1
|
Lara-Castor L, Micha R, Cudhea F, Miller V, Shi P, Zhang J, Sharib JR, Erndt-Marino J, Cash SB, Barquera S, Mozaffarian D. Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study. BMJ 2024; 386:e079234. [PMID: 39111807 PMCID: PMC11305379 DOI: 10.1136/bmj-2024-079234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE To quantify global intakes of sugar sweetened beverages (SSBs) and trends over time among children and adolescents. DESIGN Population based study. SETTING Global Dietary Database. POPULATION Children and adolescents aged 3-19 years in 185 countries between 1990 and 2018, jointly stratified at subnational level by age, sex, parental education, and rural or urban residence. RESULTS In 2018, mean global SSB intake was 3.6 (standardized serving=248 g (8 oz)) servings/week (1.3 (95% uncertainly interval 1.0 to 1.9) in south Asia to 9.1 (8.3 to 10.1) in Latin America and the Caribbean). SSB intakes were higher in older versus younger children and adolescents, those resident in urban versus rural areas, and those of parents with higher versus lower education. Between 1990 and 2018, mean global SSB intakes increased by 0.68 servings/week (22.9%), with the largest increases in sub-Saharan Africa (2.17 servings/week; 106%). Of 185 countries included in the analysis, 56 (30.3%) had a mean SSB intake of ≥7 servings/week, representing 238 million children and adolescents, or 10.4% of the global population of young people. CONCLUSION This study found that intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by 23% from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. SSB intakes showed large heterogeneity among children and adolescents worldwide and by age, parental level of education, and urbanicity. This research should help to inform policies to reduce SSB intake among young people, particularly those with larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub-Saharan Africa.
Collapse
Affiliation(s)
- Laura Lara-Castor
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Renata Micha
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- University of Thessaly, Volos, Greece
| | - Frederick Cudhea
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Victoria Miller
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Peilin Shi
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Center for Surgery and Public Health, Brigham and Women's Hospital Boston, MA, USA
| | - Julia R Sharib
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josh Erndt-Marino
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Simon Barquera
- Research Center on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Dariush Mozaffarian
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
- Division of Cardiology, Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
2
|
Soares Dias Portela A, Saxena V, Rosenn E, Wang SH, Masieri S, Palmieri J, Pasinetti GM. Role of Artificial Intelligence in Multinomial Decisions and Preventative Nutrition in Alzheimer's Disease. Mol Nutr Food Res 2024; 68:e2300605. [PMID: 38175857 DOI: 10.1002/mnfr.202300605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/04/2023] [Indexed: 01/06/2024]
Abstract
Alzheimer's disease (AD) affects 50 million people worldwide, an increase of 35 million since 2015, and it is known for memory loss and cognitive decline. Considering the morbidity associated with AD, it is important to explore lifestyle elements influencing the chances of developing AD, with special emphasis on nutritional aspects. This review will first discuss how dietary factors have an impact in AD development and the possible role of Artificial Intelligence (AI) and Machine Learning (ML) in preventative care of AD patients through nutrition. The Mediterranean-DASH diets provide individuals with many nutrient benefits which assists the prevention of neurodegeneration by having neuroprotective roles. Lack of micronutrients, protein-energy, and polyunsaturated fatty acids increase the chance of cognitive decline, loss of memory, and synaptic dysfunction among others. ML software has the ability to design models of algorithms from data introduced to present practical solutions that are accessible and easy to use. It can give predictions for a precise medicine approach to evaluate individuals as a whole. There is no doubt the future of nutritional science lies on customizing diets for individuals to reduce dementia risk factors, maintain overall health and brain function.
Collapse
Affiliation(s)
| | - Vrinda Saxena
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
| | - Eric Rosenn
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
| | - Shu-Han Wang
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
| | - Sibilla Masieri
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
| | - Joshua Palmieri
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
| | - Giulio Maria Pasinetti
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10019, USA
- Geriatrics Research, Education and Clinical Center, JJ Peters VA Medical Center, Bronx, NY, 10468, USA
| |
Collapse
|
3
|
Chen Y, Zhou B, Naumova EN. How well global dietary intake estimates agree: a case of sodium consumption. J Public Health Policy 2024; 45:205-211. [PMID: 38654116 DOI: 10.1057/s41271-024-00478-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
Global dietary data repositories are key components of nutrition surveillance. The two most comprehensive databases, the Global Dietary Database (GDD) and the Global Burden Disease (GBD), provide national dietary intake estimates but use different data sources and models to generate estimates. To explore the agreement between GDD and GBD estimates, we compared country-specific average daily sodium intakes in 169 countries over a 28-year period using descriptive statistics, the Bland-Altman method, and prevalence exceeding the intake reference level of 2.3 g/day. We detected a staggering 36% difference between GDD and GBD estimates of global mean intakes (2.68 ± 0.74 vs. 3.88 ± 1.15 g/day, respectively; p < 0.0001). As 104 (61.5%) countries reported to have over-consumed sodium by both databases, the development of standardized approaches for national dietary intake estimation is critical for monitoring global sodium intake in a systematic and comprehensive way and for implementing global strategies to reduce sodium intake.
Collapse
Affiliation(s)
- Yutong Chen
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Bingjie Zhou
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Elena N Naumova
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| |
Collapse
|
4
|
D’Addezio L, Sette S, Piccinelli R, Le Donne C, Turrini A. FoodEx2 Harmonization of the Food Consumption Database from the Italian IV SCAI Children's Survey. Nutrients 2024; 16:1065. [PMID: 38613101 PMCID: PMC11013267 DOI: 10.3390/nu16071065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Estimating the habitual food and nutrient intakes of a population is based on dietary assessment methods that collect detailed information on food consumption. Establishing the list of foods to be used for collecting data in dietary surveys is central to standardizing data collection. Comparing foods across different data sources is always challenging. Nomenclatures, detail, and classification into broad food groups and sub-groups can vary considerably. The use of a common system for classifying and describing foods is an important prerequisite for analyzing data from different sources. At the European level, EFSA has addressed this need through the development and maintenance of the FoodEx2 classification system. The aim of this work is to present the FoodEx2 harmonization of foods, beverages, and food supplements consumed in the IV SCAI children's survey carried out in Italy. Classifying foods into representative food categories predefined at European level for intake and exposure assessment may lead to a loss of information. On the other hand, a major advantage is the comparability of data from different national databases. The FoodEx2 classification of the national food consumption database represented a step forward in the standardization of the data collection and registration. The large use of FoodEx2 categories at a high level of detail (core and extended terms) combined with the use of descriptors (facets) has minimized information loss and made the reference food categories at country level comparable with different food databases at national and international level.
Collapse
Affiliation(s)
- Laura D’Addezio
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.S.); (R.P.); (C.L.D.)
| | - Stefania Sette
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.S.); (R.P.); (C.L.D.)
| | - Raffaela Piccinelli
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.S.); (R.P.); (C.L.D.)
| | - Cinzia Le Donne
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.S.); (R.P.); (C.L.D.)
| | | |
Collapse
|
5
|
Yin K, Zhao X, Liu Y, Zhu J, Fei X. Aging Increases Global Annual Food Greenhouse Gas Emissions up to 300 Million Tonnes by 2100. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:5784-5795. [PMID: 38507561 DOI: 10.1021/acs.est.3c06268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
The dietary preferences of the elderly population exhibit distinct variations from the overall averages in most countries, gaining increasing significance due to aging demographics worldwide. These dietary preferences play a crucial role in shaping global food systems, which will result in changed environmental impacts in the future such as greenhouse gas (GHG) emissions. We present a quantitative evaluation of the influence of population aging on the changes in GHG emissions from global food systems. To achieve this, we developed regional dietary coefficients (DCs) of the elderly based on the Global Dietary Database (GDD). We then reconciled the GDD with the dataset from the Food and Agriculture Organization of the United Nations (FAO) to calculate the food GHG emissions of the average population in each of the countries. By applying the DCs, we estimated the national food GHG emissions and obtained the variations between the emissions from aged and average populations. We employed a modified version of the regional integrated model of climate and the economy model (RICE) to forecast the emission trends in different countries based on FAO and GDD data. This integrated approach allowed us to evaluate the dynamic relationships among aging demographics, food consumption patterns, and economic developments within regions. Our results indicate that the annual aging-embodied global food GHG emissions will reach 288 million tonnes of CO2 equivalent (Mt CO2e) by 2100. This estimation is crucial for policymakers, entrepreneurs, and researchers as it provides insights into a potential future environmental challenge and emphasizes the importance of sustainable food production and consumption strategies to GHG emission mitigations associated with aging dietary patterns.
Collapse
Affiliation(s)
- Ke Yin
- Department of Environmental Engineering, College of Ecology and Environment, Nanjing Forestry University, 159 Longpan Road, Nanjing 210037, China
| | - Xingyu Zhao
- Department of Environmental Engineering, College of Ecology and Environment, Nanjing Forestry University, 159 Longpan Road, Nanjing 210037, China
| | - Yuru Liu
- Department of Environmental Engineering, College of Ecology and Environment, Nanjing Forestry University, 159 Longpan Road, Nanjing 210037, China
| | - Jingyu Zhu
- Department of Environmental Engineering, College of Ecology and Environment, Nanjing Forestry University, 159 Longpan Road, Nanjing 210037, China
| | - Xunchang Fei
- School of Civil and Environmental Engineering, Nanyang Technological University, Singapore 639798, Singapore
- Nanyang Environment and Water Research Institute, Singapore 637141, Singapore
| |
Collapse
|
6
|
Fisberg M, Duarte Batista L, Previdelli AN, Ferrari G, Fisberg RM. Exploring Diet and Nutrient Insufficiencies across Age Groups: Insights from a Population-Based Study of Brazilian Adults. Nutrients 2024; 16:750. [PMID: 38474878 DOI: 10.3390/nu16050750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
Assessing dietary inadequacies can contribute to understanding the nutritional vulnerabilities of a country. This study aimed to investigate nutrient intakes and micronutrient inadequacies in the Brazilian adult population, with an interest in different age subgroups. We conducted a cross-sectional study with 1812 individuals aged 19 to 65 years from a population-based study with a representative sample of Brazilian adults. Dietary intake was assessed by two 24 h food recalls, and the probabilities of inadequate intake were estimated using the Dietary Reference Intake targets. Adequate macronutrient intake was over 99% for proteins, 84.7% for carbohydrates, and 80.7% for total fats. There was a high probability of inadequacy (above 90%) for vitamins D and E, but vitamin D inadequacy was very similar between the sexes. In contrast, vitamin E was more likely to be inadequately consumed among women. A high probability of inadequacies (above 85%) of calcium and magnesium were found in the population, regardless of age group. Except for iron, the probability of an inadequacy of other minerals increased with age. The results showed a relevant proportion of nutrient inadequacies, with those most at risk being women and older individuals, helping with the better targeting and monitoring of public-health policies that address nutritional problems in the population.
Collapse
Affiliation(s)
- Mauro Fisberg
- Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo 01227-200, Brazil
- Department of Pediatrics, Federal University of São Paulo, São Paulo 04023-062, Brazil
| | - Lais Duarte Batista
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | | | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| |
Collapse
|
7
|
Karageorgou D, Lara Castor L, Padula de Quadros V, Ferreira de Sousa R, Holmes BA, Ioannidou S, Mozaffarian D, Micha R. Harmonising dietary datasets for global surveillance: methods and findings from the Global Dietary Database. Public Health Nutr 2024; 27:e47. [PMID: 38238892 PMCID: PMC10882534 DOI: 10.1017/s1368980024000211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Abstract
OBJECTIVE The Global Dietary Database (GDD) expanded its previous methods to harmonise and publicly disseminate individual-level dietary data from nutrition surveys worldwide. DESIGN Analysis of cross-sectional data. SETTING Global. PARTICIPANTS General population. METHODS Comprehensive methods to streamline the harmonisation of primary, individual-level 24-h recall and food record data worldwide were developed. To standardise the varying food descriptions, FoodEx2 was used, a highly detailed food classification and description system developed and adapted for international use by European Food Safety Authority (EFSA). Standardised processes were developed to: identify eligible surveys; contact data owners; screen surveys for inclusion; harmonise data structure, variable definition and unit and food characterisation; perform data checks and publicly disseminate the harmonised datasets. The GDD joined forces with FAO and EFSA, given the shared goal of harmonising individual-level dietary data worldwide. RESULTS Of 1500 dietary surveys identified, 600 met the eligibility criteria, and 156 were prioritised and contacted; fifty-five surveys were included for harmonisation and, ultimately, fifty two were harmonised. The included surveys were primarily nationally representative (59 %); included high- (39 %), upper-middle (21 %), lower-middle (27 %) and low- (13 %) income countries; usually collected multiple recalls/ records (64 %) and largely captured both sexes, all ages and both rural and urban areas. Surveys from low- and lower-middle v. high- and upper-middle income countries reported fewer nutrients (median 17 v. 30) and rarely included nutrients relevant to diet-related chronic diseases, such as n-3 fatty acids and Na. CONCLUSIONS Diverse 24-h recalls/records can be harmonised to provide highly granular, standardised data, supporting nutrition programming, research and capacity development worldwide.
Collapse
Affiliation(s)
- Dimitra Karageorgou
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA02111, USA
| | - Laura Lara Castor
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA02111, USA
| | | | | | | | | | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA02111, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA02111, USA
| |
Collapse
|
8
|
Demmler KM, Beal T, Ghadirian MZ, Neufeld LM. Characteristics of Global Data on Adolescent's Dietary Intake: A Systematic Scoping Review. Curr Dev Nutr 2024; 8:102054. [PMID: 38230349 PMCID: PMC10790018 DOI: 10.1016/j.cdnut.2023.102054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024] Open
Abstract
Data on adolescents' dietary intake are essential to improve their diets and nutrition. However, the availability of (high-quality) data on adolescents' dietary intake is scarce with great global differences. We conducted a systematic scoping review to investigate the availability, characteristics, and gaps in global adolescent dietary data, following the Preferred Reporting Items for Systematic Reviews and Meta Analyses-Extension for Scoping Reviews checklist and guidelines (registered under PROSPERO no. 171170 https://www.crd.york.ac.uk/PROSPERO/). We included peer-reviewed and grey literature articles (2010 onwards) on the dietary intake of male and female adolescents (10-24 y). Studies from all countries and languages and including any information related to types of food consumed, diet composition, dietary diversity, or meal patterns were considered. We excluded studies with insufficient methodological information, unclear description of population, samples sizes <25, school-based data sets containing <6 schools, and studies that focused on pregnant or unhealthy study populations. Data, including year(s) of data collection, age, gender, sample size, dietary assessment methods, number of food items/groups, study design, location, and representativeness, were extracted. A total of 52,889 titles were identified and 722 articles, describing 1,322 data sets, were retained for analysis. Nationally representative, detailed dietary data for adolescents aged 10-24 y are still lacking, particularly in sub-Saharan Africa, South Asia, and low-income countries. Data quality and representativeness remain limited, highlighting the need for data disaggregation by age, gender, locality, comprehensive dietary information, and broader geographic coverage. A notable amount of data was available through grey literature, especially in data-scarce countries. The study underscores the importance of addressing adolescent nutrition, emphasizing the urgent need for more robust, accessible, and representative data on adolescents' dietary intake to support effective nutritional efforts.
Collapse
Affiliation(s)
- Kathrin M Demmler
- Knowledge Leadership, Global Alliance for Improved Nutrition (GAIN), Berlin, Germany
| | - Ty Beal
- Knowledge Leadership, Global Alliance for Improved Nutrition (GAIN), Washington, DC, United States
| | - Mona Z Ghadirian
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Lynnette M Neufeld
- Nutrition Division, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| |
Collapse
|
9
|
Lara-Castor L, Micha R, Cudhea F, Miller V, Shi P, Zhang J, Sharib JR, Erndt-Marino J, Cash SB, Mozaffarian D. Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries. Nat Commun 2023; 14:5957. [PMID: 37788998 PMCID: PMC10614169 DOI: 10.1038/s41467-023-41269-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
Sugar-sweetened beverages (SSBs) are associated with cardiometabolic diseases and social inequities. For most nations, recent estimates and trends of intake are not available; nor variation by education or urbanicity. We investigated SSB intakes among adults between 1990 and 2018 in 185 countries, stratified subnationally by age, sex, education, and rural/urban residence, using data from the Global Dietary Database. In 2018, mean global SSB intake was 2.7 (8 oz = 248 grams) servings/week (95% UI 2.5-2.9) (range: 0.7 (0.5-1.1) in South Asia to 7.8 (7.1-8.6) in Latin America/Caribbean). Intakes were higher in male vs. female, younger vs. older, more vs. less educated, and urban vs. rural adults. Variations by education and urbanicity were largest in Sub-Saharan Africa. Between 1990 and 2018, SSB intakes increased by +0.37 (+0.29, +0.47), with the largest increase in Sub-Saharan Africa. These findings inform intervention, surveillance, and policy actions worldwide, highlighting the growing problem of SSBs for public health in Sub-Saharan Africa.
Collapse
Affiliation(s)
- Laura Lara-Castor
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- University of Thessaly, Volos, Greece
| | - Frederick Cudhea
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Medicine, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton, Canada
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Julia R Sharib
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josh Erndt-Marino
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
- Tufts University School of Medicine, Boston, MA, USA.
- Department of Medicine, Tufts Medical Center, Boston, MA, USA.
| |
Collapse
|
10
|
Fish-Williamson A, Hahn-Holbrook J. Nutritional factors and cross-national postpartum depression prevalence: an updated meta-analysis and meta-regression of 412 studies from 46 countries. Front Psychiatry 2023; 14:1193490. [PMID: 37398595 PMCID: PMC10311512 DOI: 10.3389/fpsyt.2023.1193490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
Background Postpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression. Methods To estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016-2021 and combined our findings with a previous meta-analysis of articles published between 1985-2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables. Results 412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010-0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016-0.242). Conclusion The global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.
Collapse
|
11
|
O'Hearn M, Lara-Castor L, Cudhea F, Miller V, Reedy J, Shi P, Zhang J, Wong JB, Economos CD, Micha R, Mozaffarian D. Incident type 2 diabetes attributable to suboptimal diet in 184 countries. Nat Med 2023; 29:982-995. [PMID: 37069363 PMCID: PMC10115653 DOI: 10.1038/s41591-023-02278-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/28/2023] [Indexed: 04/19/2023]
Abstract
The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8-14.4 million) incident T2D cases, representing 70.3% (68.8-71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0-27.1%)), excess refined rice and wheat intake (24.6% (22.3-27.2%)) and excess processed meat intake (20.3% (18.3-23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4-87.7%)) and Latin America and the Caribbean (81.8% (80.1-83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1-60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.
Collapse
Affiliation(s)
- Meghan O'Hearn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
- Food Systems for the Future Institute, Chicago, IL, USA.
| | - Laura Lara-Castor
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Frederick Cudhea
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Julia Reedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - John B Wong
- Tufts University School of Medicine, Boston, MA, USA
- Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Food Science and Nutrition, University of Thessaly, Volos, Greece
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
- Tufts University School of Medicine, Boston, MA, USA.
- Department of Medicine, Tufts Medical Center, Boston, MA, USA.
| |
Collapse
|
12
|
Matabura VV, Rweyemamu LMP. Formulation of plant-based food and characterisation of the nutritional composition: A case study on soy-moringa beverage. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2022; 59:3794-3805. [PMID: 36193372 PMCID: PMC9525469 DOI: 10.1007/s13197-022-05397-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 05/14/2023]
Abstract
Formulation of plant-based food ingredients rich in nutrients is becoming a viable intervention to enhance food security. In this study, a novel soy-moringa beverage was produced using two processing methods. Method I involved blending soymilk and moringa juice, whereas method II dealt with the co-grinding of soymilk together with blanched moringa leaves. The proximate and mineral compositions, pH, total dissolved solids, and viscosity of the soy-moringa beverages were carefully analysed using standard methods. The results showed different nutritional compositions in the soy-moringa beverages formulated. Moreover, method II was found to be the most effective technique to process the soy-moringa beverage. Hence, the proximate compositions were observed to increase significantly (p < 0.05) with an increase in moringa leaves. The amounts of protein, fat, ash, fibre and carbohydrates increased by 49.77%, 8.59%, 84.85%, 85.71%, and 114.56%, respectively with the increase of moringa leaves. The concentrations of β-carotene, iron, calcium, copper, magnesium, and potassium presented an increasing trend by 147%, 40%, 284%, 30%, 12% and 190%, respectively as moringa leaves increase. The quantitative data on nutritional values and physicochemical properties suggested that the soy-moringa beverages produced with 30 and 40% moringa leaves under method II could be suitable to address undernutrition for vulnerable people.
Collapse
Affiliation(s)
- Victor V. Matabura
- Department of Food Science and Technology, University of Dar es Salaam, P. O. Box, 35134, Dar es Salaam, Tanzania
| | - Leonard M. P. Rweyemamu
- Department of Food Science and Technology, University of Dar es Salaam, P. O. Box, 35134, Dar es Salaam, Tanzania
| |
Collapse
|
13
|
Lividini K, Masters WA. Tracing global flows of bioactive compounds from farm to fork in Nutrient Balance Sheets can help guide intervention towards healthier food supplies. NATURE FOOD 2022; 3:703-715. [PMID: 36226129 PMCID: PMC7613697 DOI: 10.1038/s43016-022-00585-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022]
Abstract
Adequate supplies of healthy foods available in each country are a necessary but not sufficient condition for adequate intake by each individual. This study provides complete Nutrient Balance Sheets that account for all plant-based and animal-sourced food flows from farm production through trade to non-food uses and waste in 173 countries from 1961 to 2018. We track 36 bioactive compounds in all farm commodities recorded by the Food and Agriculture Organization of the United Nations, accounting for nutrient-specific losses in processing and cooking as well as bioavailability. We compare supply to requirements given each country's age-sex distribution and find that the adequacy of food supplies has increased but often remains below total needs, with even faster rise in energy levels and lower density of some nutrients per calorie. We use this nutrient accounting to show how gaps could be filled, either from food production and trade or from selected biofortification, fortification and supplementation scenarios for nutrients of concern such as vitamin A, iron and zinc.
Collapse
Affiliation(s)
- Keith Lividini
- Friedman School of Nutrition Science and Policy, Tufts University, Boston MA
- International Food Policy Research Institute (IFPRI), Washington DC
| | - William A Masters
- Friedman School of Nutrition Science and Policy, Tufts University, Boston MA
| |
Collapse
|
14
|
Miller V, Webb P, Cudhea F, Shi P, Zhang J, Reedy J, Erndt-Marino J, Coates J, Mozaffarian D. Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity. NATURE FOOD 2022; 3:694-702. [PMID: 37118151 DOI: 10.1038/s43016-022-00594-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/12/2022] [Indexed: 04/30/2023]
Abstract
Evidence on what people eat globally is limited in scope and rigour, especially as it relates to children and adolescents. This impairs target setting and investment in evidence-based actions to support healthy sustainable diets. Here we quantified global, regional and national dietary patterns among children and adults, by age group, sex, education and urbanicity, across 185 countries between 1990 and 2018, on the basis of data from the Global Dietary Database project. Our primary measure was the Alternative Healthy Eating Index, a validated score of diet quality; Dietary Approaches to Stop Hypertension and Mediterranean Diet Score patterns were secondarily assessed. Dietary quality is generally modest worldwide. In 2018, the mean global Alternative Healthy Eating Index score was 40.3, ranging from 0 (least healthy) to 100 (most healthy), with regional means ranging from 30.3 in Latin America and the Caribbean to 45.7 in South Asia. Scores among children versus adults were generally similar across regions, except in Central/Eastern Europe and Central Asia, high-income countries, and the Middle East and Northern Africa, where children had lower diet quality. Globally, diet quality scores were higher among women versus men, and more versus less educated individuals. Diet quality increased modestly between 1990 and 2018 globally and in all world regions except in South Asia and Sub-Saharan Africa, where it did not improve.
Collapse
Affiliation(s)
- Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
- Population Health Research Institute, Hamilton, Ontario, Canada.
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Frederick Cudhea
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Julia Reedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josh Erndt-Marino
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Coates
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| |
Collapse
|
15
|
Brink LR, Bender TM, Davies R, Luo H, Miketinas D, Shah N, Loveridge N, Gross G, Fawkes N. Optimizing Maternal Nutrition: The Importance of a Tailored Approach. Curr Dev Nutr 2022; 6:nzac118. [PMID: 36157850 PMCID: PMC9492153 DOI: 10.1093/cdn/nzac118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/08/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Improving nutritional status during pregnancy is a global interest. Frequently, women either fail to meet or exceed nutrient recommendations. Current strategies to improve maternal nutrition focus on a "one-size-fits-all" approach and fail to consider individual factors that affect the mother's overall nutritional status. The objectives of this review were to determine the importance of key nutrients for optimal maternal and fetal health, to explore to what extent current recommendations consider individual factors, and to explore novel strategies to close the gap between current guidelines and real-world challenges through more personalized approaches. This review intercalated different nutritional guidelines and recent scientific publications and research initiatives related to maternal nutrition. Based on that, an overview of current recommendations, challenges related to present approaches, and perspectives for future directions are described. Current guidelines are not optimally supporting adequate nutrient intake and health of expectant mothers and their offspring. Existing recommendations are not consistent and do not sufficiently take into account how interindividual variation leads to differences in nutrient status. Personalized nutrition offers women the opportunity to improve their health by using strategies that are tailored to their unique nutritional needs. Such strategies can include personalized supplementation, holistic lifestyle interventions, digital and application-based technologies, and dietary assessment through blood biomarker and genetic analysis. However, these approaches warrant further investigation and optimization. More personalized approaches have the potential to optimize mothers' and their offspring's health outcomes more appropriately to their nutritional needs before, during, and after pregnancy. Moving away from a generalized "one-size-fits-all" approach can be achieved through a variety of means. Future aims should be to provide supporting evidence to create customized subpopulation-based or individualized recommendations, improve nutrition education, and develop novel approaches to improve adherence to dietary and lifestyle interventions.
Collapse
Affiliation(s)
- Lauren R Brink
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Evansville, IN, USA
| | - Tonya M Bender
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Evansville, IN, USA
| | - Rosalind Davies
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| | | | - Derek Miketinas
- Nutrition and Food Sciences, Texas Woman's University, Houston, TX, USA
| | - Neil Shah
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| | - Nik Loveridge
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| | - Gabriele Gross
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Nijmegen, The Netherlands
| | - Neil Fawkes
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| |
Collapse
|
16
|
Passarelli S, Free CM, Allen LH, Batis C, Beal T, Biltoft-Jensen AP, Bromage S, Cao L, Castellanos-Gutiérrez A, Christensen T, Crispim SP, Dekkers A, De Ridder K, Kronsteiner-Gicevic S, Lee C, Li Y, Moursi M, Moyersoen I, Schmidhuber J, Shepon A, Viana DF, Golden CD. Estimating national and subnational nutrient intake distributions of global diets. Am J Clin Nutr 2022; 116:551-560. [PMID: 35687422 PMCID: PMC9348991 DOI: 10.1093/ajcn/nqac108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Access to high-quality dietary intake data is central to many nutrition, epidemiology, economic, environmental, and policy applications. When data on individual nutrient intakes are available, they have not been consistently disaggregated by sex and age groups, and their parameters and full distributions are often not publicly available. OBJECTIVES We sought to derive usual intake distributions for as many nutrients and population subgroups as possible, use these distributions to estimate nutrient intake inadequacy, compare these distributions and evaluate the implications of their shapes on the estimation of inadequacy, and make these distributions publicly available. METHODS We compiled dietary data sets from 31 geographically diverse countries, modeled usual intake distributions for 32 micronutrients and 21 macronutrients, and disaggregated these distributions by sex and age groups. We compared the variability and skewness of the distributions and evaluated their similarity across countries, sex, and age groups. We estimated intake inadequacy for 16 nutrients based on a harmonized set of nutrient requirements and bioavailability estimates. Last, we created an R package-nutriR-to make these distributions freely available for users to apply in their own analyses. RESULTS Usual intake distributions were rarely symmetric and differed widely in variability and skewness across nutrients and countries. Vitamin intake distributions were more variable and skewed and exhibited less similarity among countries than other nutrients. Inadequate intakes were high and geographically concentrated, as well as generally higher for females than males. We found that the shape of usual intake distributions strongly affects estimates of the prevalence of inadequate intakes. CONCLUSIONS The shape of nutrient intake distributions differs based on nutrient and subgroup and strongly influences estimates of nutrient intake inadequacy. This research represents an important contribution to the availability and application of dietary intake data for diverse subpopulations around the world.
Collapse
Affiliation(s)
- Simone Passarelli
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Christopher M Free
- Bren School of Environmental Science and Management, University of California, Santa Barbara, Santa Barbara, CA, USA
- Marine Science Institute, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Lindsay H Allen
- ARS Western Human Nutrition Research Center, USDA, Davis, CA, USA
| | - Carolina Batis
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ty Beal
- Department of Environmental Science and Policy, University of California, Davis, Davis, CA, USA
- Global Alliance for Improved Nutrition, Washington, DC, USA
| | - Anja Pia Biltoft-Jensen
- Division of Food Technology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Sabri Bromage
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Ling Cao
- School of Oceanography, Shanghai Jiao Tong University, Shanghai, China
| | | | - Tue Christensen
- Division of Food Technology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Sandra P Crispim
- Department of Nutrition, Federal University of Paraná, Curitiba, Brazil
| | - Arnold Dekkers
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Karin De Ridder
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Selma Kronsteiner-Gicevic
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Institute for Statistics of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | | | - Yanping Li
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mourad Moursi
- Intake, Center for Dietary Assessment, FHI Solutions, Washington, DC, USA
| | - Isabelle Moyersoen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Josef Schmidhuber
- Trade and Markets Division, UN's Food and Agricultural Organization, Rome, Italy
| | - Alon Shepon
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Studies, The Porter School of the Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel F Viana
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Betty and Gordon Moore Center for Science, Conservation International, Arlington, VA, USA
| | - Christopher D Golden
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
17
|
Fanzo J. The need for nuance with dietary data. Am J Clin Nutr 2022; 116:297-298. [PMID: 35679433 DOI: 10.1093/ajcn/nqac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 04/27/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jessica Fanzo
- Berman Institute of Bioethics, Nitze School of Advanced International Studies (SAIS), Washington, DC, USA.,Bloomberg School of Public Health, Johns Hopkins University, Washington, DC, USA
| |
Collapse
|
18
|
Reverri EJ, Arensberg MB, Murray RD, Kerr KW, Wulf KL. Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding. Nutrients 2022; 14:3093. [PMID: 35956275 PMCID: PMC9370290 DOI: 10.3390/nu14153093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
The first 1000 days is a critical window to optimize nutrition. Young children, particularly 12-24 month-olds, are an understudied population. Young children have unique nutrient needs and reach important developmental milestones when those needs are met. Intriguingly, there are differences in the dietary patterns and recommendations for young children in the US vs. globally, notably for breastfeeding practices, nutrient and food guidelines, and young child formulas (YCFs)/toddler drinks. This perspective paper compares these differences in young child nutrition and identifies both knowledge gaps and surveillance gaps to be filled. Parental perceptions, feeding challenges, and nutrition challenges are also discussed. Ultimately, collaboration among academia and clinicians, the private sector, and the government will help close young child nutrition gaps in both the US and globally.
Collapse
Affiliation(s)
- Elizabeth J. Reverri
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Mary Beth Arensberg
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Robert D. Murray
- Department of Pediatrics, The Ohio State University, Columbus, OH 43219, USA;
| | - Kirk W. Kerr
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Karyn L. Wulf
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| |
Collapse
|
19
|
Hughes J, Pearson E, Grafenauer S. Legumes—A Comprehensive Exploration of Global Food-Based Dietary Guidelines and Consumption. Nutrients 2022; 14:nu14153080. [PMID: 35956258 PMCID: PMC9370574 DOI: 10.3390/nu14153080] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/04/2022] Open
Abstract
Despite the well-known human and planetary health benefits of legumes, consumption is often low. This scoping review aimed to evaluate the inclusion of legumes in global food-based dietary guidelines (FBDG), and to review consumption data against global food group classifications for legumes. The review of FBDG from 94 countries identified legume-based key messaging, the key terms used to define legumes, recommended serving size and frequency of consumption and the classification of legumes into food groups as depicted by food guides. The 2018 Global Dietary Database isolated consumption data of legumes and beans using individual-level, nationally representative dietary survey data for matched countries. Food-based dietary guidelines from 40/94 countries most often identified legumes utilising the term legumes, followed by beans (n = 13), pulses (n = 10), or as beans, peas and lentils (n = 5). The serving size recommendations for legume consumption varied widely, and there was no consistency in the suggested frequency of consumption. Median bean and legume consumption for countries with FBDG ranged from 1.2 g/d (Norway) to 122.7 g/d (Afghanistan). Classification of legumes into food groups varied, with 38% of countries categorising legumes in the protein-rich food group, 20% were in a group on their own and 15% were in the starchy staples group. In countries where legumes were together with either nuts or seeds had the greatest range in intake (11.6–122.7 g/day), followed by those that grouped legumes together with protein-rich foods (4.0–104.7 g/day), while countries that grouped legumes into two food groups, in an attempt to promote consumption, tended to have a lower consumption. Greater emphasis and perhaps repositioning of legumes in dietary guidelines may be required to encourage consumption for health, environmental and economic benefits.
Collapse
Affiliation(s)
- Jaimee Hughes
- Grains & Legumes Nutrition Council, 1 Rivett Rd., North Ryde 2113, Australia
- Correspondence:
| | - Emma Pearson
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong 2522, Australia;
| | - Sara Grafenauer
- School of Health Science, Faculty of Medicine and Health, University of New South Wales, Randwick 2052, Australia;
| |
Collapse
|
20
|
Hammond D, Vanderlee L, White CM, Acton RB, White M, Roberto CA, Cameron A, Sacks G, Kirkpatrick S, Dubin J, Adams J, Jauregui A, Thrasher JF. The Conceptual Framework for the International Food Policy Study: Evaluating the Population-Level Impact of Food Policy. J Nutr 2022; 152:1S-12S. [PMID: 35274695 PMCID: PMC9188864 DOI: 10.1093/jn/nxac042] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/16/2022] [Accepted: 02/20/2022] [Indexed: 11/14/2022] Open
Abstract
An unhealthy diet is among the leading global causes of death and disability. Globally, a range of policies are being implemented to support healthy food choices at a population level, including novel polices in the areas of food marketing, nutrition labeling, and taxation of less healthy foods. There is a need to evaluate and inform the implementation of these policies, including their impacts on marginalized population subgroups. The International Food Policy Study (IFPS) consists of repeated cross-sectional surveys conducted in 5 high- and upper-middle-income countries: Australia, Canada, Mexico, the United Kingdom, and the United States. In each country, approximately 4000 adults and 1200 children and youth (aged 10-17) were recruited from a global commercial panel to complete an online survey using consistent measures and methodologies across countries. The first annual IFPS surveys were conducted in 2017 with adults; annual surveys for young people aged 10-17 were launched in 2019 in the same countries, as well as in Chile. The design of the IFPS surveys creates a framework for evaluating "natural experiments" in food policies, including comparisons over time within countries implementing the policy and comparisons with countries in which the policy was not implemented. IFPS surveys have 3 primary areas of focus: 1) knowledge, attitudes, and beliefs associated with specific policies; 2) diet-related behaviors; and 3) dietary intake, including 24-hour dietary recalls for adults in 4 of the 5 countries. Surveys also assess food insecurity, income adequacy, sex and gender, race/ethnicity, and a range of other measures to assess trends among priority subgroups. Overall, the IFPS project has the potential to address important gaps in national monitoring surveys for dietary patterns, and to evaluate the impacts of novel food policies implemented in any of the 5 countries over the study period.
Collapse
Affiliation(s)
- David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Martin White
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Adrian Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Sharon Kirkpatrick
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joel Dubin
- Department Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Jean Adams
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Alejandra Jauregui
- Centre for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
21
|
Nista F, Bagnasco M, Gatto F, Albertelli M, Vera L, Boschetti M, Musso N, Ferone D. The effect of sodium restriction on iodine prophylaxis: a review. J Endocrinol Invest 2022; 45:1121-1138. [PMID: 35079975 DOI: 10.1007/s40618-022-01749-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Sodium is essential to life. However, its dietary excess is detrimental to the cardiovascular system, and sodium restriction is a crucial step in cardiovascular prevention. Iodine deficiency has been fought worldwide for decades, and substantial success has been achieved introducing the use of iodine-enriched salt. Nevertheless, areas of iodine deficiency persist around the world, both in developing and industrialized countries, and a major concern affecting dietary sodium reduction programs is represented by a possible iodine intake deficiency. There are substantial differences in the source of alimentary iodine among countries, such as iodized salt added, household tap water, seafood, or salt employed in packaged food. It is clear that a sodium-restricted diet can induce differences in terms of iodine intake, depending on the country considered. Moreover, iodine status has undergone relevant changes in many countries in the last years. METHODS Systematic review of literature evidence about the possible effects of sodium restriction on population iodine status. RESULTS To date, the available results are conflicting, depending on country, salt iodization policy, as well as time frame of data collection. However, to ensure an optimal iodine supply by salt fortification, without exceeding the current recommendation by World Health Organization for salt intake, seems to be an achievable goal. CONCLUSION A balanced approach may be obtained by an adequate iodine concentration in fortified salt and by promoting the availability of iodized salt for household consumption and food industry use. In this scenario, updated prospective studies are strongly needed.
Collapse
Affiliation(s)
- F Nista
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - M Bagnasco
- Department of Internal Medicine and Medical Specialties, President-elect of the Italian Thyroid Association, University of Genoa, Genoa, Italy
| | - F Gatto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy.
| | - M Albertelli
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - L Vera
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - M Boschetti
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - N Musso
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - D Ferone
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| |
Collapse
|
22
|
Miller V, Reedy J, Cudhea F, Zhang J, Shi P, Erndt-Marino J, Coates J, Micha R, Webb P, Mozaffarian D. Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database. Lancet Planet Health 2022; 6:e243-e256. [PMID: 35278390 PMCID: PMC8926870 DOI: 10.1016/s2542-5196(21)00352-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diet is a major modifiable risk factor for human health and overall consumption patterns affect planetary health. We aimed to quantify global, regional, and national consumption levels of animal-source foods (ASF) to inform intervention, surveillance, and policy priorities. METHODS Individual-level dietary surveys across 185 countries conducted between 1990 and 2018 were identified, obtained, standardised, and assessed among children and adults, jointly stratified by age, sex, education level, and rural versus urban residence. We included 499 discrete surveys (91·2% nationally or subnationally representative) with data for ASF (unprocessed red meat, processed meat, eggs, seafood, milk, cheese, and yoghurt), comprising 3·8 million individuals from 134 countries representing 95·2% of the world population in 2018. We used Bayesian hierarchical models to account for differences in survey methods and representativeness, time trends, and input data and modelling uncertainty, with five-fold cross-validation. FINDINGS In 2018, mean global intake per person of unprocessed red meat was 51 g/day (95% uncertainty interval [UI] 48-54; region-specific range 7-114 g/day); 17 countries (23·9% of the world's population) had mean intakes of at least one serving (100 g) per day. Global mean intake of processed meat was 17 g/day (95% UI 15-21 g/day; region-specific range 3-54 g/day); seafood, 28 g/day (27-30 g/day; 12-44 g/day); eggs, 21 g/day (18-24 g/day; 6-35 g/day); milk 88 g/day (84-93 g/day; 45-185 g/day); cheese, 8 g/day (8-10 g/day; 1-34 g/day); and yoghurt, 20 g/day (17-23 g/day; 7-84 g/day). Mean national intakes were at least one serving per day for processed meat (≥50 g/day) in countries representing 6·9% of the global population; for cheese (≥42 g/day) in 2·3%; for eggs (≥55 g/day) in 0·7%; for milk (≥245 g/day) in 0·3%; for seafood (≥100 g/day) in 0·8%; and for yoghurt (≥245 g/day) in less than 0·1%. Among the 25 most populous countries in 2018, total ASF intake was highest in Russia (5·8 servings per day), Germany (3·8 servings per day), and the UK (3·7 servings per day), and lowest in Tanzania (0·9 servings per day) and India (0·7 servings per day). Global and regional intakes of ASF were generally similar by sex. Compared with children, adults generally consumed more unprocessed red meat, seafood and cheese, and less milk; energy-adjusted intakes of other ASF were more similar. Globally, ASF intakes (servings per week) were higher among more-educated versus less-educated adults, with greatest global differences for milk (0·79), eggs (0·47), unprocessed red meat (0·42), cheese (0·28), seafood (0·28), yoghurt (0·22), and processed meat (0·21). This was also true for urban compared to rural areas, with largest global differences (servings per week) for unprocessed red meat (0·47), milk (0·38), and eggs (0·20). Between 1990 and 2018, global intakes (servings per week) increased for unprocessed red meat (1·20), eggs (1·18), milk (0·63), processed meat (0·50), seafood (0·44), and cheese (0·14). INTERPRETATION Our estimates of ASF consumption identify populations with both lower and higher than optimal intakes. These estimates can inform the targeting of intervention, surveillance, and policy priorities relevant to both human and planetary health. FUNDING Bill & Melinda Gates Foundation and American Heart Association.
Collapse
Affiliation(s)
- Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Julia Reedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Frederick Cudhea
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jianyi Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josh Erndt-Marino
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Coates
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Department of Food Science and Nutrition, University of Thessaly, Volos, Greece
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| |
Collapse
|
23
|
Hess SY, McLain AC, Frongillo EA, Afshin A, Kassebaum NJ, Osendarp SJM, Atkin R, Rawat R, Brown KH. Challenges for Estimating the Global Prevalence of Micronutrient Deficiencies and Related Disease Burden: A Case Study of the Global Burden of Disease Study. Curr Dev Nutr 2021; 5:nzab141. [PMID: 34993390 PMCID: PMC8728001 DOI: 10.1093/cdn/nzab141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/05/2021] [Accepted: 11/16/2021] [Indexed: 11/12/2022] Open
Abstract
Information on the prevalence of micronutrient deficiencies is needed to determine related disease burden; underpin evidence-based advocacy; and design, deliver, and monitor safe, effective interventions. Assessing the global prevalence of deficiency requires a valid micronutrient status biomarker with an appropriate cutoff to define deficiency and relevant data from representative surveys across multiple locations and years. The Global Burden of Disease Study includes prevalence estimates for iodine, iron, zinc, and vitamin A deficiencies, for which recommended biomarkers and appropriate deficiency cutoffs exist. Because representative survey data are lacking, only retinol concentration is used to model vitamin A deficiency, and proxy indicators are used for the other micronutrients (goiter for iodine, hemoglobin for iron, and dietary food adequacy for zinc). Because of data limitations, complex statistical modeling is required to produce current estimates, relying on assumptions and proxies that likely understate the extent of micronutrient deficiencies and the consequent global health burden.
Collapse
Affiliation(s)
- Sonja Y Hess
- Institute for Global Nutrition and Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Reed Atkin
- The Micronutrient Forum, Washington, DC, USA
| | - Rahul Rawat
- Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Kenneth H Brown
- Institute for Global Nutrition and Department of Nutrition, University of California, Davis
, Davis, CA, USA
| |
Collapse
|
24
|
Micronutrient supply from global marine fisheries under climate change and overfishing. Curr Biol 2021; 31:4132-4138.e3. [PMID: 34289388 DOI: 10.1016/j.cub.2021.06.067] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022]
Abstract
Fish are rich in bioavailable micronutrients, such as zinc and iron, deficiencies of which are a global food security concern.1,2 Global marine fisheries yields are threatened by climate change and overfishing,3,4 yet understanding of how these stressors affect the nutrients available from fisheries is lacking.5,6 Here, using global assessments of micronutrient content2 and fisheries catch data,7 we investigate how the vulnerability status of marine fish species8,9 may translate into vulnerability of micronutrient availability at scales of both individual species and entire fishery assemblages for 157 countries. We further quantify the micronutrient evenness of catches to identify countries where interventions can optimize micronutrient supply. Our global analysis, including >800 marine fish species, reveals that, at a species level, micronutrient availability and vulnerability to both climate change and overfishing varies greatly, with tropical species displaying a positive co-tolerance, indicating greater persistence to both stressors at a community level.10 Global fisheries catches had relatively low nutritional vulnerability to fishing. Catches with higher species richness tend to be nutrient dense and evenly distributed but are more vulnerable to climate change, with 40% of countries displaying high vulnerability. Countries with high prevalence of inadequate micronutrient intake tend to have the most nutrient-dense catches, but these same fisheries are highly vulnerable to climate change, with relatively lower capacity to adapt.11 Our analysis highlights the need to consolidate fisheries, climate, and food policies to secure the sustainable contribution of fish-derived micronutrients to food and nutrition security.
Collapse
|