Dietary Nutrition Research Articles

Mercapto–palygorskite decreases the Cd uptake of wheat by changing Fe and Mn fraction in Cd contaminated alkaline soil

Wheat is one of the major sources of dietary nutrition for human body, and excessive Cadmium (Cd) in wheat poses a serious risk to human health. Mercapto–palygorskite (MP) has been proven to efficiently reduce Cd stress in wheat, but the contribution of major soil oxides to the stability of soil Cd under MP treatment is unclear. Here, a wheat pot experiment was conducted to evaluate the effects of soil Fe and Mn oxides on the Cd fraction under MP treatment. The results showed that the application of MP decreased the diethylenetriaminepentaacetic acid (DTPA)–extractable Cd by 24.0–34.7 %, increased the Fe and Mn oxide-bound Cd (OX–Cd) by 5.0–12.0 % and significantly reduced the Cd content in wheat grains (17.9–69.5 %). It also decreased the soil’s free Fe and Mn oxides by 6.1–11.7 %and 6.9–12.4 %, respectively, and increased the amorphous Fe and Mn oxides by 19.3–32.5 % and 21.9–24.1 %, respectively. In addition, the application of MP increased the concentration of Fe and Cd in soil colloid by 19.3–33.3 % and 11.3–45.3 %, respectively. Correlation analysis indicated that the amorphous Fe, Mn oxides in soil had a significant positive correlation with the content of Fe and Mn bound Cd in soil (P < 0.01). Primary component analysis (PCA) analysis shows colloidal Fe and Mn on the soil available Cd had relatively high positively loadings. Meanwhile, soil colloidal Fe exhibited a significant positive correlation with colloidal Cd (P < 0.01) and amorphous Fe oxides (P < 0.01). These results indicated that MP remediated Cd-contaminated soil by promoting an increase in amorphous Fe, Mn oxides and their adsorption and precipitation of Cd on these oxides.

Does the Nutritional Intake and Diet Quality of Children With Chronic Kidney Disease Differ From Healthy Controls? A Comprehensive Evaluation

Children with chronic kidney disease (CKD) experience many obstacles to achieving optimal dietary intake. Dietary intake patterns remain unexplored or poorly described. This study compares nutritional intake and diet quality of Australian children with CKD to controls. A food frequency questionnaire captured intake data and was compared to controls. Nutritional intake was determined using individualized nutrient reference values, and diet quality described using the Australian Guide to Healthy Eating and the Australian Child and Adolescent Recommended Food Score. Children with CKD (n=36) and controls (n=82) were studied. Children with CKD had lower weight and height z scores, but higher body mass index (P<.0001 for all parameters). Children with CKD had adequate energy intake, and excessive protein and sodium intake (336% and 569%). They were significantly less likely to meet requirements for vitamin A (P<.001), thiamine (P=.006), folate (P=.01), vitamin C (P=.008), calcium (P< .0001), iron (P=.01), magnesium (P=.0009), and potassium (P=.002). No child met recommended vegetable intake; however, less than half of children with CKD met fruit (44%), grains (31%), and dairy serves (31%). They were also less likely to meet recommended fruit and dairy serves (P=.04 and P=.01, respectively). Non-core foods provided 36% of energy, and although comparable to controls, was contributed more by takeaway foods (P=.01). Children with CKD have reduced nutritional intake of key nutrients and consume more takeaways than controls. Attention to increasing core foods, limiting sodium intake, and managing restrictions while promoting nutrient density appears necessary.

Nutrient Profiling, ICP-OES Mineral Analysis and UPLC Estimation of Amino Acids in Three Selected Ethnomedicinal Plants of North East India

Background: Ethnomedicinal plants are rich traditional resources of Northeast India. Most of these plants are edible and are used as food by the tribal population of Northeast India. Quantitative nutritional analyses of three ethnomedicinal wild edible plant from Northeast India namely: Zanthoxylum oxyphyllum Edgew, Rotheca serrata (L.) Steane and Mabb. and Blumea lanceolaria (Roxb.) Druce were carried out to identify the occurrence and abundance of nutrients, minerals and amino acids. Methods: Proximate nutrients were estimated by standard AOAC methods. ICP-OES mineral analyzer was used to screen and quantify individual mineral elements. By performing UPLC analysis the presence and abundance of amino acids were investigated. Result: Proximate analysis revealed that the plant species contains adequate amounts of protein, fibre and ash. From nutritional perspectives, low fat and carbohydrate in these species specifies that they are desirable diet for human nutrition. In regard to mineral content, the plant species were rich in macro minerals K, Ca, Na and Mg. Heavy metals were found within the recommended dietary permissible limits for humans. All the essential and non essential amino acids excluding cysteine, methionine and histidine were present in reasonable quantities. The plant species may be exploited to provide quality diets to mitigate nutrient deficiency. Adding together its nutritional and medicinal properties it may potentially be utilized in therapeutics. The further scope of the research involves ascertaining their potentiality in food-based strategies to perk up nutritional health.

Correlation between socio-demographic characteristics, metabolic control factors and personality traits with self-perceived health status in patients with diabetes: A cross-sectional study.

This study aimed to assess the relationship between metabolic control factors, socio-demographic characteristics, personality traits, and self-perceived health status in diabetes. This cross-sectional study included 318 patients with type 1 and 2 diabetes (DM). Participants completed a questionnaire-based survey, which included the NEO Personality Inventory-Revised to measure five personality dimensions and the SF-12 survey to assess self-perceived health status. Binary logistic regression was performed to analyze the data, with socio-demographic characteristics, clinical data, and nutrition status as independent variables, and self-perceived health status (categorized as poor or good condition) as the dependent variable. Unadjusted and adjusted binary logistic regression analyses were used to examine the association between personality traits (high vs. low) and metabolic control factors (good control vs. bad control) with health status scores. 60.7% of the participants with diabetes in the study described their health as "good." The results indicated that female gender (OR: 0.314, 95%CI: 0.105-0.938, P = 0.038), age > 60 years (OR: 0.263, 95%CI: 0.117-0.592, P = 0.001), comorbidities (OR: 0.314, 95%CI: 0.178-0.556, P = 0.001), DM complications (OR: 0.531, 95%CI: 0.337-0.838, P = 0.007), diabetic neuropathy (OR: 0.562, 95%CI: 0.356-0.886, P = 0.013), and diabetic ulcer (OR: 0.130, 95%CI: 0.023-0.747, P = 0.022) were independent variables associated with a "poor" health status. However, regular physical activity (OR: 3.144, 95%CI: 1.209-8.175, P = 0.019) and a healthy nutritional diet (OR: 2.456, 95%CI: 1.421-4.245, P < 0.001) were associated with a higher likelihood of a "good" self-perceived health status. Preventive programs and interventions aimed at improving self-perceived health among patients with diabetes should focus on increasing regular physical activity and promoting a healthy nutritional status. These actions should be particularly targeted towards female and older patients with higher neuroticism traits.

Nutrition Knowledge and Diet in Female College Students in Turkey: Youth Education in Nutrition Initiative/Nutrition Education Works (YENI/NEW)—A Cross-Sectional Pilot Study

Healthy dietary patterns can play a major role in preventing chronic diseases. Improving nutrition-related knowledge in young individuals is considered a promising approach to adopting healthy dietary behaviors, thus improving outcomes later in life. However, healthy eating habits in college students may prove challenging to acquire and maintain. This cross-sectional pilot study aimed to investigate the relationship between nutrition knowledge and its effect on dietary factors, body weight, and body composition in female college students in Turkey. Second- and third-year female college nutrition students (NS), (n = 85) and corresponding non-nutrition/non-health sciences students (NNS) (n = 80), aged 20–22 years old, were evaluated using a validated nutrition knowledge questionnaire, 24 h recalls, anthropometry, and body composition analysis using bioelectrical impedance during the 2015–2016 academic year. The findings revealed that nutrition knowledge was positively associated with increased intake of water, fruits and vegetables, grains, and fiber, whereas total carbohydrate intake exhibited an inverse relationship with nutrition knowledge. Moreover, protein and lipid intake, while not significant, appeared to show higher and lower values, respectively, for the NS participants compared to NNS, revealing a healthier trend for more nutrition-knowledgeable students, which was similar to the finding of a marginally better body composition profile in nutrition-knowledgeable students. As young adulthood is critical for the development of dietary habits, demonstrating the effectiveness of nutrition education is important as a potential tool for public health in terms of improving the risk of chronic diseases.

ÉPOP (traditional starter culture): a complex composition of plant resources prepared by the Misings of Assam, Northeast India

Ethnic practices with relation to starter culture reflect a region-specific traditions; therefore, documentation of such knowledge is key to improvise basic understanding as how traditions, cultures, and processes are linked to local dietary systems, food and nutrition security, and social connection. Considering this, the present study aims to investigate the Mising ethnic tribal group, Assam state in Northeast India, with a focus to investigate mode of starter culture making for preparing local beverage along with plant species being used, time of collection, procedure of making starter culture, and how it is preserved. The community maintains an agrarian culture and is closely associated with forest-based natural resources. This group of people consumes various foods prepared from wild plants and crops along with meat and fish. Apong is one of the most important components of their culture, used as a beverage made up of rice by using starter culture locally known as ÉPOP. Detailed process of making of starter culture was documented. A total of 31 plant species varying from 22 families belonging to both flowering and non-flowering plants were recorded used by the community. Eight species also comprised market potential for diverse uses besides being used in starter culture preparation. The source of the collected resources varied from fallow land to forest, with the highest collection concentration in the forest (35.5%), mostly collected in the afternoon (51.61%) to ensure a quality of the plant material. The collected plant materials are mixed with soaked glutinous rice and made into starter cultures of different sizes that have a shelf life of 6 months. The study highlights that use of starter culture is consistent and harmless with distinct flavor and taste that apt to local appetite. Conserving community knowledge on starter culture making, however, requires appropriate policy planning and action line. The investigation not only increases our understanding on local food tradition but also has potential for applications in fermented food industry and thus opens up a new line of research in future.

Effects of Educational Intervention on Dietary Pattern and Nutrition Intake among Elders in Oyo State, Nigeria

Effects of Educational Intervention on Dietary Pattern and Nutrition Intake among Elders in Oyo State, Nigeria

A Parental perspective on School Children’s Dietary habits, Nutrition and Health outcomes

A Parental perspective on School Children’s Dietary habits, Nutrition and Health outcomes

Nutrition in Alzheimer’s Disease: A Review of an Underappreciated Pathophysiological Mechanism

AbstractBackgroundPharmacy therapy of Alzheimer’s disease (AD) is one of the areas that are well funded, but where little progress has been made due to the complex pathogenesis. The gut‐microbiota‐brain axis has gained tremendous traction in the pathogenesis of AD through bidirectional communication with multiple neural, immune, and metabolic pathways, providing new insights into novel therapeutic strategies. Dietary nutrition is an important and profound environmental factor that influences the composition and function of the microbiota. The Nutrition for Dementia Prevention Working group recently found that dietary nutrition can affect the cognition of AD‐related dementia directly or indirectly through complex interactions of behavioral, genetic, systemic, and brain factors. This review aimed to emphasize the knowledge gaps to provide direction for future research and to establish optimal nutrition‐based intervention strategies for AD.MethodThis review discusses the associated evidence between malnutrition and the onset and development of AD for modifying the potentially reversible nutrition‐related risk factors of AD, describe the potential pathogenesis underlying the role of nutrition in the progression of AD and emphasize the current knowledge gaps for further research.ResultThe role and effects that nutrition and diet have on AD are more pervasive than previously believed. We identified and highlighted a novel vicious cycle comprising malnutrition, development of AD, and heavy caregiver burden (Figure 1). As pharmacological approaches demonstrate limited benefits for improving the symptoms of AD, early nutritional intervention for preventing or delaying the progression of AD are worth attempting. The mechanisms underlying the effect of nutrition on the development of AD remain uncertain, including genetics and epigenetics, AD‐specific biomarkers, metabolic pathways, the gut‐microbiota‐inflammation‐brain axis, and their complex interactions (Figure 2).ConclusionThese potential nutrition‐related pathogenic pathways can be exploited as an important environmental factor and could be the focus of targeted AD interventions. Future research is needed to fill in the discussed gaps in knowledge, including prospective studies to identify nutritional biomarkers that can predict AD, multi‐omics studies to elucidate the exact mechanisms by which nutrition influences AD, and clinical trials to identify the best nutritional intervention strategies to prevent and improve cognitive and behavioral disturbances in the AD population.

Ретроспективный анализ восстановительного лечения в условиях соматического отделения коморбидных пациентов, перенесших COVID-19

Purpose: TTo study the practice and features of rehabilitation treatment in a somatic hospital for comorbid patients who have suffered pneumonia associated with COVID-19. Effective medical rehabilitation of SARS CoV-2 survivors is critical to recovery and optimization of emergency and specialty care outcomes. The new coronavirus infection and the severe pathology associated with it are more common in people of older age groups, burdened by many concomitant diseases, and occurs with damage to many organs and systems. The consequences of the disease pose the need for practical healthcare to carry out urgent and large-scale rehabilitation and preventive measures using for these purposes, in accordance with the requirements of the procedure for the rehabilitation of adults, approved by the Ministry of Health of the Russian Federation capabilities of specialized therapeutic hospitals. Underestimation of the capabilities of this approach leads to unjustifiably delayed use and, most importantly, loss of quality of rehabilitation treatment. The COVID-19 disease itself, damage to organs and systems, and the reaction of concomitant pathology with it have not yet been fully studied (G.E. Ivanova et al., 2020) and these patients often have to go through a broad search for optimal treatment and rehabilitation regimens. Material and methods:80 case histories of patients (57 women and 23 men) who had pneumonia associated with the new coronavirus infection COVID-19 were studied. The time from the onset of the disease was 2 months, the average age of patients was 55 years. The study included patients who had mild, moderate, and severe pneumonia and in 85% of cases had one or another concomitant pathology. Each patient was assigned an individual rehabilitation program, consisting of “respiratory block” procedures, including therapeutic exercises, hyperbaric oxygenation, laser therapy, magnetic therapy, manual massage, psychotherapy, dietary nutrition and physiotherapeutic procedures, also aimed at concomitant pathology. All patients received drug treatment. Restorative treatment of patients who had pneumonia associated with COVID-19 and had a concomitant disease was carried out with a rehabilitation routing scale value of 2-3 points. Conclusions: When developing individual medical rehabilitation programs for patients who have suffered COVID-19, procedures aimed at concomitant pathology should also be taken into account and highlighted. It is advisable to observe this group of patients in the somatic department of a multidisciplinary hospital. With this approach, clear positive dynamics were noted, both in the main and concomitant pathologies.

Developing a psychoeducational programme for family caregivers of people living with late stage dementia

AbstractBackgroundFamily caregivers often find it difficult to access information and support in the later stages of dementia. They may have difficulties attending in‐person support groups due to caring responsibilities. If caregivers are able to attend these groups, the information and support is often targeted towards the earlier stages of dementia.MethodAn eight session psychoeducational programme was developed in order to enable caregivers to access peer support and information from professionals with expertise relevant to the later stages of dementia. The programme sessions are held over Zoom and include the following topics: sensory stimulation, nutrition diet and swallowing, legal matters, care in the home and care homes, palliative care and pain management, funeral planning and brain donation. Sessions are co‐facilitated by health and social care professionals with relevant expertise, including a speech and language therapist, dietitian, solicitor and palliative care practitioner. Themes and session content have been co‐created through partnership working between facilitators and programme participants.ResultThe programme has been completed by four groups of caregivers (n = 26). All participants care for someone living with a rare or young onset form of dementia, and include those caring at home as well as caregivers of people living in a care or nursing home. Participants have reported a number of positive outcomes from attending the programme, with one participant stating: ‘Joining this late stage carers group – I was a bit worried about it… it’s absolutely one of the best things I could have done. In some respects, I wish I could have joined this earlier’. The programme is currently being evaluated using a time and cost survey to determine ongoing feasibility.ConclusionThere is a need for accurate and timely access to information and support for family caregivers of people living with dementia in the later stages. Online psychoeducational programmes provide the opportunity for caregivers to access both peer and professional support in their own homes. The development of this programme has benefited from ongoing and iterative input from both caregivers and professionals in the dementia support field.

Occupational and non-occupational risk factors correlating with the severity of clinical manifestations of carpal tunnel syndrome and related work disability among workers who work with a computer.

The contribution of certain occupational and personal factors to the development of carpal tunnel syndrome (CTS) is still uncertain. We investigated which specific occupational and non-occupational factors correlate with the level of clinical manifestations and work disability related to CTS. The study included 190 workers who work with a computer and have diagnosed CTS (100 men, 90 women, aged 20-65 years). Subjective experience of CTS-related impairments was assessed with the Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) of the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). The objective, neural impairments were tested with electrodiagnostics (EDX), whereas CTS-related work disability data were collected from medical records. We found a high inter-correlation between BCTQ, EDX, and work disability data. These also showed high correlations with certain occupational factors (duration of computer-working in months and hours spent daily in computer-working, certain ergonomic, microclimatic, and other occupational conditions) and non-occupational factors (demographic and lifestyle factors: nutritional status, diet, smoking, alcohol consumption, and physical activity). Despite its limitations, our study has identified occupational and non-occupational risk factors that can aggravate CTS and work disability, but which can also be improved with workplace and lifestyle preventive and corrective measures. More research is needed, though, to establish the possible causal relationships and the independent influence of each of those risk factors.

Nutritional therapy for inflammatory bowel disease

This article presents a synthesis of publications from the relevant scientific literature, addressed to the importance of nutritional treatment in patients with inflammatory bowel diseases (IBD). Various restrictive and elimination diets are critically reviewed from the perspective of evidence-based medicine, including: exclusive enteral nutrition, low-FODMAP, specific carbohydrate, paleolithic, anti-inflammatory, CD-TREAT, and other diets. Although there are countless books and websites on „medical nutrition” in IBD, there is no conclusive evidence to support restrictive diets in IBD patients. Thus, current recommendations for these patients should rather focus on a healthy and balanced diet, based on natural, unprocessed products, rather than limiting and/or adding certain dietary components. In addition, patients with IBD should be encouraged to practice appropriate physical activity, which during the remission period should not differ from that recommended for healthy people.

Effects of grape peel phenolics on lipid accumulation in sodium palmitate-treated HepG2 cells

Phenolics were extracted from grape peels, and the compounds of grape peel phenolics (GPP) were identified by LC-MS/MS. From a perspective of dietary nutrition, this study aimed to evaluate the effect of GPP on lipid accumulation in sodium palmitate (PA)-treated HepG2 cells, and further to explore its mechanisms. HepG2 cells were induced by 0.4 mmol/L PA as an in vitro model of lipid accumulation. The results showed that GPP could significantly reduce the TG level and ROS production in PA-treated HepG2 cells. RT-qPCR and Western blotting analysis indicated that GPP supplementation can downregulate the mRNA and protein expression of lipogenesis factors and upregulate the expression of lipolysis factors in PA-treated cells. GPP reduced lipid accumulation and oxidative stress by activating the AMPK/mTOR/AKT signaling pathways, and the most significant effect was detected at 250 μg/mL GPP. Thus, GPP as a dietary phenolic, have the function to regulate lipid metabolism.

Associations among the Duodenal Ecosystem, Gut Microbiota, and Nutrient Intake in Functional Dyspepsia.

: Functional dyspepsia (FD) has long been regarded as a syndrome because its pathophysiology is multifactorial. However, recent reports have provided evidence that changes in the duodenal ecosystem may be the key. This study aimed to identify several gastrointestinal factors and biomarkers associated with FD, specifically changes in the duodenal ecosystem that may be key to understanding its pathophysiology. : In this case-control study, 28 participants (12 with FD and 16 healthy control individuals) were assessed for dietary nutrients, gastrointestinal symptom severity, immunological status of the duodenal mucosa, and microbiome composition from oral, duodenal, and fecal samples. Integrated data were analyzed using immunohistochemistry, real-time polymerase chain reaction, 16S rRNA sequencing, and network analysis. : Duodenal mucosal inflammation and impaired expression of tight junction proteins were confirmed in patients with FD. The relative abundance of duodenal Streptococcus (p=0.014) and reductions in stool Butyricicoccus (p=0.047) were confirmed. These changes in the gut microbiota were both correlated with symptom severity. Changes in dietary micronutrients, such as higher intake of valine, were associated with improved intestinal barrier function and microbiota. : This study emphasizes the relationships among dietary nutrition, oral and gut microbiota, symptoms of FD, impaired function of the duodenal barrier, and inflammation. Assessing low-grade inflammation or increased permeability in the duodenal mucosa, along with changes in the abundance of stool Butyricicoccus, is anticipated to serve as effective biomarkers for enhancing the objectivity of FD diagnosis and monitoring.

Relationship between Nutritional Status, Diet, and Calorie Adequacy on Work Fatigue of Female Pottery Crafters in Karanganyar Village, Borobudur, Magelang

Background: Work Fatigue is a common condition often experienced by workers characterized by decreased work performance. Work fatigue can be caused by poor nutritional status, diet and calorie intake received by workers. Objectives: This study purpose is to analyze the relationship between nutritional status, diet, calorie intake and work fatigue experienced by female pottery craftsmen in Karanganya Village, Central Java. Methods: This research is a quantitative analytic research with cross-sectional study design. The study population was 70 female pottery artisans in Karanganyar Village, Borobudur District, Magelang Regency, Central Java. The number of samples taken was 43 people determined using simple random sampling. The variables studied were nutritional status, diet, calorie adequacy and physical labor fatigue. The instruments used were digital weight scales and staturemeter, Food Frequency Questionnaire, 24-hour food recall form and reaction timer. Data analysis techniques using SPSS with Chi-square test and logistic regression. Results: 48,84% of pottery crafters have abnormal nutritional. 65.12% of pottery crafters have a good diet although 69.77% of the calorie adequacy of pottery crafters is not met. 34.88% of pottery craftsmen experienced physical fatigue in the moderate category and 4.65% experienced physical fatigue in the severe category. Based on the results of bivariate analysis, there is a relationship between diet (p=0.010), calorie adequacy (p=0.044) with physical work fatigue. There is no relationship between nutritional status (p=0.098) with physical fatigue. Conclusions: Work fatigue experienced by female pottery crafters in Karanganyar Village is caused by diet and calorie adequacy deficits.

Pengetahuan Gizi dan Riwayat Pola Makan Ibu Hamil Berhubungan dengan Kejadian Stunting pada Balita

Stunting is a global problem including Indonesia and a threat to developing countries related to the impact of malnutrition, malnutrition and infection on children, so this problem is urgent to be addressed. This study aims to analyze the relationship between nutritional knowledge and dietary history of pregnant women with the incidence of Stunting cases. The cross-sectional correlation design study used the purposive sampling method for as many as 53 respondents, based on the guidance of the results of height measurements 6 months earlier in the MCH book and researchers measured height and weight together with nurses/midwives during Posyandu activities in the month of data collection. The research was conducted for 1 month in the working area of the Puskesmas Tanah Tinggi Kota Tangerang. Data were collected using maternal nutrition knowledge questionnaires and dietary history of pregnant women developed by researchers with reliability results of 0.935 and 0.912. The results of the chi-square statistical test, show that low nutritional knowledge in pregnant women can trigger six times the incidence of Stunting with p: 0.002 and poor diet of pregnant women contributes seven times the incidence of Stunting with p: 0.003. Stunting is triggered by low maternal knowledge about nutrition and poor diet during pregnancy. Providing education related to nutrition for pregnant women and diet is better given before pregnancy, especially for adolescent girls or couples before marriage by utilizing adolescent posyandu.

A cohort study of factors influencing the physical fitness of preschool children: a decision tree analysis.

Based on the decision tree model, to explore the key influencing factors of children's physical fitness, rank the key influencing factors, and explain the complex interaction between the influencing factors. A cohort study design was adopted. 1,276 children (ages 3-6) from 23 kindergartens in Nanchang, China, were chosen for the study to measure the children's physical fitness at baseline and a year later and to compare the physical fitness scores at the two stages. The study was conducted following the Chinese National Physical Fitness Testing Standard (Children Part); To identify the primary influencing factors of changes in physical fitness, a decision tree model was developed, and a questionnaire survey on birth information, feeding patterns, SB, PA, dietary nutrition, sleep, parental factors, and other relevant information was conducted. The levels of physical fitness indicators among preschool children showed a significant increase after 1 year. The accuracy of the CHAID model is 84.17%. It showed that 7 variables were strongly correlated with the physical changes of children's fitness, the order of importance of each variable was weekend PA, weekend MVPA, mother's BMI, mother's sports frequency, father's education, mother's education, and school day PA. Three factors are related to PA. Four factors are related to parental circumstances. In addition to the seven important variables mentioned, variables such as breakfast frequency on school day, puffed food, frequency of outing, school day MVPA, parental feeling of sports, father's occupation, and weekend breakfast frequency are all statistically significant leaf node variables. PA, especially weekend PA, is the most critical factor in children's physical fitness improvement and the weekend MVPA should be increased to more than 30 min/d based on the improvement of weekend PA. In addition, parental factors and school day PA are also important in making decisions about changes in fitness for children. The mother's efforts to maintain a healthy BMI and engage in regular physical activity are crucial for enhancing the physical fitness of children. Additionally, other parental factors, such as the parents' educational levels and the father's occupation, can indirectly impact the level of physical fitness in children.

Improving nutrition care and diet intake for hospitalised older people at risk of malnutrition through a nurse-driven mealtime assistance bundle.

Poor dietary intake is common in hospitalised older people. A targeted mealtime intervention is needed to improve nutrition care and dietary intake, especially for those at risk of malnutrition. This quality improvement project designed, implemented and evaluated a mealtime assistance bundle consisting of care measures driven by the hospital nursing team. The aims were to improve the mealtime care process to promote dietary intake of the hospitalised older people and to improve nursing staff's knowledge, attitude and practice in malnutrition. This project adopted a pre-post design, targeting older people aged 65 years and above, who were admitted to a general medical unit in a regional hospital in Singapore. A mealtime assistance bundle consisting of seven care measures, using the acronym CANFEED, was implemented for older adults at risk of malnutrition. Outcome measures on the amount of dietary intake during meals through chart reviews and surveys of nursing staff using Malnutrition Knowledge, Attitudes and perceived Practices (M-KAP) questionnaire were performed before and after implementation. There were fewer older adults with poor intake in the post-implementation group than the pre-implementation group. Among those at risk of malnutrition, older adults in the post-implementation group had higher average intake of all provided meals as well as the protein-dense main dish. Significant improvements were noted in the total scores rated by the nursing staff in both the Knowledge-Attitude subscale and Practice subscale of the M-KAP questionnaire. Integrating a nurse-driven mealtime assistance bundle into usual care may have positive outcomes on nutritional intake of hospitalised older people at risk of malnutrition, and on knowledge, attitude and practice of hospital nurses in nutrition care. Nurses play a critical role in nutrition care for hospitalised older people. Continuing efforts to improve nutritional intake of hospitalised older people should focus on staff education, building a multidisciplinary food-promoting culture and patient, family and community empowerment. More efficient clinical processes incorporating information technology with the EMR to support better nutrition care of the hospitalised older people are needed.

A Review of the Nutritional Approach and the Role of Dietary Components in Children with Autism Spectrum Disorders in Light of the Latest Scientific Research

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects several areas of mental development. The onset of ASD occurs in the first few years of life, usually before the age of 3 years. Proper nutrition is important to ensure that an individual’s nutrient and energy requirements are met, and it can also have a moderating effect on the progression of the disorder. A systematic database search was conducted as a narrative review to determine whether nutrition and specific diets can potentially alter gastrointestinal symptoms and neurobehavioral disorders. Databases such as Science Direct, PubMed, Scopus, Web of Science (WoS), and Google Scholar were searched to find studies published between 2000 and September 2023 on the relationship between ASD, dietary approaches, and the role of dietary components. The review may indicate that despite extensive research into dietary interventions, there is a general lack of conclusive scientific data about the effect of therapeutic diets on ASD; therefore, no definitive recommendation can be made for any specific nutritional therapy as a standard treatment for ASD. An individualized dietary approach and the dietician’s role in the therapeutic team are very important elements of every therapy. Parents and caregivers should work with nutrition specialists, such as registered dietitians or healthcare providers, to design meal plans for autistic individuals, especially those who would like to implement an elimination diet.