Adequate Dietary Intake Research Articles

Child Stunting is Associated with Low Circulating Essential Amino Acids

BackgroundStunting affects about one-quarter of children under five worldwide. The pathogenesis of stunting is poorly understood. Nutritional interventions have had only modest effects in reducing stunting. We hypothesized that insufficiency in essential amino acids may be limiting the linear growth of children. MethodsWe used a targeted metabolomics approach to measure serum amino acids, glycerophospholipids, sphingolipids, and other metabolites using liquid chromatography-tandem mass spectrometry in 313 children, aged 12–59months, from rural Malawi. Children underwent anthropometry. FindingsSixty-two percent of the children were stunted. Children with stunting had lower serum concentrations of all nine essential amino acids (tryptophan, isoleucine, leucine, valine, methionine, threonine, histidine, phenylalanine, lysine) compared with nonstunted children (p<0.01). In addition, stunted children had significantly lower serum concentrations of conditionally essential amino acids (arginine, glycine, glutamine), non-essential amino acids (asparagine, glutamate, serine), and six different sphingolipids compared with nonstunted children. Stunting was also associated with alterations in serum glycerophospholipid concentrations. InterpretationOur findings support the idea that children with a high risk of stunting may not be receiving an adequate dietary intake of essential amino acids and choline, an essential nutrient for the synthesis of sphingolipids and glycerophospholipids.

Is violence in part a lithium deficiency state?

Violence, particularly firearm violence, leading to suicide and homicide is a significant problem worldwide. A majority of suicidal and homicidal violence involves males; homicidal violence is prevalent among young men and suicide is the leading cause of violence worldwide. Lithium, in pharmacological doses, has been used successfully for decades in treating bipolar disorders, and has been shown to decrease violent crime in this situation. Interestingly, lithium, in trace amounts, as occurs in some drinking water, has been inversely related to aggression, and suicidal and homicidal violence. Lithium is naturally found in vegetables, grains and drinking water, and dietary intake varies from nearly zero to 3mg daily. Elemental lithium, in trace doses, has been shown to improve mood in weeks. Moreover, lithium, in trace amounts, has no toxicity. In order to ensure adequate dietary intakes of elemental lithium daily for the purpose of decreasing aggression and violence, we propose considering the fortification of cereal grain products with lithium and also the addition of lithium to vitamin preparations for adults. Importantly, randomized trials in various populations are needed to test this hypothesis.

Resting energy expenditure in adult patients with Crohn's disease

Crohn's disease (CD) is a chronic intestinal disorder of unknown etiology involving any section of the gastrointestinal tract often associated with protein-energy malnutrition (PEM). Increased resting energy expenditure (REE) unmatched by adequate dietary intake is amongst the pathogenetic mechanisms proposed for PEM. Aim of this study was to evaluate REE in CD patients receiving or not immuno-suppressive therapy as compared to controls. 36 CD patients (22M and 14F, age range 18-55 years) clinically stable and without complications since at least 6 month were studied. REE was evaluated by indirect calorimetry and body composition by BIA. Full biochemistry was performed. Patients were divided into two groups: Group 1 (G1=12 patients) without and Group 2 (G2=24 patients) with immuno-suppressive therapy. The two groups were similar for age, height and BMI whereas significantly differed for weight (G1 vs G2: 56.9±7.44 vs 62.3±8.34kg), fat free mass (FFM: 40.4±5.73 vs 48.2±7.06kg), fat mass (FM: 17.0±3.55 vs 13.9±5.54kg) and phase angle (PA: 5.6±1.4 vs 6.5±1.0°). Serum inflammation parameters were significantly higher in G1 than in G2: hs-PCR: 7.76±14.2 vs 7.16±13.4mg/dl; alfa 2-protein: 11.7±3.69 vs 9.74±2.08mg/dl; fibrinogen: 424±174 vs 334±118mg/dl (p<0.05). REE was higher in G2 vs G1: 1383±267 vs 1582±253kcal/die (p<0.05) both in men: 1579±314 vs 1640±203 and women: 1267±140 vs 1380±132. Nevertheless, when corrected for FFM, REE resulted higher in G1 than G2 (34.8±4.89 vs 33.0±4.35kcal/kg, p<0.05) group, also higher compared to our, age and sex matched, control population (REE/FFM: 30.9±4.5kcal/kg). Our preliminary results show that REE when adjusted for FFM is increased in clinically stable CD patients and mildly reduced by immunosuppressive therapy possibly through a direct action on inflammation and on body composition characteristics.

Dietary Intake Adequacy and Evaluation of Nutritional Value in Diabetic Patients

Dietary Intake Adequacy and Evaluation of Nutritional Value in Diabetic Patients Behrooz Ebrahimzadeh Koor1, Mahmoud R. Nakhaie2*, Saied Babaie3 and Mehdi Ranjbaran4 1Department of Nutrition, Faculty of Health, Yasouj University of Medical Sciences, Yasouj, Iran. 2Department of Nutrition, Arak Faculty of Health Sciences, Arak, Iran. 3Department of Anatomy, Arak University of Medical Sciences, Arak, Iran. 4Department of Epidemiology, Arak Faculty of Health Sciences, Arak, Iran. Abstracts Aims: Diabetes as a health problem, leads to many pathological effects. Many studies showed that micronutrients found in these patients are not in accordance with the recommendations of RDA*. The aim of this study was to assess the adequacy of nutrient intake in diabetic patients attending diabetes clinics in Markazi Province of Iran, there by basic information on the nutritional status of this group of patients was obtained and early survey started. Study Design: Cross - sectional study. Place and Duration of Study: Clinical Research Unit, Markazi Province, Arak, Iran, between April 2012 and July 2013. Methodology: In a random sample procedure 250 diabetic patients referring to diabetic clinics in Markazi Province was assessed. A questionnaire was completed for each patient. This form included some demographic data and laboratory food frequency questionnaire (FFQ -168) and a 24-hour dietary recall. After completing the questionnaire the amount of energy and nutrients in each food and beverage ingredients were calculated by using food composition table USDA designed in a food processing software. The standard amounts of Recommended Daily Allowances (RDA 1989) were used to evaluate the adequacy of the diet. Data was analyzed using Pearson correlation coefficient, chi-square and Independent Samples T-test, Paired Samples T-test the SPSS16 statistical software were used. Results: In this study, about 32% of patients had normal weight and 68% of them were overweight or obese. The mean of fasting blood glucose was 212.5 mg /dl. Percentage of energy derived from carbohydrate, protein and fat, was 58.8 and 13.6 and 27.6% respectively. Percentage of energy from saturated fat was around 17%. Among male patients, energy intake, fiber, unsaturated saturated fat energy percentage, calcium, phosphorus, iron, potassium, zinc, vitamin A, selenium, vitamin K, vitamin C and vitamin E intake values are significantly different from RDA values, the amounts of iron, percent of energy from saturated fatty acids, and vitamin E intakes were significantly higher than RDA values and other nutrient intakes were lesser than the RDA. Among female patients, fiber intake, percentage of energy from unsaturated and saturated fat, calcium, phosphorus, potassium, zinc, vitamin B1, folic acid and vitamin E values are significantly different from RDA values, among of these amounts, energy from saturated fat, zinc, vitamin B1 and vitamin E were significantly higher than RDA values and other nutrient intakes were lesser than the RDA. Conclusion: Our findings indicate that the nutritional adequacy of food intake in diabetic patients, is not desirable. The amount of energy from carbohydrate was higher than RDA recommendations. Percent of energy from saturated fatty acids was higher than standard. Percent of energy from saturated fatty acids was higher than standard. Despite the apparent over-weight and obesity of patients, there was nutrient deficiency in them. In overall, in this area choice of balance diet and training are necessary. Keywords : Diabetes mellitus; macronutrient; micronutrient.

A Study on the Dietary Intake and the Nutritional Status among the Pancreatic Cancer Surgical Patients

The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts. The rates of malnutrition at admission were 45.1% (14/31) and 28.9% (9/31) by NRI and MUST method, respectively, but those were increased to 87% (27/31) and 86.6% (26/31) after operation on discharge. The median values of daily intake of energy, carbohydrates, fat, and protein were 588.1 kcal, 96.0 g, 11.8 g, and 27.0 g, respectively. Most patients (n = 20, 64.5%) experienced two or more symptoms such as anorexia, abdominal bloating and early satiety. There were negative correlations between C-reactive protein (CRP) levels and the intake of total energy, protein, fat, and zinc. The rates of malnutrition were increased sharply after surgery and the dietary intake also influenced the inflammatory indicators. The results suggested that need of considering special therapeutic diets for the patients who received pancreatic surgery.

NUTRITIONAL RICKETS – REVISITED

Nutritional rickets is a bone disease in early childhood resulting in bone pain, delayed motor development, and bending of the bones, caused by vitamin D deficiency and/or inadequate dietary calcium intake. The consequences of nutritional rickets include stunted growth, developmental delay, lifelong bone deformities, seizures, cardiomyopathy, and even death. Dark skin pigmentation, sun avoidance, covering the skin, prolonged breast feeding without vitamin D supplementation, insufficient calcium supply, are important risk factors for nutritional rickets. The disease is most commonly seen in children from the Middle East, Africa, and South Asia in high-income countries. European Vitamin D Association (EVIDAS) recommends screening all children from the risk groups (dark skin ethnic groups) for nutritional rickets. Nutritional rickets is entirely preventable when regular vitamin D supplementation and adequate dietary calcium intake are implemented. Vitamin D supplementation of all neonates and infants with a use of 400 IU/d during the first year of life and with at least 600 IU/d of vitamin D and 500mg/d of calcium thereafter will effectively prevent nutritional rickets. EVIDAS call on national health authorities to implement vitamin D deficiency prevention programs as addition to vaccination programs.

Wound Healing Society 2015 update on guidelines for pressure ulcers.

Wound Healing Society 2015 update on guidelines for pressure ulcers.

Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda.

IntroductionNodding syndrome was first reported in Uganda in 2003 among internally displaced populations. Risk factors for the syndrome remain unknown. We therefore explored vitamin B6 deficiency and resulting high 3-hydroxykynurenine (3-HK) levels as risk factor for nodding syndrome in Northern Uganda.MethodsCase-control study conducted in Gulu and Amuru districts. Cases were children/young adults with nodding syndrome. Healthy children/young adults were recruited as controls from same community as cases. Data on socio-demographic and other risk factors was collected using questionnaires. Whole blood was collected in EDTA tubes for assay of 3-HK and vitamin B6 using sandwich ELISA. Conditional logistic regression model was used to assess associations.Results66 cases and 73 controls were studied. Factors associated with nodding syndrome were being positive for 3-HK (AOR=4.50, p=0.013), vitamin B6 concentration below mean (AOR=7.22, P=0.001), child being taken care of by mother only (AOR=5.43, p=0.011), child being taken care of by guardian (AOR=5.90, p=0.019) and child consuming relief food at weaning (AOR=4.05, p=0.021).ConclusionHaving low vitamin B6 concentration which leads to a build up of 3-hydroxykynurenine concentration in cases as a main risk factor. Therefore, cases should be treated with vitamin B6 and community members should be sensitise to ensure adequate dietary intake of vitamin B6 so that the risk of nodding syndrome among children is averted. We encourage future prospective intervention study to be conducted to assess the effect of low vitamin B6 on the development of nodding syndrome via raised 3-HK concentration.

Ghanaians Might Be at Risk of Inadequate Dietary Intake of Potassium.

Adequate dietary intake of potassium (K) helps fight noncommunicable diseases (NCDs), mainly hypertension and cardiovascular diseases. This paper (i) estimated the K intake of Ghanaian population using food supply and food composition data and (ii) compared this estimate with the WHO recommended requirement for K in order to assess if there is a risk of inadequate K intake. Food supply data (1961–2011) was obtained from the FAO Food Balance Sheet (FBS) to derive trends in food and K supply. The average food supply in the FBS for 2010 and 2011 was used in assessing the risk of inadequate dietary intake of K. The K contents of the food items were obtained from food composition databases. The mean K supply per capita per day was approximately 856 mg. The assessment suggests a potentially large risk of inadequate dietary K supply at both individual and population levels. The results suggest the need for assessing options for managing K deficiency, including assessment of K supplying power of soils and K fertilizer management in food crop production systems, as well as empirical estimates of K content of food items (including those underreported in the FBS) and mixed diets in Ghana.

ASSOCIATION BETWEEN FOOD CONSUMPTION AS PREDICTOR OF CARDIOVASCULAR RISK AND WAIST CIRCUMFERENCE INCREASE IN TEENAGERS

Introduction: the eating habits of young people have changed significantly over the last few decades. Teenagers tend to have less than desirable intake of fruits, vegetables, dairy products and wholegrain products, and higher intake of foods high in saturated and trans fats, leading to increased waist circumference and consequent increased risk of cardiovascular disease. Objective: to analyse the relationship between dietary intake as predictor of and increased abdominal circumference in teenagers. Methods: a cross-sectional study was conducted in a sample of 818 teenagers aged between 10 and 14 years, of both genders, enrolled in state public schools in the metropolitan region of Vitória, Espirito Santo, Brazil, from August 2012 to October 2013. Waist circumference (WC) measurements were carried out in duplicate and the arithmetic mean was calculated. The dietary intake was identified from a simplified food questionnaire containing foods whose consumption is high or that present excessive risk of coronary heart disease in teenagers. The statistical analysis was done through Pearson’s chi-squared test. Results: a proportion of 55.9% of the sample had an adequate food intake, 15.6% a high intake and 28.5% an excessive intake. Among teenagers who had an adequate, high and excessive dietary intake, 5.6% (N = 46), 1.1% (N = 9) and 2.6% (N = 21) had increased WC, respectively. The result of the chi-squared test indicated no association between dietary intake as predictor of cardiovascular risk and WC, p-value = 0.576. Conclusion: there was no association between dietary intake presenting cardiovascular risk and increased waist circumference.

Impaired bone mineral accrual in prepubertal HIV-infected children: a cohort study

ObjectiveTo evaluate bone mass accrual and determine the influence of clinical, anthropometric, dietary and biochemical parameters on bone mass. MethodsA cohort study including 35 prepubertal HIV-infected children, between 7 and 12 years, attended at a referral center. At time 1 (T1) and time 2 (T2), patients were assessed according to clinical, anthropometric, dietary, biochemical parameters and bone mineral density (BMD). At T2, patients were divided into prepubertal and pubertal. ResultsDespite the increase in bone mass absolute values, there was no improvement in lumbar spine BMD (LSBMD) Z-score (p=0.512) and worsening in total body BMD (TBMD) Z-score (p=0.040). Pubertal patients (n=19) showed higher bone mineral content (BMC) (p=0.001), TBMD (p=0.006) and LSBMD (p=0.002) compared to prepubertal patients. After multivariate linear regression analysis, the predictors of bone mass in T1 were age, BMI and HA Z-scores for BMC; BMI Z-score, adequate serum magnesium concentration and dietary calcium intake for TBMD; adequate serum concentration of magnesium, BMI and HA Z-scores for LSBMD. In T2, age, total body fat and lean body mass (kg) for BMC; BMI Z-score and puberty for TBMD; dietary fat intake, BMI Z-score for BMD and puberty for LSBMD. ConclusionHIV-infected children have compromised bone mass and the presence of puberty seems to provide suitability of these parameters. Adequate intake of calcium and fat appears to be protective for proper bone mass accumulation factor, as well as monitoring nutritional status and serum magnesium concentration.

Malnutrition and hyperphosphatemia in dialysis patients

Abstract This study aims to document the incidence of hyperphosphatemia in dialysis patients and correlate it with malnutrition. The incidence and severity of malnutrition (low serum albumin) and hyperphosphatemia (increased serum phosphorus level) were correlated with serum calcium, serum alkaline phosphate, and serum parathyroid hormone levels in patients on dialysis. In India, approximately on an average, every 10th person has evidence of early stage of chronic kidney disease. There is high incidence of malnutrition in chronic kidney disease (CKD) patients on dialysis (stage 5D). There have been varying reports of incidence of hyperphosphatemia in dialysis patients in India. Patients on maintenance hemodialysis (MHD) also have high incidence of malnutrition. Indian patients on dialysis have been reported to have less incidence and severity of hyperphosphatemia. A total of 500 patients on MHD (122 female and 378 male patients, age range 9–89 years, and mean age 47.0 ± 15.25 years) were evaluated for hyperphosphatemia, malnutrition, and degree of renal failure. There was trend of more hyperphosphatemia in the group of patients with serum albumin level ≥3.0 g/dl, because these patients were taking adequate dietary protein intake. Patients with malnutrition (serum albumin level

Protein Requirements and Recommendations for Older People: A Review.

Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise). Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV) that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations.

Chemosensory Properties of Pungent Spices: Their Role in Altering Nutrient Intake

The general population is not compliant with national dietary recommendations for promoting health and reducing chronic disease risk. While rising obesity rates suggest that the majority of the population is overconsuming, many individuals affected with either acute or chronic diseases struggle to maintain adequate dietary intake and are at high nutritional risk. Flavor is the primary driver of food intake; however, disliked flavors are a major barrier to consumer adherence with dietary recommendations for both groups. Spices that contribute to chemical burn—such as black pepper, garlic, ginger, mustard, oregano, red pepper, and wasabi—alter food flavors. This paper explores the role of these pungent spices in altering nutrient intake across the lifespan. The role of chemical burn in manipulating dietary intake in both diseased and healthy populations is discussed. Implications for using pungent spices to enhance compliance with dietary manipulations are described. Proposed functions of pungent spices are maintaining, preserving, and enhancing flavor to offset the reductions in liking and palatability that are associated with dietary modifications and disease status.

Adverse bone health among children and adolescents growing up with HIV

Adverse bone health is one of the important non-communicable conditions during the course of life-long HIV treatment. Adolescence is the critical period of bone mineral acquisition for attaining adult peak bone mass. With traditional and HIV-related risk factors, adolescents growing with HIV have a greater chance of having impaired bone mineral density (BMD). Prevalence of low BMD has been reported in 16–32% of HIV-infected adolescents from middle-income countries. The deep interaction between the immune and skeletal systems, called the immunoskeletal interface, is proposed as one of the underlying mechanisms of adverse bone health in HIV-infected individuals. Dual-energy X-ray absorptiometry (DXA) is a standard tool to assess BMD among HIV-infected adolescents. Non-invasive imaging techniques such as quantitative computed tomography (QCT) and quantitative magnetic resonance imaging (QMRI) provide more information on true volumetric density and bone microarchitecture. To date, there are no paediatric recommendations on the treatment and prevention of adverse bone health. Having a healthy lifestyle, routine weight-bearing exercises and adequate dietary intake are the standard approaches to optimise bone health. There are several ongoing randomised clinical trials using pharmacological treatment options, for example vitamin D, calcium and alendronate to improve bone health among this population.

Nutritional intake and anthropometric changes of professional road cyclists during a 4-day competition.

Appropriate nutrition through adequate dietary intake of total calories, macronutrients, and micronutrients is an essential component of optimizing the performance of all elite athletes. The aim of this study was to describe the food intake, body composition, and biochemical profile of professional cyclists during the Tour of Andalusia, a four-stage race covering a total distance of 647.6 km. Nutritional data were collected by trained investigators who weighed all of the food and fluid ingested by the cyclists. The nutritional intake of the cyclists was as follows: CHO, 12.8 ± 1.7 g/kg of body weight (BW; 62.3%); fat, 2.1 ± 0.2 g/kg BW (23.2%); proteins, 3.0 ± 0.3 g/kg BW (14.5%); total kcal was 5644.3 ± 593.1. Intake of all micronutrients, except for folate and potassium [which were 93.7% and 91.3% of Recommended Dietary Allowances (RDA)] exceeded the RDA/I. Percentage of body fat and fat weight significantly decreased (P < 0.05) while weight of muscle mass remained unchanged after the Tour. Concentrations of urea, aspartate aminotransferase, alanine aminotransferase, creatine kinase, myoglobin, and high-density lipoproteins significantly increased (P < 0.05) after the Tour. To our knowledge, this is the first study to describe both nutritional intake and the body and biochemical composition of a sample of professional road cyclists during a top-class cycling race.

Dietary ratio of animal:plant protein is associated with 24-h urinary iodine excretion in healthy school children.

Adequate dietary iodine intake in children is essential for optimal physical and neurological development. Whether lower dietary animal food and salt intake may adversely affect iodine status is under discussion. We examined the association between dietary animal:plant protein ratio with 24-h urinary iodine excretion (24-h UI, μg/d), and whether this is modified by salt intake. A 24-h UI was measured in 1959 24-h urine samples from 516 6- to 12-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Parallel 3 d weighed food records were used to estimate dietary intakes. Protein sources were classified as dairy, animal and plant. A repeated-measures regression model (PROC MIXED) was used to analyse the effect of animal:plant protein ratios on 24-h UI. plant protein ratios ranged from 0.5 (95 % CI 0.4, 0.6) to 1.6 (95 % CI 1.4, 1.9) (lowest and highest quartile). After adjustment for total energy intake, main dietary iodine sources (dairy and salt intake), and further covariates, the inter-individual variation in animal:plant protein ratio was significantly associated with variation in 24-h UI. One unit higher animal:plant protein ratio predicted 6 μg/d higher 24-h UI (P= 0.002) in boys and 5 μg/d (P= 0.03) in girls. This relationship was partially mediated by a higher salt intake at higher animal:plant protein ratios. These results suggest that lower consumption of animal protein is associated with a small decline in iodine excretion, partially mediated by decreased salt intake. Because limited salt and increased intake of plant-based foods are part of a preferable healthy food pattern, effective nutrition political strategies will be required in the future to ensure appropriate iodine nutrition in adherent populations.

Dietary flavonoid intake and Barrett's esophagus in western Washington State

PurposeFlavonoids, concentrated in fruits and vegetables, demonstrate in experimental studies chemopreventive properties in relation to Barrett's esophagus (BE), a precursor lesion for esophageal adenocarcinoma. One case-control investigation reported an inverse association between isoflavone intake and odds of BE, yet no epidemiologic study has considered other flavonoid classes, which are more commonly consumed by Americans. MethodsWe examined intake of total flavonoids, six flavonoid classes, and lignans among case-control study participants in western Washington State. Food frequency questionnaires were self-completed by BE cases with specialized intestinal metaplasia (n = 170) and matched controls (n = 183). ResultsIn logistic regression models adjusted for age, sex, body mass index, and energy intake, the odds ratio (OR) for specialized intestinal metaplasia BE associated with anthocyanidin intake was 0.49 (95% confidence interval: 0.30–0.80, for quartiles 2–4 combined vs. quartile 1), for which wine and fruit juice were major dietary sources. More moderate decreased ORs were noted for flavanones, flavonols, isoflavones, and lignans. A modest increased OR was observed for flavones, for which pizza was the main dietary source in our population. ConclusionsOur findings of an inverse association between anthocyanidins and odds of BE suggest that adequate dietary intake of these compounds may lower risk of this cancer precursor lesion.

Nutritional adequacy of dietary intake in women with anorexia nervosa.

Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the treatment. Therefore, estimates of total energy and nutrient consumption were made in a group of young women (19 to 30 years) with restricting and binge purge subtypes of AN participating in an ecological momentary assessment study. Participants completed three nonconsecutive 24-hour diet recalls. Mean nutrient intakes were stratified by subtype and by quartiles of energy intake and compared to the age specific Dietary Reference Intake (DRI) levels, as well as to the reported intakes from the What We Eat In America (WWEIA) dietary survey 2011–2012. Reported intake was determined for energy, macronutrients, and micronutrients. The mean body mass index (BMI) for all participants was 17.2 ± 0.1 kg/m2. Reported nutrient intake was insufficient for participants in quartiles 1–3 of both AN subtypes when compared to the DRIs. Intake reported by participants in quartile 4 of both subgroups met requirements for most nutrients and even met or exceeded estimated energy needs. Counseling of AN patients should be directed to total food consumption to improve energy intake and to reduce individual nutritional gaps.

Vegetable dishes, dairy products and fruits are key items mediating adequate dietary intake for Japanese adults with spinal cord injury.

This is a cross-sectional study. The objective of this study was to ascertain the essential items mediating adequate dietary intake based on the Japanese Food Guide in common among the transtheoretical model (TTM), self-efficacy (SE) and outcome expectancy (OE). Members of the organization Spinal Injuries Japan. We posted a questionnaire survey to 2731 community-dwelling Japanese adults with spinal cord injury (SCI), and responses from 841 individuals were analyzed. Food intake was assessed as the frequency scores of 10 food items eaten in a daily diet in Japan. The correlations between the frequency scores of food intake and TTM, SE and OE were determined by binominal logistic regression analysis. The frequency scores of food intake were significantly associated with 'To eat vegetable dishes (dishes made mainly from vegetables or potatoes) not less than twice a day', 'To eat green/yellow vegetables not less than twice a day', 'To eat dairy products not less than once a day' and 'To eat fruits not less than once a day' in TTM. 'To eat vegetable dishes (dishes made mainly from vegetables or potatoes) not less than twice a day', 'To eat dairy products not less than once a day' and 'To eat fruits not less than once a day' were significantly associated with the frequency scores of food intake in SE. In OE, no differences were shown. This study finds that vegetable dishes, dairy products and fruits are the key items mediating adequate dietary intake. Dietary guidelines promoting the intake of these dishes for SCI individuals are needed.