Contribution of Beef to Key Nutrient Intakes and Nutrient Adequacy in Pregnant and Lactating Women: NHANES 2011-2018 Analysis

Beef is an important source of high-quality protein and several micronutrients, including iron, zinc, and B-vitamins. The objective was to assess the association of beef intake with nutrient intake and adequacy among pregnant and lactating women using 24-h dietary recall data. Usual intakes from foods were determined with the National Cancer Institute (NCI) method and % population below Estimated Average Requirement (EAR) or above Adequate Intake (AI) were estimated. A high proportion of pregnant and lactating women had inadequate intakes for vitamin D (94%), vitamin E (82%), vitamin C (52%), and vitamin A (50%), magnesium (35%), folate (31%), zinc (25%), and vitamin B6 (22%); only 4% and 35% met AI for choline and potassium, respectively. About 67% of pregnant and lactating women were beef consumers, consuming 49 g beef/day. Beef consumers had higher intakes (p < 0.05) of energy, protein, calcium, iron, phosphorus, selenium, sodium, zinc, thiamin, riboflavin, and niacin, and a higher proportion (p < 0.05) met nutrient recommendations for protein, calcium, iron, zinc, thiamin, riboflavin, niacin, vitamin B6, and vitamin B12 compared to non-consumers. In conclusion, pregnant and lactating women generally have inadequate nutrient intakes from their diets. Beef consumers have higher intakes and adequacy for certain nutrients, many of which are inherently available in beef or in foods eaten with beef.

Title-plus-abstract versus title-only first-level screening approach: a case study using a systematic review of dietary patterns and sarcopenia risk to compare screening performance

BACKGROUND

Conducting a systematic review is a time- and resource-intensive multi-step process. Enhancing efficiency without sacrificing accuracy and rigor during the screening phase of a systematic review is of interest among the scientific community.

METHODS

This case study compares the screening performance of a title-only (Ti/O) screening approach to the more conventional title-plus-abstract (Ti + Ab) screening approach. Both Ti/O and Ti + Ab screening approaches were performed simultaneously during first-level screening of a systematic review investigating the relationship between dietary patterns and risk factors and incidence of sarcopenia. The qualitative and quantitative performance of each screening approach was compared against the final results of studies included in the systematic review, published elsewhere, which used the standard Ti + Ab approach. A statistical analysis was conducted, and contingency tables were used to compare each screening approach in terms of false inclusions and false exclusions and subsequent sensitivity, specificity, accuracy, and positive predictive power.

RESULTS

Thirty-eight citations were included in the final analysis, published elsewhere. The current case study found that the Ti/O first-level screening approach correctly identified 22 citations and falsely excluded 16 citations, most often due to titles lacking a clear indicator of study design or outcomes relevant to the systematic review eligibility criteria. The Ti + Ab approach correctly identified 36 citations and falsely excluded 2 citations due to limited population and intervention descriptions in the abstract. Our analysis revealed that the performance of the Ti + Ab first-level screening was statistically different compared to the average performance of both approaches (Chi-squared: 5.21, p value 0.0225) while the Ti/O approach was not (chi-squared: 2.92, p value 0.0874). The predictive power of the first-level screening was 14.3% and 25.5% for the Ti/O and Ti + Ab approaches, respectively. In terms of sensitivity, 57.9% of studies were correctly identified at the first-level screening stage using the Ti/O approach versus 94.7% by the Ti + Ab approach.

CONCLUSIONS

In the current case study comparing two screening approaches, the Ti + Ab screening approach captured more relevant studies compared to the Ti/O approach by including a higher number of accurately eligible citations. Ti/O screening may increase the likelihood of missing evidence leading to evidence selection bias.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO Protocol Number: CRD42020172655.

Reply to Consavage Stanley, K.; Kraak, V.I. Comment on "Lau et al. Trends in Beef Intake in the United States: Analysis of the National Health and Nutrition Examination Survey, 2001-2018. Nutrients 2023, 15, 2475"

We thank the authors [...].

Iron-Rich Complementary Foods: Imperative for All Infants

Nearly 1 in 5 (18%) infants in the United States is not consuming sufficient iron. A deficiency of iron during early life may be associated with long-term neurodevelopmental consequence(s). The 2020-2025 Dietary Guidelines for Americans (DGA) are the first DGA to address recommendations for children under 2 y of age. The 2020 Dietary Guidelines Advisory Committee scientific report includes food-group combinations emphasizing iron-rich foods for 6-12-mo-old infants, but these examples did not meet criteria to establish DGA recommended dietary patterns; consequently, iron-rich dietary patterns for ages 6-12 mo are not provided in the 2020-2025 DGA. The 2020-2025 DGA encourage iron-rich foods by 6 mo of age while emphasizing the importance "particularly for infants fed human milk." Early feeding transitions are dynamic and milk feeding groups are rarely static or exclusive such that emphasizing milk feeding groups may become confusing. Risk-to-benefit favors iron-rich complementary feeding for all infants.