Adult Diet Research Articles

Metabolic effects of early life stress and pre-pregnancy obesity are long-lasting and sex-specific in mice.

Early life stress (ELS) is associated with metabolic-, cognitive-, and psychiatric diseases and has a very high prevalence, highlighting the urgent need for a better understanding of the versatile physiological changes and identification of predictive biomarkers. In addition to programming the hypothalamic-pituitary-axis (HPA), ELS may also affect the gut microbiota and metabolome, opening up a promising research direction for identifying early biomarkers of ELS-induced (mal)adaptation. Other factors affecting these parameters include maternal metabolic status and diet, with maternal obesity shown to predispose offspring to later metabolic disease. The aim of the present study was to investigate the long-term effects of ELS and maternal obesity on the metabolic- and stress phenotype of rodent offspring. To this end, offspring of both sexes were subjected to an adverse early-life experience, and their metabolic and stress phenotypes were examined. In addition, we assessed whether a prenatal maternal and an adult high-fat diet (HFD) stressor further shape observed ELS-induced phenotypes. We show that ELS has long-term effects on male body weight (BW) across the lifespan, whereas females more successfully counteract ELS-induced weight loss, possibly by adapting their microbiota, thereby stabilizing a balanced metabolome. Furthermore, the metabolic effects of a maternal HFD on BW are exclusively triggered by a dietary challenge in adult offspring and are more pronounced in males than in females. Overall, our study suggests that the female microbiota protects against an ELS challenge, rendering them more resilient to additional maternal- and adult nutritional stressors than males.

Crop-pollinating Diptera have diverse diets and habitat needs in both larval and adult stages.

Insects are important pollinators of global food crops and wild plants. The adult and larval diet and habitat needs are well known for many bee taxa, but poorly understood for other pollinating taxa. Non-bee pollinators often feed on different substrates in their larval and adult life stages, and this diet and habitat diversity has important implications for their conservation and management. We reviewed the global literature on crop pollinating Diptera (the true flies) to identify both larval and adult fly diet and habitat needs. We then assembled the published larval and adult diets and habitat needs of beneficial fly pollinators found globally into a freely accessible database. Of the 405 fly species known to visit global food crops, we found relevant published evidence regarding larval and adult diet and habitat information for 254 species, which inhabited all eight global biogeographic regions. We found the larvae of these species lived in 35 different natural habitats and belong to 10 different feeding guilds. Additionally, differences between adult Diptera sexes also impacted diet needs; females from 14 species across five families fed on protein sources other than pollen to start the reproductive process of oogenesis (egg development) while males of the same species fed exclusively on pollen and nectar. While all adult species fed at least partially on floral nectar and/or pollen, only five species were recorded feeding on pollen and no fly larvae fed on nectar. Of the 242 species of larvae with established diet information, 33% were predators (n = 79) and 30% were detritivores (n = 73). Detritivores were the most generalist taxa and utilized 17 different habitats and 12 different feeding substrates. Of all fly taxa, only 2% belonged to the same feeding guild in both active life stages. Our results show that many floral management schemes may be insufficient to support pollinating Diptera. Pollinator conservation strategies in agroecosystems should consider other non-floral resources, such as wet organic materials and dung, as habitats for beneficial fly larvae.

A randomized clinical trial comparing low-fat with precision nutrition–based diets for weight loss: impact on glycemic variability and HbA1c

BackgroundRecent studies have demonstrated considerable interindividual variability in postprandial glucose response (PPGR) to the same foods, suggesting the need for more precise methods for predicting and controlling PPGR. In the Personal Nutrition Project, the investigators tested a precision nutrition algorithm for predicting an individual’s PPGR. ObjectiveThis study aimed to compare changes in glycemic variability (GV) and HbA1c in 2 calorie-restricted weight loss diets in adults with prediabetes or moderately controlled type 2 diabetes (T2D), which were tertiary outcomes of the Personal Diet Study. MethodsThe Personal Diet Study was a randomized clinical trial to compare a 1-size-fits-all low-fat diet (hereafter, standardized) with a personalized diet (hereafter, personalized). Both groups received behavioral weight loss counseling and were instructed to self-monitor diets using a smartphone application. The personalized arm received personalized feedback through the application to reduce their PPGR. Continuous glucose monitoring (CGM) data were collected at baseline, 3 mo and 6 mo. Changes in mean amplitude of glycemic excursions (MAGEs) and HbA1c at 6 mo were assessed. We performed an intention-to-treat analysis using linear mixed regressions. ResultsWe included 156 participants [66.5% women, 55.7% White, 24.1% Black, mean age 59.1 y (standard deviation (SD) = 10.7 y)] in these analyses (standardized = 75, personalized = 81). MAGE decreased by 0.83 mg/dL per month for standardized (95% CI: 0.21, 1.46 mg/dL; P = 0.009) and 0.79 mg/dL per month for personalized (95% CI: 0.19, 1.39 mg/dL; P = 0.010) diet, with no between-group differences (P = 0.92). Trends were similar for HbA1c values. ConclusionsPersonalized diet did not result in an increased reduction in GV or HbA1c in patients with prediabetes and moderately controlled T2D, compared with a standardized diet. Additional subgroup analyses may help to identify patients who are more likely to benefit from this personalized intervention.This trial was registered at clinicaltrials.gov as NCT03336411.

Initiatives to Reduce the Content of Sodium in Food Products and Meals and Improve the Population's Health.

Table salt is the main source of sodium (Na) in the human diet. Excessive supply of Na in a diet is strongly linked to many non-communicable human diseases, such as hypertension, obesity and stomach cancer. The World Health Organization recommends that daily intake of salt in adult diets should be kept below 5 g/person/day, which corresponds to 2 g Na/person/day. However, on average, adults consume about 9-10 g/person/day, and children and young people about 7-8 g/person/day. Initiatives to reduce salt intake include modifications of food composition in collaboration with the food industry, education of consumers, salt marking on foodstuff labels and taxation of salt. A need also exists to educate society so that they choose low-sodium products. In view of the food technology and amount of salt intake, the most important and the easiest change to make is to reduce the content of salt in baked goods. This paper analyses the results of surveys regarding strategies to reduce salt content in food products and considers multifaceted initiatives to reduce salt intake as a possible efficient method of improving the population's health status.

The growth of the buccal mass in Sepia officinalis: functional changes throughout ontogeny

Due to their small size, juveniles are more likely to show lower absolute levels of performance leading to a potential competitive disadvantage compared to adults. Therefore, juveniles are expected to compensate by showing a higher relative performance, and/or partitioning resources to overcome this performance disadvantage. Here, we investigate the link between ontogeny and feeding performance in the common cuttlefish Sepia officinalis. We explore the changes in beak shape, wear pattern, mechanical properties, muscular anatomy, and bite force during growth from 3-month post hatching to adults. We show that both upper and lower beaks present important ontogenetic shape variation in the rostrum area that might be due to wear induced by feeding. The mechanical properties of the beaks in juveniles indicate greater resistance compared to adults. Tanning observed on the beaks provides reinforcement to areas under high load during biting. In addition, muscle development and relative bite force were found to differ between cuttlefish of different ages, resulting in juveniles having a similar bite force for their size but with a muscular advantage for opening. Finally, an isometric relation is found in the bite force of S. officinalis, with no sign of feeding performance compensation in juveniles. Feeding performance thus does not reflect the ontogenetic shift from a crustacean-based diet in juveniles to a fish-based diet in adults.

The feeding apparatus of Rhea americana (Aves, Palaeognathae): Jaw myology and ontogenetic allometry.

In birds, the jaw musculature is a crucial adaptive feature involved in feeding. The morphological traits and postnatal growth patterns of jaw muscles constitute a useful proxy to interpret feeding function and ecology. This study aims to describe the jaw muscles of Rhea americana and explore their postnatal growth pattern. A total of 20 specimens of R. americana representing four ontogenetic stages were studied. Jaw muscles were described, weighed and their proportions with respect to body mass were calculated. Linear regression analysis was used to characterize ontogenetic scaling patterns. The morphological patterns of jaw muscles were characterized by their simplicity: bellies with few or no subdivisions and similar to those described for other flightless paleognathous birds. In all stages, the muscles pterygoideus lateralis, depressor mandibulae, and pseudotemporalis had the greatest mass values. The proportion of total jaw muscle mass decreased with age from 0.22% in 1-month-old chicks to 0.05% in adults. Linear regression analysis showed that all muscles scaled with negative allometry with respect to body mass. The progressive decrease of jaw muscle mass relative to body mass in adults could be related to the generation of less force, which is in accordance with the herbivorous diet of adults. In contrast, the diet of rhea chicks includes a large proportion of insects thus, this greater muscle proportion could be associated with the ability to generate more force, thus providing better abilities to grasp and hold more mobile prey.

Associations between dietary inflammatory scores and biomarkers of inflammation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Since the first version of the dietary inflammatory index (DII®) developed in the past decade, several other versions have been developed. However, to date no study has attempted to compare these versions with respect to their associations with biomarkers of inflammation. We aimed to investigate the relationship between four dietary inflammatory scores [DII, two energy-adjusted derivatives (E-DII and E-DIIr), and the Inflammatory Score of the Diet (ISD)], and circulating levels of several inflammatory markers and adipokines. This study included 17637 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort with at least one marker of inflammation measured in blood. Associations between the four scores and C-reactive protein (CRP), interleukin (IL)6, IL10, IL1RA, tumor necrosis factor-α (TNFα), soluble tumor necrosis factor receptor-1 (sTNFR1), sTNFR2, leptin, soluble leptin receptor (sLeptin R), adiponectin, and High Molecular Weight (HMW) adiponectin were evaluated using multivariable linear regressions adjusted for potential confounders. Positive associations were observed between the four dietary inflammatory scores and levels of CRP, IL6, sTNFR1, sTNFR2 and leptin. However, only the DII and the ISD were positively associated with IL1RA levels and only the DII and the E-DIIr were positively associated with TNFα levels. The proportion of variance of each biomarker explained by the scores was lower than 2%, which was equivalent to the variance explained by smoking status but much lower than that explained by body mass index. Our results suggest that the four dietary inflammatory scores were associated with some biomarkers of inflammation and could be used to assess the inflammatory potential of diet in European adults but are not sufficient to capture the inflammatory status of an individual. These findings can help to better understand the inflammatory potential of diet, but they need to be replicated in studies with repeated dietary measurements.

The association of dietary inflammatory potential with sarcopenia in Chinese community-dwelling older adults

BackgroundDietary-induced inflammation is potentially associated with sarcopenia. Nevertheless, few studies have investigated the structure of the inflammatory diet and its correlation with muscle function and performance in both the upper and lower limbs. This study was performed to explore the association of the dietary inflammatory index (DII) with sarcopenia and its diagnostic parameters.MethodsWe conducted a cross-sectional survey on a sample of 515 Chinese community-dwelling older adults selected through multistage cluster sampling from three districts in Shanghai. DII scores were calculated using a validated food frequency questionnaire. Sarcopenia and its diagnostic parameters were determined based on the definition set by the Asian Working Group on Sarcopenia (AWGS).ResultsThe mean age of study participants was 71.31 ± 4.71 years. The prevalence of sarcopenia in the cohort was 12.4%. Older adults in the highest DII quartile had a 3.339 times increased risk of sarcopenia compared to those in the lowest quartile (OR Quartile4vs1:3.339, 95%CI: 1.232, 9.052, p-trend: 0.004) after adjusting for confounding factors. Additionally, a more pro-inflammatory diet was associated with lower appendicular skeletal muscle index (ASMI) (OR Quartile4vs1: 3.005, 95%CI: 1.275, 7.318, p-trend: 0.005), a higher 5-times sit-stand test time score (OR Quartile4vs1: 4.942, 95%CI: 1.745, 13.993, p-trend: 0.005), and lower gait speed (OR Quartile4vs1: 2.392, 95%CI: 1.104, 5.185, p-trend: 0.041) after adjusting for confounding factors. However, there was no significant association between DII, handgrip strength, and Short Physical Performance Battery (SPPB) score in either the unadjusted or adjusted model.ConclusionThis study found that the association between consuming a more pro-inflammatory diet and sarcopenia in Chinese community-dwelling older adults was mainly due to underlying low intakes of dietary energy, protein, and anti-inflammatory foods, and not due to the high intake of pro-inflammatory foods. Meanwhile, DII was more highly correlated with lower limb muscle strength and performance compared to upper limb muscle strength.

Synergistic effects of overweight/obesity and high hemoglobin A1c status on elevated high-sensitivity C-reactive protein in Chinese adults: a cross-sectional study.

High-sensitivity C-reactive protein (hs-CRP) is an inflammatory marker that has been suggested as a predictor of cardiovascular diseases. High glycated hemoglobin (HbA1c) levels and overweight/obesity are independently associated with elevated hs-CRP; meanwhile, high HbA1c levels are frequently accompanied by overweight or obesity. However, their joint effect on elevated hs-CRP levels has not been well-established. Therefore, we evaluated whether overweight/obesity modified the association between high HbA1c levels and elevated hs-CRP. Based on cross-sectional data from the Chinese Urban Adults Diet and Health Study (CUADHS) in 2016, we included 1,630 adults aged 18-75 years (mean age 50.16 years and 33.6% male). Elevated hs-CRP was defined as serum hs-CRP ≥ 3 and <10 mg/L. The interactive effects of BMI and HbA1c levels on the risk of elevated hs-CRP levels were calculated by using multiple logistic regression models, followed by strata-specific analyses. Individuals with elevated hs-CRP had a higher rate of HbA1c level than those without elevated (25.3 vs. 11.3%, P < 0.001), as well as a higher rate of overweight/obesity (67.1 vs. 43.5%, P < 0.001). Higher HbA1c levels were independently associated with an increased risk of elevated hs-CRP [adjusted odds ratio (aOR) = 2.31, 95% confidence interval (CI): 1.47, 3.65], as well as overweight/obesity with the risk of elevated hs-CRP (aOR = .31, 95% confidenc-3.73). Furthermore, overweight/obesity showed a significant synergistic effect on high HbA1c levels with a higher aOR of 5.25 (2.77, 9.95) (Pinteraction < 0.001). This synergistic effect was more prominent when stratified by age (in 18-44 years old, aOR, 95% CI = 30.90, 4.40-236.47 for interaction vs. 6.46, 1.38-30.23 for high HbA1c only) and gender (in women, aOR, 95% CI = 8.33, 3.80-18.23 for interaction vs. 2.46,1.38-4.40 for high HbA1c only). There are synergistic effects of high HbA1c levels and overweight/obesity on the risk of elevated hs-CRP in Chinese adults, with more significant effects in adults aged 18-44 years or females. Intervention strategies for preventing high blood glucose levels and body weight simultaneously may be important for reducing hs-CRP-related diseases. Further studies are needed to confirm this finding in other populations, and its molecular mechanisms need to be elucidated.

Assessment of nutritional potential with respect to macroelements in the Tropical fruits from Solomon Islands

The present study reports the contents of macroelements such as calcium, magnesium, potassium, and sodium in tropical fruits samples from Solomon Islands. The fruit samples were analyzed using flame atomic absorption spectrometer. The method used was validated by analyzing standard reference material of Blueberry fruit (NIST-SRM3287). The macroelemental concentrations in fruits revealed the highest content of K (480 ± 13 mg/100 g) in breadfruit while the maximum concentrations of Ca (41.9 ± 2.0 mg/100 g) and Mg (150 ± 8 mg/100 g) were found in cutnut. Banana exhibited the highest concentration of Na as 14.7 ± 0.6 mg/100 g. Potassium showed dominance while Na showed the least concentration in the studied fruits except for starfruit which had Ca as the least concentrated element. The estimated recommended dietary allowance (RDA) coverage for macroelements in fruits showed the highest percentage covering for children followed by adolescents and adults, in respective ranges of 0.173 ̶ 188, 0.138 ̶ 71.4 and 0.173 ̶ 48.4% RDA. The individual macroelements RDA coverage for children, adolescents and adults were estimated to be K (3.87 ̶ 16.0, 3.13 ̶ 10.7 and 3.00 ̶ 10.2% RDA), Ca (0.393 ̶ 5.99, 0.302 ̶ 3.22 and 0.330 ̶ 4.19% RDA) and Na (0.173 ̶ 1.47, 0.138 ̶ 0.980 and 0.138 ̶ 1.23% RDA), respectively. Based on the estimated percentage RDA coverage, the studied fruits have been classified as sources and rich sources of different macroelements for children, adolescents and adult diets.

Dental Condition, Diet, and Glycaemic Control: Analysis of NHANES 2011–2014

ObjectivesA bidirectional relationship between periodontitis and diabetes has been reported. Its mechanisms are yet to be elucidated. This study examines the interplays amongst dental conditions (periodontitis and functional dentition), diet, and glycaemic control of adults. MethodsRelevant data of the NHANES surveys (2011–2012 and 2013–2014) (n = 6076) were extracted, including dental examination for generalised severe periodontitis (GSP) and functional dentition, laboratory tests for haemoglobin A1c (HbA1c), and 24-hour dietary recall. Multiple regressions and path analysis were conducted to assess the association between dental conditions and glycaemic control and the mediation effect of diet. ResultsHigher HbA1c value was associated with GSP (coef: 0.34; 95% CI: 0.10 to 0.58) and nonfunctional dentition (coef: 0.12; 95% CI: 0.01 to 0.24). Associations were also found between lower fibre intake (g/1000 kcal) with GSP (coef: −1.16; 95% CI: −1.61 to −0.72) and nonfunctional dentition (coef: −0.80; 95% CI: −1.18 to −0.42). Mediation effect of diet (% energy from carbohydrate and energy-adjusted fibre intake) for the association between dental conditions and glycaemic control was not significant. ConclusionsPeriodontitis and functional dentition are significantly associated with fibre intake and glycaemic control in adults. Dietary intake, however, does not mediate the association between dental conditions and glycaemic control.

Plant-Based Diet and Risk of Frailty in Older Chinese Adults.

This study examined the relationship between the consumption of plant-based diet and frailty in older Chinese adults. Prospective cohort study. Community-based setting in 22 provinces of China. The final sample included data from 3990 older adults from 2011-2014 from the Chinese Longitudinal Healthy Longevity Survey. A plant-based diet index (PDI) was calculated based on a qualitative food frequency questionnaire. Frailty was defined using modified Fried criteria. A Generalized Estimating Equation was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for frailty. We further performed subgroup analyses stratified by sex and lifestyle factors. 557 cases of frailty were observed. After adjustment for covariates, the RR for frailty of a high PDI was 0.792 (95% CI: 0.644-0.973), relative to a low PDI. During follow-up, compared with respondents with a continually low PDI, the respondents with a continually high PDI had a significantly reduced risk of frailty (RR = 0.683, 95% CI: 0.514-0.908). In further subgroup analysis, a consistently high PDI over time resulted in a significantly reduced risk of frailty for male (RR = 0.591, 95% CI: 0.391-0.893); for never smokers (RR = 0.670, 95% CI: 0.458-0.979); for people who did never consume alcohol (RR = 0.654, 95% CI: 0.454-0.941); and for people with current or former exercise habits (RR = 0.488, 95% CI: 0.313-0.762). Plant-based diet was associated with low risk of frailty in men and in older adults with healthy lifestyle. These findings stress that plant-based diet should be recommended as a dietary strategy to prevent and reduce frailty in older adults; in addition, more dietary interventions along with lifestyle modification should be adopted to promote successful ageing, especially for women.

Study design and baseline profile for adults with type 2 diabetes in the once-weekly subcutaneous SEmaglutide randomized PRAgmatic (SEPRA) trial

IntroductionOnce-weekly subcutaneous semaglutide, a glucagon-like peptide-1 analog, is approved in the USA as an adjunct to diet and exercise for adults with inadequately controlled type 2 diabetes (T2D) to improve...

Weight loss associated with low-energy diets with different glycaemic loads does not improve arterial stiffness: a randomised clinical trial.

We evaluated the effects of two low-energy diets with different glycaemic loads on arterial stiffness in adults with excess weight. This was a 45-day parallel-group, randomised clinical trial including seventy-five participants (20-59 years; BMI 32 kg/m2). They were assigned to two similar low-energy diets (reduction of ∼750 kcal.d-1) with macronutrient composition (55 % carbohydrates, 20 % proteins and 25 % lipids) but different glycaemic loads: high-glycaemic load (HGL 171 g.d-1; n 36) or low-glycaemic load (LGL 67 g.d-1; n 39). We evaluated: arterial stiffness (pulse wave velocity, PWV); augmentation index (AIx@75); reflection coefficient; fasting blood glucose; fasting lipid profile; blood pressure and body composition. We found no improvements in PWV (P = 0·690) and AIx@75 (P = 0·083) in both diet groups, but there was a decrease in the reflection coefficient in the LGL group (P = 0·003) compared with baseline. The LGL diet group showed reductions in body weight (Δ -4·9 kg; P = 0·001), BMI (Δ -1·6 kg/m2; P = 0·001), waist circumference (Δ -3·1 cm; P = 0·001), body fat (Δ -1·8 %; P = 0·034), as well as TAG (Δ -14·7 mg/dl; P = 0·016) and VLDL (Δ -2·8 mg/dl; P = 0·020). The HGL diet group showed a reduction in total cholesterol (Δ -14·6 mg/dl; P = 0·001), LDL (Δ -9·3 mg/dl; P = 0·029) but a reduction in HDL (Δ -3·7 mg/dl; P = 0·002). In conclusion, a 45-day intervention with low-energy HGL or LGL diets in adults with excess weight was not effective to improve arterial stiffness. However, the LGL diet intervention was associated with a reduction of reflection coefficient and improvements in body composition, TAG and VLDL levels.

Additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluates the additional effect of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes. Embase, Medline, Web of Science and Cochrane Central databases were evaluated, and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone. Exercise interventions consisted of walking or jogging, cycle ergometer training, football training or resistance training and duration varied from 2 to 52 weeks. Body weight and measures of body composition and glycaemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (-0.77 kg [95% CI: -2.03; 0.50]), BMI (-0.34 kg/m2 [95% CI: -0.73; 0.05]), waist circumference (-1.42 cm [95% CI: -3.84; 1.00]), fat-free mass (-0.18 kg [95% CI: -0.52; 0.17]), fat mass (-1.61 kg [95% CI: -4.42; 1.19]), fasting glucose (+0.14 mmol/L [95% CI: -0.02; 0.30]), HbA1c (-1 mmol/mol [95% CI: -3; 1], -0.1% [95% CI: -0.2; 0.1]) and HOMA-IR (+0.01 [95% CI: -0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO2max and showed significant increases upon the addition of exercise to hypocaloric diet. Based on limited data, we did not find additional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes on body weight, body composition or glycaemic control, while cardio-respiratory fitness improved.

The Utilization of the Ketogenic Diet for Adults with Status Epilepticus (P8-7.003)

<h3>Objective:</h3> To characterize the utilization of ketogenic diet (KD) among healthcare providers caring for adult patients with status epilepticus (SE). <h3>Background:</h3> KD is a high fat, low carbohydrate diet that has been shown to effectively treat refractory seizures, both in the outpatient and inpatient settings. The successful implementation of KD involves a multifaceted, interdisciplinary approach with many potential barriers. <h3>Design/Methods:</h3> 27-question web-based survey (Qualtrics®) targeting healthcare providers who manage adult SE patients in both academic and community-based settings distributed by various neurology and critical care specialties societies. <h3>Results:</h3> Of 156 respondents, 80% of physicians and 18% of non-physicians reported using KD for SE. Achieving ketosis (36.3%), lack of expertise (24.2%), and lack of resources (20.9%) were identified as some of the most important barriers limiting the utilization of KD. Absence of nutrition support (37.1%) and of pharmacy support (25.7%) were the most important missing resources. Reasons for stopping KD were identified as ineffectiveness (29.1%), difficulty achieving ketosis (24.6%) and side-effects (17.3%). The discrepancies are evident when comparing providers in the academic versus non-academic settings. The former has significantly more experience with the use of KD and EEG monitoring availability, and fewer barriers to its implementation. The need for more randomized clinical trials supporting efficacy (36.5%) and increased practical guidelines for implementation and maintenance of KD (29.6%) were mostly cited as factors to increase the utilization of KD for SE. <h3>Conclusions:</h3> We identified multiple target areas to improve the utilization of KD through future research. These include better interdisciplinary collaboration, studies exploring factors affecting the achievement of ketosis and the management of side effects, and large-scale clinical trials examining the efficacy of this treatment. KD represents an underexplored treatment modality which may prove crucial in improving management of SE. <b>Disclosure:</b> Dr. Jacinto Pereira Teixeira has nothing to disclose. Ms. Shannon has nothing to disclose. Dr. Robinson has nothing to disclose. Bakhtawar Ahmad has nothing to disclose. Mr. Katz has nothing to disclose. Guanhong Miao has nothing to disclose. Ms. Seckar has nothing to disclose. Dr. Bruzzone has nothing to disclose. Dr. Busl has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society of Critical Care Medicine. The institution of Dr. Busl has received research support from University of Florida Self Insurance Program. The institution of Dr. Busl has received research support from National Institutes of Health. Dr. Busl has a non-compensated relationship as a Board Member with Art in Medicine that is relevant to AAN interests or activities. Dr. Busl has a non-compensated relationship as a Associate Editor with Critical Care Explorations that is relevant to AAN interests or activities. Dr. Busl has a non-compensated relationship as a Editorial Board Member with Neurocritical Care that is relevant to AAN interests or activities. Dr. Cervenka has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Nutricia. Dr. Cervenka has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nestle Health Science/Vitaflo. The institution of Dr. Cervenka has received research support from Nestle Health Science/Vitaflo. Dr. Cervenka has received publishing royalties from a publication relating to health care. Dr. Maciel has received research support from American Heart Association. Dr. Maciel has received research support from National Institute of Health.

Association between Diet and Adiposity in Adults: Influence of Sedentary Behavior Patterns.

This study analyzed the influence of sedentary behavior (SB) on the association between dietary patterns and adiposity in community-dwelling adults. Eight hundred and forty-three adults (age: 56.5 ± 18.3 years) participated in this cross-sectional epidemiological study. Dietary patterns were evaluated using self-report questions regarding the weekly frequency of consumption of certain foods. Adiposity was determined using anthropometric measurements of weight, waist circumference, and height. SB was evaluated according to the time spent on screen devices. The usual physical activity level and socioeconomic status were considered confounding factors. Associations were determined using multivariate linear models with simultaneous adjustments for confounding variables. A statistical analysis indicated that fruit consumption was negatively related to the body mass index, regardless of the adjustment for SB domains. Red meat consumption was positively related to the body mass index, and fried food consumption was positively related to the waist-to-height ratio, regardless of the adjustment for SB domains. The consumption of fried food was positively associated with global and central adiposity after the adjustments for confounding factors and time spent on screen devices. We concluded that dietary habits are related to adiposity in adults. However, SB domains seem to influence the relationship between body adiposity and dietary habits, mainly regarding the consumption of fried foods.

Helicopter Parenting Among Socio-Economically and Ethnically/Racially Diverse Emerging Adults: Associations with Weight-Related Behaviors.

Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-economic families, with little research examining weight-related health or with emerging adult children. The current study examined associations with emerging adult diet, physical activity, and body mass index (BMI) among a diverse population-based sample of parent and emerging adult dyads (n = 919). Helicopter parenting was highest among lower socioeconomic households and those identifying as Black, Indigenous, or people of color. Helicopter parenting was associated with both healthy and less healthy dietary behaviors across ethnic/racial groups, but was not associated with physical activity or BMI. Greater consideration of the cultural context related to helicopter parenting is needed before making conclusions about its benefits or harms.

Efficacy of low carbohydrate and ketogenic diets in treating mood and anxiety disorders: systematic review and implications for clinical practice.

There is mounting interest in the potential efficacy of low carbohydrate and very low carbohydrate ketogenic diets in various neurological and psychiatric disorders. To conduct a systematic review and narrative synthesis of low carbohydrate and ketogenic diets (LC/KD) in adults with mood and anxiety disorders. MEDLINE, Embase, PsycINFO and Cochrane databases were systematically searched for articles from inception to 6 September 2022. Studies that included adults with any mood or anxiety disorder treated with a low carbohydrate or ketogenic intervention, reporting effects on mood or anxiety symptoms were eligible for inclusion. PROSPERO registration CRD42019116367. The search yielded 1377 articles, of which 48 were assessed for full-text eligibility. Twelve heterogeneous studies (stated as ketogenic interventions, albeit with incomplete carbohydrate reporting and measurements of ketosis; diet duration: 2 weeks to 3 years; n = 389; age range 19 to 75 years) were included in the final analysis. This included nine case reports, two cohort studies and one observational study. Data quality was variable, with no high-quality evidence identified. Efficacy, adverse effects and discontinuation rates were not systematically reported. There was some evidence for efficacy of ketogenic diets in those with bipolar disorder, schizoaffective disorder and possibly unipolar depression/anxiety. Relapse after discontinuation of the diet was reported in some individuals. Although there is no high-quality evidence of LC/KD efficacy in mood or anxiety disorders, several uncontrolled studies suggest possible beneficial effects. Robust studies are now needed to demonstrate efficacy, to identify clinical groups who may benefit and whether a ketogenic diet (beyond low carbohydrate) is required and to characterise adverse effects and the risk of relapse after diet discontinuation.

Diet and Nutritional Status of West African and Caribbean Adults in the United Kingdom: Perspectives to Inform Community-Based Approaches to Healthy Eating

Diet and Nutritional Status of West African and Caribbean Adults in the United Kingdom: Perspectives to Inform Community-Based Approaches to Healthy Eating