optimizing nutrient intake can minimize accrual of DNA damage. The objectives of this review are to: 1) assemble and systematically analyze high-level evidence for the effect of supplementation with micronutrients and phytochemicals on baseline levels of DNA damage in humans, and 2) use this knowledge to identify which of these essential micronutrients or nonessential phytochemicals promote DNA integrity in vivo in humans. We conducted systematic literature searches of the PubMed database to identify interventional, prospective, cross-sectional, or in vitro studies that explored the association between nutrients and established biomarkers of DNA damage associated with developmental and degenerative disease risk. Biomarkers included lymphocyte chromosome aberrations, lymphocyte and buccal cell micronuclei, DNA methylation, lymphocyte/leukocyte DNA strand breaks, DNA oxidation, telomere length, telomerase activity, and mitochondrial DNA mutations. Only randomized, controlled interventions and uncontrolled longitudinal intervention studies conducted in humans were selected for evaluation and data extraction. These studies were ranked for the quality of their study design. In all, 96 of the 124 articles identified reported studies that achieved a quality assessment score ≥ 5 (from a maximum score of 7) and were included in the final review. Based on these studies, nutrients associated with protective effects included vitamin A and its precursor β-carotene, vitamins C, E, B1, B12, folate, minerals selenium and zinc, and phytochemicals such as curcumin (with piperine), lycopene, and proanthocyanidins. These findings highlight the importance of nutrients involved in (i) DNA metabolism and repair (folate, vitamin B12, and zinc) and (ii) prevention of oxidative stress and inflammation (vitamins A, C, E, lycopene, curcumin, proanthocyanidins, selenium, and zinc). Supplementation with certain micronutrients and their combinations may reduce DNA damage and promote cellular health by improving the maintenance of genome integrity.

Combination of seed priming and nutrient foliar application improved physiological attributes, grain yield, and biofortification of rainfed wheat

Seed priming and foliar application are two crop management practices that can increase grain yield and quality. The research aimed to assess the influence of seed priming and foliar application on rainfed wheat. Two field experiments with two seed priming rates (control and priming) and five foliar applications [control, urea (4%), silicon (4 mM), FeSO4.7H2O (0.6%), and ZnSO4.7H2O (0.4%)] at the anthesis/Z61 stage were conducted. Seeds were primed for 12 h at 25 ± 2°C, by soaking in an aerating solution [urea (20 g L-1) + FeSO4.7H2O (50 ppm) + ZnSO4.7H2O (50 ppm) + silicon (20 mg L-1)]. Seed weight-to-solution volume ratio was 1:5 (kg L-1). A pot experiment was also conducted to examine the effect of priming on root growth. Overall, combined seed priming and foliar application induced a positive impact on physiological traits and attributes. Maximum chlorophyll a, chlorophyll b, total chlorophyll, and carotenoid concentrations (1.58, 0.669, 2.24, and 0.61 mg g-1 FW), membrane stability index (77.31%), superoxide dismutase and peroxidase activity (0.174 and 0.375 Unit mg-1 protein), 1,000-grain weight (35.30 g), biological yield, grain yield (8,061 and 2,456 kg ha-1), and minimum malondialdehyde concentration (3.91 µg g-1 FW) were observed in seed priming combination with ZnSO4 foliar application. The highest glycine betaine concentration (6.90 mg g-1 DW) and proline (972.8 µg g-1 FW) were recorded with the co-application of seed priming and foliar urea spraying. Foliar application of ZnSO4, FeSO4, and urea drastically enhanced grain Zn (29.17%), Fe (19.51%), and protein content (increased from 11.14% in control to 12.46% in urea foliar application), respectively. Compared to control, seed priming increased root length, root volume, and dry mass root by 8.95%, 4.31%, and 9.64%, respectively. It is concluded that adequate Zn, Fe, silicon, and N supply through seed priming and foliar applications of these compounds at the terminal stage of rainfed wheat alleviates drought stress and improves GY and biofortification.

Genetic Mapping for QTL Associated with Seed Nickel and Molybdenum Accumulation in the Soybean 'Forrest' by 'Williams 82' RIL Population

Understanding the genetic basis of seed Ni and Mo is essential. Since soybean is a major crop in the world and a major source for nutrients, including Ni and Mo, the objective of the current research was to map genetic regions (quantitative trait loci, QTL) linked to Ni and Mo concentrations in soybean seed. A recombinant inbred line (RIL) population was derived from a cross between 'Forrest' and 'Williams 82' (F × W82). A total of 306 lines was used for genotyping using 5405 single nucleotides polymorphism (SNP) markers using Infinium SNP6K BeadChips. A two-year experiment was conducted and included the parents and the RIL population. One experiment was conducted in 2018 in North Carolina (NC), and the second experiment was conducted in Illinois in 2020 (IL). Logarithm of the odds (LOD) of ≥2.5 was set as a threshold to report identified QTL using the composite interval mapping (CIM) method. A wide range of Ni and Mo concentrations among RILs was observed. A total of four QTL (qNi-01, qNi-02, and qNi-03 on Chr 2, 8, and 9, respectively, in 2018, and qNi-01 on Chr 20 in 2020) was identified for seed Ni. All these QTL were significantly (LOD threshold > 2.5) associated with seed Ni, with LOD scores ranging between 2.71-3.44, and with phenotypic variance ranging from 4.48-6.97%. A total of three QTL for Mo (qMo-01, qMo-02, and qMo-03 on Chr 1, 3, 17, respectively) was identified in 2018, and four QTL (qMo-01, qMo-02, qMo-03, and qMo-04, on Chr 5, 11, 14, and 16, respectively) were identified in 2020. Some of the current QTL had high LOD and significantly contributed to the phenotypic variance for the trait. For example, in 2018, Mo QTL qMo-01 on Chr 1 had LOD of 7.8, explaining a phenotypic variance of 41.17%, and qMo-03 on Chr 17 had LOD of 5.33, with phenotypic variance explained of 41.49%. In addition, one Mo QTL (qMo-03 on Chr 14) had LOD of 9.77, explaining 51.57% of phenotypic variance related to the trait, and another Mo QTL (qMo-04 on Chr 16) had LOD of 7.62 and explained 49.95% of phenotypic variance. None of the QTL identified here were identified twice across locations/years. Based on a search of the available literature and of SoyBase, the four QTL for Ni, identified on Chr 2, 8, 9, and 20, and the five QTL associated with Mo, identified on Chr 1, 17, 11, 14, and 16, are novel and not previously reported. This research contributes new insights into the genetic mapping of Ni and Mo, and provides valuable QTL and molecular markers that can potentially assist in selecting Ni and Mo levels in soybean seeds.

Association of Maternal Diet with Infant Birthweight in Women with Gestational Diabetes Mellitus

OBJECTIVE

This study aimed to explore the potential impact of pre-pregnancy and early pregnancy maternal nutrition on the incidence of small-for-gestational-age neonates (SGA) in women with gestational diabetes mellitus (GDM).

METHODS

A prospective cohort study was conducted between 2020 and 2022 at the 3rd Department of Obstetrics and Gynaecology (School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece). Pregnant women from routine care were surveyed about their dietary habits during two distinct periods: six months prior to pregnancy (period A) and from the onset of pregnancy until the oral glucose tolerance test at 24-28 gestational weeks (period B). The intake of various micronutrients and macronutrients was quantified from the questionnaire responses. Logistic regression models, adjusted for potential confounders including age, pre-pregnancy body mass index (BMI), smoking status, physical activity and parity, were used to evaluate the association between nutrient intake and small-for-gestational-age neonate incidence.

RESULTS

In total, 850 women were screened and of these, 90 (11%) were diagnosed with gestational diabetes mellitus and were included in the study. There were significant associations between the intake of specific nutrients and the occurrence of small-for-gestational-age neonates; higher fat intake compared to non-small for gestationa age during period B (aOR: 1.1, p = 0.005) was associated with an increased risk for small-for-gestational-age neonates, while lower intake of carbohydrates (g) (aOR: 0.95, p = 0.005), fiber intake (aOR: 0.79, p = 0.045), magnesium (aOR: 0.96, p = 0.019), and copper (aOR:0.01, p = 0.018) intake during period B were significantly associated with a decreased risk for small-for-gestational-age neonates.

CONCLUSIONS

The findings of this study highlight the potential role of maternal nutrition in modulating the risk of small for gestational age neonatesamong women with gestational diabetes mellitus. The results advocate for further research on the assessment and modification of both pre-pregnancy and early pregnancy nutrition for women, especially those at higher risk of gestational diabetes mellitus, to reduce the risk of gestational diabetes mellitus.

Regional and Age-Related Variations in Blood Calcium Levels among Patients with Plasmodium falciparum and P. vivax malaria: A Systematic Review and Meta-Analysis

Despite several studies examining the relationship between calcium levels and malaria, inconsistencies and varied results remain in the literature. This study aimed to synthesize the evidence on the association between blood calcium levels and malaria severity. A systematic literature search was conducted in the Embase, Scopus, PubMed, Ovid, and Google Scholar databases. The studies that investigated calcium levels in participants with malaria were reviewed and included for synthesis. The quality of included studies was assessed based on a standardized checklist by the Joanna Briggs Institute (JBI) critical appraisal checklists. The thematic synthesis had been used for qualitative synthesis. For the quantitative synthesis, the meta-analysis was performed to estimate the pooled effect sizes for differences in calcium levels between groups of participants using a random effect model using Hedge's g as a measure of effect size. Out of the 4574 identified records, 14 studies were reviewed. The thematic synthesis across these studies noted a consistent theme: reduced calcium levels in malaria patients compared to uninfected controls. However, the meta-analysis encompassing three specific analyses-comparing calcium levels between malaria patients and controls, severe and non-severe malaria cases, and fatal cases versus survivors-showed no significant difference in calcium levels. The statistics were as follows: (1) p = 0.15, Hedge's g: -1.00, 95% CI: -2.37-0.38, I2: 98.97, 9 studies; (2) p = 0.35, Hedge's g: -0.33, 95% CI: -1.02-0.36, I2: 81.61, 3 studies; and (3) p = 0.71, Hedge's g: -0.14, 95% CI: -0.91-0.62, I2: 87.05, 3 studies. Subgroup analyses indicated that regional disparities, especially between Africa and Asia, and participant age groups may influence these outcomes. While a trend of decreased calcium levels in malaria patients was observed, the meta-analytical results suggest regional and age-related variations. Further investigations should emphasize these differences to better guide clinical management, prognostic applications, and the crafting of policies concerning malaria's metabolic effects.

Development and Evaluation of Zinc and Iron Nanoparticles Functionalized with Plant Growth-Promoting Rhizobacteria (PGPR) and Microalgae for Their Application as Bio-Nanofertilizers

Micronutrient deficiencies are widespread and growing global concerns. Nanoscale nutrients present higher absorption rates and improved nutrient availability and nutrient use efficiency. Co-application of nanofertilizers (NFs) with biological agents or organic compounds increases NF biocompatibility, stability, and efficacy. This study aimed to develop and evaluate zinc and iron bio-nanofertilizers formulated with plant growth-promoting rhizobacteria (PGPR) and microalgae. Nanoparticles (NPs) were synthesized with the co-precipitation method and functionalized with Pseudomonas species and Spirulina platensis preparation. NPs were characterized and evaluated on seed germination, soil microbial growth, and early plant response under seedbed conditions. NPs corresponded to zinc oxide (ZnO; 77 nm) and maghemite (γ-Fe2O3; 68 nm). Functionalized nanoparticles showed larger sizes, around 145-233 nm. The seedling vigor index of tomato and maize was significantly increased (32.9-46.1%) by bacteria-functionalized ZnO- and γ-Fe2O3-NPs at 75 ppm. NFs at 250 and 75 ppm significantly increased bacterial growth. NFs also improved early plant growth by increasing plant height (14-44%), leaf diameter (22-47%), and fresh weight (46-119%) in broccoli and radish, which were mainly influenced by bacteria capped ZnO- and γ-Fe2O3-NPs at 250 ppm. Beneficial effects on plant growth can be attributed to the synergistic interaction of the biological components and the zinc and iron NPs in the bio-nanofertilizers.

Mental Health Component Scale Is Positively Associated with Riboflavin Intake in People with Central Obesity

Micronutrient deficiencies are a well-established fact in obesity. However, few studies exist on the relationship between micronutrient intake and mental health. In this study, we investigated the associations between daily intakes of vitamins and minerals and scoring items that measure mental health in people living with central obesity. One hundred males and females with central obesity and metabolic abnormalities were included in the study. Demographic, clinical, anthropometric, and biochemical data were collected. Mental health statuses were assessed with validated questionnaires, and daily micronutrient intakes were assessed with food diaries and Nutritionist ProTM software v7.9. The mental component score (MCS-12) positively correlated with vitamin A (Rho = 0.249, p = 0.038), vitamin C (Rho = 0.293, p = 0.014), riboflavin (Rho = 0.264, p = 0.026), and folate (Rho = 0.238, p = 0.046). Rosenberg Self-Esteem Scale (RSES) correlated with sodium (Rho = 0.269, p = 0.026), and the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) correlated with chromium (Rho = 0.313, p = 0.009). In the regression analysis, after potential confounders were adjusted for, only riboflavin was positively associated with the MCS-12 log (beta ± SD = 0.047 ± 0.023, p = 0.044). Our study provides evidence of the link between dietary riboflavin and mental health in people with obesity, and it highlights the importance of monitoring both nutritional status and mental health when managing obesity.

Nutrient synergy: definition, evidence, and future directions

Nutrient synergy refers to the concept that the combined effects of two or more nutrients working together have a greater physiological impact on the body than when each nutrient is consumed individually. While nutrition science traditionally focuses on isolating single nutrients to study their effects, it is recognized that nutrients interact in complex ways, and their combined consumption can lead to additive effects. Additionally, the Dietary Reference Intakes (DRIs) provide guidelines to prevent nutrient deficiencies and excessive intake but are not designed to assess the potential synergistic effects of consuming nutrients together. Even the term synergy is often applied in different manners depending on the scientific discipline. Considering these issues, the aim of this narrative review is to investigate the potential health benefits of consuming different nutrients and nutrient supplements in combination, a concept we define as nutrient synergy, which has gained considerable attention for its impact on overall well-being. We will examine how nutrient synergy affects major bodily systems, influencing systemic health. Additionally, we will address the challenges associated with promoting and conducting research on this topic, while proposing potential solutions to enhance the quality and quantity of scientific literature on nutrient synergy.

Genotypic and environmental effects on quality and nutritional attributes of Moroccan barley cultivars and elite breeding lines

Although barley is mainly used for livestock feed and beverages, its use as human feed can enrich human diets with some health benefits. The development of new hulless varieties rich in β-glucans and micronutrients can enhance the use of barley as food, but little is known about the effects of the environment on these nutritional traits. In this study, we evaluated five Moroccan varieties and two elite breeding lines of barley at four locations in Morocco during the 2016-2017 and 2017-2018 cropping seasons. The results showed highly significant differences between genotypes for β-glucan, protein, iron, and selenium contents, as well as 1000 kernel weight, but not zinc content; significant to highly significant differences between environments for all traits except β-glucan content; and significant to highly significant interactions for all traits. The highest level of β-glucan content has reached 11.57% observed at the Sidi El Aydi site during the growing season 2017-2018 for the hulless variety Chifaa. This variety has shown the highest content of β-glucan (6.2-11.57%) over all environments except at Tassaout during the 2016-2017 seasons. The breeding line M9V5 has achieved significantly higher protein content at all the locations during the two growing seasons, ranging from 12.38 to 20.14%. Most hulless lines had significantly higher β-glucan and protein contents, but lower 1000 kernel weight. For micronutrients, the content ranges were 28.94 to 38.23 ppm for Fe, 28.78 to 36.49 ppm for Zn, and 0.14 to 0.18 ppm for Se, with the highest content for Fe and Zn shown by the breeding line M9V5 and Chifaa showing average contents of 33.39 ppm, 35.34 ppm, and 0.18 ppm for Fe, Zn, and Se, respectively. The GGE biplot confirmed the high and relatively stable content of β-glucan and acceptable micronutrient contents of the Chifaa variety and identified Marchouch as the most discriminant site to breed for biofortified barley varieties.

Nutrient Intake and Status in Children and Adolescents Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review

Health authorities increasingly recommend sustainable and healthy diets rich in plant foods and with moderate amounts of animal foods. However, there are concerns about whether such diets can meet all nutrient requirements, especially in children and adolescents, who have relatively high nutrient needs for growth and development. Therefore, we aimed to evaluate the nutrient intake and status of children and adolescents (2-18 y) consuming plant-based (i.e., vegetarian and vegan) diets compared to those of meat-eating children following a systematic literature review of studies published between 2000 and 2022. Mean intake and status data of nutrients were calculated across studies and benchmarked to dietary reference values and cut-off values for nutrient deficiencies. A total of 30 studies were included (15 in children 2-5 y, 24 in children 6-12 y, and 11 in adolescents 13-18 y). In all diets, there were risks of inadequate intakes of vitamin D and calcium. Children consuming meat had a risk of inadequate folate and vitamin E intake; and mean fiber, SAFA, and PUFA intakes were not in line with the recommendations. Children consuming plant-based diets risked inadequate vitamin B12, iron, and zinc intakes. In contrast to vegans, vegetarian children may not meet the recommended intakes of fiber, SAFA, and possibly PUFA, but their mean intakes were more favorable than in meat-eating children. Although the data are limited and need further validation, our findings indicate that there are risks of nutritional inadequacies in all diet groups. Therefore, increasing consumption of a variety of plant-based foods, in combination with food fortification and supplementation where needed, is recommended for children and adolescents to have sustainable and nutritionally adequate diets.

Comparison of micronutrients in adult enteral formulas widely used in clinical practice

In recent decades, great progress in the area of enteral nutrition has provided a large variety and commercial availability of enteral formulas, usually produced by the nutrition divisions of several pharmaceutical or dairy manufacturers, with specific compositions for each type of disease or patient condition. Despite the widespread use of enteral formulas, both in hospitals and at home, studies performed on the micronutrient compositions of adult enteral formulas are few in China. The content of micronutrients in 31 commercially available adult enteral formulas in the Chinese market was compared with the Chinese dietary reference intakes (DRIs), the tolerable upper limits (UL), the limit requirements in Food Safety National Standards General Rules of Foods for Special Medical Purposes (GB 29922-2013), and the European Society for Clinical Nutrition and Metabolism (ESPEN) micronutrient guideline (2022). The micronutrient content was calculated by multiplying the value provided on the nutrition label for each product by the daily energy dose of 1500 and 1800 Kcal/day. The research results showed that most adult enteral formulas were generally suitable for patients on long-term total enteral nutrition support in the Chinese market, and foods for special medical purpose (FSMP) formulas were more suitable than enteral nutrition preparation (ENP) formulas. However, the vitamin D, vitamin K, and iron content in these formulas should be appropriately increased to the limit recommended by the ESPEN micronutrient guideline. The results could provide a basis for manufacturers to research and develop more suitable enteral formulas and help clinical dietitians administer more effective enteral nutrition support for patients on long-term total enteral nutrition in clinical practice, especially individualized treatment.

Millets: A Nutritional Powerhouse With Anti-cancer Potential

Millets are important food crops widely grown by smallholder farmers in the arid and semi-arid regions of the world. Millets are rich in protein, dietary fiber, micronutrients, and have a low glycemic index (GI) and desirable bioactive compounds. Due to their higher nutritional content, millets are popularly known as "nutricereals". Coinciding with the United Nations and the Food and Agriculture Organization's declaration of 2023 as the "International Year of Millets," this review underscores the nutritional value of these grains from the Poaceae family. The consumption of nutricereals is associated with several health benefits including lowering of blood sugar levels (diabetes), controlling blood pressure, and providing protection against thyroid, cardiovascular, and cancer diseases. A review of the literature from PubMed and Google Scholar was done focusing on the health benefits and anti-cancer properties of different millets. Millets have a rich content of macronutrients like carbohydrates and proteins, as well as micronutrients and bioactive compounds, including dietary fibers, essential fatty acids, and phytochemicals. This article explores millets' nutritional elements, i.e., macronutrients, micronutrients, and bioactive compounds, and provides insights into the types of carbohydrates present, the prebiotic function of dietary fibers, and millets' low GI. The study identified the mechanisms by which millets may deter cancer growth, focusing on the roles of dietary fibers, plant protease inhibitors, and bioactive peptides. Additionally, it compared the mineral and vitamin content of millets to other common grains, such as rice and wheat, and explored the potential health advantages of millets over other cereal crops. This review systematically investigated the health advantages of millets, particularly, their anti-cancer capabilities. Dietary fibers, plant protease inhibitors, and bioactive peptides present in millets have the capacity to induce apoptosis, inhibit cell proliferation, and interact with gut microbiota leading to potential anti-cancer effects. This review also identified existing challenges in the bioavailability and effective delivery of millets' bioactive peptides, advocating for further research to maximize their health benefits.

Characterisation of parathyroid hormone concentration in extremely preterm or very low birthweight infants in routine clinical screening for metabolic bone disease: A service evaluation cohort study

AIM

To characterise parathyroid hormone (PTH) concentrations in infants at high risk for metabolic bone disease, in order to assist clinical decisions around the use of PTH for screening.

METHODS

Infants born under 28 weeks' postmenstrual age or with birthweight under 1.5 kg in a tertiary neonatal unit in the UK were included. Clinical guidance was to assess PTH concentration in the first 3 weeks after birth. Clinical information was extracted from prospective records.

RESULTS

Sixty-four infants had mean birth gestation of 26 weeks and birthweight of 882 g. Median PTH (sent on median day 18 of life) was 9.2 pmol/L (interquartile range 5.3-17 pmol/L). Sixty-seven per cent of infants had a PTH greater than 7 pmol/L. For 22% of the infants, raised PTH was not accompanied by abnormal phosphate or alkaline phosphatase. Eighty-nine per cent of infants tested were insufficient or deficient for 25-hydroxyvitamin D.

CONCLUSIONS

Universal screening highlights the high frequency of high PTH in this high-risk population, implying a need for calcium supplementation. A considerable number of infants would not be identified as showing potential signs of metabolic bone disease if the assessment excludes the use of PTH. The high level of 25-hydroxyvitamin D deficiency may be a confounder.

Unraveling the potential of bacterial phytases for sustainable management of phosphorous

Phosphorous actively participates in numerous metabolic and regulatory activities of almost all living organisms including animals and humans. Therefore, it is considered as an essential macronutrient required supporting their proper growth. On contrary, phytic acid (PA), an antinutritional substance, is widely known for its strong affinity to chelate essential mineral ions including PO4 3- , Ca2+ , Fe2+ , Mg2+ , and Zn2+ . Being one the major reservoir of PO4 3- ions, PA has great potential to bind PO4 3- ions in diverse range of foods. Once combined with P, PA transforms into an undigested and insoluble complex namely phytate. Produced phytate leads to a notable reduction in the bioavailability of P due to negligible activity of phytases in monogastric animals and humans. This highlights the importance and consequent need of enhancement of phytase level in these life forms. Interestingly, phytases, catalyzing the breakdown of phytate complex and recycling the phosphate into ecosystem to its available form, have naturally been reported in a variety of plants and microorganisms over past few decades. In pursuit of a reliable solution, the focus of this review is to explore the keynote potential of bacterial phytases for sustainable management of phosphorous via efficient utilization of soil phytate. The core of the review covers detailed discussion on bacterial phytases along with their widely reported applications viz. biofertilizers, phosphorus acquisition, and plant growth promotion. Moreover, meticulous description on fermentation-based strategies and future trends on bacterial phytases have also been included.