Dietary Adequacy Research Articles

Locally relevant food-based recommendations could increase iron and calcium intake for adolescent girls in Vietnam.

Unhealthy eating habits are common among adolescents in Vietnam, where transitioning food environments increasingly offer energy-dense micronutrient-poor foods. Successful behavior change approaches must be feasible and acceptable, promoting local foods that are available, accessible, and preferred. Yet, few studies have investigated the potential of food-based approaches for adolescents. We used linear programming to identify problem nutrients, local nutrient sources, and realistic food-based recommendations (FBRs) to improve nutrient intake among girls 16-22 years in Thai Nguyen, Vietnam. We then identified a reduced set of FBRs to prioritize the most critical micronutrient gaps. Calcium and iron targets could not be met in any realistic diet modeling scenario. The best set of FBRs included seven recommendations which could meet intake targets for 9 of 11 modeled micronutrients. The best reduced set of three FBRs targeting iron and calcium only-although more feasible for behavior change-was less effective at improving intake of these nutrients since fewer foods were recommended. Given the difficulty of meeting calcium and iron targets using local foods within acceptable dietary patterns, additional interventions, such as supplementation, staple food fortification, or increasing the availability of affordable calcium- and iron-rich foods, may be necessary to promote dietary adequacy for adolescent girls.

Childhood Obesity: A Public Health Crisis

Over the past three decades, pediatric obesity prevalence has significantly increased globally. This obesity epidemic is thought to be the cause of the rising incidence of illnesses like type 2 diabetes in youngsters. Understanding the genetics and physiology of hunger control has advanced greatly, and as a result, the reasons for various unusual obesity diseases have been clarified. Children of thin parents may do better in weight control than children of obese parents. Adherence to exercise is likely to be a problem with obese children, and the choice or design of an exercise program should take these adherence problems into account. The nutritional adequacy of the child's diet should be evaluated both in terms of what the child is eating as well as in terms of the prescribed diet. We have learned almost little about how to prevent or reverse childhood obesity from these rare illnesses, though. Due to the modern sedentary lives of children, calorie intake and activity recommendations require re-evaluation and enhanced quantification at the population level. Given the growing understanding of the so-called energy gap, the current calorie recommendations for individual treatment may be too conservative. High-quality multicentre studies with long-term follow-ups are required despite improvements in the quality of research into prevention and therapy. During this time, efforts should be made to reduce intake and enhance energy expenditure through preventative and therapeutic measures. Increased efforts should be undertaken on all fronts to maintain this potentially promising trend in light of recent data that suggest that the spiralling rise in pediatric obesity prevalence may be slowing.

Nutritional Adequacy Assessment of the Japanese Diet Using the Number of Dishes Compared to Existing Dietary Diversity Indices: A Cross-Sectional Analysis from the 2012 National Health and Nutrition Survey, Japan.

The Japanese diet has attracted attention as a factor contributing to the Japanese population's longevity. A typical Japanese meal, traditionally called "ichiju-sansai," is composed of various dishes. This study assessed the nutritional adequacy of the Japanese diet using the number of dishes in all meals (NDAM) compared to existing dietary diversity indices (DDIs). This cross-sectional study used data from the 2012 National Health and Nutrition Survey. A total of 25,976 participants aged ≥20 y were included in this study. NDAM was calculated for whole dishes or single foods (except supplements and beverages) from one-day weighted dietary records. The food variety score (FVS), number of foods, dietary diversity score (DDS), and number of food groups are some of the existing DDIs. NDAM had relatively high positive correlation coefficients with potassium, magnesium, and dietary fiber. The partial correlation coefficients with an indicator of the overall nutrient adequacy of NDAM was 0.42 for men and 0.42 for women. It was almost the same as that of the FVS (men: 0.44, women: 0.42) and DDS (men: 0.44, women: 0.43). On the other hand, NDAM, similar to existing DDIs, was also positively correlated with nutrient restriction in both sexes. These findings indicate that the nutrient adequacy of NDAM is similar to that of the existing DDIs. Because of the higher sodium intake and cholesterol intake in higher NDAM and existing DDIs, the effect of higher NDAM on health outcomes must be investigated in future studies.

Diet Quality Index and Food Choice Motives in Vietnam: The Roles of Sensory Appeal, Mood, Convenience, and Familiarity.

Food choices that shape human diets and health are influenced by various socio-economic factors. Vietnam struggles to meet many nutrition targets where links between food choice and diet have not been widely explored. This study assesses the food choice motives, based on a 28-item food choice questionnaire (FCQ), and the diet quality of 603 adults in three sites (urban, peri-urban, and rural) in northern Vietnam. We assess diet quality using the Diet Quality Index-Vietnam (DQI-V) which consists of variety, adequacy, moderation, and balance components. Using factor analysis, we grouped FCQ items into five factors: health focus, sensory appeal, mood ethics, convenience, and familiarity. The structural equation modeling indicates that food choice motives significantly impact the DQI-V and its components but in different directions. The results show that sensory appeal has a positive association with the overall DQI-V score, while having a negative impact on the variety component. Findings present a potential trade-off issue for interventions and policies related to food products. Nutrition knowledge is positively associated with all elements of diet quality across all three study sites. Vietnamese agrobiodiversity could be better utilized to increase dietary diversity. Differentiated policies are necessary to address the poor dietary diversity and adequacy in northern Vietnam.

Plant-Based Dietary Patterns and Cardiovascular Disease Risk in Australians: Protocol for a Cross-Sectional Study.

Plant-based diets (PBDs) emphasise higher intakes of plant foods and lower intakes of animal foods, and they have been associated with reduced cardiovascular morbidity/mortality and lower cardiovascular disease (CVD) risk factors. Evidence is limited regarding the dietary profile, diet quality, and nutritional adequacy of PBDs, including their impact on CVD risk compared with traditional meat-eating diets in Australians. The PBD Study (PBDS) is a cross-sectional study that will recruit 240 adults from the Hunter region (NSW) without known CVD who are habitually consuming vegan (no animal flesh/animal products), lacto-ovo vegetarian (dairy and/or eggs only), pesco-vegetarian (fish/seafood only), or semi-vegetarian (minimal animal flesh) diets or are a regular meat-eater. To investigate dietary profile, diet quality, nutritional adequacy, and CVD risk, questionnaires (medical history, demographics, and physical activity), blood samples (biomarkers), physical measures (anthropometry, blood pressure, body composition, and bone density), and dietary intake (food frequency questionnaire and diet history) will be collected. One-way ANOVA and Kruskal-Wallis tests will compare the CVD risk and other quantitative measures, and Chi-square or Fisher's Exact tests will be used for qualitative data. Directed acyclic graphs will determine the confounding variables, and linear regression and mediation analyses will account for the confounders and estimate the effect of dietary patterns on CVD risk. p-values will be adjusted using the Benjamini-Hochberg method to control the False Discovery Rate to 5%.

Cohort profile: the BABY1000 pilot prospective longitudinal birth cohort study based in Sydney, Australia

PurposeThe health of parents prior to conception, a woman’s health during pregnancy and the infant’s environment across their first months and years collectively have profound effects on the child’s health...

Assessing dietary adequacy and temporal variability in the context of Covid-19 among Indigenous and rural communities in Kanungu District, Uganda: a mixed-methods study

Dietary adequacy is hard to achieve for many people living in low-income countries, who suffer from nutritional deficiencies. Climate change, which alters weather conditions, has combined with other cascading and compound events to disrupt Indigenous communities’ food systems, limiting the consumption of adequate diets. The aim of this work was to conduct a proof-of-concept study exploring dietary adequacy, and to investigate evidence for temporal variation in the dietary intake of Indigenous and non-Indigenous communities in Kanungu District, Uganda in the context of the Covid-19 outbreak. We randomly selected 60 participants (20 mothers, 20 fathers and 20 children aged between 6 and 23 months) from two Indigenous Batwa and two Bakiga settlements. A mixed-methods study with concurrent qualitative and quantitative data collection was conducted. Monthly dietary intake data were collected from each participant from February to July 2021 through 24 h recall surveys using a specially developed Ugandan food composition database included in the online tool myfood24. At the same time, we also collected: (i) demographic and contextual data related to Covid-19; (ii) data on weather and seasonality; (iii) data on the perception of dietary intake over the year, and during the Covid-19 period; (iv) baseline anthropometric measurements. The majority of the participants did not achieve nutrient adequacy over the 6 months period, and household dietary diversity scores were generally low. Pregnant and lactating women consumed a diet which was severely inadequate in terms of nutrient consumption. Caloric and nutrient intake varied over the 6 months period, with the highest food consumption in June and lowest in April. Temporal variation was more evident among Batwa participants. Vitamin A intake varied more over months than other nutrients in adults’ and children’s diets, and none met iodine requirements. Participants characterised the diverse mechanisms by which season and weather variability determined the type and amount of food consumed each month. Dietary intake showed indications of temporal variation that differed between nutrients. Also, they reported that the Covid-19 pandemic influenced their diet. During lockdown, 58% of adults reported changing dietary habits by consuming less—and less nutritious—foods. The findings of this work highlight that the majority of the Batwa and Bakiga participants did not meet the dietary requirements for their age and gender. Also, our research indicates that weather patterns and seasonality may cause variations in smallholder food production with consequences on households’ dietary intake. Emerging evidence suggests that nutrients and caloric intake vary monthly and under different weather conditions. Accurate and time-varying nutrition evaluations would help in identifying seasonal and monthly dietary needs, supporting preventive interventions protecting children and their parents from any form of malnutrition. Consideration of time-varying nutritional intake will become increasingly important as climate change affects the seasonality and availability of smallholder subsistence crops.

Assessing the Quality of Simulated Food Patterns with Reduced Animal Protein Using Meal Data from NHANES 2017-2018.

The nutritional consequences of progressively replacing meat products with plant-based foods need to be systematically evaluated. Modeling analyses provide insights into the predicted food consumption and nutritional adequacy of plant-based diets. We developed a novel methodology to simulate food patterns and evaluate diet quality. Meal data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 was used to create 100 7-day meal plans subject to various nutrient and food group optimization criteria. Omnivore (reference diet), flexitarian, pescatarian, and vegetarian food patterns were modeled using mixed integer linear programming. The modeled food patterns used the 25th and 75th percentiles of the US Usual Dietary Intakes to set the optimization constraints. The diet quality was determined using the Healthy Eating Index 2015 (HEI-2015). The modeled vegetarian, pescatarian, and flexitarian food patterns outperformed the omnivore diet on the HEI-2015, with the vegetarian pattern achieving the highest score (82 for females, 78 for males). Modeled flexitarian patterns, with a 25 to 75% reduction in animal protein, offer viable options for those seeking to reduce but not eliminate their animal protein intake while supporting the transition from omnivore to fully plant-based diets. This methodology could be applied to evaluate the nutrient and diet quality of different dietary patterns with various constraints.

Dietary Intake and Menstrual Health among Acrobatics and Tumbling NCAA Division I Student-Athletes

Objective Acrobatics & Tumbling (A&T) is an emerging sport in the National Collegiate Athletic Association that lacks research regarding the dietary intake and health of A&T student-athletes (A&Tsa). This study assessed the dietary intake adequacy, estimated energy availability (EA), self-reported menstrual health, and body composition of A&Tsa. Methods Twenty-four female A&Tsa participated during week 8 of the preseason (11 top: Age= 20.1 ± 0.9 years; BMI= 22.1 ± 1.7 kg/m2; 13 base: Age= 19.5 ± 1.3 years; BMI= 26.2 ± 2.7 kg/m2). Total energy intake (TEI) and macronutrient intakes were assessed via a paper-based 3-day dietary recall. Resting Metabolic Rate [RMR = 500 + 22 * fat-free mass (FFM)] and energy availability [EA = (TEI – exercise energy expenditure)/FFM)] were estimated; and LEAF-Q assessed menstrual health. Body composition was measured using Dual-Energy X-Ray Absorptiometry. Macronutrient intakes and EA were compared to sports nutrition recommendations (carbohydrate: 6–10 g/kg; protein: 1.2–2.0 g/kg) and the Acceptable Macronutrient Distribution Range (carbohydrate: 45–65%; protein: 10–35%; fat: 20–35%). Results TEI was 1753 ± 467 kcal (top) and 1980 ± 473.8 kcal (base). A total of 20.8% of A&Tsa failed to meet RMR with TEI, with a higher prevalence in the top (-266 ± 219.2 kcal, n = 3) vs. base (-414.3 ± 534.4 kcal, n = 2) A&Tsa. Top and base A&Tsa had both low EA (28.8 ± 13.4 kcals·FFM−1; 23.8 ± 9.5 kcals·FFM−1) and inadequate carbohydrate intake averages (4.2 ± 1.3 g/kg; 3.5 ± 1.1 g/kg, p < 0.001), respectively. A total of 17% of A&Tsa reported secondary amenorrhea, with a higher prevalence in the top (27.3%, n = 3) vs. the base (7.7%, n = 1). Conclusion TEI and carbohydrate intake of the majority of A&Tsa were below recommendations. Sports dietitians should encourage and educate A&Tsa about following an adequate diet that meets energy and sports-specific macronutrient needs.

Could local foods achieve recommended calcium intakes for nutritionally vulnerable populations in Uganda, Guatemala, and Bangladesh?

Globally, dietary intake of calcium is often insufficient, and it is unclear if adequacy could be achieved by promoting calcium-rich local foods. This study used linear programming and household consumption data from Uganda, Bangladesh, and Guatemala to assess whether local foods could meet calcium population reference intakes (CaPRIs). The most promising food-based approaches to promote dietary calcium adequacy were identified for 12- to 23-month-old breastfed children, 4- to 6-year-old children, 10- to 14-year-old girls, and nonpregnant and nonbreastfeeding (NPNB) women of reproductive age living in two regions of each country. Calcium-optimized diets achieved 75-253% of the Ca PRI, depending on the population, and were <100% for 4- to 6-year-olds in one region of each country and 10- to 14-year-old girls in Sylhet, Bangladesh. The best food sources of calcium were green leafy vegetables and milk, across geographic locations, and species of small fish, nixtamalized (lime-treated) maize products, sesame seeds, and bean varieties, where consumed. Food-based recommendations (FBRs) achieving the minimum calcium threshold were identified for 12- to 23-month-olds and NPNB women across geographic locations, and for 4- to 6-year-olds and 10-to 14-year-old girls in Uganda. However, for 4- to 6-year-olds and 10- to 14-year-old girls in Bangladesh and Guatemala, calcium-adequate FBRs could not be identified, indicating a need for alternative calcium sources or increased access to and consumption of local calcium-rich foods.

Assessing Food Security Scenario at the Ward Level in Nepal: An Analysis of Caloric Needs from Diverse Crops Based on Location-Specific Factors and Policy Implications

Food security means access to food along with food production and availability to every individual at a reasonable cost according to the calorific needs of people. To assure food safety to 30 million Nepali people, it is essential to utilize every piece of available farmable land in each geographic region of seven provinces. We analyzed individual household food intake, dietary energy adequacy, and nutritional status and needs at the ward level of Nepal. We used a decadal (2010-2020) average food production of different crops per unit of farmable area, and food needs for people living in that ward based on their gender and nutritional requirements to perform various activities in different geographic regions of seven provinces. We assumed three food consumption scenarios: a) traditional practices of meeting dietary needs only from major crops; b) consuming major and minor crops; and c) consuming major and minor crops and meat and fruit products. Our analysis revealed that it is essential for Nepal to implement policies that will encourage crop diversification comprising both major and minor crops and inform the public about the nutritional values of various crops that can be grown utilizing location-specific environments in different geographic regions of seven provinces. Our findings assist in policy instrumentation that will pursue farming communities to supplement their dietary needs with diverse crop products and suggest government set aside some matching funds to encourage remitters, who return to Nepal with knowledge and financial resources, to engage in agriculture. We also argue that crop diversification is needed to assure farm productivity if certain crops fail due to unforeseen environmental calamities.

Effect of Milk or Milk Derived Food Supplementation on Body Composition of Young Indian Women

Background: Lysine intake in India is low mainly due to consumption of cereals as staple diet and processing loss of lysine. The present study was aimed to assess the impact of supplementation either in the form of dietary supplements of lysine, calcium and vitamin D in order to identify an appropriate approach for the improvement of body composition. Methods: One hundred and twenty volunteer subjects in the age group of 20-30 years residing in Punjab Agricultural University hostels were selected for supplementary trial. Supplementation of milk and its products in amounts to fill the gap of dietary intake and adequacy of protein as well as limiting amino acid lysine in their diets for a period of 12 weeks was done to determine its effect on body composition. Result: The diets were also poor in protein quality as the limiting amino acid lysine was only 55% of the recommended level. Supplementation of milk and its products resulted in a significant reduction in body fat (6.62%) and visceral fat rating (9.47%) and a significant increase in skeletal muscle mass (3.98%) and bone mass (2.72%). The study recommends that improving the quality of diets through dietary supplementation of lysine, calcium and vitamin D is an effective approach to achieve optimum body composition.

Risk assessment of low cognitive performance among fishermen's children in Malaysia

ObjectivesLow cognitive performance is a major concern among fishermen's children in Malaysia. Thus, this study was aimed at assessing dietary intake, nutritional status, physical activity, and socio-economic status, and their associations with cognitive performance among fishermen's children in Terengganu, Malaysia. We also investigated the risk associated with low cognitive performance. MethodsThis cross-sectional study included 94 children 7–11 years of age in Terengganu. Dietary adequacy was assessed with two 24-h dietary recall surveys. Anthropometric measurements were assessed by calculation of the body mass index (BMI)-for-age Z-score and height-for-age Z-score. In addition, median urinary iodine tests were conducted to determine iodine concentrations. Physical activity was measured with the Physical Activity Questionnaire for Children (PAQ-C). Raven's coloured progressive matrices were used to determine cognitive performance. Binominal logistic regressions were performed on factors associated with cognitive performance, to identify the risk factors with the strongest association with cognitive performance. ResultsThe children of fishermen had adequate intake of all necessary nutrients except for fat, dietary fibre, thiamine, folate, vitamin C, vitamin E, calcium, zinc, and potassium. Most of the children had normal BMI-for-age [median = −0.86 (2.11)] and height-for-age (mean = −1.01 ± 1.03). However, more than half had iodine deficiency [median = 83.9 (102)]. In addition, 16% had low physical activity levels, and their cognitive performance was classified with a low average score [median = 80.0 (21.0)]. The mother's education level (p = 0.037), children's BMI-for-age (p = 0.012), protein (p = 0.020), and niacin (p = 0.032), exhibited significant relationships with cognitive performance (p < 0.05). Of these variables, BMI-for-age (OR = 0.290, p = 0.036) and fourth quartile protein intake (≥52.69 g) (OR = 7.565, p = 0.015) were significant risk factors for low cognitive performance among fishermen's children in Terengganu. ConclusionA balanced diet and healthy lifestyle are crucial for children's cognitive development. Thus, interventions emphasising the promotion of healthy lifestyles, particularly focusing on BMI-for-age and protein intake, are advised.

Parental Nutritional Knowledge and Type of Diet as the Key Factors Influencing the Safety of Vegetarian Diets for Children Aged 12-36 Months.

There are some concerns about the adequacy of vegetarian diets for pregnant women, infants, and young children because diets that exclude meat and other animal-based products increase the risk of nutrient deficiencies. The aim of the present study was to assess the nutritional knowledge of parents raising 12- to 36-month-old children on vegetarian diets and to evaluate the children's diets based on the recommendations formulated in the model food ration. The study involved a questionnaire survey that was completed by 326 women raising their children on various types of vegetarian diets and 198 women raising their children on an omnivorous diet. Mothers raising children on a lacto-ovo-vegetarian diet had the highest nutritional knowledge scores (15.8 points on average), whereas control group mothers and women raising children on a vegan diet had the lowest nutritional knowledge scores (average of 13.6 points). Parents who raised their children on more restrictive vegetarian diets were more aware of the risk of nutritional deficiencies and administered dietary supplements more frequently. A vegetarian diet can be safe for young children, but parents should be educated about the risk of nutritional deficiencies and the principles of healthy nutrition regardless of the administered diet, and effective communication between parents, pediatricians, and dietitians should be the cornerstone of every nutritional strategy in the management of vegetarian children.

Dietary Micronutrient Adequacy and Risk of Multimorbidity in Community-dwelling Older Adults

BackgroundMultimorbidity refers to the coexistence of multiple chronic health conditions. The effect of nutritional adequacy on multimorbidity is mostly unknown. ObjectiveThe aim of this study was to assess the prospective association between dietary micronutrient adequacy and multimorbidity among community-dwelling older adults. MethodsThis cohort study included 1461 adults aged ≥65 y from the Seniors-ENRICA II cohort. Habitual diet was assessed at baseline (2015–2017) with a validated computerized diet history. The intakes of 10 micronutrients (calcium, magnesium, potassium, vitamins A, C, D, E, zinc, iodine, and folate) were expressed as percentages relative to the dietary reference intakes, with higher scores indicating greater adequacy. Dietary micronutrient adequacy was computed as the average of all the nutrient scores. Information on medical diagnosis was obtained from the electronic health records up to December 2021. Conditions were grouped into a comprehensive list of 60 categories and occurrence of multimorbidity was defined as having ≥6 chronic conditions. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders. ResultsThe mean age was 71.0 y (SD: 4.2) and 57.8% of participants were males. During a median follow-up of 4.79 y, we documented 561 incident cases of multimorbidity. Participants in the highest (85.8%–97.7%) versus the lowest tertile (40.1%–78.7%) of dietary micronutrient adequacy had a low risk of multimorbidity [fully adjusted hazard ratio (95% confidence interval): 0.75 (0.59–0.95); P-trend: 0.02]. A 1-SD increment in minerals and vitamins adequacy was associated with a low risk of multimorbidity, although estimates were attenuated after additional adjustment for the opposite subindex [minerals subindex: 0.86 (0.74–1.00); vitamins subindex: 0.89 (0.76–1.04)]. No differences were observed by strata of sociodemographic and lifestyle factors. ConclusionA high micronutrient index score was associated with low risk of multimorbidity. Improving the dietary micronutrient adequacy could prevent multimorbidity among older adults. Clinical Trial Registryclinicaltrials.govNCT03541135.

Features of a Balanced Healthy Diet With Cardiovascular and Other Benefits.

Cardiovascular (CV) disease (CVD) remains the leading cause of death globally. Besides lack of exercise, obesity, smoking, and other risk factors, poor nutrition and unhealthy/unbalanced diets play an important role in CVD. This review examined data on all issues of the CV-health benefits of a balanced diet, with tabulation of nutritional data and health-authority recommendations and pictorial illustration of the main features of a CV-healthy diet. PubMed and Google Scholar were searched for relevant studies and reviews on diet and CV health. For a long time, there has been evidence, corroborated by recent findings, that pro-vegetarian diets have a beneficial influence on serum lipid levels, markers of inflammation and endothelial function, prooxidant-antioxidant balance, and gut microbiome, all probably contributing to reduced CV risk. Worries about the nutritional adequacy of vegetarian diets are circumvented by obtaining certain nutrients lacking or found in lower amounts in plants than in animal foods, by consuming a wide variety of healthy plant foods and through intake of oral supplements or fortified foods. Well-balanced diets, such as the Mediterranean or the Dietary-Approaches-to-Stop-Hypertension diets, provide CV-health benefits. Nevertheless, a broad variety of plant-based diets with low/minimal animal food intake may allow for the personalized and culturally adjusted application of dietary recommendations contributing to the maintenance of CV health. Universal adoption of a balanced CV-healthy diet can reduce global, CV and other mortality by ~20%. This requires world-wide programs of information for and education of the public, starting with school children and expanding to all groups, sectors, and levels.

A cross-sectional study of nutritional status and dietary intake of paediatric oncology patients in Indonesia: Comparison between cancer aetiologies.

Background: Adequate energy and protein intakes are required to maintain nutritional status and prevent clinical deterioration in paediatric oncology patients. There are limited investigations of malnutrition and dietary intake adequacy during treatment in developing countries. Aim: This study aimed to assess the nutritional status and macro- and micronutrient intake adequacy in paediatric oncology patients undergoing therapy. Methods: This cross-sectional study was conducted at Dr Sardjito Hospital, Indonesia. Sociodemographic, anthropometry, dietary intake, and anxiety status were collected. Patients were grouped based on cancer aetiology (haematological malignancy (HM) or solid tumour (ST). Variables between groups were compared. P-values of <0.05 were considered statistically significant. Results: 82 patients aged 5-17 years (65.9% HM) were analysed. The prevalence of underweight was 24.4% (ST vs HM: 26.9% vs 23.2%), overweight 9.8% (ST vs HM: 11.5% vs 8.5%), and obesity 6.1% (ST vs HM: 0.0% vs 8.5%) according to BMI-for-age z-score. Mid-upper-arm circumference identified undernutrition in 55.7% and overnutrition in 3.7% of the patients. Stunted growth was found in 20.8% of the patients. Percentages of children with inadequate energy and protein intake were 43.9% and 26.8%, respectively. The percentages of participants meeting the national micronutrient requirements were low, ranging from 3.8% to 56.1%, with the highest adherence rate observed for vitamin A and the lowest for vitamin E. Appetite loss was associated with lower overall intake. Conclusion: This study confirmed that malnutrition is prevalent in paediatric patients treated for cancer. Inadequate intakes of macro- and micro-nutrients were also common, highlighting the need for early nutritional assessment and intervention.

Shifting towards optimized healthy and sustainable Dutch diets: impact on protein quality

PurposeTo reduce the environmental impact of Western diets, a reduction of meat consumption and a substitution by plant-based protein sources is needed. This protein transition will affect the quantity and quality of dietary protein. Therefore, the aim of this study was to evaluate the protein adequacy of diets optimized for nutritional health and diet-related greenhouse gas emission (GHGE).MethodsData from 2150 adult participants of the Dutch National Food Consumption Survey were used, with diet assessed using two non-consecutive 24 h dietary recalls. Utilizable protein of current diets per day was based on meal composition and the Protein Digestibility-Corrected Amino Acid Score and was compared to protein requirements. Optimized diets were derived as linear combinations of current diets that minimized GHGE and maximized the Dutch Healthy Diet 2015 score, with/without constraints to keep dietary change within 33% of current consumption. Protein adequacy was evaluated in both current and optimized diets.ResultsIn all age and gender strata, the healthiest diets had higher GHGE, the most sustainable diets had the lowest dietary quality, though higher than current diets, and protein adequacy remained sufficient. When limiting dietary change to 33% of current consumption, in the most promising trade-off diet GHGE was reduced by 12–16%. The current diet provided 1.4–2.2 times the required amount of utilizable protein.ConclusionThese results suggest that a realistic aim for the next decade might be to reduce diet-related GHGE to 12–16% of the current levels without compromising protein adequacy and diet quality. To achieve global targets, upstream food system transformations are needed with subsequent dietary changes.

Feeding practices, dietary adequacy, and dietary diversities among caregivers with under-five children: A descriptive cross-section study in Dodoma region, Tanzania.

Suboptimal feeding practices among caregivers contribute to nutritional-related health problems in children in low and middle-income countries, such as Tanzania. The continuum of the recommended feeding practices has been an utmost challenge among caregivers during the transition from health facilities to homes for improved under-five children's health. This study assessed feeding practices, dietary diversities, and dietary adequacy among caregivers with under-five children in the Dodoma region, Tanzania. A community-based descriptive cross-sectional study in a quantitative research approach was adopted to study 289 randomly selected caregivers of under-five children in Dodoma region, Tanzania from March to August 2022. The World Health Organization Infant and Young Children Feeding Guidelines was the main data collection tool. Data were analyzed descriptively using a Statistical Package for Social Sciences computer software program version 25. Statistical limits were set at a 95% confidence interval and a 5% significance level. Mean age was 26±6.47 of which 68.2% (n = 197) were females. Findings revealed 66.1% of caregivers had unsatisfactory feeding practices. It was observed that 67.8% of the caregivers fed their under-five children inadequately. Only 32.2% of them attained the minimum dietary diversity while 35.3% and 31.5% of caregivers demonstrated feeding practices < and > the recommended minimum Dietary diversity respectively. Moreover, 90.7% of caregivers fed their children group one food while 59.1% of them did not practice feeding the children snacks between meals. Feeding practice, dietary diversity, and dietary adequacy were significantly related to the caregiver's sex, education level, and socioeconomic status (p<0.05). Under-five children are at serious risk of nutritional problems as most caregivers in this study demonstrated unsatisfactory feeding practices on dietary diversities for dietary adequacy below the world health organization recommended Minimum Dietary diversity and Minimum Meal Frequency. Community-based nutritional education programs for caregivers need to be disseminated to the community level to address the problem accordingly.

Dietary diversity and micronutrients adequacy among the women of reproductive age at St. Martin’s island in Bangladesh

Minimum dietary diversity for women, an important dimension of diet quality, has been widely used as a proxy indicator for micronutrient adequacy. In low- and middle-income countries (LMICs), women of reproductive age (WRA) particularly are at high risk of inadequate micronutrient intake resulting from poor diversified diets. Therefore, the present study aimed to assess dietary diversity and micronutrients adequacy in the diets of WRA of St. Martin’s island, along with their socio-economic determinants. A cross-sectional study was conducted on a representative sample of 201 WRA living at St. Martin’s island. Utilizing the Estimated Average Requirement (EAR) cut-point approach, the adequacy of micronutrient intake was evaluated from observed 24-h recall dietary data. The recent guideline of FAO was employed to evaluate Minimum Dietary Diversity for Women (MDD-W). Binary logistic regression and multiple linear regression analyses were performed to identify socio-economic determinants of MDD-W and micronutrients adequacy. The mean (SD) dietary diversity score was 4.25 (1.17) and about 40.3% of the participants met the MDD-W cut-off. Starchy staples (100%), meat/poultry/fish (87%), and other vegetables (79%) were consumed more frequently, while, the least reported food groups were dairy (2%), nuts and seeds (11%), and vitamin A-rich fruits and vegetables (11%). Except for Niacin, intake of all micronutrients was inadequate, with an inadequacy prevalence of 36–100%. Educational level, and decision-making role of women were significantly related to their dietary diversity. On the other hand, age, decision-making role, and MDD-W were important determinants of micronutrient adequacy. In conclusion, the WRA of St. Martin's island consumed neither a sufficient amount of micronutrients nor an adequate diversity of foods. In addition, several socio-economic components are linked with dietary diversity and micronutrient adequacy. Therefore, attention is needed to decide on the best strategies to improve the quality of diet and dietary diversity for WRA in this setting.