Dietary Reference Values for nutrients Summary report

Mycoremediation of Flotation Tailings with Agaricus bisporus

Due to their enzymatic and bioaccumulation faculties the use of macromycetes for the decontamination of polluted matrices seems reasonable for bioremediation. For this reason, the aim of our study was to evaluate the mycoremediation ability of Agaricus bisporus cultivated on compost mixed with flotation tailings in different quantities (1, 5, 10, 15, and 20% addition). The biomass of the fruit bodies and the content of 51 major and trace elements were determined. Cultivation of A. bisporus in compost moderately polluted with flotation tailings yielded significantly lower (the first flush) and higher (the second flush) biomass of fruit bodies, compared with the control treatment. The presence of toxic trace elements did not cause any visible adverse symptoms for A. bisporus. Increasing the addition of flotation tailings to the compost induced an elevated level of most determined elements. A significant increase in rare earth elements (both flushes) and platinum group elements (first flush only) was observed. The opposite situation was recorded for major essential elements, except for Na and Mg in A. bisporus from the second flush under the most enriched compost (20%). Nevertheless, calculated bioaccumulation factor values showed a selective accumulation capacity—limited for toxic elements (except for Ag, As, and Cd) and the effective accumulation of B, Cu, K, and Se. The obtained results confirmed that A. bisporus can be used for practical application in mycoremediation in the industry although this must be preceded by larger-scale tests. This application seems to be the most favorable for media contaminated with selected elements, whose absorption by fruiting bodies is the most efficient.

Trans Fatty Acids Content in Whole-Day Diets Intended for Pregnant and Breastfeeding Women in Gynaecological and Obstetric Wards: Findings from the Study under the “Mum’s Diet” Pilot Program in Poland

Trans fatty acids (TFAs) have been proven to have an adverse effect on human health by interfering with n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) synthesis. LC-PUFA n-3 are necessary for the development and maturation of the nervous system and retina during the prenatal period and infancy. TFAs are not synthesized de novo in the human body. Their presence in body fluids arises from the diet. The aim of our study was to determine the content of TFAs in individual meals and in a whole-day hospital diet intended for pregnant and breastfeeding women. Samples were collected from six different hospitals in Poland which voluntarily applied to the “Mum’s Diet” Pilot Program. The content of fatty acids, including TFAs, was determined by gas chromatography coupled with mass spectrometry (GC-MS). The TFAs content in the whole-day hospital diets ranged from 3.86 to 8.37% of all fatty acids (% wt/wt). Food products served for elevenses and afternoon snacks contributed the highest amounts of TFAs. These mainly included dairy products containing TFAs of natural origins. The estimated average intake of TFAs with the hospital diet was 0.72 g/person/day (range: 0.34–1.16 g/person/day) and did not exceed the maximum level of 1% of dietary energy recommended by the World Health Organization.

Flavanol-Rich Cocoa Supplementation Inhibits Mitochondrial Biogenesis Triggered by Exercise

The potential role of cocoa supplementation in an exercise context remains unclear. We describe the effects of flavanol-rich cocoa supplementation during training on exercise performance and mitochondrial biogenesis. Forty-two male endurance athletes at the beginning of the training season received either 5 g of cocoa (425 mg of flavanols) or maltodextrin (control) daily for 10 weeks. Two different doses of cocoa (equivalent to 5 g and 15 g per day of cocoa for a 70 kg person) were tested in a mouse exercise training study. In the athletes, while both groups had improved exercise performance, the maximal aerobic speed increased only in the control group. A mitochondrial DNA analysis revealed that the control group responded to training by increasing the mitochondrial load whereas the cocoa group showed no increase. Oxidative stress was lower in the cocoa group than in the control group, together with lower interleukin-6 levels. In the muscle of mice receiving cocoa, we corroborated an inhibition of mitochondrial biogenesis, which might be mediated by the decrease in the expression of nuclear factor erythroid-2-related factor 2. Our study shows that supplementation with flavanol-rich cocoa during the training period inhibits mitochondrial biogenesis adaptation through the inhibition of reactive oxygen species generation without impacting exercise performance.

Comparative analysis of dietary fibre determination by AOAC 991.43 and AOAC 2011.25 for frequently consumed foods in Slovenia

The definition of dietary fibre was modified by Codex Alimentarius commission in 2009, and now includes low molecular weight soluble dietary fibre. This prompted the development of new methods for determination of dietary fibre, such as AOAC 2009.01 and AOAC 2011.25. We compared the dietary fibre contents of 45 different foods from six food groups, as sources of dietary fibre frequently consumed in Slovenia. Dietary fibre was determined with methods AOAC 991.43 and AOAC 2011.25, and the results were compared. Majority of results show significantly higher dietary fibres when determined using AOAC 2011.25. Differences can be explained by low molecular weight soluble dietary fibre, which is measured by AOAC 2011.25. New methods for dietary fibre determination have impacts on national food composition databases, which remain mainly based on AOAC 991.43; defining the need to update food composition databases with data that include low molecular weight soluble dietary fibre.

Protein intake, physical activity and grip strength in European and North American community-dwelling older adults: a pooled analysis of individual participant data from four longitudinal ageing cohorts

INTRODUCTION

Higher dietary protein, alone or in combination with physical activity (PA), may slow the loss of age-related muscle strength in older adults. We investigated the longitudinal relationship between protein intake and grip strength, and the interaction between protein intake and PA, using four longitudinal ageing cohorts.

METHODS

Individual participant data from 5584 older adults (52% women; median: 75, IQR: 71.6, 79.0 years) with up to 8.5 years (mean: 4.9, SD: 2.3 years) of follow-up from the Health ABC, NuAge, LASA and Newcastle 85+ cohorts were pooled. Baseline protein intake was assessed with food frequency questionnaires and 24h recalls and categorized into <0.8, 0.8-<1.0, 1.0-<1.2 and ≥1.2 g/kg adjusted body weight (aBW)/d. The prospective association between protein intake, its interaction with PA, and grip strength (sex- and cohort-specific) was determined using joint models (hierarchical linear mixed effects and a link function for Cox proportional hazards models).

RESULTS

Grip strength declined on average by 0.018 SD (95%CI: -0.026, -0.006) every year. No associations were found between protein intake, measured at baseline, and grip strength, measured prospectively, or rate of decline of grip strength in models adjusted for sociodemographic, anthropometric, lifestyle and health variables (e.g., protein intake ≥1.2 vs <0.8 g/kg aBW/d: β= -0.003, 95%CI: -0.014,0.005 SD per year). There also was no evidence of an interaction between protein intake and PA.

CONCLUSIONS

We failed to find evidence in this study to support the hypothesis that higher protein intake, alone or in combination with higher PA, slowed the rate of grip strength decline in older adults.

Performance of Apple Pomace for Gluten-Free Bread Manufacture: Effect on Physicochemical Characteristics and Nutritional Value

Apple pomace has been proposed as a quality enhancer for gluten-free bread, but its composition and physicochemical features differ significantly depending on the apple cultivar. The objective of this article was to characterize apple pomace powder (APP) from certain varieties from the Basque Country and to study the feasibility of adding it to gluten-free bread, focusing on physicochemical and nutritional aspects. APP was obtained by washing, drying and grinding, and it was added at 0, 5, 6 and 8%, together with other ingredients, such as gluten-free flours, corn starch and whey protein. APP had a reddish-grey coloration (L* 56.49 ± 1.39, a* 11.07 ± 0.47, b* 27.69 ± 1.76), pH 4.19 ± 0.15 and Aw 0.235 ± 0.084. Pomace powder was used successfully in higher amounts than experiences reported before. Key physicochemical parameters such as specific volume (≥2.5 cm3/g) and cohesiveness or resilience values (0.538 and 0.378, respectively) suggested good acceptability for gluten-free breads with 8% APP. Additionally, breads were a source of antioxidant potential (437.66 ± 38.95 µM DPPHeq/g APP), fiber (80.13 ± 6.07 g/100 g) and micronutrients such as Cu, Mg, Mn and Fe. In conclusion, local apple varieties are a good source of raw material for gluten-free bread manufacture, which offers a solution for environmental pollution and may contribute to boosting the circular economy.

Effect of Chia Seed as Egg Replacer on Quality, Nutritional Value, and Sensory Acceptability of Sponge Cake

This study aimed to make a cake by incorporating chia seed flour (CSF) at 0, 3, 5, and 7% with egg replacement at 0, 25, 50, and 100%, respectively. The addition of CSF increased the total proteins, fats, and mineral contents. However, cake volume, uniformity, and symmetry were lowered significantly ( $p>0.05$ ) at an elevated level (5% and 7%) of CSF. Similarly, the cake depicted relatively higher textural hardness, springiness, cohesiveness, and chewiness upon addition of CSF. The higher substitution of CSF resulted in darker crust and crumb with lower sensory acceptability by the panelists, though the 3% CSF addition did not compromise the cake acceptance. Nonetheless, there were a significant rise in total phenolics and better antioxidant activity with CSF, measured as free radical scavenging activity. Most importantly, a massive rise in unsaturated fatty acids (ω-3, ω-6) and the simultaneous decline in total cholesterol were detected with increasing substitution of CSF.

Safety of vitamin D2 mushroom powder as a Novel food pursuant to Regulation (EU) 2015/2283 (NF 2019/1471)

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on vitamin D₂ mushroom powder as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is produced from Agaricus bisporus mushroom that has been exposed to ultraviolet (UV) irradiation to induce the conversion of provitamin D₂ (ergosterol) to vitamin D₂ (ergocalciferol). The NF contains levels of vitamin D in the form of vitamin D₂ in the range of 125-375 µg/g. The information provided on the production process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF as an ingredient in a variety of foods and beverages in amounts that result in either 1.125 or 2.25 µg vitamin D₂ per 100 g or 100 mL of the food as consumed. The applicant also intends to add the NF in food supplements, for infants from 7 to 11 months at a maximum of 10 µg vitamin D₂/day and of 15 µg vitamin D₂/day for individuals aged 1 year or older, as well as in foods for special medical purposes (FSMPs) and total and meal diet replacement for weight control. For the adult population, the maximum intended use level in FSMPs is 15 µg vitamin D₂/day and 5 µg vitamin D₂/meal in total and meal diet replacement for weight control. The Panel concludes that the NF is safe under the proposed conditions of use. The Panel notes uncertainty regarding the calculated combined exposures to vitamin D for the general population, given the fact that the range of foods fortified with vitamin D has increased over the years, as well as the marketing of high-dose vitamin D supplements.

Effect of long-term storage and harvest site on the fatty acid profiles, mineral and antioxidant properties of selected edible Scottish seaweeds

The limited understanding of the effect of pre-and post-harvest techniques still hinders the full exploitation of seaweed. Here, the effect of harvest site, long term storage and species on the elemental composition, fatty acid profile, lipid content, and antioxidant properties were determined in eight intertidal seaweed species common to Scotland, harvested for potential food application and stored for up to 128 weeks. Result showed that the most significant variation was due to species, with no statistical link found for the combined interaction effect of both storage duration and harvest site in most cases, except for the antioxidant parameters and some selected elements, which was limited to some seaweed species. Overall, our result showed that the chemical profiles of the seaweed species studied were remarkably consistent and unaffected by long term storage. Thus, suggesting that seaweeds sampled from Scotland could be a valuable resource for the development of functional foods.

Suboptimal Consumption of Relevant Immune System Micronutrients Is Associated with a Worse Impact of COVID-19 in Spanish Populations

Coronavirus disease 2019 (COVID-19) has caused a global health crisis and the factors behind its differential impact on COVID-19 among populations are still being known. Geographical differences in nutrient profile could be a relevant factor, especially considering that scientific evidence supports that 10 micronutrients are essential for proper immune system function. This study aims to evaluate these micronutrient intakes in the territories of Spain and to analyze their relationship with epidemiological indicators of COVID-19 from the first two waves of COVID-19, when neither specific vaccines nor drugs had yet come into play. Results showed that vitamin D, A, B9, and zinc intakes were particularly insufficient in Spain. The joint intake of these four micronutrients was lower in regions with the highest COVID-19 incidence and mortality, and of particular importance, was the insufficient intake of vitamin D. A pattern of food consumption associated with lower COVID-19 impact was observed. In conclusion, the results show the relevance of the optimal consumption of foods rich in essential nutrients for the immune system. Therefore, this assessment could serve to launch specific dietary recommendations to strengthen the immune system in Spanish territories to better face potential new COVID-19 variants and/or further infectious diseases.

Application of Laser-Induced Breakdown Spectroscopy in the Quantitative Analysis of Elements-K, Na, Ca, and Mg in Liquid Solutions

Results of laser-induced breakdown spectroscopy measurements of K, Na, Ca, and Mg content in liquid media are discussed in the paper. Calibration results show correct parameters—linearity and R² coefficients of determination at the levels of 0.94–0.99. Obtained regression equations have been used to determine K, Na, Ca, and Mg concentrations in biological samples with known element content. Measurement results showed acceptable, within the expanded standard uncertainty, conformity with their content in the certified materials. Results have been supported by multivariate factorial analysis, which was especially effective for Ca and Mg samples. For these elements, factorial analysis allows the application of the whole spectra to obtain quantitative data on the tested samples, in contrast to a common method based on the selection of a particular spectral line for the calibration.

Safety of pea and rice protein fermented by Shiitake (Lentinula edodes) mycelia as a Novel food pursuant to Regulation (EU) 2015/2283

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on pea and rice protein fermented by Shiitake mushroom (Lentinula edodes) mycelia as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is a mixture of fermented pea and rice protein concentrates (65% and 35%, respectively). The NF is proposed to be used as a food ingredient in specific food categories. The target population is the general population. The major constituent of this NF is protein (≥ 75% dry weight), which is well digestible and provides sufficient amounts of essential amino acids. Although a tolerable upper intake level (UL) has not been derived for protein, the protein intake from the NF may nevertheless further contribute to an already high dietary protein intake in Europe. The Panel notes that the cumulative exposure to the nutrients and contaminants analysed does not raise concern. The reported values for the levels of antinutritional factors in the NF are comparable to those in other foodstuffs. The Panel considers that taking into account the composition of the NF and the proposed conditions of use, consumption of the NF is not nutritionally disadvantageous. No toxicological studies with the NF were provided by the applicant; however, the Panel considers that no toxicological studies are required for this NF. The NF has the potential capacity to sensitise individuals or to induce allergic reactions in individuals allergic to pea, rice and Shiitake mushroom. However, this risk is expected not to be higher than that resulting from the normal consumption of pea, rice or the fruiting body of the Shiitake mushroom. The Panel considers that the NF is safe at the proposed conditions of use.

Dietary Fat Intake: Associations with Dietary Patterns and Postmenopausal Breast Cancer-A Case-Control Study

The aim of this study was to assess the associations of dietary fat intake with BC occurrence and dietary patterns. This case-control study involved 420 women aged 40−79 years from northeastern Poland, including 190 newly diagnosed BC cases. Dietary data were collected using a food frequency questionnaire (62-item FFQ-6®). The Quick Food Scan of the National Cancer Institute and the Percentage Energy from Fat Screener scoring procedures were used to estimate the percentage energy from dietary fat (Pfat). The odds of BC occurrence was three times higher in the Pfat > 32%. The Pfat > 32% was positively associated with the ‘Non-Healthy’ DP and inversely associated with the Polish-aMED® score, ‘Prudent’ DP, and ‘Margarine and Sweetened Dairy’ DP. This case-control study suggests that a higher dietary fat intake (>32%) may contribute to an increased occurrence of peri- and postmenopausal breast cancer in women. Given the obtained results, an unhealthy dietary pattern characterized by the consumption of highly processed, high in sugar foods and animal fat foods should be avoided to reduce fat intake. Instead, the frequent consumption of low-processed plant foods, fish, and moderate consumption of low-fat dairy should be recommended since this pro-healthy diet is inversely associated with dietary fat intake.

Nutritional Quality and Safety of the Spirulina Dietary Supplements Sold on the Slovenian Market

The microalgae Spirulina may be a popular dietary supplement rich in essential nutrients and vitamins, but oversight of the supplement industry, in general, remains limited, and increasing incidents of adulteration, misbranding, and undeclared ingredients together with misleading claims create potential risks. In response, this study characterized the elemental, amino acid and fatty acid content of commercially available Spirulina supplements in Slovenia using EDXRF, ICP-MS and GC-MS and compared the results with their nutritional declaration. The gathered data confirm that Spirulina supplements are a good source of calcium (0.15 to 29.5% of RDA), phosphorous (3.36–26.7% of RDA), potassium (0.5 to 7.69% of RDA) and selenium (0.01 to 38.6% of RDA) when consumed within recommended amounts. However, although iron contents were relatively high (7.64 to 316% of RDA), the actual bioavailability of iron was much lower since it was mainly present as the ferric cation. This study also confirms that pure Spirulina supplements are a good source of essential and non-essential amino acids, and ω-6 but not ω-3 polyunsaturated fatty acids. The presence of additives resulted in significant variation in nutrient content and, in some instances, lower product quality. Moreover, a high proportion (86.7%) of inappropriate declarations regarding the elemental content was observed. Overall, the study conclusions underline the need for a stricter control system for Spirulina-based supplements.

Priority Micronutrient Density in Foods

Background

Despite concerted efforts to improve diet quality and reduce malnutrition, micronutrient deficiencies remain widespread globally, especially in low- and middle-income countries and among population groups with increased needs, where diets are often inadequate in iron, zinc, folate, vitamin A, calcium, and vitamin B12. There is a need to understand the density of these micronutrients and their bioavailability across diverse foods and the suitability of these foods to help meet requirements for populations with high burdens of micronutrient malnutrition.

Objective

We aimed to identify the top food sources of these commonly lacking micronutrients, which are essential for optimal health, to support efforts to reduce micronutrient malnutrition among various populations globally.

Methods

We built an aggregated global food composition database and calculated recommended nutrient intakes for five population groups with varying requirements. An approach was developed to rate foods according to their density in each and all priority micronutrients for various population groups with different nutrient requirements.

Results

We find that the top sources of priority micronutrients are organs, small fish, dark green leafy vegetables, bivalves, crustaceans, goat, beef, eggs, milk, canned fish with bones, mutton, and lamb. Cheese, goat milk, and pork are also good sources, and to a lesser extent, yogurt, fresh fish, pulses, teff, and canned fish without bones.

Conclusion

The results provide insight into which foods to prioritize to fill common micronutrient gaps and reduce undernutrition.

The Impact of the Quality of Nutrition and Lifestyle in the Reproductive Years of Women with PKU on the Long-Term Health of Their Children

A woman’s nutritional status before and during pregnancy can affect the health of her progeny. Phenylketonuria (PKU), a rare disorder causing high blood and brain phenylalanine (Phe) concentrations, is associated with neurocognitive disability. Lifelong treatment is mainly dietetic with a Phe-restricted diet, supplemented with a low-Phe protein substitute. Treatment adherence commonly decreases in adolescence, with some adults ceasing dietary treatment. In maternal PKU, elevated blood Phe is harmful to the fetus so a strict Phe-restricted diet must be re-established preconception, and this is particularly difficult to achieve. A woman’s reproductive years introduces an opportunity to adopt healthier behaviours to prepare for successful pregnancies and positive health outcomes for both themselves and their children. Several factors can influence the health status of women with PKU. Political, socioeconomic, and individual food and lifestyle choices affect diet quality, metabolic control, and epigenetics, which then pre-condition the overall maternal health and long-term health of the child. Here, we reflect on a comprehensive approach to treatment and introduce practical recommendations to optimize the wellbeing of women with PKU and the resultant health of their children.

The Symbiotic Effect of a New Nutraceutical with Yeast β-Glucan, Prebiotics, Minerals, and Silybum marianum (Silymarin) for Recovering Metabolic Homeostasis via Pgc-1α, Il-6, and Il-10 Gene Expression in a Type-2 Diabetes Obesity Model

The use of natural products and derivatives for the prevention and control of non-communicable chronic diseases, such as type-2 diabetes (T2D), obesity, and hepatic steatosis is a way to achieve homeostasis through different metabolic pathways. Thus, male C57BL/6 mice were divided into the following groups: high-fat diet (HFD) vehicle, HFD + Supplemented, HFD + Supplemented_S, and isolated compounds. The vehicle and experimental formulations were administered orally by gavage once a day over the four weeks of the diet (28 consecutive days). We evaluated the energy homeostasis, cytokines, and mitochondrial gene expression in these groups of mice. After four weeks of supplementation, only the new nutraceutical group (HFD + Supplemented) experienced reduced fasting glycemia, insulin, HOMA index, HOMA-β, dyslipidemia, ectopic fat deposition, and hepatic fibrosis levels. Additionally, the PPARγ coactivator 1 α (Pgc-1α), interleukin-6 (Il-6), and interleukin-10 (Il-10) gene expression were augmented, while hepatic steatosis decreased and liver parenchyma was recovered. The glutathione-S-transferase activity status was found to be modulated by the supplement. We discovered that the new nutraceutical was able to improve insulin resistance and hepatic steatosis mainly by regulating IL-6, IL-10, and Pgc-1α gene expression.

Use of Healthy Emulsion Hydrogels to Improve the Quality of Pork Burgers

The present research evaluated the use of oil mixture emulsion hydrogels as animal fat replacers and their effect on the physicochemical, nutritional and sensory characteristics of pork burgers. Three different types of burgers were manufactured: control (samples elaborated with 100% pork fat), T1 and T2 (pork fat totally replaced by emulsion hydrogels of walnut or pistachio oil and algal oil, respectively). Fat replacement increased the moisture and ash contents and colour parameters (L* and b*) of pork burgers. Modified samples turned out to be firmer and chewier than those in the control group. The addition of oil emulsion hydrogels caused a significant decrease in fat and energy contents and the products obtained can be considered "reduced fat content". Moreover, the content of saturated fatty acids decreased, while mono- and polyunsaturated fatty acids increased, constituting an improvement in health indices. Sensory differences were found between the samples and T2 was the most preferred for flavour and overall. However, both modified burgers had good levels of acceptability. To conclude, the use of the proposed oil mixture emulsion hydrogels as pork backfat substitutes represents a promising strategy to obtain healthier pork burgers without negatively affecting technological or sensory properties.

Assessment of Fish Quality Based on the Content of Heavy Metals

The aim of this study was to estimate the fish quality in terms of the Cu, Fe, Mn and Zn contents. The research material was the muscle tissue of the fish crucian carp (Carassius carassius Linnaeus, 1758), flounder (Platichthys flesus Linnaeus, 1758), Gilthead seabream (Sparus aurata Linnaeus, 1758), mackerel (Scomber scombrus Linnaeus, 1758), Blue grenadier (Macruronus novaezelandiae Hector, 1871), rainbow trout (Oncorhynchus mykiss Walbaum, 1792), tench (Tinca tinca Linnaeus, 1758), tilapia (Oreochromis niloticus Linnaeus, 1758), Walleye pollock (Gadus chalcogrammus Pallas, 1814) and perch (Perca fluviatilis Linnaeus, 1758.). Heavy metals were determined with the atomic absorption spectrometry method (AAS). Significantly high concentrations of zinc (19.52 mg/kg wet weight), copper (0.77 mg/kg) and iron (6.95 mg/kg) were found in the muscles of crucian carp (p < 0.05) compared to the other fish studied, whereas Walleye pollock had a higher content of manganese (0.266 mg/kg) (p < 0.05). All studied fish species do not pose a threat to humans from these four metals. This was indicated by quality indexes (THQ and HI) whose values were below one. The values of these metals also did not exceed the maximum allowable concentrations established by the FAO (1983), but monitoring both the aquatic environment and the fish living there is necessary, for example, for the time-changing abiotic and biotic factors that can cause an increase in metals in the organs of fish.

Sustainable Diet Optimization Targeting Dietary Water Footprint Reduction—A Country-Specific Study

Food production creates 70% of the total anthropogenic water footprint, and it is the main cause of water pollution. Thus, more sustainable diets could contribute to the achievement of the Sustainable Development Goals. A linear programming-based stepwise optimization was designed to create dietary water footprint-reduced, culturally acceptable, and healthier diets in the case of Hungary based on a representative dietary survey. Optimization resulted in a considerable total dietary water footprint reduction (women: 18%; men: 28%) with a moderate dietary shift (~32%). Milk and dairies (observed: ~31.5%, optimized: ~20.5%) and meats and meat products (observed: ~28.0%, optimized: 28.9%) contributed the most to the dietary water footprint. In the water footprint–healthiness synergy, the vegetables, eggs, poultries, and fermented dairies were the most beneficial, increasing in amount, while fatty dairies, foods high in added sugar, and meat products were the most non-beneficial food sub-groups, decreasing in amount in the optimized diets. The problematic nutrients to fulfill in the optimized diets were energy, dietary fibers, sodium, vitamin D, zinc, vitamin B12, calcium, iron, and potassium at the maximum water footprint reduction. The study provides supporting evidence about the dietary water footprint–healthiness synergy for the further improvement of the national food-based dietary guideline.

Importance and Relevance of Phytochemicals Present in Galenia africana

Many people in developing countries rely primarily on medicinal plants as their main source of healthcare, particularly for the treatment of skin infections. Despite the widespread use of medicinal plants, there is a lack of literature describing the relevance and risks of exposure of the phytochemicals present. Galenia africana has been used traditionally in the form of pastes, decoctions, and lotions to treat wounds and other skin-related ailments. This is a report on the phytochemical composition of G. africana and a review on the pharmacological importance and relevance of these phytochemicals. The major groups of phytochemicals identified in G. africana extracts were aliphatics, aliphatic triterpenoids, fatty acids, flavonoids, and phenolic and tocopherol compounds. These have been found to exhibit medicinal properties, thus highlighting the need to assess the safety of G. africana for topical application. The information related to the safety of the various compounds could indicate the potential risks related to accidental intake of the extract upon topical product applications. This report concludes that the quantities of the phytochemicals present in G. africana should not cause undue risk to human health, which provides comfort to pursue future work on using and developing G. africana as a therapeutic agent.

Nutrition in Abrupt Sunlight Reduction Scenarios: Envisioning Feasible Balanced Diets on Resilient Foods

Abrupt sunlight reduction scenarios (ASRS) following catastrophic events, such as a nuclear war, a large volcanic eruption or an asteroid strike, could prompt global agricultural collapse. There are low-cost foods that could be made available in an ASRS: resilient foods. Nutritionally adequate combinations of these resilient foods are investigated for different stages of a scenario with an effective response, based on existing technology. While macro- and micronutrient requirements were overall met, some-potentially chronic-deficiencies were identified (e.g., vitamins D, E and K). Resilient sources of micronutrients for mitigating these and other potential deficiencies are presented. The results of this analysis suggest that no life-threatening micronutrient deficiencies or excesses would necessarily be present given preparation to deploy resilient foods and an effective response. Careful preparedness and planning-such as stock management and resilient food production ramp-up-is indispensable for an effective response that not only allows for fulfilling people's energy requirements, but also prevents severe malnutrition.

Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5

This review summarizes the current knowledge on essential vitamins B1, B2, B3, and B5. These B-complex vitamins must be taken from diet, with the exception of vitamin B3, that can also be synthetized from amino acid tryptophan. All of these vitamins are water soluble, which determines their main properties, namely: they are partly lost when food is washed or boiled since they migrate to the water; the requirement of membrane transporters for their permeation into the cells; and their safety since any excess is rapidly eliminated via the kidney. The therapeutic use of B-complex vitamins is mostly limited to hypovitaminoses or similar conditions, but, as they are generally very safe, they have also been examined in other pathological conditions. Nicotinic acid, a form of vitamin B3, is the only exception because it is a known hypolipidemic agent in gram doses. The article also sums up: (i) the current methods for detection of the vitamins of the B-complex in biological fluids; (ii) the food and other sources of these vitamins including the effect of common processing and storage methods on their content; and (iii) their physiological function.

Anthropometrics, Dietary Intake and Body Composition in Urea Cycle Disorders and Branched Chain Organic Acidemias: A Case Study of 18 Adults on Low-Protein Diets

Low-protein diets (LPDs) are the mainstream treatment for inborn errors of intermediary protein metabolism (IEIPM), but dietary management differs worldwide. Most studies have investigated pediatric populations and their goals such as growth and metabolic balance, showing a tendency toward increasing overweight and obesity. Only a few studies have examined nutritional status and dietary intake of adult IEIPM patients on LPDs. We assessed nutritional parameters (dietary intake using a 7-day food diary record, body composition by bioimpedance analysis, and biochemical serum values) in a group of 18 adult patients with urea cycle disorders (UCDs) and branched chain organic acidemia (BCOA). Mean total protein intake was 0.61 ± 0.2 g/kg/day (73.5% of WHO Safe Levels) and mean natural protein (PN) intake was 0.54 ± 0.2 g/kg/day; 33.3% of patients consumed amino acid (AA) supplements. A totally of 39% of individuals presented a body mass index (BMI) > 25 kg/m2 and patients on AA supplements had a mean BMI indicative of overweight. All patients reported low physical activity levels. Total energy intake was 24.2 ± 5 kcal/kg/day, representing 72.1% of mean total energy expenditure estimated by predictive formulas. The protein energy ratio (P:E) was, on average, 2.22 g/100 kcal/day. Plasmatic levels of albumin, amino acids, and lipid profiles exhibited normal ranges. Phase angle (PA) was, on average, 6.0° ± 0.9°. Fat mass percentage (FM%) was 22% ± 9% in men and 36% ± 4% in women. FM% was inversely and significantly related to total and natural protein intake. Data from IEIPM adults on LPDs confirmed the pediatric trend of increasing overweight and obesity despite a low energy intake. A low protein intake may contribute to an increased fat mass. Nutritional parameters and a healthy lifestyle should be routinely assessed in order to optimize nutritional status and possibly reduce risk of cardiovascular degenerative diseases in adult UCD and BCOA patients on LPDs.

Chemical Composition, Fatty Acid Profile, and Lipid Quality Indices in Commercial Ripening of Cow Cheeses from Different Seasons

The aim of the study was to compare and demonstrate whether commercial rennet ripening cheeses available on the market in summer and winter differ in their chemical composition, fatty acid profile, content of cis9trans11 C18:2 (CLA) acid and other trans isomers of C18:1 and C18:2 acid and whether they are characterized by different values of lipid quality assessment indices. The experimental material consisted of rennet ripening of cheeses produced from cow's milk available in the Polish market. The first batch contained cheeses produced in winter and purchased from the market between May and June. The second batch contained cheeses produced in summer and purchased between November and December. Chemical composition was analyzed by FoodScan apparatus. The gas chromatography (GC) method was used to determine the content of fatty acids. Results obtained in the presented study indicate that the chemical composition, content of fatty acids trans isomers, and lipid quality indices varied between summer and winter cheeses. The summer cheeses were richer sources of MUFA and PUFA compared to winter cheeses. Summer cheeses were also characterized by lower content of SFA, higher content n - 3, lower n - 6/n - 3 ratio, and higher content of DFA. Higher contents of CLA and trans C18:1 and C18:2 were found in summer cheeses.

Modeling the Contribution of Milk to Global Nutrition

Nutrient-rich foods play a major role in countering the challenges of nourishing an increasing global population. Milk is a source of high-quality protein and bioavailable amino acids, several vitamins, and minerals such as calcium. We used the DELTA Model, which calculates the delivery of nutrition from global food production scenarios, to examine the role of milk in global nutrition. Of the 29 nutrients considered by the model, milk contributes to the global availability of 28. Milk is the main contributing food item for calcium (49% of global nutrient availability), Vitamin B2 (24%), lysine (18%), and dietary fat (15%), and contributes more than 10% of global nutrient availability for a further five indispensable amino acids, protein, vitamins A, B5, and B12, phosphorous, and potassium. Despite these high contributions to individual nutrients, milk is responsible for only 7% of food energy availability, indicating a valuable contribution to global nutrition without necessitating high concomitant energy intakes. Among the 98 food items considered by the model, milk ranks in the top five contributors to 23 of the 29 nutrients modeled. This quantification of the importance of milk to global nutrition in the current global food system demonstrates the need for the high valuation of this food when considering future changes to the system.

A Progressive Nutrient Profiling System to Guide Improvements in Nutrient Density of Foods and Beverages

Improving the nutrient density of processed foods is one way to bring the global food supply closer to the WHO Sustainable Development Goals. Nutrient profiling (NP) has emerged as the preferred method of monitoring the progress toward product innovation and reformulation. This paper presents PepsiCo Nutrition Criteria (PNC), a new internal NP model that was designed to guide and monitor improvements in nutrient density and overall nutritional quality of foods and beverages. The new PNC NP model assigns food products into four classes of increasing nutritional value, based on the content of nutrients to limit, along with nutrients and ingredients to encourage. The nutrient standards used for category assignment followed those developed by global dietary authorities. Standards are proposed for calories, sodium, added sugars, saturated, and industrially produced trans fats. Also included are minimum values for food groups to encourage, low-fat dairy, and for country-specific gap nutrients. Internal use of the NP model has spurred product changes that are consistent with WHO goals for industry transparency. An audited review of company products showed that 48% met added sugar, 65% met sodium, and 71% met saturated fat goals. By the end of 2020, in the top 26 regions in which products are sold, 48% of the total sales volume of global beverages had 100 kcal or less from added sugars per 355 ml serving representing 80% of beverage volume and over 90% of food volume sold globally. The PNC NP model is not consumer-facing but is specifically intended for internal use to motivate stepwise and incremental product innovation and reformulation. Transparent and published NP models further WHO goals of engaging industry stakeholders in the (re)formulation of processed foods and beverages consistent with public health goals.

Influence of Gender and Age of Brown Seaweed (Fucus vesiculosus) on Biochemical Activities of Its Aqueous Extracts

Fucus vesiculosus L. is a common coastal brown seaweed associated with various benefits to human health due to its phenolic content and nutrients and is used as food through different methods of consumption. This study aims to evaluate the influence of the seaweed’s gender and growth stage on different types of biological activities as well as its chemical constitution and elements present. Akin to food preparation, aqueous extracts of the seaweed were prepared at 25 °C (salad) and 100 °C (soup). Biological activities were determined by measuring total phenol content (TPC), antioxidant activity and inhibition of acetylcholinesterase (AChE). Liquid Chromatography High Resolution Mass Spectrometry (LC-HRMS/MS) was used for compound identification, and elemental analysis was carried out by using Total Reflection X-ray Fluorescence Spectrometry (TXRF). Older females and males had higher TPC compared to the new ones at 100 °C. Antioxidant activity depended on the extraction temperature but was higher for the youngest male at 100 °C. AChE inhibitory activity was higher for older males at 25 °C, but at 100 °C it was higher for older females. Primary metabolites and various phloroglucinol were the main compounds identified. Additionally, since this seaweed is often harvested in estuarine systems with high anthropogenic impacts, its safety was evaluated through the evaluation of the sample’s metal content. The heavy metals detected are within the limits established by various regulating entities, pointing to a safe food source.

Priority Micronutrient Density of Foods for Complementary Feeding of Young Children (6-23 Months) in South and Southeast Asia

Background: Given their high nutrient requirements and limited gastric capacity, young children during the complementary feeding period (6-23 months) should be fed nutrient-dense foods. However, complementary feeding diets in low- and middle-income countries are often inadequate in one or more essential micronutrients. In South and Southeast Asia infants' and young children's diets are commonly lacking in iron, zinc, vitamin A, folate, vitamin B12, and calcium, hereafter referred to as priority micronutrients. Objective: This study aimed to identify the top food sources of priority micronutrients among minimally processed foods for complementary feeding of children (6-23 months) in South and Southeast Asia. Methods: An aggregated regional food composition database for South and Southeast Asia was built, and recommended nutrient intakes (RNIs) from complementary foods were calculated for children aged 6-23 months. An approach was developed to classify foods into one of four levels of priority micronutrient density based on the calories and grams required to provide one-third (for individual micronutrients) or an average of one-third (for the aggregate score) of RNIs from complementary foods. Results: We found that the top food sources of multiple priority micronutrients are organs, bivalves, crustaceans, fresh fish, goat, canned fish with bones, and eggs, closely followed by beef, lamb/mutton, dark green leafy vegetables, cow milk, yogurt, and cheese, and to a lesser extent, canned fish without bones. Conclusions: This analysis provided insights into which foods to prioritize to fill common micronutrient gaps and reduce undernutrition in children aged 6-23 months in South and Southeast Asia.

Placing a Well-Designed Vegan Diet for Slovenes

Interest in vegan diets has increased globally as well as in Slovenia. The quantity of new scientific data requires a thorough synthesis of new findings and considerations about the current reserved position of the vegan diet in Slovenia. There is frequently confusion about the benefits of vegetarian diets that are often uncritically passed on to vegan diets and vice versa. This narrative review aims to serve as a framework for a well-designed vegan diet. We present advice on how to maximize the benefits and minimize the risks associated with the vegan diet and lifestyle. We highlight the proper terminology, present the health effects of a vegan diet and emphasize the nutrients of concern. In addition, we provide guidance for implementing a well-designed vegan diet in daily life. We conducted a PubMed search, up to November 2021, for studies on key nutrients (proteins, vitamin B12, vitamin D, omega-3 long chain polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), calcium, iron, zinc, iodine and selenium) in vegan diets. Given the limited amount of scientific evidence, we focus primarily on the general adult population. A well-designed vegan diet that includes a wide variety of plant foods and supplementation of vitamin B12, vitamin D in the winter months and potentially EPA/DHA is safe and nutritionally adequate. It has the potential to maintain and/or to improve health. For physically active adult populations, athletes or individuals with fast-paced lifestyles, there is room for further appropriate supplementation of a conventional vegan diet according to individuals' health status, needs and goals without compromising their health. A healthy vegan lifestyle, as included in government guidelines for a healthy lifestyle, includes regular physical activity, avoidance of smoking, restriction of alcohol and appropriate sleep hygiene.

Composition of Brazil Nut (Bertholletia excels HBK), Its Beverage and By-Products: A Healthy Food and Potential Source of Ingredients

The consumption of plant-based beverages is a growing trend and, consequently, the search for alternative plant sources, the improvement of beverage quality and the use of their by-products, acquire great interest. Thus, the purpose of this work was to characterize the composition (nutrients, phytochemicals and antioxidant activity) of the Brazil nut (BN), its whole beverage (WBM), water-soluble beverage (BM-S), and its by-products of the beverage production: cake, sediment fraction (BM-D), and fat fraction (BM-F). In this study, advanced methodologies for the analysis of the components were employed to assess HPLC-ESI-QTOF (phenolic compounds), GC (fatty acids), and MALDI-TOF/TOF (proteins and peptides). The production of WBM was based on a hot water extraction process, and the production of BM-S includes an additional centrifugation step. The BN showed an interesting nutritional quality and outstanding content of unsaturated fatty acids. The investigation found the following in the composition of the BN: phenolic compounds (mainly flavan-3-ols as Catechin (and glycosides or derivatives), Epicatechin (and glycosides or derivatives), Quercetin and Myricetin-3-O-rhamnoside, hydroxybenzoic acids as Gallic acid (and derivatives), 4-hydroxybenzoic acid, ellagic acid, Vanillic acid, p-Coumaric acid and Ferulic acid, bioactive minor lipid components (β-Sitosterol, γ-Tocopherol, α-Tocopherol and squalene), and a high level of selenium. In beverages, WBM had a higher lipid content than BM-S, a factor that influenced the energy characteristics and the content of bioactive minor lipid components. The level of phenolic compounds and selenium were outstanding in both beverages. Hydrothermal processing can promote some lipolysis, with an increase in free fatty acids and monoglycerides content. In by-products, the BM-F stood out due to its bioactive minor lipid components, the BM-D showed a highlight in protein and mineral contents, and the cake retained important nutrients and phytochemicals from the BN. In general, the BN and its beverages are healthy foods, and its by-products could be used to obtain healthy ingredients with appreciable biological activities (such as antioxidant activity).

Homemade Kefir Consumption Improves Skin Condition-A Study Conducted in Healthy and Atopic Volunteers

Diet has a fundamental role in the homeostasis of bodily functions, including the skin, which, as an essential protective barrier, plays a crucial role in this balance. The skin and intestine appear to share a series of indirect metabolic pathways, in a dual relationship known as the “gut-skin axis”. Hence, the gut-skin axis might be receptive to modulation via dietary modification, where probiotics can be included, thus representing a potential therapeutic target in inflammatory skin diseases, such as atopic dermatitis (AD), in order to control and/or ameliorate symptoms. Kefir is one of the most ancient fermented foods, with probiotic characteristics that have been associated with a wide variety of health-promoting benefits, and it presents a microbiological diversity that makes its application as a probiotic in the gut-skin relationship of the utmost interest. However, the impact of a diet containing kefir on skin health has yet to be reported in scientific literature. This study aimed to assess the impact of the intake of homemade kefir in the skin of healthy and atopic volunteers. The intervention resulted in a boost on barrier function in both skin types verified only in the respective kefir intake groups. An improvement in the degree of severity of AD was also confirmed for the kefir intake group. Atopic individuals may benefit from kefir intake, especially in regard to their skin hydration. Finally, the effects observed on skin barrier function in this study probably culminate from the effects of all the ingredients in kefir, including the complex microbiota, its metabolites and macro- and micronutrients resulting from the fermentation. This work opens the way for more advanced research on the impact of the probiotic kefir on cutaneous health, further clarifying its mechanism of action namely via gut-skin axis.

Development and evaluation of a new dietary index assessing nutrient security by aggregating probabilistic estimates of the risk of nutrient deficiency in two French adult populations

Although micronutrient deficiencies affect 2 billion people worldwide, no index focuses on measuring the risk of overt nutrient deficiency. We aimed to develop an index that could capture the nutrient dimension of nutritional security, a nutrient security index (named SecDiet), and evaluate its apparent validity. The SecDiet (range: 0-1) is based on the square-weighted average of the probabilities that the intake of twelve critical nutrients exceeds the threshold value associated with a risk of overt deficiency. Using adult populations from a French representative survey (INCA3, n 1774) and a large cohort (NutriNet-Santé, n 104 382), the content and construct validity of the SecDiet was evaluated by estimating associations of the SecDiet with its components and with relevant socio-demographic characteristics. The SecDiet was high in the overall population (0·93 (SD 0·09) in INCA3) and markedly skewed towards 1 (i.e. lower risk of insufficient intake). It correlated positively with its twelve components (r 0·17-0·78, all P < 0·001). The SecDiet was associated with monthly income (P = 0·002), perception of financial situation, professional situation, food insufficiency and security statuses (all P < 0·001) in the INCA3 population and with monthly income, professional situation and level of education (all P < 0·001) in the NutriNet-Santé population. Unlike a broader nutrient-based quality index taken as comparison, the SecDiet mean decreased and the tail of its distribution notably extended downwards in at-risk sub-populations, thus revealing its specific sensitivity. The SecDiet could be used to screen sub-groups or study the determinants of nutrient insecurity in large population surveys.

Determining the Influence of Habitual Dietary Protein Intake on Physiological Muscle Parameters in Youth and Older Age

Protein ingestion is a potent stimulator of skeletal muscle protein synthesis (MPS). However, older adults demonstrate resistance to anabolic stimuli. Some evidence has demonstrated that a larger acute protein dose is required in older compared to younger adults to elicit the same synthetic response, suggesting that older adults should be consuming higher habitual dietary protein to optimise muscle mass. However, limited research has explored dietary habits in different age groups or the relationship between habitual dietary intake and mechanistic physiological parameters associated with muscle mass and function. This work investigated the effect of habitual dietary intake in young (n = 10, 25.9 (3.2y)) and older (n = 16, 70.2 (3.2y)) community-dwelling adults (16:10 male: female) on physiological muscle parameters. Dietary intake was assessed using four-day diet diaries. Post-absorptive MPS and MPS responses to feeding (4.25x basal metabolic rate; 16% protein) were determined in muscle biopsies of the m. vastus lateralis via stable isotope tracer ([1, 2^-13C₂]-leucine) infusions with mass-spectrometric analyses. Body composition was measured by dual-energy x-ray absorptiometry. Whole body strength was assessed via 1-repetition maximum assessments. No significant differences in habitual dietary intake (protein, fat, carbohydrate and leucine as g.kgWBLM^-1.day^-1) were observed between age groups. Whole-body lean mass (61.8 ± 9.9 vs. 49.8 ± 11.9 kg, p = 0.01) and knee-extensor strength (87.7 ± 28.3 vs. 56.8 ± 16.4 kg, p = 0.002) were significantly higher in young adults. Habitual protein intake (g.kg^-1.day^-1) was not associated with whole-body lean mass, upper-leg lean mass, whole-body strength, knee-extensor strength, basal MPS or fed-state MPS across both age groups. These findings suggest that differences in muscle mass and strength parameters between youth and older age are not explained by differences in habitual dietary protein intake. Further research with a larger sample size is needed to fully explore these relationships and inform on interventions to mitigate sarcopenia development.

Application of Oleogel and Conventional Fats for Ultrasound-assisted Obtaining of Vegan Creams

The purpose of this study was to determine the impact of the fat system type (milk fat - MF, palm oil - PO or oleogel - OG, i.e. RO-LO - rapeseed oil and linseed oil mixture structured by candelilla wax) on the properties of soy creams, in comparison with dairy cream. The MF exhibited the most increase of acid value (2.5-fold), and the RO-LO - increase of peroxide value (3-fold), after 30 days of storage at 20°C. The PO was the most oxidative stable. The OG presented the slightest oxidative changes, the highest slip melting point (39°C) and centrifugal stability (99.6%). The pH and total acidity values of soy creams were similar to soy drink. All creams exhibited unimodal distribution of dispersed particles. The average particle size and dispersity indexes of these emulsions were in range of 1.74-1.80 µm and 0.93-1.16, respectively. The creams with MF or OG exhibited a greater viscosity than sweet dairy cream - 1.66 10^-5 nm^-2, and a higher degree of shear-thinning. The accelerated creaming phenomenon (flotation of lipids molecules) occurred during centrifugation. The cream with PO had the lowest resistance to centrifugal force (instability index - 0.052). The possibility to obtain a stable vegan soy creams containing oleogel (as replacer of conventional fats) has been demonstrated.

Liver disease in obesity and underweight: the two sides of the coin. A narrative review

PURPOSE

Malnutrition, whether characterized by not enough or too much nutrient intake, is detrimental to the liver. We herein provide a narrative literature revision relative to hepatic disease occurrence in over or undernourished subjects, to shed light on the paradox where both sides of malnutrition lead to similar liver dysfunction and fat accumulation.

METHODS

Medline, EMBASE, and Cochrane Library were searched for publications up to July 2020. Articles discussing the association between both chronic and acute liver pathology and malnutrition were evaluated together with studies reporting the dietary intake in subjects affected by malnutrition.

RESULTS

The association between overnutrition and non-alcoholic fatty liver disease (NAFLD) is well recognized, as the beneficial effects of calorie restriction and very low carbohydrate diets. Conversely, the link between undernutrition and liver injury is more complex and less understood. In developing countries, early exposure to nutrient deficiency leads to marasmus and kwashiorkor, accompanied by fatty liver, whereas in developed countries anorexia nervosa is a more common form of undernutrition, associated with liver injury. Weight gain in undernutrition is associated with liver function improvement, whereas no study on the impact of macronutrient distribution is available. We hypothesized a role for very low carbohydrate diets in the management of undernutrition derived liver pathology, in addition to the established one in overnutrition-related NAFLD.

CONCLUSIONS

Further studies are warranted to update the knowledge regarding undernutrition-related liver disease, and a specific interest should be paid to macronutrient distribution both in the context of refeeding and relative to its role in the development of hepatic complications of anorexia nervosa.

LEVEL OF EVIDENCE

Narrative review, Level V.

Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review

Managing the body composition of athletes is a common practice in the field of sports nutrition. The loss of body weight (BW) in resistance-trained athletes is mainly conducted for aesthetic reasons (bodybuilding) or performance (powerlifting or weightlifting). The aim of this review is to provide dietary–nutritional strategies for the loss of fat mass in resistance-trained athletes. During the weight loss phase, the goal is to reduce the fat mass by maximizing the retention of fat-free mass. In this narrative review, the scientific literature is evaluated, and dietary–nutritional and supplementation recommendations for the weight loss phase of resistance-trained athletes are provided. Caloric intake should be set based on a target BW loss of 0.5–1.0%/week to maximize fat-free mass retention. Protein intake (2.2–3.0 g/kgBW/day) should be distributed throughout the day (3–6 meals), ensuring in each meal an adequate amount of protein (0.40–0.55 g/kgBW/meal) and including a meal within 2–3 h before and after training. Carbohydrate intake should be adapted to the level of activity of the athlete in order to training performance (2–5 g/kgBW/day). Caffeine (3–6 mg/kgBW/day) and creatine monohydrate (3–5 g/day) could be incorporated into the athlete’s diet due to their ergogenic effects in relation to resistance training. The intake of micronutrients complexes should be limited to special situations in which there is a real deficiency, and the athlete cannot consume through their diet.

Portuguese Football Federation consensus statement 2020: nutrition and performance in football

Nutrition is an undeniable part of promoting health and performance among football (soccer) players. Nevertheless, nutritional strategies adopted in elite football can vary significantly depending on culture, habit and practical constraints and might not always be supported by scientific evidence. Therefore, a group of 28 Portuguese experts on sports nutrition, sports science and sports medicine sought to discuss current practices in the elite football landscape and review the existing evidence on nutritional strategies to be applied when supporting football players. Starting from understanding football's physical and physiological demands, five different moments were identified: preparing to play, match-day, recovery after matches, between matches and during injury or rehabilitation periods. When applicable, specificities of nutritional support to young athletes and female players were also addressed. The result is a set of practical recommendations that gathered consensus among involved experts, highlighting carbohydrates periodisation, hydration and conscious use of dietary supplements.

Low-Field NMR Study of Shortcake Biscuits with Cricket Powder, and Their Nutritional and Physical Characteristics

The growing human population renders challenges for the future supply of food products with high nutritional value. Here, we enhanced the functional and nutritional value of biscuits, a popular sweet snack, by replacing the wheat flour with 2%, 6%, or 10% (w/w) cricket powder. Consumer acceptance ratings for reference and 2% augmented cookies were comparable, whereas the higher levels of enhancement received inferior consumer scores. This relatively small change in biscuit recipe provided significant and nutritionally desirable enhancements in the biscuits, observed in a series of analyses. An increase in the protein content was observed, including essential amino acids, as well as minerals and fat. This conversion also affected the physical properties of the biscuits, including hardness, and water molecular dynamics measured by 1H NMR. Cricket powder-augmented biscuits join the line of enhanced, functionally superior food products. This and similar food augmentation provide a viable scenario to meet the human food demands in the future.

Effect of a Hydration Management Program on Older Adults' Fluid Consumption and Dehydration Parameters: A Quasi-Experimental Study

The purpose of the current study was to assess effects of a hydration management program on the fluid consumption and dehydration parameters (i.e., dehydration risk scores, urine specific gravity, and urine color) of older adults. The study was conducted as a pre-/post-test quasi-experimental study with a control group (intervention group: n = 42, control group: n = 37). The hydration management program applied to the intervention group was completed in 1 week. After the intervention, the knowledge and awareness of the intervention group regarding fluid consumption increased (p = 0.001). The dehydration risk score of the intervention group was significantly lower than that of the control group (p = 0.0001). There was a significant change in average 3-day water intake (p = 0.0001), urine specific gravity value (p = 0.01), and urine color scale score (p = 0.0001) in the intervention group between pre- and post-test. The hydration management program provided a significant improvement in daily water intake and dehydration risk score and increased knowledge and awareness among older adults concerning the importance of fluid intake. [Journal of Gerontological Nursing, 47(9), 40-48.].

Dietary Intake Adequacy and Food Sources of Nutrients Involved in the Methionine-Methylation Cycle in Women of Childbearing Age from the ANIBES Spanish Population

Growing evidence confirms choline as a critical perinatal nutrient. However, intake levels of choline and betaine among the Spanish fertile population remain unknown. Given their role in one-carbon metabolism with potential epigenetic effects, the aim of the present study was to evaluate the dietary intakes, their adequacy to existing guidelines and the main food sources together with other micronutrients involved in the methylation-methionine cycle (vitamin B6, folates and vitamin B12) in women of childbearing age. The ANIBES study, a cross-sectional study of a representative sample of women of childbearing age (18-45 years, n = 641) resident in Spain, was used. The sample was divided into younger women (18-30 years, n = 251) and older women (31-45 years, n = 390). Dietary intake was assessed by a three-day dietary record by using a tablet device. Total median intakes for the total sample were 303.9 mg/d for choline; 122.6 mg/d for betaine; 1.3 mg/d for vitamin B6; 140.8 μg/d for folates, and 3.8 μg/d for vitamin B12. The older subgroup showed significantly higher choline (p < 0.05), betaine (p < 0.001) and folates (p < 0.05) intakes than younger women. Main food sources for the whole sample were meat and meat products for choline (28.3%), vitamin B6 (25.7%) and vitamin B12 (22.8%); cereals and derivatives (79.9%) for betaine; vegetables (20.0%) for folates. Overall intake adequacy was only observed for vitamin B12, with a very limited number of participants showing adequate intakes for all the other micronutrients. These results illustrate there is a relevant need to raise awareness about optimizing the status of the methionine cycle-related vitamins and cofactors in this potentially vulnerable population.

Dietary intake of protein and fat of 12- to 36-month-old children in a Dutch Total Diet Study

Purpose

This study attempted gaining insight into the intake of protein and fat of 12- to 36-month-old children in the Netherlands.

Methods

In 2017, a Total Diet Study (TDS) was carried out in the Netherlands including following three age groups: 12–17-, 18–23- and 24- to 36-month-old children. Protein and fat concentrations of 164 composite samples were analysed and combined with the consumption data from the Dutch National Food Consumption Survey 2012–2016 (DNFCS).

Results

Median protein intake of the 12- to 35-month-old Dutch children based on the TDS was 35 g/day with main contributions from the food subgroups “milk and milk-based beverages”, “beef” and “yoghurts and desserts”. Median fat intake was 34 g/day with main contributions from the food subgroups “margarines”, “cheeses” and “milk and milk-based beverages”. For the youngest age group (12- to 18-month-old children), (ready to drink) follow-on formula was one of the main contributors to the fat intake.

Conclusion

Compared to the EFSA reference values, protein intake of the Dutch 12- to 36-month-old children is high, whereas fat intake follows the reference intake. A TDS is a suitable instrument to estimate macronutrient intakes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-021-02653-6.

Vitamin D Supplementation for Patients with Chronic Kidney Disease: A Systematic Review and Meta-analyses of Trials Investigating the Response to Supplementation and an Overview of Guidelines

A large proportion of patients with chronic kidney disease (CKD) are vitamin D deficient (plasma 25-hydroxyvitamin D (25(OH)D) < 25 or 30 nmol/L per UK and US population guidelines) and this contributes to the development of CKD-mineral bone disease (CKD-MBD). Gaps in the evidence-base for the management of vitamin D status in relation to CKD-MBD are hindering the formulation of comprehensive guidelines. We conducted a systemic review of 22 RCTs with different forms of vitamin D or analogues with CKD-MBD related outcomes and meta-analyses for parathyroid hormone (PTH). We provide a comprehensive overview of current guidelines for the management of vitamin D status for pre-dialysis CKD patients. Vitamin D supplementation had an inconsistent effect on PTH concentrations and meta-analysis showed non- significant reduction (P = 0.08) whereas calcifediol, calcitriol and paricalcitol consistently reduced PTH. An increase in Fibroblast Growth Factor 23 (FGF23) with analogue administration was found in all 3 studies reporting FGF23, but was unaltered in 4 studies with vitamin D or calcifediol. Few RCTS reported markers of bone metabolism and variations in the range of markers prevented direct comparisons. Guidelines for CKD stages G1-G3a follow general population recommendations. For the correction of deficiency general or CKD-specific patient guidelines provide recommendations. Calcitriol or analogues administration is restricted to stages G3b-G5 and depends on patient characteristics. In conclusion, the effect of vitamin D supplementation in CKD patients was inconsistent between studies. Calcifediol and analogues consistently suppressed PTH, but the increase in FGF23 with calcitriol analogues warrants caution.

"My Patients Asked Me If I Owned a Fruit Stand in Town or Something." Barriers and Facilitators of Personalized Dietary Advice Implemented in a Primary Care Setting

Primary care is especially well positioned to address prevention of non-communicable diseases. However, implementation of health promotion activities such as personalized dietary advice is challenging. The study aim was to understand barriers and facilitators of the personalized dietary advice component of a lifestyle intervention in primary care, as perceived by health center professionals and program participants. Thirteen focus groups were conducted with 49 professionals and 47 participants. Audio recordings were transcribed. Professional group text was coded using the Consolidated Framework for Implementation Research (CFIR). Participant group text was coded via an inductive approach with thematic analysis. Across most CFIR domains, both barriers and facilitators were equally present, except for ‘characteristics of individuals’, which were primarily facilitators. Intervention characteristics was the most important domain, with barriers in design and packaging (e.g., the ICT tool) and complexity. Facilitators included high evidence strength and quality, adaptability, and relative advantage. Participants described the importance of more personalized advice, the value of follow-up with feedback, and the need to see outcomes. Both professionals and patients stated that primary care was the place for personalized dietary advice intervention, but that lack of time, workload, and training were barriers to effective implementation. Implementation strategies targeting these modifiable barriers could potentially increase intervention adoption and intervention effectiveness.

[Zinc and its relation to insulin resistance in children]

Zinc is an essential trace element involved in catalytic, structural, and regulatory functions, participating also in the metabolism of nutrients. Its role in insulin resistance appears to be of great importance, as it is involved in oxidative stress, the endocrine regulation of insulin, and the regulation of glucose uptake. For this reason, both intake and serum levels of zinc are inversely related to insulin resistance. Currently, zinc intake in children is low, and zinc deficiency exists in a significant proportion. Zinc can be found in meat, fish, eggs, and dairy products. Although it certainly is present in foods of plant origin, their high phytate contents generally reduce its bioavailability. For this reason, it is important to monitor intake throughout childhood, and to consider supplementation in children with insulin resistance or obesity.

Pre-Pregnancy Diet and Vaginal Environment in Caucasian Pregnant Women: An Exploratory Study

Vaginal microbes and their metabolic products have crucial functions, affecting local immunity development and maternal-fetal health. The composition of the vaginal microbiome can vary in response to various factors, including body mass index (BMI), and diet. In this study we get new insights into the vaginal ecosystem of Caucasian women (n = 24) at the first trimester of pregnancy, assessing whether pre-pregnancy diet can affect the structure of the vaginal environment in terms of bacterial composition and vaginal metabolite concentration. We characterized 1) the vaginal bacterial composition (Nugent score), 2) the vaginal metabolic profiles (¹H-NMR spectroscopy), and 3) the dietary nutrient intake by means of a validated food frequency questionnaire. Pre-pregnancy BMI was negatively related to vaginal health status, indicating that women who begin pregnancy overweight/obese have a greater occurrence of vaginal dysbiosis during pregnancy. A lactobacilli-dominated vaginal microbiota was negatively associated with higher pre-pregnancy intake of animal-sourced protein. Conversely, a higher pre-pregnancy consumption of total carbohydrates and sugars seemed to be a protective factor for vaginal health. The vaginal environment of BV-women was characterized by higher levels of biogenic amines and organic acids, whereas higher levels of phenylpropionate and diverse amino acids were fingerprints of a healthy vaginal status. A significant association between a higher pre-pregnancy BMI and several dysbiosis-related vaginal metabolites was also found. Our study shed light on the role of pre-pregnancy BMI and diet on the vaginal environment during pregnancy, underlining the importance of limiting protein intake from animal foods to maintain a healthy lactobacilli-dominated microbiota.

Association of Daily Physical Activity and Sedentary Behaviour with Protein Intake Patterns in Older Adults: A Multi-Study Analysis across Five Countries

Physical activity and protein intake are associated with ageing-related outcomes, including loss of muscle strength and functional decline, so may contribute to strategies to improve healthy ageing. We investigated the cross-sectional associations between physical activity or sedentary behaviour and protein intake patterns in community-dwelling older adults across five countries. Self-reported physical activity and dietary intake data were obtained from two cohort studies (Newcastle 85+ Study, UK; LiLACS, New Zealand Māori and Non-Māori) and three national food consumption surveys (DNFCS, The Netherlands; FINDIET, Finland; INRAN-SCAI, Italy). Associations between physical activity and total protein intake, number of eating occasions providing protein, number of meals with specified protein thresholds, and protein intake distribution over the day (calculated as a coefficient of variance) were assessed by regression and repeated measures ANOVA models adjusting for covariates. Greater physical activity was associated with higher total protein intake and more eating occasions containing protein, although associations were mostly explained by higher energy intake. Comparable associations were observed for sedentary behaviour in older adults in Italy. Evidence for older people with higher physical activity or less sedentary behaviour achieving more meals with specified protein levels was mixed across the five countries. A skewed protein distribution was observed, with most protein consumed at midday and evening meals without significant differences between physical activity or sedentary behaviour levels. Findings from this multi-study analysis indicate there is little evidence that total protein and protein intake patterns, irrespective of energy intake, differ by physical activity or sedentary behaviour levels in older adults.

Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss

With energy intake restriction and exercise remaining the key diet and lifestyle approaches to weight loss, this is not without potential negative implications for body composition, metabolic health, and quality and quantity of life. Ideally, weight loss should be derived almost exclusively from the fat mass compartment as this is the main driver of metabolic disease, however, several studies have shown that there is an accompanying loss of tissue from the fat-free compartment, especially skeletal muscle. Population groups including post-menopausal women, the elderly, those with metabolic disease and athletes may be particularly at risk of skeletal muscle loss when following a weight management programme. Research studies that have addressed this issue across a range of population groups are reviewed with a focus upon the contribution of resistance and endurance forms of exercise and a higher intake dietary protein above the current guideline of 0.8 g/kg body weight/day. While findings can be contradictory, overall, the consensus appears that fat-free and skeletal muscle masses can be preserved, albeit to varying degrees by including both forms of exercise (but especially resistance forms) in the weight management intervention. Equally, higher intakes of protein can protect loss of these body compartments, acting either separately or synergistically with exercise. Elderly individuals in particular may benefit most from this approach. Thus, the evidence supports the recommendations for intakes of protein above the current guidelines of 0.8 g/kg body weight/d for the healthy elderly population to also be incorporated into the dietary prescription for weight management in this age group.

COVID-19 demand-induced scarcity effects on nutrition and environment: investigating mitigation strategies for eggs and wheat flour in the United Kingdom

The COVID-19 pandemic has drawn attention to food insecurity in developed countries. Despite adequate levels of agricultural production, consumers experienced demand-induced scarcity. Understanding the effects on nutrition and the environment is limited, yet critical to informing ecologically embedded mitigation strategies. To identify mitigation strategies, we investigated wheat flour and egg retail shortages in the United Kingdom (UK), focusing on consumer behavior during the COVID-19 lockdown. The 6 Steps for Quality Intervention Development (6SQuID) framework informed the methodology. Mixed qualitative and quantitative methods were used to pinpoint the causes of the shortages, and ecological impacts of consumer behavior were related using survey results (n = 243) and environmental and nutritional databases. This research confirmed consumers' narrowed consideration set, willingness to pay, and significant reliance on processed foods which indicates agronomic biofortification, breeding strategies, selective imports and improved processed food quality are important mitigation strategies. We identified positive and negative synergies in consumer, producer and retailer behavior and related these to mitigation strategies in support of a circular bio-economy for food production. We found that the substitutes or alternative foods consumed during the COVID-19 lockdown were nutritionally inadequate. We identified the most ecological substitute for wheat flour to be corn flour; and for eggs, yogurt. Our findings also indicate that selenium deficiency is a risk for the UK population, especially to the increasing fifth of the population that is vegetarian. Due to the need to implement short-, medium-, and long-term mitigation strategies, a coordinated effort is required by all stakeholders.

Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women

The menopausal transition can be a challenging period for women’s health and a trigger of uncomfortable symptoms. Beer is the main food source of isoxanthohumol, a precursor of 8-prenylnaringenin, the strongest phytoestrogen identified to date. As phytoestrogens are reported to reduce perimenopausal symptoms, we evaluated if a daily moderate consumption of beer with (AB) and without alcohol (NAB) could improve menopausal symptoms and modify cardiovascular risk factors. A total of 37 postmenopausal women were enrolled in a parallel controlled intervention trial and assigned to three study groups: 16 were administered AB (330 mL/day), 7 NAB (660 mL/day), and 14 were in the control group. After a 6-month follow-up of the 34 participants who finished the trial, both interventions (AB and NAB) significantly reduced the severity of the menopause-related symptoms (p-value AB vs. Control: 0.009; p-value NAB vs. Control: 0.033). Moreover, AB had a beneficial net effect on psychological menopausal discomforts compared to the control group. As the sex hormone profile did not differ significantly between the study groups, the effects of both types of beers (AB and NAB) are attributed to the non-alcoholic fraction of beer. Furthermore, moderate NAB consumption improved the lipid profile and decreased blood pressure in postmenopausal women.