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Leschewski A, Pierce SJ, Aragon MC, Baker SS, Udahogora M, Pybus K, Duffy NO, Roe AJ, Sankavaram K. A Proposed Cost-Benefit Analysis of Adult EFNEP Utilizing Biomarkers of Chronic Disease Risk. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00396-8. [PMID: 39254620 DOI: 10.1016/j.jneb.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVE To assess whether the adult Expanded Food and Nutrition Education Program (EFNEP) is a cost-effective intervention that generates sustained improvement in biomarkers of chronic disease risk. DESIGN A longitudinal quasi-experimental design with 2 parallel arms (untreated comparison vs EFNEP) and 4 waves of data collection (pretest, posttest, 6 months, and 12 months after completion). SETTING Eligible adult EFNEP community settings in Colorado, Florida, Maryland, and Washington. PARTICIPANTS Free-living adults (n = 500) aged 18-50 years, with income ≤ 185% of the Federal Poverty Line. INTERVENTION(S) Adult EFNEP delivered using an evidence-based curriculum, Eating Smart • Being Active. MAIN OUTCOME MEASURE(S) Chronic disease biomarkers (body mass index, blood pressure, and HbA1c), food and physical activity behaviors, dietary intake, health status, and demographics will be measured using objective biometric indicators, the Adult EFNEP Questionnaire, a 24-hour dietary recall, a health questionnaire, and demographic forms. ANALYSIS Linear mixed models will be used to assess whether adult EFNEP has a significant (P < 0.01) impact on 3 chronic disease biomarkers. The program's estimated impact on chronic disease biomarkers will be incorporated into a cost-benefit analysis framework to assess the economic value generated by adult EFNEP through chronic disease risk reduction.
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Affiliation(s)
- Andrea Leschewski
- Ness School of Management and Economics, South Dakota State University, Brookings, SD.
| | - Steven J Pierce
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI
| | | | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Margaret Udahogora
- Department of Nutrition and Food Science, University of Maryland, College Park, MD
| | - Kylie Pybus
- Expanded Food & Nutrition Education Program, Washington State University-Extension, Spokane, WA
| | - Nicole Owens Duffy
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL
| | - Annie J Roe
- Margaret Ritchie School of Family and Consumer Sciences, College of Agricultural and Life Sciences, University of Idaho, Moscow, ID
| | - Kavitha Sankavaram
- Department of Nutrition and Food Science, University of Maryland, College Park, MD
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Li M, Zhang L, Huang B, Liu Y, Chen Y, Lip GYH. Free fatty acids and mortality among adults in the United States: a report from US National Health and Nutrition Examination Survey (NHANES). Nutr Metab (Lond) 2024; 21:72. [PMID: 39256788 PMCID: PMC11389384 DOI: 10.1186/s12986-024-00844-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/26/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND The relationship between free fatty acids (FFAs) and the risk of mortality remains unclear. There is a scarcity of prospective studies examining the associations between specific FFAs, rather than total concentrations, of their effect on long-term health outcomes. OBJECTIVE To evaluate the correlation between different FFAs and all-cause and cardiovascular mortality in a large, diverse, nationally representative sample of adults in the US, and examine how different FFAs may mediate this association. METHODS This cohort study included unsaturated fatty acids (USFA) and saturated fatty acids (SFA) groups in the US National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014 and provided blood samples for FFAs levels. Multiple model calibration was performed using Cox regression analysis for known risk factors to explore the associations between FFAs and all-cause and cardiovascular mortality. RESULTS In the group of USFA, 3719 people were included, median follow-up, 6.7 years (5.8-7.8 years). In the SFA group, we included 3900 people with a median follow-up, 6.9 years (5.9-8 years). In the USFA group, myristoleic acid (14:1 n-5) (hazard ratio (HR) 1.02 [1.006-1.034]; P = 0.004), palmitoleic acid (16:1 n-7) (HR 1.001 [1.001-1.002]; P < 0.001), cis-vaccenic acid (18:1 n-7) (HR 1.006 [1.003-1.009]; P < 0.001), nervonic acid (24:1 n-9) (HR 1.007 [1.002-1.012]; P = 0.003), eicosatrienoic acid (20:3 n-9) (HR 1.027 [1.009-1.046]; P = 0.003), docosatetraenoic acid (22:4 n-6) (HR 1.024 [1.012-1.036]; P < 0.001), and docosapentaenoic acid (22:5 n-6) (HR 1.019 [1.006-1.032]; P = 0.005) were positively associated with the all-cause mortality, while docosahexaenoic acid (22:6 n-3) had a statistically lower risk of all-cause mortality (HR 0.998 [0.996-0.999]; P = 0.007). Among the SFA group, palmitic acid (16:0) demonstrated a higher risk of all-cause mortality (HR 1.00 [1.00-1.00]; P = 0.022), while tricosanoic acid (23:0) (HR 0.975 [0.959-0.991]; P = 0.002) and lignoceric acid (24:0) (HR 0.992 [0.984-0.999]; P = 0.036) were linked to a lower risk of all-cause mortality. Besides 23:0 and 24:0, the other FFAs mentioned above were linearly associated with the risks of all-cause mortality. CONCLUSIONS In this nationally representative cohort of US adults, some different FFAs exhibited significant associations with risk of all-cause mortality. Achieving optimal concentrations of specific FFAs may lower this risk of all-cause mortality, but this benefit was not observed in regards to cardiovascular mortality.
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Affiliation(s)
- Meng Li
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
| | - Lijing Zhang
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Bi Huang
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Liu
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Yang Chen
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Jung S, Young HA, Braffett BH, Simmens SJ, Ogden CL. Development of a sustainable diet index in US adults. Nutr J 2024; 23:46. [PMID: 38658958 PMCID: PMC11040758 DOI: 10.1186/s12937-024-00943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND A transformation towards healthy diets through a sustainable food system is essential to enhance both human and planet health. Development of a valid, multidimensional, quantitative index of a sustainable diet would allow monitoring progress in the US population. We evaluated the content and construct validity of a sustainable diet index for US adults (SDI-US) based on data collected at the individual level. METHODS The SDI-US, adapted from the SDI validated in the French population, was developed using data on US adults aged 20 years and older from the National Health and Nutrition Examination Survey, 2007-2018 (n = 25,543). The index consisted of 4 sub-indices, made up of 12 indicators, corresponding to 4 dimensions of sustainable diets (nutritional quality, environmental impacts, affordability (economic), and ready-made product use behaviors (sociocultural)). A higher SDI-US score indicates greater alignment with sustainable diets (range: 4-20). Validation analyses were performed, including the assessment of the relevance of each indicator, correlations between individual indicators, sub-indices, and total SDI-US, differences in scores between sociodemographic subgroups, and associations with selected food groups in dietary guidelines, the alternative Mediterranean diet (aMed) score, and the EAT-Lancet diet score. RESULTS Total SDI-US mean was 13.1 (standard error 0.04). The correlation between SDI-US and sub-indices ranged from 0.39 for the environmental sub-index to 0.61 for the economic sub-index (Pearson Correlation coefficient). The correlation between a modified SDI-US after removing each sub-index and the SDI-US ranged from 0.83 to 0.93. aMed scores and EAT-Lancet diet scores were significantly higher among adults in the highest SDI-US quintile compared to the lowest quintile (aMed: 4.6 vs. 3.2; EAT-Lancet diet score: 9.9 vs. 8.7 p < .0001 for both). CONCLUSIONS Overall, content and construct validity of the SDI-US were acceptable. The SDI-US reflected the key features of sustainable diets by integrating four sub-indices, comparable to the SDI-France. The SDI-US can be used to assess alignment with sustainable diets in the US. Continued monitoring of US adults' diets using the SDI-US could help improve dietary sustainability.
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Affiliation(s)
- Sukyoung Jung
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
- The Korean Institute of Nutrition, Hallym University, 1 Hallymdaehak-gil, Chuncheon, 24252, South Korea.
| | - Heather A Young
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Barbara H Braffett
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Samuel J Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Cynthia L Ogden
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Lechner K, Bock M, von Schacky C, Scherr J, Lorenz E, Lechner B, Haller B, Krannich A, Halle M, Wachter R, Duvinage A, Edelmann F. Trans-fatty acid blood levels of industrial but not natural origin are associated with cardiovascular risk factors in patients with HFpEF: a secondary analysis of the Aldo-DHF trial. Clin Res Cardiol 2023; 112:1541-1554. [PMID: 36640187 PMCID: PMC10584704 DOI: 10.1007/s00392-022-02143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Industrially processed trans-fatty acids (IP-TFA) have been linked to altered lipoprotein metabolism, inflammation and increased NT-proBNP. In patients with heart failure with preserved ejection fraction (HFpEF), associations of TFA blood levels with patient characteristics are unknown. METHODS This is a secondary analysis of the Aldo-DHF-RCT. From 422 patients, individual blood TFA were analyzed at baseline in n = 404 using the HS-Omega-3-Index® methodology. Patient characteristics were: 67 ± 8 years, 53% female, NYHA II/III (87/13%), ejection fraction ≥ 50%, E/e' 7.1 ± 1.5; NT-proBNP 158 ng/L (IQR 82-298). A principal component analysis was conducted but not used for further analysis as cumulative variance for the first two PCs was low. Spearman's correlation coefficients as well as linear regression analyses, using sex and age as covariates, were used to describe associations of whole blood TFA with metabolic phenotype, functional capacity, echocardiographic markers for LVDF and neurohumoral activation at baseline and after 12 months. RESULTS Blood levels of the naturally occurring TFA C16:1n-7t were inversely associated with dyslipidemia, body mass index/truncal adiposity, surrogate markers for non-alcoholic fatty liver disease and inflammation at baseline/12 months. Conversely, IP-TFA C18:1n9t, C18:2n6tt and C18:2n6tc were positively associated with dyslipidemia and isomer C18:2n6ct with dysglycemia. C18:2n6tt and C18:2n6ct were inversely associated with submaximal aerobic capacity at baseline/12 months. No significant association was found between TFA and cardiac function. CONCLUSIONS In HFpEF patients, higher blood levels of IP-TFA, but not naturally occurring TFA, were associated with dyslipidemia, dysglycemia and lower functional capacity. Blood TFAs, in particular C16:1n-7t, warrant further investigation as prognostic markers in HFpEF. Higher blood levels of industrially processed TFA, but not of the naturally occurring TFA C16:1n-7t, are associated with a higher risk cardiometabolic phenotype and prognostic of lower aerobic capacity in patients with HFpEF.
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Affiliation(s)
- Katharina Lechner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Bock
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
| | | | - Johannes Scherr
- University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Elke Lorenz
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Benjamin Lechner
- Department of Internal Medicine IV, Ludwig-Maximilians University, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | | - Martin Halle
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Rolf Wachter
- Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Göttingen, Göttingen, Germany
| | - André Duvinage
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Frank Edelmann
- Department of Cardiology, Campus Virchow Klinikum (CVK), Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany.
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Hibbing PR, Welk GJ, Ries D, Yeh HW, Shook RP. Criterion validity of wrist accelerometry for assessing energy intake via the intake-balance technique. Int J Behav Nutr Phys Act 2023; 20:115. [PMID: 37749645 PMCID: PMC10521469 DOI: 10.1186/s12966-023-01515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Intake-balance assessments measure energy intake (EI) by summing energy expenditure (EE) with concurrent change in energy storage (ΔES). Prior work has not examined the validity of such calculations when EE is estimated via open-source techniques for research-grade accelerometry devices. The purpose of this study was to test the criterion validity of accelerometry-based intake-balance methods for a wrist-worn ActiGraph device. METHODS Healthy adults (n = 24) completed two 14-day measurement periods while wearing an ActiGraph accelerometer on the non-dominant wrist. During each period, criterion values of EI were determined based on ΔES measured by dual X-ray absorptiometry and EE measured by doubly labeled water. A total of 11 prediction methods were tested, 8 derived from the accelerometer and 3 from non-accelerometry methods (e.g., diet recall; included for comparison). Group-level validity was assessed through mean bias, while individual-level validity was assessed through mean absolute error, mean absolute percentage error, and Bland-Altman analysis. RESULTS Mean bias for the three best accelerometry-based methods ranged from -167 to 124 kcal/day, versus -104 to 134 kcal/day for the non-accelerometry-based methods. The same three accelerometry-based methods had mean absolute error of 323-362 kcal/day and mean absolute percentage error of 18.1-19.3%, versus 353-464 kcal/day and 19.5-24.4% for the non-accelerometry-based methods. All 11 methods demonstrated systematic bias in the Bland-Altman analysis. CONCLUSIONS Accelerometry-based intake-balance methods have promise for advancing EI assessment, but ongoing refinement is necessary. We provide an R package to facilitate implementation and refinement of accelerometry-based methods in future research (see paulhibbing.com/IntakeBalance).
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Affiliation(s)
- Paul R Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St, Rm 650, Mail Code 517, Chicago, IL, 60612, USA.
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Daniel Ries
- Statistical Sciences Department, Sandia National Laboratories, Albuquerque, NM, USA
| | - Hung-Wen Yeh
- Biostatistics & Epidemiology Core, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA
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Egele VS, Klopp E, Stark R. Evaluating self-reported retrospective average daily fruit, vegetable, and egg intake: Trustworthy-Sometimes! Appl Psychol Health Well Being 2023; 15:1130-1149. [PMID: 36509422 DOI: 10.1111/aphw.12430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Retrospective self-reports are commonly used to assess dietary intake. Yet, their use is criticized as it is unclear whether the underlying assumptions for valid self-reports are met: Individuals have to consider the behavior of all days in the retention interval and weigh the behavior of all days equally. This study examines whether these assumptions for retrospective self-reports are met and whether interindividual differences in self-report performance are relevant regarding these assumptions. Ninety-two participants aged 18-61 years participated in seven sequential 24-h recalls and one retrospective 7-day recall concerning their intake of fruit, vegetables, and eggs. A multiple linear regression approach was used to examine the relation between the daily reported dietary intake and the 7-day recall. In the overall sample, the requirements for retrospective self-reports were not tenable. Distinguishing good and poor self-reporters based on a rational criterion showed that the requirements can be taken as given for good self-reporters, whereas poor self-reporters base their retrospective self-reports mostly on recency effects. The underlying requirements for retrospective self-reports appear to be met in two thirds of the sample, supporting the use of retrospective self-reports to capture dietary behavior. Future research should investigate characteristics separating good from poor self-reporters.
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Affiliation(s)
- Viktoria S Egele
- Department of Educational Research, Saarland University, Saarbrücken, Germany
| | - Eric Klopp
- Department of Educational Research, Saarland University, Saarbrücken, Germany
| | - Robin Stark
- Department of Educational Research, Saarland University, Saarbrücken, Germany
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Hibbing PR, Shook RP, Panda S, Manoogian EN, Mashek DG, Chow LS. Predicting energy intake with an accelerometer-based intake-balance method. Br J Nutr 2023; 130:344-352. [PMID: 36250527 PMCID: PMC10106530 DOI: 10.1017/s0007114522003312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Nutritional interventions often rely on subjective assessments of energy intake (EI), but these are susceptible to measurement error. To introduce an accelerometer-based intake-balance method for assessing EI using data from a time-restricted eating (TRE) trial. Nineteen participants with overweight/obesity (25-63 years old; 16 females) completed a 12-week intervention (NCT03129581) in a control group (unrestricted feeding; n 8) or TRE group (n 11). At the start and end of the intervention, body composition was assessed by dual-energy X-ray absorptiometry (DXA) and daily energy expenditure (EE) was assessed for 2 weeks via wrist-worn accelerometer. EI was back-calculated as the sum of net energy storage (from DXA) and EE (from accelerometer). Accelerometer-derived EI estimates were compared against estimates from the body weight planner of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Mean EI for the control group declined by 138 and 435 kJ/day for the accelerometer and NIDDK methods, respectively (both P ≥ 0·38), v. 1255 and 1469 kJ/day, respectively, for the TRE group (both P < 0·01). At follow-up, the accelerometer and NIDDK methods showed excellent group-level agreement (mean bias of -297 kJ/day across arms; standard error of estimate 1054 kJ/day) but high variability at the individual level (limits of agreement from -2414 to +1824 kJ/day). The accelerometer-based intake-balance method showed plausible sensitivity to change, and EI estimates were biologically and behaviourally plausible. The method may be a viable alternative to self-report EI measures. Future studies should assess criterion validity using doubly labelled water.
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Affiliation(s)
- Paul R. Hibbing
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, 610 E 22 St, Kansas City, MO 64108, USA
| | - Robin P. Shook
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, 610 E 22 St, Kansas City, MO 64108, USA
- School of Medicine, University of MO-Kansas City, 2411 Holmes St, Kansas City, MO 64108, USA
| | - Satchidananda Panda
- Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Emily N.C. Manoogian
- Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Douglas G. Mashek
- Division of Diabetes, Endocrinology, and Metabolism; Department of Medicine, University of MN Medical School, 909 Fulton St SE, Minneapolis, MN 55455, USA
| | - Lisa S. Chow
- Division of Diabetes, Endocrinology, and Metabolism; Department of Medicine, University of MN Medical School, 909 Fulton St SE, Minneapolis, MN 55455, USA
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Hirschberger S, Schmid A, Kreth S. [Immunomodulation by nutritional intervention in critically ill patients]. DIE ANAESTHESIOLOGIE 2023; 72:229-244. [PMID: 36797533 PMCID: PMC9934515 DOI: 10.1007/s00101-023-01258-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 04/12/2023]
Abstract
Critically ill patients often suffer from a complex and severe immunological dysfunction. The differentiation and function of human immune cells are fundamentally controlled through metabolic processes. New concepts of immunonutrition therefore try to use enteral and parenteral nutrition to positively impact on the immune function of intensive care unit patients. This review article concisely presents the currently available evidence on the commonly used isolated supplements (anti-oxidative substances, amino acids, essential fatty acids) and difficulties related to their clinical use. The second part presents new and more comprehensive concepts of immunonutrition to influence the intestinal microbiome and to modulate the macronutrient composition. Immunonutrition of critically ill patients bears enormous potential and could become a valuable clinical tool for modulation of the immunometabolism of intensive care unit patients.
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Affiliation(s)
- Simon Hirschberger
- Klinik für Anaesthesiologie, LMU Klinikum München, München, Deutschland
- Walter-Brendel-Zentrum für experimentelle Medizin, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 68, 81377, München, Deutschland
| | - Annika Schmid
- Klinik für Anaesthesiologie, LMU Klinikum München, München, Deutschland
- Walter-Brendel-Zentrum für experimentelle Medizin, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 68, 81377, München, Deutschland
| | - Simone Kreth
- Klinik für Anaesthesiologie, LMU Klinikum München, München, Deutschland.
- Walter-Brendel-Zentrum für experimentelle Medizin, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 68, 81377, München, Deutschland.
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Kaufman HW. Let's Modernize Public Health Care Data. Am J Clin Pathol 2023; 159:207-208. [PMID: 36622333 PMCID: PMC10010068 DOI: 10.1093/ajcp/aqac156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Ihekweazu C. Is Coffee the Cause or the Cure? Conflicting Nutrition Messages in Two Decades of Online New York Times' Nutrition News Coverage. HEALTH COMMUNICATION 2023; 38:260-274. [PMID: 34519247 DOI: 10.1080/10410236.2021.1950291] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Two-thirds of US adults report hearing news stories about diet and health relationships daily or a few times a week. These stories have often been labeled as conflicting. While public opinion suggests conflicting nutrition messages are widespread, there has been limited empirical research to support this belief. This study examined the prevalence of conflicting information in online New York Times' news articles discussing published nutrition research between 1996-2016. It also examined the contextual differences that existed between conflicting studies. The final sample included 375 news articles discussing 416 diet and health relationships (228 distinct relationships). The most popular dietary items discussed were alcoholic beverages (n = 51), vitamin D (n = 26), and B vitamins (n = 23). Over the 20-year study period, 12.7% of the 228 diet and health relationships had conflicting reports. Just under three-fourths of the conflicting reports involved changes in study design, 79% involved changes in study population, and 31% involved changes in industry funding. Conflicting nutrition messages can have negative cognitive and behavioral consequences for individuals. To help effectively address conflicting nutrition news coverage, a multi-pronged approach involving journalists, researchers, and news audiences is needed.
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Heredia NI, Zhang X, Balakrishnan M, Hwang JP, Thrift AP. Association of lifestyle behaviors with non-alcoholic fatty liver disease and advanced fibrosis detected by transient elastography among Hispanic/Latinos adults in the U.S. ETHNICITY & HEALTH 2023; 28:299-312. [PMID: 35067116 PMCID: PMC9307692 DOI: 10.1080/13557858.2022.2027883] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/05/2022] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent liver disease, with the highest prevalence observed in the U.S. among Hispanic/Latino adults. While physical activity and dietary behaviors have established protective associations with NAFLD and its severity, these associations have not been well-characterized in Hispanic/Latino adults. The purpose of this study was to assess the association of lifestyle behaviors with NAFLD and advanced fibrosis in US Hispanic/Latino adults. DESIGN We selected all Hispanic/Latino adults from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). NAFLD was defined as CAP ≥285 dB/m, and advanced fibrosis as liver stiffness measurements ≥8.6 kPa. Multivariate-adjusted logistic regression models assessed associations of physical activity and sedentary behavior (Global Physical Activity Questionnaire), as well as diet quality (Healthy Eating Index [HEI]-2015) and total energy intake (24-hour recall) with NAFLD and advanced fibrosis. RESULTS In Hispanic/Latino adults, the overall prevalence of NAFLD was 41.5%, while the prevalence of advanced fibrosis among those with NAFLD was 17.2%. We found that higher levels of physical activity and high diet quality were associated with lower risk of NAFLD. Compared to those reporting on average 0 metabolic equivalent (MET) hours/week of physical activity, participants reporting high levels of physical activity (≥32 MET hours/week) had 40% lower risk of NAFLD (Adjusted OR = 0.60, 95%CI 0.38, 0.93). High diet quality (HEI-2015) was associated with a 30% lower risk of NAFLD (Adjusted OR = 0.70, 95% CI 0.51, 0.97) and 72% lower risk of advanced fibrosis (Adjusted OR = 0.28, 95% CI 0.12, 0.66), as compared to those with low diet quality. CONCLUSIONS In this population-based study, high levels of physical activity and diet quality were associated with lower risk of NAFLD in Hispanic/Latino adults. Public health and medical professionals need to concentrate efforts on lifestyle behavior change in Hispanic/Latino adults who are at high risk for serious liver disease.
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Affiliation(s)
- Natalia I Heredia
- Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Xiaotao Zhang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maya Balakrishnan
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
| | - Jessica P Hwang
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aaron P Thrift
- Department of Medicine, Section of Epidemiology and Population Sciences &Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
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Macdonald E, Buchan D, Cerexhe L, Renfrew L, Sculthorpe N. Accelerometer measured physical activity and sedentary time in individuals with multiple sclerosis versus age matched controls: A systematic review and meta-analysis. Mult Scler Relat Disord 2023; 69:104462. [PMID: 36521386 DOI: 10.1016/j.msard.2022.104462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND People with Multiple Sclerosis (PwMS) find it more difficult to engage in physical activity (PA) than healthy controls. Accelerometers can be used to measure sedentary time and free-living physical activity, understanding the differences between PwMS and controls can help inform changes such as interventions to promote a more active lifestyle. This in turn will help prevent secondary conditions and reduce symptom progression. OBJECTIVE To conduct a systematic review and meta-analysis on accelerometer measured sedentary behavior and physical activity between PwMS and healthy controls. METHODS A systematic search of five databases (PubMed, Web of Science, Ovid, Science Direct and CINAHIL) from inception until 22nd November 2019. Inclusion criteria was (1) included a group of participants with a definite diagnosis of multiple sclerosis of any type; (2) have 3 or more days of PA monitoring using accelerometers during free living conditions; (3) include age matched healthy controls; (4) assess adults over the age of 18; (5) reported data had to have been reported in a manner suitable for quantitative pooling including: percent of time spent sedentary, minutes per day of sedentary, light, moderate, vigorous activity (moderate and vigorous totaled together), steps per day or counts per day. RESULTS Initial search produced 9021 papers, after applying inclusion criteria 21 eligible papers were included in the study. One paper was a longitudinal study from which only baseline data was included. One paper was a reliability and validity study, with data for PwMS versus controls in the validity section. All other papers are cross sectional, with one being a pilot study and another a random control study. One paper used two devices in unison, only one set of data is included in the statistics. Outcome data was available for 1098 participants, 579 PwMS and 519 healthy controls. Significant differences were seen in all categories tested: (1) sedentary time (min/day), standard mean difference -0.286, P = 0.044, n = 4 studies; (2) relative sedentary time (%/day), standard mean difference -0.646, P = 0.000, n = 5 studies; (3) LPA (min/day), standard mean difference 0.337, P = 0.039, n = 5 studies; (4) relative LPA (%/day), standard mean difference 0.211, P = 0.152, n = studies; (5) MVPA (min/day), standard mean difference 0.801, P = 0.000, n = 8 studies; (6) relative MVPA (%/day), mean difference 0.914, P = 0.000, n = 5 studies; (7) step count, standard mean difference 0.894, P = 0.000, n = 8 studies; (8) activity count, standard mean difference 0.693, P = 0.000, n = 13 studies. CONCLUSION PwMS are more sedentary and engage in less LPA, MVPA, steps per day and accelerometer counts per day than healthy controls when measured using accelerometers during free-living conditions.
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Affiliation(s)
- Eilidh Macdonald
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom.
| | - Duncan Buchan
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom
| | - Luke Cerexhe
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom
| | - Linda Renfrew
- Douglas Grant Rehabilitation Unit, Ayrshire Central Hospital, Kilwinning Road, Irvine, Ayrshire, Scotland KA12 8SS, United Kingdom
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom
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14
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KIANI AYSHAKARIM, DHULI KRISTJANA, DONATO KEVIN, AQUILANTI BARBARA, VELLUTI VALERIA, MATERA GIUSEPPINA, IACONELLI AMERIGO, CONNELLY STEPHENTHADDEUS, BELLINATO FRANCESCO, GISONDI PAOLO, BERTELLI MATTEO. Main nutritional deficiencies. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E93-E101. [PMID: 36479498 PMCID: PMC9710417 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2752] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Nutrition is the source of energy that is required to carry out all the processes of human body. A balanced diet is a combination of both macro- and micronutrients. "Nutritional inadequacy" involves an intake of nutrients that is lower than the estimated average requirement, whereas "nutritional deficiency" consists of severely reduced levels of one or more nutrients, making the body unable to normally perform its functions and thus leading to an increased risk of several diseases like cancer, diabetes, and heart disease. Malnutrition could be caused by environmental factors, like food scarcity, as well as disease conditions, like anorexia nervosa, fasting, swallowing inability, persistent vomiting, impaired digestion, intestinal malabsorption, or other chronic diseases. Nutritional biomarkers - like serum or plasma levels of nutrients such as folate, vitamin C, B vitamins, vitamin D, selenium, copper, zinc - could be used for the evaluation of nutrient intake and dietary exposure. Macronutrients deficiencies could cause kwashiorkor, marasmus, ketosis, growth retardation, wound healing, and increased infection susceptibility, whereas micronutrient - like iron, folate, zinc, iodine, and vitamin A - deficiencies lead to intellectual impairment, poor growth, perinatal complications, degenerative diseases associated with aging and higher morbidity and mortality. Preventing macro- and micronutrient deficiency is crucial and this could be achieved through supplementation and food-based approaches.
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Affiliation(s)
| | | | - KEVIN DONATO
- MAGI EUREGIO, Bolzano, Italy
- Correspondence: Kevin Donato, MAGI EUREGIO, Bolzano,
39100, Italy. E-mail:
| | - BARBARA AQUILANTI
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli
IRCCS, Rome, Italy
| | - VALERIA VELLUTI
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli
IRCCS, Rome, Italy
| | - GIUSEPPINA MATERA
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli
IRCCS, Rome, Italy
| | - AMERIGO IACONELLI
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli
IRCCS, Rome, Italy
| | - STEPHEN THADDEUS CONNELLY
- San Francisco Veterans Affairs Health Care System,
Department of Oral & Maxillofacial Surgery, University of
California, San Francisco, CA, USA
| | - FRANCESCO BELLINATO
- Section of Dermatology and Venereology, Department of
Medicine, University of Verona, Verona,
Italy
| | - PAOLO GISONDI
- Section of Dermatology and Venereology, Department of
Medicine, University of Verona, Verona,
Italy
| | - MATTEO BERTELLI
- MAGI EUREGIO, Bolzano, Italy
- MAGI’S LAB, Rovereto (TN),
Italy
- MAGISNAT, Peachtree Corners (GA),
USA
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Ducharme-Smith K, Brady TM, Vizthum D, Caulfield LE, Mueller NT, Rosenstock S, Garcia-Larsen V. Diet quality scores associated with improved cardiometabolic measures among African American adolescents. Pediatr Res 2022; 92:853-861. [PMID: 34916627 PMCID: PMC8674518 DOI: 10.1038/s41390-021-01893-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/19/2021] [Accepted: 11/24/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The Reversing the Negative cardiovascular Effects on Weight (ReNEW) Clinic is a prospective cohort study in children and adolescents (≤21 years) at the Johns Hopkins Children's Center. METHODS Cross-sectional analysis between diet quality using the Alternative Healthy Eating Index (AHEI-2010), pro-inflammatory potential using the Children's Dietary Inflammatory Index (C-DII), and cardiometabolic outcomes. AHEI-2010 and C-DII scores were assessed by median intake determined from the sample distribution and associated with cardiometabolic measures using linear regression models. Changes in measures were evaluated in a sub-sample of participants invited to attend follow-up visits due to the presence of hypertensive blood pressure (n = 33). RESULTS Participants (n = 90) reported an average energy intake of 1790 kcal/day (SD ± 734), AHEI-2010 score of 55.04 (SD ± 9.86) (range: 0 to 110) and C-DII score of -0.12 (±0.86) (range -5 to 5). Participants with higher quality/anti-inflammatory diets trended towards more favorable cardiometabolic measures at baseline. Among the sub-sample (n = 33), there was a significant reduction in total energy (m = -302 kcal/day; p-value= 0.03) but no change in AHEI-2010 (p-value = 0.73) or C-DII score (p-value = 0.85) over follow-up. CONCLUSIONS Despite stable diet quality scores, outpatient dietary and behavioral counseling may be an effective tool to reduce energy intake in youth with overweight/obesity and elevated blood pressure. IMPACT Diet quality scores among obese, hypertensive, African American adolescents were low and reflect a pro-inflammatory diet. Reported intake was negligible for fruits, whole grains, nuts, and legumes, and well above the daily limit for sodium and saturated fat. Participants with high quality/anti-inflammatory diet quality scores trended toward improved cardiometabolic measures. Outpatient dietary counseling resulted in reduced total energy intake.
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Affiliation(s)
- Kirstie Ducharme-Smith
- Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tammy M Brady
- Pediatric Hypertension Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Diane Vizthum
- The Institute for Clinical and Translational Research, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Laura E Caulfield
- Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noel T Mueller
- Program in Cardiovascular and Clinical Epidemiology, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Summer Rosenstock
- Social and Behavioral Interventions, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Tufford AR, Diou C, Lucassen DA, Ioakimidis I, O'Malley G, Alagialoglou L, Charmandari E, Doyle G, Filis K, Kassari P, Kechadi T, Kilintzis V, Kok E, Lekka I, Maglaveras N, Pagkalos I, Papapanagiotou V, Sarafis I, Shahid A, van ’t Veer P, Delopoulos A, Mars M. Toward Systems Models for Obesity Prevention: A Big Role for Big Data. Curr Dev Nutr 2022; 6:nzac123. [PMID: 36157849 PMCID: PMC9492244 DOI: 10.1093/cdn/nzac123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/24/2022] [Accepted: 07/28/2022] [Indexed: 11/14/2022] Open
Abstract
The relation among the various causal factors of obesity is not well understood, and there remains a lack of viable data to advance integrated, systems models of its etiology. The collection of big data has begun to allow the exploration of causal associations between behavior, built environment, and obesity-relevant health outcomes. Here, the traditional epidemiologic and emerging big data approaches used in obesity research are compared, describing the research questions, needs, and outcomes of 3 broad research domains: eating behavior, social food environments, and the built environment. Taking tangible steps at the intersection of these domains, the recent European Union project "BigO: Big data against childhood obesity" used a mobile health tool to link objective measurements of health, physical activity, and the built environment. BigO provided learning on the limitations of big data, such as privacy concerns, study sampling, and the balancing of epidemiologic domain expertise with the required technical expertise. Adopting big data approaches will facilitate the exploitation of data concerning obesity-relevant behaviors of a greater variety, which are also processed at speed, facilitated by mobile-based data collection and monitoring systems, citizen science, and artificial intelligence. These approaches will allow the field to expand from causal inference to more complex, systems-level predictive models, stimulating ambitious and effective policy interventions.
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Affiliation(s)
- Adele R Tufford
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Christos Diou
- Department of Informatics and Telematics, Harokopio University of Athens, Athens, Greece
| | - Desiree A Lucassen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Ioannis Ioakimidis
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Grace O'Malley
- W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
- Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland University for Medicine and Health Sciences, Dublin, Ireland
| | - Leonidas Alagialoglou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Gerardine Doyle
- College of Business, University College Dublin, Dublin, Ireland
- Geary Institute for Public Policy, University College Dublin, Dublin, Ireland
| | | | - Penio Kassari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Tahar Kechadi
- CeADAR: Ireland's Centre for Applied AI, University College Dublin, Dublin 4, Ireland
| | - Vassilis Kilintzis
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Esther Kok
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Irini Lekka
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nicos Maglaveras
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Vasileios Papapanagiotou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Sarafis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Arsalan Shahid
- CeADAR: Ireland's Centre for Applied AI, University College Dublin, Dublin 4, Ireland
| | - Pieter van ’t Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Anastasios Delopoulos
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Albalawi AA, Hambly C, Speakman JR. Consumption of takeaway and delivery meals is associated with increased BMI and percent fat among UK Biobank participants. Am J Clin Nutr 2022; 116:173-188. [PMID: 35681260 PMCID: PMC9257477 DOI: 10.1093/ajcn/nqac078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/28/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Consumption of meals bought from out-of-home sources is a suggested risk factor for obesity, but the supporting evidence is mixed. OBJECTIVES To investigate the association between consumption of different types of meals and BMI or percent body fat. METHODS Data were from the UK Biobank in response to a "Type of Meals Eaten" survey, which specified the sources of the meals consumed over the previous 24 h. Because direction of causality is unknown, the data were analyzed with meal choice as the dependent variable first and then BMI as the dependent variable second. RESULTS The total number of participants was 5197 (2841 women and 2356 men). Participants with higher BMI and percent body fat were more likely to report consuming takeaway and/or delivery meals, with prevalence ORs (95% CIs) of 2.12 (95% CI: 1.40, 3.22; Bonferroni P < 0.0001) for women's adjusted BMI, 1.95 (95% CI: 1.30, 2.93; Bonferroni P < 0.0001) for women's adjusted percent body fat, 1.65 (95% CI: 1.05, 2.59; Bonferroni P < 0.002) for men's adjusted BMI, and 1.41 (95% CI: 0.70, 2.84; Bonferroni P < 0.01) for men's adjusted percent body fat. As BMI and percent body fat increased, both men and women were increasingly less likely to report having consumed a home-cooked and prepared meal during the previous 24 h. Analyzing the data with BMI and percent body fat as the dependent variable showed that both unadjusted and adjusted BMI and percent body fat were higher in individuals reporting consumption of takeaway and delivery foods the previous day and lower in those consuming homecooked meals. The probability of having consumed a meal that was prepared and eaten at a restaurant and/or café was also associated with BMI and percent fat among men but not women. CONCLUSIONS Homecooked meals were more often consumed by those with low BMI and percent body fat, whereas delivery and takeaway meals were more often eaten by individuals with higher BMI. Consumption of fast-food/café meals was not consistently associated with BMI or percent body fat. The direction of causality in these associations cannot be inferred from this cross-sectional study.
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Affiliation(s)
- Ahmad A Albalawi
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK,School of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Catherine Hambly
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
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King BM. The Influence of Social Desirability on Sexual Behavior Surveys: A Review. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1495-1501. [PMID: 35142972 PMCID: PMC8917098 DOI: 10.1007/s10508-021-02197-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 05/10/2023]
Abstract
Research in fields for which self-reported behaviors can be compared with factual data reveals that misreporting is pervasive and often extreme. The degree of misreporting is correlated with the level of social desirability, i.e., the need to respond in a culturally appropriate manner. People who are influenced by social desirability tend to over-report culturally desired behaviors and under-report undesired behaviors. This paper reviews socially desirable responding in sexual behavior research. Given the very private nature of the sexual activity, sex researchers generally lack a gold standard by which to compare self-reported sexual behaviors and have relied on the anonymity of participants as the methodology to assure honest answers on sexual behavior surveys. However, indirect evidence indicates that under-reporting (e.g., of a number of sexual partners, receptive anal intercourse, condom use) is common. Among the general population, several studies have now reported that even with anonymous responding, there are significant correlations between a variety of self-reported sexual behaviors (e.g., use of condoms, sexual fantasies, exposure to pornography, penis size) and social desirability, with evidence that extreme under- or over-reporting is as common as is found in other fields. When asking highly sensitive questions, sex researchers should always include a measure of social desirability and take that into account when analyzing their results.
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Affiliation(s)
- Bruce M King
- Department of Psychology, 418 Brackett Hall, Clemson University, Clemson, SC 29634, USA.
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Waterworth SP, Kerr CJ, McManus CJ, Costello R, Sandercock GRH. Obese individuals do not underreport dietary intake to a greater extent than nonobese individuals when data are allometrically‐scaled. Am J Hum Biol 2022; 34:e23743. [PMID: 35257435 PMCID: PMC9286371 DOI: 10.1002/ajhb.23743] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/21/2022] [Accepted: 02/27/2022] [Indexed: 01/25/2023] Open
Abstract
Objective The aim of this study was to assess the extent of misreporting in obese and nonobese adults on an absolute, ratio‐scaled, and allometrically‐scaled basis. Method Self‐reported daily energy intake (EI) was compared with total energy expenditure (TEE) in 221 adults (106 male, 115 female; age 53 ± 17 years, stature 1.68 ± 0.09 m, mass 79.8 ± 17.2 kg) who participated in a doubly‐labeled water (DLW) subsection of 2013–2015 National Diet and Nutrition Survey. Data were log transformed and expressed as absolute values, according to simple ratio‐standards (per kg body mass) and adjusted for body mass allometrically. Absolute and ratio‐scaled misreporting were examined using full‐factorial General Linear Models with repeated measures of the natural logarithms of TEE or EI as the within‐subjects factor. The natural logarithm of body mass was included as a covariate in the allometric method. The categorical variables of gender, age, obesity, and physical activity level (PAL) were the between‐factor variables. Results On an absolute‐basis, self‐reported EI (2759 ± 590 kcal·d−1) was significantly lower than TEE measured by DLW (2759 ± 590 kcal·d−1: F1,205 = 598.81, p < .001, ηp2 =0.75). We identified significantly greater underreporting in individuals with an obese BMI (F1,205 = 29.01, p <.001, ηp2 =0.12), in more active individuals (PAL > 1.75; F1,205 = 34.15, p <.001, ηp2 =0.14) and in younger individuals (≤55 years; F1,205 = 14.82, p < .001, ηp2 =0.07), which are all categories with higher energy needs. Ratio‐scaling data reduced the effect sizes. Allometric‐scaling removed the effect of body mass (F1,205 =0.02, p = 0.887, ηp2 =0.00). Conclusion In weight‐stable adults, obese individuals do not underreport dietary intake to a greater extent than nonobese individuals. These results contradict previous research demonstrating that obesity is associated with a greater degree of underreporting.
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Affiliation(s)
- Sally P. Waterworth
- School of Sport, Rehabilitation, and Exercise Sciences University of Essex Essex UK
| | - Catherine J. Kerr
- School of Sport, Rehabilitation, and Exercise Sciences University of Essex Essex UK
| | | | - Rianne Costello
- Oxford Brookes Centre for Nutrition and Health Oxford Brookes University Oxford UK
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Liu J, Qi X, Wang X, Qin Y, Jiang S, Han L, Kang Z, Shan L, Liang L, Wu Q. Evolving Patterns of Nutritional Deficiencies Burden in Low- and Middle-Income Countries: Findings from the 2019 Global Burden of Disease Study. Nutrients 2022; 14:931. [PMID: 35267908 PMCID: PMC8912291 DOI: 10.3390/nu14050931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 12/04/2022] Open
Abstract
Low- and middle-income countries (LMICs) suffered the most from nutritional deficiencies (NDs). Although decades of efforts have reduced it, little is known about the changing trajectory of ND burden in LMICs. By extracting data of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, we calculated indicators of incidence and disability-adjusted life years (DALYs) to measure the burden of NDs and its main subcategories in LMICs, including protein-energy malnutrition, iodine deficiency, vitamin A deficiency, dietary iron deficiency, and other nutritional deficiencies by sex, age and spatial patterns. In LMICs, ND incidence still increased in the age group 15+ born before 2005, especially in males. The effort of reducing the DALYs of NDs has generated a strong decline in per age group. In the main subcategories of NDs, protein-energy malnutrition incidence in males age 45+ born before 1970 still increased. Despite vitamin A deficiency incidence and dietary iron deficiency, DALYs strongly experienced decreases over three decades while still remaining at the heaviest level in 2019, especially in females and children under 5 years. The top largest tendency estimates occurred in Mali' females and Bhutan' males. Zimbabwe was the only country with increased DALYs rate tendency in both sexes.
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Affiliation(s)
- Jingjing Liu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Xinye Qi
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Xing Wang
- The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu 322000, China;
| | - Yinghua Qin
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Shengchao Jiang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Liyuan Han
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, China;
| | - Zheng Kang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Linghan Shan
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Libo Liang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150086, China; (J.L.); (X.Q.); (Y.Q.); (S.J.); (Z.K.); (L.S.)
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150086, China
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21
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Shook RP, Yeh HW, Welk GJ, Davis AM, Ries D. Commercial Devices Provide Estimates of Energy Balance with Varying Degrees of Validity in Free-Living Adults. J Nutr 2022; 152:630-638. [PMID: 34642741 DOI: 10.1093/jn/nxab317] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/11/2021] [Accepted: 08/26/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The challenges of accurate estimation of energy intake (EI) are well-documented, with self-reported values 12%-20% below expected values. New approaches rely on gold-standard assessments of the other components of energy balance, energy expenditure (EE) and energy storage (ES), to estimate EI. OBJECTIVES The purpose of this study was to evaluate the validity, repeatability, and measurement error of consumer devices when estimating energy balance in a free-living population. METHODS Twenty-four healthy adults (14 women, 10 men; mean ± SD age: 30.7 ± 8.2 y) completed two 14-d assessment periods, including assessments of EE and ES using gold-standard [doubly labeled water (DLW) and DXA] and commercial devices [Fitbit Alta HR activity monitor (Alta) and Fitbit Aria wireless body composition scale (Aria)], and of EI by dietician-administered recalls. Accuracy and validity were assessed using Spearman correlation, interclass correlation, mean absolute percentage error, and equivalency testing. We also applied linear measurement error modeling including error in gold-standard devices and within-subject repeated-measures design to calibrate consumer devices and quantify error. RESULTS There was moderate to strong agreement for EE between the Fitbit Alta and DLW at each time point (rs = 0.82 and 0.66 for Times 1 and 2, respectively). There was weak agreement for ES between the Fitbit Aria and DXA (rs = 0.15 and 0.49 for Times 1 and 2, respectively). Correlations between methods to assess EI ranged from weak to strong, with agreement between the DXA/DLW-calculated EI and dietary recalls being the highest (rs = 0.63 for Time 1 and 0.73 for Time 2). Only EE from the Fitbit Alta at Time 1 was equivalent to the DLW value using equivalency testing. CONCLUSIONS Commercial devices provide estimates of energy balance in free-living adults with varying degrees of validity compared to gold-standard techniques. EE estimates were the most robust overall, whereas ES estimates were generally poor.
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Affiliation(s)
- Robin P Shook
- Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.,School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Hung-Wen Yeh
- Department of Pediatrics, Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Ann M Davis
- Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - Daniel Ries
- Sandia National Laboratories, Albuquerque, NM, USA
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22
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Lee JH, Duster M, Roberts T, Devinsky O. United States Dietary Trends Since 1800: Lack of Association Between Saturated Fatty Acid Consumption and Non-communicable Diseases. Front Nutr 2022; 8:748847. [PMID: 35118102 PMCID: PMC8805510 DOI: 10.3389/fnut.2021.748847] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/20/2021] [Indexed: 12/15/2022] Open
Abstract
We reviewed data on the American diet from 1800 to 2019. Methods: We examined food availability and estimated consumption data from 1800 to 2019 using historical sources from the federal government and additional public data sources. Results: Processed and ultra-processed foods increased from <5 to >60% of foods. Large increases occurred for sugar, white and whole wheat flour, rice, poultry, eggs, vegetable oils, dairy products, and fresh vegetables. Saturated fats from animal sources declined while polyunsaturated fats from vegetable oils rose. Non-communicable diseases (NCDs) rose over the twentieth century in parallel with increased consumption of processed foods, including sugar, refined flour and rice, and vegetable oils. Saturated fats from animal sources were inversely correlated with the prevalence of NCDs. Conclusions: As observed from the food availability data, processed and ultra-processed foods dramatically increased over the past two centuries, especially sugar, white flour, white rice, vegetable oils, and ready-to-eat meals. These changes paralleled the rising incidence of NCDs, while animal fat consumption was inversely correlated.
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Affiliation(s)
- Joyce H. Lee
- Department of Neurology, New York University, Grossman School of Medicine, New York, NY, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Miranda Duster
- Department of Neurology, New York University, Grossman School of Medicine, New York, NY, United States
| | - Timothy Roberts
- New York University, Health Sciences Library, New York, NY, United States
| | - Orrin Devinsky
- Department of Neurology, New York University, Grossman School of Medicine, New York, NY, United States
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23
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Fuchs HE, O’Connell K, Du M, Navarro SL, Brasky TM, Kantor ED. Vitamin B 12 Supplementation and Vitamin B 12 Blood Serum Levels: Evaluation of Effect Modification by Gender and Smoking Status. Nutr Cancer 2022; 74:2373-2383. [PMID: 34817305 PMCID: PMC9761981 DOI: 10.1080/01635581.2021.2007271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Research suggests that high intake of supplemental vitamin B12 may be associated with increased risk of cancer, with some evidence that this association may vary by gender and smoking status. This investigation evaluates if similar patterns in association are observed for data for 11,757 adults from the National Health and Nutrition Examination Survey (1999-2006). Survey-weighted multivariable-adjusted linear regression was used to evaluate the association between regular B12 supplement use and log-transformed serum B12 levels. Persons taking vitamin B12 through a multivitamin/multimineral (MVMM) had a median supplemental intake of 12 mcg/day (Q1: 6, Q3: 25), compared to 100 mcg/day (Q1: 22, Q3: 500) for persons reporting supplemental B12 intake through a MVMM-exclusive source. MVMM users had a geometric mean serum B12 26% (95% CI: 23%-30%) higher than nonusers, whereas MVMM-exclusive users' geometric mean was 61% (95% CI: 53%-70%) higher than nonusers (p-trend < 0.001). Although a positive trend (p-trend < 0.001) was observed for both men and women, the association was stronger among women (p-interaction < 0.001). No interaction was observed for smoking status (p-interaction = 0.45). B12 supplementation is associated with higher levels of serum B12, with significant interaction by gender but not smoking. Further work is needed to better understand the interplay of B12 and gender.
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Affiliation(s)
- Hannah E. Fuchs
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kelli O’Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mengmeng Du
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sandi L. Navarro
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Theodore M. Brasky
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Elizabeth D. Kantor
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Elizabeth D. Kantor, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017, Phone: 646.888.8247,
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24
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Jones L, Ness A, Emmett P. Misreporting of Energy Intake From Food Records Completed by Adolescents: Associations With Sex, Body Image, Nutrient, and Food Group Intake. Front Nutr 2021; 8:749007. [PMID: 34966768 PMCID: PMC8710752 DOI: 10.3389/fnut.2021.749007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/28/2021] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: A healthy diet during adolescence is important for growth and pubertal development. Assessing the diet of adolescents may be challenging as the behavioural factors and food habits which impact on what they eat may also affect how they report dietary intake. This study assesses factors associated with the misreporting of dietary intake. Methods: Adolescents (n = 4,844; average age 13.8 years) from the Avon Longitudinal Study of Parents and Children (ALSPAC) completed a 3-day diet record. Misreporting was estimated using an individualised method, and adolescents were categorised by reporting status. Foods were categorised as core and noncore foods to evaluate diet quality. Body composition measurements were recorded at a research clinic. Information on dieting, weight concern, family socioeconomic status, and parental BMI were collected via questionnaires. Binary logistic regression was performed, in boys and girls separately, to investigate factors associated with underreporting of dietary intake. Results: Girls were much more likely than boys to be dissatisfied with their weight and to diet, but showed similar levels of underreporting (~67%). In adjusted regression analysis underreporters (UR) were more likely to be overweight or obese: OR in boys 2.8 (95% CI 1.7–4.8) and in girls 2.2 (95% CI 1.5–3.2). Dissatisfaction with weight and dieting were positively associated, and perception of being underweight negatively associated with underreporting in boys. Perception of being overweight, dieting, and exact age were positively associated with underreporting in girls. UR obtained a greater percentage of energy from protein and a smaller percentage of energy from fat; they reported greater intake of core foods and lower intakes of non-core foods than plausible reporters. Conclusion: A large proportion of adolescents underreported their dietary energy intake. This was associated with their body weight status and body image and had a differential effect on their estimated food and macronutrient intakes. Assessment of misreporting status is essential when collecting and interpreting dietary information from adolescents.
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Affiliation(s)
- Louise Jones
- Centre for Child Academic Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Andy Ness
- Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Pauline Emmett
- Centre for Child Academic Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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25
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Chen AYA, Sturm R. Diet quality in the US improved during the Great Recession and deteriorated during economic recovery. J Acad Nutr Diet 2021; 122:974-980. [PMID: 34954082 PMCID: PMC9038615 DOI: 10.1016/j.jand.2021.09.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/21/2021] [Accepted: 09/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Macroeconomic changes are associated with population health outcomes, such as mortality, accidents, and alcohol use. Diet quality is a risk or protective factor that could be influenced by economic conditions. OBJECTIVE This study examined the trajectory of diet quality measured by the Healthy ] before, during, and after the 2008/2009 Great Recession. DESIGN Repeated cross-sectional survey data from the National Health and Nutrition Examination Survey (NHANES) were analyzed. PARTICIPANTS/SETTING The analytic sample included 48,679 adults who completed at least one dietary recall from NHANES 1999-2018. MAIN OUTCOME MEASURES Diet quality was assessed with a 24-hour dietary recall to calculate the Healthy Eating Index (HEI)-2015 total scores, a measure of the conformance with the 2015-2020 Dietary Guidelines for Americans. STATISTICAL ANALYSES PERFORMED Least squares regression was used to adjust for demographic changes across waves. RESULTS Diet quality improved noticeably during the Great Recession and deteriorated as economic conditions improved. CONCLUSIONS Deteriorating economic circumstances may constrain choices, but that does not necessarily imply a worsening of dietary quality. During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift towards food prepared at home instead of prepared food bought away from home.
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Affiliation(s)
- Annie Yu-An Chen
- RAND Corporation, Santa Monica, CA; Pardee RAND Graduate School, Santa Monica, CA.
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26
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Whitton C, Healy JD, Collins CE, Mullan B, Rollo ME, Dhaliwal SS, Norman R, Boushey CJ, Delp EJ, Zhu F, McCaffrey TA, Kirkpatrick SI, Atyeo P, Mukhtar SA, Wright JL, Ramos-García C, Pollard CM, Kerr DA. Accuracy and Cost-effectiveness of Technology-Assisted Dietary Assessment Comparing the Automated Self-administered Dietary Assessment Tool, Intake24, and an Image-Assisted Mobile Food Record 24-Hour Recall Relative to Observed Intake: Protocol for a Randomized Crossover Feeding Study. JMIR Res Protoc 2021; 10:e32891. [PMID: 34924357 PMCID: PMC8726032 DOI: 10.2196/32891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden, and cost; however, they need to be evaluated to inform large-scale use. OBJECTIVE The aim of this study is to compare the accuracy, acceptability, and cost-effectiveness of 3 technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across 3 meals. METHODS Using a controlled feeding study design, 24HR data collected using 3 methods will be obtained for comparison with observed intake. A total of 150 healthy adults, aged 18 to 70 years, will be recruited and will complete web-based demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study center on 3 separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR process using 1 of 3 methods: the Automated Self-Administered Dietary Assessment Tool, Intake24, or the Image-Assisted mobile Food Record 24-Hour Recall. The sequence of the 3 methods will be randomized, with each participant exposed to each method approximately 1 week apart. Acceptability and the preferred 24HR method will be assessed using a questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared with the observed intake for each day. Linear mixed models will be used, with 24HR method and method order as fixed effects, to assess differences in the 24HR methods. Reporting bias will be assessed by examining the ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-square tests. Psychosocial, demographic, and cognitive factors associated with energy misestimation will be evaluated using chi-square tests and multivariable logistic regression. The financial costs, time costs, and cost-effectiveness of each 24HR method will be assessed and compared using repeated measures analysis of variance tests. RESULTS Participant recruitment commenced in March 2021 and is planned to be completed by the end of 2021. CONCLUSIONS This protocol outlines the methodology of a study that will evaluate the accuracy, acceptability, and cost-effectiveness of 3 technology-enabled dietary assessment methods. This will inform the selection of dietary assessment methods in future studies on nutrition surveillance and epidemiology. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621000209897; https://tinyurl.com/2p9fpf2s. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/32891.
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Affiliation(s)
- Clare Whitton
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Janelle D Healy
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Barbara Mullan
- Enable Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Megan E Rollo
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Richard Norman
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Enable Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | | | - Paul Atyeo
- Health Section, Health and Disability Branch, Australian Bureau of Statistics, Canberra, Australia
| | - Syed Aqif Mukhtar
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Janine L Wright
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - César Ramos-García
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Division of Health Sciences, Tonalá University Center, University of Guadalajara, Guadalajara, Mexico
| | - Christina M Pollard
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Enable Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Deborah A Kerr
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
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27
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Daily Intake and Serum Levels of Copper, Selenium and Zinc According to Glucose Metabolism: Cross-Sectional and Comparative Study. Nutrients 2021; 13:nu13114044. [PMID: 34836302 PMCID: PMC8622420 DOI: 10.3390/nu13114044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/21/2022] Open
Abstract
Trace elements play an important role in metabolism. We compared the daily intake and serum concentrations of copper (Cu), selenium (Se), and zinc (Zn) across a spectrum of glucose tolerance status in a representative U.S. population. Daily intake and serum concentrations of Cu, Zn and Se in 5087 adults from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) were examined and compared to normal (NGT) and abnormal (AGT) glucose tolerance and the presence of diabetes mellitus (DM). Other than Zn deficiency (21.15%), the prevalence of Zn, Se, and Cu excess and Se and Cu deficiency were low (<4.00%). As compared to the NGT group, Cu and Se supplementation was higher in the AGT and DM groups (p < 0.0001 for all). Serum Se and Zn, but not Cu, concentrations were highly correlated with daily intake (p < 0.0001 for both). As compared to the NGT group, serum Cu concentration was highest in the AGT group (p = 0.03), serum Se concentration was highest in the DM group (p < 0.0001), and serum Zn concentration was highest in the AGT group (p < 0.0001). Serum Se and Zn concentration was correlated with daily Se and Zn intake. Even within the reference range for serum Cu, Se, and Zn concentrations, a higher serum concentration of Cu, Se, and Zn was associated with abnormal glucose metabolism. Although the casual relationship remains to be elucidated, these data suggest caution in Cu, Se and Zn supplementation in non-deficient individuals.
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28
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Dobersek U, Teel K, Altmeyer S, Adkins J, Wy G, Peak J. Meat and mental health: A meta-analysis of meat consumption, depression, and anxiety. Crit Rev Food Sci Nutr 2021:1-18. [PMID: 34612096 DOI: 10.1080/10408398.2021.1974336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In this meta-analysis, we examined the quantitative relation between meat consumption or avoidance, depression, and anxiety. In June 2020, we searched five online databases for primary studies examining differences in depression and anxiety between meat abstainers and meat consumers that offered a clear (dichotomous) distinction between these groups. Twenty studies met the selection criteria representing 171,802 participants with 157,778 meat consumers and 13,259 meat abstainers. We calculated the magnitude of the effect between meat consumers and meat abstainers with bias correction (Hedges's g effect size) where higher and positive scores reflect better outcomes for meat consumers. Meat consumption was associated with lower depression (Hedges's g = 0.216, 95% CI [0.14 to 0.30], p < .001) and lower anxiety (g = 0.17, 95% CI [0.03 to 0.31], p = .02) compared to meat abstention. Compared to vegans, meat consumers experienced both lower depression (g = 0.26, 95% CI [0.01 to 0.51], p = .041) and anxiety (g = 0.15, 95% CI [-0.40 to 0.69], p = .598). Sex did not modify these relations. Study quality explained 58% and 76% of between-studies heterogeneity in depression and anxiety, respectively. The analysis also showed that the more rigorous the study, the more positive and consistent the relation between meat consumption and better mental health. The current body of evidence precludes causal and temporal inferences.
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Affiliation(s)
- Urska Dobersek
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Kelsey Teel
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Sydney Altmeyer
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Joshua Adkins
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Gabrielle Wy
- Department of Criminology and Criminal Justice, University of Maryland, College Park, Maryland, USA
| | - Jackson Peak
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
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29
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Hasselgren A, Karmacharya BM, Stensdotter AK. Relevance of anthropometric measurements as predictors of prevalent diabetes type 2: a cross-sectional study on a Norwegian population. BMJ Open 2021; 11:e046162. [PMID: 34433594 PMCID: PMC8388272 DOI: 10.1136/bmjopen-2020-046162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The objective was to determine the predictive potential of anthropometric indices to screen prevalent diabetes mellitus type 2 in a Norwegian population. DESIGN This is a cross-sectional design to determine the potential association of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and body mass index (BMI) with prevalent diabetes mellitus type 2 through logistic regression analysis. Receiver operating characteristic (ROC) curves were used to determine the predictive potential of the anthropometric indices. Youden's index was applied to determine the optimal cut-off points for each anthropometric index. SETTING This study used cross-sectional data from the populations-based Health Study in Nord-Trøndelag which invited all citizens in the county above 20 years of age. PARTICIPANTS This study included all those who were non-pregnant and had complete data (N=50 042), 98.5% of the participants. The sample is to be considered representative for the population of Norway. PRIMARY AND SECONDARY OUTCOME MEASURES OR and ROC of the potential association between diabetes mellitus type 2 and anthropometric indices were the main planned and performed outcome measures. RESULTS The results suggest that the anthropometric indices performed differently within the Norwegian population with WHR and WHtR being the stronger predictor with (ROC) of 0.746 (0.735 to 0.757) and 0.741 (0.730 to 0.752). The predictive potential for the investigated anthropometric indices was generally stronger for women than men. CONCLUSION Anthropometric indices of size BMI and the highly correlated WC are less associated with prevalent diabetes mellitus type 2 than WHR (WC adjusted for hip circumference) or WHtR (WC adjusted for height) in a Norwegian population.
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Affiliation(s)
- Anton Hasselgren
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Biraj Man Karmacharya
- Department of Public Health and Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Ann-Katrin Stensdotter
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
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30
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Watanabe D, Yoshida T, Nanri H, Watanabe Y, Date H, Itoi A, Goto C, Ishikawa-Takata K, Sagayama H, Ebine N, Kobayashi H, Kimura M, Yamada Y. Association Between the Prevalence of Frailty and Doubly Labeled Water-Calibrated Energy Intake Among Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:876-884. [PMID: 32490529 DOI: 10.1093/gerona/glaa133] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Appropriate energy intake (EI) is essential to prevent frailty. Because self-reported EI is inaccurate and has systematic errors, adequate biomarker calibration is required. This study examined the association between doubly labeled water (DLW)-calibrated EI and the prevalence of frailty among community-dwelling older adults. METHOD A cross-sectional study was performed using baseline data of 7,022 older adults aged ≥65 years in the Kyoto-Kameoka Study. EI was evaluated using a validated food frequency questionnaire (FFQ), and calibrated EI was obtained from a previously established equation using the DLW method. Physical and comprehensive frailty were defined by the Fried phenotype (FP) model and the Kihon Checklist (KCL), respectively. We used multivariable-adjusted restricted cubic spline logistic regression analysis. RESULTS The prevalence of physical frailty was 14.8% and 13.6% in women and men, respectively. The spline models showed significant reverse J-shaped or U-shaped relationships between the prevalence of physical or comprehensive frailty against the DLW-calibrated EI, respectively. The lowest prevalence of both types of frailty was found at 1,900-2,000 kcal/d in women and 2,400-2,500 kcal/d in men, which corresponded to approximately 40 kcal/d/kg IBW (ideal body weight = 22 × height2) with DLW-calibrated EI. Uncalibrated EI underestimated approximately 20% compared with calibrated EI; underestimated EI were attenuated by calibration approach. CONCLUSIONS This study suggests that low EI has a greater detrimental effect compared with excessive EI, particularly on physical frailty. Using biomarkers to calibrate EI holds promise for providing accurate energy requirements to establish guidelines used in public health and clinical nutrition.
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Affiliation(s)
- Daiki Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Department of Pharmacology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kyoto, Japan.,Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Hinako Nanri
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan
| | - Heiwa Date
- Department of Data Science, Shiga University, Shiga, Japan
| | - Aya Itoi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo, Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University, Aichi, Japan
| | - Kazuko Ishikawa-Takata
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan
| | | | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
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Hutchesson M, Rollo M, Burrows T, McCaffrey TA, Kirkpatrick SI, Kerr D, Truby H, Clarke E, Collins CE. Current practice, perceived barriers and resource needs related to measurement of dietary intake, analysis and interpretation of data: A survey of Australian nutrition and dietetics practitioners and researchers. Nutr Diet 2021; 78:365-373. [PMID: 34109725 DOI: 10.1111/1747-0080.12692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/15/2021] [Accepted: 05/11/2021] [Indexed: 01/26/2023]
Abstract
AIM To inform future training and professional development for individuals who measure, analyse and interpret dietary intake data. METHODS A cross-sectional online survey was distributed via e-newsletter to members of Dietitians Australia, Dietitian Connection and Nutrition Society Australia. The survey included 37 questions on three key areas of practice: (a) methods used to assess dietary intake, (b) barriers faced when conducting dietary intake assessment and (c) resources needed to optimise collection, analysis and interpretation of dietary intake data. RESULTS Of 173 responses, 103 respondents provided complete data over 2 weeks. Of these, 76% were APDs. The majority (90%) indicated that dietary assessment was important in their role. Respondents (63%) undertook dietary assessments to inform individual/patient care. When assessing intakes, the majority (79%) were interested in examining food/food group intakes. Paper based methods were most commonly used and diet histories, food frequency questionnaires and 24-hour recalls were the most frequently used methods. The biggest barrier identified to implementing dietary assessment methods into practice was participant burden. Over a third of respondents reported they had received specific training on selecting an appropriate dietary assessment method. The majority of respondents (83%) believed having access to a dietary assessment methods toolkit would be useful. CONCLUSION Survey findings provide insight into the need for further capacity building strategies, including professional development to improve collection, analysis and interpretation of dietary intake for Australian nutritionists and dietitians. The creation of online resources could help overcome identified barriers and provide a link to best practice methodologies and contemporary tools.
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Affiliation(s)
- Melinda Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Megan Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Tracy Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Deborah Kerr
- School of Public Health, Curtin University, Perth, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Erin Clarke
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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Nargesi AA, Jeyashanmugaraja GP, Desai N, Lipska K, Krumholz H, Khera R. Contemporary National Patterns of Eligibility and Use of Novel Cardioprotective Antihyperglycemic Agents in Type 2 Diabetes Mellitus. J Am Heart Assoc 2021; 10:e021084. [PMID: 33998258 PMCID: PMC8403287 DOI: 10.1161/jaha.121.021084] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background SGLT‐2 (sodium glucose transporter‐2) inhibitors and GLP‐1RAs (glucagon‐like peptide‐1 receptor agonists) effectively lowered cardiovascular risk in large clinical trials for patients with type 2 diabetes mellitus at high risk for these complications, and have been recommended by guidelines. To evaluate the contemporary landscape in which these recommendations would be implemented, we examined the use of these medications according to clinical guideline practice. Methods and Results In the National Health and Nutrition Examination Survey for 2017 to 2018, we defined compelling indications for SGLT‐2 inhibitors by the presence of atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease, and for GLP‐1RAs by the presence of established or high‐risk atherosclerotic cardiovascular disease, based on large clinical trials that have been incorporated in guideline recommendations of the American College of Cardiology and American Diabetes Association. We then evaluated use of these medications among patients with physician‐diagnosed type 2 diabetes mellitus. All analyses incorporated complex survey design to produce nationally representative estimates. A total 1104 of 9254 sampled individuals had type 2 diabetes mellitus, representing 10.6% (95% CI, 9.7%–11.6%) of the US population or 33.2 million adults nationally. Of these, 52.6% (95% CI, 47.7%–57.5%) had an indication for SGLT‐2 inhibitors, 32.8% (95% CI, 28.8%–37.2%) for GLP‐1RAs, and 26.6% (95% CI, 22.2%–31.7%) for both medications. During 2017 to 2018, 4.5% (95% CI, 2.4%–8.2%) were treated with SGLT‐2 inhibitors and 1.5% (95% CI, 0.7%–3.2%) with GLP‐1RAs. Atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease were not independently associated with SGLT‐2 inhibitor or GLP‐1RA use in patients with diabetes mellitus. Conclusions Despite a large number of patients being eligible for guideline‐recommended cardiorenal protective therapies, there are substantial gaps in the use of SGLT‐2 inhibitors and GLP‐1RAs, limiting their public health benefits.
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Affiliation(s)
- Arash A Nargesi
- Department of Internal Medicine Yale School of Medicine New Haven CT
| | - Gini P Jeyashanmugaraja
- Department of Internal Medicine Bridgeport HospitalYale-New Haven Health System Bridgeport CT
| | - Nihar Desai
- Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT.,Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT
| | - Kasia Lipska
- Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.,Section of Endocrinology and Metabolism Department of Internal Medicine Yale School of Medicine New Haven CT
| | - Harlan Krumholz
- Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT.,Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.,Department of Health Policy and Management Yale School of Public Health New Haven CT
| | - Rohan Khera
- Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT.,Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT
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Tucker LA. Fruit and Vegetable Intake and Telomere Length in a Random Sample of 5448 U.S. Adults. Nutrients 2021; 13:1415. [PMID: 33922436 PMCID: PMC8146059 DOI: 10.3390/nu13051415] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023] Open
Abstract
The relationship between fruit and vegetable intake and telomere length was examined using a cross-sectional design and an NHANES random sample of 5448 U.S. adults. Fruit and vegetable (F&V) consumption was assessed using a 24 h recall, and telomere length, an index of cellular aging, was measured using the quantitative polymerase chain reaction method. Telomere length was linearly related to F&V intake when combined (F = 22.7, p < 0.0001) and also when separated as fruit (F = 7.2, p < 0.0121) or vegetables (F = 15.4, p < 0.0005), after adjusting for covariates. Specifically, telomeres were 27.8 base pairs longer for each 100 g (3.5 ounces) of F&V consumed. Because each additional year of chronological age was associated with telomeres that were 14.9 base pairs shorter, when women and men were analyzed together, results indicated that a 100 g (3.5 oz) per day increment in F&V corresponded with 1.9 years less biological aging. When the 75th percentile of F&V intake was compared to the 25th, the difference was 4.4 years of cellular aging. When separated by sex, fruits and vegetables were both related to telomere length in women, but only vegetable intake was predictive of telomere length in men. In conclusion, evidence based on a random sample of U.S. adults indicates that the more the servings of F&V, the longer telomeres tend to be.
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Affiliation(s)
- Larry A Tucker
- College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
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Global Trends (1961-2017) in Human Dietary Potassium Supplies. Nutrients 2021; 13:nu13041369. [PMID: 33921853 PMCID: PMC8074176 DOI: 10.3390/nu13041369] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Potassium (K) is an essential mineral and major intracellular electrolyte involved in the regulation of blood pressure, muscle contraction and nerve transmission in humans. Major dietary sources of K include fruits and vegetables, starchy roots and tubers, and whole grains. The aim of this study was to assess and report: (i) the sufficiency of K in national food systems globally, (ii) to quantify the contribution from food groups, and (iii) to explore spatial and temporal trends in the period of 1961–2017. Methods: Food supply and demography (1961–2017), K composition and K requirement data were combined to estimate per capita human dietary supplies of potassium (DSK), adequate intake of K (AIK) and K sufficiency ratio (KSR) at national, regional, continental and global levels. Results and Discussion: Globally, the mean ± SD. DSK (mg capita−1 d−1) increased from 2984 ± 915 in 1961 to 3796 ± 1161 in 2017. There was a wide range in DSK between geographical regions and across years, with particularly large increases in east Asia, where DSK increased from <3000 to >5000 mg capita−1 day−1. Roots and tubers contributed the largest dietary source of K, providing up to 80% of DSK in most regions. At the global level, throughout the 57-year period, the population-weighted KSR was <1 based on the 2006 Institute of Medicine AIK recommendation, while it was >1 based on the 2019 National Academies of Science and the 2016 European Union AIK recommendation. While KSR ≥ 1 shows sufficiency of DSK, KSR < 1 does not indicate K deficiency risk. Conclusion: Due to the absence of a Recommended Daily Allowance (RDA) for K, this study used the ratio of DSK:AIK (i.e., KSR) to assess dietary K sufficiency. Estimates of dietary K sufficiency are, therefore, highly sensitive to the AIK reference value used and this varied greatly based on different institutions and years. To quantify the risk of dietary K deficiency, bridging the data gap to establish an RDA for K should be a global research priority.
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Astorino TA, De Revere JL. Effect of Ethnicity on Changes in Fat and Carbohydrate Oxidation in Response to Short-Term High Intensity Interval Training (HIIT): A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084314. [PMID: 33921694 PMCID: PMC8072605 DOI: 10.3390/ijerph18084314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 03/31/2021] [Accepted: 04/09/2021] [Indexed: 12/24/2022]
Abstract
This study compared changes in substrate metabolism with high intensity interval training (HIIT) in women of different ethnicities. Twelve Caucasian (C) and ten Hispanic women (H) (age = 24 ± 5 yr) who were inactive completed nine sessions of HIIT at 85 percent peak power output (%PPO). Pre-training, changes in fat oxidation (FOx) and carbohydrate oxidation (CHOOx) during progressive cycling were measured on two days to compute the minimum difference (MD). This test was repeated after the last training session. Between baseline tests, estimates of FOx and CHOOx were not different (p > 0.05) and were highly related (intraclass correlation coefficient equal to 0.72 to 0.88), although the coefficient of variation of maximal fat oxidation (MFO) was equal to 30%. Training significantly increased MFO (p = 0.03) in C (0.19 ± 0.06 g/min to 0.21 ± 0.06 g/min, d = 0.66) and H (0.16 ± 0.03 g/min to 0.19 ± 0.03 g/min, d = 1.3) that was similar (p = 0.92) between groups. There was a significant interaction for FOx (p = 0.003) as it was only increased in H versus C, although both groups exhibited reduced CHO oxidation (p = 0.002) with training. Use of MD revealed that only 3 of 22 women show meaningful increases in MFO (>0.08 g/min). The preliminary data reveals that a small dose of low-volume HIIT does not alter fat and CHO oxidation and there is little effect of ethnicity on the response to training.
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Importance of EPA and DHA Blood Levels in Brain Structure and Function. Nutrients 2021; 13:nu13041074. [PMID: 33806218 PMCID: PMC8066148 DOI: 10.3390/nu13041074] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
Brain structure and function depend on a constant and sufficient supply with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) by blood. Blood levels of EPA and DHA reflect dietary intake and other variables and are preferably assessed as percentage in erythrocytes with a well-documented and standardized analytical method (HS-Omega-3 Index®). Every human being has an Omega-3 Index between 2 and 20%, with an optimum of 8–11%. Compared to an optimal Omega-3 Index, a lower Omega-3 Index was associated with increased risk for total mortality and ischemic stroke, reduced brain volume, impaired cognition, accelerated progression to dementia, psychiatric diseases, compromises of complex brain functions, and other brain issues in epidemiologic studies. Most intervention trials, and their meta-analyses considered EPA and DHA as drugs with good bioavailability, a design tending to produce meaningful results in populations characterized by low baseline blood levels (e.g., in major depression), but otherwise responsible for many neutral results and substantial confusion. When trial results were evaluated using blood levels of EPA and DHA measured, effects were larger than comparing EPA and DHA to placebo groups, and paralleled epidemiologic findings. This indicates future trial design, and suggests a targeted use EPA and DHA, based on the Omega-3 Index.
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Gender Disparities in Food Security, Dietary Intake, and Nutritional Health in the United States. Am J Gastroenterol 2021; 116:584-592. [PMID: 33443848 DOI: 10.14309/ajg.0000000000001118] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Food insecurity is associated with negative nutritional outcomes and is experienced differently by women vs men. We evaluated the effects of gender on food insecurity and dietary intake in the United States. METHODS Data from the National Health and Nutrition Examination Survey (2007-2016) were analyzed. Survey-weighted linear and logistic regression models were used to evaluate predictors of food security and the effect of food security on dietary consumption and body anthropometrics. Gender was modeled as a covariable and as an effect modifier. RESULTS A total of 30,251 respondents were included. Approximately 15.1% (95% confidence interval [CI]: 14.1%-16.1%) of participants were food insecure. This increased over time from 11.7% in 2007-2008 to 18.2% in 2015-2016. A higher proportion of women experienced food insecurity compared with men (53.3% vs 46.7%, P = 0.02), although this was not significant after adjusting for poverty and other confounders (adjusted odds ratio 1.01; 95% CI: 0.93-1.09; P = 0.81). Among food insecure women, 32.4% (95% CI: 30.0%-34.9%) received emergency food assistance and 75.0% (95% CI: 71.5%-78.2%) received supplemental nutrition assistance benefits. Relative to men, food insecure women were less likely to meet the recommended dietary allowance of most macronutrients and micronutrients. They were also significantly more likely to be obese, have a wider waist circumference, and have higher total body fat percentage (P interaction all <0.001). DISCUSSION Food insecurity represents a substantial public health challenge in the United States that differentially affects women compared with men. Alternative strategies may be required to meet the nutritional requirements for food insecure women.
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Later Meal and Sleep Timing Predicts Higher Percent Body Fat. Nutrients 2020; 13:nu13010073. [PMID: 33383648 PMCID: PMC7823810 DOI: 10.3390/nu13010073] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/12/2020] [Accepted: 12/18/2020] [Indexed: 12/14/2022] Open
Abstract
Accumulating evidence suggests that later timing of energy intake (EI) is associated with increased risk of obesity. In this study, 83 individuals with overweight and obesity underwent assessment of a 7-day period of data collection, including measures of body weight and body composition (DXA) and 24-h measures of EI (photographic food records), sleep (actigraphy), and physical activity (PA, activity monitors) for 7 days. Relationships between body mass index (BMI) and percent body fat (DXA) with meal timing, sleep, and PA were examined. For every 1 h later start of eating, there was a 1.25 (95% CI: 0.60, 1.91) unit increase in percent body fat (False Discovery Rate (FDR) adjusted p value = 0.010). For every 1 h later midpoint of the eating window, there was a 1.35 (95% CI: 0.51, 2.19) unit increase in percent body fat (FDR p value = 0.029). For every 1 h increase in the end of the sleep period, there was a 1.64 (95% CI: 0.56, 2.72) unit increase in percent body fat (FDR p value = 0.044). Later meal and sleep timing were also associated with lower PA levels. In summary, later timing of EI and sleep are associated with higher body fat and lower levels of PA in people with overweight and obesity.
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Van Asbroeck S, Matthys C. Use of Different Food Image Recognition Platforms in Dietary Assessment: Comparison Study. JMIR Form Res 2020; 4:e15602. [PMID: 33284118 PMCID: PMC7752530 DOI: 10.2196/15602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/02/2020] [Accepted: 10/02/2020] [Indexed: 01/29/2023] Open
Abstract
Background In the domain of dietary assessment, there has been an increasing amount of criticism of memory-based techniques such as food frequency questionnaires or 24 hour recalls. One alternative is logging pictures of consumed food followed by an automatic image recognition analysis that provides information on type and amount of food in the picture. However, it is currently unknown how well commercial image recognition platforms perform and whether they could indeed be used for dietary assessment. Objective This is a comparative performance study of commercial image recognition platforms. Methods A variety of foods and beverages were photographed in a range of standardized settings. All pictures (n=185) were uploaded to selected recognition platforms (n=7), and estimates were saved. Accuracy was determined along with totality of the estimate in the case of multiple component dishes. Results Top 1 accuracies ranged from 63% for the application programming interface (API) of the Calorie Mama app to 9% for the Google Vision API. None of the platforms were capable of estimating the amount of food. These results demonstrate that certain platforms perform poorly while others perform decently. Conclusions Important obstacles to the accurate estimation of food quantity need to be overcome before these commercial platforms can be used as a real alternative for traditional dietary assessment methods.
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Affiliation(s)
- Stephanie Van Asbroeck
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Christophe Matthys
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
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The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review. Nutr Res Rev 2020; 34:185-208. [PMID: 33148371 DOI: 10.1017/s0954422420000268] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
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Yang Q, Zhang Z, Steele EM, Moore LV, Jackson SL. Ultra-Processed Foods and Excess Heart Age Among U.S. Adults. Am J Prev Med 2020; 59:e197-e206. [PMID: 33012621 PMCID: PMC10924299 DOI: 10.1016/j.amepre.2020.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION A high percentage of total calories from ultra-processed foods has been associated with several cardiovascular disease risk factors. No study has examined the association between ultra-processed foods and heart age. This study examines the association between ultra-processed foods and excess heart age (difference between estimated heart age and chronological age) among U.S. adults. METHODS The National Health and Nutrition Examination Survey (2009-2016) data for participants aged 30-74 years without cardiovascular disease or stroke (n=12,640) was used. Ultra-processed food was assigned based on NOVA classification of food processing, with ultra-processed food being the highest level. This study estimated the usual percentage of calories from ultra-processed foods and used sex-specific Framingham heart age algorithms to calculate heart age. The multivariable linear or logistic regression was used to examine the association between ultra-processed foods and excess heart age or likelihood of excess heart age being ≥10 years. Data analyses were conducted in 2020. RESULTS The median usual percentage of calories from ultra-processed foods was 54.5% (IQR=45.8%‒63.1%). Adjusted excess heart age increased from 7.0 years (95% CI=6.4, 7.6) in the lowest quintile (Q1) to 9.9 years (95% CI=9.2, 10.5) in the highest quintile (Q5) (p<0.001). Compared with Q1, AORs for excess heart age of ≥10 years were 1.16 (95% CI=1.08, 1.25) in Q2, 1.29 (95% CI=1.14, 1.46) in Q3, 1.43 (95% CI=1.20, 1.71) in Q4, and 1.66 (95% CI=1.29, 2.14) in Q5 (p<0.001). The pattern of association was largely consistent across subgroups. CONCLUSIONS U.S. adults consumed more than half of total daily calories from ultra-processed foods. A higher percentage of calories from ultra-processed foods was associated with higher excess heart age and likelihood of excess heart age of ≥10 years.
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Affiliation(s)
- Quanhe Yang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Euridice Martinez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Latetia V Moore
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Bozeman JF, Springfield S, Theis TL. Meeting EAT-Lancet Food Consumption, Nutritional, and Environmental Health Standards: A U.S. Case Study across Racial and Ethnic Subgroups. ENVIRONMENTAL JUSTICE (PRINT) 2020; 13:160-172. [PMID: 33101580 PMCID: PMC7580058 DOI: 10.1089/env.2020.0018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In 2019, The EAT-Lancet Commission developed criteria to assist policymakers and health care systems worldwide in sustaining natural resources to feed a forecasted 10 billion people through the year 2050. Although American dietary habits and underlying food production practices have a disproportionately negative impact on land, greenhouse gas (GHG), and water resources, there is limited information on how this population can meet the EAT-Lancet criteria. To address this, we measured adherence to an adapted version of the EAT-Lancet diet score criteria in United States (U.S.) populations overall and across racial/ethnic subgroups (i.e., black, Latinx, and white). In addition, we assessed the benefits of adherence in terms of saved environmental resources (i.e., land, GHG, and water). By performing these objectives, we provide vital information for the development of effective intervention strategies in the U.S. with enough refinement to address the human health and environmental implications of marginalized populations. Our results demonstrate that, on average, Americans do not meet EAT-Lancet criteria overall or across racial/ethnic subgroups. Shifting dietary intakes to meet the criteria could reduce environmental degradation between 28% and 38%. Furthermore, these methods can be adapted to other nations for the development of meaningful strategies that address the food, energy, and water challenges of our time.
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Affiliation(s)
- Joe F. Bozeman
- Dr. Bozeman III is a Research Associate at Civil and Materials Engineering Department and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois. Dr. Springfield is an Assistant Professor at Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA. Dr. Theis is a Professor at Civil and Materials Engineering Department and Director at Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sparkle Springfield
- Dr. Bozeman III is a Research Associate at Civil and Materials Engineering Department and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois. Dr. Springfield is an Assistant Professor at Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA. Dr. Theis is a Professor at Civil and Materials Engineering Department and Director at Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Thomas L. Theis
- Dr. Bozeman III is a Research Associate at Civil and Materials Engineering Department and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois. Dr. Springfield is an Assistant Professor at Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA. Dr. Theis is a Professor at Civil and Materials Engineering Department and Director at Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
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Chalmers E, Samocha-Bonet D. The effect of body acid-base state and manipulations on body glucose regulation in human. Eur J Clin Nutr 2020; 74:20-26. [PMID: 32873953 DOI: 10.1038/s41430-020-0692-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Long-term exposure to high dietary acid load has been associated with insulin resistance and type 2 diabetes in epidemiological studies. However, it remains unclear whether the acid load of the diet translates to mild metabolic acidosis and whether it is responsible for the impairment in glucose regulation in humans. Previously, in a cross-sectional study we have reported that dietary acid load was not different between healthy individuals with normal weight and those with overweight/obesity, irrespective of insulin sensitivity. However, 4-week high acid load diet increased plasma lactate (a small component of the anion gap) and increased insulin resistance in healthy participants. The change in plasma lactate correlated significantly with the change in insulin resistance. Because cause-and-effect could not be evaluated in these settings, we sought to directly test the effect of an alkalizing treatment preload on postprandial glucose regulation. In a randomized placebo-controlled study with a crossover design, we administered sodium bicarbonate (NaHCO3, 1.68 g) prior to high acid load meal to healthy individuals. We found that while the bicarbonate preload attenuated the post meal decrease in pH observed with placebo, no effect on postprandial glucose regulation (glucose, insulin, and C-peptide) was observed. Following 3-month treatment of nondiabetic individuals with bicarbonate, others have reported no change in insulin resistance markers, consistent with our findings. Together, studies in human suggest that insulin resistance associated with longstanding obesogenic diet may be mediated by mild metabolic acidosis. However, buffering the Western diet with bicarbonate and increasing body pH does not change glucose homeostasis in nondiabetic individuals. Further studies are required to shed light on the role of body acid-base balance and glucose homeostasis in health and disease.
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Affiliation(s)
- Eliza Chalmers
- Diabetes & Metabolism Division, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Dorit Samocha-Bonet
- Diabetes & Metabolism Division, Garvan Institute of Medical Research, Sydney, NSW, Australia. .,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
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Flanagan E, Lamport D, Brennan L, Burnet P, Calabrese V, Cunnane SC, de Wilde MC, Dye L, Farrimond JA, Emerson Lombardo N, Hartmann T, Hartung T, Kalliomäki M, Kuhnle GG, La Fata G, Sala-Vila A, Samieri C, Smith AD, Spencer JP, Thuret S, Tuohy K, Turroni S, Vanden Berghe W, Verkuijl M, Verzijden K, Yannakoulia M, Geurts L, Vauzour D. Nutrition and the ageing brain: Moving towards clinical applications. Ageing Res Rev 2020; 62:101079. [PMID: 32461136 DOI: 10.1016/j.arr.2020.101079] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 12/11/2022]
Abstract
The global increases in life expectancy and population have resulted in a growing ageing population and with it a growing number of people living with age-related neurodegenerative conditions and dementia, shifting focus towards methods of prevention, with lifestyle approaches such as nutrition representing a promising avenue for further development. This overview summarises the main themes discussed during the 3rd Symposium on "Nutrition for the Ageing Brain: Moving Towards Clinical Applications" held in Madrid in August 2018, enlarged with the current state of knowledge on how nutrition influences healthy ageing and gives recommendations regarding how the critical field of nutrition and neurodegeneration research should move forward into the future. Specific nutrients are discussed as well as the impact of multi-nutrient and whole diet approaches, showing particular promise to combatting the growing burden of age-related cognitive decline. The emergence of new avenues for exploring the role of diet in healthy ageing, such as the impact of the gut microbiome and development of new techniques (imaging measures of brain metabolism, metabolomics, biomarkers) are enabling researchers to approach finding answers to these questions. But the translation of these findings into clinical and public health contexts remains an obstacle due to significant shortcomings in nutrition research or pressure on the scientific community to communicate recommendations to the general public in a convincing and accessible way. Some promising programs exist but further investigation to improve our understanding of the mechanisms by which nutrition can improve brain health across the human lifespan is still required.
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Archer E, Arjmandi B. Falsehoods and facts about dietary sugars: a call for evidence-based policy. Crit Rev Food Sci Nutr 2020; 61:3725-3739. [PMID: 32799555 DOI: 10.1080/10408398.2020.1804320] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sugar, tobacco, and alcohol have been demonized since the seventeenth century. Yet unlike tobacco and alcohol, there is indisputable scientific evidence that dietary sugars were essential for human evolution and are essential for human health and development. Therefore, the purpose of this analytic review and commentary is to demonstrate that anti-sugar rhetoric is divorced from established scientific facts and has led to politically expedient but ill-informed policies reminiscent of those enacted about alcohol a century ago in the United States. Herein, we present a large body of interdisciplinary research to illuminate several misconceptions, falsehoods, and facts about dietary sugars. We argue that anti-sugar policies and recommendations are not merely unscientific but are regressive and unjust because they harm the most vulnerable members of our society while providing no personal or public health benefits.
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Affiliation(s)
| | - Bahram Arjmandi
- Department of Nutrition, Food, and Exercise Sciences, Florida State University, Tallahassee, FL, USA.,Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL, USA
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46
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Connor S. Underreporting of Dietary Intake: Key Issues for Weight Management Clinicians. CURRENT CARDIOVASCULAR RISK REPORTS 2020. [DOI: 10.1007/s12170-020-00652-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Green MA, Watson AW, Brunstrom JM, Corfe BM, Johnstone AM, Williams EA, Stevenson E. Comparing supermarket loyalty card data with traditional diet survey data for understanding how protein is purchased and consumed in older adults for the UK, 2014-16. Nutr J 2020; 19:83. [PMID: 32791968 PMCID: PMC7427066 DOI: 10.1186/s12937-020-00602-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background Our ability to understand population-level dietary intake patterns is dependent on having access to high quality data. Diet surveys are common diet assessment methods, but can be limited by bias associated with under-reporting. Food purchases tracked using supermarket loyalty card records may supplement traditional surveys, however they are rarely available to academics and policy makers. The aim of our study is to explore population level patterns of protein purchasing and consumption in ageing adults (40 years onwards). Methods We used diet survey data from the National Diet and Nutrition Survey (2014–16) on food consumption, and loyalty card records on food purchases from a major high street supermarket retailer (2016–17) covering the UK. We computed the percentage of total energy derived from protein, protein intake per kg of body mass, and percentage of protein acquired by food type. Results We found that protein consumption (as the percentage of total energy purchased) increased between ages 40–65 years, and declined thereafter. In comparison, protein purchased in supermarkets was roughly 2–2.5 percentage points lower at each year of age. The proportion of adults meeting recommended levels of protein was lowest in age groups 55–69 and 70+. The time of protein consumption was skewed towards evening meals, with low intakes during breakfast or between main meals. Meat, fish and poultry dominated as sources of protein purchased and consumed, although adults also acquired a large share of their protein from dairy and bread, with little from plant protein. Conclusions Our study provides novel insights into how protein is purchased and consumed by ageing adults in the UK. Supermarket loyalty card data can reveal patterns of protein purchasing that when combined with traditional sources of dietary intake may enhance our understanding of dietary behaviours.
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Affiliation(s)
- Mark A Green
- Geographic Data Science Lab, School of Environmental Sciences, University of Liverpool, Liverpool, UK.
| | - Anthony W Watson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon-Tyne, UK
| | | | - Bernard M Corfe
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | | | | | - Emma Stevenson
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon-Tyne, UK
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Etminani R, Manaf ZA, Shahar S, Azadbakht L, Adibi P. Predictors of Nonalcoholic Fatty Liver Disease Among Middle-Aged Iranians. Int J Prev Med 2020; 11:113. [PMID: 33088441 PMCID: PMC7554566 DOI: 10.4103/ijpvm.ijpvm_274_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran. METHODS A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria. RESULTS The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; P < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women (P < 0.05 for all variables). CONCLUSIONS The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy.
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Affiliation(s)
- Reza Etminani
- School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahara Abdul Manaf
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, UniversitiKebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, UniversitiKebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Jiang H, Zhang J, Du W, Su C, Zhang B, Wang H. Energy intake and energy contributions of macronutrients and major food sources among Chinese adults: CHNS 2015 and CNTCS 2015. Eur J Clin Nutr 2020; 75:314-324. [PMID: 32724092 DOI: 10.1038/s41430-020-0698-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 06/18/2020] [Accepted: 07/14/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Excessive energy intake and unbalanced food choices are major health concerns associated with obesity and related chronic diseases. This study evaluates the levels of dietary energy intake and the energy contributions of macronutrients, major food sources, and various eating occasions and processed food among Chinese adults. METHODS The study examined a cross-sectional sample from CHNS and CNTCS 2015 that used three 24 h recalls and calculated energy intake and food sources based on the China Food Composition Table. After excluding extreme values, the analyses included 11,974 subjects aged 18-64. RESULTS The estimated energy intake was 2063.3 kcal/d (2243.8 kcal/d for males and 1902.4 kcal/d for females), and 39.1% of subjects met the gender-age-PA-based Estimated Energy Requirement. The proportion of energy from fats was 35.8% without significant age or gender differences. Adults of lower socioeconomic statuses, indicated by lower education levels and lower household incomes per capita, consumed lower percentages of energy from fats and higher percentages from carbohydrates. The study population as a whole reported an average energy density of 1.88 kcal/g and an energy contribution from restaurant foods of 1.8%. CONCLUSIONS The study reports a lower energy intake level than CHNS 2009. Adults living in southern China or urban areas, which are relatively developed regions, or with higher socioeconomic statuses consumed less energy from carbohydrates, moderate amounts from proteins, and more from fats, indicating a need for dietary guidelines or interventions that take into account socio-demographic factors.
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Affiliation(s)
- Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ji Zhang
- Department of Global Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Intake of Calanus finmarchicus oil for 12 weeks improves omega-3 index in healthy older subjects engaging in an exercise programme. Br J Nutr 2020; 125:432-439. [PMID: 32698912 PMCID: PMC7844606 DOI: 10.1017/s0007114520002809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The n-3 PUFA, EPA and DHA, play an important role in human health. As the intake of EPA and DHA from the diet is often inadequate, supplementation of those fatty acids is recommended. A novel source of n-3 PUFA is Calanus finmarchicus oil (CO) which contains fatty acids mainly bound in wax esters. To date, no data are available on the effects of long-term intake of this marine oil on n-3 PUFA blood levels. Therefore, the aim of this study was to evaluate the effect of CO on the n-3 PUFA blood levels using the omega-3 index (O3I). The data originate from a larger randomised controlled trial. For this analysis, samples from seventy-two participants (59·2 (sd 6·2) years, BMI 27·7 (sd 5·28) kg/m2) were analysed. Of those, thirty-six performed 2×/week exercise and received 2 g of CO, which provided 124 mg stearidonic acid (SDA), 109 mg EPA and 87 mg DHA daily (EXCO group), while the other group performed exercise only (EX group) and served as a control for this analysis. The O3I increased from 6·07 (sd 1·29) % at baseline to 7·37 (sd 1·10) % after 12 weeks within the EXCO group (P < 0·001), while there were no significant changes in the EX group (6·01 (sd 1·26)–6·15 (sd 1·32) %, P = 0·238). These data provide first evidence that wax ester-bound n-3 PUFA from CO can significantly increase the O3I despite relatively low EPA + DHA amounts. Further, the effects of exercise could be excluded.
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