Adequate Dietary Intake Research Articles

Vitamin B12 concentrations in milk from Norwegian women during the six first months of lactation

BackgroundHuman milk vitamin B12 (B12) concentrations depend on maternal status and intake; only few data are available in high-income countries.ObjectiveWe assessed human milk B12 concentrations during the first 6 months postpartum in Norwegian women and its association with maternal dietary B12 intake and maternal urinary methylmalonic acid (MMA) concentration.MethodsIn this cross-sectional study, 175 mothers, exclusively (80%) or partially (20%) breastfeeding, were included. Milk B12 was measured by IMMULITE®/IMMULITE® 1000 B12 competitive protein binding assay and urinary MMA relative to creatinine (MMA/Cr) by liquid chromatography–tandem-mass spectrometry. Maternal habitual B12 intake and supplement use were estimated using a food frequency questionnaire.ResultsMean human milk B12 concentration was 327 pmol/L (range 140–1089), with 402 pmol/L at 1 month (n = 21), 333 pmol/L at four months (n = 32), and 299 pmol/L at 6 months (n = 21). Maternal B12 intake was 5 µg/d, 89% met the Estimated Average Requirement, and supplement use did not affect milk B12 concentrations. MMA/Cr was low in all women compared with published data. In exclusively breastfeeding women, MMA/Cr (beta (95% CI) −42.5 (−82.5, −2.5) and time since birth (−4.9 (−9.6, −0.3)) were significant predictors of human milk B12 concentrations. There was no association between total B12 intake and milk B12 concentration or between total B12 intake and MMA/Cr.ConclusionsMaternal B12 status and human milk B12 concentrations are likely sufficient, based on adequate maternal B12 dietary intake combined with low urinary MMA concentrations. Nevertheless, milk B12 concentration fell during 6 months postpartum while maternal B12 status did not change.

Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings from the ERICA survey

Vitamin D plays a role in bone and metabolic health in life long, however hypovitaminosis D is common in different settings. The aim of this study was to describe vitamin D status among adolescents from a large sunny country and analyze associated factors. This was a multicenter, cross-sectional, school-based study. A total of 1152 adolescents age 12–17 from four Brazilian cities, Rio de Janeiro, Fortaleza, Brasília, and Porto Alegre, were included. Anthropometric variables, diet, type of school, race and season of data collection were evaluated. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured and categorized into three levels: ≤ 20 ng/mL, 21–29 ng/mL and ≥ 30 ng/mL. Ordered logistic regression models were used to explore the factors associated with hypovitaminosis D. The prevalence of vitamin D levels below 20 ng/mL, between 21 and 29 ng/mL and above 30 ng/mL was 21 % (95 %CI: 19 %–24 %), 42 % (95 %CI: 39 %–46 %) and 37 % (95 %CI: 33 %–40 %), respectively. In the final adjusted model, hypovitaminosis D was positively associated with gender, center (latitudes), data collected in winter or spring, non-whites, and private school students. A higher proportional odds ratio (POR) for hypovitaminosis D was found among obese boys (POR = 2.2, 95 %CI: 1.1–4.5), but not girls. Adequate dietary intake of vitamin D was a protective factor (POR = 0.4, 95 %CI: 0.2-0.6) against hypovitaminosis D. In conclusion, there is a high prevalence of Brazilian adolescents at risk of hypovitaminosis D, independent of region. Due to their potential benefits, lifestyle changes should be stimulated, including healthier food choices and spending more time outdoors (with sun protection).

Prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana.

BackgroundAnaemia remains a major cause of morbidity and mortality among women and children worldwide. Because deficiencies in essential micronutrients such as iron, folate and vitamin B12 prior to and during gestation increase a woman’s risk of being anaemic, adequate dietary intake of such nutrients is vital during this important phase in life. However, information on the dietary micronutrient intakes of pregnant women in Ghana, particularly of those resident in rural areas is scanty. Thus, this study aimed to assess anaemia prevalence and dietary micronutrient intakes in pregnant women in urban and rural areas in Ghana.MethodsA comparative cross sectional study design involving 379 pregnant women was used to assess the prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. Anaemia status and mid upper arm circumference (MUAC) were used as proxy for maternal nutritional status. Haemoglobin measurements were used to determine anaemia prevalence and the dietary diversity of the women were determined with a 24-hour dietary recall and a food frequency questionnaire.ResultsOverall, anaemia was present in 56.5% of the study population. Anaemia prevalence was higher among rural residents than urban dwellers. Majority of the respondents had inadequate intakes of iron, zinc, folate, calcium and vitamin A. The mean dietary diversity score (DDS) of the study population from the first 24-hour recall was 3.81 ± 0.7. Of the 379 women, 28.8% met the minimum dietary diversity for women (MDD-W). The independent predictors of haemoglobin concentration were, gestational age, maternal age and dietary diversity score. Such that respondents with low DDS were more likely to be anaemic than those with high DDS (OR = 1.795, p = 0.022, 95% CI: 1.086 to 2.967).ConclusionsA large percentage of pregnant women still have insufficient dietary intakes of essential nutrients required to support the nutritional demands during pregnancy. Particularly, pregnant women resident in rural areas require interventions such as nutrition education on the selection and preparation of diversified meals to mitigate the effects of undernutrition.

Zinc transporters maintain longevity by influencing insulin/IGF-1 activity in Caenorhabditiselegans.

Adequate dietary intake of essential metals such as zinc is important for maintaining homeostasis. Abnormal zinc intake in Caenorhabditiselegans has been shown to increase or decrease normal lifespan by influencing the insulin/IGF-1 pathway. Distribution of zinc is achieved by a family of highly conserved zinc transport proteins (ZIPT in C.elegans). This study investigated the role of the zipt family of genes and showed that depletion of individual zipt genes results in a decreased lifespan. Moreover, zipt-16 and zipt-17 mutants synthetically interact with the insulin/IGF cofactors daf-16 and skn-1, and cause abnormal localisation of DAF-16. This study suggests that the zipt family of genes are required for maintaining normal lifespan through influencing the insulin/IGF-1 pathway.

Riboflavin metabolism: role in mitochondrial function

Riboflavin, known as vitamin B2, a water-soluble vitamin, is an essential nutrient in vertebrates, hence adequate dietary intake is imperative. Riboflavin plays a role in a variety of metabolic pathways, serving primarily as an integral component of its crucial biologically active forms, the flavocoenzymes flavin adenine dinucleotide and flavin mononucleotide. These flavocoenzymes ensure the functionality of numerous flavoproteins including dehydrogenases, oxidases, monooxygenases, and reductases, which play pivotal roles in mitochondrial electron transport chain, β-oxidation of fatty acids, redox homeostasis, citric acid cycle, branched-chain amino acid catabolism, chromatin remodeling, DNA repair, protein folding, and apoptosis. Unsurprisingly, impairment of flavin homeostasis in humans has been linked to various diseases including neuromuscular and neurological disorders, abnormal fetal development, and cardiovascular diseases. This review presents an overview of riboflavin metabolism, its role in mitochondrial function, primary and secondary flavocoenzyme defects associated with mitochondrial dysfunction, and the role of riboflavin supplementation in these conditions.

ASSESSMENT OF NUTRITIONAL STATUS AND FREQUENCY OF COMPLICATIONS ASSOCIATED TO FEEDING IN PATIENTS WITH SPASTIC QUADRIPLEGIC CEREBRAL PALSY.

ABSTRACTObjective: To correlate the nutritional status with variables associated to the type of diet and feeding route of children and adolescents with spastic quadriplegic cerebral palsy (CP).Methods: This cross-sectional study included 28 patients aged ≤13 years old who presented a diagnosis of spastic quadriplegic CP and were followed by the nutrition team of the Outpatient Clinic for Special Patients of Hospital de Clínicas de Uberlândia - Universidade Federal de Uberlândia (HC-UFU), between July/2016 and January/2017. Consent forms were signed by the legal guardians. The nutritional status was evaluated and data on dietary complications food route and type of diet were collected. For the description of data, average and median values were used. Correlation was tested with Spearman’s index. Significance was set at p<0.05.Results: 75% of patients used alternative feeding routes (nasoenteral, catheter or gastrostomy), 57% were eutrophic. The most frequent complications were oropharyngeal dysphagia, reflux and intestinal constipation. No correlation was found between the occurrence of complications and the nutritional status. There was a positive correlation between the diet received and the patient’s nutritional status (0.48; p=0.01), i.e. individuals with adequate caloric and macronutrients intake had a better nutritional status.Conclusions: The results reinforce the need for continued nutritional guidance for the children’s parents/caregivers, as well as the choice of an adequate rout of feeding to each child by the multi-professional team, in order to contribute to improved nutritional status and adequate dietary intake.

Redox status, inflammation, necroptosis and inflammasome as indispensable contributors to high fat diet (HFD)-induced neurodegeneration; Effect of N-acetylcysteine (NAC)

Adequate dietary intake has a crucial effect on brain health. High fat diet (HFD) rich in saturated fatty acids is linked to obesity and its complications as neurodegeneration via inducing oxidative stress and inflammation. The present study aimed to evaluate the effect of HFD on cerebral cortex in addition to shedding the light on the modulatory role of N-acetylcytsteine (NAC) and its possible underlying biochemical and molecular mechanisms. Twenty eight male Wistar rats were equally and randomly divided into four groups. Group III, and group IV were fed on HFD (45% kcal from fat) for 10 weeks. Group II and group IV were treated with NAC in a dose of 150 mg/kg body weight via intraperitoneal route. Body weight, blood glucose, serum insulin, insulin resistance index, cerebral cortex redox and inflammatory status were evaluated. Cerebral cortex receptor-interacting serine/threonine-protein kinase3 (RIPK3), mixed-lineage kinase domain-like protein (MLKL), nod like receptor protein 3 (NLRP3), interleukin (IL)-18 levels were determined by immunoassay. In addition, apoptosis-associated speck-like proteins (ASC) expression by real-time PCR; inducible nitric oxide synthase (iNOS), glial fibrillary activating protein (GFAP) and matrix metalloproteinase-9 (MMP-9) expression by immunohistochemistry were evaluated. NAC supplementation protected against HFD-induced gain of weights, hyperglycemia, and insulin resistance. Furthermore, NAC improved redox and inflammatory status; decreased levels of RIPK3, MLKL, NLRP3, IL-18; down-regulated ASC, iNOS, GFAP and MMP-9 expression; and decreased myeloperoxidase activity in cerebral cortex. NAC could protect against HFD-induced neurodegeneration via improving glycemic status and peripheral insulin resistance, disrupting oxidative stress/neuroinflammation/necroptosis/inflammasome activation axis in cerebral cortex. NAC may represent a promising strategy for conserving brain health against metabolic diseases-induced neurodegeneration.

Exploring Dietary Behavior in At-Risk Youth Participating in an After-school Agricultural Program

ABSTRACT Developing strategies to promote adequate dietary intake in children experiencing toxic stress could potentially reduce the cognitive impact on the brain and promote physical and mental health. The purpose of this research was to explore the impact of an afterschool agricultural and nutrition program on dietary behavior in 18 at-risk youth. We examined dietary intake and used Photovoice and semi-structured interviews to explore factors relating to dietary behavior. Results indicated higher intakes of fruit, vegetables and milk compared to a national sample. Further, the youth participants discussed the impact of the program on their dietary behavior through key socio-environmental and cognitive factors.

Caregivers’ perceptions of household hunger and adequacy of dietary intake in a resource limited community in the Bronkhorstspruit District (Gauteng)

This paper describes households’ perceptions of hunger and adequacy of dietary intake by caregivers. A descriptive cross-sectional study in the quantitative research paradigm was conducted to collect data from caregivers (N=50) who were responsible for buying and preparing food for school aged children, residing in different households in Bronkhorstspruit in the Gauteng Province South Africa. Caregivers were individually interviewed using structured questionnaires (socio-demographic, Hunger Scale and the 24 hour-recall questionnaires, respectively). The majority (68%) of the caregivers had good nutrition knowledge but they did not know how to apply the knowledge in their dietary lifestyle. The socio-economic status and nutrition knowledge and attitudes of the caregivers were found to be possible factors that influenced dietary intakes of the households. The mean Household Food Variety Score (FVS) was 4.38 (± 1.0) and the Household Dietary Diversity Score (DDS) was 4.28 (±1.0). The results indicated an average of eight food items were consumed in the households during the 24-hour period of the maximum of 24 food items, identified by the 24-hour recalls. It was concluded that there is a need to eradicate the problem of low food diversity and there is a need to increase micronutrient intakes of children. The DDS of households showed that the food groups that were consumed by the households were ranging from an average of three (food items which incorporated a number of food groups from one) to seven groups. It can also be concluded that the households had a limited variety and diversity of diet since the food items and food groups were limited. This study showed that there is a limited food access by the households due to low incomes. Caregivers should be encouraged to get involved in food production activities; such as greenery projects, brick making projects, etc. that they can use the money they get from the projects to buy food for their families. This would help the caregivers in improving the dietary diversity and variety of their households. Keywords: Household hunger, dietary adequacy, food accessibility, Hidden hunger, Nutrition education Afr. J. Food Agric. Nutr. Dev . 2019; 19(3): 14541-14554

Caregivers’ perceptions of household hunger and adequacy of dietary intake in a resource limited community in the Bronkhorstspruit District (Gauteng)

Caregivers’ perceptions of household hunger and adequacy of dietary intake in a resource limited community in the Bronkhorstspruit District (Gauteng)

Ounce Equivalent Protein Ingestion Does Not Result in Equivalent Responses of Protein Kinetics (OR27-05-19)

ObjectivesThe progressive loss of muscle mass, or sarcopenia, is inherent to aging and related to functionality and independence. It is well established that the loss of muscle mass can be mitigated with adequate dietary protein intake. To help the consumers meet protein requirements utilizing a variety of protein food sources, the Dietary Guidelines for Americans (DGAs) published an “ounce equivalents” recommendation for protein food sources. However, the actual equivalency of these varied protein food groups has not been established. We examined the responses of protein kinetics in response to consumption of ounce equivalents of ground beef, sirloin, eggs, pork loin, kidney beans, peanut butter, tofu, and mixed nuts in young subjects. MethodsSubjects adhered to 3 days of activity and dietary control, and were then studied using an 8.5 h metabolic study which included a 4.5 h basal overnight-fasted period followed by a 4 h post-meal period. All groups were balanced by sex (4 males/4 females). ResultsConsumption of animal-based protein food sources resulted in higher whole body net balance than the plant-based protein food sources (P < 0.05). Consumption of beef sirloin, eggs, and pork loin induced a higher whole-body anabolic response than ground beef and the plant- based proteins. Consumption of tofu (soy-protein) induced a higher whole-body anabolic response than the other plant proteins (P < 0.05). The improvement in whole-body net balance with animal-based protein sources and tofu was due to a significant increase in protein synthesis (P < 0.05) as well as a significant suppression of protein breakdown in most protein sources (P < 0.05). Whole-body net balance was related to higher plasma EAA concentrations with animal-based protein sources and tofu realizing greater peripheral concentrations (P < 0.05). ConclusionsThe results of this study indicate that the “ounce equivalents” as expressed in the DGAs do not produce equivalent anabolic responses, nor are they equivalent in terms of the amount of protein provided, or the caloric cost of protein consumption. The magnitude of anabolic response appears to be largely determined by the amount of essential amino acids per gram of protein food source. Funding SourcesThe Beef Checkoff, National Pork Board, and Egg Nutrition Center.

PS1107 IMPACT OF SEVERITY OF THE DISEASE AND FVIII INHIBITOR ON BONE MINERAL DENSITY AND BONE TURNOVER MARKER IN CHILDREN WITH HEMOPHILIA A

Background:Recurrent hemarthroses, and prolonged immobilization may predispose to low bone mineral density in children with hemophilia. Furthermore, adequate dietary calcium intake is a major determinant of bone mass accrual.Aims:To evaluate the impact of severity of the disease and history of FVIII inhibitor on bone density and bone turnover markers in children with hemophilia A.Methods:Children with hemophilia A (severe FVIII: &lt;1 iu/dl, moderate: ≤ 1‐ 5 iu/dl), aged 6–18 years, were evaluated for bone mineral density (BMD) and bone turnover markers. Positive FVIII inhibitor (&gt;0.6 BU, Bethesda units) history was recorded. Patients were categorized into three groups. Group I: severe cases with inhibitor, II: severe cases without inhibitor and III: moderate cases. Dual‐energy X‐Ray absorptiometry (DXA) of total body (TB) and/or lumbar spine (LS) was applied for BMD measurement and expressed as z‐score (low for chronological age, z‐score ≤ ‐2). Bone resorption [urinary deoxypyridinoline/cretinine (uDPD/uCr), urinary excretion of calcium (uCa/uCr), tartrate‐resistant acid phosphatase (Trap)] and bone formation markers [serum total and bone specific alkaline phosphatase (ALP, bALP), osteocalcin and carboxy‐terminal propeptides of type I collagen], as well as vitamin D, parathormone and serum Ca were measured. All patients completed a validated questionnaire about their dietary calcium intake.Results:Fifty one children with hemophilia A (severe 40), mean age: 11.7 ± 3.6 years, were included. Fourteen children (27.4%) had history of FVIII inhibitor. Mean z‐score for LS BMD was −0.51 ± 0.98 [4/40 (10%) had z‐score ≤ ‐2 and 8/40 (20%) had z‐score between −1 and −2)]. Mean z‐score for TB BMD was 0.18 ± 0.85 [none had z‐score ≤ ‐2 and 4/44 (9.1%) had z‐score between −1 and −2)]. Significant difference was found in mean TB and LS BMD between severe and moderate cases (0.81 ± 0.13 vs 0.94 ± 0.18, p = 0.017). Furthermore, hemophilic children with history of inhibitor had lower mean BMD both on TB (0.74 ± 0.069 vs 0.88 ± 0.16, p = 0.005) and LS measurement site (0.66 ± 0.7 vs 0.87 ± 0.24, p = 0.013). Mean TB and LS BMD was significantly higher in group I compared to groups II and III (p &lt; 0.05). On the other hand, patients with severe hemophilia had increased levels of uCa/uCr compared to children with moderate disease (0.35 ± 0.27 vs 0.17 ± 0.08, p &lt; 0.05). In addition, mean value of uDPD/uCr was increased in children with history of inhibitor in comparison to non inhibitor (40.49 ± 11.1 vs 29.09 ± 15.04, p = 0.014). Group I had higher uDPD/uCr values (p &lt; 0.05) compared to group II and group III (40.49 ± 11.1 vs 30.7 ± 16.3 and 24.78 ± 10.54). No differences were observed in other bone markers among all groups. The dietary calcium intake was adequate (&gt; of EAR, Estimated Average Requirement) in only 19% of children, but no differences in both LS and TB BMD were revealed. Nevertheless, children with inadequate calcium intake had significant increased (p &lt; 0.05) ALP/bALP, compared to the rest of patients.Summary/Conclusion:In our study, 10% of children with Haemophilia A had low for chronological age LS BMD. Severe disease and history of FVIII inhibitor seem to burden bone health, as measured with DXA. Resorption markers were found to be impaired. Homeostasis of calcium seem to overweigh low dietary intake. Severe cases, especially those with history of inhibitor, are in higher risk to develop bone metabolic disturbances; thus, close monitoring of bone status seems to be necessitated.

Identifikasi status gizi, somatotipe, asupan makan dan cairan pada atlet atletik remaja di Indonesia

Athletes’ nutrition status, somatotype, and adequate dietary intake are strongly related to their sport performance. Examining those markers in adolescent age is essential in order to develop the optimum physical characteristics for the future. This study was conducted to identify the nutrition status based on anthropometry value, somatotype, food and fluid intake of youth athletic athletes in Indonesia. Descriptive quantitative design was used in this study. Subjects participated in the study were 25 youth athletic athletes from Students Education and Training Program (Program Pembinaan dan Pelatihan Pelajar) in Yogyakarta and Aceh, and School of Sports (Sekolah Keolahragaan) Ragunan, Jakarta Selatan. Anthropometry measurement consists of body weight, height, body fat percentage, and somatotype. Nutrition status was identified according to BMI/age and height/age. Food and fluid intake were assessed using 24-hour dietary recall interview and semi quantitative fluid frequency questionnaire. Descriptive statistical analysis was performed and the result was presented in mean and standard deviation (SD). BMI/ age values in male and female athletes were -2 SD ≤ Z ≤ +1 SD (normal) and +1 SD &lt; Z ≤ +2 SD (overweight), respectively. Height/age value for both gender was normal in -2 SD ≤ Z ≤ +2 SD. Percentage of body fat ranged in 12-16% for males and 18-28% for females. Somatotype category for males was ectomorphic mesomorph (2.3-5.0-3.3) and endomorphic mesomorph (4.4-5.6-2.0) for females. Fulfillment of energy and carbohydrate was found inadequate (&lt; 80%), whereas fat intake was found excess (&gt; 110%). Total fluid intake was ranged from 2700 ml to 5800 ml per day. Overweight nutrition status was still found in femaleathletes. Ideal somatotype was found only in male athletes. Excessive percentage of body fat was detected in both gender. Total energy, macro nutrients, micro nutrients, and fluid intake were inadequate compared to dietary recommendation.

Agronomic biofortification of maize and beans in Kenya through selenium fertilization.

Deficiency in calcium, zinc, selenium, and iodine remains a major health issue in Africa. A selenium (Se) status survey conducted in central Kenya highlands revealed a high risk of dietary Se deficiency. This study investigates the effect of soil and foliar Se fertilizer application on Se concentration in maize and bean grains. It further tests the combination of Se fertilizer with phosphorus and nitrogen fertilizers, and with zinc and iodine fertilizers. Selenium fertilization results in a significant increase in Se concentration in grains. For the soil application, Se concentration increases on average by 3µgkg-1 in maize and by 10µgkg-1 in beans, for each gram of Se applied as sodium selenate. Foliar Se fertilization is more effective and increases Se concentration in grains on average by 18µgkg-1 in maize, and by 67µgkg-1 in beans. Total soil phosphorus/availability appears as an important factor influencing soil Se availability. Addition of phosphorus fertilizers positively affects the impact of Se fertilization in locations with low soil P, Fe, and Al. A Se + Zn + I fertilizer combination does not affect the impact on Se concentration in grains. Fertilizing beans alone is found to be more efficient compared to fertilizing only maize. In locations at high risk of dietary Se deficiency, foliar application at 10g Se ha-1 on beans or 31g Se ha-1 on maize is sufficient to achieve adequate daily dietary Se intake. The study points towards a multi-mineral agronomic biofortification, based on a site-specific biofortification strategy.

Modeled industry-wide food and beverage reformulations reduce the gap between current and nutritionally adequate dietary intakes among French adults.

The objective was to assess the capacity of food reformulations to reduce the required dietary changes to reach overall nutritional adequacy in the French adult population. Reformulation standards, defined using the Nestlé Nutritional Profiling System (NNPS), were applied to the French food composition database (CIQUAL-2013), classifying foods into "PASS" or "FAIL". Baseline nutritional intakes were estimated for 1838 adults of the INCA2 French national survey according to three scenarios based on: (1) the original food composition database (CURRENT), (2) a "reformulated" database in which the nutrient composition of FAIL products was adjusted to the NNPS standards (REFORMULATION), and (3) a "substituted" database in FAIL products were replaced by the most nutritionally similar PASS products from the same NNPS-category (SUBSTITUTION). For each scenario, starting from each baseline diet, a new optimized diet was modeled to fulfill a complete set of nutrient recommendations while remaining closest to the respective baseline diet. To quantify the dietary changes needed to reach nutritional adequacy in the optimized diets, the total dietary deviation (TDD) was calculated as the sum in quantities (grams) of the absolute difference between observed and optimized amount of repertoire foods (i.e., foods already consumed) plus the amount of non-repertoire foods (i.e., new foods added). TDD was significantly lower in the REFORMULATION and the SUBSTITUTION scenarios compared to CURRENT (1269g/day, 1191g/day and 1494g/day, respectively). This was explained by smaller shifts among repertoire foods and less additions of non-repertoire foods. Nutritional reformulation of the food supply may reduce the dietary changes required to achieve nutritionally adequate diets, but would not suffice to reach the complete set of nutrient recommendations.

Reference range of random urinary calcium creatinine ratio in North Indian children and adolescents.

PurposeUrinary calcium creatinine ratio (UCaCrR) is a reliable indicator for monitoring hypercalciuria following vitamin D supplementation. However, the reference range varies from region to region. Previous studies did not take vitamin D and parathyroid hormone status into account while evaluating UCaCrR. Hence, we undertook this study to establish the 95th percentile of UCaCrR as an indicator of hypercalciuria in North Indian children and adolescents.MethodsFour hundred seventy-three participants (boys 62.2%, girls 37.8%) with adequate dietary calcium intake, normal serum levels of 25-hydroxy-vitamin D (>20 ng/mL), and without secondary hyperparathyroidism following supplementation were selected for evaluation of UCaCrR.ResultsThe mean age and body mass index of subjects were 11.2±2.6 years and 18.0±3.6 kg/m2, respectively. The 95th percentile of UCaCrR in the study population was 0.126. The mean, median, and 95th percentile of UCaCrR was significantly higher in prepubertal children (age ≤10 years) (0.0586±0.0374, median=0.0548, 95th percentile=0.136) compared to those >10 years old (0.0503±0.0363, median=0.0407, 95th percentile=0.123, P=0.02). No significant difference in UCaCrR was observed between genders and different weight categories.ConclusionsUCaCrR of 0.13 defines the cutoff value for hypercalciuria in North Indian children and adolescents with adequate dietary intake of calcium and sufficient serum vitamin D levels.

Health practitioner practices and their influence on nutritional intake of hospitalised patients

ObjectivesIn the hospital setting, poor dietary intake interacts with disease and represents a major and modifiable cause of malnutrition. Understanding barriers to adequate dietary intake is an important strategy to guide the development of interventions to improve nutrition intake. The aim of this study reported in this paper was to explore patient, family and health care professionals' perceptions of barriers to and enablers of adequate nutrition care and dietary intake of medical inpatients. MethodsAn exploratory qualitative study design incorporating group and individual interviews of patients (n = 14), their family members (n = 4), and health care professionals (n = 18) was undertaken. Participants were recruited pragmatically, using a mix of convenience and purposive sampling. A theoretically informed, semi-structured interview schedule was based on observations of practice and the Theoretical Domains Framework. Interviews were audio-recorded, transcribed verbatim and analysed inductively using a general inductive approach. ResultsThree key themes emerged from analysing participant interviews. Siloed approaches to nutrition care reflected the diverse range of health care professionals responsible for nutrition care but who often worked in isolation from their colleagues. Competing work priorities for nurses reflected the challenge in prioritise nutrition care which was often constrained because of other care needs or work-related pressures. Helping patients to eat highlighted that nurses were often the only health care professional who would provide assistance to patients at mealtimes and lack of available staff could negatively influence patients' nutrition intakes. ConclusionsWe have identified many complex and interrelated barriers which preclude adequate dietary intake in acute medical patients. These predominantly reflect issues inherent in the hospital culture and environment. Multi-faceted and sustainable interventions that support a facilitating nutrition culture and multidisciplinary collaboration, inclusive of patients and families, are needed to address these underlying barriers.

Frequency of Tongue Cleaning Impacts the Human Tongue Microbiome Composition and Enterosalivary Circulation of Nitrate.

The oral microbiome has the potential to provide an important symbiotic function in human blood pressure physiology by contributing to the generation of nitric oxide (NO), an essential cardiovascular signaling molecule. NO is produced by the human body via conversion of arginine to NO by endogenous nitric oxide synthase (eNOS) but eNOS activity varies by subject. Oral microbial communities are proposed to supplement host NO production by reducing dietary nitrate to nitrite via bacterial nitrate reductases. Unreduced dietary nitrate is delivered to the oral cavity in saliva, a physiological process termed the enterosalivary circulation of nitrate. Previous studies demonstrated that disruption of enterosalivary circulation via use of oral antiseptics resulted in increases in systolic blood pressure. These previous studies did not include detailed information on the oral health of enrolled subjects. Using 16S rRNA gene sequencing and analysis, we determined whether introduction of chlorhexidine antiseptic mouthwash for 1 week was associated with changes in tongue bacterial communities and resting systolic blood pressure in healthy normotensive individuals with documented oral hygiene behaviors and free of oral disease. Tongue cleaning frequency was a predictor of chlorhexidine-induced changes in systolic blood pressure and tongue microbiome composition. Twice-daily chlorhexidine usage was associated with a significant increase in systolic blood pressure after 1 week of use and recovery from use resulted in an enrichment in nitrate-reducing bacteria on the tongue. Individuals with relatively high levels of bacterial nitrite reductases had lower resting systolic blood pressure. These results further support the concept of a symbiotic oral microbiome contributing to human health via the enterosalivary nitrate-nitrite-NO pathway. These data suggest that management of the tongue microbiome by regular cleaning together with adequate dietary intake of nitrate provide an opportunity for the improvement of resting systolic blood pressure.

Nutritional Knowledge and Dietary Practice in Elite 24-Hour Ultramarathon Runners: A Brief Report.

Several factors contribute to athletes’ sporting performance and diet is a key component. Higher levels of nutritional knowledge seem to correlate with a higher quality of diet, but this remains poorly explored and findings are still not conclusive. The aim of our study was to assess nutritional knowledge and dietary adequacy, detecting any potential association between these two factors in elite 24-hour ultramarathon runners, a sport which seems to have been increasing in popularity over the last decade. Nutritional knowledge and Mediterranean dietary adequacy scores were assessed by means of validated questionnaires given to 10 elite ultramarathon runners (six males and four females) from the Italian Ultramarathon and Trail Association (IUTA). The overall nutritional knowledge in the entire sample of athletes seemed to be good, especially in terms of “dietary recommendations” and “nutrient sources” knowledge. However, females had higher total nutritional knowledge scores when compared to males. Finally, linear regression analysis showed that greater nutritional knowledge was positively associated with an increase in Mediterranean dietary adequacy scores (β = 1.27; 95% CI = 0.039–2.494; p = 0.045) after adjusting for level of education. Our findings provide evidence that higher nutritional knowledge is associated with better dietary practice in elite 24-hour ultramarathon runners. Future studies are needed to assess the usefulness of educational programs as a strategy to improve the adequacy of dietary intake in this specific population.

Excess nutritional risk in infants and toddlers in a Spanish city.

Adequate dietary intake is vital for infants' growth and development. The aim was to analyse food consumption and energy and nutrient intakes in a group of healthy Spanish infants and toddlers. Cross-sectional study. 154 infants were assessed at 6 months, and followed at 12 and 30 months. Clinical history, anthropometry, type of feeding, food consumption and energy and nutrient intakes (24-hours recall) were estimated. Advice about food consumed, estimated average requirements, the prevalence of inadequate intakes and percentage of adequacy of the recommended dietary allowance were applied. Toddlers had an excessive daily consumption of meat (>51.3g/day), milk (>545g/day), fish (>20.8g/day) and free-sugar foods (>30.5g/day). This consumption was related to a very high intake of proteins (>18%) and free sugars (>10%), at 12 and 30 months, as a percentage of daily energy intake. The mean prevalence of inadequacy intakes was above 48% for iron at 6 months, and 68% and 87% for vitamin D at 12 and 30 months, respectively. At 6 months, infants who were breastfed had greater adequacy in energy and nutrients to recommended dietary, while infants fed infant formula had a higher intake (>120% compared with RDA) in vitamins E, C, B1, B2, pantothenic acid, B6, B12 and folic acid. The contribution of micronutrients in infant formula should be reviewed, appropriate protein and free sugars should be provided during complementary feeding, as well as strategies to avoid vitamin D deficiency since childhood; and continue with the promotion of breastfeeding.