A Review of the Science of Colorful, Plant-Based Food and Practical Strategies for "Eating the Rainbow"

Not All Maca Is Created Equal: A Review of Colors, Nutrition, Phytochemicals, and Clinical Uses

Maca (Lepidium meyenii, Lepidium peruvianum) is part of the Brassicaceae family and grows at high altitudes in the Peruvian Andes mountain range (3500-5000 m). Historically, it has been used as a nutrient-dense food and for its medicinal properties, primarily in enhancing energy and fertility. Scientific research has validated these traditional uses and other clinical applications by elucidating maca's mechanisms of action, nutrition, and phytochemical content. However, research over the last twenty years has identified up to seventeen different colors (phenotypes) of maca. The color, hypocotyl size, growing location, cultivation, and post-harvest processing methods can have a significant effect on the nutrition content, phytochemical profile, and clinical application. Yet, research differentiating the colors of maca and clinical applications remains limited. In this review, research on the nutrition, phytochemicals, and various colors of maca, including black, red, yellow (predominant colors), purple, gray (lesser-known colors), and any combination of colors, including proprietary formulations, will be discussed based on available preclinical and clinical trials. The gaps, deficiencies, and conflicts in the studies will be detailed, along with quality, safety, and efficacy criteria, highlighting the need for future research to specify all these factors of the maca used in publications.

The Systematic Assessment of the Membrane-Stabilizing and Antioxidant Activities of Several Kazakhstani Plants in the Asteraceae Family

The objective of our research was to examine the antioxidant and membrane-protective characteristics of a few medicinal plant extracts belonging to the Asteracea family, along with their flavonoid and polyphenolic content, in order to identify strategies for enhancing beverage composition and boosting the antioxidant capacity of green and black tea. The activity of aqueous-ethanolic extracts from the dried parts of plants, such as Arictum tomentosum Mill., Ghnapilum kasachstanicum Kirp. & Kuprian. ex Kirp., Artemisia schrenkiana Ledeb., A. rutifolia Steph. ex Spreng., A. cina O.Berg, and A. vulgaris L., were examined using a model of Wistar rats. Thiobarbituric acid-reacting substances (TBARS), a marker of malondialdehyde concentration, were used to measure the amount of lipid peroxidation (LPO) in liver microsomes. Considering the outcomes, the extracts from A. tomentosum, G. kasachstanicum, and A. vulgaris exhibit the strongest membrane-stabilizing action among those examined. At a concentration of 5 g/mL, the extracts of these plants demonstrated a significant anti-hemolitic impact, whereas the remaining extracts displayed a similar effect at doses above 10 g/mL. Accordingly, among the extracts studied, the A. tomentosum, G. kasachstanicum, A. schrenkiana, A. rutifolia, A. cina, and A. vulgaris extracts have significant antioxidant properties. The integrated antioxidant and antihemolytic qualities of A. tomentosum and green tea extracts were comparable to those of the individual plant extracts. When the extracts of A. schrenkiana and green tea were combined, similar outcomes were seen, suggesting that there was no appreciable synergistic interaction.

NutriColoring: designing a doodling toolkit to support daily self-reported dietary assessment among office workers

This study was motivated by a desire to help working-age individuals gain a better understanding of their daily nutritional intakes with a new self-reported dietary assessment method because an unhealthy eating behavior increases the risks of developing chronic diseases. In this study, we present the design and evaluation of NutriColoring, a food diary that leverages doodling on sketches to report and reflect on everyday diet in the working context. Through a 2-week field study involving 18 participants, the usefulness of NutriColoring in facilitating dietary assessment was tested by making comparisons with the typical bullet diary method. Our quantitative results showed that NutriColoring provided users with improved dietary assessment experience and intrinsic motivations, with significantly low task frustration and high enjoyment. Because of the freedom and playfulness in reporting intakes at work, the interview findings showed a high acceptance of employing NutriColoring at work. This article is concluded with a set of implications for the design and development of a Doodling toolkit to support healthy eating behaviors among office workers.

Nutrient synergy: definition, evidence, and future directions

Nutrient synergy refers to the concept that the combined effects of two or more nutrients working together have a greater physiological impact on the body than when each nutrient is consumed individually. While nutrition science traditionally focuses on isolating single nutrients to study their effects, it is recognized that nutrients interact in complex ways, and their combined consumption can lead to additive effects. Additionally, the Dietary Reference Intakes (DRIs) provide guidelines to prevent nutrient deficiencies and excessive intake but are not designed to assess the potential synergistic effects of consuming nutrients together. Even the term synergy is often applied in different manners depending on the scientific discipline. Considering these issues, the aim of this narrative review is to investigate the potential health benefits of consuming different nutrients and nutrient supplements in combination, a concept we define as nutrient synergy, which has gained considerable attention for its impact on overall well-being. We will examine how nutrient synergy affects major bodily systems, influencing systemic health. Additionally, we will address the challenges associated with promoting and conducting research on this topic, while proposing potential solutions to enhance the quality and quantity of scientific literature on nutrient synergy.

Association of pre-diagnosis specific color groups of fruit and vegetable intake with ovarian cancer survival: results from the ovarian cancer follow-up study (OOPS)

Background: The colors of fruits and vegetables (FV) reflect the presence of pigmented bioactive compounds. The evidence of pre-diagnosis specific FV color group intake contributing to ovarian cancer (OC) survival is limited and inconsistent. Methods: A prospective cohort study was conducted between 2015 and 2020 with 700 newly diagnosed OC patients. Pre-diagnosis dietary information was assessed by a validated food frequency questionnaire. We classified FV into five groups based on the color of their edible parts (e.g., green, red/purple, orange/yellow, white, and uncategorized groups). Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of specific color groups of FV before diagnosis with OC survival. Potential multiplicative and additive interactions were assessed. Results: 130 patients died during a median follow-up of 37.57 (interquartile: 24.77-50.20) months. We observed the improved survival with a higher pre-diagnosis intake of total FV (HRtertile 3 vs. tertile 1 = 0.63, 95%CI = 0.40-0.99), total vegetables (HRtertile 3 vs. tertile 1 = 0.57, 95%CI = 0.36-0.90), and red/purple FV (HRtertile 3 vs. tertile 1 = 0.52, 95%CI = 0.33-0.82). In addition, we observed significant dose-response relationships for per standard deviation increment between total vegetable intake (HR = 0.79, 95%CI = 0.65-0.96) and red/purple group intake (HR = 0.77, 95%CI = 0.60-0.99) before diagnosis with OC survival. Additionally, pre-diagnosis green FV intake was borderline associated with better OC survival (HRper standard deviation increment = 0.83; 95%CI = 0.69-1.00). In contrast, we did not observe significant associations between pre-diagnosis intake of total fruits, orange/yellow, white, and uncategorized groups and OC survival. Conclusion: Pre-diagnosis FV intake from various color groups, especially the green and red/purple ones, may improve OC survival. Further studies are needed to validate our findings.

Contribution of Different Food Types to Vitamin A Intake in the Chinese Diet

Vitamin A is a fat-soluble micronutrient that is essential for human health. In this study, the daily vitamin A intake of Chinese residents was evaluated by investigating the vitamin A content of various foods. The results show that the dietary intake of vitamin A in common foods was 460.56 ugRAE/day, which is significantly lower than the recommended dietary reference intake of vitamin A (800 ugRAE/day for adult men and 700 ugRAE/day for adult women). Vegetables contributed the most to daily vitamin A dietary intake, accounting for 54.94% of vitamin A intake (253.03 ugRAE/day), followed by eggs, milk, aquatic products, meat, fruit, legumes, coarse cereals, and potatoes. Therefore, an increase in the vitamin A content of vegetables and the fortification of vegetable oils with vitamin A are effective ways to increase vitamin A intake to meet the recommended dietary guidelines in China. The assessment results support the design of fortified foods.

Quantity and Variety in Fruit and Vegetable Consumption and Mortality in Older Chinese: A 15-year Follow-Up of a Prospective Cohort Study

BACKGROUND

Independent associations of quantity and variety of fruit and vegetables (FVs) with mortality in older people are still unclear.

OBJECTIVES

This study aimed to explore the association between the quantity and variety in FV consumption and mortality in older Chinese.

METHODS

A total of 19,597 participants of the Guangzhou Biobank Cohort Study aged >50 y were recruited from 2003 to 2006 and followed up until April 2021. The diet was assessed using a 300-item validated FFQ. Variety as a continuous variable was defined as the number of unique FV items (excluding potatoes, legumes, and fruit juices) intake per week over the past week. The associations of quantity and variety of FVs with mortality were analyzed, and analyses by the color of edible parts was performed. Multivariable Cox regression yielded HRs and 95% CIs.

RESULTS

During 286,821 person-year of follow-up, 4385 deaths occurred, including 1678 cardiovascular diseases (CVD), 1450 cancer, and 1257 other causes. Compared with the lowest quintile of variety in FV, the highest quintile was associated with lower risks of all-cause (HR: 0.81; 95% CI: 0.73-0.89) and CVD mortality (HR: 0.79; 95% CI 0.67-0.92). A greater variety of green and white FV intake was associated with lower risks of all-cause and CVD morality, and a greater variety of red/purple FV intake was associated with lower risks of all-cause and cancer mortality. However, the quantity of FV intake showed no association with all-cause, CVD, and cancer mortality.

CONCLUSION

Our findings have first showed that the variety, rather than quantity, in FV intake was associated with a lower risk of mortality in older Chinese. Dietary guidelines may recommend increasing the variety in FV intake, especially green, red/purple, and white FVs in older people.

Phytochemical Profiling, and Antioxidant Potentials of South African and Nigerian Loranthus micranthus Linn.: The African Mistletoe Exposé

Loranthus micranthus Linn. (Loranthaceae) is a botanically significant hemiparasite that grows on tree branches or trunks and is used in traditional medicine. This study compares the antioxidant activity and qualitative phytochemical screening of Nigerian and South Africa Loranthus micranthus Linn. Standard techniques for phytochemical screening were deployed while thin layer chromatography (TLC) bio-autography was utilized to analyze antioxidants qualitatively. Quantitative antioxidant analysis was performed using 2,2-diphenyl-1-picrylhydrazyl (DPPH); hydrogen peroxide (H2O2) free-radical scavenging; and ferric chloride reducing power. The results of qualitative phytochemical screening revealed the presence of flavonoids; glycosides; saponins; phenolic compounds; phlobatannins; tannins; and terpenoids. As for the antioxidant potentials of the four extracts-i.e., Nigerian dichloromethane (NGDCM); South African dichloromethane (SADCM); Nigerian methanol (NGMeOH); and South African methanol (SAMeOH)-the SADCM extract had more creamy bands compared to the Nigerian, thus indicating potentially more antioxidant compounds. A better complementary antioxidant potential was observed for the Nigerian methanol extracts over their South African counterparts. The DPPH quantitative analyses underpin that the SADCM exhibited greater scavenging activity compared to the NGDCM, but this was less than the gallic acid control, with the highest activity at a concentration of 0.2 mg/mL and 0.4 mg/mL, respectively. However, as the concentration increased from 0.6 to 1.0 mg/mL, the SADCM again dominated in its antioxidant potential over all the analytes. The half maximal inhibitory concentration (IC50) values obtained were [SADCM = 0.31 mg/mL, NGDCM = 0.51 mg/mL, SAMeOH = 0.51 mg/mL, NGMeO = 0.17, gallic acid = 1.17 mg/mL, and BHT = 1.47 Mg/mL)]. Both the H2O2 scavenging and the Fe3+ to Fe2+ reduction assays mirrored a similar trend in the antioxidant potentials of all the analytes except for the BHT, which performed better in the ferric chloride reduction assay at a concentration of 0.2-06 mg/mL. Based on the facts gathered, it can be inferred that the South African and Nigerian Loranthus micranthus Linn. are chemically equivalent. This is in support of their similar morphology and taxonomical classification, notwithstanding the environmental, biological, and edaphic impacts experienced by each plant.

Impact of Starch-Rich Food Matrices on Black Rice Anthocyanin Accessibility and Carbohydrate Digestibility

Anthocyanins reduce starch digestibility via carbohydrase-inhibitory pathways, but food matrix effects during digestion may also influence its enzymatic function. Understanding anthocyanin-food matrix interactions is significant as the efficiency of carbohydrase inhibition relies on anthocyanin accessibility during digestion. Therefore, we aimed to evaluate the influence of food matrices on black rice anthocyanin accessibility in relation to starch digestibility in common settings of anthocyanin consumption-its co-ingestion with food, and consumption of fortified food. Our findings indicate that black rice anthocyanin extracts (BRAE) had reduced intestinal digestibility of bread to a larger extent for the co-digestion of BRAE with bread (39.3%) (4CO), than BRAE-fortified bread (25.9%) (4FO). Overall anthocyanin accessibility was about 5% greater from the co-digestion with bread than fortified bread across all digestion phases. Differences in anthocyanin accessibility were also noted with changes to gastrointestinal pH and food matrix compositions-with up to 10.1% (oral to gastric) and 73.4% (gastric to intestinal) reductions in accessibility with pH changes, and 3.4% greater accessibility in protein matrices than starch matrices. Our findings demonstrate that the modulation of starch digestibility by anthocyanin is a combined result of its accessibility, food matrix composition, and gastrointestinal conditions.

Microgreens-A Comprehensive Review of Bioactive Molecules and Health Benefits

Microgreens, a hypothesized term used for the emerging food product that is developed from various commercial food crops, such as vegetables, grains, and herbs, consist of developed cotyledons along with partially expanded true leaves. These immature plants are harvested between 7-21 days (depending on variety). They are treasured for their densely packed nutrients, concentrated flavors, immaculate and tender texture as well as for their vibrant colors. In recent years, microgreens are on demand from high-end restaurant chefs and nutritional researchers due to their potent flavors, appealing sensory qualities, functionality, abundance in vitamins, minerals, and other bioactive compounds, such as ascorbic acid, tocopherol, carotenoids, folate, tocotrienols, phylloquinones, anthocyanins, glucosinolates, etc. These qualities attracted research attention for use in the field of human health and nutrition. Increasing public concern regarding health has prompted humans to turn to microgreens which show potential in the prevention of malnutrition, inflammation, and other chronic ailments. This article focuses on the applications of microgreens in the prevention of the non-communicable diseases that prevails in the current generation, which emerged due to sedentary lifestyles, thus laying a theoretical foundation for the people creating awareness to switch to the recently introduced category of vegetable and providing great value for the development of health-promoting diets with microgreens.

A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now?

Purpose of Review

The relationship between cardiovascular health and diet is evolving. Lifestyle modifications including diet changes are the primary approach in managing cardiometabolic risk factors. Thus, understanding different diets and their impact on cardiovascular health is important in guiding primary and secondary prevention of cardiovascular disease (CVD). Yet, there are many barriers and limitations to adopting a heart healthy diet.

Recent Findings

Diets rich in fruits, vegetables, legumes, whole grains, and lean protein sources, with minimization/avoidance of processed foods, trans-fats, and sugar sweetened beverages, are recommended by prevention guidelines. The Mediterranean, DASH, and plant-based diets have all proven cardioprotective in varying degrees and are endorsed by professional healthcare societies, while other emerging diets such as the ketogenic diet and intermittent fasting require more long-term study. The effects of diet on the gut microbiome and on cardiovascular health have opened a new path for precision medicine to improve cardiometabolic risk factors. The effects of certain dietary metabolites, such as trimethylamine N-oxide, on cardiometabolic risk factors, along with the changes in the gut microbiome diversity and gene pathways in relation to CVD management, are being explored.

Summary

In this review, we provide a comprehensive up-to-date overview on established and emerging diets in cardiovascular health. We discuss the effectiveness of various diets and most importantly the approaches to nutritional counseling where traditional and non-traditional approaches are being practiced, helping patients adopt heart healthy diets. We address the limitations to adopting a heart healthy diet regarding food insecurity, poor access, and socioeconomic burden. Lastly, we discuss the need for a multidisciplinary team-based approach, including the role of a nutrition specialist, in implementing culturally-tailored dietary recommendations. Understanding the limitations and finding ways to overcome the barriers in implementing heart-healthy diets will take us miles in the path to CVD prevention and management.

Functional Complementation of Anti-Adipogenic Phytonutrients for Obesity Prevention and Management

Obesity is an established risk factor for metabolic disease. This study explores the functional complementation of anti-adipogenic phytonutrients for obesity prevention and management. Nine phytonutrients were selected based on their ability to affect the expression of one or more selected adipogenic biomarker proteins. The phytonutrients include berberine, luteolin, resveratrol, fisetin, quercetin, fucoidan, epigallocatechin gallate, hesperidin, and curcumin. The selected adipogenic biomarker proteins include PPARɣ, SREBP1c, FASN, PLIN1, FABP4, and β-catenin. Individually, phytonutrients had variable effects on the expression level of selected adipogenic biomarker proteins. Collectively, the functional complementation of nine phytonutrients suppressed de novo fatty acid biosynthesis via the negative regulation of PPARɣ, FASN, PLIN1, and FABP4 expression; activated glycolysis via the positive regulation of SREBP1c expression; and preserved cell–cell adhesion via the inhibition of β-catenin degradation. In primary human subcutaneous preadipocytes, the composition of nine phytonutrients had more potent and longer lasting anti-adipogenic effects compared to individual phytonutrients. In a diet-induced obesity murine model, the composition of nine phytonutrients improved glucose tolerance and reduced weight gain, liver steatosis, visceral adiposity, circulating triglycerides, low-density lipoprotein cholesterol, and inflammatory cytokines and chemokines. The functional complementation of anti-adipogenic phytonutrients provides an effective approach toward engineering novel therapeutics for the prevention and management of obesity and metabolic syndrome.

Should We ‘Eat a Rainbow’? An Umbrella Review of the Health Effects of Colorful Bioactive Pigments in Fruits and Vegetables

Health promotion campaigns have advocated for individuals to ‘eat a rainbow’ of fruits and vegetables (FV). However, the literature has only focused on individual color pigments or individual health outcomes. This umbrella review synthesized the evidence on the health effects of a variety of color-associated bioactive pigments found in FV (carotenoids, flavonoids, betalains and chlorophylls), compared to placebo or low intakes. A systematic search of PubMed, EMBASE, CINAHL and CENTRAL was conducted on 20 October 2021, without date limits. Meta-analyzed outcomes were evaluated for certainty via the GRADE system. Risk of bias was assessed using the Centre for Evidence-Based Medicine critical appraisal tools. A total of 86 studies were included, 449 meta-analyzed health outcomes, and data from over 37 million participants were identified. A total of 42% of health outcomes were improved by color-associated pigments (91% GRADE rating very low to low). Unique health effects were identified: n = 6 red, n = 10 orange, n = 3 yellow, n = 6 pale yellow, n = 3 white, n = 8 purple/blue and n = 1 green. Health outcomes associated with multiple color pigments were body weight, lipid profile, inflammation, cardiovascular disease, mortality, type 2 diabetes and cancer. Findings show that color-associated FV variety may confer additional benefits to population health beyond total FV intake.

Statistical Methods for the Analysis of Food Composition Databases: A Review

Evidence-based knowledge of the relationship between foods and nutrients is needed to inform dietary-based guidelines and policy. Proper and tailored statistical methods to analyse food composition databases (FCDBs) could assist in this regard. This review aims to collate the existing literature that used any statistical method to analyse FCDBs, to identify key trends and research gaps. The search strategy yielded 4238 references from electronic databases of which 24 fulfilled our inclusion criteria. Information on the objectives, statistical methods, and results was extracted. Statistical methods were mostly applied to group similar food items (37.5%). Other aims and objectives included determining associations between the nutrient content and known food characteristics (25.0%), determining nutrient co-occurrence (20.8%), evaluating nutrient changes over time (16.7%), and addressing the accuracy and completeness of databases (16.7%). Standard statistical tests (33.3%) were the most utilised followed by clustering (29.1%), other methods (16.7%), regression methods (12.5%), and dimension reduction techniques (8.3%). Nutrient data has unique characteristics such as correlated components, natural groupings, and a compositional nature. Statistical methods used for analysis need to account for this data structure. Our summary of the literature provides a reference for researchers looking to expand into this area.

Association of fruit and vegetable color with incident diabetes and cardiometabolic risk biomarkers in the United States Hispanic/Latino population

Background

Color groups of fruits and vegetables (FV) are part of a healthy diet, but evidence for an association with cardiometabolic outcomes is inconsistent.

Objective

To examine the association between intake of FV of different colors with incident diabetes and cardiometabolic risk biomarkers among U.S. Hispanics/Latinos.

Subjects/methods

We used data from 9206 adults ages 18–74 years who were free of diabetes at baseline (2008–2011) and had follow-up data at visit 2 (2014–2017) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter, prospective cohort study of self-identified Hispanics/Latinos. Dietary intake was assessed using two 24 h recalls at baseline. FV were categorized into five color groups: green, white, yellow/orange, red/purple, and uncategorized. Diabetes was defined based on laboratory measures and self-reported antihyperglycemic medication. We used survey logistic regression models to evaluate the association between FV color groups and incident diabetes and survey linear regression models to evaluate the association of FV color groups with cardiometabolic risk biomarkers at visit 2.

Results

During ~6 years of follow-up, 970 incident cases of diabetes were documented. The red/purple FV color group was the least consumed (0.21 servings/day), whereas white FV were the most consumed (0.92 servings/day). For each serving of total FV intake, body mass index (BMI) was lower by 0.24% (p = 0.03) and insulin by 0.69% (p = 0.03). For each serving of red/purple FV intake, HDL was 1.59% higher (p = 0.04). For each serving of white FV intake (with potato), post-OGTT was 0.83% lower (p = 0.04) and triglycerides 1.43% lower (p = 0.04). There was no association between FV intake and incident diabetes.

Conclusions

Specific FV colors were associated with cardiometabolic benefits though the associations were of relatively small magnitudes. Dietary recommendations could consider varying colors of FV intake, especially white and red/purple color groups, for a healthy diet.

Metabolic Bone Diseases and New Drug Developments

Metabolic bone diseases are serious health issues worldwide, since several million individuals over the age of 50 are at risk of bone damage and should be worried about their bone health. One in every two women and one in every four men will break a bone during their lifetime due to a metabolic bone disease. Early detection, raising bone health awareness, and maintaining a balanced healthy diet may reduce the risk of skeletal fractures caused by metabolic bone diseases. This review compiles information on the most common metabolic bone diseases (osteoporosis, primary hyperparathyroidism, osteomalacia, and fluorosis disease) seen in the global population, including their symptoms, mechanisms, and causes, as well as discussing their prevention and the development of new drugs for treatment. A large amount of research literature suggests that balanced nutrition and balanced periodic supplementation of calcium, phosphate, and vitamin D can improve re-absorption and the regrowth of bones, and inhibit the formation of skeletal fractures, except in the case of hereditary bone diseases. Meanwhile, new and improved drug formulations, such as raloxifene, teriparatide, sclerostin, denosumab, and abaloparatide, have been successfully developed and administered as treatments for metabolic bone diseases, while others (romososumab and odanacatib) are in various stages of clinical trials.

The Anti-Cancer Effects of Red-Pigmented Foods: Biomarker Modulation and Mechanisms Underlying Cancer Progression

Cancer is one the most malignant diseases that is a leading cause of death worldwide. Vegetables and fruits contain beneficial nutrients such as vitamins, minerals, folates, dietary fibers, and various natural bioactive compounds. These can prevent the pathological processes of many cancers and reduce cancer related mortality. Specifically, the anti-cancer effect of vegetables and fruits is largely attributable to the natural bioactive compounds present within them. A lot of bioactive compounds have very specific colors with pigments and the action of them in the human body varies by their color. Red-pigmented foods, such as apples, oranges, tomatoes, cherries, grapes, berries, and red wine, have been widely reported to elicit beneficial effects and have been investigated for their anti-tumor, anti-inflammatory, and antioxidative properties, as well as anti-cancer effect. Most of the anti-cancer effects of bioactive compounds in red-pigmented foods arise from the suppression of cancer cell invasion and metastasis, as well as the induction of apoptosis and cell cycle arrest. In this review, we assessed publications from the last 10 years and identified 10 bioactive compounds commonly studied in red-pigmented foods: lycopene, anthocyanin, β-carotene, pectin, betaine, rutin, ursolic acid, kaempferol, quercetin, and myricetin. We focused on the mechanisms and targets underlying the anti-cancer effect of the compounds and provided rationale for further investigation of the compounds to develop more potent anti-cancer treatment methods.

Physiological Effects of Red-Colored Food-Derived Bioactive Compounds on Cardiovascular and Metabolic Diseases

Cardiovascular diseases (CVDs) are a major global cause of disease and mortality. CVDs are a group of disorders of the heart and blood vessels and include coronary artery disease, cerebrovascular disease, heart failure, and other conditions. The most important behavioral risk factors for heart disease and stroke are diet, physical activity, smoking, and drinking. Increased intake of fruits and vegetables is associated with reducing the risk of metabolic syndrome and CVDs. Red-colored foods align with cardiovascular health by protecting the heart and blood vessels. Red fruits and vegetables include tomatoes, strawberries, raspberries, cranberries, cherries, red apples, beets, and pomegranate. In vitro and in vivo studies, as well as clinical trials, show that the components of red foods demonstrate various potential health benefits against disease. In conclusion, there are many advantages to eating vegetable foods, especially red fruits and vegetables.

Clinical Understanding of the Sleep-Immune Connection

The science of sleep is becoming better understood all the time, and here is a fact that has only recently been revealed: sleep and immune system function have a bidirectional relationship. The disturbance of sleep can create an alteration in immune function. The opposite is also true, in that activation of the immune system can create a disturbance in sleep cycling. This dynamic can ultimately create a feed-forward loop of increasing immune dysfunction and sleep disruption. These systems are intimately intertwined. The clinical approach should be to intervene upstream in the regulation of the fundamental systems that control both sleep and immune function. Through the implementation of this approach, the treatment will focus on the cause of the epigenetic modulation of the sleep-immune system imbalance, and not just its effects and symptomatology.

A 10-Year Journey to Diagnosis With Endometriosis: An Autobiographical Case Report

Endometriosis is a multifocal, chronic disease defined by extrauterine endometrial glands and stroma. This case report describes the author’s experience of living with stage IV endometriosis, including a 10-year diagnostic delay, the impact on daily life, management, and treatment. The diagnostic delay for endometriosis averages between seven to nine years globally, which imparts significant physical, psychological, and financial effects on the lives of patients.

Higher fruit and vegetable variety associated with lower risk of cognitive impairment in Chinese community-dwelling older men: a 4-year cohort study

PURPOSE

Few studies have examined the variety in fruit and vegetable (FV) intake with cognitive impairment in older adults. This study examined the associations of variety in fruit, vegetable and combined FV with 4-year incident cognitive impairment in Chinese community-dwelling older adults.

METHODS

Data was derived from a cohort study among Chinese community-dwelling older adults aged ≥ 65 years in Hong Kong. At baseline, a validated food frequency questionnaire was used to assess variety in fruit, vegetable and combined FV. Cognitive impairment was defined as a Community Screening Instrument of Dementia score of < 29.5 points and/or Mini-Mental State Examination score of < 27 points. Adjusted multiple logistic regression was performed to examine the associations. Results are presented as odds ratio (OR) and 95% confidence interval (CI).

RESULTS

Of the 1518 participants [median age: 70 years (IQR 68-74), 32.7% women] included at baseline, 300 men and 111 women were newly identified as cognitively impaired at the 4-year follow-up. In men, higher variety in vegetable (adjusted OR: 0.97, 95% CI 0.95-0.99, p = 0.029) and combined FV (adjusted OR: 0.98, 95% CI 0.96-0.98, p = 0.039) were significantly associated with a lower risk of cognitive impairment. Fruit variety was not associated with cognitive impairment. In women, there were no associations between variety in fruit, vegetable and combined FV with cognitive impairment in the adjusted model.

CONCLUSION

Independent of FV quantity, higher variety in vegetable and combined FV were associated with lower risk of cognitive impairment in Chinese community-dwelling older adults, and these associations were only observed in men.

Automated food intake tracking requires depth-refined semantic segmentation to rectify visual-volume discordance in long-term care homes

Malnutrition is a multidomain problem affecting 54% of older adults in long-term care (LTC). Monitoring nutritional intake in LTC is laborious and subjective, limiting clinical inference capabilities. Recent advances in automatic image-based food estimation have not yet been evaluated in LTC settings. Here, we describe a fully automatic imaging system for quantifying food intake. We propose a novel deep convolutional encoder-decoder food network with depth-refinement (EDFN-D) using an RGB-D camera for quantifying a plate's remaining food volume relative to reference portions in whole and modified texture foods. We trained and validated the network on the pre-labelled UNIMIB2016 food dataset and tested on our two novel LTC-inspired plate datasets (689 plate images, 36 unique foods). EDFN-D performed comparably to depth-refined graph cut on IOU (0.879 vs. 0.887), with intake errors well below typical 50% (mean percent intake error: [Formula: see text]%). We identify how standard segmentation metrics are insufficient due to visual-volume discordance, and include volume disparity analysis to facilitate system trust. This system provides improved transparency, approximates human assessors with enhanced objectivity, accuracy, and precision while avoiding hefty semi-automatic method time requirements. This may help address short-comings currently limiting utility of automated early malnutrition detection in resource-constrained LTC and hospital settings.

2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association

Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights structural challenges that impede adherence to heart-healthy dietary patterns. Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: (1) adjust energy intake and expenditure to achieve and maintain a healthy body weight; (2) eat plenty and a variety of fruits and vegetables; (3) choose whole grain foods and products; (4) choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms); (5) use liquid plant oils rather than tropical oils and partially hydrogenated fats; (6) choose minimally processed foods instead of ultra-processed foods; (7) minimize the intake of beverages and foods with added sugars; (8) choose and prepare foods with little or no salt; (9) if you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake; and (10) adhere to this guidance regardless of where food is prepared or consumed. Challenges that impede adherence to heart-healthy dietary patterns include targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism. Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.

Experiential Learning Interventions and Healthy Eating Outcomes in Children: A Systematic Literature Review

Experiential learning is the process where learners create meaning from direct experience. This systematic review aimed to examine the effects of experiential learning activities on dietary outcomes (knowledge, attitudes, behaviors) in children. Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO were searched from database inception to 2020. Eligible studies included children 0-12 years, assessed effect of experiential learning on outcomes of interest compared to non-experiential learning and were open to any setting. The quality of studies was assessed using the revised Cochrane risk of bias tool by two independent reviewers and effect size was calculated on each outcome. Nineteen studies were conducted in primary school, six in pre-school and one in an outside-of-school setting and used nine types of experiential learning strategies. Cooking, taste-testing, games, role-playing, and gardening were effective in improving nutrition outcomes in primary school children. Sensory evaluation, games, creative arts, and storybooks were effective for preschool children. Multiple strategies involving parents, and short/intense strategies are useful for intervention success. Experiential learning is a useful strategy to improve children's knowledge, attitudes, and behaviors towards healthy eating. Fewer studies in pre-school and outside of school settings and high risk of bias may limit the generalizability and strength of the findings.

Analysis of chemical compounds’ content in different varieties of carrots, including qualification and quantification of sugars, organic acids, minerals, and bioactive compounds by UPLC

Twelve carrot varieties in different colours and sizes were investigated for chemical properties (dry matter, ash, pectins, titratable acidity, and pH), contents of vitamin C, sugar, organic acids, mineral (sodium, potassium, calcium, iron, and magnesium), and anti-oxidant activities (ABTS, FRAP, and ORAC). Moreover, total polyphenolics and total tetraterpenoids of colourful carrot varieties were presented. According to the study, sucrose was the dominant sugar and isocitric acid was the most common organic acid in carrot samples. In the case of mineral content, potassium, sodium, calcium, magnesium, and iron were identified, while copper was not identified in carrots. Additionally, most of the analyzed carrots were a good source of pectins (average—1.3%), except for mini-orange carrot. Purple-coloured carrot samples demonstrated the highest results for total sugar (11.2 g/100 g fm), total organic acid (2.8 g/100 g fm), total polyphenolic contents (224.4 mg/100 g fm), and anti-oxidant activities (17.1 mmol Trolox equivalents/100 g dm). In turn, the lowest results were observed in normal yellow carrot for total polyphenols (7.3 mg/100 g fm), and anti-oxidant activities (2.5 mmol Trolox equivalents/100 g dm); besides, the lowest total tetraterpenoids were determined in micro-white carrot—0.2 mg/100 g fm.

Fruit consumption and cardiometabolic risk in the PREDIMED-plus study: A cross-sectional analysis

BACKGROUND AND AIMS

Total fruit consumption is important for cardiovascular disease prevention, but also the variety and form in which is consumed. The aim of the study was to assess the associations between total fruit, subgroups of fruits based on their color and fruit juices consumption with different cardiometabolic parameters.

METHODS AND RESULTS

A total of 6633 elderly participants (aged 55-75 years) with metabolic syndrome from the PREDIMED-Plus study were included in this analysis. Fruit and fruit juice consumption was assessed using a food frequency questionnaire. Linear regression models were fitted to evaluate the association between exposure variables (total fruit, subgroups based on the color, and fruit juices) and different cardiometabolic risk factors. Individuals in the highest category of total fruit consumption (≥3 servings/d) had lower waist circumference (WC) (β = -1.04 cm; 95%CI:-1.81, -0.26), fasting glucose levels (β = -2.41 mg/dL; 95%CI(-4.19, -0.63) and LDL-cholesterol (β = -4.11 mg/dL; 95%CI:-6.93, -1.36), but, unexpectedly, higher systolic blood pressure (BP) (β = 1.84 mmHg; 95%CI: 0.37, 3.30) and diastolic BP (β = 1.69 mmHg; 95%CI:0.83, 2.56) when compared to those in the lowest category of consumption (<1 servings/d). Participants consuming ≥1 serving/day of total fruit juice had lower WC (β = -0.92 cm; 95%CI:-1.56, -0.27) and glucose levels (β = -1.59 mg/dL; 95%CI:-2.95, -0.23) than those consuming <1 serving/month. The associations with cardiometabolic risk factors differed according to the color of fruits.

CONCLUSION

Fruit consumption is associated with several cardiometabolic risk factors in Mediterranean elders with metabolic syndrome. The associations regarding BP levels could be attributed, at least partially, to reverse causality bias inherent to the cross-sectional design of the study.

Measuring Dietary Botanical Diversity as a Proxy for Phytochemical Exposure

The study of natural plant molecules and their medicinal properties, pharmacognosy, provides a taxonomy for botanical families that represent diverse chemical groupings with potentially distinct functions in relation to human health. Yet, this reservoir of knowledge has not been systematically applied to elucidating the role of patterns of plant food consumption on gut microbial ecology and function. All chemical classes of dietary phytochemicals can affect the composition of the microbes that colonize the gut and their function. In turn, the gut microbiome affects the host via multiple mechanisms including gut barrier function, immune function, satiety and taste regulation and the activity of biological signaling pathways that influence health and disease. Herein, we report the development of a botanical diversity index (BDI) to evaluate plant food consumption as a novel metric for identifying and quantifying phytochemicals to which an individual is exposed. A rationale is advanced for using the BDI to investigate how plant food diversity impacts gut microbial ecology and functionality.

Are Homemade and Commercial Infant Foods Different? A Nutritional Profile and Food Variety Analysis in Spain

Complementary feeding (CF) is an important determinant of early and later life nutrition with great implications for the health status and the development of an adequate growth. Parents can choose between homemade foods (HMFs) and/or commercial infant foods (CIFs). There is no consistent evidence as to whether HMFs provide a better nutritional profile and variety over CIFs. The aim of this study was to compare the nutritional profiles and food variety of HMFs versus CIFs in the Spanish market targeted for infants (6-11 months) and young children (12-18 months). Thirty mothers with their children aged 6 to 18 months were included in this cross-sectional study, following a 3-day weighed food diary of which HMFs were collected and chemically analyzed. HMFs meals for infant provided significantly lower energy, higher protein and higher fiber, for young children provided significantly higher protein and fiber than CIFs meals. HMFs fruit purees for infant shown significantly higher fiber and for young children provided higher energy than CIFs. HMFs meals contained a significantly greater number of different vegetables than CIFs meals (3.7 vs. 3.3), with carrot as the most frequently used in both. However, in CIFs fruit purees shown higher different fruits than HMFs, in both the banana was the fruit most frequently used. There was a predominance of meat and lack of oily fish and legumes in both HMFs and CIFs meals. HMFs and CIFs were equally characterized by a soft texture and yellow-orange colours. Importantly, our findings emphasize the need for clear guidelines for the preparation of HMFs as well as the promotion of food variety (taste and textures) in both HMFs and CIFs to suit infants' and young children's nutritional and developmental needs.

Investigating the Relationship between Perceived Meal Colour Variety and Food Intake across Meal Types in a Smartphone-Based Ecological Momentary Assessment

Although most people are aware of the health benefits of consuming sufficient amounts of fruit and vegetables, many do not adhere to current dietary recommendations. Recent studies have suggested meal colour variety as an intuitive cue for healthy and enjoyable lunch meal choices. The present study extends this research by testing the “colourful = healthy” association across meal types. Using smartphone-based Ecological Momentary Assessment, 110 participants recorded 2818 eating occasions over a period of eight days. For each eating occasion, a picture, a short written description of the meal, the meal type (breakfast, lunch, afternoon tea, dinner, snack) and the perceived meal colour variety were recorded. Foods were classified into seven food groups based on the pictures and descriptions. Data were analysed using multilevel modelling. For all meal types except afternoon tea which did not include vegetables, perceived that meal colour variety was positively related to vegetable consumption (bs ≥ 0.001, ts ≥ 3.27, ps ≤ 0.002, quasi-R²s ≥ 0.06). Moreover, perceived meal colour variety was negatively associated with sweets consumption for breakfast, dinner and snacks (bs ≤ −0.001, ts ≤ −2.82, ps ≤ 0.006, quasi-R²s ≥ 0.01). The “colourful = healthy” association can be generalized across meal types and thus may be a promising strategy to promote a healthier diet.

Effects of Cooking Method on the Antioxidant Activity and Inhibition of Lipid Peroxidation of the Javanese Salad "Pecel" Vegetables and Its Peanut Sauce Dressing

Vegetables are essential in our diet to maintain health, partly due to their antioxidant properties. A well-known Javanese salad called "Pecel" is prepared by boiling the vegetables and dressed with seasoned peanut sauce. Cooking can reduce or improve the antioxidant properties of foods; therefore, the purpose of this study was to evaluate the effects of brief water boiling (1 min), steaming (1 min), and water blanching (20 s) of the Javanese Pecel vegetables, with or without the peanut sauce. We assessed the in vitro antioxidant capacity and lipid peroxidation inhibition of the salad samples prepared using each cooking method. Six vegetables, i.e., Sesbania grandiflora (turi) flower, Amaranthus hybridus L. (spinach), Carica papaya (papaya) leaves, Cosmos caudatus L. (kenikir) leaves, Vigna unguiculata ssp. Sesquipedalis (yard-long beans), and Vigna radiata (mung-bean) sprouts were cooked by boiling or steaming for 1 min or blanching for 20 s. Peanut (Arachis hypogaea), the raw material for peanut sauce, was fried in either fresh palm oil or repeatedly used palm oil. Our results revealed that the highest antioxidant capacity (percent inhibition of DPPH radicals) was observed following boiling for 1 min in case of spinach (41.94 ± 9.8%), papaya (59.04 ± 5.35%), kenikir (54.93% ± 6.32%), and yard-long beans (70.21 ± 8.91%); steaming for 1 min in case of turi flower (60.25 ± 3.63%); and blanching for 20 s in case of mung-bean sprouts (49.27 ± 3.69%). Peanut sauce prepared by frying peanuts in fresh or repeatedly used palm oil reduces the natural antioxidant and lipid peroxidation inhibition properties. However, seasoning the peanut sauce with fresh garlic and lime leaves can restore the lost antioxidant properties. Our study provides the first and clear evidence of the optimal cooking method for Pecel vegetables and sheds light on the wisdom behind the existing traditional cooking method.

Corrigendum to "A Review of the Science of Colorful, Plant-Based Food and Practical Strategies for "Eating the Rainbow""

[This corrects the article DOI: 10.1155/2019/2125070.].

A Review of Dietary (Phyto)Nutrients for Glutathione Support

Glutathione is a tripeptide that plays a pivotal role in critical physiological processes resulting in effects relevant to diverse disease pathophysiology such as maintenance of redox balance, reduction of oxidative stress, enhancement of metabolic detoxification, and regulation of immune system function. The diverse roles of glutathione in physiology are relevant to a considerable body of evidence suggesting that glutathione status may be an important biomarker and treatment target in various chronic, age-related diseases. Yet, proper personalized balance in the individual is key as well as a better understanding of antioxidants and redox balance. Optimizing glutathione levels has been proposed as a strategy for health promotion and disease prevention, although clear, causal relationships between glutathione status and disease risk or treatment remain to be clarified. Nonetheless, human clinical research suggests that nutritional interventions, including amino acids, vitamins, minerals, phytochemicals, and foods can have important effects on circulating glutathione which may translate to clinical benefit. Importantly, genetic variation is a modifier of glutathione status and influences response to nutritional factors that impact glutathione levels. This narrative review explores clinical evidence for nutritional strategies that could be used to improve glutathione status.