Background and Objectives: The study objective was to assess if Dietary diversity score (DDS) based on counting 10 food groups consumed can be used as an indicator of adequacy of micronutrient intake in Filipino children and adolescents. Methods and Study Design: Dietary data of 7448 Filipinos age 3 to 18 years old included in the National Nutrition Survey in 2013 were used to assess the adequacy of intake of iron, vitamin A, vitamin C, thiamin, riboflavin and niacin. Nutrient adequacy ratio (NAR) for each micronutrient was computed and these were used to calculate the mean adequacy ratio (MAR) for each individual. Linear association for MAR and the different scores of DDS was verified using Pearson’s correlation. Sensitivity and specificity were analyzed through the receiver operating characteristics curve to determine the DDS cut-off point that can be used to ascertain adequacy of micronutrient intake. Results: The mean DDS is 6 and the mean MAR is 0.69. There was significant positive correlation between MARs and NARs (p<0.0001), as well as between MAR and DDS (r=0.29; p<0.0001). A DDS of 6 showed the highest sensitivity (74.2%) and specificity (44.6%) for achieving MAR of 0.5, while a DDS of 7 had the highest sensitivity (54.9%) and specificity (67.6%) in achieving MAR of 0.75. Conclusions: DDS is significantly correlated with micronutrient intake and a score of 6 or 7 can be used as a cutoff in screening for those with possible dietary micronutrient inadequacy in Filipino children and adolescents.
Background and Objectives: This study aims to investigate the effects of individualised dietary guidance and anti-resistance exercise intervention on blood pressure and metabolic indexes of perimenopausal women. Methods and Study Design: Between June 2018 to August 2018, 78 perimenopausal women were recruited at the Gynaecological Outpatient Department of Beijing Pinggu District Hospital. After coding, they were randomly divided into three groups, A, B and C, by lottery. Group B was required to participate in educational seminars and received individualised dietary guidance from professional nutritionists. Group C had the same intensive education classes and individualised dietary guidance as Group B, along with intensive resistance exercise. The difference in the various observation indexes was reviewed after three months of intervention. Results: The number of patients with abnormal metabolic indexes in the diet and comprehensive groups decreased significantly after intervention, compared with the statistics before intervention. The number of patients with a waist circumference ≥80 cm in the diet and comprehensive groups decreased significantly, and the difference was statistically significant (χ2=5.976, p=0.014; χ2=4.433, p=0.035). Before and after observation, the control and diet groups had a higher incidence of HDL <1.29 mmol/L than the comprehensive group, and the difference was statistically significant (p<0.05). After intervention, TGs in the comprehensive group were significantly lower than the control group (≥1.7 mmol/L), and the difference was statistically significant. Conclusions: Individualised dietary intervention combined with anti-resistance exercise can significantly improve eating and exercise habits, correct metabolic disorders and reduce the occurrence of metabolic syndrome.
Background and Objectives: Postpartum period is associated with mood depression with a high prevalence of postpartum depression globally (17.7%), as reported in a recent study. Postpartum depression may contribute to the poor health and well-being of newly delivered women. This scoping review investigates the effect of nutrition and physical activity interventions on improving and treating postpartum depression among postpartum women. Methods and Study Design: The scoping review was performed using Arksey and O'Malley's methodological framework. A thorough and systematic search was conducted using Scopus, Pubmed, EBSCOHost and Google Scholar in April 2020, and then was updated in March 2021. Only literature published between January 2010 until February 2021 were searched in each database. Results: A total of 25 articles were included in this study, of which 23 were randomised controlled trial studies, and 2 were quasi-experimental studies. A total of 76% of the study indicated a significant association on improving depression, while 24% of the study showed a non-significant effect. Based on the findings, nutrition or physical activity intervention was found to improve postpartum depression. In addition, the combination of nutrition and physical activity was believed to improve depression if a more thorough follow-up with the participants was conducted. Participants' positive involvement in the intervention was crucial to measure intervention's effectiveness. Conclusions: Nutrition and physical activity interventions through appropriate delivery and strategies are desirable in managing postpartum maternal mental health. This indicates a need for further research on non-pharmacological interventions to overcome depression among postpartum women.
Background and Objectives: Although large-scale natural disasters and the resultant changes in living environments worsen dietary habits among adults immediately after the disasters, whether this association remains for a long period is unclear. This is particularly important for recent mothers because lactating women require additional nutrition for milk production. Thus, we investigated the association of living environments with dietary habits and nutritional intake of recent mothers between four and seven years after the Great East Japan Earthquake (11th March, 2011). Methods and Study Design: We analyzed 8,551 mothers who participated to the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Living environments were characterized into four categories: “same home before the earthquake”, “rental housing”, “reconstructed home”, and “acquaintance’s home”. Dietary habits and nutritional intake were evaluated using a food frequency questionnaire answered 12 months after their deliveries (the questionnaire was answered between March 2015 and July 2018). Results: Multiple linear regression analyses demonstrated that mothers in ‘rental housing’ or ‘reconstructed home’ had a significantly lower intake of almost all nutrients or certain nutrients, respectively, compared with those residing in ‘same home before the earthquake’. However, fewer significant differences were detected between the nutritional intake of the mothers lodging in an ‘acquaintance’s home’ and that of those living in ‘same home before the earthquake’. Conclusions: Our findings indicate that living environments long-term after large-scale disasters are associated with dietary habits and nutritional intake among recent mothers.
Background and Objectives: To investigate the vitamin A, D, E concentrations and status, and analyse the associated risk factors for vitamin A, D, E deficiency in children in Shaanxi Province, Northwest China. Methods and Study Design: This study included a total of 25,806 children less than 18 years old who were admitted to hospitals in Shaanxi province, northwest China, during the period from January 2019 to December 2019. Fasting venous blood samples of all participants were collected in the morning, and serum vitamin A, D, E concentrations were measured. The logistic regression model was performed to estimate the associations between age, seasons, areas, living regions and vitamin A, D, E deficiency and insufficiency. Results: The mean serum vitamin A, D, E concentrations of participants were 0.87±0.33 µmol/L, 63.70±29.67 nmol/L and 20.84±6.98 µmol/L, respectively. The prevalence of vitamin A, D, E deficiency was extremely high in neonates (15.1%, 81.5% and 44.9%, respectively). Meanwhile, there was also a high prevalence of vitamin A and D deficiency in school-age children and adolescents. Children living in northern Shaanxi had a relatively lower vitamin A, D and E concentrations than in central and southern Shaanxi. Additionally, children living in rural areas were at high risk for vitamin A, D, E deficiency and insufficiency. Logistic regression analyses revealed that the risk of vitamin D deficiency and insufficiency in children was 7.68 times (95% CI: 6.97-8.47) higher in winter than in summer. Overall, serum vitamin A concentration was positively correlated with age (r=0.110, p<0.001), while vitamin D and E concentrations were negatively correlated with age (r=-0.370 and r= -0.250 both p<0.001), after adjustment for gender, season, and living regions. Conclusions: This study shown that the prevalence of vitamin A, D and E deficiency was extremely high in neonates in Shaanxi province, northwest China. Children living in rural areas and winter had a high risk of vitamin A, D, E deficiency and insufficiency.
Background and Objectives: Our aim was to evaluate the acute effect of switching low-carbohydrate diet (LCD) to high-carbohydrate diet (HCD) on glycemic parameters in healthy women. Methods and Study Design: Twenty-two women (age 21.7±4.0 years; HbA1c 5.3±0.3 %, mean±SD) wore flash glucose monitoring system and consumed test meals for 3 days from Day 4 to 6. Participants consumed identical HCD meals except LCD dinner on Day 5. The energy ratio of carbohydrate, fat and protein were 64%, 21%, and 15% for HCD and 47%, 35%, and 18% for Day 5 with LCD dinner (19%, 59%, and 22%). Results: The incremental glucose peak (IGP, both p<0.001) and incremental area under the curve for glucose (IAUC, both p<0.001) 3h of LCD dinner were all significantly lower than those of HCD dinner on Day 4 and 6. However, after consuming LCD dinner on Day 5, IGP breakfast (2.33±0.15 vs 1.71±0.15mmo/L, p <0.01), IGP lunch (3.31±0.25 vs 2.54±0.18 mol/L, p<0.01), IAUC 3h of breakfast (210±18 vs 136±14 mmol/L×min, p<0.001), mean blood glucose (5.72±0.11 vs 5.40±0.11 mmol/L, p<0.01), and standard deviation (1.11±0.06 vs 0.88±0.04 mmol/L, p<0.01) on Day 6 were all significantly higher than those of corresponding meals before LCD dinner on Day 4, in spite of consuming all identical HCD meals. The glycemic parameters returned to the levels before consuming LCD on Day 7. Conclusions: Consuming LCD only once is enough to cause 24-h higher postprandial blood glucose concentration in subsequent consumption of HCD in healthy women.
Background and Objectives: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life. Methods and Study Design: This prospective cohort study included healthy mother-infant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months. Results: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86], p=0.03) and 3 months old (aOR 0.43 [95% CI: 0.20, 0.93], p=0.03), while intake of confectionery items was associated with increased unscheduled doctor visits at 3 months (aOR 2.01 [95% CI 1.33, 3.06], p=0.001) and increased nebuliser treatment at both 3 months (aOR 1.88 [95% CI 1.12, 3.17], p=0.02) and 6 months (aOR 1.64 [95% CI 1.05, 2.54], p=0.03). Finally, at 6 months, hypertensive disorders during pregnancy was associated with increased nebuliser treatment (aOR 17.3 [95% CI 1.50, 199], p=0.02) while exclusive breastfeeding was associated with reduced incidence of respiratory symptoms (OR 0.47 [95% CI 0.26, 0.83], p=0.01). Conclusions: Increased antenatal maternal consumption of milk and dairy products may reduce respiratory morbidity while increased consumption of confectionery items may increase respiratory morbidity in their infants during the first 6 months of life.
Background and Objectives: Child undernutrition remains an area of public health concern across the globe, particularly in developing countries like India. Previous studies have focused on the association of maternal nutrition with premature pregnancy and birthweight of child, with few establishing the intergenerational effect but limited to select populations and geography. Methods and Study Design: This study used data from 35,452 children aged under 5 years and their biological mother from nationally representative Comprehensive National Nutrition Survey (CNNS) in India. The outcome variables were anthropometric indices: height-for-age, weight-for-height, and weight-for-age. The exposure variables were maternal height and body mass index (BMI). Multivariate regression analysis was used to examine the association between maternal height and BMI with child undernutrition. Results: Out of total number of mothers, 11.1% were short in stature and 28% were underweight. Of total number of children, 33.9%, 17.3% and 32.7% were stunted, wasted, and underweight respectively. Children born to mother with short stature were more likely to be stunted (OR=1.73, 95% CI 1.59–1.89), wasted (OR=1.26, 95% CI 1.12–1.41) and underweight (OR=1.64, 95% CI 1.50–1.79). Similarly, children with underweight mother were more likely to be stunted (OR=1.63, 95% CI 1.53–1.73), wasted (OR=1.64, 95% CI 1.52–1.77) and underweight (OR=2.14, 95% CI 2.01–2.27). Conclusions: The study shows a strong association between maternal and child undernutrition demonstrating intergenerational linkage between the two. The national programme needs to focus on holistic and comprehensive nutrition strategy with targeted interventions to improve both maternal and child health.
Background and Objectives: Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) are at high risk for malnutrition. This study aimed to 1) Investigate the prevalence of malnutrition among CKD patients undergoing maintenance HD; 2) Assess level of knowledge and appetite among patients; 3) Identify potential predictors of malnutrition. Methods and Study Design: This cross-sectional study included 71 CKD patients on HD who were recruited from two principal outpatient dialysis centers located in Jeddah, Saudi Arabia. Data were collected using an interviewer-administered questionnaire which included sociodemographic and health characteristics, nutritional status (assessed using the Patient-Generated Subjective Global Assessment [PG-SGA]), biochemical data, nutritional knowledge, and appetite status (assessed using Council of Nutrition Appetite Questionnaire [CNAQ]). Results: Forty-four percent of patients included in this study were malnourished, and over half of the patients had limited nutritional knowledge and appetite. Hemoglobin level and the CNAQ score were found to be independently negatively associated with the PG-SGA score (B: -1.03 [95% confidence interval (CI): -1.99, -0.08] and B: -0.37 [95% CI: -0.64, -0.11], respectively). Conclusions: Renal healthcare professionals should assess the nutritional status of HD patients and identify barriers to adequate nutrition. Patients with poor appetite should specifically be targeted for nutrition-focused evaluation and management.
Background and Objectives: Vitamin D deficiency has been considered a risk factor for atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to investigate the correlation between serum 25(OH)D concentration and the risk of ASCVD in Chinese, especially in Type 2 diabetes mellitus (T2DM) patients. Methods and Study Design: Based on the "REACTION" study conducted in 2011, some 9,014 Lanzhou residents aged 40-75 years were followed from 2014 to 2016. A total of 7,061 with complete data were analyzed. Baseline population was classified into four groups based on 25(OH)D quartiles. Cox proportional hazard models were used to estimate relations between 25(OH)D concentration and ASCVD. Results: The prevalence of vitamin D deficiency [25(OH)D <20 ng/mL] was 75.1%. Followed-up for 3.3 years, those with the lowest of 25(OH)D concentration had higher rates of ASCVD (HR: 1.748, 95% CI: 1.149-2.660, p<0.01). A 10 ng/mL increase in baseline serum 25(OH)D was accompanied by a 24 % decrease in ASCVD risk (HR: 0.760, 95% CI: 0.590-0.980, p<0.05). For 25(OH)D and ASCVD risk with glycaemic status, low 25(OH)D plus T2DM was highly associated with ASCVD (HR: 2.296, 95% CI: 1.246-4.232, p<0.01). With diabetes, ASCVD risk decreased by 36% when serum 25(OH)D increased by 10 ng/mL (HR: 0.644, 95% CI: 0.440-0.941, p<0.05). Conclusions: Serum 25(OH)D is independently and inversely associated with the risk of ASCVD in Lanzhou Chinese, especially those with T2DM. Maintaining sufficient levels of vitamin D adequacy may be an effective measure in ASCVD prevention.
Background and Objectives: Micronutrient deficiencies are common among bariatric patients; this study aimed to determine whether a cognitive dissonance-based virtual program improved adherence to multivitamin use in bariatric patients from northern Mexico. Methods and Study Design: A randomized controlled trial of the supplementation strategy was conducted over three months. The participants were randomized to an intervention or waitlisted control group and received two psycho-educative and four cognitive dissonance virtual sessions. Multiple linear regression was used to determine standardized estimates of associations between the intervention and dependent variables. Two path analyses were evaluated considering baseline and post-test measurements. Results: Intervention was associated with higher concentrations of Hb (β=0.758, p<0.001), vitamin D (β=0.577, p<0.001), iron (β=0.523, p<0.001), folate (β=0.494, p<0.01), calcium (β=0.452, p<0.01), higher adherence (β=0.467, p<0.001), and level of knowledge (β=0.298, p<0.05). Conclusions: The dissonance-based intervention potentiated the level of supplementation adherence. A higher level of adherence was reflected in micronutrient concentrations, thus providing confirmation of intervention. Thus, support is found for a multidisciplinary clinical practice that enhances nutrition status after bariatric surgery for obesity.
Background and Objectives: An adequate iodine status during pregnancy is very important for maternal and infant health. The aim of this study was to characterize the iodine nutritional status of healthy pregnant women in Chengdu by measuring urinary iodine (UI) and analyzing dietary iodine intake. Methods and Study Design: Pregnant women who underwent regular antenatal examinations were invited to participate in this study. Each woman underwent UI determination and urinary creatinine (Cr) measurement and recorded the details of her diet and salt intake at the beginning and end of one week. Results: In total, 139 healthy pregnant women underwent UI determination in this study; among them, 116 participants completed the diet survey. The median urine iodine/creatinine (UI/Cr) of the 139 patients was 215.92 µg/g, and the median dietary iodine level of 104 patients who completed the 7-day dietary record was 230.58 µg/d. The dietary iodine sources of the pregnant women were mainly seafood (11%), iodized salt (51%), iodized multivitamins (17%) and daily food (21%). Conclusions: We concluded that healthy pregnant women in Chengdu had sufficient iodine nutrition. The 7-day dietary record is a nice way to evaluate dietary iodine nutritional status, and there is a strong correlation between dietary iodine intake and UI concentration.
Background and Objectives: The number of older adults is increasing rapidly in Vietnam. They suffer from various health problems, including malnutrition and dysphagia. By using a simple screening questionnaire such as the Mini Nutritional Assessment - Short Form (MNA-SF) and 10-item Eating Assessment Tool (EAT-10), nutritional and dysphagic status were screened in this study. The study aimed to determine the prevalence of and relationship between malnutrition and dysphagia in Vietnamese older adult inpatients. Methods and Study Design: The study was designed as a cross-sectional study and conducted in three large hospitals in northern Vietnam. The data about nutritional status and dysphagia status of 1007 older inpatients were collected by dietitians. Results: There were 71.6% of subjects at malnourished (MNA-SF score <8) and risk of malnutrition (MNA-SF score: 8–11). The prevalence of dysphagia by EAT-10 was 24.6%. The risk of dysphagia was independently associated with higher risk of malnutrition, with an odds ratio of 3.21 (95% CI: 1.93-5.31, p<0.001). In addition, malnutrition was also an independent predictor for risk of dysphagia, with an odds ratio of 3.09 (95% CI: 1.84-5.17, p<0.001). Conclusions: Malnutrition and dysphagia prevalence were high; and malnutrition and dysphagia have a strong relationship among older adult inpatients in Vietnam. Therefore, nutritional and dysphagia screening at hospital admission are very important and recommended.
Background and Objectives: The differences of dietary iron and zinc intakes between patients with nonalcoholic fatty liver disease (NAFLD) and controls remain controversial. The meta-analysis aimed to explore the differences of dietary iron and zinc intakes between NAFLD patients and healthy subjects. Methods and Study Design: A systematic literature search was performed up to July 2021 in databases of PubMed, Embase, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang. Using a random-effects model, the differences of dietary iron and zinc intakes between cases and controls were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). A total of 21 studies from 19 articles with 6639 cases were included. Results: The pooled estimate showed no difference in dietary iron consumption in the NAFLD groups compared with control groups. The difference became significant in Asia (SMD=0.16; 95% CI: 0.04, 0.28; I2=89.1%; pheterogeneity< 0.001) as well as in cross-sectional studies (SMD=0.12; 95% CI: 0.07, 0.17; I2=4.7%; pheterogeneity = 0.350). The difference in dietary zinc intake between cases and controls was not significant. We noticed a statistically significant increase of dietary zinc intake in NAFLD compared to controls in studies using food-frequency questionnaire (FFQ) to evaluate dietary intake (SMD=0.15; 95% CI: 0.10, 0.20; I2=12.2%; pheterogeneity=0.332). Conclusions: Our findings indicated that dietary iron intake in patients with NAFLD was higher than healthy subjects in Asia.
Background and Objectives: There is emerging scientific evidence of the health benefits of traditional food plants at both molecular and folk remedy levels; however, epidemiological observations are limited. The Amami island region of Japan has a variety of unique traditions conserved till today, where a cohort study was conducted in 2005. The objective of this study was to investigate the associations between the intake of common and local vegetables and the risk of mortality and cancer incidence in Amami. Methods and Study Design: Participants were enrolled from the general population of Amami as part of the Japan Multi-institutional Collaborative Cohort (J-MICC) Study. In total, 5,015 participants (2,053 men and 2,962 women) aged 35-69 years were enrolled in this study. They were followed up to obtain information on movement, death, and cancer incidence. The hazard ratios (HRs) and 95% CIs were estimated using the Cox proportional hazard model after adjusting for potential confounding factors. Results: A significant inverse association was observed between cabbage intake and the HRs for overall mortality (p for trend=0.046) and lung cancer incidence (p=0.016). Intake of handama and togan as local vegetables was associated with decreased HRs for overall mortality (p=0.019 and 0.036, respectively). Conclusions: While the molecular and biochemical reasoning and residual confounding factors behind this association remain unclear, the findings of this study suggest that the dietary lifestyle in Amami has a positive impact on the residents, which can significantly decrease mortality risk.
Background and Objectives: Although the association between dietary protein intake and inflammatory bowel disease (IBD) risk has been investigated, the results are inconsistent. Therefore, we conducted a meta-analysis to reassess the relationship between dietary protein intake and IBD risk. Methods and Study Design: The PubMed, Web of Knowledge, and Wanfang databases were searched for pertinent studies through January 31, 2020. Relative risks (RRs) with 95% confidence intervals (CIs) were derived using a random-effect model. Subgroup analyses according to disease type, geographic location, and sex; sensitivity analysis; and publication bias analysis were performed. Results: The current report includes 8 articles consisting of 12 studies with 1069 cases and 330,676 participants. The pooled RR (95% CI) of the highest vs. the lowest categories of dietary protein intake for the IBD risk was 1.561 (0.384-6.347) in cohort studies and 1.060 (0.663-1.694) in case-control studies. Evidence of heterogeneity was found both in cohort studies (I2=86.4%, p=0.007) and in case-control studies (I2=49.0%, p=0.039). However, the association was significant among Asian populations (RR=1.675, 95% CI=1.096-2.559) but not in other populations. We did not find any relationship of dietary protein intake with the risk of either Crohn’s disease or ulcerative colitis. Conclusions: Based on limited information, the highest dietary protein intakes among Asians may increase the risk of IBD, undifferentiated for ulcerative colitis or Crohn’s disease. This may reflect dietary patterns for which protein is a marker rather than implicate protein itself.