Changes in intake of fruits and vegetables in relation to risk of obesity and weight gain among middle-aged women

Tomato genotype but not crop water deficit matters for tomato health benefits in diet-induced obesity of C57BL/6JRj male mice

Several studies have linked the intake of lycopene and/or tomato products with improved metabolic health under obesogenic regime. The aim was to evaluate the differential impact of supplementations with several tomato genotypes differing in carotenoid content and subjected to different irrigation levels on obesity-associated disorders in mice. In this study, 80 male C57BL/6JRj mice were assigned into 8 groups to receive: control diet, high fat diet, high fat diet supplemented at 5 % w/w with 4 tomato powders originating from different tomato genotypes cultivated under control irrigation: H1311, M82, IL6-2, IL12-4. Among the 4 genotypes, 2 were also cultivated under deficit irrigation, reducing the irrigation water supply by 50 % from anthesis to fruit harvest. In controlled irrigation treatment, all genotypes significantly improved fasting glycemia and three of them significantly lowered liver lipids content after 12 weeks of supplementation. In addition, IL6-2 genotype, rich in β-carotene, significantly limited animal adiposity, body weight gain and improved glucose homeostasis as highlighted in glucose and insulin tolerance tests. No consistent beneficial or detrimental impact of deficit irrigation to tomato promoting health benefits was found. These findings imply that the choice of tomato genotype can significantly alter the composition of fruit carotenoids and phytochemicals, thereby influencing the anti-obesogenic effects of the fruit. In contrast, deficit irrigation appears to have an overall insignificant impact on enhancing the health benefits of tomato powder in this context, particularly when compared to the genotype-related variations in carotenoid content.

Does college selectivity reduce obesity? A partial identification approach

We use data from the National Longitudinal Study of Adolescent to Adult Health to investigate whether the quality of tertiary education -measured by college selectivity-causally affects obesity prevalence in the medium run (by age 24-34) and in the longer run (about 10 years later). We use partial identification methods, which allow us, while relying on weak assumptions, to overcome the potential endogeneity of college selectivity as well as the potential violation of the stable unit treatment value assumption due to students interacting with each other, and to obtain informative identification regions for the average treatment effect of college selectivity on obesity. We find that attending a more selective college causally reduces obesity, both in the medium and in the longer run. We provide evidence that the mechanisms through which the impact of college selectivity on obesity operates include an increase in income, a reduction in physical inactivity and in the consumption of fast food and sweetened drinks.

Associations between food consumption/dietary habits and the risks of obesity, type 2 diabetes, and hypertension: a cross-sectional study in Jakarta, Indonesia

BACKGROUND/OBJECTIVES

This study aimed to assess the current mean daily intake of 10 food groups, analyze the sociodemographic factors associated with food consumption, and determine the associations between food consumption/dietary intake and the prevalence rates of obesity, type 2 diabetes (T2D), and hypertension (HTN) in Jakarta, Indonesia.

SUBJECTS/METHODS

A total of 600 participants aged 20-85 yrs were included in this cross-sectional study. Food consumption and dietary habits were assessed using a food frequency questionnaire. To determine the association between food consumption/dietary habits and the abovementioned diseases, logistic regression analysis was performed.

RESULTS

The average vegetable and fruit intake was lower, while sugar and salt consumption were higher than that recommended by Indonesia's national dietary guidelines. A high intake of ultra-processed foods (UPFs) was associated with young age, men, "single" status, a high education level, and employment with a high monthly income. Obesity and T2D were positively correlated with high intakes of cereals and tubers, UPFs, sugars, fats, and oils. Conversely, an inverse association was found between legume, vegetable, and fruit consumption and obesity risk. An inverse correlation was also observed between vegetable consumption and T2D risk. Moreover, a high salt intake was inversely correlated with fruit consumption in terms of HTN risk. Non-indulgence in habitual late-night snacking and refrainment from consuming more than one dish at each meal were also negatively related to the prevalence of obesity, T2D, and HTN. Inverse correlations were also observed between the prevalence rates of T2D and HTN and abstaining from adding sugar to beverages.

CONCLUSION

Foods high in fat, sugar, and sodium were strongly associated with the risks of obesity, T2D, and HTN. Additionally, poor eating habits were also associated with disease development.

Do macronutrient intakes affect obesity indices in Jordanian adults?

OBJECTIVE

To determine whether macronutrient intake is associated with novel obesity indices, including the conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI).

METHODOLOGY

A cross-sectional survey was conducted with 491 adults (344 males and 147 females) working at different universities in Jordan (July-December 2019). Daily intake of energy (kcal), carbohydrates (g), protein (g), and fat (g) was obtained using 24-h recalls collected over 2 days. Additionally, obesity indices were calculated.

RESULTS

Regardless of sex, energy, and carbohydrate intakes had a moderately significant positive association, whereas protein and fat intakes had a weakly significant association with BAI, AVI, and BRI. CI and WWI showed a weakly significant association with all macronutrients in males, a moderate correlation with energy and carbohydrate intake, and a weak association with fat and protein intake in females. Male participants had significant increases in the CI (T1 = 1.29 ± 0.01 vs. T3 = 1.36 ± 0.01, p = .018), AVI (T1 = 17.96 ± 0.52 vs. T3 = 22.81 ± 0.57, p = .011), and WWI (T1 = 10.72 ± 0.11 vs. T3 = 11.29 ± 0.09, p = .047) indices scores through the carbohydrate intake tertiles. Additionally, there was a significant increase in scores of AVI (T1 = 18.60 ± 0.56 vs. T3 = 21.42 ± 0.46, p = .048) and an almost significant increase in CI (T1 = 1.30 ± 0.01vs. T3 = 1.33 ± 0.01, p = .056) through the tertiles of protein intake.

CONCLUSION

Macronutrients were significantly associated with all indices. The effect of macronutrients on obesity indices is sex-based. Among men, CI, AVI, and WWI were the indices most affected by carbohydrate and protein intakes. Future studies should further investigate food sources and macronutrient quality.

Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review

This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.

Comparative analysis of lifestyle behaviors and dietary intake among obese and non-obese individuals following bariatric surgery: a secondary data analysis from 2020 to 2022

Objective

The aim of this research is to perform a comparative examination of lifestyle habits and dietary consumption between obese and non-obese subjects who have undergone bariatric surgery. This is done with the intent of investigating the disparities in obesity outcomes attributable to these elements.

Method

This study involves a secondary analysis of cross-sectional data obtained from the Sharik Diet and Health National Survey (SDHNS). To ensure a representative distribution of participants, the SDHNS employs a proportional quota sampling strategy, with stratification based on age, sex, and geographic location within Saudi Arabia's 13 administrative regions, utilizing the ZDataCloud® system for this purpose. The data, collected between 2020 and 2022 from over 15,000 participants, were screened to identify the eligible records of individuals who underwent bariatric surgery.

Results

Within the entire sample, a mere 5.0% (806 individuals) had undertook bariatric surgery, with females comprising 54% of this specific subgroup. The average age within this group was 38.85 years (SD 13.02) and range (18-87). Post-operative results showed that 33% of these individuals remained classified as obese. Utilizing the backward likelihood ratio regression model, it was determined that factors including age, decreased consumption of fresh juices and chicken, as well as current tobacco use, were significantly associated with persistent obesity.

Conclusion

The findings of this study suggest an association between the non-obese group and healthier lifestyle choices, including the consumption of high-protein diets and fresh juices, alongside a decreased prevalence of smoking. These observations underscore the significance of maintaining a healthy lifestyle for positive weight loss outcomes following bariatric surgery.

Does an apple a day keep away diseases? Evidence and mechanism of action

Apples and their products exemplify the recently reemphasized link between dietary fruit intake and the alleviation of human disease. Their consumption does indeed improve human health due to their high phytochemical content. To identify potentially relevant articles from clinical trials, some epidemiological studies and meta-analyses, and in vitro and in vivo studies (cell cultures and animal models), PubMed was searched from January 1, 2012, to May 15, 2022. This review summarized the potential effects of apple and apple products (juices, puree, pomace, dried apples, extracts rich in apple bioactives and single apple bioactives) on health. Apples and apple products have protective effects against cardiovascular diseases, cancer, as well as mild cognitive impairment and promote hair growth, healing of burn wounds, improve the oral environment, prevent niacin-induced skin flushing, promote the relief of UV-induced skin pigmentation, and improve the symptoms of atopic dermatitis as well as cedar hay fever among others. These effects are associated with various mechanisms, such as vascular endothelial protection, blood lipids lowering, anti-inflammatory, antioxidant, antiapoptotic, anti-invasion, and antimetastatic effects. Meanwhile, it has provided an important reference for the application and development of medicine, nutrition, and other fields.

Association between pre-pregnancy weight status and dietary patterns during pregnancy: results from the Japan Environment and Children's Study

OBJECTIVE

Pre-pregnancy weight status is related to offspring health and may influence dietary patterns during pregnancy. We aimed to evaluate the link between pre-pregnancy weight status and dietary patterns during pregnancy.

DESIGN

Dietary data were collected using a FFQ during middle or late pregnancy. Dietary patterns were identified using principal component analysis. Anthropometric data were extracted from medical charts. Multiple linear regression was used to assess associations between pre-pregnancy weight status (severely or moderately underweight, mildly underweight, normal weight, overweight and obese) and dietary patterns during pregnancy after adjusting for socio-demographic characteristics.

SETTING

Nationwide Japan.

PARTICIPANTS

Pregnant Japanese women enrolled in the Japan Environment and Children's Study, a prospective birth cohort study (n 90 765).

RESULTS

We identified three dietary patterns. Compared with women with pre-pregnancy normal weight, those with pre-pregnancy obesity were less likely to habitually consume 'fruits and vegetables' pattern (coefficient, -0·18; 95 % CI, -0·21, -0·14) and 'confectionery' pattern (coefficient, -0·18; 95 % CI, -0·21, -0·14) and more likely to consume 'white rice and soy products' pattern (coefficient, 0·08; 95 % CI, 0·04, 0·11), and those with severely or moderately pre-pregnancy underweight were more likely to consume 'confectionery' pattern (coefficient, 0·06; 95 % CI, 0·03, 0·09) during pregnancy, after adjusting for confounders.

CONCLUSION

We found that moderately and severely pre-pregnancy underweight women and those with obesity had unhealthy dietary patterns compared to those with pre-pregnancy normal weight. Our findings suggest that prenatal dietary advice is important and should be based on the pre-pregnancy weight status.

Obesogenic diet and metabolic syndrome among adolescents in India: data-driven cluster analysis

BACKGROUND

Metabolic syndrome is on the rise in India and is primarily linked to obesogenic dietary habits. The synergy of both is a prominent risk factor for cardiovascular diseases (CVDs). Hence, the present study aims to unveil clusters at high risk of metabolic syndrome and ascertain cluster characteristics based on dietary patterns among adolescents aged 10-19 years.

DATA AND METHODS

The study utilizes secondary data, i.e., Comprehensive National Nutrition Survey conducted in 2016-18. The study sample includes children and adolescents aged 10-19 years. An unsupervised learning algorithm was used to ascertain possible clusters in the data based on individuals' dietary patterns. The k-means were used to cluster the data according to their dietary patterns. To determine the number of clusters elbow method was used, and appropriate validation indices were also obtained for the final k. Further, to ascertain the distribution of the obesogenic dietary patterns and metabolic conditions in each cluster was analysed. Bivariate descriptive analysis was used to draw further inferences.

RESULTS

The k-means clusters identified five optimum clusters based on 12,318 adolescents (6333 males (mean age:14.2 ± 2.8) and 5985 females (mean age:14.3 ± 2.8)) 17 dietary patterns. Clusters were named based on how prudent these were in terms of consuming a healthy diet. Cluster phenotypic characteristics were defined as follows: a cluster of obesogenic diets (24%) constituted the highest proportion of the total sample and was significantly suffering from obesity (p < 0.001), and greater proportions of lipid anomalies (p = 0.51) and hypertension (p = 0.44) but not statistically significant. In contrast, 21% of the sample comprised a plant-based diet cluster and suffered from all deficiencies but folate (p = 0.625), zinc (p = 0.132), and greater proportion from obesity (p = 0.19; not significant), and diabetes (p < 0.001). A cluster of "convenient" (20%) mainly suffered from lipid anomalies (p = 0.00), diabetes (p = 0.03), and a greater proportion from hypertension (p = 0.56) with deficiencies of all the essential vitamins and minerals but significantly from vitamin A (p < 0.001), folate (p < 0.001), and iron (p = 0.017). Lastly, the cluster of those who follow a "Western diet" (17%) was found to have lipid anomalies (p = 0.003), diabetes (p = 0.016), greater proportion of vitamin B12 (p = 0.136), D (p = 0.002), folate (p < 0.001), and iron deficiencies (p = 0.013).

CONCLUSIONS AND RELEVANCE

Adolescents in India show a strong association between obesogenic diet and metabolic syndrome. Therefore, the burden of metabolic syndrome at early ages can be prevented by controlling obesogenic dietary practices and addressing micronutrient deficiencies. This may be done by targeted health promotional campaigns in schools and college-going populations in India.

The association of dietary phytochemical index and nonalcoholic fatty liver disease

Consumption of phytochemical-rich foods relates to the prevention of chronic diseases. In this study we assessed the dietary phytochemical index (PI) in metabolic parameters, liver enzymes, and severity of fibrosis among nonalcoholic fatty liver disease patients. This cross-sectional study was conducted on 210 patients with NAFLD. Fibrosis-4 index (FLB4), nonalcoholic fatty liver disease fibrosis score (NFS), FBS, lipids profile, AST, ALT, ALP, and GGT were measured. PI was calculated through the information obtained from a validated semi-quantitative food frequency. Multiple regression models were used to estimate mean difference changes in the evaluated variables associated with various dietary PI. Participants' mean ± SD of age and BMI were 39.23 ± 10.52 and 24.40 ± 2.64, respectively. We found that DPI is inversely associated with serum TG, TC, and LDL-C and directly associated with serum HDL-C and a higher score in DPI is associated with lower scores in NFS and FIB-4. Multivariate linear regression showed that there is an inverse association between DPI and AST, ALT, ALP, GGT, NFS, and FIB-4. Higher dietary PI could impact on reduction of NAFLD progression and improvement of metabolic parameters.

Association between the Dietary Phytochemical Index and Lower Prevalence of Obesity in Korean Preschoolers

Little is known regarding Korean preschooler dietary phytochemical index (DPIs). We used the 24 h recall data of 1196 participants aged 3-5 years from the Korea National Health and Nutrition Examination Survey to study the association between dietary food intake and obesity prevalence. The amount of dietary intake by food group was compared according to sex and DPI quartile. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. The average total DPI and energy from phytochemical food groups were not significantly different according to sex, although boys had a higher total daily food intake. Different inclinations between DPI quartiles and amount of intake were observed in the food groups; specifically, beans showed a higher intake difference between Q1 and Q4 for boys than in the other food groups. The highest DPI quartile had a significantly lower obesity prevalence than the lowest DPI quartile in all models for boys only when obesity prevalence by weight percentile was analyzed (Model 3, OR: 0.287, 95% CI: 0.095-0.868, p for trend < 0.05). Our results suggest a high DPI could help prevent obesity in preschoolers.

Plasma free amino acid profiles are associated with serum high molecular weight adiponectin levels in Japanese medical check-up population without type 2 diabetes mellitus

To prevent the progression of type 2 diabetes mellitus (T2DM), early detection and intervention are important. Several studies have already shown that the serum adiponectin level could be useful for evaluating the future risk of T2DM. Recently, plasma free amino acid (PFAA) concentrations have also emerged as potential biomarkers that predict the future onset of T2DM. In this study, we aimed to further characterise PFAA profiles by elucidating the association with the serum high molecular weight (HMW) adiponectin level in this cross-sectional study. A total of 1000 Japanese subjects who underwent medical check-ups were enrolled, and their plasma concentrations of 21 amino acids and clinical parameters were measured. The subjects without T2DM were divided into quartiles (Q1-4) by serum HMW adiponectin level, and the association with between PFAA concentrations was analysed. Concentrations of glutamate, alanine, proline, tyrosine, histidine, methionine, lysine, branched-chain amino acids (BCAAs) and tryptophan varied significantly according to the adiponectin quartile. Furthermore, serum adiponectin levels showed significant inverse correlations with these amino acids. The change in the PFAA profile in the group with the lowest adiponectin concentrations (Q1) was similar to that of T2DM patients. Although both adiponectin levels and PFAA concentrations are known to be altered by the accumulation of visceral fat and insulin resistance, the levels of glutamate, BCAA, lysine and tryptophan remain significantly associated with adiponectin level after adjustment for age, body mass index and homeostasis model assessment of insulin resistance, showing the direct association between PFAA concentrations and the serum HMW adiponectin level. Registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000029920, registered on Nov 13th 2017 (prospectively registered).

Changes in Body Mass, Physical Activity, and Dietary Intake during the COVID-19 Pandemic Lockdowns in Canadian University Students

This study examined changes in body mass and body mass index (BMI), physical activity, and dietary intake in Canadian university students during the first year of the COVID-19 pandemic. Two self-reported recall surveys were conducted: after the first lockdown in September 2020 (T1) and following the second lockdown in March 2021 (T2). Eligible participants were full-time undergraduate students attending a Canadian university and residing in Canada during the first year of the pandemic. At T1, 510 students (99 male, 411 female) completed the survey, and of those, 135 (32 males, 103 females) completed the survey at T2 (73% attrition). At both T1 and T2, most participants were 18-24 years of age (93% and 90%, respectively), Caucasian (73% and 78%, respectively), and resided in the province of Ontario (79% and 80%, respectively). Body mass increased from T1 to T2 (+0.91 ± 3.89 kg t(132) = -2.7, p = 0.008). BMI also increased from T1 to T2 (+0.30 ± 1.33 kg/m² [t(130) = -2.5, p = 0.012), with a greater number of participants within the overweight range (19.8% versus 24.4%, respectively). At T1, 38% of the participants reported a decrease in physical activity, while the number of students reporting a decrease in activity increased to 56% at T2. Dietary energy intake decreased from 1678 ± 958 kcal/day at T1 to 1565 ± 842 kcal/day at T2 [c²(1) = 7.2, p = 0.007]. Diet quality also decreased, with participants not meeting the recommended daily allowance for essential macro and micronutrients. A decrease was observed in daily servings of fruits (-27%, p < 0.001), vegetables (-72%, p < 0.001), and grains (-68%, p < 0.001). In conclusion, despite a small decrease in dietary energy intake, a modest weight gain occurred during the first year of the COVID-19 pandemic in this cohort of Canadian university students, which was potentially related to decreased physical activity and diet quality.

The relationship between intake of fruits, vegetables and dairy products with overweight and obesity in a large sample in Iran: Findings of STEPS 2016

Background

The present study aimed to investigate the association between fruits and vegetables (FVs) and dairy product intake with body weight based on the data from the nationwide Stepwise approach to surveillance (STEPS) survey in Iran.

Methods

STEPS is a national-based cross-sectional study conducted on 3,0541 people selected by stratified cluster random sampling in Iran from April to November 2016. The outcome of the current study was body mass index (BMI) which was classified as normal weight, underweight, overweight, and obese. Also, as exposure variables, dietary intakes of fruits, vegetables and dairy products were extracted from the STEPS questionnaires. Multinomial logistic regression was used to evaluate the association between dairy products, FVs consumption, and BMI category in the crude and adjusted models.

Results

In the adjusted model, we observed 41% [odd ratio (OR) = 0.59; 95% confidence intervals (CI): 0.50, 0.68, P < 0.001], 27% (OR = 0.73; 95% CI: 0.62, 0.84, P < 0.001), and 26% (OR = 0.74; 95% CI: 0.63, 0.87, P < 0.001) lower odds of being overweight, and 46% (OR = 0.54; 95% CI: 0.46, 0.64, P < 0.001), 29% (OR = 0.71; 95% CI: 0.60, 0.84, P < 0.001), and 21% (OR = 0.79; 95% CI: 0.65, 0.95, P = 0.014) decrease in obesity odds among the participants who consumed 1, 2, and more than 2 servings of fruits per day in comparison to less than one serving, respectively. Also, we observed participants who consumed 1, 2, and more than 2 servings in comparison to less than one serving of dairy products per day had 31% (OR = 0.69; 95% CI: 0.58, 0.81, P < 0.001), 23% (OR = 0.77; 95 %CI: 0.65, 0.91, P = 0.002), and 21% (OR = 0.79; 95% CI: 0.67, 0.94, P = 0.011) lower odds of being overweight and 47% (OR = 0.53; 95% CI: 0.44, 0.64, P < 0.001), 36% (OR = 0.64; 95% CI: 0.53, 0.77, P < 0.001), and 32% (OR = 0.68; 95% CI: 0.56, 0.83, P < 0.001) lower odds of obesity, respectively. In addition, compared to participants who consumed less than 2 servings of vegetables per day, participants who consumed 2, 3, and more than 3 servings had 40% (OR = 0.60; 95% CI: 0.47, 0.76, P < 0.001), 29% (OR = 0.71; 95% CI: 0.56, 0.90, P = 0.006), and 26% (OR = 0.74; 95% CI: 0.57, 0.96, P = 0.027) lower odds of being overweight, respectively. Furthermore, we observed 36% lower odds of obesity among participants who ate 2 servings of vegetables per day compared to less than 2 serving (OR = 0.64; 95% CI: 0.49, 0.84, P = 0.002).

Conclusion

Our findings showed that intake of FVs and dairy products is associated with a healthier weight status in adults. Further studies are needed to confirm these findings.

Recent Insights on the Role of Various Food Processing Operations Towards the Development of Sustainable Food Systems

Chronic hunger and malnutrition will eventually result from the population's rapid growth. It is unlikely to succeed in tackling the rising challenges of delivering sustainable food for all people unless high attention is paid on the function of food processing to ensure the supply of stable food. It is impossible to overstate the importance of developing food processing and preservation technologies that can reduce food losses and wastage during surplus seasons. Therefore, sustainable food systems must be developed to provide healthy diets without damaging our world and its resources. The goal is to use various perspectives to confirm why food processing is crucial to future food supply. It is important to show the appropriate utilization of sustainability factors and effect assessments to construct for feeding the globe while staying within planetary limits. There has never been a better time to assure a plentiful food supply to feed the people than right now, when the population is expanding at a worrying rate. The sustainable food project seeks to move the food systems in a long-term, more equitable direction. Food processing, or the conversion of raw materials into functional, edible, and consumer acceptable food, is a critical link in the food value chain between consumption and production. This review looked at various existing and emerging food processing followed by preservation techniques. Food systems must also attempt to reduce food waste and losses, as well as the current and future impacts on the environment and society, to be sustainable.

Disparities in Perceived Availability of Healthful Foods, Dietary Behaviors, Diet Quality, and Obesity Among Mothers from Low-Income Households: Additional Evidence in the Call for Broader Approaches to Obesity Prevention

Purpose

To examine racial/ethnic differences in dietary behaviors, diet quality, body mass, and the perceived availability of healthful foods in one's neighborhood among mothers from low-income California households.

Methods

Cross-sectional telephone surveys of mothers from randomly sampled households with incomes ≤185% federal poverty level in 2018 and 2019 using a validated 24-h dietary recall assessment. Dietary outcomes were cups of fruits and vegetables, ounces of sugar-sweetened beverages, teaspoons of added sugars, and kilocalories consumed the previous day. Diet quality was assessed by calculating Health Eating Index-2015 scores. Supplemental survey items assessed mothers' weight and height. Body mass index (BMI) was calculated with a BMI of 30 or higher considered obese. Perceived availability of fresh fruits and vegetables and healthy foods in general within one's neighborhood was recorded.

Results

The analytic sample of 9200 mothers was 66.3% Latina, 17.3% white, 12.6% African American, and 3.8% Asian American, Native Hawaiian, or Pacific Islander (AANHPI). African American mothers consumed the fewest cups of fruits and vegetables and the most teaspoons of added sugars, reported poor diet quality, and had the highest obesity rate, 54.7% versus 46.9% for Latinas, 39.9% for whites, and 23.5% for AANHPIs. Accordingly, a greater proportion of African Americans reported limited availability of fresh fruits and vegetables and healthy foods in general in their neighborhood.

Conclusion

Findings are interpreted in light of recent calls for broader approaches to address health disparities, including strategies that focus on inequalities in racial/ethnic socioeconomic status and systemic racism.

Methionine restriction - Association with redox homeostasis and implications on aging and diseases

Methionine is an essential amino acid, involved in the promotion of growth, immunity, and regulation of energy metabolism. Over the decades, research has long focused on the beneficial effects of methionine supplementation, while data on positive effects of methionine restriction (MR) were first published in 1993. MR is a low-methionine dietary intervention that has been reported to ameliorate aging and aging-related health concomitants and diseases, such as obesity, type 2 diabetes, and cognitive disorders. In addition, MR seems to be an approach to prolong lifespan which has been validated extensively in various animal models, such as Caenorhabditis elegans, Drosophila, yeast, and murine models. MR appears to be associated with a reduction in oxidative stress via so far mainly undiscovered mechanisms, and these changes in redox status appear to be one of the underlying mechanisms for lifespan extension and beneficial health effects. In the present review, the association of methionine metabolism pathways with redox homeostasis is described. In addition, the effects of MR on lifespan, age-related implications, comorbidities, and diseases are discussed.

Effectiveness of a Worksite-Based Lifestyle Intervention on Employees' Obesity Control and Prevention in China: A Group Randomized Experimental Study

Background: This study was to culturally adapt a lifestyle intervention for employees’ obesity control and prevention using a participatory process, and evaluate the effectiveness of the project at worksites. Methods: A group randomized experimental study included four worksites (two intervention, two control) in the Yangtze River Delta in China was conducted. A total of 388 participants (216 in the intervention worksites and 172 in the control worksites) were finally recruited from 955 employees at the four worksites (464 in the intervention worksites and 491 in the control worksites). The final evaluation was completed by two hundred and seventy-eight employees (159 in the intervention worksites and 119 in the control worksites, respectively). Data of demographic information, weight, BMI, waist circumference, hip circumference and weight-related behaviors including diary behaviors and physical activities were collected before and after a 12-month intervention and analyzed using descriptive statistics, t-test, chi-square test, linear mixed regression and logistic mixed regression. Results: Although the intervention worksites had a reduction in body mass index (23.21 to 22.95, p < 0.01), hip circumference (95.97 to 95.28, p = 0.03) and waist-to-height ratio (0.49 to 0.48, p = 0.01), the differential changes compared to those of the control group were not statistically significant. The frequency of sweet beverages (−1.81, 95%CI: −0.52, −3.11), frequency of vegetable intake (5.66, 95%CI: 1.59, 9.74), daily servings of vegetables (0.53, 95%CI: 0.24, 0.82), frequency of fruit intake (3.68, 95%CI: 1.25, 6.12), daily servings of fruit (0.26, 95%CI: 0.44, 0.92), daily servings of vegetables and fruit (0.79, 95%CI: 0.43, 1.16), daily steps (863.19, 95%CI: 161.42, 1564.97) and self-efficacy to change physical activity (OR = 1.91, 95%CI: 1.02,3.60) were more improved in the intervention group than were those measures in the control group. Conclusions: The worksite-based lifestyle intervention project for obesity control and prevention improved several employees’ dietary behaviors and physical activities at worksites in China in a short time. Long-term intervention with larger samples in more worksites should be further examined.

Dietary Flavonoids as Modulators of Lipid Metabolism in Poultry

Flavonoids, naturally-occurring compounds with multiple phenolic structures, are the most widely distributed phytochemicals in the plant kingdom, and are mainly found in vegetables, fruits, grains, roots, herbs, and tea and red wine products. Flavonoids have health-promoting effects and are indispensable compounds in nutritional and pharmaceutical (i.e., nutraceutical) applications. Among the demonstrated bioactive effects of flavonoids are anti-oxidant, anti-inflammatory, and anti-microbial in a range of research models. Through dietary formulation strategies, numerous flavonoids provide the ability to support bird health while improving the nutritional quality of poultry meat and eggs by changing the profile of fatty acids and reducing cholesterol content. A number of such compounds have been shown to inhibit adipogenesis, and promote lipolysis and apoptosis in adipose tissue cells, and thereby have the potential to affect fat accretion in poultry at various ages and stages of production. Antioxidant and anti-inflammatory properties contribute to animal health by preventing free radical damage in tissues and ameliorating inflammation in adipose tissue, which are concerns in broiler breeders and laying hens. In this review, we summarize the progress in understanding the effects of dietary flavonoids on lipid metabolism and fat deposition in poultry, and discuss the associated physiological mechanisms.

Short-Term Pilot Study to Evaluate the Impact of Salbi Educa Nutrition App in Macronutrients Intake and Adherence to the Mediterranean Diet: Randomized Controlled Trial

Promoting a healthy diet is a relevant strategy for preventing non-communicable diseases. This study aims to evaluate the impact of an innovative tool, the SAlBi educa nutrition app, in primary healthcare dietary counseling to improve dietary profiles as well as adherence to the Mediterranean diet. A multi-center randomized control trial comprising 104 participants was performed. Both control (n = 49) and intervention (n = 55) groups attended four once-weekly sessions focusing on healthy eating habits and physical activity, over one month. As well as attending the meetings, the intervention group used the app, which provides self-monitoring and tailored dietary advice based on the Mediterranean diet model. In a second intervention (one arm trial), the potential of SAlBi educa was evaluated for three months during the COVID-19 pandemic. At 4 weeks, the intervention group had significantly increased their carbohydrate intake (7.7% (95% CI: 0.16 to 15.2)) and decreased their total fat intake (−5.7% (95% CI: −10.4 to −1.15)) compared to the control group. Significant differences were also found for carbohydrates (3.5% (95% CI: −1.0 to 5.8)), total fats (−5.9% (95% CI: −8.9 to −3.0)), fruits and vegetables (266.3 g/day (95% CI: 130.0 to 402.6)), legumes (7.7g/day (95% CI: 0.2 to 15.1)), starchy foods (36.4 g/day (95% CI: 1.1 to 71.7)), red meat (−17.5 g/day (95% CI: −34.0 to −1.1)), and processed meat (−6.6 g/day (95% CI: −13.1 to −0.1)) intakes during the COVID-19 pandemic. SAlBi educa is a useful tool to support nutrition counseling in primary healthcare, including in special situations such as the COVID-19 pandemic. Trial registration: ISRCTN57186362.

The energy balance model of obesity: beyond calories in, calories out

A recent Perspective article described the "carbohydrate-insulin model (CIM)" of obesity, asserting that it "better reflects knowledge on the biology of weight control" as compared with what was described as the "dominant energy balance model (EBM)," which fails to consider "biological mechanisms that promote weight gain." Unfortunately, the Perspective conflated and confused the principle of energy balance, a law of physics that is agnostic as to obesity mechanisms, with the EBM as a theoretical model of obesity that is firmly based on biology. In doing so, the authors presented a false choice between the CIM and a caricature of the EBM that does not reflect modern obesity science. Here, we present a more accurate description of the EBM where the brain is the primary organ responsible for body weight regulation operating mainly below our conscious awareness via complex endocrine, metabolic, and nervous system signals to control food intake in response to the body's dynamic energy needs as well as environmental influences. We also describe the recent history of the CIM and show how the latest "most comprehensive formulation" abandons a formerly central feature that required fat accumulation in adipose tissue to be the primary driver of positive energy balance. As such, the new CIM can be considered a special case of the more comprehensive EBM but with a narrower focus on diets high in glycemic load as the primary factor responsible for common obesity. We review data from a wide variety of studies that address the validity of each model and demonstrate that the EBM is a more robust theory of obesity than the CIM.

Associations between farmers' market shopping behaviours and objectively measured and self-reported fruit and vegetable intake in a diverse sample of farmers' market shoppers: a cross-sectional study in New York City and rural North Carolina

OBJECTIVE

To examine cross-sectional associations between farmers' market shopping behaviours and objectively measured and self-reported fruit and vegetable (FV) intake among rural North Carolina (NC) and New York City (NYC) shoppers.

DESIGN

Cross-sectional intercept surveys were used to assess self-reported FV intake and three measures of farmers' market shopping behaviour: (1) frequency of purchasing FV; (2) variety of FV purchased and (3) dollars spent on FV. Skin carotenoids, a non-invasive biomarker for FV intake, were objectively measured using pressure-mediated reflection spectroscopy. Associations between farmers' market shopping behaviours and FV intake were examined using regression models that controlled for demographic variables (e.g. age, sex, race, smoking status, education, income and state).

SETTING

Farmers' markets (n 17 markets) in rural NC and NYC.

PARTICIPANTS

A convenience sample of 645 farmers' market shoppers.

RESULTS

Farmers' market shoppers in NYC purchased a greater variety of FV and had higher skin carotenoid scores compared with shoppers in rural NC. Among all shoppers, there was a positive, statistically significant association between self-reported frequency of shopping at farmers' markets and self-reported as well as objectively assessed FV intake. The variety of FV purchased and farmers' market spending on FV also were positively associated with self-reported FV intake, but not skin carotenoids.

CONCLUSION

Those who shop for FV more frequently at a farmers' markets, purchase a greater variety of FV and spend more money on FV have higher self-reported, and in some cases higher objectively measured FV intake. Further research is needed to understand these associations and test causality.

Apple Polyphenols Extracts Ameliorate High Carbohydrate Diet-Induced Body Weight Gain by Regulating the Gut Microbiota and Appetite

To investigate the potential contribution of appetite regulation and modulation of gut microbiota to the ameliorated effects of apple polyphenols extracts (APE) on high carbohydrate diet (HCD)-induced body weight (BW) gain, we conducted this study. One hundred C57BL/6 male mice were randomly divided into seven groups and fed with the following diets for 12 weeks: chow diet (CON), HCD (HCD), high fructose and sucrose diet (HSCD), and HCD and HSCD with 125 or 500 mg/kg·day APE gavage. Compared to the CON group, the BW of mice in the HCD and HSCD groups increased significantly. HSCD induced a more significant weight gain in the white adipose tissue (WAT) and liver than HCD, accompanied by severe impairment of glucose tolerance and a larger diameter of adipocytes. On the other hand, by decreasing food intake, APE significantly reduced BW via mechanisms, including decreased weights of the WAT and liver, amelioration of glucose tolerance, and amplification of WAT browning by upregulating the mRNA levels of Ucp-1 and Cidea. Moreover, APE promoted transcription and secretion of GLP-1, with the increased expression of gut anorexigenic hormone peptides Ffar 2/3 in the colon and anorectic neuropeptide gene expression of Pomc, Cart, and Mc4r in the hypothalamus, causing increased satiety. Additionally, APE significantly increased Verrucomicrobia colonization and the relative abundance of Akkermansia. APE potentially ameliorates high simple carbohydrate diet-induced body weight gain by mechanisms related to gut microbiota regulation and appetite inhibition.

Pressure-Mediated Reflection Spectroscopy Criterion Validity as a Biomarker of Fruit and Vegetable Intake: A 2-Site Cross-Sectional Study of 4 Racial or Ethnic Groups

BACKGROUND

Valid biomarkers of fruit and vegetable (FV) intake are needed for field-based nutrition research.

OBJECTIVES

To examine criterion-related validity of pressure-mediated reflection spectroscopy as a proxy measure of FV intake, using plasma carotenoids and self-reported FV and carotenoid intake as primary and secondary criterion measures, respectively.

METHODS

Healthy adults 18-65 y of age, self-identifying as African American/black (n = 61), Asian (n = 53), white (n = 70), or Hispanic (n = 29), in North Carolina and Minnesota were recruited. Skin carotenoids were assessed via pressure-mediated reflection spectroscopy (Veggie Meter), skin melanin via spectrophotometer, and total plasma carotenoid concentration by HPLC-photodiode array detection. Self-reported carotenoid and FV intake was assessed using a semiquantitative FFQ. Relations between skin carotenoids, plasma carotenoids, FV, and carotenoid intake, with differences by race or ethnicity, age, sex, weight status, cholesterol, and melanin index, were examined by bivariate correlations and adjusted multivariate linear regressions.

RESULTS

The overall unadjusted correlation between skin and total plasma carotenoids was r = 0.71 and ranged from 0.64 (non-Hispanic black) to 0.80 (Hispanic). Correlations between skin carotenoids and self-reported FV intake ranged from 0.24 (non-Hispanic black) to 0.53 (non-Hispanic white), with an overall correlation of r = 0.35. In models adjusted for age, sex, racial or ethnic group, and BMI, skin carotenoids were associated with plasma carotenoids (R2 = 0.55), FV (R2 = 0.17), and carotenoid intake (R2 = 0.20). For both plasma carotenoid and FV measures, associations with skin carotenoids did not vary by race, but these relations did differ by skin melanin-those with lower melanin had a lower correlation between skin and plasma carotenoids.

CONCLUSIONS

Reflection spectroscopy-assessed skin carotenoids may be a reasonable alternative to measurement of plasma carotenoids, a biomarker used to approximate FV intake.

Fruit and Vegetable Intake Among Older African American and Hispanic Adults With Cardiovascular Risk Factors

African Americans and Hispanics are disproportionately burdened by cardiovascular risk factors including hypertension, diabetes mellitus, and obesity. There is evidence that fruits and vegetables have protective benefits for cardiovascular health. Factors associated with fruit and vegetable intake among older minority adults are not well established. A cross-sectional analysis of African American and Hispanic adults >55 years with diagnosis of hypertension and/or diabetes was conducted. Daily intake of fruits and vegetables was analyzed by socio-demographic, health status, health behaviors, and access to fruits and vegetables. 77% of participants did not meet the United States Department of Agriculture ≥5 a day serving guidelines. Fruit and vegetable consumption was not associated with having hypertension or diabetes. Body mass index >25 and regular exercise were significantly associated with more vegetable intake, but not fruit. African Americans consumed significantly less fruits and vegetables than Hispanics. Among those with access to fruits and vegetables, 78% did not meet the guidelines. Many older African American and Hispanic adults with cardiovascular disease risk factors do not meet the fruit and vegetable intake guidelines. Inadequate intake is worse among African Americans, sedentary, and non-overweight/obese adults. Studies are needed to understand the barriers associated with fruit and vegetable intake in this population.

Impact of Child Interaction With Food Preparation on Vegetable Preferences: A Farm-Based Education Approach

OBJECTIVE

To identify the impact of child involvement in vegetable preparation on vegetable preference and attitudes toward eating vegetables.

DESIGN

Pre-post mixed-methods.

SETTING

Food and Farming Camp at a nonprofit urban farm in Sunnyvale, California.

PARTICIPANTS

Camp participants aged 8-10 years (n = 34 girls, n = 12 boys), and aged 11-14 years (n = 19 girls, n = 4 boys).

INTERVENTIONS

Involvement in vegetable preparation through harvesting, cutting, cooking, and seasoning before consumption. Interviews identified camper perception of vegetable preference and involvement in preparation.

MAIN OUTCOME MEASURES

Change in vegetable preference from baseline with and without involvement in vegetable preparation. Attitudes toward involvement in vegetable preparation.

ANALYSIS

Adjustment of preferences to baseline followed by tests of hypotheses to identify differences with involvement. Thematic, qualitative coding to identify prevalent themes within interview responses.

RESULTS

Younger campers preferred vegetables they prepared (P < 0.05), except for carrots. Campers were more likely to choose vegetables they prepared (P < 0.05). Campers of both age groups were curious to try their vegetable creations and described feelings of pride and responsibility related to preparing vegetables.

CONCLUSIONS AND IMPLICATIONS

Involvement with food preparation, in particular in a garden-based setting, may provide an accessible method to improve child vegetable preference.

Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study

The Feel4Diabetes-study implemented a school- and community-based intervention to promote healthy lifestyle and prevent type 2 diabetes mellitus (T2DM) in six European countries. The intervention included a special focus on families at increased T2DM risk. The current study evaluates the intervention's cost-effectiveness. A Markov-type health economic model was developed to predict the incidence of T2DM and its complications. Incremental cost-effectiveness ratios (lifetime horizon, societal perspective) were calculated based on the overall intervention effect on health behaviour, and stratified for low- and high-risk families. Sensitivity analyses captured input parameters uncertainty. A budget impact analysis was performed. The increase in children's water consumption and physical activity led to a modest gain in quality adjusted life years (QALYs) at a low intervention cost and budget impact. Medical cost savings due to avoided illness could only be achieved on the very long-term (>30 years). The intervention in its entirety was cost-effective (more QALYs at a reasonable investment) in Belgium, Finland, Bulgaria, and Hungary, while being dominant (net savings and more QALYs) in Greece and Spain. Results were cost-effective for the low-risk families, who only received the school- and community-based intervention component. Results for the high-risk families were only cost-effective (with considerable uncertainty) in Greece and Spain, but not when the intervention would need to be repeated. The Feel4Diabetes-intervention is potentially cost-effective, especially in countries with a high overweight and obesity prevalence, at a limited budget impact. The incremental financial investments to reach and support high-risk families did not result in the hoped-for health benefits.

Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries

BACKGROUND

Adolescent overweight and obesity are well documented in high-income countries (HICs). They are also emerging as a global public health concern in low-and middle-income countries (LMICs), yet there is a lack of reliable, national-level data to inform policies and interventions. This study aimed to estimate the prevalence of overweight and obesity and assess associated lifestyle risk factors amongst school-going adolescents in LMICs as well as HICs.

METHODS

A total of 282,213 samples were drawn from 89 LMICs and HICs in the 'latest Global School-based Student Health Survey' of school children, aged 11-17 years, during 2003 to 2015, in the six World Health Organisation (WHO) regions. The prevalence of adolescent overweight and obesity were estimated using the WHO BMI-for-age growth standards. A multinomial logistic regression model was employed to estimate the adjusted (age and sex) association of food patterns, physical activity, and sedentary behaviours with adolescent overweight and obesity.

RESULTS

The pooled prevalence of overweight and obesity amongst adolescents was 10.12%, and 4.96%, respectively, ranging from 2.40% in Sri Lanka to 29.08% in Niue for overweight and 0.40% in Sri Lanka to 34.66% in the Cook Islands for obesity. Overweight and obesity were associated with unhealthy dietary intake and lifestyles including respectively fast-food intake (adjusted relative risk ratio, RRR = 1.09; 95% CI: 1.05-1.12 and RRR = 1.32; 95% CI: 1.26-1.38), a high level of carbonated soft drinks consumption (RRR = 1.19; 1.12-1.24 and RRR = 1.28; 1.18-1.38), a low level of physical activity (RRR = 1.11; 1.06-1.17 and 1.20; 1.12-1.28), and high level of sedentary behaviours (RRR = 1.33; 1.27-1.39 and RRR = 1.73; 1.63-1.84). Adolescents who consumed vegetables at least two times per day had a lower risk of overweight (22%) and obesity (17%) than those who did not consume vegetables per day.

CONCLUSIONS

Adolescent overweight and obesity represent a global public health problem and can possibly track into adult weight status and morbidity. School-based obesity prevention that promotes environmental and policy changes related to healthy dietary practices and active living are urgently needed to curb the trend.

Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study

Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children's diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children's fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013-2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents' perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = -0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.

Nutrient adequacy, dietary patterns and diet quality among children with and without intellectual disabilities

BACKGROUND

Children with intellectual disabilities (ID) frequently have feeding problems, but there has been limited research on nutrient intake, dietary patterns and diet quality in this population.

METHOD

Nutrient intakes, dietary patterns and the Healthy Eating Index were compared between 48 children with ID and 55 typically developing (TD) children aged 3-8 years who participated in the Children's Mealtime Study. Three-day food records that included two weekdays and one weekend day were used to assess dietary intake. Food intake was entered into the Nutrition Data System for Research for analysis of nutrient intake, dietary patterns and diet quality. Height and weight were measured to determine body mass index (BMI). The relation of dietary patterns to weight status was also assessed.

RESULTS

Typically developing children and children with ID met the Estimated Average Requirement/Adequate Intake (EAR/AI) for most nutrients. However, a substantial number of children in both groups did not meet the EAR for vitamins E and D and calcium and the AI for vitamin K. Only one TD child met the AI for potassium. A small percentage of children in both groups did not meet the EAR for vitamin A and vitamin C, and in the ID group, a small percentage did not meet the EAR for vitamin B₁₂ . Children in the ID group consumed, on average, fewer servings of vegetables than TD children (0.5 vs. 1.2, P < 0.001), but there was no significant difference in servings of fruit (0.8 vs. 1.1, respectively), fruit juice (less than a half serving in both groups), sugar-sweetened beverages (less than a half serving in both groups) or snacks (1.1 vs. 1.4, respectively) after adjusting for BMI z-score, parental education and race. We found a significant correlation between snack intake and BMI z-score among children with ID but not among TD children (r = 0.48, P < 0.0001 vs. r = 0.19, P = 0.16, respectively). The Healthy Eating Index indicated, on average, poor overall diet quality in both groups (58.2 in the ID group and 59.1 in the TD group).

CONCLUSIONS

This study suggests that the diets of children with ID, as in TD children, need improvement. Targeting healthy eating in children with ID would improve diet quality and overall health.

Assessment of the Nutritional Status of Four Selected Rural Communities in KwaZulu-Natal, South Africa

Under- and over-nutrition co-exist as the double burden of malnutrition that poses a public health concern in countries of the developing regions, including South Africa (SA). Vulnerable groups such as pregnant women and children under five years are the most affected by malnutrition, especially in rural areas. Major contributing factors of malnutrition include food and nutrition insecurity, poverty, and unhealthy lifestyles. The current study aimed to assess the nutritional status, using selected anthropometric indices and dietary intake methods (repeated 24 h recall and food frequency), of four rural communities in KwaZulu-Natal (SA). Purposive sampling generated a sample of 50 households each in three rural areas: Swayimane, Tugela Ferry, and Umbumbulu and 21 households at Fountain Hill Estate. The Estimated Average Requirement cut-point method was used to assess the prevalence of inadequate nutrient intake. Stunting (30.8%; n = 12) and overweight (15.4%; n = 6) were prevalent in children under five years, whilst obesity was highly prevalent among adult females (39.1%; n = 81), especially those aged 16-35 years. There was a high intake of carbohydrates and a low intake of fibre and micronutrients, including vitamin A, thus, confirming the need for a food-based approach to address malnutrition and micronutrient deficiencies, particularly vitamin A deficiency.

The association between lunch composition and obesity in Iranian adults

We aimed to assess the dietary composition of lunch meal using a posteriori-derived dietary patterns and to determine the association of lunch composition with obesity in a sample of Iranian adults. This cross-sectional study was conducted on 850 men and women in Tehran (aged 20-59 years). Dietary intakes were assessed using three 24-h dietary recalls, and dietary patterns were identified via principal component factor analysis. For each identified pattern, scores were calculated for each participant and then classified into tertiles. Central obesity was defined WHO criteria. General obesity was defined as a BMI of more than 30 kg/m2. Three major dietary patterns were identified at lunch meal using twelve food groups: 'Bread, grains and fat', 'Western' and 'Potato and eggs'. After adjustment for potential confounders, participants at the top tertile of the 'Bread, grains and fat' dietary pattern had greater odds for a higher waist-to-hip ratio (WHR), compared with those in the lowest tertile (OR: 1·44, 95 % CI 1·01, 2·07). However, we found no association between 'Western' or 'potato and eggs' patterns and WHR (OR: 0·89, 95 % CI 0·62, 1·28 and OR: 1·16, 95 % CI 0·69, 1·42, respectively). None of the identified dietary patterns was associated when defining obesity with waist circumference or BMI. In conclusion, participants had a greater chance of central obesity defined based on WHR following a lunchtime pattern with a higher and positive loading factor for 'Bread, grains and fat'.

The Relationship of Diet and Physical Activity with Weight Gain and Weight Gain Prevention in Women of Reproductive Age

Reproductive-age women often see increased weight gain, which carries an increased risk of long-term overweight and obesity and adverse maternal and child health outcomes. Supporting women to achieve optimal weight through lifestyle modification (diet and physical activity) is of critical importance to reduce weight gain across key reproductive life-stages (preconception, pregnancy and postpartum). This review comprehensively summarizes the current state of knowledge on the contribution of diet and physical activity to weight gain and weight gain prevention in reproductive-aged women. Suboptimal diets including a higher proportion of discretionary choices or energy intake from fats, added sugars, sweets or processed foods are associated with higher weight gain, whereas increased consumption of core foods including fruits, vegetables and whole grains and engaging in regular physical activity are associated with reduced weight gain in reproductive age women. Diet and physical activity contributing to excessive gestational weight gain are well documented. However, there is limited research assessing diet and physical activity components associated with weight gain during the preconception and postpartum period. This review highlights the need for further research to identify key dietary and physical activity components targeting the critical windows of reproductive life-stages in women to best guide interventions to prevent weight gain.

The Effect of Dietary Intake and Nutritional Status on Anthropometric Development and Systemic Inflammation: An Observational Study

(1) Background: Daily caloric intake should aim to reduce the risk of obesity or poor anthropometric development. Our study objective was to analyze the association between food consumption, inflammatory status and anthropometric development; (2) Methods: We performed a prospective observational analytical research during September 2020 and April 2021 on a group of 160 healthy subjects, aged between 6 and 12 years old, by analyzing food ingestion, the basal metabolic rate, anthropometric development and the inflammatory status; (3) Results: IL-6 was significantly correlated to the sum of skinfolds, along with both serum proteins and triglycerides. The skin folds were significantly correlated with the caloric intake and with total fat intake, next to saturated and trans fats. Unlike the skin folds, the body weight was significantly correlated with the caloric intake along with some vitamins, such as Vitamin A and Vitamin B12. Inactive mass increased with excessive folic acid, Vitamin E, Vitamin K and saturated fat intake; (4) Conclusions: The inflammatory status was influenced by the ingestion of micronutrients, total serum lipids and proteins. The anthropometric development was associated with the ingestion of carbohydrates, energy balance and energy intake. We can conclude that daily menu and nutrition imbalances can influence both the risk of obesity and the inflammatory status.

Dietary agrobiodiversity for improved nutrition and health outcomes within a transitioning indigenous Solomon Island food system

Indigenous food systems of Pacific Small Island Developing Countries contain vast biological and cultural diversity. However, a nutrition transition is underway, characterized by shifts away from traditional diets in favour of imported and modern foods, contributing to some of the highest rates of obesity and Diabetes Type 2 Mellitus in the world. Using a mixed method approach, this study aimed to assess dietary agrobiodiversity’s relationship with nutrition indicators related to diet quality and anthropometrics within the context of the rural and Indigenous food system of Baniata village, located in the Western Province of Solomon Islands (Melanesia). A secondary aim was to evaluate the contribution of agrobiodiversity from the local food system to diet quality. A comprehensive nutrition survey was administered to the women primarily responsible for cooking of randomly selected households (n = 30). Additionally, 14 participatory focus group discussions captured the historical narrative of food system transitions, were hosted over a period of seven days, and included men, women and youth. Dietary intakes of the participants were reported below the estimated average requirement (EAR) for several essential nutrients, including protein (53%), calcium (96.6%), vitamin B1 (86.6%), vitamin B2 (80%), vitamin A (80%), zinc (40%) and fibre (77%). Focus group participants built a timeline of key historical and climatic transitions perceived to be drivers of dietary shifts away from traditional foods and towards imported and processed foods. Participants identified 221 species and varieties of agrobiodiverse foods available for cultivation or wild collection. Based on 24 h diet recalls, 87 were found to be utilised. Participants who consumed foods of a wider diversity of species richness had a higher probability of achieving recommended nutrition intakes and a lower body fat percentage (r2 = 0.205; p = 0.012). Our results suggest a nutrition transition is underway, and strategies harnessing traditional knowledge of nutrient-dense, agrobiodiverse foods can help improve food and nutrition security.

Randomized controlled trials of self-monitoring interventions with or without incentives for diet and exercise among individuals with overweight or obesity: Psychological and behavioural effects

OBJECTIVES

To test the effects of three behavioural interventions (daily monetary incentives + self-monitoring, delayed lump sum monetary incentives + self-monitoring, and self-monitoring only) on psychological constructs and fruit and vegetable consumption or physical activity behaviour change among a sample of adults with overweight or obesity.

DESIGN

A pair of 3-arm longitudinal randomized controlled trials compared daily monetary incentives + self-monitoring, delayed lump sum monetary incentives + self-monitoring, and self-monitoring only interventions for either fruit and vegetable consumption or physical activity.

METHODS

Individuals reporting elevated weight status and insufficient engagement in one of the target behaviours were randomly assigned to one of three 3-week interventions. All three interventions involved daily self-monitoring of the behaviour, and two provided monetary incentives contingent upon reported behaviour. Participants completed measures of psychological constructs and reported behaviour at baseline, the end of the intervention, and two and four weeks post-intervention.

RESULTS

Participants across all three intervention conditions demonstrated increased engagement in the target behaviour from pre- to post-intervention and reported behaviour remained above baseline levels at both follow-up time points. Increases in reported behaviour during the intervention were associated with increases in self-efficacy, and this enhanced self-efficacy prospectively predicted sustained reported behaviour at follow-up. However, contrary to hypotheses, the incentive interventions including self-monitoring were not more efficacious than self-monitoring alone, and increased reported behaviour was not associated with enhancements in attitudes.

CONCLUSIONS

Self-monitoring interventions can aid behaviour change efforts, and behavioural practice during these interventions can increase self-efficacy. However, among adults with overweight or obesity who are seeking behaviour change interventions, incentive-based self-monitoring approaches may not be superior to self-monitoring alone in driving behaviour change and maintenance.

Faktor Risiko Obesitas pada Guru Sekolah Perempuan serta Relevansi dengan PTM Selama Pandemi Covid-19

Background: The prevalence of obesity in the world is getting higher, so it becomes a severe health problem. Some factors that contribute to the problem of obesity are increased calorie intake, including the consumption of junk food and sedentary, and low physical activity. School teachers are one of the most crucial labor elements in improving the human development indeks.Objectives: The study aims to determine the risk factors for obesity in female teachers as well as some non-communicable health problems during the Covid-19 pandemic.Methods: This quantitative study uses a cross-sectional design, which was conducted on 270 female school teachers; the sample was taken by purposive sampling. Participants measured weight, height, waist circumference data. Blood pressure data were also recorded by participants, including data on diabetes, cholesterol, arthritis, coronary heart disease. While the BMI value data is calculated by the researcher Data collection using a questionnaire distributed from Google Form. Statistical analysis using test Chi-Square and Logistic Regression. Results: The results showed risk factors for obesity in female school teachers were age, waist circumference, consuming junk food, type of diet and physical activity (p< 0.05), with the main predictor being consumption junk food (OR= 3.2). Also, obesity in women is closely related to several non-communicable diseases such as hypertension and arthritis.Conclusions: The main risk factors that cause the high prevalence of obesity in female school teachers in Banda Aceh City are due to consumption habits junk food during the Covid-19 pandemic, and are strongly related to health problems such as hypertension and arthritis.

School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial

BACKGROUND

Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children.

METHODS

This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school.

RESULTS

A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure.

CONCLUSION

While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure.

CLINICAL TRIALS NUMBER

NCT02668744 .

The effect of a fresh produce incentive paired with cooking and nutrition education on healthy eating in low-income households: a pilot study

OBJECTIVE

This study pilot-tested combining financial incentives to purchase fruits and vegetables with nutrition education focused on cooking to increase the consumption of fruits and vegetables and improve attitudes around healthy eating on a budget among low-income adults. The goal of the pilot study was to examine implementation feasibility and fidelity, acceptability of the intervention components by participants and effectiveness.

DESIGN

The study design was a pre-post individual-level comparison without a control group. The pilot intervention included two components, a scan card providing free produce up to a weekly maximum dollar amount for use over a 2-month period, and two sessions of tailored nutrition and cooking education. Outcomes included self-reported attitudes about healthy eating and daily fruit and vegetable consumption from one 24-h dietary recall collected before and after the intervention.

SETTING

Greater Minneapolis/St. Paul area in Minnesota.

PARTICIPANTS

Adults (n 120) were recruited from five community food pantries.

RESULTS

Findings indicated that the financial incentive component of the intervention was highly feasible and acceptable to participants, but attendance at the nutrition education sessions was moderate. Participants had a statistically significant increase in the consumption of fruit, from an average of 1·00 cup/d to 1·78 cups/d (P < 0·001), but no significant change in vegetable consumption or attitudes with respect to their ability to put together a healthy meal.

CONCLUSIONS

While combining financial incentives with nutrition education appears to be acceptable to low-income adult participants, barriers to attend nutrition education sessions need to be addressed in future research.

Calcium intake is inversely associated with body fat in postmenopausal women

BACKGROUND & AIMS

Calcium intake seems to be inversely associated with body fat in several populations; however, little is known about this relationship in postmenopausal women. This study aimed to associate calcium intake with body fat mass in postmenopausal women.

METHODS

A cross-sectional study was performed with 107 postmenopausal women who entered in a lifestyle change program. The dietary intake was estimated through three 24-h food recalls. Body fat mass was evaluated by dual-energy X-ray absorptiometry (DXA). Linear regression analyzes were performed associating body fat variables (total fat mass, body fat percentage, trunk fat, gynoid and android fat mass; and body mass index) with calcium intake.

RESULTS

After adjustments for age; carbohydrate, protein, lipids and fiber intakes; and physical activity, it was observed that calcium intake (mg/day) was inversely associated with total fat mass (kg and percentage), trunk fat mass (kg), gynoid and android fat mass (kg). Calcium intake was not associated with body mass index, although a tendency was observed (p = 0.062).

CONCLUSION

Calcium intake was inversely associated with body fat mass in postmenopausal women.

Association between the Phytochemical Index and Lower Prevalence of Obesity/Abdominal Obesity in Korean Adults

The relatively high levels of vegetable consumption have highlighted the need to examine the association between phytochemical intake and disease prevention. We examined the association between the phytochemical index (PI) and obesity/abdominal obesity among Korean adults. We analyzed the data of 57,940 adults aged ≥ 19 years obtained from the Korea National Health and Nutrition Examination Survey. We calculated PI using the 24 h recall data, and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. Dose–response patterns were analyzed using restricted cubic spline regression. After multivariable adjustment, a higher PI was found to be associated with a lower prevalence of obesity and abdominal obesity; this association was notable in women (obesity, OR: 0.86, CI: 0.78–0.94, p for trend = 0.01; abdominal obesity, OR: 0.81, CI: 0.73–0.90, p for trend < 0.001). Spline regression showed linearity of the associations between PI and obesity/abdominal obesity in women. Our findings suggested that maintaining a phytochemical-rich diet may help to prevent obesity and abdominal obesity, especially in women, as an increased PI corresponded to lower prevalence of obesity. This study, using evidence-based data, highlighted the importance of consuming plant-derived foods to prevent obesity.

A Comprehensive Critical Assessment of Increased Fruit and Vegetable Intake on Weight Loss in Women

No previous reviews or meta-analyses have specifically assessed the effects of increased fruit and vegetable (FV) intake on weight loss with a primary focus on women. Several studies show differences between men and women in how increased FV intake affects their weight loss and maintenance, risk of becoming overweight or obese, and the influence of eating speed and frequency on weight control. This analysis provides a comprehensive and visual assessment of the effects of increasing FV intake and long-term weight change from observational studies and weight loss from randomized controlled trials (RCTs) in women. Consistent evidence from prospective studies and RCTs shows that increased intake of FV is a chief contributor to weight loss in women. This effect is enhanced with concurrent dietary restriction of high energy density (ED) or high-fat foods. Yet, the type of FV differentially impacts weight loss in women. Whole FV intake may influence weight through a variety of mechanisms including a reduction in eating rate, providing a satisfying, very-low to low energy density, low glycemic load or low-fat content. Also, FV are the primary source of dietary fiber, which can provide additional support for weight loss in women when consumed at adequate levels.

Organosulfur Compounds: A Review of Their Anti-inflammatory Effects in Human Health

Phytonutrients are widely recognized for providing protective human health benefits. Among the phytonutrients, epidemiological and experimental studies show that dietary organosulfur compounds (OSC) play a significant role in preventing various human pathological progressions, including chronic inflammation, by decreasing inflammatory mediators such as nitric oxide (NO), prostaglandin (PG)E₂, interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and IL-17, which are all typical hallmarks of inflammation. Evidence supports OSC in reducing the expression of these markers, thereby attenuating chronic inflammatory processes. Nuclear factor-kappa B (NF-κB) is a key regulating factor during inflammation, and novel evidence shows that OSC downregulates this transcriptional factor, thus contributing to the anti-inflammatory response. In vitro and in vivo studies show that inflammation is mechanistically linked with acute and chronic pathological conditions including cancer, diabetes, obesity, neural dysfunction, etc. Furthermore, a considerable number of experiments have demonstrated that the anti-inflammatory properties of OSC occur in a dose-dependent manner. These experiments also highlight indirect mechanisms as well as potent co-functions for protective roles as antioxidants, and in providing chemoprotection and neuroprotection. In this brief review, we provided an overview of the anti-inflammatory effects of OSC and elucidated probable mechanisms that are associated with inflammation and chronic disorders.

The Association Between Child Cooking Involvement in Food Preparation and Fruit and Vegetable Intake in a Hispanic Youth Population

BACKGROUND

Cooking interventions have been linked to reductions in obesity and improvements in dietary intake in children.

OBJECTIVE

To assess whether child cooking involvement (CCI) was associated with fruit intake (FI), vegetable intake (VI), vegetable preference (VP), and vegetable exposure (VE) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial.

METHODS

Baseline data from TGEG included 1231 3rd grade students and their parents. Conducted in 28 low-income, primarily Hispanic schools across Texas, TGEG schools were assigned to: 1) Coordinated School Health (CSH) only (control group), 2) CSH plus gardening and nutrition intervention (Learn, Grow, Eat & Go! or LGEG group), 3) CSH plus physical activity intervention (Walk Across Texas or WAT group), and 4) CSH plus LGEG plus WAT (combined group). Height, weight, dietary intake, VE, VP, and CCI were collected at baseline and postintervention. Linear regressions were used to assess the relation between baseline CCI and fruit and vegetable (FV) intake, VE, and VP. A priori covariates included age, sex, race/ethnicity, and TGEG treatment group.

RESULTS

Children who were always involved in family cooking had higher VP and VE when compared with children who were never involved in family cooking (β = 3.26; 95% CI: 1.67, 4.86; P < 0.01 and β = 2.26; 95% CI: 0.67, 3.85; P < 0.01, respectively). Both VI and FI were higher for children who were always involved in family cooking compared with children who never cooked with their family (β = 2.45; 95% CI: 1.47, 3.44; P < 0.01 and β = 0.93; 95% CI: 0.48, 1.39; P < 0.01, respectively). VI and fruit consumption were higher for children who reported being sometimes involved in family cooking compared with children who were never involved in family cooking, (β = 1.47; 95% CI: 0.51, 2.42; P < 0.01, and β = 0.64; 95% CI: 0.20, 1.08; P < 0.01, respectively).

CONCLUSIONS

Results show a positive relation between family cooking and FV intake and preference in high-risk, minority children.

Methodology of the health economic evaluation of the Feel4Diabetes-study

BACKGROUND

The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus.

METHODS

The aim of this paper is to describe the detailed methodology of the intervention's cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention's value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only.

CONCLUSIONS

The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.

Advances in Research on the Bioactivity of Alginate Oligosaccharides

Alginate is a natural polysaccharide present in various marine brown seaweeds. Alginate oligosaccharide (AOS) is a degradation product of alginate, which has received increasing attention due to its low molecular weight and promising biological activity. The wide-ranging biological activity of AOS is closely related to the diversity of their structures. AOS with a specific structure and distinct applications can be obtained by different methods of alginate degradation. This review focuses on recent advances in the biological activity of alginate and its derivatives, including their anti-tumor, anti-oxidative, immunoregulatory, anti-inflammatory, neuroprotective, antibacterial, hypolipidemic, antihypertensive, and hypoglycemic properties, as well as the ability to suppress obesity and promote cell proliferation and regulate plant growth. We hope that this review will provide theoretical basis and inspiration for the high-value research developments and utilization of AOS-related products.