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Knez M, Stangoulis JCR. Dietary Zn deficiency, the current situation and potential solutions. Nutr Res Rev 2023; 36:199-215. [PMID: 37062532 DOI: 10.1017/s0954422421000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Zinc (Zn) deficiency is a worldwide problem, and this review presents an overview of the magnitude of Zn deficiency with a particular emphasis on present global challenges, current recommendations for Zn intake, and factors that affect dietary requirements. The challenges of monitoring Zn status are clarified together with the discussion of relevant Zn bioaccessibility and bioavailability issues. Modern lifestyle factors that may exacerbate Zn deficiency and new strategies of reducing its effects are presented. Biofortification, as a potentially useful strategy for improving Zn status in sensitive populations, is discussed. The review proposes potential actions that could deliver promising results both in terms of monitoring dietary and physiological Zn status as well as in alleviating dietary Zn deficiency in affected populations.
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Affiliation(s)
- Marija Knez
- College of Science and Engineering, Flinders University, GPO Box 2100, AdelaideSA5001, Australia
- Center of Research Excellence in Nutrition and Metabolism, University of Belgrade, Institute for Medical Research, National Institute of the Republic of Serbia, 11000Belgrade, Serbia
| | - James C R Stangoulis
- College of Science and Engineering, Flinders University, GPO Box 2100, AdelaideSA5001, Australia
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Engidaw MT, Gebremariam AD, Tiruneh SA, Tesfa D, Fentaw Y, Kefale B, Tiruneh M, Wubie AT. Micronutrient intake status and associated factors in children aged 6-23 months in sub-Saharan Africa. Sci Rep 2023; 13:10179. [PMID: 37349358 PMCID: PMC10287638 DOI: 10.1038/s41598-023-36497-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
Micronutrient deficiency has serious consequences across all ages worldwide, particularly in sub-Saharan Africa. Poor micronutrient (MN) consumption among children remains a major public health concern in many countries. Low literacy, poor diets, a lack of access to healthcare, and insufficient agricultural productivity made proper micronutrient consumption difficult, despite numerous interventions. Thus, this research aimed to determine the adequate intake of MNs among 6-23 months of age children in sub-Saharan Africa. Initially, a two-stage stratified sampling technique was applied for the selected recent demographic and health survey data. The data source was the (2015-2020) standard demographic and health surveys (DHS) among 20 Sub-Saharan African countries. Micronutrient intake status (the outcome variable) was determined using either food rich in Vitamin A or iron consumed within the previous 24 hr or multiple micronutrient powder or iron supplementation within the previous 07 days or vitamin A supplementation or deworming within 06 months. A generalized linear mixed model based on Modified Poisson regression and robust error variance was used to identify factors associated with children's adequate micronutrient intake. An adjusted Prevalence Ratio (aPR) with a 95% confidence interval was used to identify factors, strength and direction of the association. The total samples of 65,187 children aged 6-23 months were included. Of all, 73.99% (95% CI: 73.65, 74.32) of children had adequate intake of micronutrients. Maternal education (primary (aPR = 1.04, 95% CI: 1.02, 1.06) and secondary (aPR = 1.07, 95% CI: 1.04, 1.09)), father's education (primary (aPR = 1.03, 95% CI: 1.01, 1.05) and secondary (aPR = 1.04, 95% CI: 1.02, 1.06)), occupational status of the mother (aPR = 1.04, 95% CI: 1.02, 1.06), pregnancy interval (aPR = 0.97, 95% CI: 0.95, 0.99), exclusive breastfeeding status (aPR = 0.83, 95% CI: 0.82, 0.85), birthweight (average (aPR = 1.03, 95% CI: 1.01, 1.05) and larger than average (aPR = 1.04, 95% CI: 1.02, 1.06)), multiple/twin at birth (aPR = 0.94, 95% CI: 0.91, 0.98), child age (aPR = 1.22, 95% CI: 1.19, 1.25), number of children in home (aPR = 1.02, 95% CI: 1.01, 1.03), ANC utilization (aPR = 1.20, 95% CI: 1.15, 1.27), place of birth (AOR = 0.93, 95% CI: 0.91, 0.95), rich households (aPR = 1.03, 95% CI: 1.01, 1.05), and countries from Central (aPR = 1.07, 95% CI: 1.04, 1.09), South Africa (aPR = 1.07, 95% CI: 1.03, 1.11), and West African (aPR = 0.95, 95% CI: 0.92, 0.99) were associated with level of micronutrients intake status. The prevalence of adequate intake of MN was considerable. Variables at the child, family and community levels were associated with adequate intake of micronutrients. Consequently, stakeholders' involvement is required in healthcare and community settings.
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Affiliation(s)
- Melaku Tadege Engidaw
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, P.o. Box: 272, Debre Tabor, Ethiopia.
| | - Alemayehu Digssie Gebremariam
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, P.o. Box: 272, Debre Tabor, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, P.o. Box: 272, Debre Tabor, Ethiopia
| | - Desalegn Tesfa
- Department of Public Health (Reproductive Health), College of Health Sciences, Debre Tabor University, P.o. Box: 272, Debre Tabor, Ethiopia
| | - Yalelet Fentaw
- Department of Nutritional Care and Counseling, University of Gondar Specialized Hospital, P.o. Box: 196, Gondar, Ethiopia
| | - Belayneh Kefale
- Department of Pharmacy (Clinical Pharmacy), College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahar Dar, Ethiopia
| | - Mulu Tiruneh
- Department of Public Health (Biostatistics), College of Health Sciences, Debre Tabor University, P.o. Box: 272, Debre Tabor, Ethiopia
| | - Abebaw Tadesse Wubie
- Department of Mathematics, College of Natural and Computational Sciences, Debre Tabor University, P.o. Box: 272, Debre Tabor, Ethiopia
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Flieh SM, Miguel-Berges ML, Huybrechts I, Breidenassel C, Grammatikaki E, Donne CL, Manios Y, Widhalm K, Molnár D, Stehle P, Kafatos A, Dallongeville J, Molina-Hidalgo C, Gómez-Martínez S, Gonzalez-Gross M, De Henauw S, Béghin L, Kersting M, Moreno LA, González-Gil EM. Food portion sizes and their relationship with energy, and nutrient intakes in adolescents: The HELENA study. Nutrition 2023; 106:111893. [PMID: 36462317 DOI: 10.1016/j.nut.2022.111893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/19/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study aimed to investigate the associations between portion sizes (PSs) from different food groups and energy, as well as nutrient intakes in European adolescents. METHODS A sample of 1631 adolescents (54.2 % girls) were included from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional (HELENA) study. Mean food PS was calculated by dividing the total intake of the items by the number of eating occasions of these consumed items. To determine the key items for analysis, foods were ranked by frequency of consumption. A one-way between-groups analysis of covariance was used to test for significant differences in means across tertiles. A multivariable linear regression analysis was carried out, adjusting for age, sex, maternal education, body mass index, and using country as a level. RESULTS Energy intake increased with elevated intakes of energy-dense foods. Large portions of rice and other grains, starch roots and potatoes, and meat substitutes, nuts, and pulses were associated with increased carbohydrate and fiber intake. Larger portions of cheese and butter and animal fat were significantly associated with a higher fat intake. Lower intakes of some vitamins and micronutrients were noticed with consumption of larger portions of high energy-dense foods, such as desserts and pudding, margarine and vegetable oil, and butter and animal fat. CONCLUSIONS Large food PSs may be associated with positive energy, as well as macro- and micronutrient intake. Moreover, the findings from this study may help the future development of dietary guidance in general and specific to PSs, and support targeted strategies to address intakes of certain nutrients in European adolescents.
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Affiliation(s)
- Sondos M Flieh
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - María L Miguel-Berges
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain.
| | - Inge Huybrechts
- International Agency for Research on Cancer, Lyon, France; Department of Public Health, Ghent University, Ghent, Belgium
| | - Christina Breidenassel
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany; ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport, Universidad Politécnica de Madrid, Madrid, Spain
| | - Evangelia Grammatikaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; University Lille, Inserm, Centre Hospitalier Universitarie Lille, Clinical Investigation Center, Lille, France
| | - Cinzia Le Donne
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria; Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | | | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, Lille, France
| | - Cristina Molina-Hidalgo
- Evaluacion funcional y fisiologia del ejercicio, Ciencia y Tecnologia de la Salud Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Sonia Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Marcela Gonzalez-Gross
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport, Universidad Politécnica de Madrid, Madrid, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Laurent Béghin
- University Lille, Inserm, Centre Hospitalier Universitarie Lille, Clinical Investigation Center, Lille, France; University Lille, Inserm, Institute for Translational Research in Inflammation, INFINITE, Lille, France
| | - Mathilde Kersting
- Research Department of Child Nutrition, Pediatric University Clinic, Ruhr-University Bochum, Bochum, Germany
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Esther M González-Gil
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
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Dietary Supplements Questioned in the Polish Notification Procedure upon the Basis of Data from the National Register of Functional Foods and the European System of the RASFF. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138161. [PMID: 35805820 PMCID: PMC9266288 DOI: 10.3390/ijerph19138161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023]
Abstract
Dietary supplements (DS) in the countries of the European Union falls within the scope of the food law. DS may, however, contain substances that are simultaneously applied in medicinal products as defined in the pharmaceutical law. The presence of such ingredients may cause problems with the product qualification. The phenomenon of applying such borderline ingredients in dietary supplements may require additional regulations, and ensuring them may be problematic. We conducted an analysis aiming to identify dishonest market practices resorted to by the producers and distributors of non-conforming dietary supplements. We examined mostly questioned DS and compared them with data from the RASFF system and registers of medicinal substances and pharmaceutical entities. The results show that some operators tend to re-notify the same products in response to the initiation of official control procedures. Products in the form of capsules or powders were the most common re-notifications within the 50–100 days. Based on the data obtained, it can be concluded that some entities are obliged to document the safety of the product or its compliance with the regulations, use the imperfection of the notification procedure, and re-notify the questioned product in order to keep it on the market despite potential non-compliance.
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Hribar M, Benedik E, Gregorič M, Blaznik U, Kukec A, Hristov H, Žmitek K, Pravst I. A Systematic Review of Vitamin D Status and Dietary Intake in Various Slovenian Populations. Zdr Varst 2022; 61:55-72. [PMID: 35111267 PMCID: PMC8776289 DOI: 10.2478/sjph-2022-0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/05/2021] [Indexed: 12/26/2022] Open
Abstract
AIM Vitamin D (VitD) is involved in calcium and phosphate homeostasis, bone health, and normal functioning of the immune system. VitD status is monitored using serum 25-hydroxy-vitamin D (25(OH)D) as a biomarker. Serum 25(OH)D concentrations below 30 nmol/L indicate VitD deficiency and below 50 nmol/L indicate insufficiency. VitD can be synthesised endogenously in human skin when exposed to ultraviolet B (UVB) radiation. In the absence of sufficient UVB-light exposure, VitD intake becomes the main source of VitD, with a recommended daily intake of 20 μg. The aim of this study was to conduct a review and meta-analysis on the abovementioned topics, focusing on scientific studies in various Slovenian populations. METHODS We conducted a systematic review and meta-analysis of published scientific papers, academic theses, or conference contributions reporting serum 25(OH)D status and VitD intake across various Slovenian populations. A search was carried out using Web of Science, Scopus, Medline, and the Slovenian library database. RESULTS We identified 43 pertinent studies that addressed 25(OH)D status and 16 that addressed VitD intake. Serum 25(OH)D status was generally low across all populations, and notable seasonal variability was observed. VitD intakes were below 5 μg in all studies. CONCLUSIONS A general observation is that various population groups across Slovenia are at high risk of vitamin D insufficiency and deficiency, particularly during wintertime. Regarding vitamin D intake, all included studies reported daily intakes below the recommended level. We also identified key research gaps that need to be addressed to support further public health decision-making.
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Affiliation(s)
- Maša Hribar
- Nutrition Institute, Tržaška cesta 40, 1000Ljubljana, Slovenia
- University of Ljubljana, Biotechnical Faculty, Jamnikarjeva 101, 1000Ljubljana, Slovenia
| | - Evgen Benedik
- University of Ljubljana, Biotechnical Faculty, Jamnikarjeva 101, 1000Ljubljana, Slovenia
- University Medical Centre Ljubljana, Zaloška cesta 2, 1000Ljubljana, Slovenia
| | - Matej Gregorič
- National Institute of Public Health, Trubarjeva 2, 1000Ljubljana, Slovenia
| | - Urška Blaznik
- National Institute of Public Health, Trubarjeva 2, 1000Ljubljana, Slovenia
| | - Andreja Kukec
- University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Hristo Hristov
- Nutrition Institute, Tržaška cesta 40, 1000Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition Institute, Tržaška cesta 40, 1000Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Gerbičeva cesta 53, 1000Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, 1000Ljubljana, Slovenia
- University of Ljubljana, Biotechnical Faculty, Jamnikarjeva 101, 1000Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Gerbičeva cesta 53, 1000Ljubljana, Slovenia
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Gurinović M, Nikolić M, Zeković M, Milešević J, Kadvan A, Ranić M, Glibetić M. Implementation of Harmonized Food Consumption Data Collection in the Balkan Region According to the EFSA EU Menu Methodology Standards. Front Nutr 2022; 8:809328. [PMID: 35127791 PMCID: PMC8811292 DOI: 10.3389/fnut.2021.809328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
Initiatives in the Capacity Development in Nutrition Research in the Balkan region in the last decade have been toward the creation of contemporary, harmonized Research Infrastructure (RI) compliant with European standards. This study describes the process of creation and implementation of the European Food Safety Authority (EFSA) EU Menu methodology in the Balkan region during the EFSA support projects for food consumption data collection in four countries (Serbia, Montenegro, Bosnia and Herzegovina, and North Macedonia). This process entailed the application and improvement of an innovative tool, the DIET ASSESS and PLAN (DAP), a platform for standardized food consumption data collection and dietary intake assessment. DAP comprises computerized food consumption, anthropometric measurements, and physical activity questionnaires, validated food picture book, and FoodEx2 exposure hierarchy with sets of facet descriptors of the interest. It hosts the Balkan food platform with a Serbian food composition database (FCDB) and Regional FCDB, compliant with European Food Information Resource (EuroFIR™) standards. The implementation of the DAP platform in national dietary surveys conducted with the support of the EFSA EU Menu project in Balkan countries enabled harmonized food consumption data compilation and reporting. Application of the methodology entailed the development of study protocol and extensive education and training of study personnel. The entire data collection process was managed by internal and external survey coordinators. A pilot study was conducted to test the entire data collection and control process and was afterward used to make necessary improvements and adjustments to meet EU Menu requirements. Data collected are internationally comparable with food consumption data in other European countries within the framework of the EU Menu program. The existence of such data in the Balkan region will catalyze research activities in emerging topics, such as identification of dietary patterns, the establishment of national nutrient reference values and food-based dietary guidelines (not only in Serbia, but in the whole Balkan region), dietary exposure assessments, the endorsement and evaluation of new food legislations, the environmental and other effects of diet on the food system. The developed and implemented methodology underpins evidence-based policy-making processes lacking in the field of public health nutrition in the region.
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Affiliation(s)
- Mirjana Gurinović
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Marina Nikolić
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
| | - Milica Zeković
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Jelena Milešević
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Agnes Kadvan
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Marija Ranić
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
| | - Maria Glibetić
- Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
- Capacity Development Network in Nutrition in Central and Eastern Europe (CAPNUTRA), Belgrade, Serbia
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Arini HRB, Hadju V, Thomas P, Ferguson M. Nutrient and Food Intake of Indonesian Children Under 5 Years of Age: A Systematic Review. Asia Pac J Public Health 2021; 34:25-35. [PMID: 34636257 DOI: 10.1177/10105395211041001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Indonesian Government's targets to reduce the prevalence of child malnutrition are unlikely to be met based on current progress. Adequate dietary intake is key to meeting these targets. This systematic review aimed to provide a comprehensive overview of the nutrient and food intake of Indonesian children under 5 years of age. Peer-reviewed and gray literature published between 2007 and 2019 were collected. Of 1500 records, 38 articles met the study inclusion criteria and a narrative analysis was conducted. Children under 5 years were reported to have ranging energy and macronutrient intakes, some with adequate protein intake. Micronutrient deficiencies, particularly iron, zinc, calcium, and vitamin C, were reported. Animal-source foods, fruits, and vegetables were consumed by children, but frequency and/or volume of consumption was low, and it is among the probable causes of micronutrient deficiency among children under 5 years. The absence of reporting micronutrient intake in the national survey limited evidence to inform nutrition-related policies. The implementation of a national micronutrient survey will be beneficial in informing policy and practice aimed at reducing the prevalence of child malnutrition in line with national targets, through improvement in dietary intake.
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Affiliation(s)
- Hesti Retno Budi Arini
- The University of Queensland, Brisbane, Queensland, Australia.,Research Institute of Socio-Economic Development, Surabaya, East Java, Indonesia
| | - Veni Hadju
- Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Preetha Thomas
- The University of Queensland, Brisbane, Queensland, Australia
| | - Megan Ferguson
- The University of Queensland, Brisbane, Queensland, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Hribar M, Hristov H, Lavriša Ž, Koroušić Seljak B, Gregorič M, Blaznik U, Žmitek K, Pravst I. Vitamin D Intake in Slovenian Adolescents, Adults, and the Elderly Population. Nutrients 2021; 13:3528. [PMID: 34684529 PMCID: PMC8537619 DOI: 10.3390/nu13103528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
Vitamin D is involved in calcium and phosphorus metabolism, and is vital for numerous bodily functions. In the absence of sufficient UV-B light-induced skin biosynthesis, dietary intake becomes the most important source of vitamin D. In the absence of biosynthesis, the recommended dietary vitamin D intake is 10-20 µg/day. Major contributors to dietary vitamin D intake are the few foods naturally containing vitamin D (i.e., fish), enriched foods, and supplements. The present study aimed to estimate the vitamin D intake in Slovenia, to identify food groups that notably contribute to vitamin D intake, and to predict the effects of hypothetical mandatory milk fortification. This study was conducted using data collected by the national cross-sectional food consumption survey (SI.Menu) in adolescents (n = 468; 10-17 years), adults (n = 364; 18-64 years), and the elderly (n = 416; 65-74 years). Data collection was carried out between March 2017 and April 2018 using the EU Menu Methodology, which included two 24-h recalls, and a food propensity questionnaire. Very low vitamin D intakes were found; many did not even meet the threshold for very low vitamin D intake (2.5 µg/day). Mean daily vitamin D intake was 2.7, 2.9, and 2.5 µg in adolescents, adults, and the elderly, respectively. Daily energy intake was found to be a significant predictor of vitamin D intake in all population groups. In adolescents and adults, sex was also found to be a significant predictor, with higher vitamin D intake in males. The study results explained the previously reported high prevalence of vitamin D deficiency in Slovenia. An efficient policy approach is required to address the risk of vitamin D deficiency, particularly in vulnerable populations.
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Affiliation(s)
- Maša Hribar
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia; (M.H.); (H.H.); (Ž.L.); (K.Ž.)
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Hristo Hristov
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia; (M.H.); (H.H.); (Ž.L.); (K.Ž.)
| | - Živa Lavriša
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia; (M.H.); (H.H.); (Ž.L.); (K.Ž.)
| | | | - Matej Gregorič
- National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia; (M.G.); (U.B.)
| | - Urška Blaznik
- National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia; (M.G.); (U.B.)
| | - Katja Žmitek
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia; (M.H.); (H.H.); (Ž.L.); (K.Ž.)
- VIST–Higher School of Applied Sciences, Gerbičeva cesta 51A, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia; (M.H.); (H.H.); (Ž.L.); (K.Ž.)
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
- VIST–Higher School of Applied Sciences, Gerbičeva cesta 51A, SI-1000 Ljubljana, Slovenia
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Morris JK, Addor MC, Ballardini E, Barisic I, Barrachina-Bonet L, Braz P, Cavero-Carbonell C, Den Hond E, Garne E, Gatt M, Haeusler M, Khoshnood B, Lelong N, Kinsner-Ovaskainen A, Kiuru-Kuhlefelt S, Klungsoyr K, Latos-Bielenska A, Limb E, O'Mahony MT, Perthus I, Pierini A, Rankin J, Rissmann A, Rouget F, Sayers G, Sipek A, Stevens S, Tucker D, Verellen-Dumoulin C, de Walle HEK, Wellesley D, Wertelecki W, Bermejo-Sanchez E. Prevention of Neural Tube Defects in Europe: A Public Health Failure. Front Pediatr 2021; 9:647038. [PMID: 34249803 PMCID: PMC8264257 DOI: 10.3389/fped.2021.647038] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Thirty years ago it was demonstrated that folic acid taken before pregnancy and in early pregnancy reduced the risk of a neural tube defect (NTD). Despite Public Health Initiatives across Europe recommending that women take 0.4 mg folic acid before becoming pregnant and during the first trimester, the prevalence of NTD pregnancies has not materially decreased in the EU since 1998, in contrast to the dramatic fall observed in the USA. This study aimed to estimate the number of NTD pregnancies that would have been prevented if flour had been fortified with folic acid in Europe from 1998 as it had been in the USA. Design and Setting: The number of NTD pregnancies from 1998 to 2017 that would have been prevented if folic acid fortification had been implemented in the 28 countries who were members of the European Union in 2019 was predicted was predicted using data on NTD prevalence from 35 EUROCAT congenital anomaly registries and literature searches for population serum folate levels and folic acid supplementation. Results: From 1998 to 2017 an estimated 95,213 NTD pregnancies occurred amongst 104 million births in the 28 countries in the EU, a prevalence of 0.92 per 1,000 births. The median serum folate level in Europe over this time period was estimated to be 14.1 μg/L. There is a lack of information about women taking folic acid supplements before becoming pregnant and during the first trimester of pregnancy, with one meta-analysis indicating that around 25% of women did so. An estimated 14,600 NTD pregnancies may have been prevented if the European countries had implemented fortification at the level adopted by the USA in 1998 and 25% of women took folic acid supplements. An estimated 19,500 NTD pregnancies would have been prevented if no women took folic acid supplements. Conclusions: This study suggests that failure to implement mandatory folic acid fortification in the 28 European countries has caused, and continues to cause, neural tube defects to occur in almost 1,000 pregnancies every year.
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Affiliation(s)
- Joan K Morris
- Population Health Research Institute, St. George's, University of London, London, United Kingdom
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Hospital Center, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Elisa Ballardini
- Indagine Sulle Malformazioni Congenite in Emilia-Romagna (IMER) Registry (Emilia Romagna Registry of Birth Defects) Neonatal Intensive Care Unit, Pediatric Section Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ingeborg Barisic
- Centre of Excellence for Reproductive and Regenerative Medicine, Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia
| | - Laia Barrachina-Bonet
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Elly Den Hond
- Health Department, Provincial Institute of Hygiene, Antwerp, Belgium
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt Kolding, Kolding, Denmark
| | - Miriam Gatt
- Directorate for Health Information and Research, Pietà, Malta
| | - Martin Haeusler
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Babak Khoshnood
- Université de Paris, Center of Research in Epidemiology and StatisticS/CRESS/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | - Nathalie Lelong
- Université de Paris, Center of Research in Epidemiology and StatisticS/CRESS/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | | | - Sonja Kiuru-Kuhlefelt
- Finnish Institute for Health and Welfare Terveyden Ja Hyvinvoinnin Laitos (THL), Register of Congenital Malformations, Helsinki, Finland
| | - Kari Klungsoyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Anna Latos-Bielenska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Elizabeth Limb
- Population Health Research Institute, St. George's, University of London, London, United Kingdom
| | - Mary T O'Mahony
- Health Service Executive-South, Department of Public Health, St. Finbarr's Hospital, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, CHU Estaing, Clermont-Ferrand, France
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke-University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Gerardine Sayers
- Health Intelligence R&D Health Service Executive, Dublin, Ireland
| | - Antonin Sipek
- Department of Medical Biology and Genetics, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czechia
| | | | - David Tucker
- Congenital Anomaly Register and Information Service for Wales, Public Health Wales Knowledge Directorate, Singleton Hospital, Swansea, United Kingdom
| | | | - Hermien E K de Walle
- Department of Genetics, Eurocat Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Diana Wellesley
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | | | - Eva Bermejo-Sanchez
- Spanish Collaborative Study of Congenital Malformations (ECEMC), Unidad de Investigación sobre Anomalías Congénitas, Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid, Spain
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Grygorieva N, Povoroznyuk V, Romanenko M, Synieok L. Calcium intake in an adult Ukrainian population. Arch Osteoporos 2020; 15:23. [PMID: 32090299 DOI: 10.1007/s11657-020-0712-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 02/05/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED This is a first large epidemiological study of calcium intake in Ukrainian population. The data from 1518 outpatient subjects aged 20-89 years old showed that the mean level of calcium intake composed 615.6 mg/day (735.4 mg/day in males and 565.6 mg/day in females, p < 0.0001) without any significant differences according to age. INTRODUCTION Insufficiency in calcium (Ca) intake is a worldwide problem; however, corresponding data regarding Ukrainian population is limited. This research was aimed to investigate the level of Ca consumption in daily rations of Ukrainian adults depending on age and sex. METHODS The data from 1518 outpatient subjects from urban and rural areas of Ukraine were analyzed; the Ca intake was evaluated by the method of 24-h dietary recalls during three non-consecutive days by a trained dietitian with further computer calculation. RESULTS The mean level of Ca intake in Ukrainian population composed 615.6 mg/day (735.4 mg/day in males and 565.6 mg/day in females) with significantly higher level of consumption in men than in women in whole group and in the subjects aged 50 years and more. In total, 67% of men and 78% of women consumed less than 800 mg/day Ca and only 28% of males and 10% of females consumed more than 1000 mg/day Ca. CONCLUSIONS This is a first large epidemiological study of Ca intake in Ukrainian population which confirmed its low level. This insufficiency in Ca intake can have a negative influence on exaggerated bone loss, osteoporosis development, and fracture risk that require forehanded correction.
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Affiliation(s)
- Nataliia Grygorieva
- Department of Clinical Physiology & Pathology of Locomotor Apparatus, SI "D. F. Chebotarev Institute of Gerontology NAMS of Ukraine", Vyshgorodska str., 67, Kyiv, 04114, Ukraine.
| | - Vladyslav Povoroznyuk
- Department of Clinical Physiology & Pathology of Locomotor Apparatus, SI "D. F. Chebotarev Institute of Gerontology NAMS of Ukraine", Vyshgorodska str., 67, Kyiv, 04114, Ukraine
| | - Mariana Romanenko
- Laboratory of Gerontological Dietetics, SI "D. F. Chebotarev Institute of Gerontology NAMS of Ukraine", Vyshgorodska str., 67, Kyiv, 04114, Ukraine
| | - Lyudmyla Synieok
- Laboratory of Gerontological Dietetics, SI "D. F. Chebotarev Institute of Gerontology NAMS of Ukraine", Vyshgorodska str., 67, Kyiv, 04114, Ukraine
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11
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Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Assessing diet in European populations using national dietary surveys. Proc Nutr Soc 2020; 79:1-11. [PMID: 31969200 DOI: 10.1017/s0029665119001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The WHO encourages countries to conduct national dietary surveys (NDS) to inform preventative policies targeting malnutrition and noncommunicable diseases. Previous reviews have found inadequate nutrient intakes and survey provision across Europe. This research is the first to provide an updated review of NDS provision within the whole WHO European Region, across the lifecourse, with reference to disadvantaged groups, obesity and nutrients of concern. Over a third of WHO European countries, mainly Central and Eastern European countries (CEEC), had no identifiable NDS. Where countries reported nutrient intakes, poor WHO recommended nutrient intake attainment was Europe-wide across the lifecourse, particularly in CEEC. Lower educated individuals had poorer diet quality. However, heterogeneity in age group sampled, dietary assessment method, nutrient composition database and under-reporting hindered inter-country comparisons. Average population trans fatty acid intakes below WHO recommended limits may hide inequalities in disadvantaged groups; legislative bans may help alleviate this. There were few associations between NDS-derived consumed food portion size (FPS) and BMI. However, consumed FPS was greater than on-pack serving-size in the majority of foods studied. This review illustrates how NDS can generate information on diet, nutrient intakes and the food environment. However, to enable valid inter-country comparisons, countries should be encouraged to conduct and report harmonised NDS, particularly in the age groups sampled, dietary assessment methodology, nutrient range, underpinning food composition database and treatment of under-reporters. This will aid effective, coordinated policy development that can have a real impact on dietary improvement, on a population and subgroup level, throughout Europe.
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Affiliation(s)
- Holly L Rippin
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
| | - Jayne Hutchinson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
| | - Jo Jewell
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 21000Copenhagen, Denmark
| | - Joao J Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 21000Copenhagen, Denmark
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
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12
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Use of Dietary Supplements among Spanish Pediatricians in Daily Practice: A Cross-Sectional Survey Study. J Nutr Metab 2019; 2019:5819305. [PMID: 31428471 PMCID: PMC6681612 DOI: 10.1155/2019/5819305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/16/2019] [Indexed: 11/18/2022] Open
Abstract
A cross-sectional survey study was designed to gather information on the use of dietary supplements by Spanish pediatricians. The study questionnaire was completed by 433 pediatricians (62% men, mean age 52.5 years) throughout the country. They also provided data on 10 of their patients (n = 4304) in which synbiotics, immune stimulants, and omega-3 polyunsaturated fatty acids (PUFAs) had been prescribed. Synbiotics were used by 92% of pediatricians, immune stimulants by 80.4%, and omega-3 PUFAs by 75.1%. Synbiotics were mainly used combined with antibiotics (92.6%) and for gastrointestinal disorders (91.2%), immune stimulants to enhance defenses and cold prevention (87.1%), and omega-3 PUFAs to improve symptoms of attention-deficit hyperactivity disorder (ADHD) (84.8%) and concentration (80.1%). Confidence and previous experience with the product (51.6%), composition and indications of the product (43.1%), and tolerability (39.9%) were main factors involved in decision-making. Children treated with omega-3 supplements were significantly older (mean age 7.6 (3.0) years) than those treated with synbiotics (3.9 (3.9) years) or immune stimulants (3.4 (2.8) years) (P<0.001). Short duration of treatment (<1 month) was significantly more common in the synbiotics group (90.5%), whereas longer duration of treatment (>3 months) was more frequent in the omega-3 group (79.1%). In the immune stimulants group, 60.4% of patients were treated for a period between 1 and 3 months. Clinical improvement was rated by participants as “a lot” in 39% of cases and as “quite” improvement in 50.6%. The overall level of satisfaction was rated as “very satisfied” by 52.1% of participants and as “quite satisfied” by 40.9%. The results show that the use of dietary supplements to improve different conditions, particularly minor disorders, is a widespread clinical practice among Spanish pediatricians. Administration regimens for the three types of supplements, synbiotics, immune stimulants, and omega-3 PUFAs, were consistent with guideline recommendations.
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13
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Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, Stepan J, El-Hajj Fuleihan G, Bouillon R. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol 2019; 180:P23-P54. [PMID: 30721133 DOI: 10.1530/eje-18-0736] [Citation(s) in RCA: 380] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. Severe deficiency (serum 25(OH)D <30 nmol/L or 12 ng/mL) is found in >10% of Europeans. The European Calcified Tissue Society (ECTS) advises that the measurement of serum 25(OH)D be standardized, for example, by the Vitamin D Standardization Program. Risk groups include young children, adolescents, pregnant women, older people (especially the institutionalized) and non-Western immigrants. Consequences of vitamin D deficiency include mineralization defects and lower bone mineral density causing fractures. Extra-skeletal consequences may be muscle weakness, falls and acute respiratory infection, and are the subject of large ongoing clinical trials. The ECTS advises to improve vitamin D status by food fortification and the use of vitamin D supplements in risk groups. Fortification of foods by adding vitamin D to dairy products, bread and cereals can improve the vitamin D status of the whole population, but quality assurance monitoring is needed to prevent intoxication. Specific risk groups such as infants and children up to 3 years, pregnant women, older persons and non-Western immigrants should routinely receive vitamin D supplements. Future research should include genetic studies to better define individual vulnerability for vitamin D deficiency, and Mendelian randomization studies to address the effect of vitamin D deficiency on long-term non-skeletal outcomes such as cancer.
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Affiliation(s)
- Paul Lips
- Endocrine Section, Department of Internal Medicine, Amsterdam University Medical Center, VUMC, Amsterdam, The Netherlands
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, University College Cork, Cork, Ireland
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutritional Sciences, University of Helsinki, Helsinki, Finland
| | | | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | | | - Jan Stepan
- Institute of Rheumatology, Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Roger Bouillon
- Clinic and Laboratory of Endocrinology, Gasthuisberg, KU Leuven, Leuven, Belgium
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14
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Caldeira-Araújo H, Ramos R, Florindo C, Rivera I, Castro R, Tavares de Almeida I. Homocysteine Metabolism in Children and Adolescents: Influence of Age on Plasma Biomarkers and Correspondent Genotype Interactions. Nutrients 2019; 11:nu11030646. [PMID: 30884849 PMCID: PMC6471758 DOI: 10.3390/nu11030646] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/26/2019] [Accepted: 03/06/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Imbalance of homocysteine (Hcy) metabolism links with several pathologies; nevertheless, it is poorly characterized in pediatric populations. This study investigated the impact of age on plasma concentrations of Hcy and relevant biomarkers along with correspondent genotype interactions. Methods: A healthy pediatric cohort aged 9 (n = 195) and 17 (n = 128) years old (yo) was studied. Immunoassays and GC-MS-SIM-mode quantified plasma levels of Hcy and biomarkers. PCR-RFLP or quantitative-PCR assays assessed common variations in related genes. Results: Age impacted on levels of Hcy and metabolic markers: older children presented with the lowest folates and total-cobalamin (tCbl), while with the highest Hcy concentrations, whereas methylmalonic acid (MMA) and holotranscobalamin (Holo-TC) levels remained similar in 9-yo and 17-yo children. The relationships between B-vitamins and metabolic markers were also dependent on age. Only in the older children, MMA correlated with tCbl and Holo-TC, and MMA levels were markedly higher in the 17-yo subjects presenting with the lowest quartiles of Holo-TC concentrations. Lastly, age also impacted on the correlations between genotype and biomarkers. In the 17-yo group, however not in the 9-yo children, tHcy differed between MTHFR 677 genotypes, with subjects who had the MTHFR 677TT genotype displaying the highest tHcy concentrations. Conclusions: Age impacts on the Hcy metabolism dynamics in a pediatric population.
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Affiliation(s)
- Helena Caldeira-Araújo
- Faculty of Life Sciences, University of Madeira, Campus da Penteada, 9000-390 Funchal, Portugal.
- Centro de Química da Madeira, University of Madeira, Campus da Penteada, 9000-390 Funchal, Portugal.
| | - Ruben Ramos
- Metabolism and Genetics Laboratory, Research Institute for Medicines (i.Med.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
| | - Cristina Florindo
- Metabolism and Genetics Laboratory, Research Institute for Medicines (i.Med.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
| | - Isabel Rivera
- Metabolism and Genetics Laboratory, Research Institute for Medicines (i.Med.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
- Department of Biochemistry and Human Biology, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
| | - Rita Castro
- Metabolism and Genetics Laboratory, Research Institute for Medicines (i.Med.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
- Department of Biochemistry and Human Biology, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Isabel Tavares de Almeida
- Metabolism and Genetics Laboratory, Research Institute for Medicines (i.Med.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal.
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15
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Abstract
The WHO encourages national diet survey (NDS) implementation to obtain relevant data to inform policies addressing all forms of malnutrition, which remains a pressing issue throughout Europe. This paper provides an up-to-date review on energy, macro- and selected micronutrient intakes in children across WHO Europe using the latest available NDS intakes. It assesses these against WHO recommended nutrient intakes (RNI) to highlight vulnerable groups and areas of concern. Dietary survey information was gathered by Internet searches, contacting survey authors and nutrition experts. Survey characteristics, energy and nutrient intakes were extracted and weighted means calculated and presented by region. Child energy and nutrient intakes were extracted from twenty-one NDS across a third (n 18) of the fifty-three WHO Europe countries. Of these, 38 % (n 6) reported intakes by socio-economic group, but by various indicators. Energy and macronutrients, where boys and older children had higher intakes, were more widely reported than micronutrients. Most countries met under half of the WHO RNI for nutrients reported in their NDS. Micronutrient attainment was higher than macronutrients, but worst in girls and older children. Only a third, mainly Western, WHO European member states provided published data on child nutrient intakes. Gaps in provision mean that dietary inadequacies may go unidentified, preventing evidence-based policy formation. WHO RNI attainment was poor, particularly in girls and older children. Inconsistent age groups, dietary methodologies, nutrient composition databases and under-reporting hinder inter-country comparisons. Future efforts should encourage countries to conduct NDS in a standardised format by age and sociodemographic variables.
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16
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Novaković R, Geelen A, Ristić-Medić D, Nikolić M, Souverein OW, McNulty H, Duffy M, Hoey L, Dullemeijer C, Renkema JMS, Gurinović M, Glibetić M, de Groot LCPGM, Van't Veer P. Systematic Review of Observational Studies with Dose-Response Meta-Analysis between Folate Intake and Status Biomarkers in Adults and the Elderly. ANNALS OF NUTRITION AND METABOLISM 2018; 73:30-43. [PMID: 29879709 DOI: 10.1159/000490003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Dietary reference values for folate intake vary widely across Europe. METHODS MEDLINE and Embase through November 2016 were searched for data on the association between folate intake and biomarkers (serum/plasma folate, red blood cell [RBC] folate, plasma homocysteine) from observational studies in healthy adults and elderly. The regression coefficient of biomarkers on intake (β) was extracted from each study, and the overall and stratified pooled β and SE (β) were obtained by random effects meta-analysis on a double log scale. These dose-response estimates may be used to derive folate intake reference values. RESULTS For every doubling in folate intake, the changes in serum/plasma folate, RBC folate and plasma homocysteine were +22, +21, and -16% respectively. The overall pooled regression coefficients were β = 0.29 (95% CI 0.21-0.37) for serum/plasma folate (26 estimates from 17 studies), β = 0.28 (95% CI 0.21-0.36) for RBC (13 estimates from 11 studies), and β = -0.21 (95% CI -0.31 to -0.11) for plasma homocysteine (10 estimates from 6 studies). CONCLUSION These estimates along with those from randomized controlled trials can be used for underpinning dietary recommendations for folate in adults and elderly.
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Affiliation(s)
- Romana Novaković
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Danijela Ristić-Medić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Marina Nikolić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Olga W Souverein
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Helene McNulty
- School of Biomedical Sciences, University of Ulster, Coleraine Campus, Londonderry, United Kingdom
| | - Maresa Duffy
- School of Biomedical Sciences, University of Ulster, Coleraine Campus, Londonderry, United Kingdom
| | - Leane Hoey
- School of Biomedical Sciences, University of Ulster, Coleraine Campus, Londonderry, United Kingdom
| | - Carla Dullemeijer
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Jacoba M S Renkema
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Mirjana Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Marija Glibetić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Lisette C P G M de Groot
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Pieter Van't Veer
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
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Fajardo V, Alonso-Aperte E, Varela-Moreiras G. Total folate content in ready-to-eat vegetable meals from the Spanish market. J Food Compost Anal 2017. [DOI: 10.1016/j.jfca.2017.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Adult Nutrient Intakes from Current National Dietary Surveys of European Populations. Nutrients 2017; 9:nu9121288. [PMID: 29186935 PMCID: PMC5748739 DOI: 10.3390/nu9121288] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 11/17/2022] Open
Abstract
The World Health Organization (WHO) encourages countries to undertake national dietary survey (NDS) but implementation and reporting is inconsistent. This paper provides an up-to-date review of adult macro and micronutrient intakes in European populations as reported by NDS. It uses WHO Recommended Nutrient Intakes (RNIs) to assess intake adequacy and highlight areas of concern. NDS information was gathered primarily by internet searches and contacting survey authors and nutrition experts. Survey characteristics and adult intakes by gender/age group were extracted for selected nutrients and weighted means calculated by region. Of the 53 WHO Europe countries, over a third (n = 19), mainly Central & Eastern European countries (CEEC), had no identifiable NDS. Energy and nutrient intakes were extracted for 21 (40%) countries but differences in age group, methodology, under-reporting and nutrient composition databases hindered inter-country comparisons. No country met more than 39% WHO RNIs in all age/gender groups; macronutrient RNI achievement was poorer than micronutrient. Overall RNI attainment was slightly worse in CEEC and lower in women and female elderly. Only 40% countries provided adult energy and nutrient intakes. The main gaps lie in CEEC, where unknown nutrient deficiencies may occur. WHO RNI attainment was universally poor for macronutrients, especially for women, the female elderly and CEEC. All countries could be encouraged to report a uniform nutrient set and sub-analyses of nationally representative nutrient intakes.
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Đermanović M, Miletić I, Pavlović Z. A Comparative Analysis of the Contents Of Iron, Zinc, Copper, Manganese, and Calcium in the Collective Diet Of Preschool Children in the Northwestern Region of Bosnia. Biol Trace Elem Res 2017; 175:27-32. [PMID: 27250494 DOI: 10.1007/s12011-016-0755-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/19/2016] [Indexed: 02/02/2023]
Abstract
Researches conducted worldwide indicate a frequent deficiency in mineral matters. Due to the increased need during the period of accelerated growth and development, children belong to the group that is exposed to the highest risk of mineral matter deficiency. Our objectives were to determine the iron, zinc, copper, manganese, and calcium intake in the collective diet of the preschool population in the in the northwestern region of Bosnia- in the Republic of Srpska and to estimate the adequacy of the application of the international food composition tables for nutrition planning relating to mineral matters. Samples of food intended for children's diet were collected in the preschool institution "Radost" (a kindergarten), in the city of Prijedor. In daily portions, Fe, Zn, Cu, Mn, and Ca contents were determined by flame atomic absorption spectrophotometry. Contents of mineral matters in daily meals were also calculated by the food composition tables. An average daily meal contained 2.86 mg of Fe, 1.71 mg of Zn, 0.19 mg of Cu, 0.21 mg of Mn, and 83.5 mg of Ca. With calculation method, contents of all minerals are significantly higher than the experimental data for all used food composition tables. The obtained results indicate a significant deficiency in mineral matters in the collective diet of the preschool population in the Republic of Srpska, a certain non-compliance with the applicable recommendations, and also suggest a need to create food composition tables for food being consumed in our region.
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Affiliation(s)
- Mirjana Đermanović
- Public Health Institute, Jovana Dučića 1, 78 000, Banja Luka, Bosnia and Herzegovina.
| | - Ivanka Miletić
- Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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Marangoni F, Cetin I, Verduci E, Canzone G, Giovannini M, Scollo P, Corsello G, Poli A. Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document. Nutrients 2016; 8:E629. [PMID: 27754423 PMCID: PMC5084016 DOI: 10.3390/nu8100629] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/19/2016] [Accepted: 10/08/2016] [Indexed: 12/11/2022] Open
Abstract
The importance of lifestyle and dietary habits during pregnancy and breastfeeding, for health of mothers and their offspring, is widely supported by the most recent scientific literature. The consumption of a varied and balanced diet from the preconceptional period is essential to ensure both maternal well-being and pregnancy outcomes. However, the risk of inadequate intakes of specific micronutrients in pregnancy and lactation is high even in the most industrialized countries. This particularly applies to docosahexaenoic acid (DHA), iron, iodine, calcium, folic acid, and vitamin D, also in the Italian population. Moreover, the risk of not reaching the adequate nutrient supply is increased for selected groups of women of childbearing age: those following exclusion diets, underweight or overweight/obese, smokers, adolescents, mothers who have had multiple or close pregnancies, and those with previous unfavorable pregnancy outcomes.
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Affiliation(s)
| | - Irene Cetin
- Department of Mother and Child Hospital Luigi Sacco, Center for Fetal Research Giorgio Pardi, Department of Biomedical and Clinical Sciences University of Milan-Italian Society of Perinatal Medicine (SIMP), Milano 20157, Italy.
| | - Elvira Verduci
- Department of Pediatrics, Department of Health Sciences, San Paolo Hospital, University of Milan-Italian Society of Pediatrics (SIP), Milano 20142, Italy.
| | - Giuseppe Canzone
- Obstetrics and Gynecology Unit, S. Cimino Hospital-Italian Society of Gynecology and Obstetrics (SIGO), Termini Imerese, Palermo 90018, Italy.
| | - Marcello Giovannini
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan-Italian Society of Pediatric Nutrition (SINUPE), Milano 20142, Italy.
| | - Paolo Scollo
- Division of Gynecology and Obstetrics, Maternal and Child Department, Cannizzaro Hospital-Italian Society of Gynecology and Obstetrics (SIGO), Catania 95126, Italy.
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo-Italian Society of Pediatrics (SIP), Palermo 90127, Italy.
| | - Andrea Poli
- NFI-Nutrition Foundation of Italy, Milano 20124, Italy.
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Gurinović M, Milešević J, Kadvan A, Nikolić M, Zeković M, Djekić-Ivanković M, Dupouy E, Finglas P, Glibetić M. Development, features and application of DIET ASSESS & PLAN (DAP) software in supporting public health nutrition research in Central Eastern European Countries (CEEC). Food Chem 2016; 238:186-194. [PMID: 28867092 DOI: 10.1016/j.foodchem.2016.09.114] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/08/2016] [Accepted: 09/17/2016] [Indexed: 10/21/2022]
Abstract
In order to meet growing public health nutrition challenges in Central Eastern European Countries (CEEC) and Balkan countries, development of a Research Infrastructure (RI) and availability of an effective nutrition surveillance system are a prerequisite. The building block of this RI is an innovative tool called DIET ASSESS & PLAN (DAP), which is a platform for standardized and harmonized food consumption collection, comprehensive dietary intake assessment and nutrition planning. Its unique structure enables application of national food composition databases (FCDBs) from the European food composition exchange platform (28 national FCDBs) developed by EuroFIR (http://www.eurofir.org/) and in addition allows communication with other tools. DAP is used for daily menu and/or long-term diet planning in diverse public sector settings, foods design/reformulation, food labelling, nutrient intake assessment and calculation of the dietary diversity indicator, Minimum Dietary Diversity-Women (MDD-W). As a validated tool in different national and international projects, DAP represents an important RI in public health nutrition epidemiology in the CEEC region.
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Affiliation(s)
- Mirjana Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia; Capacity Development Network in Nutrition in Central and Eastern Europe, CAPNUTRA, Serbia.
| | - Jelena Milešević
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia; Capacity Development Network in Nutrition in Central and Eastern Europe, CAPNUTRA, Serbia
| | - Agnes Kadvan
- Capacity Development Network in Nutrition in Central and Eastern Europe, CAPNUTRA, Serbia
| | - Marina Nikolić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia; Capacity Development Network in Nutrition in Central and Eastern Europe, CAPNUTRA, Serbia
| | - Milica Zeković
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia
| | | | - Eleonora Dupouy
- FAO Regional Office for Europe and Central Asia (REU), Budapest, Hungary
| | | | - Maria Glibetić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia; Capacity Development Network in Nutrition in Central and Eastern Europe, CAPNUTRA, Serbia
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Vitamin D status in mothers with pre-eclampsia and their infants: a case-control study from Serbia, a country without a vitamin D fortification policy. Public Health Nutr 2016; 20:1825-1835. [PMID: 27087002 DOI: 10.1017/s1368980016000409] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of the present study was to determine if vitamin D intake and status are associated with pre-eclampsia in a country without a vitamin D fortification policy. DESIGN A case-control study of pregnancies with (case) and without (control) pre-eclampsia was conducted from January to April when UVB is minimal. Maternal and cord blood obtained at delivery were measured for plasma 25-hydroxycholecalciferol (25-OH-D3), 3-epimer of 25-OH-D3 (3-epi-25-OH-D3) and 24,25-dihydroxycholecalciferol (24,25-(OH)2D3) by LC-MS/MS and maternal 1,25-dihydroxyvitamin D (1,25-(OH)2D). Differences between groups were tested with ANOVA and Bonferroni post hoc tests (P<0·05). SETTING Clinical Center of Serbia. SUBJECTS Pregnant women with and without pre-eclampsia (n 60) and their infants. RESULTS Exogenous vitamin D intake (0·95-16·25 µg/d (38-650 IU/d)) was not significantly different between groups. Women with pre-eclampsia delivered infants at an earlier gestational age and had significantly lower mean total plasma 25-hydroxyvitamin D (25-OH-D; case: 11·2 (sd 5·1); control: 16·1 (sd 5·7) ng/ml; P=0·0006), 25-OH-D3 (case: 10·0 (sd 4·9); control: 14·2 (sd 5·8) ng/ml; P=0·002), 3-epi-25-OH-D3 (case: 0·5 (sd 0·2); control: 0·7 (sd 0·2) ng/ml; P=0·0007) and 1,25-(OH)2D (case: 56·5 (sd 26·6); control: 81·0 (sd 25·7) pg/ml; P=0·018), while 24,25-(OH)2D3 was not different between groups. Infants did not differ in total plasma 25-OH-D, 25-OH-D3, 3-epi-25-OH-D3 and 24,25-(OH)2D3, but the mean proportion of 3-epi-25-OH-D3 was higher in the infant case group (case: 7·9 (sd 1·1); control: 7·0 (sd 1·4) % of total 25-OH-D3; P=0·005). CONCLUSIONS A high prevalence of vitamin D deficiency, as defined by plasma 25-OH-D<12 ng/ml, was observed in 47 % of all mothers and 77 % of all infants. These data underscore the need for prenatal vitamin D supplementation and a food fortification policy in Serbia.
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Stefler D, Pajak A, Malyutina S, Kubinova R, Bobak M, Brunner EJ. Comparison of food and nutrient intakes between cohorts of the HAPIEE and Whitehall II studies. Eur J Public Health 2015; 26:628-34. [PMID: 26637342 PMCID: PMC4946410 DOI: 10.1093/eurpub/ckv216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Differences in dietary habits have been suggested as an important reason for the large health gap between Eastern and Western European populations. Few studies have compared individual-level nutritional data directly between the two regions. This study addresses this hypothesis by comparing food, drink and nutrient intakes in four large population samples. METHODS Czech, Polish and Russian participants of the Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) study, and British participants in the Whitehall II study, altogether 29 972 individuals aged 45-73 years, were surveyed in 2002-2005. Dietary data were collected by customised food frequency questionnaires. Reported food, drink and nutrient intake data were harmonised and compared between cohorts using multivariable adjusted quantile regression models. RESULTS Median fruit and vegetable intakes were lower in the pooled Eastern European sample, but not in all country cohorts, compared with British subjects. Median daily consumption of fruits were 275, 213, 130 and 256 g in the Czech, Polish, Russian and Whitehall II cohort, respectively. The respective median daily intakes of vegetables were 185, 197, 292 and 246 g. Median intakes of animal fat foods and saturated fat, total fat and cholesterol nutrients were significantly higher in the Czech, Polish and Russian cohorts compared with the British; for example, median daily intakes of saturated fatty acids were 31.3, 32.5, 29.2 and 25.4 g, respectively. CONCLUSION Our findings suggest that there are important differences in dietary habits between and within Eastern and Western European populations which may have contributed to the health gap between the two regions.
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Affiliation(s)
- Denes Stefler
- 1 Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrzej Pajak
- 2 Department of Epidemiology and Population Sciences, Jagiellonian University, Krakow, Poland
| | - Sofia Malyutina
- 3 Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia 4 Novosibirsk State Medical University, Novosibirsk, Russia
| | - Ruzena Kubinova
- 5 Centre for Health Monitoring, National Institute of Public Health, Prague, Czech Republic
| | - Martin Bobak
- 1 Department of Epidemiology and Public Health, University College London, London, UK
| | - Eric J Brunner
- 1 Department of Epidemiology and Public Health, University College London, London, UK
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Does the consumption of fruits and vegetables differ between Eastern and Western European populations? Systematic review of cross-national studies. ACTA ACUST UNITED AC 2015; 73:29. [PMID: 26078867 PMCID: PMC4466869 DOI: 10.1186/s13690-015-0078-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 05/05/2015] [Indexed: 12/07/2022]
Abstract
BACKGROUND Difference in fruit and vegetable consumption has been suggested as a possible reason for the large gap in cardiovascular disease (CVD) mortality rates between Eastern and Western European populations. However, individual-level dietary data which allow direct comparison across the two regions are rare. In this systematic review we aimed to answer the question whether cross-national studies with comparable individual-level dietary data reveal any systematic differences in fruit and vegetable consumption between populations in Central and Eastern Europe (CEE) and the Former Soviet Union (FSU) compared to Western Europe (WE). METHODS Studies were identified by electronic search of MEDLINE, EMBASE and Web of Science databases from inception to September 2014, and hand search. Studies which reported data on fruit, vegetable consumption or carotene and vitamin C intake or tissue concentrations of adult participants from both CEE/FSU and WE countries were considered for inclusion. Quality of the included studies was assessed by a modified STROBE statement. Power calculation was performed to determine the statistical significance of the comparison results. RESULTS Twenty-two studies fulfilled the inclusion criteria. Fruit consumption was found to be consistently lower in CEE/FSU participants compared to Western Europeans. Results on vegetable intake were less unambiguous. Antioxidant studies indicated lower concentration of beta-carotene in CEE/FSU subjects, but the results for vitamin C were not consistent. CONCLUSION This systematic review suggests that populations in CEE and FSU consume less fruit than Western Europeans. The difference in the consumption of fruit may contribute to the CVD gap between the two regions.
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Validity of an FFQ assessing the vitamin D intake of young Serbian women living in a region without food fortification: the method of triads model. Public Health Nutr 2015; 19:437-45. [PMID: 25959015 DOI: 10.1017/s136898001500138x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The objective of the present study was to examine the external validity of an FFQ designed to estimate dietary vitamin D intake compared with a plasma biomarker and three repeated 24 h dietary recalls in women of reproductive age in Serbia, where there is no exposure to food fortified with vitamin D. The method of triads was applied. DESIGN In a cross-sectional study, 422 women completed the Women and Reproductive Health FFQ (WRH-FFQ) during the winter months. From a representative subgroup (n 44), three 24 h dietary recalls and anthropometric parameters were collected as well as a fasting blood sample for vitamin D biomarker analyses. Correlation coefficients were calculated between each of the dietary methods. Validity coefficients, as a correlation between the measured and estimated 'true' exposure, were calculated using the method of triads. Bland-Altman plots were also constructed. SETTING Three major universities in Serbia. SUBJECTS Healthy young women (n 422) aged 18-35 years. RESULTS The WRH-FFQ estimate of vitamin D intake for all participants was 4.0 (sd 3.3) µg/d and 3.1 (sd 2.3) µg/d for the subgroup. Bland-Altman plots for these intakes showed high agreement. Validity coefficients for the FFQ, 24 h recall and biomarker were ρ QI=0.847 (95% CI 0.564, 0.928), ρ RI=0.810 (95% CI 0.537, 0.997) and ρ BI=0.499 (95% CI 0.190, 0.840), while the correlation coefficients were 0.686, 0.422 and 0.404. CONCLUSIONS The FFQ applied in the present study is a valid tool for assessing dietary vitamin D intake in women living in Serbia, a region without mandatory vitamin D food fortification.
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Improving nutrition surveillance and public health research in Central and Eastern Europe/Balkan Countries using the Balkan Food Platform and dietary tools. Food Chem 2015; 193:173-80. [PMID: 26433305 DOI: 10.1016/j.foodchem.2015.03.103] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 11/11/2014] [Accepted: 03/15/2015] [Indexed: 11/21/2022]
Abstract
The objective of this paper is to share experience and provide updated information on Capacity Development in the Central and Eastern Europe/Balkan Countries (CEE/BC) region relevant to public health nutrition, particularly in creation of food composition databases (FCDBs), applying dietary intake assessment and monitoring tools, and harmonizing methodology for nutrition surveillance. Balkan Food Platform was established by a Memorandum of Understanding among EuroFIR AISBL, Institute for Medical Research, Belgrade, Capacity Development Network in Nutrition in CEE - CAPNUTRA and institutions from nine countries in the region. Inventory on FCDB status identified lack of harmonized and standardized research tools. To strengthen harmonization in CEE/BC in line with European research trends, the Network members collaborated in development of a Regional FCDB, using web-based food composition data base management software following EuroFIR standards. Comprehensive nutrition assessment and planning tool - DIET ASSESS & PLAN could enable synchronization of nutrition surveillance across countries.
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Stepaniak U, Micek A, Grosso G, Stefler D, Topor-Madry R, Kubinova R, Malyutina S, Peasey A, Pikhart H, Nikitin Y, Bobak M, Pająk A. Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study. Eur J Nutr 2015; 55:547-560. [PMID: 25762013 PMCID: PMC4767874 DOI: 10.1007/s00394-015-0871-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/02/2015] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of the study was to assess the relationships between individual-level dietary intakes of antioxidant vitamins C, E and beta-carotene with all-cause and cause-specific mortality in three Central and Eastern European (CEE) populations. METHODS Data from the Health, Alcohol and Psychosocial factors in Eastern Europe cohort study were used. At the baseline survey, between 2002 and 2005, 28,945 men and women aged 45-69 years were examined in Novosibirsk (Russia), Krakow (Poland) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Cox regression was used to estimate the association between vitamin consumption and all-cause, cardiovascular (CVD) disease and cancer mortality. RESULTS In multivariable-adjusted analyses, there were no clear inverse associations between antioxidant vitamin intakes and mortality, although in some groups, several hazard ratios (HRs) were significant. For example, in men, compared with the lowest quintile of vitamin C intake, all-cause mortality in the third and fourth quintiles was lower by 28 % (HR 0.72; 95 % CI 0.61-0.85) and by 20 % (HR 0.80; 95 % CI 0.68-0.95), respectively. CVD mortality was lower by 35 % (HR 0.65; 95 % CI 0.50-0.84) and by 23 % (HR 0.77; 95 % CI 0.59-0.99) in third and fourth quintile of vitamin C intake, respectively. In women, the third and fourth quintiles of dietary intake of vitamin E were associated with reduced risk of all-cause death by 33 % (HR 0.67; 95 % CI 0.53-0.84) and by 23 % (HR 0.77; 95 % CI 0.61-0.97), respectively. Consumption of vitamin C, vitamin E and beta-carotene was not related to CVD mortality in women and to cancer mortality in either gender. CONCLUSION This large prospective cohort study in CEE populations with low prevalence of vitamin supplementation did not find a strong, dose-response evidence for protective effects of antioxidant vitamin intake.
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Affiliation(s)
- Urszula Stepaniak
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.
| | - Agnieszka Micek
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland
| | - Giuseppe Grosso
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Roman Topor-Madry
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland
| | | | - Sofia Malyutina
- Institute of Internal and Preventive Medicine Siberian Branch Under the Russian Academy of Medical Sciences, Novosibirsk, Russia.,Novosibirsk State Medical University, Novosibirsk, Russia
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Yuri Nikitin
- Institute of Internal and Preventive Medicine Siberian Branch Under the Russian Academy of Medical Sciences, Novosibirsk, Russia
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland
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White L, Romagné F, Müller E, Erlebach E, Weihmann A, Parra G, Andrés AM, Castellano S. Genetic Adaptation to Levels of Dietary Selenium in Recent Human History. Mol Biol Evol 2015; 32:1507-18. [DOI: 10.1093/molbev/msv043] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Novaković R, Cavelaars A, Geelen A, Nikolić M, Altaba II, Viñas BR, Ngo J, Golsorkhi M, Medina MW, Brzozowska A, Szczecinska A, de Cock D, Vansant G, Renkema M, Majem LS, Moreno LA, Glibetić M, Gurinović M, van't Veer P, de Groot LCPGM. Socio-economic determinants of micronutrient intake and status in Europe: a systematic review. Public Health Nutr 2014; 17:1031-45. [PMID: 23750829 PMCID: PMC10282449 DOI: 10.1017/s1368980013001341] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 03/06/2013] [Accepted: 03/12/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To provide the evidence base for targeted nutrition policies to reduce the risk of micronutrient/diet-related diseases among disadvantaged populations in Europe, by focusing on: folate, vitamin B12, Fe, Zn and iodine for intake and status; and vitamin C, vitamin D, Ca, Se and Cu for intake. DESIGN MEDLINE and Embase databases were searched to collect original studies that: (i) were published from 1990 to 2011; (ii) involved >100 subjects; (iii) had assessed dietary intake at the individual level; and/or (iv) included best practice biomarkers reflecting micronutrient status. We estimated relative differences in mean micronutrient intake and/or status between the lowest and highest socio-economic groups to: (i) evaluate variation in intake and status between socio-economic groups; and (ii) report on data availability. SETTING Europe. SUBJECTS Children, adults and elderly. RESULTS Data from eighteen publications originating primarily from Western Europe showed that there is a positive association between indicators of socio-economic status and micronutrient intake and/or status. The largest differences were observed for intake of vitamin C in eleven out of twelve studies (5-47 %) and for vitamin D in total of four studies (4-31 %). CONCLUSIONS The positive association observed between micronutrient intake and socio-economic status should complement existing evidence on socio-economic inequalities in diet-related diseases among disadvantaged populations in Europe. These findings could provide clues for further research and have implications for public health policy aimed at improving the intake of micronutrients and diet-related diseases.
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Affiliation(s)
- Romana Novaković
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Adriënne Cavelaars
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Marina Nikolić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
| | - Iris Iglesia Altaba
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
| | - Blanca Roman Viñas
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona, Barcelona, Spain
| | - Joy Ngo
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona, Barcelona, Spain
| | - Mana Golsorkhi
- Department of Sport and Health Sciences, Oxford Brookes University, Oxford, UK
| | - Marisol Warthon Medina
- Centre for Applied Sport and Exercise Sciences, University of Central Lancashire, Preston, UK
| | - Anna Brzozowska
- Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Anna Szczecinska
- Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Diederik de Cock
- Department of Nutrition–Public Health Medicine, LFoRCe (Leuven Food Science and Nutrition Research Centre), Catholic University, Leuven, Belgium
| | - Greet Vansant
- Department of Nutrition–Public Health Medicine, LFoRCe (Leuven Food Science and Nutrition Research Centre), Catholic University, Leuven, Belgium
| | - Marianne Renkema
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Lluís Serra Majem
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona, Barcelona, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Luis Aznar Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
| | - Maria Glibetić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
| | - Mirjana Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
| | - Pieter van't Veer
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Lisette CPGM de Groot
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
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Nikolić M, Glibetić M, Gurinović M, Milešević J, Khokhar S, Chillo S, Abaravicius JA, Bordoni A, Capozzi F. Identifying critical nutrient intake in groups at risk of poverty in Europe: the CHANCE project approach. Nutrients 2014; 6:1374-93. [PMID: 24699195 PMCID: PMC4011040 DOI: 10.3390/nu6041374] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 03/06/2014] [Accepted: 03/13/2014] [Indexed: 11/23/2022] Open
Abstract
The aim of the CHANCE project is to develop novel and affordable nutritious foods to optimize the diet and reduce the risk of diet-related diseases among groups at risk of poverty (ROP). This paper describes the methodology used in the two initial steps to accomplish the project’s objective as follows: 1. a literature review of existing data and 2. an identification of ROP groups with which to design and perform the CHANCE nutritional survey, which will supply new data that is useful for formulating the new CHANCE food. Based on the literature review, a low intake of fruit and vegetables, whole grain products, fish, energy, fiber, vitamins B1, B2, B3, B6, B12 and C, folate, calcium, magnesium, iron, potassium and zinc and a high intake of starchy foods, processed meat and sodium were apparent. However, the available data appeared fragmented because of the different methodologies used in the studies. A more global vision of the main nutritional problems that are present among low-income people in Europe is needed, and the first step to achieve this goal is the use of common criteria to define the risk of poverty. The scoring system described here represents novel criteria for defining at-risk-of-poverty groups not only in the CHANCE-participating countries but also all over Europe.
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Affiliation(s)
- Marina Nikolić
- Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Tadeuša Košćuška 1, Belgrade 11000, Serbia.
| | - Maria Glibetić
- Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Tadeuša Košćuška 1, Belgrade 11000, Serbia.
| | - Mirjana Gurinović
- Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Tadeuša Košćuška 1, Belgrade 11000, Serbia.
| | - Jelena Milešević
- Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Tadeuša Košćuška 1, Belgrade 11000, Serbia.
| | - Santosh Khokhar
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Stefania Chillo
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Jonas Algis Abaravicius
- Faculty of Medicine, Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Vilnius University, Vilnius LT-03101, Lithuania.
| | - Alessandra Bordoni
- Department of Agriculture and Food Science and Technology, University of Bologna, Piazza Goidanich 60, Cesena 47023, Italy.
| | - Francesco Capozzi
- Department of Agriculture and Food Science and Technology, University of Bologna, Piazza Goidanich 60, Cesena 47023, Italy.
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Professional training in nutrition in Central and Eastern Europe: current status and opportunities for capacity development. Public Health Nutr 2014; 18:372-7. [DOI: 10.1017/s1368980014000172] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo examine the availability of academic programmes in nutrition and identify nutrition training needs in Central and Eastern Europe (CEE).DesignA questionnaire with close-ended and open-ended questions was distributed to the members of the United Nations University Standing Committee on Nutrition, Regional Network for Capacity Development in Nutrition in CEE (NCDN CEE).SettingParticipants’ responses to the questionnaire including the comments of their colleagues from home institutions were obtained in group discussions during NCDN CEE meetings in 2010–2013.SubjectsSixteen CEE countries’ experts and their colleagues from home institutions involved in NCDN CEE activities 2007–2013.ResultsThe responses were obtained from fourteen out of sixteen participating countries; five countries have established Bachelor, Master and PhD studies in nutrition (Croatia, Czech Republic, Poland, Slovak Republic and Slovenia), whereas in Latvia and Republic of Macedonia only Bachelor and Master studies are set up. Seven countries have no Bachelor, Master or PhD studies: Bosnia and Herzegovina, Bulgaria, Estonia, Lithuania, Montenegro, Romania and Serbia. Introduction to data analysis and Nutritional epidemiology are the most needed nutrition trainings that would increase working competence of nutritionists and nutrition-related professionals in CEE.ConclusionsAvailability of academic programmes in nutrition in CEE countries is limited. Opportunities for improving the competence of existing and future nutrition-related professionals should be addressed at national and regional level; distance learning courses and creation of a regional centre for nutrition training were seen as opportunities for sustainable capacity development in nutrition in CEE.
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A systematic review on micronutrient intake adequacy in adult minority populations residing in Europe: the need for action. J Immigr Minor Health 2013; 16:941-50. [PMID: 23536278 DOI: 10.1007/s10903-013-9799-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This systematic review evaluated micronutrient intake inadequacy of ten micronutrients for adult ethnic minority populations residing in Europe. Pubmed was searched for studies, related references were checked and experts consulted. Ten studies were identified and six were included in the final analysis representing Albanian, Roma, Sub-Saharan African, South Asian and African-Caribbean minority groups. The Estimated Average Requirement cut point was applied to estimate inadequate intake. With the exception of a sub-Saharan African study, of seven micronutrients analysed, inadequate intakes were markedly elevated (>50 % of the population in most cases) in both genders for folate, vitamin B(12), calcium and iron (the latter in females only). A pressing need exists for intake adequacy studies with sound methodologies addressing ethnic minority groups in Europe. These populations constitute a vulnerable population for inadequate intakes and results substantiate the need for further investigation, interventions and policy measures to reduce their nutritional risk.
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