Inadequate Diet Research Articles

Cardio-Metabolic Indices in Relation to Serum Vitamin D Levels among Middle-Aged Adults

A plethora of research showed that vitamin D deficiency is one of the most prevalent dietary inadequacies in India. The condition is addressed as hypovitaminosis-D and often intervenes with the occurrence of diseases like cardio-metabolic disease. Though several epidemiological studies have supported this fact, there is an insufficiency of rational data to support the fact. Hence the current study investigates the relationship between vitamin D levels and markers of cardio-metabolic diseases among middle-aged adults. This study recruited 100 healthy middle-aged adults, and the participants underwent evaluation of their anthropometric measurements, Heart Rate Variability (HRV), and serum vitamin D levels. Analysis was done by taking consideration of total power (TP), absolute, and normalized power of high-frequency (HF), and low-frequency (LF) power spectrum including their ratio (LF/HF) as HRV indices. Data analysis was performed using the Pearson correlation test. Data analysis showed a negative correlation between vitamin D and anthropometric measurements and a positive correlation with cardiac sympathovagal balance as determined by waist circumference and LF/HF ratio. However, there was no discernible correlation between vitamin D levels and the BMI, fat percentage, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), absolute power spectrum of HRV. The results of this study conclude that serum vitamin D levels affect central obesity and cardiac sympathovagal balance, indicating low levels of serum vitamin D might contribute higher risk for cardiovascular diseases.

Determinants of stunting in children under five: a scoping review

Background: Inadequate diet, socioeconomic condition, and maternal and child characteristics can damage stunted children under five's mental and physical development. As a result, they have difficulty developing physically and cognitively, have low intellectual abilities, are more susceptible to disease, and have less creativity and innovation. Objective: This study seeks to investigate and summarize the determinants of stunted children under five.Materials and Methods: The study used a scoping review method. The literature search was carried out on indexed databases of Scopus, PubMed, Google Scholar, Crossref, and Pro-Quest in English and Indonesian. There were 720 research articles, and 18 of them met the inclusion criteria. From the 18 journals, information was collected from the publication year 2015-2021. Relevant study articles related to the topic were analyzed qualitatively using NVIVO-12 Plus.Results: Our findings identify that maternal education, low birth weight (LBW), gender, exclusive breastfeeding, parental income, parental age, and child age are the dominant determinants of stunting among under-five children.Conclusion: Higher risk factors of stunting among children are parents' lack of knowledge, low family income, low nutrition, low level of mother's education, and lack of parents' supervision and parenting skills.

Co-occurrence of insufficient physical activity, smoking, inadequate diet, and alcohol consumption in university students from Minas Gerais, Brazil

The aim of this study was to estimate the prevalence and factors associated with the co-occurrence of insufficient physical activities, smoking, consumption of alcoholic beverages, and inappropriate eating habits in university. This is a cross-sectional study with a representative sample of students from the Federal University of Triângulo Mineiro, MG, Brazil. The information was obtained through a questionnaire and the risk criteria adopted were irregular consumption of fruits and vegetables, insufficient physical activity, smoking, and excessive consumption of alcoholic beverages. The independent variables were sex, age group, marital status, area of study and time of study. The outcomes were the co-occurrence of two and three/four risk factors. The association was measured using Odds Ratio (OR) and a multinominal logistic regression with a significance level of 5%. 1.110 university students participated. The prevalence of two and three/four risk factors was of 35.3% and 15.4%, respectively. College students with a partner were associated with lower chances for two risk factors (OR: 0.45; 95% CI: 0.21–0.98), and there was an association between three or four factors of behavioral risk with university students belonging to areas not related to health (OR: 1.90; 95% CI: 1.26–2.86). It was concluded that the prevalence of occurrence of two risk factors or more was high and that single students and those in fields unrelated to health were associated with the risk factors.

The Association between Tooth Loss and Insulin Resistance Mediated by Diet Quality and Systemic Immunoinflammatory Index

(1) Background: Both tooth loss and diabetes have high global prevalence, and both have a significant influence on patients’ general health and quality of life. Previous research has indicated a possible connection between tooth loss and diabetes, but it has been unclear whether tooth loss has an effect on the development of diabetes and how it affects it. We aim to investigate the relationship between insulin resistance (IR) and tooth loss and examine how the systemic immune-inflammation index (SII) level and diet quality mediate it. (2) Methods: The cross-sectional study data were obtained from the National Health and Nutrition Examination Survey (NHANES). After describing and comparing baseline data, we used regression models to evaluate the relationship between IR and tooth loss, diet quality and tooth loss and IR, SII and tooth loss and IR. Furthermore, we applied bootstrapping to test the mediation effect of diet quality and SII between tooth loss and IR. Diet quality is reflected by the HEI (Healthy Eating Index)-2015 score. (3) Results: The total number of subjects included was 8197, with 3861 individuals belonging to the IR group (HOMA-IR ≥ 2.5) and 4336 in the non-IR group (HOMA-IR < 2.5). In the model with all covariates adjusted, tooth loss in the fourth quartile was found to be positively correlated with an increase in HOMA-IR (OR = 1.301; 95% confidence interval (CI) = [1.102, 1.537]; p < 0.001) compared to the first quartile; tooth loss in the fourth quartile correlated with the HEI-2015 score compared to the first quantile (β = −0.121, 95% CI = [−4.839, −2.974], p < 0.001); and the highest number of tooth loss was found to have a significant effect on SII (β = 0.032; 95%CI = [1.777, 47.448]; p < 0.05). Compared to average diet quality, best diet quality acts as a safeguard against elevated HOMA-IR (OR = 0.776; 95% CI = [0.641, 0.939]; p < 0.01); inadequate diet quality is a risk factor (OR = 1.267; 95%CI = [1.138, 1.411]; p < 0.001) conversely. Meanwhile, it can be seen that compared with the first quantile of SII, the highest score is significantly correlated with the higher incidence of IR (OR = 1.363; 95%CI = [1.179, 1.575]; p < 0.001). Diet quality and SII played a partial mediating role in the relationship between HOMA-IR and tooth loss, and the mediating effect ratio for the total effect value was 4.731% and 4.576%, respectively. The mediating effect of SII and diet quality in the association of the relationship between HOMA-IR and tooth loss both was 0.003 (95%CI = [0.001, 0.004]). (4) Conclusions: Our study revealed the relationship between IR and tooth loss, and further explored the mediating role of SII and diet quality between the number of missing teeth and IR, emphasizing that improving diet quality and reducing SII can effectively prevent and treat IR and related diseases. It provides new theoretical support for the study of IR mechanisms and new ideas and approaches to deal with related diseases.

Psychological distress in nursing students: relationship with screen time, diet and physical activity.

to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students. a descriptive and cross-sectional study conducted with a sample of 648Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity. the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms. Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Суточное потребление жиров и параметры липидного профиля крови у студентов вуза на первом-втором годах обучения

New educational environment of the university and changes in social and living conditions are factors that strain the adaptation mechanisms of first-year students. Inadequate diet can decrease the body’s adaptive and compensatory capabilities and affect its basic functions. The purpose of this research was to study the dynamics of the actual fat content in the diet and key markers of lipid metabolism in the blood of university students in their first and second years of study living in a dormitory. Materials and methods. The same sample of healthy students of both sexes (n = 62) aged 18–21 years studying at Gorno-Altaisk State University were examined in 2020 and 2021. Diet information was obtained through a 7–10-day food diary. Blood concentrations of total cholesterol, low- and high-density lipoproteins as well as triglycerides were determined. Results. Daily fat intake of female students (n = 31) in their second year of study (compared with the first year) statistically significantly increased by 9.3 g. At the same time, the girls showed an increase in total cholesterol by 0.2 mmol/l and in triglycerides by 0.2 mmol/l. In the group of male students (n = 31), no statistically significant increase in dietary fats was observed in the second year. However, triglyceride concentrations in the blood plasma of male subjects increased by 0.1 mmol/l. High-density lipoprotein content increased in the second year in both sex groups: by 0.5 mmol/l in female and by 0.2 mmol/l in male respondents. Blood concentrations of low-density lipoproteins remained unchanged during the observed period in both male and female subjects.

Body condition as a descriptor of American alligator (Alligator mississippiensis) health status in the Greater Everglades, Florida, United States.

Body condition is used as an indicator of the degree of body fat in an animal but evidence of its actual relationship with health diagnostics (e.g., blood parameters) is usually lacking across species. In American alligators (Alligator mississippiensis), body condition has been used as a performance metric within the Greater Everglades ecosystem to provide insight on hydrological and landscape changes on alligator populations. However, there is no clear evidence that spatial body condition changes relate to different health conditions (low food intake vs sickness) and whether this link can be made when relating body condition values with blood parameters. We assessed the relationship between alligator body condition and 36 hematological and biochemistry (blood) parameters in four areas across two physiographic regions (Everglades and Big Cypress) of the Greater Everglades (sample size = 120). We found very strong to weak evidence of linearity between 7 (Big Cypress) and 19 (Everglades) blood parameters and relative condition factor index, from which cholesterol (38%) and uric acid (41%) for the former and phosphorus (up to 52%) and cholesterol (up to 45%) for the latter (mean absolute error MAE = 0.18 each) were the predictors that individually explain most of the body condition variation. The best combination of blood parameters for the Everglades were cholesterol, phosphorus, osmolality, total protein, albumin, alpha 2, beta, and gamma globulins, and corticosterone accounting for 40% (37 ± 21%, MAE = 0.16) of the variation found in alligator body condition for this region. We found better predictability power in models when analyzed at smaller rather than larger scales showing a potential habitat effect on the body condition-blood parameters relationship. Overall, Everglades alligators in poorer condition are likely dehydrated or have an inadequate diet and the spatial differences found between physiographic regions suggest that these areas differ in prey availability/quality.

The Relationship Between Parenting Patterns and Disease Patterns with the Incident of Stunting in Toddlers 6-36 Months at the Panyabungan Jae Community Health Center, Panyabungan District, Mandailing Regency, Christmas 2022

This study aims to analyze the relationship between parenting patterns, disease patterns, and the incidence of stunting among toddlers aged 6-36 months at the Panyabungan Jae Community Health Center, located in the Panyabungan District, Mandailing Natal Regency, in 2022. Employing an observational study design, the research involved 200 toddlers and their mothers as respondents. Data were collected through interviews with mothers to assess parenting patterns applied at home and to record the history of illnesses experienced by toddlers. Statistical analysis, including the chi-square test, was conducted to evaluate the relationship between parenting styles, disease patterns, and the incidence of stunting in toddlers. The study results revealed a significant relationship (p < 0.05) between parenting patterns, disease patterns, and the occurrence of stunting. Parenting patterns that do not cater to the needs of children's growth and development, such as inadequate diet, poor personal hygiene practices, and insufficient developmental stimulation, were associated with an increased risk of stunting in toddlers. Additionally, common disease patterns experienced by toddlers, such as respiratory tract infections and digestive disorders, were identified as contributing factors to stunting. These findings offer valuable insights into the multifaceted factors influencing children's growth and development during early childhood. The practical implication of this research underscores the importance of adopting a holistic approach to prevent stunting, which includes educating parents about effective parenting practices, disease prevention strategies, and ensuring adequate access to healthcare services to address common health issues experienced by toddlers.

Dietary Micronutrient Intake and Its Relationship with the Malnutrition–Inflammation–Frailty Complex in Patients Undergoing Peritoneal Dialysis

Background: The relationship between dietary patterns and the malnutrition–inflammation–frailty complex in patients undergoing peritoneal dialysis (PD) is currently unknown. Our objective was to measure dietary nutrient intake and evaluate its association with malnutrition, inflammation, and frailty. Methods: We prospectively recruited adult PD patients. We assessed their dietary nutrient intake using a food frequency questionnaire. Frailty, malnutrition, and inflammation were evaluated by validated Frailty Score (FQ), Subjective Global Assessment (SGA), and Malnutrition-Inflammation Score (MIS). Results: A total of 209 patients were recruited for the study. Among them, 89 patients (42.6%) had an insufficient protein intake, and 104 patients (49.8%) had an insufficient energy intake. Additionally, 127 subjects were identified as frail, characterized by being older (61.9 ± 9.5 vs. 55.6 ± 12.8, p < 0.001), malnourished (SGA: 21.0 ± 2.7 vs. 22.7 ± 3.1, p < 0.001), and having a high inflammation burden (MIS: 10.55 ± 3.72 vs. 7.18 ± 3.61, p < 0.001). There was a significant correlation between dietary zinc intake and body mass index (r = 0.31, p < 0.001), SGA (r = 0.22, p = 0.01), and MIS (r = −0.22, p = 0.01). In the multivariate model, a higher dietary zinc intake predicted a higher SGA (beta 0.03, p = 0.003) and lower FQ (beta −0.38, p < 0.001) and MIS (beta −0.14, p < 0.001), indicating a better nutrition, less frail and inflamed state. A higher dietary zinc intake was also associated with a lower odds of being frail (adjusted odds ratio 0.96, p = 0.009). Conclusion: Dietary inadequacy and micronutrient deficiency are common among the PD population. Dietary zinc intake is independently associated with an improved nutrition, physical condition, and reduced inflammatory state.

A CRITICAL REVIEW OF PATHYA-APATHYA DIETS IN DEFICIENCY OF RAKTA DHATU

"Raktam Jeeva iti Sthiti" that implies the life (Jeeva) of an individual lives in Rakta (Blood), any extreme hindrance or loss of blood can cause demise. Alterations in skin colour, such as a yellowish white discoloration, are common in Rakta deficiency. This condition can be compared to Panduroga in Ayurveda, which is frequently referred to in various Ayurvedic texts as either a separate disease or the symptoms of another disease. On the basis of symptoms and causes, it can be linked to iron deficiency anaemia in modern science. It is brought on by iron loss from the body, inadequate diet, gastrointestinal tract infections, worm infestation, and insufficient iron absorption. According to the classics of Ayurveda, it develops as a result of a decrease in Rasa Dhatu, which makes it unproductive to produce Rakta Dhatu. There are different food articles, diets, Ayurvedic herbal and herbo-mineral formulations are indicated in Ayurvedic texts for the management of lack of Rakta Dhatu. These diets and Ayurvedic formulations have been found to be safe, effective and free of side effects in numerous studies.

Comparison between self-concept, self-perception, physical exercise and lifestyle variations from 1st to 4th grade students of nursing in Tenerife, Spain.

The aim of this study was to describe and compare the self-concept, self-perception, physical exercise, and lifestyle of students from 1st to 4th year of the Nursing university studies. Descriptive observational cross-sectional study with analytical components. The study sample consisted of 1st and 4th year undergraduate Nursing students. Five questionnaires were used: a sociodemographic survey, the RSES, the GHQ-12, the PAQ-A and the HBSC. The sample consisted of 197 subjects. 44.2% had a low self-concept and a perception of self-value that improved as they progressed academically, while confidence decreased. The PAQ-A showed that 65.5% performed moderate physical activity and 15.7% were sedentary, 58.9% reported a fair lifestyle and 20.8% of the subjects reported an inadequate diet. In the GHQ-12, the perception of self-value subscale showed an improvement with respect to the academic year. The SOC-13 data showed fair coping with traumatic situations, which worsened in the 4th year, being 88.9% in males and 84.6% in females. The study identified low self-concept, an adequate self-perception, moderate physical activity with a tendency towards sedentary lifestyles, and a fair lifestyle. It is significant that adolescents do not perceive the poor figures they obtain in self-concept, physical exercise, diet, sleep, and violence as reflected in their health. It is known that the changes adopted in adolescence will be perpetuated in adulthood. Therefore, influencing this population group, and even more so, if they are potential future health professionals, is deemed necessary.

Effect of a Homestead Food Production and Food Hygiene Intervention on Biomarkers of Environmental Enteric Dysfunction in Children Younger Than 24 Months in Rural Bangladesh: A Cluster-Randomized Controlled Trial.

Poor sanitation and hygiene practices and inadequate diets can contribute to environmental enteric dysfunction (EED). We evaluated the impact of a combined homestead food production and food hygiene intervention on EED biomarkers in young children in rural Bangladesh. The analysis was conducted within the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial in Sylhet, Bangladesh. The FAARM trial enrolled 2,705 married women and their children younger than 3 years of age in 96 settlements (geographic clusters): 48 intervention and 48 control. The 3-year intervention (2015-2018) included training on gardening, poultry rearing, and improved nutrition practices and was supplemented by an 8-month food hygiene behavior change component, implemented from mid-2017. We analyzed data on 574 children age 0 to 24 months with multilevel linear regression. We assessed fecal myeloperoxidase (MPO), neopterin (NEO), and alpha-1-antitrypsin (AAT) as biomarkers of EED, and serum C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) as biomarkers of systemic inflammation, using ELISA. There was no intervention effect on NEO, AAT, CRP, and AGP concentrations, but, surprisingly, MPO levels were increased in children of the intervention group (0.11 log ng/mL; 95% CI, 0.001-0.22). This increase was greater with increasing child age and among intervention households with poultry that were not kept in a shed. A combined homestead food production and food hygiene intervention did not decrease EED in children in our study setting. Small-scale poultry rearing promoted by the intervention might be a risk factor for EED.

Lifestyle Impacts of Extended Nursing Shifts Among Nurses: A Study in Tertiary Care Hospitals in Karachi, Pakistan

A significant concern in healthcare settings is extended hours' effect on nurses' health. Objective: This study aims to explore the lifestyle impacts of extended nursing shifts among nurses at tertiary care hospitals in Karachi, Pakistan. Methods: This cross-sectional study was conducted in three tertiary care hospitals in Karachi, Pakistan, among 100 nurses. Results: Study findings reveal that majority, 87%, believe it hinders decision-making, while 88% see sleep deficits and 88% note time constraints for exercise. Communication quality is a concern for 76%. 78% see knowledge transfer issues when nurses hand over responsibilities, and 58% think religious activities are impacted. Opinions vary on patient care quality (50% positive). Stress levels concern 80%, social lives are disrupted for 91%, and physical health effects concern 93%. Additional worries include inadequate diet (39%), nurses working long shifts are exhausted (91%), child care neglect (89%), altered eliminatory patterns (84%), life expectancy (32%), memory problems (69%), hormonal disruptions (76%), workplace conflicts (88%), and infection risk (88%). Finally, 76% perceive high absenteeism. Conclusions: The findings underscore significant concerns about the negative impact of long working hours on nurses' health and performance. To address these issues, it is recommended that healthcare institutions prioritize implementing structured shift rotations and providing adequate breaks to mitigate the adverse effects of extended shifts on nurses' wellbeing and patient care quality.

Spatial variation and determinants of inappropriate complementary feeding practice and its effect on the undernutrition of infants and young children aged 6 to 23 months in Ethiopia by using the Ethiopian Mini-demographic and health survey, 2019: spatial and multilevel analysis.

Inappropriate complementary feeding practices (IACFPs) are major public health issues in Ethiopia, which usually result in stunting and becoming an intergenerational cycle. However, the spatial patterns and determinants of IACFP and its effect on undernutrition are not well understood in Ethiopia. Therefore, the aim of this study was to explore the spatial patterns and determinants of IACFPs and their effects on the undernutrition of infants and young children (IYC) in Ethiopia. This was a nationwide community-based survey study among 1,463 mothers of IYC aged 6-23 months in Ethiopia. The global spatial autocorrelation was assessed using the global Moran's-I to evaluate the spatial clustering of IACFPs. Significant clusters with high and low rates of IACFPs were explored. A multilevel mixed-effect logistic regression with cluster-level random effects was fitted to identify determinants of IACFPs with an AOR and 95% CI. The prevalence of IACFPs was 90.22%. The spatial pattern of IACFP in Ethiopia was clustered across regions (Global Moran's I = 0.63, Z-score = 12.77, value of p ≤0.001). Clusters with a high rate of IACFP were detected in southern, northwest, and eastern Ethiopia. Individual and community-level variables accounted for 63% of IACFP variation. Mothers with no education were 3.97 times (AOR = 3.97; 95% CI: 1.64-9.60) more likely to have IACFPs than those with higher education. The poorest HHs had 4.80 times the odds of having IACFPs as the richest HHs (AOR = 4.80, 95% CI: 1.23-18.71). The odds of having IACFPs were 2.18 times (AOR = 2.18; 95% CI: 1.28-3.72) higher among babies with no postnatal checkup. Non-breastfed IYC were 2.8 times (AOR = 2.80; 95% CI: 1.29-6.10) more likely to have IACFP when compared with breastfed ones. IYC with the inadequate introduction of solid, semi-solid, and soft foods, inadequate minimum dietary diversity, and inadequate minimum acceptable diet were more likely to have wasting, underweight, and stunting. This study showed the prevalence of IACFPs was very high, which had an effect on undernutrition and showed spatial variation in Ethiopia. Therefore, the government of Ethiopia and stakeholders should focus on women with no education and the poorest HHs, encourage PNC checkups, and encourage breastfeeding in the hotspot areas to minimize IACFPs in Ethiopia.

Older family caregivers’ inadequate diet and social and health inequalities

Abstract Background Family caregivers may experience financial vulnerabilities due to their caregiving role, affecting their ability to afford appropriate food and ensure optimal nutrient intake. Therefore, this cross-sectional study aimed to assess the extent to which there are diet-related disparities among older family caregivers. Methods We included 125 family caregivers from Eastern Finland (mean age 74 y). Data on family caregivers’ health, nutritional status, and sociodemographic factors were collected at their households between June 2019 and December 2019. First, we assessed the sociodemographic factors associated with family caregivers’ inadequate diet. Then, we evaluated diet-related health disparities. The associations and predictors of diet-related disparities were assessed using the independent samples t-test, χ2-test, and binary logistic regression. Results The preliminary results show that family caregivers experiencing subjective poverty were less likely to consume two or more portions of fruit and vegetables per day (odds ratio = 0.11; 95% confidence interval 0.02-0.72; p = 0.021) and were more likely to be overweight. Furthermore, family caregivers’ inadequate diet (i.e., lack of daily fruit and vegetables and risk of malnutrition) was further associated with several health conditions, including comorbidity, depression, diabetes (type I and II), and osteoporosis. Conclusions Family caregivers have diet-related disparities, which may further lead to health inequalities. Family caregivers’ diet-related disparities require increasing attention in healthcare. Thus, addressing family caregivers’ food insecurity risk could enhance their health equity. Key messages • Older family caregivers’ inadequate diet is associated with social and health inequalities. • We must assess the root causes of diet-related disparities among older family caregivers and the broad consequences to find solutions to narrow the inequalities.

4.A. Workshop: Public health interventions to counteract unhealthy diets towards a better consumer knowledge

Abstract Unhealthy diet represents the most important risk factor for chronic non-communicable diseases in Europe. It has been estimated that about half EU citizens are overweight and obese, with over a million deaths yearly are due to dietary risk factors. The growing share of energy-dense nutrient-poor unhealthy foods seem to be, at least in part, responsible for inadequate diet quality, especially among the younger population. While the current situation is already dramatic, future projections on the burden of non-communicable diseases are truly alarming if prevention control is not put in action today. However, public health interventions to improve the impact of sub-optimal quality food are challenging and require a multifaced call to action to counteract the exposure to this obesogenic environment. The transition to healthy and sustainable diets should be facilitated by policy interventions, such as adoption of front-of-pack nutrition labelling for food that would make healthy food easier to choose. The nutritional and non-nutritional content of products in the food market is driven by the industry, thus not necessarily in the best interest of the consumer. While there is consistent scientific evidence on this matter, there is still no action taken from policy makers. Empowering the consumer by improving health literacy could be another strategy to drive EU citizens toward health-conscious dietary choices. However, current efforts from a public health perspective are just shyly raising and are far from optimal nor are getting any actual results. The EUPHA Public health and law, EUPHA Food and nutrition, EUPHA Health literacy, and EUPHA Ethics Sections aim to propose this workshop to discuss about the current status of scientific evidence on the role of products in the food market and health in Europe, public health actions (such as front-of-pack labels) and missed opportunities from the EU Commission to put into practice the retrieved knowledge. Strategies for a better involvement of the citizens and explore new perspectives to counteract the burden of diseases associated with suboptimal diets will be also discussed. Key messages • The food market is most entirely regulated by food industry, with poor quality control from a public health perspective. • Adequate information of consumers may represent a key to counteract unhealthy diets.

Protocol for a 20-year follow-up after a randomized controlled trial of a Mediterranean diet in pregnancy: maternal and offspring risk factors for cardiovascular disease.

An inadequate maternal diet during pregnancy can impair offspring health and may increase the risk of cardiovascular disease later in life. The purpose of the proposed study is to assess the risk factors associated with cardiovascular disease in both mothers and their offspring 20 years following their participation in a Mediterranean diet intervention trial during pregnancy. The "Cardiovascular Risk Reduction Diet In Pregnancy" (CARRDIP) study was a randomized controlled trial performed between 1999 and 2001. The participants were randomized to adhere to either a Mediterranean diet or their regular diet during pregnancy. An extensive amount of data such as diet information, ultrasound measurements, anthropometry, and biomarkers from these mothers during pregnancy and their offspring in the neonatal period were collected. The mother-offspring pairs (n = 269) from the CARRDIP study will be invited to participate in a clinical examination and blood sample collection. This follow-up study, conducted 20 years after the original CARRDIP study, will investigate cardiovascular risk factors in mothers and offspring. The primary outcome will be the blood pressure of the offspring. In addition, the study will explore various aspects of cardiovascular health, including metabolic and inflammatory status, clinical history, and body composition of the participants. Previous studies investigating the effects of nutrition during pregnancy on maternal and offspring health have been either observational studies, animal studies, or randomized controlled trials with a follow-up period of less than 5 years. This project aims to study the long-term effects of dietary intervention during pregnancy on maternal and offspring cardiovascular risk markers. Clinicaltrials.gov, identifier (NCT05030922).

Профілактика порушень у слизових оболонках травного тракту самок щурів за дефіциту естрогенів, білка та кальцію

Purpose. Substantiation of the preventive efficacy of a complex consisting of quercetin, calcium citrate, vitamins, macro- and microelements in relation to the biochemical parameters of the mucous membranes of the digestive tract of rats with oophorectomy and insufficient protein and calcium in the diet. Materials and methods. The study was conducted on 24 female rats of herd breeding: in 16 animals, the state of estrogen deficiency was modeled by ovariectomy followed by their maintenance on an inadequate diet, half of which were injected with a prophylactic complex of vitamins and minerals. After 4 months, the rats were taken out of the experiment. In the homogenates of the mucous membranes of the oral cavity, stomach, small and large intestine, markers of inflammation (activity of elastase, acid phosphatase and the content of malonic dialdehyde) and the index of bacterial contamination (activity of urease) were determined. Results. As a result of the study, the development of inflammation was established in the mucous membranes of the digestive tract of rats with hypoestrogenism and when receiving a diet deficient in protein and calcium. The development of inflammation was accompanied by an increase in the activity of acid phosphatase (in the oral cavity – by 16.5 %, in the stomach – by 23.3 %, in the small intestine – by 27.0 %, in the large intestine – by 29.6 %), elastase ( in the oral cavity – by 9.2 %, in the stomach – by 52.6 %, in the small intestine – by 93.6 %, in the large intestine – by 28.7 % and the content of malondialdehyde (in the oral cavity – by 25.8 %, in the stomach – by 40.7 %, in the small and large intestine – by 26.4 %, in the large intestine – by 35.7 %) relative to the control group. In addition, an increase in urease activity was registered in the mucous membranes of the digestive tract of rats with pathology, which means an increase in the contamination of opportunistic microorganisms on the mucous membranes. The introduction of the prophylactic complex to rats prevented an increase in inflammation and dysbiosis in the mucous membranes of the digestive tract of animals, which was caused by pathology modeling. Findings. Anti-inflammatory and anti-dysbiotic properties of the prophylactic complex of vitamins and minerals based on quercetin and calcium citrate from Black Sea oyster shells allow us to recommend this composition of preparations for a deeper study in order to create an alternative to hormone replacement therapy for hypoestrogenism with alimentary deficiency of protein and calcium.

Linking Care and Support Systems to Improve Childhood Malnutrition: Early Childhood Development Practitioners’ Perceptions of Integrating Multisectoral Systems in South Africa

Introduction: Child malnutrition is a persistent global challenge. It is the cause of nearly 45% of global child mortalities. To ensure positive child health outcomes, integrated multisectoral approaches among families, communities, and government systems to ensure positive child health outcomes are neccesary. Objectives: This study identifies how different care support systems can be linked to ensure optimal childhood nutrition outcomes in South Africa. This is through multisectoral approaches from the early childhood development (ECD) practitioners' perspective. Materials and Methods: We integrated the components of the different support systems and multisectoral approaches. The conceptional framework of the causes of malnutrition by The United Nations Children's Fund (UNICEF) recognizes that malnutrition is due to inadequate care services, diet, and care practices influenced by individual, household, community, and structural determinants. While the Nurturing Care Framework, which looks at how policies and services can support families, parents, and other communities in providing nurturing care. Design: A sequential mixed methods approach was used. For the quantitative method, we did a cross-sectional descriptive analysis of 2 966 children who were under-five years' old in the 2017 South African National Income Dynamics Study (NIDS) between July and August 2022, we conducted five in-depth interviews with ECD practitioners using this qualitative method, and the data was analyzed using thematic analysis. Data was triangulated to understand the factors influencing children’s nutritional outcomes and to provide the narratives of ECD practitioners. This enabled us to highlight challenges and opportunities in linking children to services they need. Results: This study showed that 22.16% of children were stunted, 16.40% were overweight, and 5.04% were underweight. ECD practitioners reported a lack of support received at health facilities and other social services when making referrals, a lack of parental support in nutrition programmes, systemic challenges experienced in getting ECD centers registered, and the ECD's inability to qualify for subsidized nutrition grants. Conclusion: It is critical for us to understand the challenges and opportunities for multisector collaboration. This understanding will enable strategies and policies aimed at providing efficient and effective service referral and service delivery to improve childhood malnutrition in South Africa.

The quality of Indian diets: A comparison of two indices to predict risk of dietary inadequacies linked to non-communicable diseases

Nutritional inadequacies lead to various health problems among Indians. Improvements in diets can be addressed when different aspects of diet quality are known. The primary objective of the study was to assess diet quality of Indian adults belonging to the high-income group. The study also wanted to compare the suitability of two diet quality indices for use in the Indian scenario. A cross sectional study design with non-probability purposive sampling was used to collect data from 589 adults (20-40 years) in Delhi, India. Nutrient intake was assessed using the 24- hour dietary recall method. Two internationally recognized diet quality indices - Diet Quality Index- International Score (DQI-I) and the Global Diet Quality Score (GDQS) were selected to measure diet quality. 78% of the participants had poor diet quality using the DQI-I; the average score was 56.4 ± 5.6. The average DQI-I component scores for variety, adequacy, moderation and overall balance were 13.1±2.6, 27.5±2.2, 15.3±2.9, 0.43±0.9 respectively. Females were more likely (OR=2.07, 95% C.I.: 1.26 – 3.401) to have DQI-I scores in the lowest quartile (p=0.04). 88% had a moderate risk of nutritional inadequacy while 11% were at a high risk of nutritional inadequacy on the basis of their GDQS scores, the average of which was 16.9±2.1. There was a positive association between GDQS and DQI- I scores (ρ =0.316, p<0.001). The GDQS is better for assessing nutrient adequacy with healthy and unhealthy food consumption being compared. On the other hand, DQI-I gives a composite score combining the nutrient and food group intake and observes variety, adequacy, moderation and overall balance. Behaviour change communication strategies that encourage healthier food selection and promote dietary diversity may help improve nutritional quality of diets in Indian populations such as this one.