Current Nutritional Guidelines Research Articles

Higher fibre and lower carbohydrate intake are associated with favourable CGM metrics in a cross-sectional cohort of 470 individuals with type 1 diabetes.

The aim of this work was to investigate the association between macronutrient intakes and continuous glucose monitoring (CGM) metrics in individuals with type 1 diabetes. In 470 individuals with type 1 diabetes of the GUTDM1 cohort (65% female, median age 40 [IQR 28-53] years, median diabetes duration 15 [IQR 6-29] years), we used logistic regression to establish associations between macronutrient intakes and the CGM metrics time in range (TIR, time spent between 3.9-10.0 mmol/l blood glucose, optimally set at ≥70%) and time below range (TBR, <3.9 mmol/l blood glucose, optimally set at <4%). ORs were expressed per 1 SD intake of nutrient and were adjusted for other macronutrient intakes, age, sex, socioeconomic status, BMI, duration of type 1 diabetes, pump use, insulin dose and alcohol intake. The median (IQR) TIR was 67 (51-80)% and TBR was 2 (1-4)%; the mean ± SD energy intake was 6879±2001 kJ, fat intake 75±31 g, carbohydrate intake 162±63 g, fibre intake 20±9 g and protein intake 70±24 g. A higher fibre intake and a lower carbohydrate intake were associated with higher odds of having a TIR≥70% (OR [95% CI] 1.64 [1.22, 2.24] and 0.67 [0.51, 0.87], respectively), whereas solely a higher carbohydrate intake was associated with TBR<4% (OR 1.34 [95% CI 1.02, 1.78]). A higher fibre intake is independently associated with a higher TIR. A higher carbohydrate intake is associated with less time spent in hypoglycaemia, a lower TIR and a higher time above range. These findings warrant confirmatory (interventional) investigations and may impact current nutritional guidelines for type 1 diabetes.

Impact of Previous Dietary and Exercise Education on Knowledge of Obesity and its Comorbidities: Case Study on a College Campus

Greater than 40% of the adult U.S. population is estimated to be clinically obese based on body mass index (BMI) ≥ 30 kg/m2. Obesity is associated with several debilitating comorbidities that impact both physical and mental health including cardiovascular disease, type 2 diabetes, cancer, and depression. A college community is not immune to obesity, but with a typically younger and more active population the prevalence of obesity is generally lower on campus than the neighboring area. We hypothesized that a formal education of diet and exercise would be strongly associated with reduced obesity, and moreover an increased knowledge of obesity-linked comorbidities. College students were surveyed on their educational background, obesity and associated comorbidity knowledge, as well as anthropometric information including height and weight. Correlations were analyzed to determine links between education, obesity knowledge, and BMI. We received completed surveys from 158 students with an average age of 20.5 ± 3.0 years and BMI of 24.5 ± 5.1 kg/m2. Students with formalized education in diet and exercise were more informed about current nutritional and physical activity guidelines than those students who had not received similar education. Despite this disparity, both groups of students were similarly knowledgeable about obesity and its comorbidities. Additionally, there was no difference in the self-reported BMIs between these two groups of students. Based on our survey, the prevalence of obesity was 10.8%, much lower than the national average. We conclude that a formal education in diet and exercise did not lead to differences in weight status or obesity knowledge amongst students on this college campus. This suggests that on-campus health promotion initiatives regarding obesity would be equally beneficial to all students regardless of educational background. Honors Program; Herbert H. &amp; Grace A. College of Health Professions; Offce of Graduate Studies Central Michigan University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Redefining the Role of Nutrition in Infant Food Allergy Prevention: A Narrative Review.

Pediatric food allergy remains commonplace, despite the advancement in our understanding of risk factors and prevention modalities for the condition. Early allergen introduction, a dietary intervention, has been endorsed by professional societies globally as an effective primary preventive measure, yet awareness among medical professionals and parents is lacking. Alongside food allergen introduction, overall nutrition, such as diet diversity, also plays an important role in allergy prevention. To address both food allergen introduction and overall nutrition, dietitians play a pivotal role in the dissemination and education of current guidelines to caregivers. This review addresses the particular role of the dietitian in food allergy prevention consultations, providing up-to-date information on food allergies, their development and prevalence, risk factors, dietary factors and an overview of the current guidelines in the United States. This has not been addressed in any of the current food allergy or nutrition guidelines.

Colonization of Raphanus sativus by human pathogenic microorganisms.

Contamination of vegetables with human pathogenic microorganisms (HPMOs) is considered one of the most important problems in the food industry, as current nutritional guidelines include increased consumption of raw or minimally processed organic vegetables due to healthy lifestyle promotion. Vegetables are known to be potential vehicles for HPMOs and sources of disease outbreaks. In this study, we tested the susceptibility of radish (Raphanus sativus) to colonization by different HPMOs, including Escherichia coli PCM 2561, Salmonella enterica subsp. enterica PCM 2565, Listeria monocytogenes PCM 2191 and Bacillus cereus PCM 1948. We hypothesized that host plant roots containing bactericidal compounds are less prone to HPMO colonization than shoots and leaves. We also determined the effect of selected pathogens on radish growth to check host plant-microbe interactions. We found that one-week-old radish is susceptible to colonization by selected HPMOs, as the presence of the tested HPMOs was demonstrated in all organs of R. sativus. The differences were noticed 2 weeks after inoculation because B. cereus was most abundant in roots (log10 CFU - 2.54), S. enterica was observed exclusively in stems (log10 CFU - 3.15), and L. monocytogenes and E. coli were most abundant in leaves (log10 CFU - 4.80 and 3.23, respectively). The results suggest that E. coli and L. monocytogenes show a higher ability to colonize and move across the plant than B. cereus and S. enterica. Based on fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM) approach HPMOs were detected in extracellular matrix and in some individual cells of all analyzed organs. The presence of pathogens adversely affected the growth parameters of one-week-old R. sativus, especially leaf and stem fresh weight (decreased by 47-66 and 17-57%, respectively). In two-week-old plants, no reduction in plant biomass development was noted. This observation may result from plant adaptation to biotic stress caused by the presence of HPMOs, but confirmation of this assumption is needed. Among the investigated HPMOs, L. monocytogenes turned out to be the pathogen that most intensively colonized the aboveground part of R. sativus and at the same time negatively affected the largest number of radish growth parameters.

Fueling for and recovering from resistance training: The periworkout nutrition practices of competitive powerlifters

PurposeNutrient timing is a concept that emphasizes the intentional ingestion of whole or fortified foods, and dietary supplements, to adequately fuel for, and recover from, acute and chronic exercise. The nutrition strategies used by powerlifters around training sessions have not, to our knowledge, been previously investigated. This study explored the self-reported periworkout (before, during, and after) nutrition practices of competitive powerlifters, including what, why, and information source that informed practice, with comparison to current sport nutrition guidelines. MethodsActively competing male (n = 240) and female (n = 65) powerlifters completed a cross-sectional online survey of self-reported periworkout nutrition practices in the pre-, intra-, and postexercise periods, fasted training, and supplementation. Data are presented as the number (n) and percentage (%) of all powerlifters practicing a given strategy followed by a % of responses reporting various practices or beliefs within this strategy. Categorical subgroups (sex, age, and weight class; and competitive caliber) were analyzed with a chi-square test or Fisher's exact test and denoted where significant (P ≤ 0.05). ResultsMost powerlifters reported paying specific attention to nutrition practices in the pre-exercise period (n = 261; 85.6%) by ingesting more carbohydrate (CHO) rich foods (n = 234; 89.6%) for the purpose of assisting in training performance (n = 222; 85.1%). Most powerlifters reported intraexercise nutrition strategies (n = 211; 69.2%), of which most included ingesting more CHO rich foods (n = 159; 74.5%) for the purpose of feeling less hungry and/or boosting energy levels during training (n = 129; 61.1%). Most powerlifters reported paying attention to postexercise nutrition (n = 244; 80%), by ingesting more protein rich foods (n = 182; 74.6%) for the purpose of recovering better for the whole day (n = 152; 62.3%) and enhancing the benefits of training (n = 149; 61.1%). Most powerlifters did not complete training sessions in the fasted state (n = 262; 85.9%). Most powerlifters reported paying attention to supplementation before training (n = 237; 77.7%), of which preworkout formulas (n = 137; 57.8%), energy drinks (n = 101; 42.6%), creatine (n = 88; 37.1%), and caffeine pills (n = 70; 29.5%) were most reported. Supplementation was used to assist in training performance (n = 197; 83.1%) and increase wakefulness/alertness (n = 183; 77.2%). Males reported more often than females that they informed multiple elements of their nutrition practices with the information they read or watched somewhere (P = 0.002–0.012). ConclusionThe periworkout nutrition practices used by competitive powerlifters followed current sport nutrition guidelines, by using CHO sources to fuel for training and ensuring the provision of protein postexercise. Competitive powerlifters may wish to exert caution with supplementation, as there is a risk of harm or inadvertent doping.

Nutrition Periodization in Recreational Endurance Athletes During Training Camp – Case study

Both training and dietary practices used by athletes greatly vary. Current sports nutrition guidelines promote dietary manipulation of energy-yielding nutrients specific to the period of training. The study explores the ad libitum nutrition practices of four healthy adult recreational athletes during a 2-week cycling training camp (~100 km·d-1, ~240 min·d-1) with particular attention to the current sports nutrition recommendations. Based on evidence-based guidelines, peri-exercise carbohydrate (CHO) and protein (PRO) intake periodization cut-off levels were set for athletes. Training days were categorized as hard (HARD, two training units/day), middle (MID, one training unit/day), and easy (LOW, no training). Fourteen-day diet records were used and analyzed by nutritional software for energy intake (EI), carbohydrate (CHO), and protein (PRO) intake.&#x0D; Relative daily EI of 78.6±4.5, 73.3±6.4, 75.4±8.2 kcal·kg·d-1, and CHO 8.9±0.8, 7.8±1.0, 8.2±1.5 g·kg1 intakes were not different in HARD, MID and LOW days, respectively. The mean daily EI was 1.3× higher than the predicted total daily energy expenditure, irrespective of the training day category, resulting in ~500 kcal·d-1 energy surplus. In the 2h post-exercise period, PRO intake exceeded the current recommendations 4.6-fold, and CHO intake was significantly lower after a second training session on HARD days (0.7 g·kg·h-1) than a recommendation (1.2 g·kg·h-1). Mean in-exercise CHO intake (~11.5 g·h-1) was significantly under the moderate 30 g·h-1 recommendation.&#x0D; In conclusion, the dietary behaviours of recreational athletes are not consistent with current sports nutrition periodization guidelines. Energy intake throughout the training camp led to positive energy balance being highest on non-training days. Daily or during and post-exercise CHO and PRO intakes were not adjusted to the training sessions' volume, intensity, or duration.

The Association Between Malnutrition and High Protein Treatment on Outcomes in Critically Ill Patients: A Post Hoc Analysis of the EFFORT Protein Randomized Trial

Preexisting malnutrition in critically ill patients is associated with adverse clinical outcomes. Malnutrition can be diagnosed with the Global Leadership Initiative on Malnutrition using parameters such as weight loss, muscle wasting, and BMI. International critical care nutrition guidelines recommend high protein treatment to improve clinical outcomes in critically ill patients diagnosed with preexisting malnutrition. However, this recommendation is based on expert opinion. In critically ill patients, what is the association between preexisting malnutrition and time to discharge alive (TTDA), and does high protein treatment modify this association? This multicenter randomized controlled trial involving 16 countries was designed to investigate the effects of high vsusual protein treatment in 1,301 critically ill patients. The primary outcome was TTDA. Multivariable regression was used to identify if preexisting malnutrition was associated with TTDA and if protein delivery modified their association. The prevalence of preexisting malnutrition was 43.8%, and the cumulative incidence of live hospital discharge by day 60 was 41.2%vs52.9%in the groups with and without preexisting malnutrition, respectively. The average protein delivery in the high vsusual treatment groups was 1.6 g/kg per day vs0.9 g/kg per day. Preexisting malnutrition was independently associated with slower TTDA (adjusted hazard ratio, 0.81; 95%CI, 0.67-0.98). However, high protein treatment in patients with and without preexisting malnutrition was not associated with TTDA (adjusted hazard ratios of 0.84 [95%CI, 0.63-1.11] and 0.97 [95%CI, 0.77-1.21]). Furthermore, no effect modification was observed (ratio of adjusted hazard ratio, 0.84; 95%CI, 0.58-1.20). Malnutrition was associated with slower TTDA, but high protein treatment did not modify the association. These findings challenge current international critical care nutrition guidelines. ClinicalTrials.gov; No.: NCT03160547; URL: www. gov.

The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial

BackgroundBased on low-quality evidence, current nutrition guidelines recommend the delivery of high-dose protein in critically ill patients. The EFFORT Protein trial showed that higher protein dose is not associated with improved outcomes, whereas the effects in critically ill patients who developed acute kidney injury (AKI) need further evaluation. The overall aim is to evaluate the effects of high-dose protein in critically ill patients who developed different stages of AKI.MethodsIn this post hoc analysis of the EFFORT Protein trial, we investigated the effect of high versus usual protein dose (≥ 2.2 vs. ≤ 1.2 g/kg body weight/day) on time-to-discharge alive from the hospital (TTDA) and 60-day mortality and in different subgroups in critically ill patients with AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria within 7 days of ICU admission. The associations of protein dose with incidence and duration of kidney replacement therapy (KRT) were also investigated.ResultsOf the 1329 randomized patients, 312 developed AKI and were included in this analysis (163 in the high and 149 in the usual protein dose group). High protein was associated with a slower time-to-discharge alive from the hospital (TTDA) (hazard ratio 0.5, 95% CI 0.4–0.8) and higher 60-day mortality (relative risk 1.4 (95% CI 1.1–1.8). Effect modification was not statistically significant for any subgroup, and no subgroups suggested a beneficial effect of higher protein, although the harmful effect of higher protein target appeared to disappear in patients who received kidney replacement therapy (KRT). Protein dose was not significantly associated with the incidence of AKI and KRT or duration of KRT.ConclusionsIn critically ill patients with AKI, high protein may be associated with worse outcomes in all AKI stages. Recommendation of higher protein dosing in AKI patients should be carefully re-evaluated to avoid potential harmful effects especially in patients who were not treated with KRT.Trial registration: This study is registered at ClinicalTrials.gov (NCT03160547) on May 17th 2017.

What is Known About Cow's Milk Protein Allergy in Preterm Infants?

Background: Cow's milk protein allergy (CMPA) is well described in term infants, as opposed to preterm infants. In preterm infants, CMPA shares many gastrointestinal symptoms with necrotizing enterocolitis (NEC). Objectives: To evaluate the presentation of CMPA in preterm infants and to investigate the different diagnostic and therapeutic options. Materials and Methods: We searched for the relevant literature using the medical databases PubMed, Web of Science, and the Cochrane Library. We performed a post hoc analysis on the 25 case reports included in this study. Results: Literature was scarce and heterogeneous. The majority of preterm infants with CMPA were exposed to bovine-based milk proteins before the development of symptoms. The most common clinical manifestations were bloody stools, vomiting, and abdominal distension. Of the 25 cases, only 7 (28%) retained human milk in their diet after diagnosis. In the larger studies, no study has human milk as primary feeding choice after diagnosis. Conclusions: Preterm infants exposed to a type of cow's milk-based formula in their first days of life have a higher risk of developing CMPA. Most of the preterm infants are no longer fed with human milk after the diagnosis of CMPA is made, which is in contrast with current nutrition guidelines in preterm infants. We strongly advocate that human milk with mothers on a cow's milk-free diet is the first choice of feed after the diagnosis of CMPA. Prospective studies are necessary to obtain more information regarding clinical presentation, diagnostic tools, and therapeutic approaches.

Does protein intake correlate with tubular function in very preterm neonates?

Background High protein intake in very preterm neonates (VPN) is important for growth. However, preterm kidneys have fewer functional nephrons and many of the ones present may be immature. Studies have shown that high protein intake induces nephron hypertrophy, proteinuria, and glomerular sclerosis, which lead to tubular injury. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker that is released during proximal tubular cell injury. The uNGAL to creatinine (uNGAL/Cr) ratio is commonly performed for normalization.&#x0D; Objective To assess for a possible association between protein intake and uNGAL/Cr ratio in VPN.&#x0D; Methods A prospective cohort study was conducted in two NICUs in Jakarta. Subjects’ urine specimens were collected at 0-48 hours, 72 hours, and 21 days after birth to determine uNGAL/Cr ratio as a biomarker of tubular injury. Protein was administered according to study sites NICU guidelines. Protein intake was recorded daily from 14-21 days of age for formula and measured twice with a human milk analyzer for breast milk. ELISA was used to measure uNGAL concentration. Low protein intake was defined as &lt;3g/kg/day and high protein intake was defined as ?3g/kg/day. Maternal and perinatal variables were recorded from medical records.&#x0D; Results Fifty-nine VPN were recruited, of whom 39 completed the study. Median uNGAL/Cr ratio ranged from 0.32-104.11 ng/mg. The uNGAL/Cr ratio was not correlated with protein intake but was inversely correlated with gestational age and birth weight [r = -0.320, P=0.019 for the 72-hr (T2) urinary collection]. Higher uNGAL/Cr levels were associated with maternal infection [14.4 (range 4.4-104.1) vs 7.2 (range 0.5–32.4) ng/mg, P=0.004 at the 0-48-hr (T1)], maternal anemia [6.9 (range 1.2–66.6) vs 1.7 (range 0.3–89.2) ng/mg, P=0.001 at the 21-day (T3)] and nephrotoxic medication [15.9 (range 1.3–63.8) vs 1.0 (range 0.4–8.6) ng/mg, P=0.026 at the 72-hr].&#x0D; Conclusion Protein intake according to current nutritional guidelines does not correlate with tubular injury in VPN, as measured by uNGAL/Cr ratio. Maternal infection, maternal anemia, lower birth weight, and nephrotoxic medication, were associated with higher uNGAL/Cr levels in VPN.

Factors Associated with Dietary Habit Changes in Korean Stomach Cancer Survivors after Cancer Treatment.

The current nutritional guidelines for stomach cancer survivors (SCSs) mainly focus on the influence of the surgical resection of the stomach, with limited guidance regarding a wider range of food options. We aimed to investigate the factors associated with healthier dietary changes in Korean adult SCSs. This cross-sectional study assessed dietary pattern changes after cancer treatment for 11 food categories, using a self-administered questionnaire. A 'healthier dietary change' was operationally defined as a reduced consumption of red and processed meat, grains, salt, and burnt food, and an increased consumption of poultry, fish, vegetables, fruits, legumes, and dairy products. Among a total of 624 SCSs, approximately 60% of participants reported dietary changes in a healthier direction in three or more food categories, while 9.1% reported no changes. There was no significant difference in dietary habit changes between surgery types. Multivariable adjusted analysis showed that elderly and long-term survivors were inversely associated with a healthier dietary change. SCSs with a higher level of educational achievement and income were more likely to make healthier changes in their intake of processed meat, vegetables, fruits, burnt food, or salt. SCSs with higher levels of fear of cancer recurrence, anxiety, or depression were more likely to follow healthier dietary changes regarding fish, meat, fruits, grains, or burnt food. Change in dietary pattern varied across different food items, and was associated with various characteristics of SCSs. It is crucial to repeatedly provide SCSs with information about healthier dietary patterns, considering their sociodemographic, clinical, and psychological characteristics.

Estimated Energy Expenditures and Energy Intakes of International Female Rugby Sevens Players in Five Days of a Training Camp and Competition Preparation.

To understand the energy balance of international female rugby sevens (R7s) players in applied environments, this study estimated the energy intakes (EI) and total daily estimated energy expenditures (TDEE) during a five-day training camp (TRAIN) and phase of competition preparation (COMP) of equal duration. Tri-axial accelerometer devices were worn throughout both scenarios to estimate TDEE, whereas EI was estimated via self-reported food diaries. Energy deficits of -47% (TDEETRAIN: 14.6 ± 1.6 MJ·day-1, EITRAIN: 7.7 ± 0.9 MJ·day-1, p ≤ 0.001, d = 5.1) and -50% (TDEECOMP: 15.5 ± 1.6 MJ·day-1, EICOMP: 7.7 ± 1.0 MJ·day-1, p ≤ 0.001, d = 5.7) were observed throughout TRAIN (n = 11; age: 25 ± 4 years, height: 170 ± 6 cm, weight: 71 ± 7 kg) and COMP (n = 8; age: 25 ± 3 years, height: 172 ± 5 cm, weight: 72 ± 6 kg), respectively. Carbohydrate intakes were below the lower range of sports nutrition recommendations in both TRAIN (-62%; 2.3 ± 0.3 g·kg-1 BM, p ≤ 0.001) and COMP (-60%; 2.4 ± 0.5 g·kg-1 BM, p ≤ 0.001). For protein (TRAIN: 1.7 ± 0.4 g·kg-1 BM, COMP: 1.5 ± 0.1 g·kg-1 BM), intakes met the lower range of recommendations. Fat intake exceeded recommendations of the percentage of total EI (COMP: 39 ± 5%). Accordingly, the dietary strategies of international female R7s players may warrant optimization, as carbohydrate and fat intakes were less than optimal when compared to current performance-based sports nutrition guidelines.

A High Protein Diet Is Associated with Improved Glycemic Control Following Exercise among Adolescents with Type 1 Diabetes.

Nutritional strategies are needed to aid people with type 1 diabetes (T1D) in managing glycemia following exercise. Secondary analyses were conducted from a randomized trial of an adaptive behavioral intervention to assess the relationship between post-exercise and daily protein (g/kg) intake on glycemia following moderate-to-vigorous physical activity (MVPA) among adolescents with T1D. Adolescents (n = 112) with T1D, 14.5 (13.8, 15.7) years of age, and 36.6% overweight or obese, provided measures of glycemia using continuous glucose monitoring (percent time above range [TAR, >180 mg/dL], time-in-range [TIR, 70-180 mg/dL], time-below-range [TBR, <70 mg/dL]), self-reported physical activity (previous day physical activity recalls), and 24 h dietary recall data at baseline and 6 months post-intervention. Mixed effects regression models adjusted for design (randomization assignment, study site), demographic, clinical, anthropometric, dietary, physical activity, and timing covariates estimated the association between post-exercise and daily protein intake on TAR, TIR, and TBR from the cessation of MVPA bouts until the following morning. Daily protein intakes of ≥1.2 g/kg/day were associated with 6.9% (p = 0.03) greater TIR and -8.0% (p = 0.02) less TAR following exercise, however, no association was observed between post-exercise protein intake and post-exercise glycemia. Following current sports nutrition guidelines for daily protein intake may promote improved glycemia following exercise among adolescents with T1D.

A Low Daily Intake of Simple Sugars in the Diet Is Associated with Improved Liver Function in Cirrhotic Liver Transplant Candidates.

(1) Background: We investigated, for the first time, whether dietary simple sugar intake affects MELD score changes over time in a cohort of cirrhotic liver transplant candidates. (2) Methods: the MELD score, dietary habits using a 3-day food diary, and visceral adipose tissue index (VATI) measured with CT scan were assessed in 80 consecutive outpatient cirrhotic patients at baseline, after counseling to follow current nutritional guidelines. The MELD score was reassessed after six months and the DELTA-MELD was calculated as the MELD at the second assessment minus the MELD at baseline. (3) Results: Compared with the baseline, the MELD score of cirrhotic patients at the end of the study was decreased, stable, or increased in 36%, 8% and 56% of patients, respectively. In separate multiple linear regression models, DELTA-MELD was positively and independently correlated with the daily intake of simple sugars expressed in g/kg body weight (p = 0.01) or as a percentage of total caloric intake (p = 0.0004) and with the number of daily portions of fruit, added sugar, jam, and honey (p = 0.003). These associations were present almost exclusively in patients with VATI above the median value. (4) Conclusions: In cirrhotic patients with high amounts of visceral adipose tissue the consumption of simple sugars and fructose should be limited to improve their clinical outcome.

PROBLEMY ŻYWIENIOWE PSÓW RAS DUŻYCH I OLBRZYMICH. CZĘŚĆ I. SZCZENIĘTA

Feeding dogs is not a simple matter. Dogs are one of the most diverse animal species in the world. Thousands of years of evolution of the species of domestic dog (Canis lupus familiaris L.), have resulted in the fact that nowadays there are hundreds of dog breeds that differ not only in color, type of coat or character, but above all in size. No domestic animal has had a richer history of evolution in direct human contact than the domestic dog. Due to the growing awareness of the caregivers, the pet food market is changing dynamically. Foods are produced that are adapted to the dog’s age, lifestyle, physical activity and breed size. Despite this, often the animal’s diet is inadequate balanced. The caregivers make the mistake of choosing a food that is not adapted to the age and size of the dog. A common problem, for example, is to give puppy food to adult dogs of small breeds, although representatives of these breeds reach maturity more quickly than large breed dogs. Furthermore, the current nutritional guidelines do not provide recommended minimum and maximum amounts of any given nutrient based on the breed size of the dog. The purpose of this article is to characterize the most important nutrients, especially important in the nutrition of large and giant breed puppies.

Current nutritional guidelines in terms of the effect on gut microbiota and human health considering the WHO and FAO recommendations

The purpose of this paper is to evaluate current nutritional guidelines of modern diets based on medical and nutrition facts and their effect on gut microbiota and health, considering current recommendations of world authorities such as FAO and WHO. For this purpose, the first part is devoted to the impact of microbiota on human health, and special attention is committed to the effect of fibre on gut microbiota. The second part is dedicated to the fundamental division of diets and the evaluation of concrete nutritional guidelines of modern diets into microbiota and health, followed by the recommendations of global authorities. Modern diets include diets from the point of view of medical science (e.g. Mediterranean), promoted by nutritionists and authorities (e.g. Nordic) and by social trends (e.g. vegan). The evaluation summarises that high-fibre diets have tremendous benefits on human health. Diets with fresh, local and naturally fermented food positively impact the gut microbiota, hence human health (agrarian diets). The results of the review show that the nutritional guidelines associated with the lowest mortality are the Mediterranean with the Atlantic or Nordic diet, which is in line with the recommendation of the world authorities (FAO, WHO, UN). The low-fibre western diet with highly processed foods with no or very low levels of live bacteria appears to be high-risk in terms of preventing civilisation diseases with a negative impact on gut microbiota, which is in line with current FAO and WHO guidelines.

Food-Derived Uremic Toxins in Chronic Kidney Disease.

Patients with chronic kidney disease (CKD) have a higher cardiovascular risk compared to the average population, and this is partially due to the plasma accumulation of solutes known as uremic toxins. The binding of some solutes to plasma proteins complicates their removal via conventional therapies, e.g., hemodialysis. Protein-bound uremic toxins originate either from endogenous production, diet, microbial metabolism, or the environment. Although the impact of diet on uremic toxicity in CKD is difficult to quantify, nutrient intake plays an important role. Indeed, most uremic toxins are gut-derived compounds. They include Maillard reaction products, hippurates, indoles, phenols, and polyamines, among others. In this review, we summarize the findings concerning foods and dietary components as sources of uremic toxins or their precursors. We then discuss their endogenous metabolism via human enzyme reactions or gut microbial fermentation. Lastly, we present potential dietary strategies found to be efficacious or promising in lowering uremic toxins plasma levels. Aligned with current nutritional guidelines for CKD, a low-protein diet with increased fiber consumption and limited processed foods seems to be an effective treatment against uremic toxins accumulation.

Practical Nutrition Strategies to Support Basketball Performance during International Short-Term Tournaments: A Narrative Review.

A short-term (e.g., 6 days) basketball tournament is a shorter version of international tournaments, and qualification in it enables participation in international tournaments such as the Olympics and World championships or preparation before major tournaments. Time for recovery between matches is shorter compared with major tournaments, resulting in an accentuated load on players, which can be repeated up to four times within the 6-day competition period. Therefore, nutritional strategies need to focus on faster and adequate recovery after each match as well as optimum fuelling and hydration before and during matches. Travelling can also create additional challenges when preparing and/or applying those nutritional strategies. There are some particular evidence-based sport foods and ergogenic aids that can improve intermittent activity and/or the execution of motor skills, which may facilitate basketball players' recovery and performance. The present review provides practical nutritional strategies to support short-term basketball tournaments based on players' physiological needs and current sport nutrition guidelines.

Association of nutrition knowledge, practice, supplement use, and nutrient intake with strength performance among Taekwondo players in Nepal.

Optimum dietary intake and adequate nutritional knowledge have been recognized as the key factors that play a critical role in improving the athlete's health and nutrition status. This study aimed to measure the association of nutritional knowledge, practice, supplement use, and nutrient intake with strength performance among Nepalese Taekwondo players. Between August 2019 and January 2020, a cross-sectional study was conducted among 293 Taekwondo players in Kathmandu Metropolitan City (mean age, 18 years; 63.1% male, 36.9% female). Face-to-face interviews were conducted using semi-structured questionnaires. Anthropometric measures, nutritional intake, nutrition knowledge, and practice were all recorded. The handgrip strength was measured using a handgrip dynamometer as a proxy for strength performance. Univariate and bivariate analyses were used to find out the association between predictor and outcome variables. More than half of the participants had poor nutrition knowledge [54.3% (159/293)], and poor nutrition practice [55.3% (162/293)] scores. Daily mean energy, carbohydrate, protein and fat intake were 48.0 kcal.kg-1.d-1, 8.6, 1.6, and 1.5 g.kg-1.d-1, respectively among Taekwondo players. Daily total energy and carbohydrate intake were 48.2 kcal.kg-1.d-1 and 8.7 g.kg-1.d-1, respectively among male players which is higher than female players. However, daily protein and fat intake were higher in female players (1.7 and 1.6 g.kg-1.d-1, respectively). Both calcium (375.3 mg) and iron (9 mg) intake among Taekwondo players were significantly lower than current sports nutrition guidelines. Nutritional knowledge score (r = 0.117), height (r = 0.538), weight (r = 0.651), body mass index (r = 0.347), fat (r = 0.075), and energy (r = 0.127) intake showed significant positive correlation with strength performance of athletes. The strength performance was positively associated with training hours per day (β = 0.41, 95% CI: 0.09-0.91), body mass index (β = 0.35, 95% CI: 0.09-0.61), nutrition knowledge score (β = 0.13, 95% CI: 0.01-0.25), and energy intake (β = 0.13, 95% CI: 0.12-0.14). The nutritional knowledge and practice both were suboptimal among Taekwondo athletes. Height, weight, body mass index, nutritional knowledge, energy, and fat intake showed a positive correlation with strength performance. Future studies can build on the premise of this study to identify the robust relationship between nutritional knowledge, practice, different supplement use, and nutrient intake among other athletes too.

Oral, enteral and parenteral nutritional therapies in scleroderma: A systematic review.

Scleroderma is a multi-system disease that causes hardening of connective tissue. The gastrointestinal (GI) tract is affected in 90% of patients, which may cause nutritional decline. Due to the rarity of the disease, current nutritional guidelines in scleroderma are extrapolated from evidence in other chronic diseases. This systematic review examines the effects of oral nutrition supplements (ONS), enteral nutrition (EN) and parenteral nutrition (PN) on both clinical and nutritional outcomes of scleroderma patients. Three separate systematic searches for scleroderma and ONS, EN, and PN were performed. The searches were conducted using EMBASE, PubMed and Web of Science databases. A total of 9 studies (ONS: 2, EN: 1 and PN: 6) met the inclusion and exclusion criteria and were included in the review. All patients had scleroderma and were malnourished or at risk of malnutrition [weighted average age: 53 years, Body Mass Index (BMI): 19kg/m2]. Artificial nutrition support was shown to be an effective therapy for preventing nutritional decline and reversing malnutrition but had no impact on disease progression. Mean BMI increased with home parenteral nutrition (HPN) and EN, from 15kg/m2 to 21.0kg/m2. Weight was maintained with ONS, and sarcopenia decreased. Only HPN positively impacted quality of life and GI symptoms, with complication rates similar to patients with other indications. Scleroderma patients should be routinely screened for malnutrition. Malnutrition is treated in a stepwise manner, starting with ONS, then EN and finally PN, based on GI sufficiency and tolerance of the patient. HPN is an effective therapy for patients with advanced disease and intestinal failure. However, larger, long-term, prospective studies for each nutritional therapy are required to make firm conclusions.