Fruit and vegetable consumption and health outcomes: an umbrella review of observational studies

Association between work-related factors and health behaviour clusters among Finnish private-sector service workers

PURPOSE

We examined how work-related factors associate with several health behaviours that appear together among the large, but less-studied, blue- and pink-collar worker group, which is characterized by low education and income levels.

METHODS

In 2019, we conducted a cross-sectional survey among private sector service workers (n = 5256) in Finland. We applied two-step cluster analysis to identify groups on the basis of leisure-time physical activity, sleep adequacy, frequency of heavy drinking, smoking status, and frequency of fruit, vegetable and berry consumption. We examined the associations with work-related factors, using multinomial regression analyses and adjusting for confounding factors.

RESULTS

We identified six clusters labelled as Moderately Healthy (28% of the participants), Healthy - Vigorous Exercise (19%), Sedentary Lifestyle (16%), Inadequate Sleep (15%), Mixed Health Behaviours (15%), and Multiple Risk Behaviours (8%). Those who perceived their work to be mentally or physically strenuous more commonly belonged to the Inadequate Sleep and Multiple Risk Behaviours clusters. Time pressure made belonging to the Inadequate Sleep, Mixed Health Behaviours, and Multiple Risk Behaviours clusters more likely. Those who were dissatisfied with their work more often belonged to the Healthy - Vigorous Exercise, Inadequate Sleep, and Multiple Risk Behaviours clusters.

CONCLUSION

In addition of finding several considerably differing health behaviour clusters, we also found that adverse working conditions were associated with clusters characterized by multiple risk behaviours, especially inadequate sleep. Private-sector service workers' working conditions should be improved so that they support sufficient recovery, and occupational health services should better identify co-occurring multiple risk behaviours.

Unfavorable food consumption in children up to school entry age: results from the nationwide German KiESEL study

Introduction

Evidence points toward the early life being crucial for preventing nutrition-related diseases. As promotion of healthier food preferences in toddlerhood and preschool age might still modulate the trajectories of disease risk, understanding diet in these age groups is necessary. The objective was to analyze food consumption and diet quality of 1-5-year-old children living in Germany in relation to age and sex.

Methods

Data from 890 children, a subsample of the representative, cross-sectional Children's Nutrition Survey to Record Food Consumption (KiESEL) conducted by the German Federal Institute for Risk Assessment in 2014-2017, were analyzed. Dietary data were collected using food records (3 consecutive plus 1 independent day). Diet quality was evaluated against the German food-based dietary guidelines (FBDG).

Results

Consumption of unfavorable foods (e.g., sweets, soft drinks) exceeded the recommended maximum of 10% of energy intake (E%) by a multiple in all age and sex groups (medians: 24.8-35.8 E%). Preschoolers consumed more unfavorable foods than toddlers and boys more than girls. More than half of the children exceeded the recommendation for meat intake (medians: 2.3-3.2% of the total food consumption (%TFC) vs. 2 %TFC), especially preschoolers. In nearly all children, vegetable consumption was too low (medians: 4.2-4.5 %TFC vs. 12 %TFC). Also, milk/milk product consumption was below recommendations, more so in preschoolers (median: 12.0 %TFC ♂, 11.9 %TFC ♀ vs. 18 %TFC) than in toddlers (median: 16.1 %TFC ♂, 19.6 %TFC ♀). In toddlers and preschoolers with overweight or obesity, adherence to dietary recommendations of these food groups was largely similar to that of the total sample. Overall, 5-year-olds showed an unhealthier dietary pattern than 1-year-olds, which already emerged at age 2 years and became more evident at age 3 years.

Discussion

An adverse dietary pattern arises and even deteriorates at a very young age, showing sex-specific aspects. High attention from public health and research needs to be given to toddlerhood and even earlier life phases, e.g., to develop more age-specific FBDGs, aiming at reducing unhealthy food consumption.

Temporal trend of food consumption markers, breakfast consumption and association with overweight/obesity in schoolchildren aged 7 to 10 years between 2007 and 2019

Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.

Schools as Hubs of Health: A Comprehensive Supplemental Nutrition Assistance Program-Education Model for Promoting Wellness in Low-Income Communities

Research indicates that health interventions are most effective when they address multiple social determinants of health to support positive behavior. Schools as Hubs of Health, a comprehensive model of nutrition and physical activity education, was developed to support wellness within school communities defined as low-income by the national Supplemental Nutrition Assistance Program Education (SNAP-Ed). Components of the model include the following: classroom education; garden education; youth engagement; staff training; parent and community engagement; and policies, systems, and environments. Findings over the last decade indicate positive outcomes in nutrition and physical activity behaviors, youth leadership and engagement, and systems and environmental changes that support health and wellness.

From Information Seeking and Scanning to the Practice of Healthy Habits: A Longitudinal Test of the Integrative Model of Behavioral Prediction in the Context of Fruit and Vegetable Consumption

Fruit and vegetable intake is essential for health, but global adherence to recommended levels remains insufficient. Health information exposure positively influences consumption, yet the underlying mechanisms are not fully understood. This study aims to explore the relationships between information seeking and scanning, attitudes, norms, perceived behavioral control (PBC), intentions, and fruit and vegetable intake, following the main tenets of the Integrative Model of Behavioral Prediction (IM). Data were collected through face-to-face surveys in Santiago, Chile, with a representative sample of individuals aged 25 and older in two waves. Findings revealed that intentions in Wave 1 predicted fruit and vegetable consumption in Wave 2, with positive associations between attitudes, norms, PBC, and intentions. Information seeking was positively associated with attitudes, norms, and PBC, and it had indirect effects on fruit and vegetable consumption through attitudes, norms, PBC, and intentions. Information scanning did not show significant indirect effects on fruit and vegetable consumption, even though the path between scanning and attitudes was significant. The study provides support for the IM and highlights the importance of information seeking in promoting fruit and vegetable consumption through its influence on attitudes, norms, and PBC. The findings have practical implications for health campaigns, educational programs, healthcare interactions, and public policies targeting healthier dietary habits.

Partial substitution of red meat or processed meat with plant-based foods and the risk of colorectal cancer

OBJECTIVES

Shifting from animal-based to plant-based diets could reduce colorectal cancer (CRC) incidence. Currently, the impacts of these dietary shifts on CRC risk are ill-defined. Therefore, we examined partial substitutions of red or processed meat with whole grains, vegetables, fruits or a combination of these in relation to CRC risk in Finnish adults.

METHODS

We pooled five Finnish cohorts, resulting in 43 788 participants aged ≥ 25 years (79% men). Diet was assessed by validated food frequency questionnaires at study enrolment. We modelled partial substitutions of red (100 g/week) or processed meat (50 g/week) with corresponding amounts of plant-based foods. Cohort-specific hazard ratios (HR) for CRC were calculated using Cox proportional hazards models and pooled together using random-effects models. Adjustments included age, sex, energy intake and other relevant confounders.

RESULTS

During the median follow-up of 28.8 years, 1124 CRCs were diagnosed. We observed small risk reductions when red meat was substituted with vegetables (HR 0.97, 95% CI 0.95 - 0.99), fruits (0.97, 0.94 - 0.99), or whole grains, vegetables and fruits combined (0.97, 0.95 - 0.99). For processed meat, these substitutions yielded 1% risk reductions. Substituting red or processed meat with whole grains was associated with a decreased CRC risk only in participants with < median whole grain intake (0.92, 0.86 - 0.98; 0.96, 0.93 - 0.99, respectively; pinteraction=0.001).

CONCLUSIONS

Even small, easily implemented substitutions of red or processed meat with whole grains, vegetables or fruits could lower CRC risk in a population with high meat consumption. These findings broaden our insight into dietary modifications that could foster CRC primary prevention.

Factors associated with low fruit and vegetable consumption among people with severe mental ill health

Severe mental ill health (SMI) is associated with excess mortality, and poor diet is one associated modifiable risk factor. This study investigated factors associated with low consumption of fruit and vegetables among people with SMI (N = 9914). A total of 8.4% of participants ate no portions per day, while only 15% ate 5 + portions. Individuals who never consumed fruit and vegetables or ate < 5 portions per day were more likely to be male, younger than 65, unemployed, experience poorer general health, or perceive health as unimportant. Poor diet is common among people with SMI and tailored dietary improvement interventions are required.

Resveratrol and vascular health: evidence from clinical studies and mechanisms of actions related to its metabolites produced by gut microbiota

Cardiovascular diseases are among the leading causes of mortality worldwide, with dietary factors being the main risk contributors. Diets rich in bioactive compounds, such as (poly)phenols, have been shown to potentially exert positive effects on vascular health. Among them, resveratrol has gained particular attention due to its potential antioxidant and anti-inflammatory action. Nevertheless, the results in humans are conflicting possibly due to interindividual different responses. The gut microbiota, a complex microbial community that inhabits the gastrointestinal tract, has been called out as potentially responsible for modulating the biological activities of phenolic metabolites in humans. The present review aims to summarize the main findings from clinical trials on the effects of resveratrol interventions on endothelial and vascular outcomes and review potential mechanisms interesting the role of gut microbiota on the metabolism of this molecule and its cardioprotective metabolites. The findings from randomized controlled trials show contrasting results on the effects of resveratrol supplementation and vascular biomarkers without dose-dependent effect. In particular, studies in which resveratrol was integrated using food sources, i.e., red wine, reported significant effects although the resveratrol content was, on average, much lower compared to tablet supplementation, while other studies with often extreme resveratrol supplementation resulted in null findings. The results from experimental studies suggest that resveratrol exerts cardioprotective effects through the modulation of various antioxidant, anti-inflammatory, and anti-hypertensive pathways, and microbiota composition. Recent studies on resveratrol-derived metabolites, such as piceatannol, have demonstrated its effects on biomarkers of vascular health. Moreover, resveratrol itself has been shown to improve the gut microbiota composition toward an anti-inflammatory profile. Considering the contrasting findings from clinical studies, future research exploring the bidirectional link between resveratrol metabolism and gut microbiota as well as the mediating effect of gut microbiota in resveratrol effect on cardiovascular health is warranted.

The Influence of the School Neighborhood Food Retail Environment on Unhealthy Food Purchasing Behaviors Among Adolescents: A Systematic Review

INTRODUCTION

Adolescents are often exposed to food retailers selling unhealthy food items during their lunch breaks and school commutes. This systematic review examines the influence of school neighborhood food retail environments on adolescent food purchasing.

METHODS

A systematic search of 6 databases. Observational studies published from January 2012 to December 2022 that measured food availability, accessibility, or exposure, measured food purchasing, and focused on adolescents (aged 10-19 years) were eligible for inclusion.

RESULTS

Twelve studies with 97 findings were included. Thirty-one findings indicated that a school neighborhood with a high density of unhealthy food retail, a school with unhealthy food retail nearby, or exposure to unhealthy food retail on the journey to/from school was associated with higher prevalence and frequency of unhealthy food purchases.

DISCUSSION

Adolescents' food purchasing behaviors may be meaningfully affected by their school neighborhood food retail environment; however, the included studies have many methodological shortcomings.

IMPLICATIONS FOR RESEARCH AND PRACTICE

Results identify the need for new studies that measure food purchasing, use comprehensive definitions of food retail environments, and adopt more rigorous methods to approximate exposure to food retail. More robust evidence would strengthen the rationale for policy or program interventions and potentially indicate specific targets for intervention.

Isoflavones Effects on Vascular and Endothelial Outcomes: How Is the Gut Microbiota Involved?

Isoflavones are a group of (poly)phenols, also defined as phytoestrogens, with chemical structures comparable with estrogen, that exert weak estrogenic effects. These phytochemical compounds have been targeted for their proven antioxidant and protective effects. Recognizing the increasing prevalence of cardiovascular diseases (CVD), there is a growing interest in understanding the potential cardiovascular benefits associated with these phytochemical compounds. Gut microbiota may play a key role in mediating the effects of isoflavones on vascular and endothelial functions, as it is directly implicated in isoflavones metabolism. The findings from randomized clinical trials indicate that isoflavone supplementation may exert putative effects on vascular biomarkers among healthy individuals, but not among patients affected by cardiometabolic disorders. These results might be explained by the enzymatic transformation to which isoflavones are subjected by the gut microbiota, suggesting that a diverse composition of the microbiota may determine the diverse bioavailability of these compounds. Specifically, the conversion of isoflavones in equol-a microbiota-derived metabolite-seems to differ between individuals. Further studies are needed to clarify the intricate molecular mechanisms behind these contrasting results.

School Nutrition Personnel Perceptions of School Salad Bars before and after COVID-19

Many schools have salad bars as a means to increase students' fruit and vegetable intake. School nutrition programs experienced drastic changes to the school food environment due to COVID-19. The aim of the current study was to understand cafeteria personnel's experiences related to salad bar implementation before the COVID-19 pandemic and in the current school environment to inform efforts to enhance salad bar sustainability. Seven elementary schools (N = 30 personnel) installed salad bars prior to COVID-19; three of these schools (n = 13 personnel) re-opened salad bars after COVID-19. Cafeteria personnel completed surveys assessing their experiences with salad bars at both time points. Satisfaction with salad bar implementation and training was high pre- and post-COVID-19. Most agreed that salad bars increased students' fruit and vegetable intake, yet had concerns about cleanliness and waste. Perceived job difficulty increased post-COVID-19 (p = 0.01), and satisfaction with student salad bar training decreased (p = 0.001). Additional staff support and greater student training were needed post-COVID-19. Overall, salad bars were viewed favorably; however, more challenges and lower satisfaction were reported following COVID-19. Increasing support for cafeteria personnel is needed for salad bar sustainability and improving the school food environment.

Relationship between home garden ownership and the consumption of fruits and vegetables

OBJECTIVE

This study assessed the extent to which access to home gardens associate with the frequency of fruit and vegetable (FV) consumption.

SETTING

The study was carried out in fifty rural communities in Northern Ghana where food insecurity and malnutrition including micronutrient deficiencies are prevalent.

DESIGN

A community-based comparative analytical cross-sectional study.

PARTICIPANTS

A sample of 847 randomly selected rural households.

RESULTS

The proportion of households that consumed FV at least 3 d in a week was 45 %. Members in households who owned a home garden were 1·5 times more likely to consume FV at least 3 d in a week (adjusted OR (AOR) = 1·46 (95 % CI 1·06-2·0)), compared with their counterparts who had no home gardens. Furthermore, households in which mothers had a positive attitude towards FV consumption were 1·6 times more likely to consume FV (AOR = 1·63 (95 % CI 1·17-2·27)) compared with mothers who were less positive.

CONCLUSIONS

Our results suggest that food and nutrition policy measures that promote home gardens can improve consumption of diversified diets including FV among vulnerable rural households in Northern Ghana. Additionally, households with lower income may benefit from nutrition behaviour change communication campaigns directed towards increasing a positive attitude to FV intake.

From Health-in-All-Policies to Climate-in-All-Policies: Using the Synergies between Health Promotion and Climate Protection to Take Action

The climate crisis is developing into a life-changing event on a global level. Health promotion with the aim to increase the health status of individuals, independent of the present health status, has been developed on a scientific basis at least for the last eight decades. There are some basic principles which are prerequisites for both health promotion and climate protection. Those principles include (1) sustainability, (2) orientation on determinants, and (3) requirement of individual as well as community approaches. People are generally aiming to protect their lifestyle habits (e.g., traveling and consumer habits) and personal property (e.g., car and house) with easy solutions and as little effort as possible, and this can affect both health and climate. To reduce the emission of greenhouse gases and to protect our environment, changes towards a sustainable lifestyle have to be embedded into everybody's mind. Examples for domains that need to be addressed in health promotion as well as in climate protection include (health and climate) literacy, physical activity and active mobility, and nutrition and dietary habits. If health promotion fails to tackle those domains, this will continue to drive the climate crisis. And climate change, in turn, will affect health. On the other hand, developing and promoting health resources in the domains mentioned could help to mitigate the health-damaging effects of climate change. Success in the joint efforts to promote health and protect the climate would improve the One Health approach, the health of people and the environment.

Dietary fiber intake and all-cause and cause-specific mortality: An updated systematic review and meta-analysis of prospective cohort studies

BACKGROUND

Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and meta-analysis that compares and pools the effect of different types of fiber on mortality.

METHODS

In this systematic review and meta-analysis, all prospective cohort studies that evaluated the relationship between dietary fiber intake and all-cause or cause-specific mortality were included. The PubMed, SCOPUS, and Web of Science databases were searched up to October 2022. Data extraction and quality assessment were performed by two researchers independently. Heterogeneity between studies was assessed using Chi-square based test. Random/fixed effect meta-analysis was used to pool the hazard ratios (HR) or relative risks (RR) and 95 % confidence intervals (CI) for the association between different types of fiber and mortality.

RESULTS

This systematic review included 64 eligible studies, with a total sample size of 3512828 subjects, that investigated the association between dietary fiber intake and mortality from all-cause, cardiovascular disease (CVD), and cancer. Random-effect meta-analysis shows that higher consumption of total dietary fiber, significantly decreased the risk of all-cause mortality, CVD-related mortality, and cancer-related mortality by 23, 26 and 22 % (HR:0.77; 95%CI (0.73,0.82), HR:0.74; 95%CI (0.71,0.77) and HR:0.78; 95%CI (0.68,0.87)), respectively. The consumption of insoluble fiber tended to be more effective than soluble fiber intake in reducing the risk of total mortality and mortality due to CVD and cancer. Additionally, dietary fiber from whole grains, cereals, and vegetables was associated with a reduced risk of all-cause mortality, while dietary fiber from nuts and seeds reduced the risk of CVD-related death by 43 % (HR:0.57; 95 % CI (0.38,0.77)).

CONCLUSION

This comprehensive meta-analysis provides additional evidence supporting the protective association between fiber intake and all-cause and cause-specific mortality rates.

Adherence to Healthy or Unhealthy Pro-Vegetarian Plant-Based Diets Have Different Impact on Prostate Cancer Severity: Preliminary Findings

Prostate cancer (PCa) is a prevalent malignancy affecting men worldwide, and plant-based diets have been widely advocated for their health benefits. The aim of this study was to test the association between general, healthy, and unhealthy pro-vegetarian plant-based diets and PCa severity on 118 consecutive patients undergoing prostatectomy in a university hospital in Italy. Food frequency questionnaires were used to calculate scores for dietary patterns. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to test the associations. A general plant-based diet was not associated with cancer severity, while patients reporting a higher adherence to a healthy plant-based diet were less likely to have a more severe PCa (for medium/high vs. low-risk PCa, OR = 0.27, 95% CI: 0.08, 0.88; for high vs. medium/low-risk PCa, OR = 0.09, 95% CI: 0.02, 0.39). Patients resulting in higher adherence to an unhealthy plant-based diet were more likely to be diagnosed with more severe PCa (OR = 6.15, 95% CI: 1.70, 22.24). In conclusion, plant-based dietary patterns may have a different impact on PCa severity depending on the quality of the foods included.

Possible Beneficial Effects of Hydrolyzable Tannins Deriving from Castanea sativa L. in Internal Medicine

Hydrolyzable tannins (HTs) deriving from chestnuts have demonstrated, through numerous studies, the ability to exert multiple beneficial effects, including antioxidant and antimicrobial effects, on the lipid metabolism and cancer cells. The latter effect is very fascinating, since different polyphenols deriving from chestnuts were able to synergistically induce the inhibition of cancerous cells through multiple pathways. Moreover, the main mechanisms by which tannins induce antioxidant functions include: the reduction in oxidative stress, the ability to scavenge free radicals, and the modulation of specific enzymes, such as superoxide dismutase. HTs have also been shown to exert significant antimicrobial activity by suppressing microbial growth. The actions on the lipid metabolism are several, among which is the inhibition of lipid accumulation. Thus, tannins seem to induce a cardioprotective effect. In fact, through various mechanisms, such as the relaxation of the vascular smooth muscle, HTs were proven to be efficient against arterial hypertension. Therefore, the great number of studies in this field prove the growing interest on the utilization of natural bioactive compounds, such as HTs deriving from natural sources or obtained by circular economy models, as potential nutraceuticals or adjuvants therapies.

Sugar sweetened beverages, natural fruit juices, and cancer: what we know and what still needs to be assessed

Cancer is known as one of the leading causes of death in the world. In addition to early mortality, cancer is associated with disability in affected patients. Among environmental risk factors, special attention has been paid to the role of dietary factors. In recent decades, the consumption of sugar-sweetened beverages (SSBs) and natural fruit juices has increased. Several studies have assessed the effects of these beverages on human health and found that a higher intake of SSBs is associated with a greater risk of obesity, diabetes, cardiovascular diseases, hypertension, and non-alcoholic fatty liver disease. However, current evidence for cancer incidence and mortality is not conclusive. In the current review, we concluded that SSBs intake might be positively associated with cancer incidence/mortality through their increasing effects on obesity, inflammatory biomarkers, serum levels of insulin-like growth factor-I (IGF-I), and advanced glycation end-products. Such a positive association was also seen for natural fruit juices. However, types of natural fruit juices were not considered in most previous studies. In addition, some types of cancer including brain, lung, and renal cancers were not assessed in relation to SSBs and natural fruit juices. Therefore, further studies are needed in this regard.

Advancing Equity in the Farm Bill: Opportunities for the Gus Schumacher Nutrition Incentive Program (GusNIP)

The Gus Schumacher Nutrition Incentive Program (GusNIP) is a federally funded grant program that provides nutrition incentives-subsidies for purchasing fruits and vegetables (FV)-to Supplemental Nutrition Assistance Program (SNAP) participants. GusNIP currently advances nutrition equity by improving FV access for people with low incomes, yet inequities exist within GusNIP. We sought to identify inequities in GusNIP at the community, organization, partner, and individual levels and develop recommendations for farm bill provisions to make the program more equitable. In Spring 2021, a group of nutrition incentive experts (n = 11) from across the country convened to discuss opportunities to enhance equity in GusNIP. The iterative recommendation development process included feedback from key stakeholders (n = 15) and focus group participants with GusNIP lived experience (n = 12). Eleven recommendations to advance equity in GusNIP in the farm bill emerged across six categories: (1) increase total GusNIP funding, (2) increase funding and support to lower-resourced organizations and impacted communities, (3) eliminate the match requirement, (4) support statewide expansion, (5) expand and diversify retailer participation, and (6) expand program marketing. Including these recommendations in the upcoming and future farm bills would equitably expand GusNIP for SNAP participants, program grantees, and communities across the country.

Prostate Cancer Severity in Relation to Level of Food Processing

BACKGROUND

The level of food processing has gained interest as a potential determinant of human health. The aim of this study was to assess the relationship between the level of food processing and prostate cancer severity.

METHODS

A sample of 120 consecutive patients were examined for the following: their dietary habits, assessed through validated food frequency questionnaires; their dietary intake of food groups, categorized according to the NOVA classification; and their severity of prostate cancer, categorized into risk groups according to European Association of Urology (EAU) guidelines. Uni- and multivariate logistic regression analyses were performed to test the association between the variables of interest.

RESULTS

Individuals reporting a higher consumption of unprocessed/minimally processed foods were less likely to have greater prostate cancer severity than those who consumed less of them in the energy-adjusted model (odds ratio (OR) = 0.38, 95% confidence interval (CI): 1.17-0.84, p = 0.017 and OR = 0.33, 95% CI: 0.12-0.91, p = 0.032 for medium/high vs. low grade and high vs. medium/low grade prostate cancers, respectively); however, after adjusting for potential confounding factors, the association was not significant anymore. A borderline association was also found between a higher consumption of ultra-processed foods and greater prostate cancer severity in the energy-adjusted model (OR = 2.11, 95% CI: 0.998-4.44; p = 0.051), but again the association was not significant anymore after adjusting for the other covariates.

CONCLUSIONS

The level of food processing seems not to be independently associated with prostate cancer severity, while potentially related to other factors that need further investigation.

Adherence to UK dietary guidelines in school-aged children from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort

Compliance to UK dietary recommendations was assessed in school-aged children from a population-based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). A Children's Eatwell Guide (C-EWG) score was developed to assess socio-demographic predictors of meeting dietary recommendations. ALSPAC children with plausible diet diary data at 7 years (n 5373), 10 years (n 4450) and 13 years (n 2223) were included in the study. Their dietary intakes (recorded between 1998 and 2006) were compared with dietary guidelines for total and saturated fats, free sugars, salt, fibre, protein, carbohydrates, fruit and vegetables, non-oily and oily fish and red/processed meat. The C-EWG score (0-9 points) indicated the number of recommendations met at each age. Cross-sectional associations between socio-demographic characteristics and C-EWG scores were assessed using multivariable regression. The lowest adherence to guidelines at 7 years was for sugar (0·1 % meeting recommendations), followed by fibre (7·7 %), oily fish (9·5 %), saturated fat (9·7 %) and fruit and vegetables (15·2 %). Highest adherence was for limiting red/processed meat (67·3 %) and meeting carbohydrate recommendations (77·3 %). At 7 years, 12·1 % of participants failed to meet any of the nine recommendations, 26·9 % met one and 28·2 % met two. Similar patterns were seen at 10 and 13 years. A lower social class and maternal educational attainment and higher maternal BMI were associated with meeting fewer recommendations. Most school-aged children in this cohort did not meet UK dietary recommendations, particularly children from lower socio-economic backgrounds. Additional public health initiatives are needed to improve the quality of UK children's diets, particularly targeting lower socio-economic groups.

Association of dietary flavan-3-ol intakes with plasma phenyl-γ-valerolactones: analysis from the TUDA cohort of healthy older adults

BACKGROUND

Dietary polyphenols, including flavan-3-ols (F3O), are associated with better health outcomes. The relationship of plasma phenyl-γ-valerolactones (PVLs), the products of colonic bacterial metabolism of F3O, with dietary intakes is unclear.

OBJECTIVES

To investigate whether plasma PVLs are associated with self-reported intakes of total F3O and procyanidins+(epi)catechins.

DESIGN

We measured 9 PVLs by uHPLC-MS-MS in plasma from adults (>60y) in the Trinity-Ulster-Department of Agriculture (TUDA study (2008 to 2012; n=5186) and a follow-up subset (2014 to 2018) with corresponding dietary data (n=557). Dietary (poly)phenols collected by FFQ were analyzed using Phenol-Explorer.

RESULTS

Mean (95% confidence interval [CI]) intakes were estimated as 2283 (2213, 2352) mg/d for total (poly)phenols, 674 (648, 701) for total F3O, and 152 (146, 158) for procyanidins+(epi)catechins. Two PVL metabolites were detected in plasma from the majority of participants, 5-(hydroxyphenyl)-γ-VL-sulfate (PVL1) and 5-(4'-hydroxyphenyl)-γ-VL-3'-glucuronide (PVL2). The 7 other PVLs were detectable only in 1-32% of samples. Self-reported intakes (mg/d) of F3O (r = 0.113, P = 0.017) and procyanidin+(epi)catechin (r = 0.122, P = 0.010) showed statistically significant correlations with the sum of PVL1 and PVL 2 (PVL1+2). With increasing intake quartiles (Q1-Q4), mean (95% CI) PVL1+2 increased; from 28.3 (20.8, 35.9) nmol/L in Q1 to 45.2 (37.2, 53.2) nmol/L in Q4; P = 0.025, for dietary F3O, and from 27.4 (19.1, 35.8) nmol/L in Q1 to 46.5 (38.2, 54.9) nmol/L in Q4; P = 0.020, for procyanidins+(epi)catechins.

CONCLUSIONS

Of 9 PVL metabolites investigated, 2 were detected in most samples and were weakly associated with intakes of total F3O and procyanidins+(epi)catechins. Future controlled feeding studies are required to validate plasma PVLs as biomarkers of these dietary polyphenols.

Protocol for a randomized controlled trial comparing a very low-carbohydrate diet or moderate-carbohydrate plate-method diet for type 2 diabetes: the LEGEND (Lifestyle Education about Nutrition for Diabetes) trial

BACKGROUND

Optimal carbohydrate intake is an important and controversial area in the nutritional management of type 2 diabetes. Some evidence indicates that reducing overall carbohydrate intake with a low- or very low-carbohydrate eating plan can improve glycemic control compared to following eating plans that involve greater carbohydrate intake. However, critical knowledge gaps currently prevent clear recommendations about carbohydrate intake levels.

METHODS

The LEGEND (Lifestyle Education about Nutrition for Diabetes) Trial aims to compare a very low-carbohydrate diet to a moderate-carbohydrate plate-method diet for glycemic control in adults with type 2 diabetes. This two-site trial plans to recruit 180 adults with type 2 diabetes. We will randomize participants to either a 20-session group-based diet and lifestyle intervention that teaches either a very low-carbohydrate diet or a moderate-carbohydrate plate-method diet. We will assess participants at study entry and 4 and 12 months later. The primary outcome is HbA1c, and secondary outcomes include inflammation (high sensitivity C-reactive protein), body weight, changes in diabetes medications, lipids (small particle LDL, HDL, triglycerides), skeletal metabolism (bone mineral density from dual-energy x-ray absorptiometry and bone turnover markers serum procollagen type I N propeptide and serum C-terminal telopeptide of type I collagen), and body composition (percent body fat, percent lean body mass).

DISCUSSION

The LEGEND trial is a randomized controlled trial to assess optimal carbohydrate intake in type 2 diabetes by evaluating the effects of a very low-carbohydrate diet vs. a moderate-carbohydrate plate-method diet over a year-long period. The research addresses important gaps in the evidence base for the nutritional management of type 2 diabetes by providing data on potential benefits and adverse effects of different levels of carbohydrate intake.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05237128. Registered on February 11, 2022.

Zero fruits/vegetables consumption and associated factors among Children aged 6-23 months in Ethiopia: Mixed effect logistic regression analysis

BACKGROUND

The first two years of life is a vital period for promoting optimal growth, development and health. The lifelong nutritional habit and overall health of children is influenced by their early age feeding practice. Ethiopia is among the top five countries in Sub-Saharan Africa with the highest burden of zero fruits/vegetables consumption. This study aims to access factors associated with zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia.

METHODS

The study analyzed Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 1459 young children aged between 6-23 months and who were living with their mothers. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors.

RESULTS

Exactly 69.3% of children aged 6-23 months in Ethiopia had zero fruits/vegetables consumption. In the multivariable multilevel binary logistic regression analysis a child from household with middle (AOR = 0.55, 95% CI: 0.35, 0.86) and rich (AOR = 0.37, 95% CI: 0.23, 0.60) wealth index, mothers who aged between 25-34 years old (AOR = 0.44; 95%CI = 0.29-0.69), mothers who were married/living with partner (AOR = 3.21; 95%CI: 1.58-6.52), children of mothers who follow Islamic religion (AOR = 0.34, 95% CI: 0.19, 0.61), mothers who had more than four ANC visits during their most recent pregnancy (AOR = 0.57; 95%CI: 0.39-0.83), children in age group of 12-18 month(AOR = 0.41, 95% CI: 0.28, 0.59), and 19-23 months (AOR = 0.26, 95% CI: 0.17, 0.40), health facility delivery (AOR = 1.52, 95% CI; 1.00-2.30), and small peripheral regions (AOR = 4.40, 95% CI; 1.39-13.97) were found to be significant factors associated with children's zero fruits /vegetables consumption. The Interclass correlation coefficient (ICC) value in the null model was 0.34, which indicates that 34% of the variation in children's zero fruits /vegetables consumption was attributed to the variation between clusters.

CONCLUSION

This study found that zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia is high. Therefore, efforts should be made by stakeholders who are concerned about optimal diet and health of children to improve fruits/vegetables consumption of children particularly those from poor households, young mothers (15-24), and peripheral regions of Ethiopia. This could be done during ANC follow up visits and during nutrition counseling.

Edible insects and legumes exert an antioxidant effect on human colon mucosal cells stressed with 2,2'-azobis (2-amidinopropane)-dihydrochloride

Introduction

Edible insects have been recognized as a more sustainable source of nutrients and bio-active compounds than animal-based products, in line with classical vegetable sources such as legumes. In this study, we assessed the antioxidant properties of four edible insects (silkworms, grasshoppers, mealworms and giant worms) and four legume seeds (lentils, chickpeas, Roveja peas and grass peas).

Methods

After the aqueous extraction or in vitro simulated digestion process, selected products were assessed for: (i) in vitro antioxidant capacity through Ferric Reducing Antioxidant Power (FRAP) assay; (ii) the ability to reduce free radicals production induced by a pro-oxidant agent in cells of human colonic mucosa.

Results

All the aqueous extracts and digesta of edible insects displayed significantly higher in vitro antioxidant activity than legumes. Moreover, edible insects at all tested concentrations were able to exert an antioxidant effect in the cellular model, while legumes were effective mainly at high concentrations.

Discussion

Despite human trials are need to confirm and define these results in a physiological situation, here we suggest a role for edible insects in oxidative stress prevention. Since oxidative stress is strongly correlated with several intestinal pathologies, the results obtained could be interesting for the prevention and relief of the negative symptoms, offering new advantages to their already known ecological and nutritional properties.

Association of breakfast styles such as Japanese, Western, and cereals with sleeping habits, eating habits, and lifestyle in preschool and elementary school children

Introduction

In Japan, breakfast styles are categorized into five groups; Japanese breakfast (JB; rice and miso soup), Western breakfast (WB; bread and milk), Japanese-Western breakfast (J-WB; alternative daily serving), cereal breakfast (CB), and breakfast skipping. In our recent studies, breakfast style was highly associated with the daily sleep-wake phase (chronotype), and healthy eating habits. In contrast with other breakfast style consumers, JB-consumers were positively associated with the morning chronotype and healthy eating habits such as a high consumption of a variety of protein sources, vegetables, and dietary fibers, and low consumption of sweetened juices. These previous studies included only adult participants; hence, in the current study, we investigated whether similar observations can be made in children.

Methods

Preschool (aged 3-5 years) and elementary school children (6-8 years) (N = 6,104, 49.87% boys, 50.13% girls, mean body mass index 15.39 ± 0.03 kg/m² for preschoolers and percentage of overweight -2.73 ± 0.22 for elementary school children) participated in this cross-sectional online survey on lifestyle, including eating and sleep habits, through their mother's responses.

Results

The results showed that the morning-evening type index values (chronotype indicator, smaller indicates morning type) were negatively correlated with JB intake (-0.05, p < 0.01) and positively correlated with WB (0.03, p < 0.05) and CB intake (0.06, p < 0.01), suggesting that the JB group exhibited the morning chronotype and the WB and CB groups exhibited the evening chronotype. The JB group consumed a variety of protein sources (mean ± SE; days/week) with more frequency (fish 2.95 ± 0.038 p < 0.001, soy 3.55 ± 0.043 p < 0.001, egg 3.82 ± 0.044 p < 0.001) compared with the WB group (fish 2.58 ± 0.033, soy 3.00 ± 0.038, egg 3.49 ± 0.039). On the other hand, the JB group consumed snacks (5.48 ± 0.042 p < 0.001) and sweetened juice (2.50 ± 0.050 p < 0.001) less frequently than the WB group (snacks; 5.80 ± 0.037 and sweetened juice; 2.74 ± 0.049).

Discussion

JB-eating children with a morning chronotype exhibited better sleep and eating habits than WB-eating children with an evening type pattern. The results suggest that JB eating habits may be associated with good eating and sleeping lifestyles, even among preschool and elementary school children.

Dietary trends among Polish women in 2011-2022-cross-sectional study of food consumption frequency among women aged 20-50 in Silesia region, Poland

Background

Women's nutrition should be different from that of men. Women have lower energy requirements than men. And the need for certain vitamins and minerals is higher in women, this applies to iron, calcium, magnesium, vitamin D and vitamin B9 (folic acid). This is related to hormonal changes including menstruation, pregnancy, breastfeeding and the onset of menopause. Through hormonal changes and the changing physiological state, women are at greater risk of anaemia, bone weakness and osteoporosis.The aim of the study was to assess changes in the dietary pattern among women from the Silesian Agglomeration in Poland between 2011 and 2022.

Material and method

The survey was conducted in 2011 (March-May 2011) and in 2022 (October-November 2022) among women living in the Silesian Agglomeration (Silesia region) in Poland aged 20-50. After consideration of the inclusion and exclusion criteria, 745 women were included in the final analysis, including 437 women screened in 2011 and 308 women screened in 2022.The research tool used in this publication was a survey questionnaire consisting of 2 parts. The first part of the questionnaire consisted of demographic data. The second part of the study focused on the dietary habits of the women surveyed and the frequency of consumption of individual foods (FFQ).

Results

More women in 2022 ate breakfast than in 2011 (77.6% vs. 63.8% p < 0.001), were more likely to eat breakfast I at home (73.1% vs. 62.5%; p < 0.001), were more likely to eat breakfast II (39.0% vs. 35.2%; p = 0.001), were more likely to eat breakfast II at home (28.6% vs. 19.2%; p = 0.002), and were more likely to eat lunch at work (16.6% vs. 3.4%; p < 0.001). Women in 2022 were more likely to consume fast-food (p = 0.001), salty snacks (chips, crisps) (p < 0.001) and sweets (p < 0.001). Women in 2022 were more likely to consume whole-grain bread (p < 0.001), wholemeal pasta (p < 0.001), brown rice (p < 0.001), oatmeal (p < 0.001), buckwheat groats (p = 0.06), and bran (p < 0.001) than women in 2011. They were less likely to consume white bread (p < 0.0001), light pasta (p = 0.004), white rice (p = 0.008) and cornflakes (p < 0.001) in 2022.Women in 2022 were significantly more likely to consume vegetables (p < 0.001) than women in 2011.

Conclusion

Eating habits in Silesia region women changed between 2011 and 2022. In 2022, women were more likely to choose cereal products considered health-promoting and rich in dietary fiber (including whole-grain bread, whole-grain pasta, oatmeal, bran) were more likely to consume vegetables, dry pulses and vegetarian dinners, and consumed less meat, cured meats, fish and dairy products. Consumption of fast-food, salty snacks (such as chips) and sweets increased.

Salmonella and other Enterobacteriaceae in conventional and organic vegetables grown in Brazilian farms

This study aimed to assess the microbiological profile of conventional and organic vegetables grown in Brazilian farms through the detection of Salmonella and other Enterobacteriaceae. A total of 200 samples (100 conventional and 100 organic), including leafy greens, spices/herbs, and other unusual vegetables, were submitted to the enumeration of Enterobacteriaceae by plating on VRBG agar. Moreover, colonies of Enterobacteriaceae were randomly selected and submitted to identification by MALDI-TOF MS. Samples were also tested for Salmonella, using culture-based and PCR-based enrichment methods. The mean counts of Enterobacteriaceae in conventional and organic vegetables were 5.1 ± 1.5 and 5.4 ± 1.4 log CFU/g, respectively (P > 0.05). A total of 18 genera (including 38 species) of Enterobacteriaceae were identified, and the most frequent ones found in samples from both farming systems were Enterobacter (76%) and Pantoea (68%). Salmonella was identified in 17 samples (8.5%): nine (4.5%) in conventional and eight (4.0%) in organic vegetables. These results indicate that the farming system had no impact on the Enterobacteriaceae populations and rates of Salmonella and revealed unsatisfactory microbiological safety of some samples, mainly due to the presence of Salmonella. These findings highlight the need for control measures during vegetable production, regardless of the farming system, to reduce microbial contamination and the risks of foodborne illnesses.

A Narrative Review of Factors Associated with Skin Carotenoid Levels

Despite consistent evidence that greater consumption of fruits and vegetables (FV) is associated with significant reductions in chronic disease morbidity and mortality, the majority of adults in the United States consume less than the amounts recommended by public health agencies. As such, there is a critical need to design and implement effective programs and policies to facilitate increases in FV consumption for the prevention of these diseases. To accomplish this, an accurate, inexpensive, and convenient method for estimating the dietary FV intake is required. A promising method for quantifying the FV intake via proxy that has gained interest in recent years is the measurement of skin carotenoid levels via spectroscopy-based devices. However, there exist certain dietary and non-dietary factors that may affect the skin carotenoid levels independently of the dietary intake of carotenoids. In order to validate the ability of this method to accurately estimate the FV intake among diverse demographics, these factors must be identified and taken into consideration. Therefore, this narrative review seeks to summarize the available research on factors that may affect the skin carotenoid levels, determine current gaps in knowledge, and provide guidance for future research efforts seeking to validate spectroscopy-measured skin carotenoid levels as a means of accurately estimating the FV intake among various populations.

Dietary Patterns and Risk of Lung Cancer: A Systematic Review and Meta-Analyses of Observational Studies

PURPOSE OF REVIEW

Previous literature reviews summarized the associations between individual foods or food groups and lung cancer risk, but the relationship between dietary patterns and lung cancer risk has received less attention. We conducted a systematic review and meta-analyses of observational studies on the associations between dietary patterns and lung cancer risk.

RECENT FINDINGS

PubMed, Embase, and Web of Science were systematically searched from inception to February 2023. Random-effects models were used to pool relative risks (RR) on associations with at least two studies. Twelve studies reported on data-driven dietary patterns, and 17 studies reported on a priori dietary patterns. A prudent dietary pattern (high in vegetables, fruit, fish, and white meat) tended to be associated with a lower risk of lung cancer (RR = 0.81, 95% confidence interval [CI] = 0.66-1.01, n = 5). In contrast, Western dietary patterns, characterized by higher intakes of refined grains and red and processed meat, were significantly positively associated with lung cancer (RR = 1.32, 95% CI = 1.08-1.60, n = 6). Healthy dietary scores were consistently associated with a lower risk of lung cancer (Healthy Eating Index [HEI]: RR = 0.87, 95% CI = 0.80-0.95, n = 4; Alternate HEI: RR = 0.88, 95% CI = 0.81-0.95, n = 4; Dietary Approaches to Stop Hypertension: RR = 0.87, 95% CI = 0.77-0.98, n = 4; Mediterranean diet: RR = 0.87, 95% CI = 0.81-0.93, n = 10) while the dietary inflammatory index was associated with a higher risk of lung cancer (RR = 1.14, 95% CI = 1.07-1.22, n = 6). Our systematic review indicates dietary patterns characterized by a higher intake of vegetables and fruits, a lower intake of animal products, and anti-inflammation may be associated with a reduced risk of lung cancer.

Determination of the level of evidence for the association between different food groups/items and dietary fiber intake and the risk of cardiovascular diseases and hypertension: An umbrella review

Evidence has suggested that nutrition is a preventive factor against cardiovascular disease (CVD) risk. Because of a sharp growth in published meta-analyses and pooled analyses in recent years, a reassessment of old evidence is needed. We aimed to determine the level of evidence for the association between the consumption of different food groups/items and dietary fiber and the incidence risk of CVDs, hypertension, and atrial fibrillation from meta-analyses and pooled analyses of observational studies. Databases Scopus, PubMed/Medline, and Web of Science were searched for related studies. Fifty-eight articles met the inclusion criteria for evidence grading. In summary, grading the level of evidence showed a suggestive inverse association between the higher consumption of fruits, whole grains, fish, legumes, nuts, and dietary fibers with the incidence risk of hypertension and different types of CVD. Also, there was a probable inverse association between the higher consumption of total and low-fat dairy products and the risk of hypertension. Higher red meat consumption had a probable association with the increased risk of ischemic stroke. Higher consumption of processed meat and poultry also had a suggestive direct association with the incidence risk of stroke and hypertension. We have tried to present a comprehensive and useful overview of the level of evidence based on the most updated findings. The summary of results in the current umbrella review can be a helpful tool for nutritionists, dietitians, and researchers to establish new studies and identify research gaps in related issues.

Japanese carotenoid database with α- and β-carotene, β-cryptoxanthin, lutein, zeaxanthin, lycopene, and fucoxanthin and intake in adult women

Carotenoid intake is associated with low mortality and cancer risks; data on non-provitamin carotenoid intake is limited especially in Asians. We aimed to estimate carotenoid intake in Japanese adult women. Carotenoid content database comprises 196 food items, including 39 fruits, 87 vegetables and mushrooms, and 11 seaweeds, and was established using data from the literature and analyses of foods available in Japan. We surveyed the intake of these foods in Japanese women aged 21-56 years (n=109). Total intake of 7 carotenoids (mean±SD [range]) was 7,450±3,840 (1,160-21,300) μg/day; α-carotene, β-carotene, β-cryptoxanthin, lutein, zeaxanthin, lycopene, and fucoxanthin represented 4.3%, 23%, 3.4%, 15%, 2.0%, 39%, and 13% of total intake, respectively. Lutein intake was 1,132±686 (294-3,490) μg/day; its best sources were spinach, cucumber, chicken egg, green onion, and Chinese chives, representing 51% of total intake. Lutein can be obtained from a variety of sources. Thus, lutein intake levels did not vary widely among individuals and very few individuals consumed insufficient levels of lutein. Intake of zeaxanthin, lycopene, and fucoxanthin was 149±93 (2-479), 2,890±2,970 (0-17,100), and 980±1,230 (0-5,660) μg/day, respectively. Their intake required rich sources including chicken egg for zeaxanthin (52%); tomato products for lycopene (98%), and wakame seaweed for fucoxanthin (76%). The carotenoid content database including all food items consumed in Japan will be helpful for further investigations on carotenoid intake and its health benefits.

Identifying lifestyle factors associated to co-morbidity of obesity and psychiatric disorders, a pilot study

Obesity and psychiatric disorders are linked through a bidirectional association. Obesity rates have tripled globally in the past decades, and it is predicted that by 2025, one billion people will be affected by obesity, often with a co-morbidity such as depression. While this co-morbidity seems to be a global health issue, lifestyle factors associated to it differ between countries and are often attributed to more than one factor. Prior obesity studies were performed in Western populations; this is the first study that investigates lifestyle factors relating to obesity and mental health of the diverse population in Qatar, a country that has witnessed tremendous lifestyle change in a short time. In this pilot study, we surveyed 379 respondents to assess and compare the lifestyles of Qatar residents to the global population. However due to the high proportion of responses from the United Kingdom (UK) residents, we have made comparisons between Qatar residents and UK residents. We used chi-square analysis, spearman rank correlation and logistic regression to compare the lifestyle factors of individuals suffering from both increased BMI and mental health conditions. The types of food consumed, stress, exercise frequency and duration, alcohol and tobacco consumption, and sleep duration, were explored and results argue that different lifestyle factors can contribute to the same health condition, suggesting different mechanisms involved. We found that both groups reported similar sleep durations (p = 0.800), but that perception of sleep (p = 0.011), consumption of alcohol (p = 0.001), consumption of takeaway food (p = 0.007), and physical activity significantly varied between the groups (p = 0.0001). The study examined the predictors of comorbidity in Qatar as well as UK populations using multivariate logistic regression analysis. The result of the study showed no statistical association between comorbidity and the predictors drinking habit, smoking, physical activity, vegetable consumption, eat outs, and sleep perception for the Qatar population, and for the combined population. This study, however showed a significant association (p = 0.033) between sleep perception and comorbidity for the UK population. We conclude that further analysis is needed to understand the relationship between specific lifestyle factors and multimorbidity in each country.

Effects of a Web-Based Weight Loss Program on the Healthy Eating Index-NVS in Adults with Overweight or Obesity and the Association with Dietary, Anthropometric and Cardiometabolic Variables: A Randomized Controlled Clinical Trial

This randomized, controlled clinical trial examined the impact of a web-based weight loss intervention on diet quality. Furthermore, it was investigated whether corresponding changes in diet quality were associated with changes in measures of cardiovascular risk profile. Individuals with a body mass index (BMI) of 27.5 to 34.9 kg/m2 and an age of 18 to 65 y were assigned to either an interactive and fully automated web-based weight loss program focusing on dietary energy density (intervention) or a non-interactive web-based weight loss program (control). Examinations were performed at baseline (t0), after the 12-week web-based intervention (t1), and after an additional 6 (t2) and 12 months (t3). Based on a dietary record, the Healthy Eating Index-NVS (HEI-NVS) was calculated and analyzed using a robust linear mixed model. In addition, bootstrapped correlations were performed independently of study group to examine associations between change in HEI-NVS and change in dietary, anthropometric, and cardiometabolic variables. A total of n = 153 participants with a mean BMI of 30.71 kg/m2 (SD 2.13) and an average age of 48.92 y (SD 11.17) were included in the study. HEI-NVS improved significantly in the intervention group from baseline (t0) to t2 (p = 0.003) and to t3 (p = 0.037), whereby the course was significantly different up to t2 (p = 0.013) and not significantly different up to t3 (p = 0.054) compared to the control group. Independent of study group, there was a significant negative association between change in HEI-NVS and dietary energy density. A higher total score in HEI-NVS did not correlate with improvements in cardiovascular risk profile. The interactive and fully automated web-based weight loss program improved diet quality. Independent of study group, changes in HEI-NVS correlated with changes in energy density, but there was no association between improvements in HEI-NVS and improvements in cardiovascular risk profile.

Partnering for prevention in under-resourced communities: a randomized pilot study

BACKGROUND

Promoting health early in life is crucial to obesity prevention, but families in under-resourced communities face barriers to establishing healthy routines. The purpose of this pilot study was to examine the feasibility and preliminary effects of two dietary interventions for families in under-resourced communities.

METHODS

Fifty-one caregivers of young children (aged 0-5 years) were recruited from six community centers located in heavily populated neighborhoods with high poverty rates (i.e., under-resourced neighborhoods) in southwestern Pennsylvania. A longitudinal pilot study was conducted to examine feasibility as a primary outcome and change in dietary variety (24-Hour Recall), risk of nutritional problems (Nutrition Screen for Every Preschooler), and parenting stress (Parenting Stress Index-Short Form) over time and between groups as secondary outcomes. Six sites were randomized to receive Cooking Matters for Parents, Mealtime PREP, or a combined program (Cooking Matters + Mealtime PREP). Cooking Matters for Parents is a six-week nutrition education program designed to help parents of young children plan and cook healthy meals on a budget. Mealtime PREP is a six-week routine-based intervention designed to promote healthy dietary variety among young children. We predicted that we could feasibly deliver both programs and the combined program as determined by a priori benchmarks (ability to recruit ≥ 8 participants per site; achieving an 80% intervention completion rate; being rated as an acceptable intervention by 95% of intervention completers, and treatment fidelity of ≥ 90%). Descriptive statistics and individual growth models were used to analyze data.

RESULTS

Of 51 recruited participants, 49 were eligible, randomized by site, and included in the analyses. Fourteen were randomized to Cooking Matters, 13 to Mealtime PREP, and 22 to the combined program. Three of 4 feasibility benchmarks were met. Over time, improvements were observed in child dietary variety (p < 0.01, SE = 0.99), child nutrition risk (p = 0.01, SE = 0.61), and parenting stress (p = 0.04, SE = 1.33). An additive benefit of the combined intervention was observed for dietary variety (p = 0.03, SE = 0.79). No adverse events were observed or reported.

CONCLUSIONS

Offering complementary dietary interventions in under-resourced communities is feasible and shows promise to improve child and parent health.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT03559907).

Upcycled foods: A nudge toward nutrition

One of the aims of the United Nations Sustainable Development Goals (SDG) is to end hunger and ensure access by all people to safe, nutritious, and sufficient food all year round. An obvious synergy exists between the second SDG “Zero Hunger” and SDG target 12.3 which focuses on halving food waste and reducing food losses. In addition to helping improve global food security, reducing food waste provides financial and environmental benefits. Upcycling food is a technical solution for food waste reduction that retains the nutritional and financial value of food by-products. However, many of the upcycled foods produced are discretionary foods such as biscuits, crackers, and other snack food that are not part of a healthy dietary pattern, and should only be eaten sometimes in small amounts. Given the importance of ensuring a sustainable healthy diet, this paper discusses opportunities for upcycled food manufacturers to produce more nutritious products.

Do Antioxidant Phytochemicals Play a Role in Neurodegenerative Disorders? The Case of Polyphenols

In recent decades, numerous studies provided consistent and convincing evidence that the adoption of healthy plant-based dietary patterns is a valuable strategy to reduce the risk of most non-communicable diseases [...].

Cross-Cultural Differences between Italian and UK Consumer Preferences for 'Big Top' Nectarines in Relation to Cold Storage

Nectarines are perishable fruits grown in Southern Europe, valued for their sensorial properties. Chilling is used in the supply chain for Northern European consumers, while Southern European consumers can access fresh, locally grown fruit or cold-stored supermarket fruit. Cold storage and fruit ripening affect texture and flavour. Here a consumer survey and hedonic testing compared the appreciation of nectarines (cv. Big Top) in Italy and at two UK sites (n = 359). Fruit was at the commercial harvest stage, or stored at 1 °C or 5 °C for seven days, then sampled after two days’ (Italy and one UK site) or four days’ (second UK site) ambient recovery. In the consumer survey, the most important factors involved in purchase decision were ripeness, texture, colour, taste and price. Named varieties were more important to Italian than UK respondents, whilst ripeness, price, taste, blemishes, aroma, and ‘best before date’ were more important in the UK. In sensory analyses, fruits at the commercial harvest stage were preferred to those stored at 1 °C. Preference for the 5 °C stored peaches depended on recovery time. Distinct clusters of peach sensorial attributes were positively or negatively linked to hedonic rating. Factors important in purchase decisions did not affect hedonic rating in the tasting.

Levels of evidence for the association between different food groups/items consumption and the risk of various cancer sites: an umbrella review

This study aimed to determine the level of evidence on the association between food groups/items consumption and the risk of different cancer sites from the meta-analyses/pooled analyses of observational studies. A systematic search was executed in Scopus, PubMed/MEDLINE, and Web of Science. The criteria from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Expert Report were adopted for evidence grading. In summary, there was convincing evidence for the association between fibre intake and decreased risk of colon and breast cancer. Also, consumption of dairy products, milk, fruits, and fibre was associated with a probable decreased risk of breast cancer. Consumption of whole grains, dairy products, milk, fruits, vegetables, and fibre had a probable inverse association with the incidence risk of gastrointestinal tract cancers. More qualified studies are needed to find reliable findings on the association between various food groups/items consumption and the risk of different cancer sites.

Consumption of fruits, vegetables, and legumes are associated with overweight/obesity in the middle- and old-aged Chongqing residents: A case-control study

This study aimed to investigate the association of dietary habits with the risk of overweight/obesity among middle-and-old-aged Chongqing residents and also to examine the joint effects of behavioral lifestyles, dietary habits, and overweight/obesity. In this case-control study, age (±3 years), sex, and time of physical exercise matched 979 overweight/obesity residents, and 979 normal weight residents were recruited. A validated questionnaire was used to collect participants' information. Conditional logistic regression analysis was performed to determine the adjusted odds ratios (ORs) and 95% CIs of dietary habits and lifestyles associated with overweight/obesity risk. Overweight/obesity was defined as body mass index (BMI) ≥ 24 kg·m-2, and normal weight was defined as 18.5 ≤ BMI < 24 kg·m-2. The multivariate-adjusted models showed the weekly intake frequency of fruits 0-1 (day/week) (OR = 1.79, 95% CI = 1.04-3.10), and legumes 0-1 (day/week) (OR = 2.45, 95% CI = 1.28-4.67), as well as the weekly intake percentage of vegetables ≥ 15% (OR = 2.44, 95% CI = 1.04-5.71) were associated with a higher risk of overweight/obesity. Besides, there were joint effects of lifestyles (smoking or drinking) and dietary habits on overweight/obesity risk (P for interaction < 0.05). The consumption of vegetables, fruits, legumes, and the joint effects of behavioral habits (smoking or drinking) may modify the risk of being overweight/obese. It is essential to consume fruits and legumes at least 2 days/week, quit smoking, and stop consuming alcohol to avoid overweight/obesity among middle-aged and elderly people in Chongqing, China.

Carnauba wax nanoemulsion applied as an edible coating on fresh tomato for postharvest quality evaluation

Edible coatings to extend the shelf life and preserve the quality of fruit and vegetables are highly demanded nowadays. Recently, plant-based edible coatings have gained importance in the context of sustainability, which in combination with suitable top-down process can render “greener” nanoemulsions with optimized properties. Herein we developed a carnauba wax nanoemulsion (CWN) by using a high-pressure processing to be applied as an edible coating for fruit and vegetables. The as-developed nanoemulsion properties were compared to conventional carnauba wax emulsion (CWM), where CWN showed particle size diameter of 44 nm and narrow distribution, while CWM displayed larger particles and wider size distribution (from 200 to 1700 nm). For assessment of the postharvest quality, cv. ‘Debora’ tomatoes, employed here as a model, were coated with CWN or CWM, at concentrations of 9 and 18%, and then compared to uncoated fruit during storage at 23 °C for 15 days. Evaluation of fruit quality, including sugar, acids, pH, water vapor loss, firmness, gloss, color, ethylene and respiratory activity, were assessed at every 3 days, while sensory test were carried out at the end of storage. Uncoated tomatoes presented the highest water loss values, meanwhile, firmness, ethylene, and respiratory activity were not largely modified by the coatings during storage. Tomatoes coated with the CWN exhibited the highest instrumental gloss and were preferred by consumers in sensory evaluations, indicating the potential of the as-developed carnauba wax green nanoemulsion for postharvest applications.

The issue of acidity and alkalinity in our diet – Facts, popular beliefs, and the reality

Several misconceptions exist about foods and nutrition. Many believe, that the human body can “acidify”, thus, an “alkaline diet” should be followed. The acid-base balance is a characteristic of a normally functioning human body. Throughout our metabolic processes, acids and substances with acidic pH are produced continuously, which, in the case of a healthy person, does not affect the pH of the human body. In those rare cases, when an overall pH imbalance evolves in the human body due to its life-threatening nature, it requires urgent medical intervention. Furthermore, it cannot be influenced by dietary interventions.

This paper highlights evidence regarding acidification and the acid-base balance, with special attention to certain food groups. Foodstuffs have different specific pH value (acid-base character), they can be acidic, alkaline, or neutral in elemental state. Beside their chemical nature, the effect they have on the human body depends on the mechanism of their metabolism, as well. Diet and ingredients have direct and indirect effects on the human body's intracellular and extracellular compartments (especially blood and urine), still they do not influence its pH significantly.

Alkaline diets were born in the absence of evidence-based information and/or the misunderstanding and wrong interpretation of the available and up-to-date scientific facts. The convictions of consumers and the promotion of the alkaline diet lack the scientific basis, so it can be harmful or even dangerous in the long run.

In summary, scientific evidence on the efficacy or prophylactic effects of an alkaline diet is not available.

Metabolic and Blood Pressure Effects of Consuming Two Kiwifruit Daily for 7 Weeks: A Randomised Controlled Trial

Background: Eating two kiwifruit before breakfast by equi-carbohydrate partial exchange of cereal has been associated with lower postprandial glucose and insulin, but it increases the intake of fruit sugar. We assessed the effects of kiwifruit ingestion at breakfast over 7 weeks on metabolic and physiologic factors. Method: Forty-three healthy Asian participants were randomised to ingest 500 mL of carbonated water (control) or 500 mL of carbonated water plus two kiwifruit (intervention), before breakfast. Three-day weighed diet records were taken before and at week 4 during the intervention. Overnight fasting blood samples were taken at baseline and week 7. Forty-two participants completed the study (n = 22 control, n = 20 intervention). Results: The kiwifruit group consumed more fructose, vitamin C, vitamin E, and carbohydrates as a percentage of energy compared with the control group (p < 0.01). There was no evidence of between-group changes in metabolic outcomes at the end of the intervention, with the following mean (95% confidence interval) differences in fasting blood samples: glucose 0.09 (−0.06, 0.24) mmol/L; insulin −1.6 (−3.5, 0.3) μU/mL; uric acid −13 (−30, 4) μmol/L; triglycerides −0.10 (−0.22, 0.03) mmol/L; and total cholesterol −0.05 (−0.24, 0.14) mmol/L. There was a −2.7 (−5.5, 0.0) mmHg difference in systolic blood pressure for the intervention group compared with the control group. Conclusion: Eating two kiwifruit as part of breakfast increased fruit consumption and intake of antioxidant nutrients without a change in fasting insulin. There was a difference in systolic blood pressure and no adverse fructose-associated increases in uric acid, triglycerides, or total cholesterol. This simple intervention may provide health benefits to other demographic groups.

NuMoOS – COVID-19 Nutrition and Mood Online Survey: Perception about dietary aspects, stress, anxiety, and depression in the social isolation of Coronavirus Disease 2019

Background

Methods

Results

Conclusions

How Does the Gus Schumacher Nutrition Incentive Program Work? A Theory of Change

Increased fruit and vegetable (FV) intake is associated with decreased risk of nutrition-related chronic diseases. Sociodemographic disparities in FV intake indicate the need for strategies that promote equitable access to FVs. The United States Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP) supports state and local programs that offer nutrition incentives (NIs) that subsidize purchase of FVs for people participating in the Supplemental Nutrition Assistance Program (SNAP). While a growing body of research indicates NIs are effective, the pathways through which GusNIP achieves its results have not been adequately described. We used an equity-focused, participatory process to develop a retrospective Theory of Change (TOC) to address this gap. We reviewed key program documents; conducted a targeted NI literature review; and engaged GusNIP partners, practitioners, and participants through interviews, workshops, and focus groups in TOC development. The resulting TOC describes how GusNIP achieves its long-term outcomes of increased participant FV purchases and intake and food security and community economic benefits. GusNIP provides NIs and promotes their use, helps local food retailers develop the capacity to sell FVs and accept NIs in accessible and welcoming venues, and supports local farmers to supply FVs to food retailers. The TOC is a framework for understanding how GusNIP works and a tool for improving and expanding the program.

Free and glycosidically bound aroma compounds in fruit: biosynthesis, transformation, and practical control

Fruit aroma makes an initial flavor impression and largely determines the consumer preference and acceptance of fruit products. Free volatile organic compounds (FVOCs) directly make up the characteristic aromas of fruits. While glycosidically bound volatile compounds (GBVs) can be hydrolyzed during fruit ripening, postharvest storage, and processing, releasing the attached aglycones as free volatiles that could alter the overall aroma attributes of fruits. GBVs typically exhibit significantly higher concentrations than their free counterparts in fruits such as grapes, cherries, kiwifruits, tomatoes, and tamarillos. This review highlights the biosynthesis of FVOCs and GBVs in fruit and illustrates their biological transformations for various functional purposes such as detoxification, aroma enhancement, plant defense, and pollinator attraction. Practical applications for regulating the levels of aroma compounds emitted or accumulated in fruit are also reviewed, emphasizing the metabolic engineering of free volatile metabolites and hydrolytic technologies on aroma glycosides. Generally, enzymatic hydrolysis using AR2000 is a common strategy to enhance the sensory attributes of fruit juices/wines, while acidic hydrolysis induces the oxidation and rearrangement of aglycones, generating artifacts with off-aromas. This review associates the occurrence of free and glycosidic bound volatiles in fruit and addresses their importance in fruit flavor enhancement and industrial applications.

Variations in Total Phenolic, Total Flavonoid Contents, and Free Radicals' Scavenging Potential of Onion Varieties Planted under Diverse Environmental Conditions

Genetic diversity and Agro-climatic conditions contribute significantly to the agronomic and morphological features of the food plant species, and their nutraceutical potential. The present study was intended to evaluate the impact of growing conditions on total phenolic and total flavonoid contents, and in vitro antioxidant potential in the bulbs and leaves of onion varieties planted under diverse environmental conditions. Standard analytical methods were used to quantify total phenolic content (TPC), total flavonoid content (TFC), and free radicals’ scavenging/antioxidant capacity. The impact of climatic and soil conditions was assessed using statistical tools. In general, onion varieties cultivated at three different locations viz. Kalar Kahar, Lahore and Swabi exhibited significant variations in TPC and TFC, and antioxidant activities. The bulbs and leaves of Mustang (V1) variety planted at Lahore and Swabi had significantly (p < 0.05), high levels of TPC (659.5 ± 6.59, and 631.1 ± 8.58 mg GAE/100 g, respectively). However, leaves of Red Orb (V2) and bulbs of Mustang (V1), and Golden Orb (V6), harvested from Kalar Kahar depicted the highest concentration of TFC (432.5 ± 10.3, 303.0 ± 6.67, and 303.0 ± 2.52 mg QE/100 g DW, respectively). Likewise, bulbs of V1 planted at Kalar Kahar, Lahore and Swabi exhibited maximum inhibition of DPPH, ABTS, and H2O2 radicals (79.01 ± 1.49, 65.38 ± 0.99, and 59.76 ± 0.90%, respectively). Golden Orb (V6) harvested from Lahore had the highest scavenging of OH radical (67.40 ± 0.09%). Likewise, bulbs of V1 variety planted at KalarKahar and Swabi had significant capacity to scavenge ferric ions (415.1 ± 10.6 mg GAE/100 g DW), and molybdate ions (213.7 ± 0.00 mg AAE/100 g DW). Conversely, leaves of Amazon (V8), planted at Lahore and Swabi depicted significant levels of DPPH, ABTS, H2O2 radical scavenging (90.69 ± 0.26, 63.55 ± 1.06, 51.86 ± 0.43%, respectively), and reduction of ferric ions (184.2 ± 6.75 mg GAE/100 g DW). V6 leaves harvested from Lahore and that of Super Sarhad (V3) from Swabi showed the highest inhibition of OH radical (61.21 ± 0.79%), and molybdate ions (623.6 ± 0.12 mg AAE/100 g DW), respectively. Pearson correlation and principal component analysis revealed strong relationships of climatic conditions, soil properties and elevation with TPC, TFC and free radicals’ scavenging potential in the bulbs and leaves of onion varieties. The variations in the total phenolic and flavonoid contents, and antioxidant potential of different varieties, and their associations with climatic and soil factors revealed the complexity of the growing conditions and genetic makeup that imposed significant impacts on the synthesis of secondary metabolites and nutraceutical potential of food and medicinal plant species.