Meat consumption providing a surplus energy in modern diet contributes to obesity prevalence: an ecological analysis

Evolution of dietary patterns in Flanders: an ecological trend study on best-selling cookbook recipes (2008-2018) and their correlation with household purchases

BACKGROUND

With rising obesity rates in Western societies, analyzing changes in dietary patterns is paramount. While nutritional surveys have been informative, traditional cookbooks have historically shed light on national cuisines and its changes. Despite the growing popularity of online platforms for food information, cookbooks might still reflect prevalent dietary trends and the diets people follow. This study examined (1) the changes in nutritional content and food group usage in the best-selling cookbooks from 2008 to 2018, and (2) the correlation between the food groups in these cookbooks and dietary patterns (inferred from household purchases) over the same timeframe.

METHODS

An exploratory ecological study was conducted on 20 main course recipes of each of the five best-selling cookbooks in Flanders annually between 2008 and 2018. Trends in macronutrients and food group usage in these recipes were analyzed using generalized linear models. Additionally, these trends were compared to household purchase data in Flanders using correlation matrices.

RESULTS

Our results reveal a rising trend towards the use of plant-based ingredients and meat alternatives in cookbooks over the period 2008-2018. There was an increase in the usage of vegetables, nuts & seeds, and cheese. Conversely, there was a decline in the usage of meat, sugar & sweeteners, alcohol, and dairy (all p-values < 0.05). In terms of macronutrient content, there was an upswing in carbohydrate, fibre, and sugar levels, while the total fat content showed a decrease (all p-values < 0.05). The levels of protein and saturated fat remained consistent over time. Notably, shifts in plant-based and animal-based food group preferences in popular cookbook recipes align with the trends seen in actual household purchases of these food groups (all p-values < 0.05).

CONCLUSION

These findings indicate that cookbook content evolves over time, potentially reflecting shifts in population dietary patterns. Future research is needed to determine (Buisman ME, Jonkman J. Dietary trends from 1950 to 2010: a Dutch cookbook analysis. J Nutr Sci [Internet]. 2019 ed [cited 2022 Apr 19];8. https://www.cambridge.org/core/journals/journal-of-nutritional-science/article/dietary-trends-from-1950-to-2010-a-dutch-cookbook-analysis/AB281ADE0F09FF8F518B8AC4A2A5BEA8#supplementary-materials ) any causative link between cookbooks and dietary habits, and (Ashwell M, Barlow S, Gibson S, Harris C. National Diet and Nutrition Surveys: the British experience. Public Health Nutr. 2006;9(4):523-30.) the potential for cookbooks to aid in health promotion.

A qualitative study of young peoples' thoughts and attitudes to follow a more plant-based diet

Plant-based diets (PBDs) refer to dietary habits that reduce the consumption of animal-based products and increase the consumption of nutritionally rich plant foods. PBD's have been shown to provide significant health benefits, such as reducing obesity and improving psychological wellbeing, and are environmentally friendly. However, few studies have investigated factors that influence young people's thoughts and attitudes toward following a PBD in western societies, particularly in the United Kingdom. Understanding these factors may benefit public health interventions that encourage the consumption of more fruit and vegetables. The aim of this study was to explore the factors that affect young people's intentions toward following a PBD. Twenty-one young people (18-24 years) participated in this qualitative study. Participants were asked about their views of PBDs in a semi-structured interview. Thematic analysis was utilized to explore views and the barriers and facilitators to following a PBD. The Theory of Planned Behavior (TPB) was used as a framework to organise the findings. Within attitudes, the sub-themes identified were an awareness of a healthy diet, environmental concerns, health concerns and distrust, perceptions of PBDs and associated stereotypes, perceived restriction and lack of enjoyment, and need for education. Within subjective norms, the sub-themes identified were cultural and familial norms, peer influence, and exposure through social media. Within perceived behavioral control (PBC), the sub-themes identified were a lack of independence and parental control, lack of knowledge and perceived difficulty, lack of inclusiveness and accessibility, and inconvenience. Overall, the findings suggest that increased provision of education and knowledge about PBDs to young people, and widening access to PBDs, could encourage and help improve their understanding and intention to follow this dietary style. Tailored health promotion strategies, which also consider additional barriers and facilitators found within this study, could motivate young people to consume a more PBD.

Food System Transformation and Gut Microbiota Transition: Evidence on Advancing Obesity, Cardiovascular Diseases, and Cancers-A Narrative Review

Food, a vital component of our daily life, is fundamental to our health and well-being, and the knowledge and practices relating to food have been passed down from countless generations of ancestors. Systems may be used to describe this extremely extensive and varied body of agricultural and gastronomic knowledge that has been gathered via evolutionary processes. The gut microbiota also underwent changes as the food system did, and these alterations had a variety of effects on human health. In recent decades, the gut microbiome has gained attention due to its health benefits as well as its pathological effects on human health. Many studies have shown that a person's gut microbiota partially determines the nutritional value of food and that diet, in turn, shapes both the microbiota and the microbiome. The current narrative review aims to explain how changes in the food system over time affect the makeup and evolution of the gut microbiota, advancing obesity, cardiovascular disease (CVD), and cancer. After a brief discussion of the food system's variety and the gut microbiota's functions, we concentrate on the relationship between the evolution of food system transformation and gut microbiota system transition linked to the increase of non-communicable diseases (NCDs). Finally, we also describe sustainable food system transformation strategies to ensure healthy microbiota composition recovery and maintain the host gut barrier and immune functions to reverse advancing NCDs.

Double Burden of Malnutrition: A Population Level Comparative Cross-Sectional Study across Three Sub-Saharan African Countries-Malawi, Namibia and Zimbabwe

BACKGROUND

The double burden of malnutrition in sub-Saharan African countries at different levels of economic development was not extensively explored. This study investigated prevalence, trends, and correlates of undernutrition and overnutrition among children under 5 years and women aged 15-49 years in Malawi, Namibia, and Zimbabwe with differing socio- economic status.

METHODS

Prevalence of underweight, overweight, and obesity were determined and compared across the countries using demographic and health surveys data. Multivariable logistic regression was used to ascertain any relationships between selected demographic and socio-economic variables and overnutrition and undernutrition.

RESULTS

An increasing trend in overweight/obesity in children and women was observed across all countries. Zimbabwe had the highest prevalence of overweight/obesity among women (35.13%) and children (5.9%). A decreasing trend in undernutrition among children was observed across all countries, but the prevalence of stunting was still very high compared to the worldwide average level (22%). Malawi had the highest stunting rate (37.1%). Urban residence, maternal age, and household wealth status influenced maternal nutritional status. The likelihood of undernutrition in children was significantly higher with low wealth status, being a boy, and low level of maternal education.

CONCLUSIONS

Economic development and urbanization can result in nutritional status shifts.

Although in shortage, nursing workforce is still a significant contributor to life expectancy at birth

OBJECTIVES

Previous studies have not fully reported the strength and independency of the correlation of nursing workforce to life expectancy. This study advances that nursing workforce is a major independent contributor to life expectancy at birth (LEB) globally and regionally.

DESIGN

A cross-sectional study was conducted at population level.

SAMPLE

Ecological data were extracted from the United Nations agencies for 215 populations. Each population is considered a research subject.

MEASUREMENTS

The correlation between nursing workforce and LEB was analyzed with scatter plots, bivariate correlation, partial correlation, and multiple linear regression analyses, Analysis of Variance post hoc and independent T-test. Economic affluence, urban lifestyle and obesity were included as the potential confounders in this study.

INTERVENTION

Not applicable RESULTS: Nursing workforce correlated to LEB and this relationship remained regardless of the competition of economic affluence, urbanization, and obesity. Second to economic affluence, nursing workforce showed the greatest influence on LEB. In total, 64.50% of LEB was explained in this study. Nursing workforce was a determinant of regional variations of LEB.

CONCLUSIONS

Nursing workforce may be a significant contributor to LEB globally and regionally. This contribution was independent of the potential confounding effects of economic affluence, urbanization, and obesity.

Diet's Role in Modifying Risk of Alzheimer's Disease: History and Present Understanding

Diet is an important nonpharmacological risk-modifying factor for Alzheimer's disease (AD). The approaches used here to assess diet's role in the risk of AD include multi-country ecological studies, prospective and cross-sectional observational studies, and laboratory studies. Ecological studies have identified fat, meat, and obesity from high-energy diets as important risk factors for AD and reported that AD rates peak about 15-20 years after national dietary changes. Observational studies have compared the Western dietary pattern with those of the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MedDi), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. Those studies identified AD risk factors including higher consumption of saturated and total fats, meat, and ultraprocessed foods and a lower risk of AD with higher consumption of fruits, legumes, nuts, omega-3 fatty acids, vegetables, and whole grains. Diet-induced factors associated with a significant risk of AD include inflammation, insulin resistance, oxidative stress, elevated homocysteine, dietary advanced glycation end products, and trimethylamine N-oxide. The molecular mechanisms by which dietary bioactive components and specific foods affect risk of AD are discussed. Given most countries' entrenched food supply systems, the upward trends of AD rates would be hard to reverse. However, for people willing and able, a low-animal product diet with plenty of anti-inflammatory, low-glycemic load foods may be helpful.

Exploring the role of mindful eating and self-compassion on eating behaviours and orthorexia in people following a vegan diet

Orthorexia nervosa (ON) is a new concept that is more prevalent in vegan populations. ON is characterised by obsessive focus on healthy eating, following restrictive dietary practices and dietary restrictions escalating over time. The aim of this study was to explore problematic eating behaviours in a vegan population, and to explore whether mindful eating and self-compassion have an impact on ON. Two hundred and eighty-seven females and twenty-eight males who followed a vegan diet completed scales in Orthorexia, Self-Compassion, Mindful, Emotional, External and Restraint Eating. The results indicated that individuals with high levels of ON display low levels of self-compassion, and high levels of restrained eating. Moreover, the findings indicated that self-compassion, but not mindful eating, partially mediated the relationship between restrained eating and orthorexia nervosa. The present results contribute to a better understanding of orthorexic eating behaviours in a vegan population, and identifies the mediating capacity of self-compassion. Further implications and future directions are discussed.Level of evidence: Level V, cross-sectional descriptive study.

Moral Reasons for Individuals in High-Income Countries to Limit Beef Consumption

This paper argues that individuals in many high-income countries typically have moral reasons to limit their beef consumption and consume plant-based protein instead, given the negative effects of beef production and consumption. Beef production is a significant source of agricultural greenhouse gas emissions and other environmental impacts, high levels of beef consumption are associated with health risks, and some cattle production systems raise animal welfare concerns. These negative effects matter, from a variety of moral perspectives, and give us collective moral reasons to reduce beef production and consumption. But, as some ethicists have argued, we cannot draw a straight line from the ethics of production to the ethics of consumption: even if a production system is morally impermissible, this does not mean that any given individual has moral reasons to stop consuming the products of that system, given how miniscule one individual’s contributions are. This paper considers how to connect those dots. We consider three distinct lines of argument in support of the conclusion that individuals have moral reasons to limit their beef consumption and shift to plant-based protein, and we consider objections to each argument. This argument applies to individuals in high beef-consuming and high greenhouse gas-emitting high-income countries, though we make this argument with a specific focus on the United States.

The early-life exposome modulates the effect of polymorphic inversions on DNA methylation

Polymorphic genomic inversions are chromosomal variants with intrinsic variability that play important roles in evolution, environmental adaptation, and complex traits. We investigated the DNA methylation patterns of three common human inversions, at 8p23.1, 16p11.2, and 17q21.31 in 1,009 blood samples from children from the Human Early Life Exposome (HELIX) project and in 39 prenatal heart tissue samples. We found inversion-state specific methylation patterns within and nearby flanking each inversion region in both datasets. Additionally, numerous inversion-exposure interactions on methylation levels were identified from early-life exposome data comprising 64 exposures. For instance, children homozygous at inv-8p23.1 and higher meat intake were more susceptible to TDH hypermethylation (P = 3.8 × 10⁻²²); being the inversion, exposure, and gene known risk factors for adult obesity. Inv-8p23.1 associated hypermethylation of GATA4 was also detected across numerous exposures. Our data suggests that the pleiotropic influence of inversions during development and lifetime could be substantially mediated by allele-specific methylation patterns which can be modulated by the exposome.

Analysis of the relationship between presence of common DNA sequence inversions and DNA methylation patterns suggests a role for environmental exposures (such as food intake) in mediating inversion state-specific methylation patterns.

Factors associated with serum ferritin levels and iron excess: results from the EPIC-EurGast study

PURPOSE

Excess iron is involved in the development of non-communicable diseases such as cancer, type 2 diabetes and cardiovascular conditions. We aimed to describe the prevalence of excess iron and its determinants in healthy European adults.

METHODS

Sociodemographic, lifestyle, iron status, dietary information, and HFE genotyping were obtained from controls from the nested case-control study EPIC-EurGast study. High sensitivity C-reactive protein (hsCRP) was measured to address possible systemic inflammation. Descriptive and multivariate analyses were used to assess iron status and its determinants.

RESULTS

Out of the 828 participants (median age: 58.7 years), 43% were females. Median serum ferritin and prevalence of excess iron were 143.7 µg/L and 35.2% in males, respectively, and 77 µg/L and 20% in females, both increasing with latitude across Europe. Prevalence of HFE C282Y mutation was significantly higher in Northern and Central Europe (~ 11%) than in the South (5%). Overweight/obesity, age, and daily alcohol and heme iron intake were independent determinants for iron status, with sex differences even after excluding participants with hsCRP > 5 mg/L. Obese males showed a greater consumption of alcohol, total and red meat, and heme iron, compared with those normal weight.

CONCLUSION

Obesity, higher alcohol and heme iron consumption were the main risk factors for excess iron in males while only age was associated with iron overload in females. Weight control and promoting healthy lifestyle may help prevent iron overload, especially in obese people. Further research is needed to clarify determinants of excess iron in the healthy adult population, helping to reduce the associated comorbidities.

Plant-based dietary patterns are associated with lower body weight, BMI and waist circumference in older Australian women

OBJECTIVE

To investigate the association between plant-based diets (PBD) and overweight/obesity compared to regular meat eaters in older women.

DESIGN

Cross-sectional analysis.

SETTING

1946-1951 birth cohort of the Australian Longitudinal Study on Women's Health (ALSWH). PBD were categorised as vegan, lacto-ovo vegetarian, pesco-vegetarian, semi-vegetarian and regular meat eaters. Outcomes included body weight (BW), BMI and waist circumference (WC).

PARTICIPANTS

Women who completed Survey 7 (n 9102) with complete FFQ data.

RESULTS

Compared to regular meat eaters, BW, BMI and WC were significantly lower in pesco-vegetarians (-10·2 kg (95 % CI -5·1, -15·2); -3·8 kg/m2 (95 % CI -2·0, -5·6); -8·4 cm (95 % CI -3·9, -12·9)) and BW and BMI lower in lacto-ovo vegetarians (-7·4 kg (95 % CI -1·2, -13·6); -2·9 kg/m2 (95 % CI -0·6, -5·1)). In regular meat eaters, individuals consuming meat daily or multiple times/d had significantly higher BW, BMI and WC compared to those consuming meat >2 times/week but 1 but ≤2 times/week (6·8 kg (95 % CI 1·8, 11·8); 2·1 kg/m2 (95 % CI 0·3, 4·0) and 6·0 cm (95 % CI 1·7, 10·4)). This association was dose-dependent such that for every increase in category of weekly meat intake (i.e. >1 time/week but ≤2 times/week; >2 times/week but less than daily, and daily or multiple times/d), an associated 2·6 kg (95 % CI 1·8, 3·4) increase in BW, 0·9 kg/m2 (95 % CI 0·6, 1·2) increase in BMI and 2·3 cm (95 % CI 1·6, 3·0) increase in WC was reported.

CONCLUSIONS

BW, BMI and WC are lower in women following PBD and positively associated with increasing meat consumption. Results were robust to adjustment for confounders including physical activity levels, smoking status, habitual alcohol intake, use of supplements, and hormone replacement therapy.

Identifying dietary pattern associated with adiposity among Malaysian young adults

BACKGROUND: Recognizing food groups consumption in young adults offers an opportunity to improve dietary pattern in early adulthood. OBJECTIVE: Hence, this cross-sectional study aimed to determine food groups’ intake of young adults and to identify food groups associated with adiposity. METHODS: Youths aged 18–25 years old from private universities in Klang Valley, Malaysia, participated in the study (n = 294). Three days 24-hour dietary recall assessed youths’ food groups intake. Adiposity (BMI, body fat percentage, visceral fat level, waist circumference) was determined based on standard protocol. Height was measured using SECA 206 body meter, while weight, body fat percentage, and visceral fat level were measured using the Omron HBF-356 Body Fat Analyzer. Waist circumference was determined using a measuring tape. RESULTS: In total, 49.3% and 34.7% of youths were overweight/obese and abdominally obese, respectively. The median visceral fat level was 4 (6). Youths consumed 214 (247) kcal of ultra-processed foods daily and exceeded the sugar [32.43 (41.20) g] and sodium recommendation [2425.26 (1455.18) mg]. Fruits [0.29±0.72 servings/day], vegetables [0.95±0.77 servings/day] and milk [0.24±0.38 servings/day] were below recommendations. Increased intake of meat and sodium were associated with higher BMI, waist circumference, body fat percentage, and visceral fat (p <  0.001). Greater intake of ultra-processed food was associated with high BMI (p = 0.009), waist circumference (p = 0.046), and visceral fat (p = 0.014). Besides, high sugar intake was associated with greater BMI (p = 0.003), body fat percentage (p = 0.020), and visceral fat (p = 0.027). CONCLUSIONS: Meat, sugar, sodium, and ultra-processed foods were high-risk foods associated with adiposity among young adults. There is a need to improve education and support to promote healthy eating for chronic disease prevention related to metabolic abnormalities.

Plant-based dietary intake moderates adverse childhood experiences association with early mortality in an older Adventist cohort

BACKGROUND

Adverse Childhood Experiences (ACEs) consistently predict poor mental and physical health as well as early all-cause mortality. Much work examines health harming behaviors that may be used to cope with ACEs associated stress responses and dysregulation. Limited research has been conducted assessing plant-based dietary intake on the ACEs and mortality relationship. We investigate moderators of the ACEs and mortality association including plant-based dietary intake.

OBJECTIVE

The purpose of this study is to examine if the association between ACEs and early mortality is potentially moderated by plant-based dietary intake.

PARTICIPANTS

An observational, prospective cohort study that included 9301 Seventh-day Adventists were assessed from 2006 to 2017 in the Biopsychosocial Religion and Health Study (BRHS).

METHODS

We examined the potential impact of plant-based intake frequency on the ACEs and all-cause mortality relationship, while adjusting for potential confounders (e.g., demographics, health risks, mental and physical health) in a cox regression survival analysis.

RESULTS

ACEs were adversely associated with survival time (HR = 2.76, 95% CI: 1.15-6.64). Plant-based intake was associated with a reduction in the association of 4+ ACEs with early mortality (HR = 0.73, 95% CI: 0.59-0.90) above and beyond demographics, animal-based intake, physical health, mental health, BMI, exercise, and worship. We estimate that after 4+ ACEs, those eating high versus low plant-based dietary intake may live 5.4 years longer.

CONCLUSION

Plant-based dietary intake may potentially moderate the ACEs and early mortality relationship; however, observational studies cannot determine causality.

Impact of Plant-Based Meat Alternatives on the Gut Microbiota of Consumers: A Real-World Study

Eating less meat is increasingly seen as a healthier, more ethical option. This is leading to growing numbers of flexitarian consumers looking for plant-based meat alternatives (PBMAs) to replace at least some of the animal meat they consume. Popular PBMA products amongst flexitarians, including plant-based mince, burgers, sausages and meatballs, are often perceived as low-quality, ultra-processed foods. However, we argue that the mere industrial processing of ingredients of plant origin does not make a PBMA product ultra-processed by default. To test our hypothesis, we conducted a randomised controlled trial to assess the changes to the gut microbiota of a group of 20 participants who replaced several meat-containing meals per week with meals cooked with PBMA products and compared these changes to those experienced by a size-matched control. Stool samples were subjected to 16S rRNA sequencing. The resulting raw data was analysed in a compositionality-aware manner, using a range of innovative bioinformatic methods. Noteworthy changes included an increase in butyrate metabolising potential-chiefly in the 4-aminobutyrate/succinate and glutarate pathways-and in the joint abundance of butyrate-producing taxa in the intervention group compared to control. We also observed a decrease in the Tenericutes phylum in the intervention group and an increase in the control group. Based on our findings, we concluded that the occasional replacement of animal meat with PBMA products seen in flexitarian dietary patterns can promote positive changes in the gut microbiome of consumers.

The Relationship between Hemoglobin Level and Socio-economic Indicators among Women of Childbearing Age in South Africa: A Secondary Analysis of DHS Data

The nutritional double burden of disease refers to the phenomenon of undernutrition, wasting, stunting, micronutrient deficiency coinciding with overweight, obesity, and diet-related non-communicable diseases, within individuals, households and populations throughout the lifecycle. This study aimed to determine whether there were differences in hemoglobin levels between anthropometric categories and socio-economic factors among women aged 15 to 49 years old in South Africa. Data were obtained from the Demographic and Health Survey (DHS) South Africa survey 2016. There were 2690 women between 15 and 49 years old included in the sample. Variables selected for analysis included height and weight, hemoglobin (adjusted for altitude), wealth index, access to improved water and sanitation. Variables were tested for normality using Q-Q plots. Missing data was removed. Frequencies and percentages were reported for categorical data. Non-parametric continuous variables were reported as medians and interquartile ranges. As data were not normally distributed, analysis was conducted using the Kruskall-Wallis test and Mann-Whitney U test. The type I error rate was set to p < .05. Where it was found that a significant difference exists, post hoc Dunn tests were performed to determine the location of the differences. Anemia was prevalent among 28.9% of the sample and 63.5% were either overweight or obese. Hemoglobin levels were significantly different between normal weight women and women with a body mass index in the obese class I and obese class II respectively (Kruskall-Wallis = 27.014; df = 5; p = .000; n = 2690). There were significant differences in hemoglobin levels between women with access to improved sanitation and those without access (Mann-Whitney U test p = .017), but hemoglobin levels were similar between women with access to improved water and those without (Mann-Whitney U test p = .175). Poorer women had significantly different hemoglobin levels to the wealthiest women in the sample (Kruskall-Wallis = 29.568; df = 4; p = .000). The nutritional double burden of disease is prevalent in South Africa among women of childbearing age. A wealth disparity exists among South African women in terms of hemoglobin levels.

Protein Intake During Infancy and Subsequent Body Mass Index in Early Childhood: Results from the Melbourne InFANT Program

BACKGROUND

The link between high protein intake during infancy and obesity later in childhood has been much debated, and the association with differing protein sources remains unclear.

OBJECTIVE

This study aimed to examine the associations between total protein intake and protein from different sources (ie, nondairy animal, dairy, and plant) reported at age 9 months and development in body mass index (BMI) z scores until age 5 years.

DESIGN

This study involved a secondary data analysis of the Melbourne InFANT (Infant Feeding, Activity and Nutrition Trial) program, an observational prospective cohort study that was conducted from 2008 to 2013.

PARTICIPANTS/SETTING

Participants were children (n = 345) who completed both the 9-month and 5-year follow-up visits within the Melbourne InFANT program.

MAIN OUTCOME MEASURES

BMI z score was measured at age 5 years.

STATISTICAL ANALYSES PERFORMED

Linear mixed models with a random effect for clusters of mother's group and with adjustment for baseline child and maternal covariates were conducted.

RESULTS

With adjustment for covariates, every 1 g or 1% energy increase in total protein intake at age 9 months was associated with a 0.016-unit (95% CI 0.003 to 0.029) or 0.034-unit (95% CI 0.005 to 0.063) increase in BMI z score at age 5 years, respectively. With respect to protein sources, associations of similar magnitude were found for nondairy animal protein. No evidence of an association with BMI z score was found for dairy (including milk, yogurt, cheese, breast milk, and infant formula) and plant proteins.

CONCLUSIONS

High intakes of total protein, nondairy animal protein, but not dairy or plant proteins, during infancy were associated with higher BMI z score in early childhood. These findings can inform dietary recommendations regarding protein intakes during infancy.

CLINICAL TRIAL REGISTRATION

The InFANT program was registered with Current Controlled Trials (ISRCTN81847050); http://www.isrctn.com/ISRCTN81847050.

Articulating the effect of food systems innovation on the Sustainable Development Goals

Food system innovations will be instrumental to achieving multiple Sustainable Development Goals (SDGs). However, major innovation breakthroughs can trigger profound and disruptive changes, leading to simultaneous and interlinked reconfigurations of multiple parts of the global food system. The emergence of new technologies or social solutions, therefore, have very different impact profiles, with favourable consequences for some SDGs and unintended adverse side-effects for others. Stand-alone innovations seldom achieve positive outcomes over multiple sustainability dimensions. Instead, they should be embedded as part of systemic changes that facilitate the implementation of the SDGs. Emerging trade-offs need to be intentionally addressed to achieve true sustainability, particularly those involving social aspects like inequality in its many forms, social justice, and strong institutions, which remain challenging. Trade-offs with undesirable consequences are manageable through the development of well planned transition pathways, careful monitoring of key indicators, and through the implementation of transparent science targets at the local level.

Association of nutritional components with falls in oldest-old men: The Helsinki Businessmen Study (HBS)

INTRODUCTION

Falls are associated with increased morbidity and mortality in older people. We examined how nutritional factors are associated with self-reported falls in the oldest-old community-dwelling men.

METHODS

Participants of the longitudinal and socioeconomically homogenous Helsinki Businessmen Study are men born in 1919-1934. A cross-sectional analysis from a random sample of 122 home-living oldest-old men who underwent medical examinations in 2017-2018 is reported here. Food and nutrient intakes were retrieved from 3-day food diaries, and the number of falls during past year was requested in the screening questionnaire. Nutritional status was assessed using Mini Nutritional Assessment Short Form (MNA-SF) and waist circumference was measured. Body composition was assessed with dual-energy X-ray absorptiometry (DXA)-scans, physical performance with short physical performance battery (SPPB), sarcopenia status using European Working Group on Sarcopenia in Older People's 2 (EWGSOP2) criteria, and frailty with phenotypic criteria.

RESULTS

Mean age of participants was 87 years (range 83-99 years) and 30% reported at least one fall during past year. Falls were associated with higher waist circumference (p = .031), frailty (p < .001) and sarcopenia (p = .002), and inversely associated with SPPB total score (p = .002). Of nutritional factors, intakes of fish (p = .016), fish protein (p = .039), berry (p = .027) and vitamin D (p = .041), and snacking more protein between breakfast and lunch (p = .017) were inversely associated with falls. Red meat intake was associated with higher frequency of falls (p = .044).

CONCLUSION

Higher waist circumference, but not body mass index, was associated with increased frequency of falls. Healthy dietary choices appeared protective from falls in these oldest-old men of similar socioeconomic status.

Gluten consumption may contribute to worldwide obesity prevalence

Gluten consumption has been controversially associated with obesity in previous studies. We sought to examine this association at the worldwide level.

Country specific data were obtained from 168 countries. Scatter plots, bivariate, partial correlation and multiple linear regression models were used to explore and compare the coincidence between obesity prevalence and consumption of gluten, non-gluten cereal protein and total cereal protein respectively. The established risk factors of obesity: caloric intake, sedentary lifestyle, urbanization, socioeconomic status, meat protein intake and sugar consumption were included in analyses as potential confounders. The 168 countries were also stratified into developing and developed country groupings for further examination of the relationships.

Worldwide, bivariate correlation analyses revealed that the strength and direction of correlations between all variables (independent, dependent and potential confounders) were at similar levels. Obesity prevalence was positively correlated to gluten consumption but was negatively correlated to consumption of non-gluten cereal protein, and was in almost nil correlation to total cereal protein consumption. These relationships were similar across all countries (n= 168), developed country grouping (N=44) and developing country grouping (n=124). When caloric intake, Gross Domestic Product at Purchasing Power Parity, sedentary lifestyle and urbanization were kept statistically constant in the partial correlation analysis, obesity was significantly correlated to gluten consumption in all countries, developed country grouping and developing country grouping, and was significantly but inversely and weakly correlated to non-gluten cereal protein in all countries and developing countries, and was in almost nil correlation to total cereal protein in all country groupings. Globally, stepwise multiple regression analysis, when all the independent variables and potential confounding factors were included, selected consumption of sugar as the variable having the greatest influence on obesity with R2 = 0.510, while gluten was placed second increasing R2 to 0.596. Gluten consumption may have been emerging as an inconspicuous, but significant cause of obesity. While Westernization has driven the diet patterns worldwide to incorporate more gluten crops, obesity prevalence projection methods may estimate future obesity rates poorly if gluten consumption is not considered.

Double Burden of Malnutrition and Nutrition Transition in Asia: A Case Study of 4 Selected Countries with Different Socioeconomic Development

Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.

Prospects and challenges for cell-cultured fat as a novel food ingredient

BACKGROUND

In vitro meat production has been proposed as a solution to environmental and animal welfare issues associated with animal agriculture. While most academic work on cell-cultured meat has focused on innovations for scalable muscle tissue culture, fat production is an important and often neglected component of this technology. Developing suitable biomanufacturing strategies for adipose tissue from agriculturally relevant animal species may be particularly beneficial due to the potential use of cell-cultured fat as a novel food ingredient.

SCOPE AND APPROACH

Here we review the relevant studies from areas of meat science, cell biology, tissue engineering, and bioprocess engineering to provide a foundation for the development of in vitro fat production systems. We provide an overview of adipose tissue biology and functionality with respect to meat products, then explore cell lines, bioreactors, and tissue engineering strategies of potential utility for in vitro adipose tissue production for food. Regulation and consumer acceptance are also discussed.

KEY FINDINGS AND CONCLUSIONS

Existing strategies and paradigms are insufficient to meet the full set of unique needs for a cell-cultured fat manufacturing platform, as tradeoffs are often present between simplicity, scalability, stability, and projected cost. Identification and validation of appropriate cell lines, bioprocess strategies, and tissue engineering techniques must therefore be an iterative process as a deeper understanding of the needs and opportunities for cell-cultured fat develops.

Prevalence and factors associated with overweight and obesity among adults in Hawassa city, southern Ethiopia: a community based cross-sectional study

BACKGROUND

In Ethiopia, limited information is available about the epidemiology of over-nutrition. This study assessed the prevalence of, and factors associated with overweight and obesity among adults in Hawassa city, Southern Ethiopia.

METHODS

A community-based cross-sectional survey was conducted in August 2015 in the city. A total of 531 adults 18-64 years of age were selected using multistage sampling approach. Interviewer administered qualitative food frequency questionnaire was used to assess the consumption pattern of twelve food groups. The level of physical exercise was measured via the General Physical Activity Questionnaire (GPAQ). Based on anthropometric measurements, Body Mass Index (BMI) was computed and overweight including obesity (BMI of 25 or above) was defined. For identifying predictors of overweight and obesity, multivariable binary logistic regression model was fitted and the outputs are presented using Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI).

RESULTS

The prevalence of overweight including obesity was 28.2% (95% CI: 24.2-32.2). Significant proportions of adults had moderate (37.6%) or low (2.6%) physical activity level. As compared to men, women had 2.56 (95% CI: 1.85-4.76) times increased odds of overweight/obesity. With reference to adults 18-24 years of age, the odds were three times higher among adults 45-54 (3.06, 95% CI: 1.29-7.20) and 55-64 (2.88, 95% CI: 1.06-7.84) years. Those from the highest income tercile were 3.16 times (95% CI: 1.88-5.30) more likely to be overweight/obese as compared to adults from the lowest tercile. Having moderate (3.10, 95% CI: 1.72-5.60) or low (4.80 95% CI: 2.50-9.23) physical activity was also significantly associated with the outcome. Further, daily intake of alcohol and, frequent consumption of sweets, meat and eggs were associated with overweight/obesity. Conversely, no significant associations were evident for meal frequency, practices of skipping breakfast, behavior of eating away from home and frequency of consumption of fast foods, fruits and vegetables.

CONCLUSIONS

Prompting active lifestyle, limiting intakes of sweets, advocating optimum consumption of alcohol and calorie dense animal source foods, especially amongst the better-off segment of the population, may reduce the magnitude of over-nutrition.

Normality, Naturalness, Necessity, and Nutritiousness of the New Meat Alternatives

In the West, meat is acceptable, tasty, delicious, palatable, and enjoyable. It has a well-established position in the consumers' food habits shaping the taste of the affluent eating culture and accepted as normal, natural, necessary, and nutritious. Although recent scientific evidence recognizes that meat has a high negative environmental impact, there is still lack of attention on the fact that we live on a planet with limited resources which need to be preserved. Part of this is a transition to more sustainable consumption habits and diets. This chapter examines the social readiness and acceptability of new meat alternatives as normal, natural, necessary, and nutritious amongst Gen Y and Gen Z consumers. It concludes that a reduction in meat consumption should be an essential part of creating a more sustainable diet in light of the projected increase of the world population, expected human health benefits, and improved environmental wellbeing of the planet.

Reconciling Not Eating Meat and Masculinity in the Marketing Discourse for New Food Alternatives

Traditional hegemonic masculinity can be traced on the typical man's plate where meat represents the centerpiece. Meat consumption dominates the current marketing discourse which builds on masculinity to reinforce the stereotyped gender-based diets. In light of scientific evidence about the detrimental impacts of meat consumption on human wellbeing and environmental health, this chapter argues that men are at the crossroads where the concept of masculinity is being redefined. Their social role is similarly changing with new expectations for more sustainable diets which call for plant-based food choices and possibly lab-grown meat. Some men are endorsing these imperatives while others continue to succumb to social inertia. A new marketing discourse is needed which reconciles masculinity with not eating meat and encourages a transition to alternative dietary choices that are better for personal health, allow improved use of the planet's resources, and have less impact on climate change.

Effects of audiovisual stimuli on psychological and psychophysiological responses during exercise in adults with obesity

The present experiment sought to further understanding of the effects of personalised audiovisual stimuli on psychological and psychophysiological responses during exercise in adults with obesity. Twenty-four participants (M_age = 28.3, SD = 5.5 years; M_BMI = 32.2, SD = 2.4) engaged in self-paced exercises on a recumbent cycle ergometer and three conditions (sensory stimulation [ST], sensory deprivation [DE], and control [CO]) were administered. Perceptual (attentional focus and perceived exertion), affective (affective state and perceived activation), and psychophysiological (heart rate variability) parameters were monitored throughout the exercise bouts. A one-way repeated measures analysis of variance was used to compare self-reported and psychophysiological variables (main and interaction effects [5 Timepoints × 3 Conditions]). The results indicate that ST increased the use of dissociative thoughts throughout the exercise session (η_p² = .19), ameliorated fatigue-related symptoms (η_p² = .15) and elicited more positive affective responses (η_p² = .12) than CO and DE. Accordingly, personally-compiled videos are highly effective in ameliorating exertional responses and enhancing affective valence during self-paced exercise in adults with obesity. Audiovisual stimuli could be used during the most critical periods of the exercise regimen (e.g., first training sessions) when individuals with obesity are more likely to focus on fatigue-related sensations.

Relaxed natural selection contributes to global obesity increase more in males than in females due to more environmental modifications in female body mass

OBJECTIVE

Relaxed natural selection, measured by Biological State Index (Ibs), results in unfavourable genes/mutations accumulation in population. Obesity is partly heritable. We aim to examine and compare the effects of relaxed natural selection on male and female obesity prevalence.

METHODS

Data for 191 countries of the world were captured for this ecological study. Curvilinear regressions, bivariate and partial correlations, linear mixed models and multivariate linear regression analyses were used to examine the relationship between Ibs and sex-specific obesity prevalence. Per capita GDP, urbanization and caloric intake were controlled for as the confounding factors. Fisher r-to-z transformation, R2 increment in multivariate regression and F-test were used to compare the correlations.

RESULTS

Curvilinear regressions, bivariate and partial correlations (controlled for GDP, urbanization and calories) revealed that Ibs was significantly correlated to obesity prevalence of both sexes, but significantly stronger to male than to female obesity prevalence. Curvilinear regression models also showed strong correlations. Mixed linear models, with effects of GDP, urbanisation and caloric intake controlled for, showed that male and female average obesity prevalence rates were significantly higher in countries with greater Ibs value than their equivalents in countries with lower Ibs. Between higher and lower Ibs countries, the gap of male obesity prevalence is 60% greater than the gap of female obesity prevalence. Stepwise multiple regression identified that Ibs was a significant predictor of obesity prevalence of both sexes. Multivariate regression showed that, adding Ibs as an obesity predictor, R2 increment in male model was significantly greater than in female model.

CONCLUSIONS

Relaxed natural selection may drive males and females to accumulate metabolic faulty genes equally. Probably due to greater environmental, personal intervention in regulating female body mass, relaxed natural selection shows less contributing effects to female obesity prevalence than to male obesity prevalence. Gene therapy to prevent obesity may need to be also taken into account.

Obesity and neurological disorders: Dietary perspective of a global menace

Obesity is considered a major public health concern throughout the world among children, adolescents, as well as adults and several therapeutic, preventive and dietary interventions are available. In addition to life style changes and medical interventions, significant milestones have been achieved in the past decades in the development of several functional foods and dietary regimens to reduce this menace. Being a multifactorial phenomenon and related to increased fat mass that adversely affects health, obesity has been associated with the development of several other co-morbidities. A great body of research and strong scientific evidence identifies obesity as an important risk factor for onset and progression of several neurological disorders. Obesity induced dyslipidaemia, metabolic dysfunction, and inflammation are attributable to the development of a variety of effects on central nervous system (CNS). Evidence suggests that neurological diseases such as Parkinson's disease and Alzheimer's disease could be initiated by various metabolic changes, related to CNS damage, caused by obesity. These metabolic changes could alter the synaptic plasticity of the neurons and lead to neural death, affecting the normal physiology of CNS. Dietary intervention in combination with exercise can affect the molecular events involved in energy metabolism and synaptic plasticity and are considered effective non-invasive strategy to counteract cognitive and neurological disorders. The present review gives an overview of the obesity and related neurological disorders and the possible dietary interventions.