Healthy Diet Research Articles

Effect of plastic-free diet, education and Bisphenol A exposure feedback on urine BPA in adolescent

Abstract Background BPA is an endocrine disrupting chemical and is mostly taken orally. Adolescence is the critical sensitivity to these chemicals is maximum. This study was conducted to compare the effects of a plastic-free diet program, plastic-free diet education program and BPA exposure feedback on urine BPA levels in adolescents with high use of packaged products. Methods The first phase of the two-phase study is descriptive, the second phase is a single-centre, single-blind, three-arm non-randomized experimental design. The study was conducted at Antalya/Türkiye in the 2022-2023 academic year, and in the first stage, adolescents with high use of plastic packaged products and low attitudes towards healthy nutrition were identified. In the second stage, participants were assigned to the group-1 (n = 36), group-2 (n = 36) and group-3 (n = 36) by simple random sampling method. An eight-week plastic-free diet program was applied to the group 1, plastic-free diet education program and BPA exposure feedback was given to the group-2, and only BPA exposure feedback was given to the group-3. Plastic Packaged Product Usage Survey, Attitude Scale towards Healthy Nutrition, and spot urine samples were used to collect data. Results It was found that 2% of adolescents used low plastic packaging, 34% medium, 57% high, and 7% very high. Pre-posttest urine BPA levels ng/ml (µg/g creatinine) were 1.98 (2.54), 1.43 (1.51) in the intervention1 group, respectively; 1.91 (2.35), 1.43 (1.47) in the intervention2 group; It was found to be 1.97 (2.49) and 1.49 (1.66) in the intervention3 group. The effect sizes of pre-posttest BPA/creatinine values were calculated as 1.38, 1.13 and 1.09 in intervention1-2-3 groups, respectively. Conclusions All three interventions (plastic-free diet program, plastic-free diet education program and BPA exposure feedback) were effective in reducing urinary BPA levels, reducing plastic-packaged product use levels, and increasing attitudes towards healthy eating. Key messages • Since all three interventions are effective in reducing adolescents’ urinary BPA levels, it may be recommended to use the intervention appropriate to the field conditions. • In the post-tests, the use of plastic packaged products by adolescents in all three groups decreased and their attitudes towards healthy nutrition increased.

Stakeholders engagement model- Social Marketing strategies to improve students’ eating behaviour

Abstract Previous studies have adopted the social marketing framework to investigate change behaviours towards healthier eating habits. However, despite the unequivocal link between Mediterranean Diet and healthy eating, the adoption of social marketing strategies to foster the adherence to such food pattern, remains unexplored, particularly in the context of HEIs. One research goal was to develop a stakeholder engagement model, in order to better craft social marketing strategies aligned with stakeholders’ needs. Hence, as different stakeholders call for different engagement designs, we consider that crossing the Social Marketing Framework with the Stakeholder Engagement Model, provides a solid basis to understand how to engage key stakeholders in the implementation of a program aimed at changing and influencing healthier eating habits aligned with the Mediterranean Diet within public HEIs canteens. Behavioural change in such contexts, demands a systemic and holistic approach, able to engage a diverse range of stakeholders, beyond those whose behaviour is expected to change. Social Marketing provides a strategic framework to promote behavioural change towards collective welfare. In the specific context of public health interventions towards healthier eating habits, this framework has been particularly useful. Hence, in-depth understanding on which stakeholders need to be involved in the social marketing process and at what stages, may yield insights into why some interventions change behaviour and why others do not. Findings revealed that it is not enough to create a single stakeholder engagement model throughout the social marketing plan in a more global perspective, as if one solution fits all. This study highlights the importance of designing glocal social marketing strategies, embedding glocal models of stakeholder engagement: standardizing the tools and practices that are possible and adapting what is necessary so that it has success in different national realities

Social prescribers’ referral processes and decision-making about healthy eating and physical activity

Abstract Background Social Prescribing (SP) connects primary care patients with non-medical sources of support within the community. There are various SP models, with different referral routes. Many involve patients being referred to a link practitioner, who considers their needs and then “prescribes” or links them to appropriate local support services or resources, typically provided by the third sector. The present study aimed to explore the SP process and the decision-making of link practitioners, particularly around food and physical activity practices. Methods Sixteen semi-structured interviews were conducted with link practitioners working across Aberdeen City. A pragmatic Thematic Framework analysis was undertaken. Findings Participating link practitioners described their approach with clients as building rapport and trust while maintaining boundaries and managing expectations, and their community role as resource mapping and networking. Three broad categories of factors were considered during referral: 1) practicality (e.g., location, transport, cost, mobility, availability), 2) clients’ engagement (e.g., interest, motivation, readiness for change), and 3) link practitioners’ past experiences with services. Challenges identified included navigating waiting lists and service limitations, clients’ engagement and expectations, under-resourced services, navigating waiting lists with caseloads and the emotional burden of seeing people in very difficult situations. All link practitioners considered diet and exercise to fit within the remit of social prescribing but emphasised that clients should lead this discussion. Dietary support via social prescribing typically revolved around poverty rather than health. Discussion The study provides insight into the practical reality of making social prescribing decisions and has the potential to inform training and evaluation processes and support the development of health-focused social prescribing lifestyle interventions. Key messages • Social prescribing – a personalised approach, with clients supported to identify and achieve their health and wellbeing goals based on their strengths and resources available in the local community. • Social Prescribing - a promising platform for offering healthy eating interventions tailored to individual needs.

Quality of life and adherence to healthy lifestyle factors among breast cancer survivors in Cyprus

Abstract Breast cancer is a prevalent disease for women globally, with rising survival rates highlighting the need to address the breast cancer survivors’ (BCS) quality of Life (QoL). Furthermore, adherence to a healthy lifestyle is associated with decreased mortality in BCS. Mapping the Lifestyle Medicine pillars and the World Cancer Research Fund/American Institute for Cancer Research recommendations identifies 7 healthy lifestyle components: weight management, physical activity, healthy eating, restorative sleep, avoidance of risky substances, positive social connections and stress management. This study examines adherence to these healthy lifestyle components and QoL among BCS. A cross-sectional study conducted in 2022-23 recruited primary adult BCS from the Bank of Cyprus Oncology Centre. Participants completed a survey assessing self-reported QoL and adherence to the aforementioned 7 healthy lifestyle components, through validated questionnaires. Out of 349 BCS approached, 272 were included in the final analysis. Mean age and time since main treatment completion were 51 (SD: 7.4) and 3.6 (SD: 2.5) years respectively. Amongst study participants 58% were classified as bad sleepers, 53.3% were overweight or obese, 23% were stressed, 78% reported to have moderate/high physical activity, and 60% adhered to the Mediterranean diet. Regarding substance use, 16% were current smokers, and 18% were hazardous drinkers. Median score for social support was 75 (IQR: 53-97; max score=100) and for QoL was 67 (IQR: 50-97; max score:100). BCS in Cyprus generally exhibit moderate adherence to the Mediterranean diet, engage in fairly active lifestyles and enjoy high levels of social support and QoL. On the other hand, a substantial proportion smoke or drink, are overweight or obese, are stressed and have poor sleep quality. Targeted interventions to increase the adherence of breast cancer survivors to the 7 healthy lifestyle components are required. Key messages • Overall variability exists in the adherence to healthy lifestyle components among BCS in Cyprus. • This population can benefit from intervention targeting sleep, stress and weight management.

Correlates of using behavioural sciences to design health promotion interventions and programs

Abstract Background The World Health Organization highlighted the need to better integrate behavioural science in the field of public health. Based on the theoretical domains framework, this study examined correlates of public health practitioners’ use of behavioural science principles to plan public health actions aim at promoting physical activity and healthy eating. Methods This study adopted a cross-sectional design. A convenience sample of 160 public health practitioners were recruited from different public health agencies (non-profit organizations, governmental and para-governmental agencies). They were asked to complete a survey questionnaire online and self-reported their use of behavioural science to plan health promotion interventions. Regression analyses were conducted to examine correlates of behaviour and behavioural intentions. All analyses were controlled for sex, number of years of experience in public health and the type of organization they work for. Results Skills (OR = 4.1, 95%CI: 1.3, 13.5) and intentions/goals (OR = 9.2, 95%CI: 2.3, 36.1) were the two domains significantly associated with the use of behavioural science. Perceived capacity to overcome the fact that none of their colleagues rely on behavioural sciences in their organization (OR = 7.2, 95%CI: 1.7, 30.3) was also associated with behaviour. Knowledge (OR = 8.6, 95%CI: 1.9, 39.1) and beliefs about consequences (OR = 4.0, 95%CI: 1.1, 14.7) were in turn associated with intentions/goals. Conclusions This unique study provides important insights for the development of future knowledge transfer activities aim at supporting positive attitudes and motivations toward the use of behavioural science as well as developing competencies and a normative use of behavioural science. The development of a strong knowledge basis would also need to be a core component of trainings to support the integration of behavioural science in public health to design physical active lifestyles and healthy eating interventions. Key messages • Increasing knowledge and skills in behavioural sciences is a key for a better integration in public health practices. • Changes in norms and attitudes toward the use of behavioural sciences will also support a better uptake.

Characterising users of community-based interventions designed to improve the food practices

Abstract Promoting affordable ways to help low-income families improve dietary behaviours and achieve a healthy weight represents a priority for UK public health policy. For such interventions to be appropriately tailored and targeted, it is important to better understand the intended recipients. The present study aimed to assess the dietary practices and psychosocial characteristics of users of Aberdeen City community-based interventions (e.g., food banks, pantries, social cafés) designed to support low-income communities in accessing food and engaging in healthier food practices. From January to June 2023, a cross-sectional survey was conducted employing convenience sampling among users of community-based interventions (N = 105; 73 females). The questionnaire assessed diet quality (SFFQ), household food insecurity (HFIAS), mental health (PHQ-4), well-being (Cantril Ladder), intention and self-efficacy toward healthy eating, and sociodemographic variables. Data were analysed using descriptive statistics, group comparisons, correlations, and regression analyses. Results indicated that community-based food provision users are highly vulnerable to food insecurity. Among participants, 53.3% reported severe food insecurity, and 18.1% reported moderate levels. Service users’ diets were high in discretionary foods and drinks (26% consume daily >1 portion of fizzy juice, 18.2% sweets, 16.7% crisps vs. 11.5% fruits and 10.6% vegetables). The mean dietary quality score was 9.48 (SD = 1.90) from a possible 15. Higher food insecurity and lower diet quality were significantly associated with greater mental distress (r=.41, p<.001; r=-.287, p=.005;) and poorer well-being (r=-.460, p<.001; r=.19, p=.049;). This study is part of a larger project aiming to optimise community-based dietary interventions for low-income populations. The results provide a clearer picture of the intended beneficiaries of such interventions and highlight user needs that can be prioritised in optimisation efforts. Key messages • Community-based food provision users are highly vulnerable to food insecurity and related negative health experiences. • The burden of poor diet and its associated health consequences disproportionately affect those living in the most deprived communities.

INSATISFAÇÃO CORPORAL EM ADOLESCENTES E A RELAÇÃO COM AS MÍDIAS SOCIAIS DIGITAIS

Body dissatisfaction and the use of social networks are current phenomena that mark female adolescence and therefore require evaluation. Objective: to analyze the relationship between the use of social media and body dissatisfaction in female adolescents. Methodology: This is a literature review consisting of nine scientific articles found in the databases: SciElo and PubMed. Results and Discussion: The articles selected for this study, through the analysis of their elements, allowed the understanding that social networks exert a strong influence on the development of body dissatisfaction (BD) in adolescent girls, because these networks present information about the so-called ideal body, which is equally unattainable for most women. It was also identified that body dissatisfaction causes serious consequences to the psychological and physical health of adolescents, such as: problems with self-esteem, distorted selfperceptions, hatred of one’s own body, depression, insomnia, social isolation, alcohol use, restrictive diets, eating disorders, among other complications. Therefore, actions aimed at resolving and/or alleviating this scenario were demonstrated, such as interventions aimed at periodically withdrawing from social networks, healthy diets and self-acceptance. Final considerations: Although the social pressure on women’s bodies is an old phenomenon, it currently has strong allies in the media and social networks. Therefore, the relevance of the topic discussed in this article for science and society is considered and it is suggested that further studies be developed on this subject.

Evaluation of food pattern behaviours following nutritional education for health professionals

Abstract Background The “Work Programme - UN Decade of action on nutrition 2016-2025” highlights the importance of implementing Recommendation 19 of the Second International Conference on Nutrition of FAO and WHO related to nutrition education interventions (NEI) for health professionals (HP), in order to develop nutritional skills based on national dietary guidelines and coherent policies relating to food. The Local Health Agency integrated with Trieste University (ASUGI), since 2009, has performed 25 NEI with the formation of 910 HP. Post pandemic, the content of ASUGI’s last 5 NEI, programmed by the prevention plan of the Autonomous Region of Friuli Venezia Giulia, was aligned with the principles of the European Farm to Fork Strategy linked to Sustainable Healthy Diets (SHD). Objectives The objectives of the training programme (TP), approved for Continuing Medical Education, was to change and evaluate food pattern behaviour (FPB) of HP (n = 200) to adhere to the SHD. TP was characterized by a systemic view on complex interconnections between nutritional and sensorial food value, sustainability of food chain systems, evolution of urban food environments, as contexts into which SHD choices can be applied. The 2 days training, spread over 14 hours with 40 participants, concluded with interactive work and experiences to applied knowledge and beginning to make informed healthy dietary choices in practice. Results 6 months after the conclusion of TP it was reported that the percentage of HP who consumed the recommended portions of fruits and vegetables had increased from 62% to 70% and from 28% to 35% respectively, while those who consumed no cured meats, red meats or legumes, changed from 24% to 35%, from 19% to 25%, from 6% to 3% respectively. Conclusions The evaluation of the TP systemic structure has shown its effectiveness in improving some healthy FPB of HP and the importance of applying a continuous improvement process of the program to better adhere to the whole SHD. Key messages • The systemic and integrated structure of nutritional education intervention programs for health professionals contributes to improving their healthy food pattern behaviour. • The relationships between complex policies of food systems and the 17 SDGs included in the training programs on nutrition education are useful for promoting adherence to healthy and sustainable diets.

Development of rapid methods to monitor nutritional standards in sustainable healthy public catering

Abstract Background The WHO and FAO in the Second International Conference on Nutrition stress the role of nutrition standards for public facilities catering services (CS) and in the Sustainable Healthy Diet guiding principles (SHD) underline synergies among foods, nutrients present in dietary patterns and their bioavailability, degree of food processing, and subsequent health impact. In Italy almost one in 10 people eat a meal in CS every day. In accordance with SHD, the Italian Ministry of Health (MH) in the national guidelines for CS indicate activating procedures for the conservation of nutritional qualities (NQ) of micronutrients and bioactive substances. The central purchasing body of the Region of Friuli Venezia Giulia have applied these criteria, introducing the process of critical control points of nutrient analysis (NACCP) in the Public Procurement for the school catering of 69 municipalities and for all 18 regional hospital with more than 3 million meals per year served. The aim of the project was to develop rapid and cheap methods for monitoring the NQ of meals by applying the NACCP process. Methods 150 samples of pasta, milk and also vegetables, meat, fish with different degrees of processing, were taken from the CS and analysed both with chemical techniques and with optical rapid techniques (1300 analyses). Results The samples were subjected to conventional analyses to determine the oxidation state and the content of characterizing molecules such as polyphenols, histamine, and total compounds of Maillard. The same samples were then analyzed by color measurements. The results showed a good correlation between the two analytical systems, in particular the color measurements and the Maillard compounds and the color measurements and the oxidation state. Conclusions Project findings can be applied in the NACCP process to rapidly cost-effectively monitor the nutritional quality of CS meals, and adhere to WHO and FAO the SHD guiding principles and MH guidelines for CS. Key messages • The development of rapid methods of monitoring the nutritional standards of public catering can implement sustainable food systems thereby promoting the healthy diets recommended by the FAO and WHO. • Rapid methods of monitoring nutritional standards represent an innovative component in improving the culture of food and nutritional security in public catering.

Exploring the Vital Role of Vitamins in Disease Prevention and Health Maintenance

The human body relies on vitamins to carry out fundamental functions, yet it is unable to produce them on its own. Certain nutrients, like phytochemicals, are considered essential as the body cannot produce them in sufficient quantities. While ideally vitamins are obtained through a healthy diet, supplements are often necessary. Vitamins are crucial for growth, metabolism, and overall health, with vitamin D being the only one the body can produce. Vitamers, related molecules with similar vitamin activity, make up the bulk of vitamins. Vitamin C is a potent antioxidant drug used in dermatology to treat photoageing and hyperpigmentation. L-ascorbic acid is the active form, with limited oral absorption, making topical application more effective. Its electron-donating ability is crucial for various physiological processes, and its deficiency can lead to scurvy. Vitamin E (tocopherols and tocotrienols) has demonstrated significant biological effects on enhancing human health and play a promising role in food systems Supplementation of α-tocopherol up to 0.2% in oils provides higher oxidative stability, making vitamin E a valuable functional ingredient for food preservation and nutritional quality enhancement.This study investigates the roles of vitamins C and E in disease prevention and management, highlighting their antioxidant properties and physiological functions. Both vitamins are crucial for neutralizing free radicals, thereby reducing oxidative stress linked to various diseases, including cardiovascular conditions, cancer, and neurodegenerative disorders. Vitamin C supports immune function and collagen synthesis, while Vitamin E contributes to cellular integrity and skin health. The research underscores the synergistic effects of these vitamins, which enhance each other's antioxidant capabilities and may improve overall health outcomes. By addressing their roles in disease processes, the study emphasizes the importance of adequate vitamin intake for promoting health and preventing illness

Valencia and the Right to Energy approach

Abstract Background Valencian (Spain) vulnerable households are suffering both winter and summer energy poverty. An increasing number of families have difficulties paying energy bills and are being forced to cut consumption, consequently reducing their well-being and quality of life. This study presents the development and implementation of the Right to Energy urban program in the Valencia pilot city, as part of the larger European WELLBASED project. Methods The interventions were designed based on the social ecological model, aiming at impacting the different layers influencing individuals’ health, following co-creation sessions with 6-9 stakeholders from policy, citizens and practice. Implementation efforts were monitored using administration of participation. The experience of the Energy Office was also valuable for the design and implementation phase. Results The program consisted of bill optimization and advice, socio-energetic audit at home and the installation of an efficiency kit. On top of that, the Valencia pilot has created the Citizen School for the Right to Energy [CSRE] to empower households and improve their health through education activities. In total, 130 vulnerable households with different profiles were supported. The CSRE has carried out 28 workshops to train people in energy and health topics: energy rights, healthy diet, mental health, sleep quality or preparation for heat waves. These were an opportunity to share experiences among participants, fighting stigmatization and isolation by creating a community. The CSRE has also organized capacity-building sessions for professionals who can identify energy poverty such as healthcare and social workers, teachers or NGO’s. Conclusions Energy poverty, both winter and summer, is a major public health issue that impacts people’s health. The CSRE is an innovative way to tackle it and promote the Right to Energy across society by supporting and training people to improve their wellbeing.

Effectiveness of Internet + E-Coach chronic disease management on blood glucose, lipid levels, liver function, and quality of life in patients with chronic diabetic retinopathy: a comparative study

ObjectiveThis study aims to explore the effect of Internet + E-Coach chronic disease system intervention on fasting blood glucose (FPG), 2-hour postprandial blood glucose(2hPG), fasting serum insulin (FINS), triglyceride (TG), alanine transaminase (ALT) and quality of life in patients with chronic diabetic retinopathy.Methods208 patients with chronic diabetic retinopathy who were treated in the hospital from March 2021 to March 2023 are chosen and separated into two groups by random number Table 104 patients in the control group received routine continuous intervention, and the research group received Internet + E-Coach chronic disease system intervention. The cognition of disease related knowledge, blood related indicators inflammatory factor levels and improvement of life quality between the two groups before intervention, 6 and 12 months after intervention were compared.ResultsBefore the intervention, the comparison between the two groups in disease related knowledge scores, blood glucose, blood lipid, liver function indicators, inflammatory factor, and low vision quality of life scale (CLVQOL) scores was with P > 0.05. After 6 and 12 months of intervention, the research group had significantly higher scores for basic blood glucose intervention, healthy diet, reasonable exercise, and correct medication use compared to the control group (P < 0.05). FPG, 2hPG, TG and ALT in the research group were lower than those in the control group. FINS were higher in the control group, with P < 0.05. Interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and hypersensitive C-reactive protein (Hs-CRP) in the research group were obviously lower than those in the control group (P < 0.05). The scores of far vision, movement and light perception, adjustment ability, reading and fine work, and daily living ability in the research group were higher than those in the control group, with P < 0.05.ConclusionThe intervention of Internet + E-Coach chronic disease system can improve the knowledge of chronic diabetic retinopathy patients about their own condition, stabilize the levels of blood sugar, blood lipid and liver function indicators, reduce the inflammatory reaction of the body, and improve the quality of life.

A Multi-Modal Approach for A Healthier Weight and More Active Lifestyle

Abstract Background Obesity and overweight has been increasing globally and in the UK over the last few years, bringing along a wide array of challenges in health and wellbeing. Not only do they take a heavy toll on those affected, but obesity and overweight-related ill-health is costing the UK National Health Service £6.1 with projected costs to run up to £9.7 billion in 2050. This project aimed to apply artificial intelligence to identify the predictive indicators for obesity and co-create an intervention with public health practitioners and stakeholders. Methods Using health and wellbeing public health population data from the 2015, 2018 and 2022 from a city in the East Midlands, we applied artificial intelligence that uses machine learning techniques to discover insights, find hidden patterns and discover relationships in the data about engaging in physical activity and a healthy diet. The data on dietary choices and physical activity preferences were further analysed using advanced machine learning techniques. Results The outcomes from our machine learning process revealed patterns of physical activity engagement and diet from specific locations, along with a range of demographic variables that influence individuals’ patterns of physical ability and dietary practices. These findings, which will be presented in detail, have been integrated into a comprehensive city map. This map not only showcases opportunities for engaging in a healthy lifestyle but also aids in prioritising interventions in areas of greatest need. Conclusions The AI technology we employed allowed us to parameterise and generalise our findings with the possibility of scaling up the machine learning approach to other similar datasets. The findings facilitated the development of bespoke training for public health officers working with underserved communities, further demonstrating the impact of applying AI to inform the design of public health interventions. Key messages • Applying Artificial Intelligence to public health data has the potential to inform the development of effective interventions and increase precision. • Using AI in public health data can generate new insights into population health and well-being and inform public health policy.

Practicing what you preach. Do cardiology trainees in the United Kingdom follow the lifestyle advice that they would give to patients?

Abstract Background The role of lifestyle factors in determining the risk of cardiovascular disease is well established. As a result, lifestyle modification is recommended as part of numerous European Society of Cardiology guidelines. However, it remains uncertain how closely cardiologists adhere to guidelines in their personal life. Poor lifestyle among clinicians can contribute to poor health and may increase absenteeism and potentially reduce the quality of patient care. Purpose To establish whether cardiology trainees in the UK follow appropriate guideline-directed lifestyle advice in their personal life. Methods All cardiology trainees within the UK were eligible to participate in the 2023 British Junior Cardiologists' Association (BJCA) training survey and the survey was advertised through national and local campaigns. The survey contained questions on smoking status, alcohol intake, healthy diet, partaking in regular exercise, frequency of adequate quality of sleep, and demographic questions. Responders were eligible for inclusion if they consented to participate in health and wellbeing survey questions, and if they had completed four demographic questions. Results Of the 398 responders to the 2023 BJCA survey, 212 consented to answer health and wellbeing questions (66% male, age 34±4 years, 42% had dependents) and were included. Responders included trainees representing all four UK nations. Very few cardiology trainees were current smokers either of cigarettes/cigars (n=2, 1%), or e-cigarettes (n=2, 1%), with 12 (6%) being ex-smokers. Few trainees (n=13, 6%) consumed alcohol above the UK recommended maximum of 14 units per week (Fig 1A). However, only 14% (n=29) regularly achieved 30 minutes of moderate or 15 minutes of intense exercise on at least 5 days each week (Fig 1B). Most trainees (n=167, 80%) only obtained adequate sleep on four or fewer nights each week (Fig 1C). Only 37% (n=78) of trainees agreed or strongly agreed that they were able to maintain a healthy diet most days (Fig 1D). Conclusions Most UK cardiology trainees followed guidance related to smoking and alcohol intake. However, far fewer trainees followed healthy lifestyle guidance relating to exercise, sleep, and diet. Whether these findings are similar across other ESC nations should be investigated. Further work is required to establish the impact of healthy living on clinician working activity and subsequent quality of patient care. Training bodies should consider how occupational factors may contribute to a trainee’s adverse healthy living.

Impact of MaNu dietary counselling on Oxidative Stress and Gestational Weight Gain during pregnancy

Abstract According to the WHO guidelines, to counteract the excessive weight gain during pregnancy and to mitigate the increase in oxidative stress (OS) which naturally increases during pregnancy, a healthy lifestyle and a correct diet are crucial as preventive measures to promote health. The MaNu project was conceived precisely to control these factors through dietary counselling. We expect that pregnant women who voluntarily undergo an educational program consisting of specific and accurate dietary advice will be able to emphasize weight control and contain the increase in OS. Our randomized controlled trial (RCT) has a parallel group design and takes place in the Obstetrics and Clinical Nutrition Departments of Michele and Pietro Ferrero Hospital (Verduno, north-western Italy), where physiological pregnant women are enrolled between 12-17 gestational weeks (GWs). The educational intervention takes place between 12-24 GWs. Dietary habits were collected with a questionnaire and urine samples were analysed to quantify the OS using 15-F2t-isoprostane, malondialdehyde and total antioxidant power. The descriptive analyses are based on paired t-tests. Preliminary analyses on 76 women who completed two out of three time points (T0 and T1) indicate that, of women who received the intervention, 35% experienced excessive weight gain (based on guidelines), compared to 39% shown by controls. Following the counselling, the 15-F2t-isoprostane decreased significantly (mean T0=5.1 ng/ml vs. mean T1=3.5 ng/ml, p = 0.02). Concerning nutrient intake, a statistically significant reduction in sugar consumption has been found in the intervention group (mean T0=92.2 g vs. mean T1=83.3 g, p = 0.03). Conversely, no correlations have been detected between OS and the main pro and anti-oxidant macronutrients. Although promising, our findings need further verification since the RCT is still ongoing, and it is imperative to attain the anticipated sample size before drawing any definitive conclusions. Key messages • Dietary counselling during pregnancy should be implemented as a preventive strategy used to counteract potential pregnancy complications and ensure the well-being of both the mother and the baby. • Healthy diet is essential to control the increase in oxidative stress levels during pregnancy and to prevent excessive weight gain, factors that can lead to the onset of pregnancy complications.

Circulating ketone bodies, genetic predisposition, and incident atrial fibrillation

Abstract Background Ketone bodies (KB) are essential alternative fuel sources for the myocardium. However, the evidence on the level of circulating KB and heart disorders is inconsistent. Whether the total and individual KB are associated with risk of onset atrial fibrillation (AF) in the general population and in individuals with different genetic susceptibilities to AF are still unclear. Purpose To examine the association between circulating KB and AF risk and to further test whether genetic risk could modify the above association. Methods In the UK Biobank, 247,304 participants (mean age 56.5, 45.3% men) with available data on KB and without baseline AF were included. The concentrations of KB, including β-hydroxybutyrate (β-OHB), acetoacetate, and acetone, were measured using nuclear magnetic resonance, and the values of KB were increased by one and then log10-transformed for analyses. The genetic risk of AF was based on the standard polygenic risk score. The definitions of AF were based on the ICD-10 code I48, which was linked to primary care, hospital admission electronic health records and death records. Cox proportional hazard model was used to estimate the hazard ratio (HR) with 95% confidence interval (CI). Results During a median follow-up of 13.8 years, 16,936 cases of onset of AF were recorded. After adjusting for age, sex, race, Townsend index, education, alcohol intake frequency, smoking status, healthy diet, metabolic equivalent, body mass index, systolic blood pressure (SBP), total cholesterol, estimated glomerular filtration rate, cardiovascular diseases, and diabetes, elevated total KB, β-OHB, acetoacetate, and acetone were all with the risk of AF (HR, 95% CI per 10-fold increase: 1.20, 1.13-1.28; 1.13, 1.07-1.19; 1.12, 1.06-1.18; and 1.78, 1.57-2.01, respectively). The highest risk of AF was observed among individuals at high genetic risk to AF and had the highest quartile of total KB (HR 2.91, 95% CI 2.66-3.19). Participants who had low genetic risk were more susceptible to high total KB for incident AF (p for interaction = 0.036). The associations of total KB, β-OHB, and acetone with AF risk were more prominent for men (HR, 95% CI per 10-fold increase: 1.32, 1.22-1.44; 1.22, 1.14-1.31; 2.01, 1.72-2.36) than for women (p for interaction &amp;lt;0.05). The association between total KB and AF risk was strengthened in individuals &amp;lt;60 years, current smokers, and those with SBP&amp;lt;130 mmHg (p for interaction = 0.033, 0.021, and 0.017, respectively). Conclusions Circulating KB concentrations were associated with AF risk, with acetone showing the strongest relationship with AF. Individuals at low genetic risk were more susceptible to the level of total KB for incident AF. Our findings suggest that KB may be a biomarker, particularly for identifying individuals without AF at baseline who are at low genetic risk. The additive value of plasma KB to a risk prediction score warrants further investigation.

Food and nutrition literacy in Austria - results of a representative study

Abstract Background A healthy diet is a key factor in people’s long-term health. The nutritional health literacy and food literacy of the population play a crucial role in this. In 2021, comprehensive data on these competences were collected for the first time in Austria. Methods Almost 3,000 people were surveyed online. Nutrition health literacy was assessed with the newly developed Nutrition Health Literacy Scale (NHLS) and food literacy with the Self-Perceived Food Literacy Scale Short-Form (SPFL-SF). Scores and subscores were calculated. Associations between socio-demographic and socio-economic factors and the competences surveyed were assessed using t-tests, variance analysis, correlations, and multivariate regression models. Results In terms of nutritional health literacy, respondents score an average of 60 out of 100 points, with judging (51 points) and applying (60 points) nutritional information being the most difficult. In the area of food literacy, respondents score an average of 62 out of 100 points. The most challenging areas are ‘healthier choices’ (44 points), ‘healthy snacking’ (52 points) and ‘healthy eating in exceptional circumstances’ (54 points). In both areas, men and people with less formal education score lower. In the case of nutritional health literacy, people aged 65 and over have greater difficulties. Conversely, this group performs better in the area of food literacy. Differences by income can only be seen for nutritional health literacy, to the detriment of low-income groups. Conclusions Possible options for action include the provision of quality-assured and target-group-specific information, the implementation of appropriate tools to facilitate the assessment of foods, and measures to strengthen assessment skills, digital health literacy, food and nutrition skills. Key messages • The survey showed that there is potential for improvement in both nutritional health literacy and food literacy. • The biggest challenge is to evaluate and use nutritional information and to stick to a healthy diet without making exceptions.

UnDErstanding consumer food choices &amp; promotion of healthy and sustainable Mediterranean diet and LIfestyle in Children and adolescents through behavIOUral change actionS: the DELICIOUS project

Abstract Over the last decades, the abandonment of traditional dietary patterns and engagement in unhealthy lifestyles (including poor physical activity, prolonged screen time, poor sleep behaviours) in children and adolescents has been considered an important threat for the future health of the younger generations living in the Mediterranean area and the safeguard of the environment. The DELICIOUS project aims to promote healthy lifestyles among children and adolescents by implementing activities and tools to increase the adherence to the Mediterranean diet with an attention to the environmental impacts of dietary habits. The DELICIOUS project as a single-arm, uncontrolled behavioral intervention program providing formal and non-formal education activities, development of new snacks and recipe reformulation, web/mobile app development, and physical activities to school children and adolescents in five European countries. Over 2000 families joined a preliminary survey to investigate potential determinants of adherence to a healthy diet. Children and adolescents recruited from schools in the parterns’ countries are now currently being recruited to participate to the intervention activities. A web application for school canteen and a mobile application for parents have been developed to help both schools and families to track and provide healthy and sustainable meals. The project aims to increase awareness of the nutritional benefits and the sustainability aspects of the Mediterranean Diet and to promote consumers’ empowerment through an online platform for sustainable and healthy meal planning in the school canteen.

Association of healthy lifestyle on overweight and obesity among adolescents in Luxembourg

Abstract Background Adolescent overweight and obesity are significant public health challenges. Understanding the impact of healthy lifestyle behaviours is crucial for effective intervention strategies. The aim of this study is to analyse the association between healthy lifestyle behaviours with overweight and obesity among adolescents in Luxembourg. Methods The study was based on the HBSC Luxembourg 2022 survey and includes 8415 adolescents aged 11 to 18 years. Adolescents self-reported the frequency of fruit and vegetable consumption, physical activity, height, and body mass. Eating and physical activity behaviours were categorized based on WHO recommendations. Body Mass Index categorization followed International Obesity Task Force criteria. Binomial logistic regression of obesity and overweight with the interaction between healthy diet and physical activity was performed, controlling for age, gender, family affluence, migration background, and family structure. Results The results indicated a significant protective effect of healthy lifestyle behaviours against overweight and obesity. For overweight, adolescents engaging in either fruit and vegetable consumption (OR = 0.829, 95% CI [0.697-0.986]) or physical activity (OR = 0.719, 95% CI [0.566-0.913]) showed reduced odds compared to those with unhealthy behaviours. For obesity, similar associations were observed. Adolescents engaging in physical activity (OR = 0.407, 95% CI [0.235-0.705]) showed reduced odds compared to those with unhealthy behaviours. Combining both behaviours resulted in the lowest risk of obesity (OR = 0.366, 95% CI [0.177-0.760]) and overweight (OR = 0.473, 95% CI [0.340-0.658]). Conclusions Promoting health eating and physical activity behaviours are important strategies for preventing overweight and obesity in youth in Luxembourg. Implementing targeted interventions aimed to promote these behaviours could mitigate the burden of overweight and obesity in this population. Key messages • Healthy lifestyle matters: Fruit and vegetables consumption or regular physical activity significantly reduce the risk of overweight and obesity among adolescents. • Combining behaviours counts: Concurrent engagement in both fruit and vegetables consumption and physical activity offers the greatest protection against overweight and obesity.

Effect of green coffee on miR-133a, miR-155 and inflammatory biomarkers in obese individuals

ObjectivesMetabolic syndrome is a cluster of conditions that increases the risk of atherosclerotic cardiovascular diseases. The current study was a randomized, double blind, placebo-controlled study that aimed to determine the impact of green coffee (GC) in obese patients with metabolic syndrome through analysis of miRNA-155, miRNA-133a and the inflammatory biomarkers such as resistin, TNF-α, total sialic acid, homocysteine, high sensitivity C-reactive protein (hs-CRP), and the anti-inflammatory cytokine, adiponectin.MethodsOne hundred-sixty obese patients were randomly supplemented either with GC capsules (800 mg) or placebo daily for six months. Both groups were advised to take a balanced diet. Blood samples were collected at baseline and after six months of supplementation.ResultsGC supplementation for 6 months reduced BMI (p = 0.002), waist circumference (p = 0.038), blood glucose (p = 0.002), HbA1c% (p = 0.000), Insulin (p = 0.000), systolic blood pressure (p = 0.005), diastolic BP (p = 0.001) compared with placebo. GC significantly decreased total cholesterol (TC, p = 0.000), LDL-C (p = 0.001), triglycerides (TG, p = 0.002) and increased HDL-C (p = 0.008) compared with placebo group. In addition, GC significantly (p ≤ 0.005) reduced total sialic acid, homocysteine, resistin, TNF-α, hs-CRP and the oxidative stress marker malondialdehyde (MDA), but increased serum adiponectin (p = 0.000) compared to placebo group. There was a significant reduction in the gene expression of miR-133a (p = 0.000) in GC group as compared with baseline levels and with the control placebo group (p = 0.001) after 6 months.ConclusionGC administration modulated metabolic syndrome by decreasing BMI, high BP, blood glucose, dyslipidemia, miRNA-133a and inflammatory biomarkers that constitute risk factors for cardiovascular diseases.ClinicalTrials.gov registration No. is NCT05688917.Graphical