Dietary Patterns Research Articles

The Impact of Macronutrient and Dietary Patterns on Gestational Diabetes Mellitus

Pregnancy is a physiological condition that increases insulin resistance (IR) due to hormonal changes, including elevated levels of estrogen, progesterone, and human placental lactogen (HPL). Such IR, especially in the later stages of pregnancy, can cause gestational diabetes mellitus (GDM), characterized by glucose intolerance first detected during pregnancy. GDM poses significant health risks for both the mother and the fetus, including the potential for pre-eclampsia, emergency C-sections, and type 2 diabetes (T2D) for the mother, as well as preterm birth, hypoglycemia, and being large for gestational age (LGA) for the baby. Proper dietary modifications can help regulate blood sugar levels, improve insulin sensitivity, and ensure healthy gestational weight gain (GWG), thereby reducing the possibility of undesirable outcomes. This paper discusses the role of energy, carbohydrate, fat, and protein, and compares the effects of the Mediterranean diet (MD) and Western diet (WD) on the risk of GDM. The main objective of this paper is to identify the most effective dietary strategies for preventing and managing GDM. The finding indicates that a MD rich in nutrient-dense foods, complex carbohydrates/lower GI, unsaturated fatty acids (FAs), and balanced protein has beneficial effects on GDM. In contrast, the WD with empty calories, simple carbohydrates/higher glycemic index (GI), saturated FAs (SFA), and animal-based protein increases the risk of GDM. Future studies should continue to explore the long-term effects of dietary interventions, integrate other lifestyle factors, and consider genetic differences to provide comprehensive management strategies for GDM.

The Role of Nutrition in Non-Communicable Diseases: Literature Review

Cardiovascular diseases, diabetes, obesity, and certain types of cancer, collectively referred to as NCDs, are a global concern and contribute to about 71% of the total global mortality. This paper focuses on examining nutrition in an attempt to understand how it influences these diseases since the consumption of certain foods is a modifiable risk factor. The results reveal that an increased concentration of fruits and vegetables, whole meal grains, and health-promoting fats can help reduce the vulnerability to NCDs, but a high diet of processed foods and sugar makes the problem worse. However, there is still a dearth of knowledge on the multifaceted processes regarding how particular diet patterns influence NCDs. This study synthesizes available literature on nutrition and NCDs concerning how dietary patterns and nutrient intakes influence the prevention and treatment of diseases. Conclusions are drawn from numerous investigations, stressing the positive effects of dietary modifications like Mediterranean and DASH diets on NCD risk and actual health status. This review contributes to the future development of nutrition and health as a quick reference for researchers about the specific effects of nutrition on health. However, some barriers have not yet been solved like the incidence of unhealthy dietary patterns. Subsequent research should closely examine factors that can be employed that would ensure the effective administration of both nutritional interventions as well as the formulation of improved public health policies that would ensure a change of habits and eating behaviors in a bid to reduce the effects of NCDs.

Association between improved erectile function and dietary patterns: a systematic review and meta-analysis.

Erectile dysfunction (ED) is prevalent among men, but its relationship with dietary habits is uncertain. The aim of our study was to assess whether dietary patterns enhance erectile function by reviewing the literature published before August 1, 2022, via PubMed, Web of Science, and EMBASE databases. The data compiled included author details; publication dates, countries, treatments, patient numbers, ages, follow-ups, and clinical trial outcomes, such as ED cases, odds ratios (ORs), confidence intervals (CIs), and International Index of Erectile Function-5 (IIEF-5) scores with means and standard deviations. An analysis of 14 studies with 27 389 participants revealed that plant-based diets (OR = 0.71, 95% CI: 0.66-0.75; P < 0.00001), low-fat diets (OR = 0.27, 95% CI: 0.13-0.53; P = 0.0002), and alternative diets such as intermittent fasting and organic diets (OR = 0.54, 95% CI: 0.36-0.80; P = 0.002) significantly reduced ED risk. High-protein low-fat diets (hazard ratio [HR] = 1.38, 95% CI: 1.12-1.64; P < 0.00001) and high-carb low-fat diets (HR = 0.79, 95% CI: 0.55-1.04; P < 0.00001) improved IIEF-5 scores. Combined diet and exercise interventions decreased the likelihood of ED (OR = 0.49, 95% CI: 0.28-0.85; P = 0.01) and increased the IIEF-5 score (OR = 3.40, 95% CI: 1.69-5.11; P < 0.0001). Diets abundant in fruits and vegetables (OR = 0.97, 95% CI: 0.96-0.98; P < 0.00001) and nuts (OR = 0.54, 95% CI: 0.37-0.80; P = 0.002) were also correlated with lower ED risk. Our meta-analysis underscores a strong dietary-ED association, suggesting that low-fat/Mediterranean diets rich in produce and nuts could benefit ED management.

Shaping childhood obesity: behavioral and environmental risk factors associated with body mass index trajectories between 2 and 9 years in Samoan children.

Pacific children are at high obesity risk, yet the behavioral and environmental factors that contribute to obesity development in this setting remain poorly understood. We assessed associations between childhood risk factors for obesity with body mass index (BMI) trajectories between ages 2-9 years in Samoa. In a prospective cohort of 485 children from 'Upolu, we measured weight and height at ages 2-4 (2015), 3.5-8 (2017-18), and 5.5-11 years (2019-20). Modern dietary pattern adherence was assessed using factor analysis of primary caregiver-reported food frequency questionnaire data. Physical activity was estimated with the Netherlands Physical Activity Questionnaire. Socioeconomic resources were assessed using an 18-item household asset score. Urbanicity was based on village residence. Associations of these risk factors with predicted weight, height, and BMI (at 1-year intervals and velocity) were assessed using multilevel cubic spline regressions. Females had greater adjusted weight velocity with high modern dietary pattern adherence compared to low (p-value for interaction with age spline term 1 = 0.028 and age spline term 2 = 0.007). Starting at age 3 years, children with higher physical activity had higher BMI, but this association was not meaningful up to age 9 (all p-value > 0.05). Males with very high compared to low household assets had higher BMI from age 2 to 4 years (95% CI: 0.26-1.53 kg/m2, p = 0.006) and greater BMI velocity (p-value for interaction with age spline term 2 = 0.001). Males in the urban region had the greatest BMI gain after age 5 compared to the rural region (p-value for interaction with age spline term 2 = 0.014). High, centile-crossing BMI trajectories suggest that obesity prevention and intervention are needed among Samoan children before age 9 years. Positive associations between high modern dietary pattern adherence, greater asset ownership, and urbanization offer initial insights into who, and which behavioral risk factors, should be prioritized in implementing public health solutions.

Dietary Approaches for Complementary Feeding: The Greek Mediterranean Diet as a Model for Caregivers

Background/Objectives: Complementary feeding (CF), is defined as the process of providing foods in addition to milk when breast milk or milk formula alone are no longer adequate to meet nutritional requirements. CF affects not only growth but also the subsequent development of the child’s dietary preferences. The Mediterranean diet (MedDiet) is one of the most studied dietary patterns worldwide. The main purpose of this article is to provide practical guidance for CF to caregivers introducing the Greek MedDiet, summarizing the current different approaches. The evidence-based information provided could be used by developers to create a reliable digital app for CF based on Mediterranean foods and traditional dishes. Methods: An in-depth literature review of the existing guidelines and recently published research data on CF using PubMed, national recommendations, and grey literature were undertaken. Results: Practical, simple, evidence-based, comprehensive tables are presented. The tables serve as a guide to simplify the process of introducing Mediterranean foods in CF. Τhe tables consist of a total of more than 90 foods and day-to-day guidance for the first 13 weeks of CF. Furthermore, specific dietary guidance and suggestions regarding the order and content of meals during CF are given. Discussion: The tables are based on updated recommendations, summarizing the optimal feeding practices in a MedDiet-based perspective. Conclusions: Conclusively, there are significant contradictions among different organizations that present practical issues and cause confusion among caregivers. An effort was carried out to provide practical evidence-based guidance for caregivers introducing MedDiet during CF.

Associations Between Combinations of 24-Hour Movement Behaviors and Dietary Outcomes in Children and Adolescents: A Systematic Review

Background/Objectives: Twenty-four-hour movement behaviors, including physical activity, sedentary time, and sleep, are associated with a range of health outcomes. However, the relationship between the combinations of these behaviors and dietary outcomes in young populations remains unclear. We conducted a systematic review to explore how combined movement behaviors are linked to dietary outcomes in children and adolescents. Methods: We searched MEDLINE, Embase, and PsycINFO from January 2017 to July 2024, including studies that were (1) written in English, (2) published in peer-reviewed journals, (3) quantitatively analyzed two or three movement behaviors with dietary outcomes, and (4) focused on populations aged between 0 and 18 years. Results: Ten cross-sectional studies met these criteria. The majority of studies (6 out of 10) assessed all three movement behaviors, although sleep was less frequently examined, appearing in only 4 of the studies. Our findings indicated that adhering to all movement recommendations was consistently associated with healthier dietary patterns, including a higher consumption of fruits, vegetables, nuts, fish, and cereals, and a lower intake of sweets and pastries. Additionally, adhering to physical activity and sedentary time guidelines was linked to improved dietary habits in children, including more fruit and vegetable intake and less sugary drink and snack consumption. Conversely, higher sedentary time and inadequate sleep were linked to poorer dietary outcomes, particularly lower fruit intake and hydration. Conclusions: This review suggests that meeting movement behavior guidelines correlates with healthier dietary outcomes in children and adolescents. However, given the limited number of studies and their cross-sectional design, further high-quality research, including longitudinal and intervention studies, is needed to clarify causal relationships.

A Mediterranean dietary pattern intervention does not improve cardiometabolic risk but does improve quality of life and body composition in an Aotearoa New Zealand population at increased cardiometabolic risk: A randomised controlled trial.

To test if a New Zealand food-based Mediterranean diet (NZMedDiet) with behavioural intervention improves cardiometabolic health and wellbeing. A randomised controlled trial comparing 12 weeks of the NZMedDiet to usual diet in participants with increased cardiometabolic risk (metabolic syndrome severity score [MetSSS] > 0.35). The intervention group was provided with food and recipes to meet 75% of their energy requirements, supported by a behavioural intervention to improve adherence. The primary outcome measure was (MetSSS) after 12 weeks. Two hundred individuals with mean (SD) age 49.9 (10.9) years of which 62% women were enrolled with their household/whānau. After 12 weeks, the mean (SD) MetSSS was 1.0 (0.7) in the control (n = 98) and 0.8 (0.5) in the intervention (n = 102) group; estimated difference (95% confidence interval [CI]) of -0.05 (-0.16 to 0.06), p = 0.35. The Mediterranean diet score (PyrMDS) was greater in the intervention group 1.6 (1.1-2.1), p < 0.001, consistent with a change to a more Mediterranean dietary pattern. Weight reduced in the NZMedDiet group compared with control (-1.9 kg [-2.0 to -0.34]), p = 0.006 and wellbeing, assessed by the SF-36 quality of life questionnaire, and improved across all domains. For example, the physical component summary score difference (95% CI) was 4.0 (2.4-5.7), p < 0.001, and the mental component summary score difference was 3.0 (0.7-5.2), p = 0.01. In participants with increased cardiometabolic risk, food provision with a Mediterranean dietary pattern and a behavioural intervention did not improve metabolic risk scores but was associated with reduced weight and improved quality of life.

Lifestyle habits and openness to alternative tobacco products: insights from the Minerva Project

Abstract Background Recent studies have suggested that the use of alternative tobacco products (ATPs) is a significant predictor of cigarette smoking, particularly among young individuals. The present study evaluates the association between dietary patterns, specifically junk food consumption, and the willingness to try ATPs among non-smokers. Methods MINERVA (My changINg lifEstyles, our Research, and eVeryone’s heAlth) is an ongoing prospective international cohort study primarily focused on investigating the link between smoking habits and the dietary and lifestyle habits of participants. Subjects are given a web-based survey to report socio-demographic characteristics, dietary and lifestyle habits, smoking habits, and attitudes towards ATPs. This analysis concentrates on respondents from Italy who do not smoke traditional tobacco products. Results The survey included 7,535 respondents from Italy; of these, 40% (2,992 subjects) were non-smokers. Among the non-smokers, 219 (7%) were identified as fast-food consumers (defined as consuming fast-food at least once a week). Fast-food consumers were significantly more likely to consume junk food as snacks (87% vs. 62%) and were less likely to report daily consumption of fruits and vegetables. Notably, fast-food consumers were 2.5 times more likely to be willing to try ATPs compared to those who do not consume junk food (Odds Ratio [OR] 2.55, 95% Confidence Interval [CI] 1.68-3.88). Conclusions Junk food consumption has been identified as being associated with an increased willingness to use ATPs among non-smokers. This finding is significant from a public health standpoint, highlighting the crucial influence of unhealthy eating habits in fostering an interest in ATP use. Key messages • The Minerva study evaluates the association between dietary patterns, specifically junk food consumption, and the willingness to try alternative tobacco products among non-smokers. • The study underscores the public health importance of addressing dietary patterns alongside smoking habits.

Empirical dietary inflammatory pattern could increase the odds of breast cancer: a case-control study

BackgroundIt has been shown that chronic inflammation is a significant factor in cancer development and progression. The current study aimed to investigate whether a higher score on the empirical dietary inflammatory pattern (EDIP), which indicates a more pro-inflammatory diet, is related to higher odds of breast cancer in Iranian women.MethodsIn the present case-control study, subjects in the case (n = 133) and control (n = 265) groups were chosen from the hospitals in Tehran, Iran. The cases consisted of women with newly diagnosed breast cancer, while the controls were selected from other parts of the same hospital and had no history of cancer or hormone therapy. Individuals whose reported energy intake deviated by three standard deviations above or below the mean energy intake of the population were excluded from the study. A reliable and valid semi-quantitative food frequency questionnaire was used to determine the participants’ dietary intake. Additionally, the association between breast cancer and EDIP was evaluated by logistic regression analysis in both crude and adjusted models.ResultsThe median scores of EDIP in the case and control groups were 0.65 and 0.61, respectively. The findings also indicated that, in the adjusted model, the odds of developing breast cancer significantly increased in the last tertile of EDIP compared to the first tertile (odds ratio (OR) = 1.859; 95% confidence interval (CI): 1.059–3.265; P = 0.031). Additionally, after adjusting for potential confounders, higher odds of breast cancer were observed in the last tertile of EDIP compared to the first tertile in postmenopausal women (OR = 2.516; 95% CI: 1.081–5.856; P = 0.033).ConclusionsThe current study indicated that individuals with a higher pro-inflammatory diet score were more likely to develop breast cancer.

Barriers in translating existing nutrigenetics insights to precision nutrition for cardiometabolic health in ethnically diverse populations.

Cardiometabolic diseases pose a significant threat to global public health, with a substantial majority of cardiovascular disease mortality (more than three-quarters) occurring in low- and middle-income countries. There have been remarkable advances in recent years in identifying genetic variants that alter disease susceptibility by interacting with dietary factors. Despite the remarkable progress, several factors need to be considered before the translation of nutrigenetics insights to personalised and precision nutrition in ethnically diverse populations. Some of these factors include variations in genetic predispositions, cultural and lifestyle factors as well as socioeconomic factors. This review aims to explore the factors that need to be considered in bridging the gap between existing nutrigenetics insights and the implementation of personalised and precision nutrition across diverse ethnicities. Several factors might influence variations among individuals with regards to dietary exposures and metabolic responses and these include genetic diversity, cultural and lifestyle factors as well as socioeconomic factors. A multi-omics approach involving disciplines such as metabolomics, epigenetics and the gut microbiome might contribute to improved understanding of the underlying mechanisms of gene-diet interactions and the implementation of precision nutrition although more research is needed to confirm the practicality and effectiveness of this approach. Conducting gene-diet interaction studies in diverse populations is essential and studies utilising large sample sizes are required as this improves the power to detect interactions with minimal effect sizes. Future studies should focus on replicating initial findings to enhance reliability and promote comparison across studies. Once findings have been replicated in independent samples, dietary intervention studies will be required to further strengthen the evidence and facilitate their application in clinical practice. Nutrigenetics has a potential role to play in the prevention and management of cardiometabolic diseases. Conducting gene-diet interaction studies in diverse populations is essential giving the genetic diversity and variations in dietary patterns. Integrating data from disciplines such as metabolomics, epigenetics and the gut microbiome could help in early identification of individuals at risk of cardiometabolic diseases as well as the implementation of precise dietary interventions for preventing and managing cardiometabolic diseases.

Development of rapid methods to monitor nutritional standards in sustainable healthy public catering

Abstract Background The WHO and FAO in the Second International Conference on Nutrition stress the role of nutrition standards for public facilities catering services (CS) and in the Sustainable Healthy Diet guiding principles (SHD) underline synergies among foods, nutrients present in dietary patterns and their bioavailability, degree of food processing, and subsequent health impact. In Italy almost one in 10 people eat a meal in CS every day. In accordance with SHD, the Italian Ministry of Health (MH) in the national guidelines for CS indicate activating procedures for the conservation of nutritional qualities (NQ) of micronutrients and bioactive substances. The central purchasing body of the Region of Friuli Venezia Giulia have applied these criteria, introducing the process of critical control points of nutrient analysis (NACCP) in the Public Procurement for the school catering of 69 municipalities and for all 18 regional hospital with more than 3 million meals per year served. The aim of the project was to develop rapid and cheap methods for monitoring the NQ of meals by applying the NACCP process. Methods 150 samples of pasta, milk and also vegetables, meat, fish with different degrees of processing, were taken from the CS and analysed both with chemical techniques and with optical rapid techniques (1300 analyses). Results The samples were subjected to conventional analyses to determine the oxidation state and the content of characterizing molecules such as polyphenols, histamine, and total compounds of Maillard. The same samples were then analyzed by color measurements. The results showed a good correlation between the two analytical systems, in particular the color measurements and the Maillard compounds and the color measurements and the oxidation state. Conclusions Project findings can be applied in the NACCP process to rapidly cost-effectively monitor the nutritional quality of CS meals, and adhere to WHO and FAO the SHD guiding principles and MH guidelines for CS. Key messages • The development of rapid methods of monitoring the nutritional standards of public catering can implement sustainable food systems thereby promoting the healthy diets recommended by the FAO and WHO. • Rapid methods of monitoring nutritional standards represent an innovative component in improving the culture of food and nutritional security in public catering.

Foresight diet quality: current trends and future problems

Abstract Current evidence suggests that several aspects of diet quality is globally suboptimal. While increasing animal-based products could exert certain benefits against undernutrition in developing countries, the preference of mass-produced low-quality meat-products over other animal-based ones (i.e., milk, dairy, and eggs) and their overall excessive consumption in spite of plant-based ones has been deemed responsible, at least in part, of the rise of non-communicable diseases. The industry-led response to the growing need of animal-food alternatives may not necessarily meet the health objectives of a natural vegetable source against highly processed products rich in chemical additives. Research in this area is growing producing mixed results, while adoption of plant-based dietary patterns seems less and less equivalent to be synonymous of a healthy nor sustainable choice. In this presentation, data on the current state of evidence on global food consumption, dietary patterns, as well as the relation between level of food processing and health will be provided.

SWITCHtoHEALTHY: Switching Mediterranean Consumers to Mediterranean Sustainable Healthy Dietary Patterns

Abstract In the Mediterranean countries profound changes in diet are taking place, largely due to cultural and socio-economic changes in lifestyle, which are leading to the erosion of the Mediterranean food cultures. The diet modernization process is noticeable; it has generated not only a modification of food choices in the direction of unhealthy foods, but also the habit of sedentary behaviours leading to an imbalance between energy intake and consumption. All of this has negative health impacts, as shown by the ever-increasing prevalence of overweight and obesity, as well as the rise of chronic diet-related diseases. The SWITCHtoHEALTHY project aims to generate an overall change of approach to the modern problem of eating behaviours, by strengthening the role of families towards the promotion of the sustainable Mediterranean food model. The main goal is to generate an actual switch to healthier dietary models, that are more consistent with the Mediterranean Diet. The project SWITCHtoHEALTHY aims to generate a dietary behaviour change in the direction of a greater adherence to the Mediterranean food model, by strengthening the role of families in the process of acquiring and maintaining healthy eating habits. The Mediterranean Diet (MD) is a healthy and sustainable food model, with an essentially plant-based dietary pattern (high consumption of fresh fruits and vegetables, cereals, and legumes). This goal will be reached by making available to families a combination of hands-on educational material and digital tools and complementing the dietary and lifestyle recommendations with easy-to-eat healthier snacking products.

Gut microbiota predict retinopathy in patients with diabetes: A longitudinal cohort study

The gut microbiota has emerged as an independent risk factor for diabetes and its complications. This research aimed to delve into the intricate relationship between the gut microbiome and diabetic retinopathy (DR) through a dual approach of cross-sectional and prospective cohort studies. In our cross-sectional study cross-sectional investigation involving ninety-nine individuals with diabetes, distinct microbial signatures associated with DR were identified. Specifically, gut microbiome profiling revealed decreased levels of Butyricicoccus and Ruminococcus torques group, alongside upregulated methanogenesis pathways among DR patients. These individuals concurrently exhibited lower concentrations of short-chain fatty acids in their plasma. Leveraging machine learning models, including random forest classifiers, we constructed a panel of microbial genera and genes that robustly differentiated DR cases. Importantly, these genera also demonstrated significant correlations with dietary patterns and the molecular profiles of peripheral blood mononuclear cells. Building upon these findings, our prospective cohort study followed 62 diabetes patients over a 2-year period to assess the predictive value of these microbial markers. The results underlined the panel’s efficacy in predicting DR incidence. By stratifying patients based on the predictive genera and metabolites identified in the cross-sectional phase, we established significant associations between reduced levels of Butyricicoccus, plasma acetate, and increased susceptibility to DR. This investigation not only deepens our understanding of how gut microbiota influences DR but also underscores the potential of microbial markers as early indicators of disease risk. These insights hold promise for developing targeted interventions aimed at mitigating the impact of diabetic complications.Key points• Microbial signatures are differed in diabetic patients with and without retinopathy• DR-related taxa are linked to dietary habits and transcriptomic profiles• Lower abundances of Butyricicoccus and acetate were prospectively associated with DR

Youth Health Trends in Northern Portugal: Analyzing Diet, Physical Activity, and Body Image

(1) Background: In the face of global concerns regarding unhealthy lifestyles among youths, understanding dietary habits, physical activity, and weight management strategies among third-cycle students in Portugal becomes essential. This study aims to evaluate the extent to which middle school students adhere to the Mediterranean diet and assess their physical activity habits and overall weight perceptions. (2) Methods: This study is a cross-sectional observational study. Using self-reported data from a sample of 232 students aged between 12 and 18, this study delved into their dietary patterns, engagement in physical activities, perceptions of weight, and weight management approaches, measured by the KIDMED and YRB questionnaires. (3) The results demonstrated that adolescents engaged in a varied diet, and 65.5% had recently engaged in physical activity. However, 25% reported exercise-related injuries, suggesting potential safety gaps. Extreme weight management practices were minimal, but a disparity in weight perception and weight loss desire emerged, hinting at underlying societal and media influences. Gender differences in certain habits were minimal. (4) Conclusions: While students were generally inclined towards healthy habits, there are evident areas of concern, particularly regarding safety in physical activities and weight perceptions. In the future, interventions should be implemented to increase students’ literacy and raise awareness of the Mediterranean diet and physical well-being.

Onset of cognitive impairment, diet quality and adherence to dietary guidelines over 12 years: the Personality and Total Health Cohort Study.

Around 55 million people worldwide live with dementia, and more are expected due to population ageing. We aimed to investigate associations between healthy diet and mild cognitive impairment and dementia in 1753 older adults aged 60-64 from the PATH (Personality and Total Health Through Life Cohort) study. Healthy diet was defined by the Mediterranean-DASH diet Intervention for Neurological Delay (MIND) and two dietary guideline quality scores (Dietary Guideline Index (DGI) and Index Diet Quality (IDQ)), which were calculated from baseline FFQ. Higher dietary scores indicated higher diet quality. Incidence of Alzheimer's disease/vascular dementia (National Institute of Neurological Disorders criteria) and mild cognitive impairment (Winbald criteria) was assessed after 12 years of follow-up using validated questionnaires with nominated proxies. Logistic regression explored associations between dietary scores and cognitive function, adjusting for demographics, lifestyle factors and medical preconditions. Adjusted logistic regression comparing the per unit linear increase in diet scores showed MIND (OR = 0·82, 95 % CI = 0·68, 0·99), but not DGI (0·99 (0·97, 1·00)) or IDQ (1·12 (0·95, 1·32)), was significantly associated with lower odds of developing cognitive impairment. In conclusion, a healthier neuroprotective dietary pattern is associated with better cognitive function over time, whereas dietary patterns generated from general dietary guidelines did not show a significant association. Further research and well-designed clinical studies are needed to determine the effects of the MIND diet on cognitive impairment in older adults without a family history of dementia.

Malnutrition in Guinea-Bissau: a country wide representative cross-sectional study

Abstract Background According to the WHO, malnutrition refers to deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. Children under five are especially vulnerable to malnutrition. The problem is widespread, but it is particularly prevalent in West African countries, where a prevalence of 30% stunting, 6.7% wasting and 2.4% overweight was described in 2022. In this study, we aimed to evaluate malnutrition in Guinea-Bissau (GB), a low-income country in West Africa. Methods We conducted a cross-sectional study between May and June 2023 on a representative sample of 1608 children aged 6 to 59 months, who had access to health care in all 11 regions of GB. Nutritional status was assessed by evaluating weight for height/length, weight for age, height/length for age, and hemoglobin concentration was determined using a portable hemoglobin analyzer. Furthermore, semi-structured questionnaires were applied to children’s parents, including questions on sociodemographic and behavioral factors, such as ethnicity, parental literacy, health care, and dietary patterns. Results 802 boys and 806 girls were included in the study, with a mean age of 26 months. Malnutrition rates were comparable to those described in other West African countries. We found wasting rates of 8,3%, stunting rates of 24,3%, low weight rates of 17,4%, and overweight rates of 2,4% among children under five. Importantly, 55.9% of the children had anemia: 23.6% had mild anemia, 31.1% had moderate anemia, and 1.2% had severe anemia. Statistical analyses are underway to investigate factors associated with malnutrition. Conclusions An important challenge in global health is combating malnutrition in all its forms. The identified prevalence of malnutrition in GB is high and emphasizes the importance of developing strategies and policies with local authorities so that the Sustainable Development Goals and Global Goals of Nutrition can be achieved and health outcomes improved. Key messages • Collaboration essential: researchers, policymakers, healthcare, and local authorities must unite for targeted malnutrition interventions. • Sustainable development in GB hinges on addressing malnutrition among its children through concerted efforts.

A Multi-Modal Approach for A Healthier Weight and More Active Lifestyle

Abstract Background Obesity and overweight has been increasing globally and in the UK over the last few years, bringing along a wide array of challenges in health and wellbeing. Not only do they take a heavy toll on those affected, but obesity and overweight-related ill-health is costing the UK National Health Service £6.1 with projected costs to run up to £9.7 billion in 2050. This project aimed to apply artificial intelligence to identify the predictive indicators for obesity and co-create an intervention with public health practitioners and stakeholders. Methods Using health and wellbeing public health population data from the 2015, 2018 and 2022 from a city in the East Midlands, we applied artificial intelligence that uses machine learning techniques to discover insights, find hidden patterns and discover relationships in the data about engaging in physical activity and a healthy diet. The data on dietary choices and physical activity preferences were further analysed using advanced machine learning techniques. Results The outcomes from our machine learning process revealed patterns of physical activity engagement and diet from specific locations, along with a range of demographic variables that influence individuals’ patterns of physical ability and dietary practices. These findings, which will be presented in detail, have been integrated into a comprehensive city map. This map not only showcases opportunities for engaging in a healthy lifestyle but also aids in prioritising interventions in areas of greatest need. Conclusions The AI technology we employed allowed us to parameterise and generalise our findings with the possibility of scaling up the machine learning approach to other similar datasets. The findings facilitated the development of bespoke training for public health officers working with underserved communities, further demonstrating the impact of applying AI to inform the design of public health interventions. Key messages • Applying Artificial Intelligence to public health data has the potential to inform the development of effective interventions and increase precision. • Using AI in public health data can generate new insights into population health and well-being and inform public health policy.

The relationship between anxiety and diet quality in adolescent populations: a cross-sectional analysis.

Globally, more than 13 % of adolescents have clinically significant mental health problems, with anxiety and depression comprising over 40 % of cases. Despite the high prevalence of anxiety disorders among youth, dietary research has been focused on youth with depression, resulting in a significant knowledge gap regarding the impact of anxiety on adolescent diet quality. Adolescents with diagnosed anxiety disorders and healthy controls were included in this study. Anxiety symptoms were measured using the Screen for Child Anxiety-Related Disorders. Diagnosis of anxiety disorder was determined using the Kiddie Schedule for Affective Disorders and Schizophrenia interview. Five diet quality indices were scored from FFQ. Diet quality indices associated with anxiety symptoms in the correlation matrix were interrogated using multiple linear regression modelling. All models were adjusted for depression. One hundred and twenty-eight adolescents (mean age 14·8 years (sd: 2·1); 66·4 % female) were included in this cross-sectional analysis. Although healthy controls and outpatient participants had similar unhealthy dietary index subscale scores, outpatient participants had lower healthy index scores. Higher anxiety symptoms were associated with lower healthy dietary indices in univariate analysis; after adjusting for comorbid depression; however, anxiety symptoms were no longer associated with dietary indices following adjustment for multiple testing (P = 0·038 to P = 0·077). The association between anxiety symptoms and a poor diet is attenuated by depression. The results of this study support the need for an integrated approach to the assessment of mental and physical well-being and further research aimed at understanding the unique contribution of depression to healthy dietary patterns.

Effect of DASH vs. Mediterranean diet on metabolic syndrome and cardiometabolic profile in adults with high normal blood pressure or grade 1 hypertension: the DASH-MedDiet randomized controlled trial

Abstract Background Lifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic profile. However, studies directly comparing the effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on metabolic syndrome prevalence and cardiometabolic risk factors are currently lacking. Purpose We aimed to assess the effects of a 3-month intensive dietary intervention implementing salt restriction either alone or on top of the DASH and MedDiet compared to no/ minimal intervention on metabolic syndrome prevalence and cardiometabolic profile in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension. Methods We randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60). All patients were followed monthly for 3 months in individual sessions coordinated by the clinical dietician. For the patients of all four study groups, the goal was to maintain the initial body weight unchanged. Patients in the CG received general advice on dietary principles for BP control. For the patients in all three intervention groups, the goal was to limit sodium intake to 2,000 mg/ day (equivalent to 5,0g salt/ day). In addition, patients in the DDG and the MDG received an individualized dietary plan with six daily sample menus to facilitate the adoption of the assigned dietary pattern. Anthropometric indices, dietary intake, office BP, and fasting blood samples were evaluated pre- and post-intervention. Results According to the intention-to-treat analysis, at 3 months post-intervention, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of elevated BP levels compared to both the DDG and the SRG [0.08 (0.03, 0.19), and 0.13 (0.05, 0.34), respectively], and lower odds of metabolic syndrome compared to the SRG [0.25 (0.09, 0.67)]. In addition, the DDG and the MDG had lower odds of elevated fasting glucose compared to both the CG and the SRG, whereas the study groups did not differ regarding the odds of elevated waist circumference, elevated triglycerides, and reduced HDL- cholesterol. Regarding cardiometabolic indices, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/ diastolic BP were reduced in all three intervention groups compared to the CG. Conclusions On a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.