Dietary Intake Of Micronutrients Research Articles

Ultra-processed foods consumption reduces dietary diversity and micronutrient intake in the Mexican population.

Currently, 30% of the total energy intake in the Mexican diet comes from ultra-processed foods. Although its consumption is associated with high intakes of added sugar and saturated fats and low intakes of dietary fibre, there is no evidence regarding its association with dietary diversity and micronutrient intake. The present study evaluated the association between ultra-processed foods consumption with dietary diversity and micronutrient intake in Mexico. Ultra-processed foods items were identified in a 24-h recall from a sample of 10,087 participants aged ≥ 1 year. The minimum dietary diversity (MDD) was established by using the Food and Agriculture Organization 10 food group indicators with unprocessed, minimally processed and processed foods. The study conducted multiple linear regression models to evaluate the association between quintiles of energy contribution of ultra-processed foods with dietary diversity and micronutrient intake. A high consumption of ultra-processed foods was associated with a low dietary diversity and micronutrients intake. The association between ultra-processed foods and MDD was not linear (47.1%, 57.1%, 52.5%, 45.0% and 28.0% of participants achieved the MDD). On the other hand, the association was linear and negatively associated with: niacin, pantothenic acid, pyridoxine, folate, vitamin B12 , vitamin C, vitamin E, zinc, calcium, magnesium, potassium and phosphorus (p < 0.05). These findings are relevant in the context of the double burden of malnutrition currently faced in Mexico. Increasing dietary diversity and micronutrient intake is essential by discouraging ultra-processed foods consumption. However, other strategies are also needed to promote the dietary diversity and increase the consumption of unprocessed and minimally processed foods.

Natural Variation in Vitamin B1 and Vitamin B6 Contents in Rice Germplasm.

Insufficient dietary intake of micronutrients contributes to the onset of deficiencies termed hidden hunger—a global health problem affecting approximately 2 billion people. Vitamin B1 (thiamine) and vitamin B6 (pyridoxine) are essential micronutrients because of their roles as enzymatic cofactors in all organisms. Metabolic engineering attempts to biofortify rice endosperm—a poor source of several micronutrients leading to deficiencies when consumed monotonously—have led to only minimal improvements in vitamin B1 and B6 contents. To determine if rice germplasm could be exploited for biofortification of rice endosperm, we screened 59 genetically diverse accessions under greenhouse conditions for variation in vitamin B1 and vitamin B6 contents across three tissue types (leaves, unpolished and polished grain). Accessions from low, intermediate and high vitamin categories that had similar vitamin levels in two greenhouse experiments were chosen for in-depth vitamer profiling and selected biosynthesis gene expression analyses. Vitamin B1 and B6 contents in polished seeds varied almost 4-fold. Genes encoding select vitamin B1 and B6 biosynthesis de novo enzymes (THIC for vitamin B1, PDX1.3a–c and PDX2 for vitamin B6) were differentially expressed in leaves across accessions contrasting in their respective vitamin contents. These expression levels did not correlate with leaf and unpolished seed vitamin contents, except for THIC expression in leaves that was positively correlated with total vitamin B1 contents in polished seeds. This study expands our knowledge of diversity in micronutrient traits in rice germplasm and provides insights into the expression of genes for vitamin B1 and B6 biosynthesis in rice.

Comparison of Two Pathways Linking Agriculture to Child Health: Dietary Diversity and Micronutrient Intake in the Malagasy Highlands

Comparison of Two Pathways Linking Agriculture to Child Health: Dietary Diversity and Micronutrient Intake in the Malagasy Highlands

Nutrition, Overweight, and Cognition in Euthymic Bipolar Individuals Compared to Healthy Controls.

Bipolar disorder (BD) is associated with impairments in cognitive functions, in which metabolic factors, e.g., overweight, seem to play a significant role. The aim of this study was to investigate the association between nutritional factors and cognitive performance in euthymic individuals with BD. A study cohort of 56 euthymic individuals with BD was compared to a sample of 53 mentally healthy controls. To assess cognitive function, the following tests were applied: California Verbal Learning Test, Trail Making Test A/B, d2 Test of Attention-Revised, and Stroop’s Color-Word Interference Test. Furthermore, a 4-day food record was processed to evaluate dietary intake of macronutrients, specific micronutrients, and food diversity. Body mass index and waist to height ratio were calculated to assess overweight and central obesity. Results showed no nutritional differences between individuals with BD and controls. Individuals with BD performed worse in the d2 test than controls. Hierarchical regression analyses yielded no association between cognitive and nutritional parameters. However, waist to height ratio was negatively correlated with almost all cognitive tests. Central obesity seems to affect cognitive functioning in BD, while the lack of finding differences in nutritional data might be due to problems when collecting data and the small sample size. Consequently, further studies focusing on objectively measuring food intake with adequate sample size are needed.

The consumption of micronutrients in relation to calorie intake and risk of insulin resistance

Background and aimsAdequate dietary intakes of essential micronutrients are critical to prevent insulin resistance (IR)-related diseases. Even though the excess calorie intake linked with obesity is also associated with such diseases, no previous studies evaluated the importance of meeting the Dietary Reference Intake (DRI) of micronutrients in relation to calorie intake in those at risk for developing IR. Methods and resultsWe evaluated the relationship between the ability or failure to meet the DRI of micronutrients in relation to daily calorie intake in 463 childbearing-age women with a higher prevalence of IR. 56–65% women met the DRIs for vitamin B12, vitamin C, thiamine, and riboflavin while only 0%–49% met the DRIs for folate, pyridoxine, niacin, pantothenic acid, total carotene, vitamins A, D and E by consuming an acceptable number of calories. Women who met the DRIs of folate and vitamin C within acceptable daily calorie intakes were 59% and 66% less likely to have higher Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) compared to women who did not. ConclusionsUnderstanding the mechanisms that explain our findings will be of value to address IR-associated with exposure to high calorie/low-micronutrient dense diets consumed by childbearing-age women. Since there is a global recognition that IR has been increasing in adults and children, similar studies of this nature in pregnant women at risk for IR will provide much needed data to assess the burden of such adverse dietary habits in the offspring. Our study approach may form the foundation for such studies.

Differentials in dietary intake of macro and micronutrients in patients with type 2 diabetes and foot ulcers: Observations from a pilot study.

The dietary profiles of patients with type 2 diabetes mellitus (T2DM) from Southern India have been infrequently studied. We aimed to study the differences in dietary intake of macro and micronutrients in elderly patients of Type 2 diabetes mellitus (T2DM), with and without foot ulcers. Elderly patients with T2DM and foot ulcers (n=79; mean age: 60.6 years) and those without foot ulcers (n=59; mean age: 55.0 years) were studied. Biochemical evaluation for measures of glycemia, lipids and albumin were done and staging of foot ulcers was done using Wagner's scale. A 24-hour dietary recall was administered to quantify the mean daily intake (MDI) of macro, micronutrients and trace elements from portion sizes of food items consumed and compared to the recommended dietary allowance (RDA) for Indians aged 55 years and above. In patients with T2DM and foot ulcers, the MDI of carbohydrates, fats and phosphorus were significantly higher whereas the MDI of proteins and micronutrients namely zinc, folic acid, iron and carotene were lower than the RDA. Elderly patients with nephropathy and longer duration of T2DM have higher odds of developing foot ulcers, when compared to patients without foot ulcers. Elderly patients with T2DM and foot ulcers were deficient in dietary intake of proteins and micronutrients inclusive of carotene, folic acid, zinc, and Iron. Clinical care, regular monitoring of dietary intake and appropriate correction of nutritional deficiencies will aid in the management of diabetic foot ulcers.

One-Carbon Metabolism: Pulling the Strings behind Aging and Neurodegeneration.

One-carbon metabolism (OCM) is a network of biochemical reactions delivering one-carbon units to various biosynthetic pathways. The folate cycle and methionine cycle are the two key modules of this network that regulate purine and thymidine synthesis, amino acid homeostasis, and epigenetic mechanisms. Intersection with the transsulfuration pathway supports glutathione production and regulation of the cellular redox state. Dietary intake of micronutrients, such as folates and amino acids, directly contributes to OCM, thereby adapting the cellular metabolic state to environmental inputs. The contribution of OCM to cellular proliferation during development and in adult proliferative tissues is well established. Nevertheless, accumulating evidence reveals the pivotal role of OCM in cellular homeostasis of non-proliferative tissues and in coordination of signaling cascades that regulate energy homeostasis and longevity. In this review, we summarize the current knowledge on OCM and related pathways and discuss how this metabolic network may impact longevity and neurodegeneration across species.

Validation of a Short Food Frequency Questionnaire to Measure Dietary Intake of a Selection of Micronutrients in Oncology Patients Undergoing Systemic Therapy.

Dietary intake, specifically consumption of anti-inflammatory micronutrients, can play a role in both cancer initiation as well as the treatment-related outcomes experienced by patients receiving systemic cancer therapy. Increasing research is being conducted to determine whether micronutrient supplementation can aid in altering the tumor microenvironment (TME), reducing inflammatory side effects and immune-related adverse events (irAEs). However, further research pertaining to the adequacy of dietary micronutrient intake is indicated in the oncology cohort. Currently, no tool measuring dietary intakes of various micronutrients exists in the oncology population. In this study, a 21-item food frequency questionnaire (FFQ) measuring intakes of 14 different micronutrients was validated using diet history as the reference method in 112 oncology patients. Bland Altman plot and Passing Bablok regression analysis were conducted to determine agreement between the two methods. The results showed adequate agreement between FFQ and diet history for 12 nutrients including copper, iron, vitamins A, E, and D, alpha linolenic acid (ALA), long-chain omega 3 fatty acids (LC n3-FA), arginine, glutamic acid, isoleucine, leucine, and valine. This 21-item FFQ, which takes an average of 10 min to complete, can be utilized as a quick screening tool to determine adequacy for 12 different micronutrients in place of a diet history.

P-OGC01 Prevalence and treatment of nutritional deficiencies following Upper Gastrointestinal Surgery for Oesophageal or Gastric Cancer

Abstract Background Patients undergoing Upper Gastrointestinal (UGI) surgery for cancer are left nutritionally vulnerable due to alterations in digestion and absorption this is becoming increasingly evident as more patients are achieving five year survival. Patients are more likely to endure nutritional deficiencies in particular B12, Iron, Vitamin D, Calcium, Zinc and folic acid. Reduced absorption and inadequate dietary intake of calories, protein and micronutrients are the main contributing factors post operatively and longer term. At 2 years post UGI resection the following nutritional deficiencies have been observed: 48% Iron, 42% B12, 40% Folic Acid, 34% Calcium, 33% Zinc, 24% Vitamin D. Methods Data was collected retrospectively from various systems on our Trusts Network. The trusts reporting system was utilised for blood results. Digital systems were used to confirm if any action had been taken and if this was appropriate. Additional digital systems were used to obtain clinic lists for the last 6 months. The Data was collected and entered into an Excel spread sheet for comparison. Chi squared testing was utilised to compare deficiency rate between different Upper GI surgeries. Results Chi squared statistical analysis of the nutritional deficiencies in the three main Cancer surgery types (Ivor Lewis / Total OG / Sub-total OG) found there was no statistical difference in prevalence of nutritional deficiency. Comparison of deficiencies indicated that the main prevalence was or Zinc and Vitamin D pre and post operatively. Conclusions Nutritional deficiencies should be corrected pre operatively. Monitoring thereafter of nutritional vitamin and mineral status should be individually tailored to suit the patient. All UGI patients should be commenced on a nutritionally complete vitamin and mineral supplement at the point of initial assessment in the UGI surgical clinic pre operatively. The recommendation would be to commence Forceval vitamin and mineral supplement as this offers optimal trace element coverage. Vitamin D deficiency pre operatively should have supplementation to maintain 25(OH)D levels greater than 50nmol/L and rechecked after 3 months. Zinc replacement should be monitored routinely.

Effects of a Culinary Boot Camp intervention on food/nutrition aptitudes and dietary intake of college students

Objective: College is characterized by transition, students shifting from dependence to independence in numerous roles/responsibilities. Deficiencies in food/nutrition aptitudes and dietary intake exist, evidenced by declining physical well-being and poor eating patterns/practices within the population. Studies examining interventions to improve food/nutrition aptitudes and dietary intake among college students are limited. Participants/methods: A nutrition education program, Culinary Boot Camp (CBC), was developed and delivered to college students at a land-grant university. Online surveys assessed food/nutrition aptitudes and dietary intake pre-/post-/follow-up intervention. Results: Of 86 CBC participants, 71 pre-, 46 post-, and 20 follow-up surveys were completed. Several food/nutrition aptitudes improved (p ≤ 0.05), with greatest improvements in cooking skills/attitudes and healthy eating/grocery shopping self-efficacy (p < 0.01). Additionally, dietary intake of various micronutrients (vitamin C, magnesium, potassium) and fiber increased with statistical significance (p < 0.01). Conclusions: Results suggest CBC is an effective nutrition education program to improve food/nutrition aptitudes and dietary intake amomg college students.

Clinical audit on micronutrient supplementasion for Covid 19 patients, a single center study

Rationale: High dose supra-physiological micronutrients supplementation was recommended by Covid 19 management guidelines previously. However, current ESPEN guideline on nutritional management of Covid 19 patients (1) has suggested to provide only recommended dietary intake of micronutrients for Covid 19 patients without micronutrients deficiencies, since high dose micronutrients supplementation did not improve outcome.

Dietary Diversity and Nutrient Intake of Han and Dongxiang Smallholder Farmers in Poverty Areas of Northwest China.

This study aimed to evaluate the status of dietary diversity and nutrient intake among Han and Dongxiang smallholder farmers in poor rural areas of northwest China. In this cross-sectional study, dietary intake was assessed in 499 smallholder farmers aged 18–75 years from two nationally designated impoverished counties in Gansu Province, China, using three consecutive 24 h dietary recalls. The dietary diversity score (DDS) and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. The mean DDS (range from 1 to 9) in participants was relatively low (3.81 ± 1.01). Consumption of grains was excessive, while consumption of vegetables, fruits, meat, beans, eggs, fish, and dairy was inadequate. The NAR values were higher in Han Chinese, with the exceptions of vitamin C, potassium, pyridoxine, and selenium (p < 0.05). For each nutrient, the high DDS group had a higher mean NAR (p < 0.05), except for pyridoxine. High household monthly income, being Han Chinese, high DDS, and being aged over 45 years were positively associated with mean adequacy ratio (MAR) of 14 micronutrients evaluated. Lack of dietary diversity and insufficient intake of essential micronutrients are public health concerns in northwest China. Nutrition education and other proper methods to address these issues are needed.

Dietary Factors and Breast Cancer Prognosis among Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies.

Simple SummaryWhile most systematic reviews have focused on the association between dietary factors and breast cancer incidence, this current study focuses on the association between comprehensive dietary factors and breast cancer prognosis among breast cancer survivors by systematic review and meta-analysis. We reviewed a total of 63 cohort studies to assess the association between dietary factors and breast cancer prognosis by subgroup analysis with prediagnostic or postdiagnostic dietary intake, menopausal status, and dietary or supplementary micronutrient intake. We found that unhealthy dietary patterns, including the intake of beer and saturated fat, exacerbated the risk of breast cancer prognosis; however, the supplementation of most vitamins was desirable for breast cancer prognosis. Therefore, this study’s systematic review and meta-analysis provide useful dietary information for the development of dietary guidelines/recommendations to improve prognosis among breast cancer survivors.Few studies have summarized the association between dietary factors and breast cancer (BC) prognosis among breast cancer survivors (BCS). Therefore, we carried out a systematic review and meta-analysis to determine the associations between dietary factors and BC prognosis among BCS. We performed a literature search in PubMed and Embase to investigate the association between dietary factors and BC prognosis. We applied a random-effects model to compute the hazard ratio/relative risk and their 95% confidence intervals and heterogeneity (Higgins I2) and to generate forest plots using STATA. Among the 2279 papers identified, 63 cohort studies were included in the systematic review and meta-analysis. Our main finding was that higher consumption of beer and saturated fat negatively affected BC prognosis. However, the intake of lignans, fiber, multivitamins, and antioxidants was negatively associated with the risk of mortality. Furthermore, we performed subgroup analyses by menopausal status and dietary or supplementary micronutrient intake. Most trends were similar to the main findings; in particular, the vitamin C, vitamin D, and vitamin E supplements decreased the risk of mortality. This study’s current systematic review and meta-analysis provide comprehensive dietary information for the development of dietary guidelines/recommendations to improve prognosis among BCS.

Intraindividual Double Burden of Malnutrition in Chinese Children and Adolescents Aged 6-17 Years: Evidence from the China Health and Nutrition Survey 2015.

Studies on the intraindividual double burden of malnutrition (DBM) among Chinese children and adolescents were lacking. This study aimed to analyze the prevalence of intraindividual DBM defined as the coexistence of overweight/obesity and dietary micronutrient intake insufficiency and investigate dietary micronutrient intake in Chinese children and adolescents. Using data from the 2015 China Health and Nutrition Survey (CHNS), 1555 children and adolescents aged 6 to 17 years were selected as the subjects. We referred to China Food Composition to calculate the intakes of 11 selected dietary micronutrients from diet data collected by consecutive three days of 24 h recalls combined with household weighing of seasonings. We used the Chinese estimated average requirement (EARs) as a cutoff to define the dietary micronutrients deficiency, and applied the body-mass-index-for-age Z-scores (BAZ) of World Health Organization (WHO) child growth standards to define the category of body weight. Among the subjects in present study, the prevalence of overweight and obesity was 15.43% and 11.06%, respectively, and 26.24% of the subjects had undergone intraindividual DBM. The results suggest that the prevalence of intraindividual DBM and dietary micronutrients deficiency in Chinese children and adolescents is high.

Micronutrient intake is associated with reductions in chemical exposure effects on blood pressure of electronic waste recyclers at Agbogbloshie, Ghana

BACKGROUND AND AIM: Increasing evidence suggests that chemical exposures may influence micronutrient status and further induce certain disease outcomes like hypertension- even at lower levels of exposure. This study, therefore, investigated whether micronutrient-rich diet intake may reduce the adverse effects of heavy metals and rare earth elements released during informal recycling of e-waste on blood pressure (BP) of e-waste recyclers in Ghana. METHODS: Blood and urine samples were collected from 100 e-waste recyclers and 51 controls in March 2017 and analyzed for chemicals (cadmium, lead (Pb), arsenic (As), Terbium, Thallium (Tl), and Cerium) and micronutrients (calcium, magnesium, iron, selenium, zinc, and copper) using the ICP-MS. Dietary micronutrient intake was assessed using a 2-day-24-hour-dietary-recall. Cardiovascular indices (systolic BP (SBP), diastolic BP (DBP), and arterial pressure (AP)) were measured using a sphygmomanometer. Joint associations between chemicals, micronutrients and BP indices were modelled using simple linear regressions. RESULTS:Urinary As and Pb as well as blood levels of TI were significantly associated with increases in SBP, AP and pulse pressure in both groups and still similar when analyses were limited to only recyclers. Nonetheless, dietary intake of calcium and iron-rich diets were associated with significant reductions in SBP, DBP and AP in both groups. Further in the joint model, consumption of Fe-rich diets were associated with significant reductions in SBP (β= -0.070; 95% CI: -0.131, -0.009; p = 0.026), DBP (β= -0.085; 95% CI: -0.167, -0.004; p = 0.040), and AP (β= -0.080; 95% CI: -0.143, -0.016; p = 0.014), despite the particularly high exposure of e-waste recyclers to Pb. CONCLUSIONS:Although the body burden of Pb, As and Tl seem to be associated with and serve as predictors of hypertension, the consumption of Fe-rich foods were associated with significant reductions in SBP, DBP and AP of e-waste recyclers even at high exposures of these chemicals. KEYWORDS: Chemical exposures, cardiovascular diseases, food/ nutrition

Dietary methyl donor micronutrients intake in relation to psychological disorders in adults.

Previous investigations have mostly studied an individual methyl donor nutrient in relation to psychological disorders and the findings were inconsistent. We investigated the association of methyl donor micronutrients (folate, B6, B12, choline, betaine and methionine) with psychological disorders in Iranian adults. In this cross-sectional study, dietary intakes of 3299 adults were collected using a validated food frequency questionnaire. Methyl donor micronutrient score (MDMS) was calculated based on energy-adjusted deciles of each nutrient. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), validated for Iranians, have been applied to assess depression, anxiety and psychological distress. Participants had a mean age of 36·3 ± 7·9 years, of whom 58·5 % were women. After considering potential confounders, adults in the top quartile of MDMS, compared to the bottom one, had decreased odds of anxiety (OR: 0·53, 95 % CI: 0·37, 0·75), depression (OR: 0·75, 95 % CI: 0·58, 0·97) and psychological distress (OR: 0·61, 95 % CI: 0·46, 0·80). Among women, the top quartile of MDMS was protectively associated with anxiety (OR: 0·60, 95 % CI: 0·40, 0·90), depression (OR: 0·68, 95 % CI: 0·50, 0·93) and psychological distress (OR: 0·53, 95 % CI: 0·38, 0·74). Overweight and obese subjects in the highest quartile of MDMS had a 67 %, 35 % and 53 % lower odds of anxiety (95 % CI: 0·20, 0·56), depression (95 % CI: 0·44, 0·94) and psychological distress (95 % CI: 0·31, 0·70), respectively. We found that high consumption of methyl donor micronutrients was related to a reduced odds of psychological disorders, especially in women and overweight or obese individuals.

Dietary Macronutrient and Micronutrient Intake over a 7-Day Period in Female Varsity Ice Hockey Players.

This study examined the energy, macronutrient, and micronutrient intakes of female ice hockey players over a 7-d period including game, practice, and rest days. Twenty-three female varsity players (19.0 ± 1.1 yr, 167.1 ± 6.5 cm, 67.0 ± 8.0 kg) volunteered for the study. Average total daily energy expenditure (TDEE) was estimated over the 7-day period. Average 7-day energy intake (EI) and TDEE were 2354 ± 353 and 2304 ± 204 kcal. The majority (n = 19) of athletes had an EI ≥ 90% of their estimated TDEE. Macronutrient intake was 52% carbohydrate (CHO), 32% fat, and 16% protein of total EI, although CHO intake was slightly below recommendations (5 g/kg BM/d) on game and practice (4.8 ± 1.4 and 4.5 g/kg BM/d) days. Game day EI was greater than practice and rest days. Recommended micronutrient intakes were not met by most athletes for iron, calcium, vitamin D, and potassium, and intakes were similar between game, practice, and rest days. In summary, the average EI for female varsity ice hockey players appeared adequate to meet their energy needs over a weekly cycle of game, practice, and rest days. However, these female athletes would benefit from increasing CHO intake on game and practice days and selecting foods that are rich in vitamins and minerals.

Dietary Antioxidant Micronutrient Intake and Toxicity during Remission Induction in Children with Acute Lymphoblastic Leukemia (ALL): Results from Dana-Farber Cancer Institute (DFCI) ALL Consortium Trial 05-001

Introduction: Treatment related toxicities are a major contributor to morbidity during induction therapy in childhood ALL. Our prior study in 103 children with ALL suggested that low intakes of antioxidant micronutrients were associated with toxicity and delays in chemotherapy administration (Am J Clin Nutr 79:1029, 2004). The objective of this study was to examine whether inadequate antioxidant micronutrient dietary intake in children with ALL is associated with episodes of infection or ≥grade 3 mucositis during Remission Induction.Methods: Assessment of dietary intake was collected in patients (pts) ages 1-17.9 years enrolled on the DFCI ALL Consortium Protocol 05-001 from 2005-2011. Institutional review board approval was obtained by each of the 9 participating centers. Grade 3 or higher (NCI CTCAEvs) mucositis, culture positive bacteremia and fungemia, and radiographic invasive fungal disease were prospectively collected. Dietary intake was assessed with the Harvard Service Food Frequency Questionnaire (FFQ) for children ages 1-5 years and the Youth and Adolescent Harvard FFQ for children ages 5-18 years and queried about intake in the past 30 days at the end of induction. Dietary antioxidant intake from food sources ± supplementation was examined by comparing consumption above and below recommended intake for age and sex as per the Dietary Reference Intake (DRI). Micronutrient intake was summarized with descriptive statistics and plotted by the presence/absence of a given toxicity in induction. Categorical and continuous variables were compared between group with the Fisher's exact test and the Wilcoxon rank sum test respectively. Logistic regression was used to model the probability of a given toxicity univariately and with a multivariable adjustment for sex and age.Results: Among 794 eligible pts, 561 (71%) had analyzable FFQs. The sample with dietary surveys responses was marginally younger (p=0.06) and more often classified as initial standard risk (p=0.01) than those with no end of induction survey. DRI recommendations were not met for vitamin C (18%), vitamin E (67%) and zinc (12%); 39% of pts reported zinc overconsumption. 141 (25%) of pts with dietary data had ≥1 bacterial and/or fungal infection, 131 (23%) had ≥1 bacterial infection, and 19 (3%) had ≥1 fungal infection. 24 (4%) pts experienced at least 1 event of ≥grade 3 mucositis. Female sex was associated with overall and bacterial infection (p=0.02) and marginally with mucositis (p=0.06). The proportion of patients with ≥Grade 3 mucositis was marginally higher (p=0.06) for those not meeting the vitamin C recommendation (OR=2.3; 95% CI 1.0-5.5), but was not significant (p=0.10) in a multivariable model. Supplementation was reported by 88 (16%) for zinc, vitamins C, E, and A in combination, 16 (3%) for β-carotene and total carotene, and 87 (15%) for vitamin E alone. Intake levels of vitamins C, E, and A, zinc and total carotenoids from food sources and total (food + supplementation) were compared for pts with and without infection and mucositis (unadjusted for age/sex) (Figure 1). Bacterial infection was associated with low intake from food only of zinc (p=0.02), vitamin A (p=0.01), and vitamin E (p=0.049). Mucositis was associated with the following: low intakes of vitamin C from food (p=0.04), vitamin E from food (p=0.03), total lycopene (p=0.03), total α-carotene (p=0.01), total β-carotene (p=0.007) and from food (p=0.008), total carotene (p=0.005) and carotene from food (p=0.006), and total vitamin A (p=0.01) and vitamin A from food (p=0.004). Females age <10 had higher rates of bacterial infection with low β-carotene (p=0.05) and vitamin A from food (p=0.004). In males age ≥10, low vitamin E from food was observed in those with bacterial infections (p=0.05). Supplementation did not confer an added benefit for most nutrients.Conclusions: Confirming our pilot study, data from a large prospective cohort show that low dietary intakes of antioxidant vitamins, carotenoids and zinc primarily from food sources predict risk for bacterial infection or mucositis during induction therapy for childhood ALL. Dietary supplementation for most vitamins and minerals did not confer an added benefit for prevention of infection or mucositis over levels obtained from food. Our results suggest a possible modifiable dietary intervention to reduce toxicity during induction therapy for ALL. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Inadequate Maternal Dietary Micronutrient Intake and Differences by Nutritional Status: Findings From Pregnant Women in the COVID-19 Era

ObjectivesCOVID-19 pandemic increases the risk of an inadequate micronutrient intake and therefore, the risk of double burden of malnutrition in countries with high obesity prevalence. An adequate nutritional status, including micronutrient status is critical for pregnancy and offspring development; however, there is a lack of evidence regarding maternal dietary micronutrient intake and its relationship with BMI in the COVID-19 era. Henceforth, we sought to assess the adequacy of maternal dietary micronutrient intake and its relationship with BMI in pregnant women exposed to the COVID-19 pandemic.MethodsThis prospective cohort study included 810 Chilean pregnant women (>18 years) enrolled between March and October 2020 in Santiago, Chile. Maternal lifestyle, anthropometric and dietary intake (24-hr recall, n = 389) information was collected in the first trimester by telephonic interviews and from clinical records.Folate, calcium, iron, vitamins B-6, B-12 and D intake was estimated using the USDA nutrient database. Pre-pregnancy BMI was categorized according to the WHO criteria.ResultsOverall, 70% of women were classified as overweight or obese. Median (IQR) daily intake was 1.3 (0.8–1.8) mg for B-6, 2.5 (1.3–4.4) µg for B-12, 284 (187–408) µg for folate, 26 (7.2–86) IU for vitamin D, 639 (391–951) mg for calcium and 9.9 (6.9–13.7) mg for iron. Of all, <10% met the daily intake recommendation (RDA) for folate, vitamin D, iron, and calcium, while <25% and 50% met the recommendation for B-6 and B-12, respectively. B-6 intake was inversely correlated with BMI (ρ = −0.15, P < 0.05; Spearman correlation test). Furthermore, B-6, B-12, folate, iron, and calcium intake significantly differed by pre-pregnancy BMI categories (P < 0.05; KruskalWallis test), with obese and overweight women having a lower intake compared to normal or underweight women.ConclusionsIn this subgroup of Chilean pregnant women exposed to the COVID-19 pandemic, the inadequacy of micronutrient intake was highly prevalent, especially in women with excess weight; these results need to be confirmed with the complete sample and by including more detailed analyses of both diet and potential confounders but suggest a very concerning nutrition scenario emerging from the pandemic.Funding SourcesChilean National Agency for Investigation

The nutritional quality of cereals varies geospatially in Ethiopia and Malawi

Micronutrient deficiencies (MNDs) remain widespread among people in sub-Saharan Africa1–5, where access to sufficient food from plant and animal sources that is rich in micronutrients (vitamins and minerals) is limited due to socioeconomic and geographical reasons4–6. Here we report the micronutrient composition (calcium, iron, selenium and zinc) of staple cereal grains for most of the cereal production areas in Ethiopia and Malawi. We show that there is geospatial variation in the composition of micronutrients that is nutritionally important at subnational scales. Soil and environmental covariates of grain micronutrient concentrations included soil pH, soil organic matter, temperature, rainfall and topography, which were specific to micronutrient and crop type. For rural households consuming locally sourced food—including many smallholder farming communities—the location of residence can be the largest influencing factor in determining the dietary intake of micronutrients from cereals. Positive relationships between the concentration of selenium in grain and biomarkers of selenium dietary status occur in both countries. Surveillance of MNDs on the basis of biomarkers of status and dietary intakes from national- and regional-scale food-composition data1–7 could be improved using subnational data on the composition of grain micronutrients. Beyond dietary diversification, interventions to alleviate MNDs, such as food fortification8,9 and biofortification to increase the micronutrient concentrations in crops10,11, should account for geographical effects that can be larger in magnitude than intervention outcomes.